Quintessence International, 01/1998

Objective: This clinical trial aimed at studying the long-term performance in routine clinical practice of saucer-shaped Class II resin composite restorations. Method and materials: Fifty-one preparations were completed and filled with either of two light-cured posterior composites by seven dentists of the Public Dental Service. The restorations were evaluated annually, using the US Public Health Service criteria, bitewing radiographs, and dies based on replica impressions. At the final evaluation, the recall rate ws 100%. Results: After a meanof 7.2 ± 1.3 years of service (censored maximum of 9.6 years), 70% of the restorations were acceptable for continued use. Caries and technical deficiencies were the main causes of failure. Conclusion: The saucer configuration, by respecting and utilizing inherent properties of the resin composites, spares sound dentin and is preferable to the box preparation

Elongated and spaced incisors are common in patients suffering from severe periodontal disease. Intrusion and uprighting of incisors might be the logical solution for this problem. This article describes a team appraoch to treatment planning for adult patients with severe localized periodontitis accompained by marginal bone loss and spacing and elongation of incisors. The treatment involves the combination of peridontal treatment, orthodontic intrusion, and prosthetic therapy. Controlled intrusion in two patients led to a decrease in the clinical crown length, better access for oral hygiene procedures, better gingival form, and a more suitable distribution of occlusal forces.

Objective: This study investigated the effect of differing bonding and luting system combinations on the fracture resistance of teeth restored with dentin-bonded all-ceramic crowns. Method and materials: Standardized preparations were carried out on five groups, each of 10 sound, unrestored, maxillary premolar teeth. Ceramic crowns were constructed, their internal surfaces were etched with hydrofluoric acid, and the crowns were placed with the following dentin bonding and resin-based luting system combinations: group A, Mirage ABC and Mirage FLC, group B, Metabond luting material; group C, All-Bond 2 and Duo-link; group D, Scotchbond MP Plus and 3M Indirect Porcelain Bonding Kit; and group E, All-Bond 2 and 3M Indirect Porcelain Bonding Kit. The restored teeth were loaded in compression at 1.0 mm/min. Results: Mean fracture loads of 0.77 kN, 0.81 kN, 0.71 kN, 1.24 kN, and 1.03 kN were recorded for groups A, B, C, D, and E, respectively. Statistical analysis indicated that the mean fracture resistance of the restored teeth of groups D and E was significantly greater (P .05) than that of the other three groups. Conclusion: The fracture resistance of dentin-bonded crowns used in this laboratory study was dependent on the bonding and luting systems used.

Objective: This study developed a computer image analysis technique as a quantitative means to measure changes in dental stain after brushing with various dentifrices. Method and materials: Enamel specimens with naturally occurring mature stain were cut from bovine incisors. The specimens were subjected to in vitro toothbrushing with one of the four tested groups, consisting of two dentifrices that make claims of stain removal (Aquafresh Whitening and Rembrandt Sensitive), a regular dentifrice, (Aquafresh Triple Protection), and water. Digital images of stain specimens were recorded uner standardized lighting conditions and analyzed with an image analysis software. The area-intensity stain determinant, which accounted for the reflected intensity and the corresponding areas of stain, was computed. Stain removal efficacy was calculated based on the difference in area-intensity stain determinant before and after brushing. Results: Brushing with any of the tested dentifrices removed more stain than did brushing with water along. The fining that brushing with a regular dentifrice resulted in higher stain removal efficacy than brushing with water seems to indicate a role for abrasivity. Aquafresh Whitening had a higher stain removal efficacy than did Rembrandt for the removal of mature calcified stain used in this study. However, there were certain stains that none of the dentifrices removed. Conclusion: Computer image analysis provides an objective and quantitative measurement to distinguish in vitro stain rem oval efficacy of dentifrices.

A patient had a serious esthetic problem: One maxillary central incisor was discolored and the other was malpositioned and fractured. The fabrication of two all-ceramic crowns fulfilled both functional and esthetic objectives.

Objective: Control of subgingival plaque is of paramount importance in the treatment of periodontal diseases. The role of subgingival sustained-release antibiotic therapy needs elucidation. A single-blind clinical trial was carried out in 13 patients with adult periodontitis to compare the effects of subgingival application of metronidazole dental gel with those of subgingival scaling. Method and materials: A split-mouth design was used so that each patient received all treatments simultaneously. Randomly selected quadrants were treated with application of 25% metronidazole gel, subgingival scaling, or a combination of scaling and gel application. The remaining quadrant in each patient was left untrated as a control. Results: All three treatments were effective in significantly reducing Plaque Index, Gingival Index, and bleeding on probing over the 14-week observation period. No statistically significant differences were found between scaling alone and bomined treatment. Scaling and combined treatment were better than metronidazole. Metronidaz ole produced transient effects, best noted during the first 4 weeks after treatment. No additive effect o f metronidazole was noted in the combined treatment. At week 14, only combined treatment sites and scaled sites showed statistically greater probing depth reduction than control sites. Conclusion: For the treatment of mild-to-moderate adult periodontitis, subgingival scaling alone is as effective as the combination of scaling and antibiotic therapy.

Supernumerary teeth are common and can occur throughout the oral cavity. Molariform supernumerary teeth in the maxillary central incisor area have rarely been reported. This article reports the presence of mesiodentes in two siblings, one of whom exhibited an unusual molariform mesiodens. The clinical and radiographic appearance of the anomalies and treatment modalities are discussed.

Single-tooth implants were used to replace congenitally absent maxillary lateral incisors in a 17-year-old patient. The inclination of the alveolar process caused a severe discrepancy betwen the axes of the planned implant and the crown. To avoid the need for a labial screw opening in the crown or labial overcontouring, a CeraOne abutment of the Branemark system was modified by selective grinding in the dental laboratory. Individual all-ceramic crowns were fabricated with the Celay In-Ceram system.