Amalgam onlay restoration

This article discusses a conservative class II amalgam cavity preparation that is similar to a cast onlay preparation except for the absence of the lingual and facial bevels. When extensive decay is removed and undermined cusps are present, onlays from amalgam support tooth structure and prevent fractures. To achieve this, cusps must be reduced to provide for a sufficient bulk of amalgam. The described technique can be applied to class II cavity preparations with weak cusps, class I cavity preparations when the remaining cavity provides adequate retention, and to endodontically treated teeth for which finances do not permit cast restorations. © 1991

Principles of anterior guidance: Development and clinical applications

Occlusal concepts related to the anterior determinants of occlusion have been evolving since the early days of modern dentistry. Many of these theories have led dentists to treat natural dentitions using techniques meant only for the construction of artificial dentures. This can of course result in complications for the patient. The advanced knowledge in the area of occlusion that is now available has led most knowledgeable clinicians to a consensus of opinion concerning criteria for a proper occlusion. Most agree that the anterior teeth should disclude the posterior teeth in function in a healthy dentition. This article describes practical techniques for establishing and reproducing this desired scheme of disclusion in the restored dentition. © 1983 Taylor and Francis Group, LLC

A comparison of the shear strength of chemically versus electrolytically etched metal retainers

The recent popularity of acid-etched, resin-bonded retainers (RBR) has initiated improvements in design, technique, and etching. This study compared the shear strength of chemically etched Biobond retainers with electrolytically etched retainers bonded to enamel using identical cement. Shear fracture loads were recorded using Instrom testing for all specimens. The mean fracture load for the electrolytically etched castings was greater than that of the chemically etched castings. Electrolytically etched specimens also recorded the greatest and the least fracture load values. These results indicated that, while there were significant differences between the two groups with greater shear strength values for electrolytic etching, there was also more variation in shear fracture load with electrolytic etching. © 1992 The Editorial Council of The Journal of Prosthetic Dentistry

Management of provisional restorations' deficiencies: A literature review

Provisional restorations are designed in order to protect oral structures and promote function and esthetics for a limited period of time, after which they are to be replaced by a definite prosthesis. They play a particular role in diagnostic procedures and continued evaluation of the treatment plan, as they should resemble the form and function of the definite rehabilitation that they precede. Therefore, interim treatment should satisfy the criteria of marginal adaptation, strength, and longevity. In complicated treatment plans that intend to last for extended periods of time, the function of provisional prostheses involves the possibility of relining, modification, or repair. These adjustments raise considerations regarding the strength of the resultant bond. Chemical composition of the base and repair material, surface characteristics of fracture parts, and time elapsed since the initial set of the rehabilitation should be considered in the decision of the appropriate repair material and technique. Proper pretreatment of the provisional components' surfaces is essential to ensure bonding as well. The purpose of this article is to illustrate the management of provisional restorations' deficiencies. This article highlights possible failures of custom-fabricated provisional restorations, describes methods to prevent their occurrence, and discusses clinical techniques for their management. Finally, the proper combination of materials and surface preparation to achieve the optimum treatment outcomes are presented. © 2011 Wiley Periodicals, Inc

Modified PEEK Resin Bonded Fixed Dental Prosthesis for a Young Cleft Lip and Palate Patient

CLINICAL SIGNIFICANCE: This modified PEEK material known as BioHPP, is a biocompatible, non allergic, rigid material with good mechanical properties, wear resistance, chemical stability, high polishing and low absorption properties. BioHPP frameworks can be manufactured either via CAD/CAM or via the conventional lost wax technique. The low modulus of elasticity, combined with the use of indirect composite resin as a veneering material, provide a distinct advantage over ceramics or metal ceramics on dampening the occlusal forces, reducing the risk of debonding. (J Esthet Restor Dent 28:201-207, 2016). OBJECTIVE: This clinical report presents the use of a modified poly ether-ether ketone material as an alternative material for the fabrication of resin-bonded fixed dental prosthesis (RBFDP) framework. This new material can be used for patients allergic to metals, maintaining the same high esthetic demand of ceramics, presenting light weightness and a flexibility similar to bone as a distinct advantage over ceramic materials. CONCLUSIONS: The use of a BioHPP RBFDP framework could be considered as an alternative restoration for the replacement of missing lateral incisors in young patients with cleft palate defects. © 2016 Wiley Periodicals, Inc

Provisional restorations for optimizing esthetics in anterior maxillary implants: A case report

The use of implants for the restoration of anterior missing teeth has been established and documented during the past years. However, the use of dental implants in the anterior region is a technique-sensitive procedure. The placement of implants in an ideal position is often not possible because of the lack of sufficient bone. The clinical situation can be further complicated if the teeth were lost as a result of trauma and there is possible damage to the surrounding soft and hard tissues. The restoration of lost anterior teeth and maintenance of the surrounding soft tissues with adequate surgical and prosthetic techniques are a real challenge for the clinician. The aim of this article was to report the laboratory and clinical stages in the restoration of anterior maxillary teeth, which were lost as a result of trauma with implant-supported fixed partial denture. In this case, an intraoperative transfer of the impression posts allowed the construction of provisional restorations, which were inserted at implant uncoverage surgery and contributed significantly to the creation of a better emergence profile and to the final esthetic result. CLINICAL SIGNIFICANCE: Provisional restorations are an important stage in anterior maxillary implants, allowing guided soft tissue management and creating an esthetic emergence profile. © 2007, Copyright The Authors

4.2 Clinical records and global diagnostic codes

A clinical record should include the personal demographic details of the patient, health status, diagnostic information and management/ treatment options. However, clinical records are of little use without effective filing and retrieving systems. Coding is therefore necessary to deal with large amounts of differing data and a global coding system could be effectively developed through the use of information technology. The aim of this section was to review the main existing vocabularies and coding systems and to examine ways of improving their global application. It was concluded that global diagnostic codes would be beneficial to the patient, to the profession and to those responsible for strategic decisions concerning the delivery of health care. Extant dental clinical codes are not accepted widely or applied universally. There is an urgent need to identify existing coding systems and to assess their utility and potential for global application. Every effort should be made to include existing codes in the development of a global coding system on which all specialist areas would need to agree. This would require the provision of an overarching interdisciplinary focus and funding should be made available for this development and its implementation. © Blackwell Munksgaard, 2002

Accuracy of implant impressions for partially and completely edentulous patients: A systematic review

Purpose: To compare the accuracy of digital and conventional impression techniques for partially and completely edentulous patients and to determine the effect of different variables on the accuracy outcomes. Materials and Methods: An electronic and manual search was conducted to identify studies reporting on the accuracy of implant impressions. Pooled data were descriptively analyzed. Factors affecting the accuracy were identified, and their impact on accuracy outcomes was assessed. Results: The 76 studies that fulfilled the inclusion criteria featured 4 clinical studies and 72 in vitro studies. Studies were grouped according to edentulism; 41 reported on completely edentulous and 35 on partially edentulous patients. For completely edentulous patients, most in vitro studies and all three clinical studies demonstrated better accuracy with the splinted vs the nonsplinted technique (15 studies, splint; 1, nonsplint; 9, no difference). One clinical study and half of the in vitro studies reported better accuracy with the open-tray vs the closed-tray technique (10 studies, open-tray; 1, closed-tray; 10, no difference). For partially edentulous patients, one clinical study and most in vitro studies showed better accuracy with the splinted vs the nonsplinted technique (8 studies, splint; 2, nonsplint; 3, no difference). The majority of in vitro studies showed better accuracy with the open-tray vs the closed-tray technique (10 studies, open-tray; 1, closed-tray; 7, no difference), but the only clinical study reported no difference. Conclusion: The splinted impression technique is more accurate for both partially and completely edentulous patients. The open-tray technique is more accurate than the closed-tray for completely edentulous patients, but for partially edentulous patients there seems to be no difference. The impression material (polyether or polyvinylsiloxane) has no effect on the accuracy. The implant angulation affects the accuracy of implant impressions, while there are insufficient studies for the effect of implant connection type. Further accuracy studies are needed regarding digital implant impressions. © 2014 by Quintessence Publishing Co Inc