International Journal of Periodontics & Restorative Dentistry, 01/2005

The purpose of this study was to retrospectively evaluate the clinical performance of laminate veneers placed in the anterior segments of the dental arches over a 12-year period at two different private dental practices. Forty-six patients were restored with 182 porcelain laminate veneers. The veneers were studied for a mean observation time of 5.69 years. Color match, porcelain surface, marginal discoloration, and marginal integrity were clinically examined following modified CDA/Ryge criteria. On the basis of the criteria used, most of the veneers rated A. Risk of fracture was determined with a Kaplan-Meier survival analysis. Probability of survival of the 182 veneers was 94.4% at 12 years, with a low clinical failure rate (approximately 5.6%). Porcelain veneers must be bonded with a correct adhesive technique to reach this successful survival rate.

Bone grafting may be required prior to implant placement, at the time of implant placement, or subsequent to it. The aim of this study was to compare the healing of onlay block grafts when deproteinized bovine bone coverage was used with the healing of the grafts without such coverage. The purpose was a clinical evaluation of deproteinized bovine bone's ability to reduce grafted bone resorption. The results indicated that bovine bone can be placed over grafted areas, taking advantage of its osteoconductive properties and compensating for the natural bone resorption caused by remodeling.

This article aims to: (1) describe the treatment of three consecutive completely edentulous patients with fixed implant-supported restorations, including simultaneous same-day immediate loading with fixed provisional restorations in both jaws; and (2) illustrate a step-by-step definitive restoration approach. All patients followed the same diagnostic protocol. One surgical intervention was performed for simultaneous implant placement in both maxilla and mandible. Following implant placement, all patients received a simultaneous, same-day, complete-arch, screw-retained provisional restoration in both jaws according to the "pickup" technique. After healing, final impressions were taken, and occlusion recorder devices were prepared on working casts. For the first occlusal record, the "half-provisionals" method was used. Definitive solid abutments were used for both laboratory and clinical procedures. After casting and finishing, the frameworks were tried in, and a new occlusal record was made. The definitive segmented restorations consisted of four fixed partial dentures in the maxilla and three in the mandible and were cemented with provisional cement. All patients received a nightguard. The pickup technique facilitated simultaneous immediate loading in both maxilla and mandible. A complete, fixed, segmented rehabilitation supported by six to eight anteroposterior implants is a reproducible treatment for completely edentulous patients when optimal anatomic conditions are present.

This study evaluated, in the dog, the periodontal response to resin-modified glass-ionomer cement or amalgam restorations placed in surgical windows and left for 124 days. Plaque control was performed in half of the sites. Histologic analyses showed that sites restored with amalgam were consistently more inflamed than sites restored with resin-modified glass-ionomer. Plaque control was associated with less inflammation in both cases. Some sites restored with resin-modified glass-ionomer presented bone repair and a connective tissue lining. The inflammatory response of the periodontium to resin-modified glassionomer restorations is less pronounced than that associated with amalgam restorations.

This study compared the clinical effectiveness of a combination therapy consisting of bovine porous bone mineral (BPBM), guided tissue regeneration (GTR), and platelet-rich plasma (PRP) in the regeneration of periodontal intrabony defects in humans. Twentyeight paired intrabony defects were surgically treated using a split-mouth design. Defects were treated with BPBM, GTR, and PRP (experimental), or with open-flap debridement (control). Clinical parameters evaluated included changes in attachment level, pocket depth, and defect fill as revealed by reentry at 6 months. Preoperative pocket depths, attachment levels, and transoperative bone measurements were similar for the two groups. Postsurgical measurements taken at 6 months revealed that both treatment modalities significantly decreased pocket depth and increased clinical attachment and defect fill compared to baseline. The differences between the experimental and control groups were 2.22 ± 0.39 mm on buccal and 2.12 ± 0.34 mm on lingual sites for pocket depth, 3.05 ± 0.51 mm on buccal and 2.88 ± 0.46 mm on lingual sites for gain in clinical attachment, and 3.46 ± 0.96 mm on buccal and 3.42 ± 0.02 mm on lingual sites for defect fill. These differences between groups were statistically significant in favor of the experimental defects. The combined therapy was also clinically more effective than open-flap debridement. The superiority of the experimental group could not be attributed solely to the surgical intervention and was likely a result of the BPBM/GTR/ PRP application. Combining BPBM, GTR, and PRP was an effective modality of regenerative treatment for intrabony defects in patients with advanced periodontitis.

Guided tissue regeneration (GTR) using bioabsorbable barrier membranes has shown promising and somewhat predictable clinical results. However, limited information is available on the stages of histologic healing when these types of barriers are used. Therefore, the aim of this study was to compare three currently available bioabsorbable GTR barriers (type 1 collagen, polylactide/polyglycolide copolymer, and citric acid copolymer) for the treatment of surgically created periodontal dehiscences in dogs. Eight three-walled periodontal dehiscences were surgically created in the mandibles of six beagle dogs (four on each side of the jaw). The periodontal dehiscences were randomly assigned to receive one of the three barriers. One defect was left untreated to serve as a control. Histomorphometric analyses were conducted at 4 and 12 weeks. Data were analyzed using the Student-Fisher test. The membrane-treated group had a statistically significant increase in new bone formation and connective tissue attachment compared to the nontreated control sites. However, no statistical difference was noted among the various membranes. In addition, no difference was found between test and control sites when new cementum was examined. Sites treated with barrier membranes achieved greater bone regeneration than nontreated control sites in the canine model.

This study evaluated the microleakage of endodontically treated teeth restored with prefabricated dowels and tooth-colored restoratives (Solitaire, Surefil, Filtek P60, Admira, Z-100) as core materials with and without the use of a flowable composite liner. A total of 200 extracted premolars were endodontically treated and prepared for post-core restorations. Prefabricated posts were inserted and cemented with resin cement into the root canals. Each resin system included the corresponding bonding agent for each respective flowable composite. For each group, half of the teeth were restored with composite alone, while the others were restored with the composite lined with flowable liner. Teeth were thermocycled for 1,000 cycles between 5 and 55°C using a 30-second dwell time. The teeth were then coated with nail polish, placed in 5% methylene blue for 24 hours, sectioned, and scored for microleakage. Flowable liners reduced microleakage. Z-100 both with and without flowable liner demonstrated better resistance to leakage. Solitaire, Admira, and Filtek P60 showed more leakage than the other materials.

All prosthetic rehabilitations require healthy, stable oral conditons. The biologic response to the preliminary treatment provides important criteria for planning the final reconstruction and permits testing of the desired prosthetic treatment goals within the unique patient-specific biologic conditions before final restoration. This study used long-term provisional restorations that corresponded in both form and function to the anticipated restorations. Intraoral testing of the diagnostic waxup is an outstanding basis for discussing the provisional as well as final restoration. As required, changes necessary to teeth form and position can be simply accomplished.

This article describes a new and cost-effective concept comprising innovative and simplified clinical and laboratory procedures for the rational fabrication of abutment- free, cast-titanium superstructures with passive fit to implants. Other alloys, such as precious metal or cobalt-chromium, can also be used. The precision of fit between the implants and superstructure is obtained by the Cresco Ti Precision method. This method is a user-friendly technology and can be adapted to most implant systems on the market. The method does not include any abutments, even when implants are positioned in extremely different angulations or inclined in a facial or palatal direction. Coupled with a simple All Parts Included (API) delivery system, the concept therefore represents an efficient treatment alternative.