Quintessence International, 02/1997

The employment of adhesively bonded porcelain or resin composite inlays is considered problematic in Class II cavities extending into the dentin and cannot be recommended as a routine procedure for current clinical practice. A two-part restoration in the form of a double inlay provides an alternative to the clinically established gold inlay restoration. The double inlay is composed of a conventionally cemented metal base an an adhesively bonded porcelain inlay. After the metal substructure is coated with silica or a microretentive opaque glaze is fired, the porcelain inlay can be luted to the metallic base with a bonding resin composite. This procedure incorporates the advantages of cast restorations at the critical cervicoproximal cavity margin and the esthetic and stabilizing properties of the adhesively bonded restoration technqiue in visible areas.

The clinical condition of a ptient with chronic adult-type periodontal disease, as well as gingival recession reaching the tooth apex on a mandibular lateral incisor, is discussed. Because the use of conventional techniques would have resulted in tooth loss, the guided tissue regeneration procedure was applied, with successful results.

The scanning electron microscope was used to evaluate the effects of ultrasonic irrigation before and after root conditioning. Six groups of five specimens each received saline irrigation; ultrasonic irrigation; saline irrigation followed by root conditioning with either citric acid or tetracycline hydrochloride; or ultrasonic irrigation followed by root conditioning with either citric acid or tetracycline hydrochloride. After immersion in citric acid or tetracycline hydrochloride solutions, root dentin was rinsed again with saline or irrigated ultrasonically. Control specimens exhibited an amorphous, irregular surface smear layer. Ultrasonic irrigation, citric acid, and tetracycline hydrochloride were effective in removing the smear layer. use of ultrasonic irrigation before and after acid application improved the exposure of dentinal fibrils.

A study of 15 extracted teeth with carious lesions and artificially prepared defects adjacent to restorations compared the macroscopic morphology of the lesions and the extent of teh defects with their appearance on conventional and computerized tomosynthetic radiography. Tuned Aperture Computerized Tomography offers advantages for the diagnosis of the extent of carious lesions and of defective restorations. The display of computer sections through teeth (slice images) allows a three-dimensional view to permit an assessment of the extent of carious lesions, restorations, and defects often masked in conventional radiography.

Air-abrasive technology offers several advantages over conventional handpieces. Although modern high-speed evauation systems result in limited powder accumulation, the microabrasive debris continues to be a major concern. This article highlights the need for rubber dam isolation and introduces a makeshift evacuation device fabricated from a plastic soft drink container.

The use of a barrier membrane, with or without osseous allograft, has been shown to establish regeneration of osseous tissue around dental implants. Following three episodes of persistent symptomatic failed apicoectomy and subsequent tooth extraction, an osseointegrated implant was placed in a wide fenestrated defect. Demineralized freeze-dried bone allograft was covered by an occlusive expanded polytetrafluorethylene membrane. The reentry procedure revealed complete bone fill that followed the texture of the augmentation material beyond the previous buccal bony envelope.

The posterior design of the implant superstructure (the ceramometal crown) was classified into four categories: a cera mometal crown with an access hole on top; a cemented ceramometal crown; a ceramometal crown retained with a lingual screw; and a telescopic ceramometal crown. Cemented ceramometal crowns and telescopic ceramometal crowns are considered simpler, more esthetic, and more resistant to fracture among the four models.

This article describes a practical and expeditious method of converting an existing fixed partial denture into an interim complete-denture prosthesis with minimal inconvenience to the patient. The esthetic, phonetic, and functional demands are maintained during the fabrication of the prosthesis.

A practical and economical system of casting testers, formed by simple constituents that can be found anywhere, has been developed. Pattern formation is a quick procedure, and because the testers are small and imitate forms familiar to dental technicians, they can incorporate them easily into their daily work routine. Results can be interpreted without the use of any apparatus, because they are based on the principle of all or nothing. The proposed sytem was field tested in 13 commerical dental laboratories, and the percentage of successes obtained affirmed that the goals of the procedure are attainable and valid.

Twenty recently extracted human molars had standardized Class II slot cavities prepared on the mesial and distal surfaces with the gingival floor located on dentin. The teeth were embeeded in a stone template, warmed to 37 degrees C, and restored immediately using one of two incremental placement techniques with visible light-cured composite (VLC), or one of two directed shrinkage placement techniques using an autocrure/VLC composite combination. Teeth were stored at 37 degrees C for 2 weeks, thermocycled, stained, sectioned in the middle of the preparation, and evaluated for dye penetration. Reevaluation of the microleakage following removal of the resin composite from the preparation revealed greater microleakage at the gingival margin than did the initial sectioning technique. There were no differences among any of the groups. Enamel margins exhibited minimal leakage and no differences among the groups.