Laser-Aided Ceramic Bracket Debonding: A Comprehensive Review

Different techniques have been introduced for the removal of ceramic brackets. Since the early 1990s, lasers have been used experimentally for debonding ceramic brackets. The goal of this study is to give a comprehensive literature review on laser-aided ceramic bracket debonding. PubMed and Google Scholar databases were used to identify dental articles with the following combination of key words: Ceramic brackets, Debonding, and Laser. Sixteen English articles from 2004 to 2015 were selected. The selected studies were categorized according to the variables investigated including the intrapulpal temperature, shear bond strength, debonding time, enamel damage and bracket failure. Most articles reported decreased shear bond strength and debonding time following laser irradiation without any critical and irritating increase in pulpal temperature. There were no reports of bracket failure or enamel damage. Laser irradiation is an efficient way to reduce shear bond strength of ceramic bracket and debonding time. This technique is a safe way for removing ceramic bracket with minimal impact on intrapulpal temperature and enamel surface and it reduces ceramic bracket failure

Preemptive Ibuprofen and Orally Administered Dexamethasone for Prevention of Pain and Swelling following Implant Surgery

Introduction: The post-operative pain and swelling are frequently observed after different surgical procedures. Orofacial pain management is a challenging topic for the dental-medical profession. The main objective of this study was to compare the effects of two designed medical regimens in the context of post-operative management of pain and swelling following simple dental implant surgery. Materials and Methods: In this randomized and double-blinded controlled clinical trial, a total of 39 implants were placed in 31 patients by one clinician. Patients were divided into the test and control groups. Before surgery, each patient in the control group received 1gr of amoxicillin and 400 mgr of ibuprofen, and each one in test group received 1gr of amoxicillin, 400 mgr of ibuprofen and 0.5 mgr of dexamethasone. Antibiotic regimen, together with analgesics and anti-inflammatory treatment was provided after surgery for both groups. Pain was measured using visual analogue scale in days 1, 3 and 6 after surgery. Swelling was evaluated by a verbal scale in day 6. Also, the impact of following factors gender, age, duration of surgery, type and number of implant on pain and swelling was measured by the general linear model analysis. Results: The majority of patients in both study groups reported the pain to be mild, with peak intensity occurring at 24 hours after operation. No significant difference was observed across the groups for any given time. Also, there was no significant difference between two groups regarding their swelling profile. Conclusion: The experiments provide evidence that both of these methods are effective in pain and swelling reduction

Smile Design: Mechanical Considerations.

Smile designing refers to the cosmetic and esthetic dental reconstruction that is visible during smiling. The use of modern digital tools requires adequate knowledge about the tooth shape and shade principles. Mechanical, biological, and psychological factors should be understood and tailor an individualized treatment accordingly to achieve pleasing esthetic outcomes. Dental therapy is becoming more appearance-driven, and thus, both patients and dental clinicians mainly emphasize on cosmetic dental and facial aspects of treatments

Comparative evaluation of the effect of impression materials and trays on the accuracy of angulated implants impressions

Vinyl Polyether Siloxane is a newly introduced impression material and studies on that is scarce. Implant insertion in posterior mandible might be angulated due to anatomical considerations. The purpose of this study was to compare the dimensional and angular accuracy of impressions using full-arch versus sectional tray and Vinyl Polysiloxane versus Vinyl Polyether Siloxane in angulated implants. Four implants were placed in dental areas #19, #21, #28 and #30 of a Kennedy class I mandibular acrylic model with 30° lingual angulation. Twenty sectional and 20 full-arch open trays were made on the primary cast. Impressions were taken using Vinyl Polysiloxane and Vinyl Polyether Siloxane (n=10 in 4 groups); and were poured with type IV dental stone. The coordinate measuring machine was used to measure displacements in the X, Y and Z axes and rotational discrepancies of implants. The data were analyzed using SPSS 22 and two-way ANOVA. Type of tray had no significant effect on the dimensional and angular accuracy of impressions (p >0.05). Type of impression material significantly affected linear displacement (?r) (P 0.05). Vinyl Polysiloxane yielded more accurate impressions of angulated implants

Laser Aided Ceramic Restoration Removal: A Comprehensive Review

Introduction: All-ceramic restorations are being widely used due to its various advantages. However, they have restricted durability and may have to be removed. The conventional procedure for removal is grinding the restoration with rotary instruments which are considered time-consuming and inconvenient. A newer advantageous method is the application of lasers for debonding ceramics from the tooth surface. The objective of this study is to provide a comprehensive literature review on laser-aided ceramic restorations debonding.Methods: We searched PubMed and Google Scholar databases. Seven articles from 2011 to 2018 were identified. Studies were assessed for the efficacy of laser application and the amount of pulpal temperature rise.Results: Studies selected were categorized according to variables including shear bond strength, debonding time and intrapulpal temperature. Oztoprak and Iseri investigated that erbium-doped yttrium, aluminum, and garnet (Er:YAG) laser application reduced shear bond strength of ceramic laminate veneers. The time of debonding took an average of 190 seconds in Rechmann’s study and 106 seconds in Morford’s study. One of the main issues while using the laser is thermal irritation of the pulp. A 5.5°C temperature increase may cause pulpal damage according to Zach and Cohen. Philips et al and Rechmann et al reported no intrapulpal harm due to temperature increase. Additionally, Phillips et al demonstrated that the laser setting affects both the debonding time and the temperature alterations and that a laser adjustment of 2.5 W/25 Hz would be the best safest group.Conclusion: Removal of ceramic crowns and veneers from tooth surfaces can be successfully done by Er:YAG laser application in a less time-consuming procedure and without any harm to the underlying dentin. However, a temperature rise in the pulp may occur which could be overcome by adequate air water cooling

Radiographic Evaluation of Implant Impression Component Misfit

Statement of Problem: Radiographs are commonly used to detect misfit of implant components, but various factors including implant connection and component opacity could affect this decision.Purpose: The purpose of this study was to evaluate the diagnostic capability of senior students and experienced dentists on the adaptation of implant and impression coping in different vertical and horizontal angled radiographs.Materials and Methods: The implant and the impression coping were attached to each other; once without any gap and once with a gap of 0.5 mm. Totally, 40 digital X-rays were taken with vertical inclinations of 0, 5, 10, 15, 20, 25, 30 degrees in positive and negative directions, and the rest were horizontally inclined with the same values. Forty senior students and twenty experienced dentists observed the radiographs. Their diagnoses were compared with the real status of components.Results: No significant difference was observed between the performance of students and experts (P=0.74). Statistical T-test analysis revealed that the directions (inclinations toward the implants or the impression copings) does not result in any significant difference in diagnoses of students (P=0.29) and dentists (P= 0.15). Nevertheless, general linear model showed the radiograph angulations had a significant impact on the diagnoses of students (P=0.003) and dentists (P<.001). Youden factor revealed that there was not a consistent trend regarding sensitivity and specificity of vertically angled radiographs; however, sensitivity and in particular, specificity decreased as a result of horizontal angle inclination.Conclusion: Increasing vertical angulations of the radiographs for diagnosing the adaptation of implant components is likely to reduce diagnostic capability of clinicians, even experienced ones. Specificity is more affected than sensitivity in both horizontally and vertically angled radiographs. 

Restoring a post-traumatic partial edentulous mandible with the Toronto prosthesis: a clinical report

Implants provide support, stability and retention for restorations used in fully and partially edentulous patients. This clinical report describes prosthetic treatment of a 30-year-old man suffering from a dentoalveolar deficiency due to an old gunshot trauma to the left side of the mandible. The patient was rehabilitated with implant-supported Toronto prosthesis following surgical placement of three implants with undesirable location and angulations due to lack of sufficient bone. This prosthetic option offers advantages of both screw-retained and cement-retained prostheses and provides acceptable aesthetic and functional results

Implant assisted ortho-surgery in edentulous jaws: a clinical report

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Evaluation of Accuracy of DIAGNOdent in Diagnosis of Primary and Secondary Caries in Comparison to Conventional Methods

Introduction: Today the prevalence of teeth decays has considerably decreased. Related organizations and institutions mention several reasons for it such as improvement of decay diagnostic equipment and tools which are even capable of detecting caries in their initial stages. This resulted in reduction of costs for patients and remarkable increase in teeth life span. There are many methods for decay diagnostic, like: visual and radiographic methods, devices with fluorescence such as Quantitative light-induced fluorescence (QLF), Vista proof, Laser fluorescence (LF or DIAGNOdent), Fluorescence Camera (FC) and Digital radiography. Although DIAGNOdent is considered a valuable device for decay diagnostic, there are concerns regarding its efficacy and accuracy. Considering the sensitivity of decay diagnosis and the exorbitant annual expenses supported by government and people for caries treatment, finding the best method for early caries detection is of the most importance. Numerous studies were performed to compare different diagnostic methods with conflicting results. The objective of this study is a comparative review of the efficiency of DIAGNOdent in comparison to visual methods and radiographic methods in the diagnostic of teeth occlusal surfaces.Methods: Search of PubMed, Google Scholar electronic resources was performed in order to find clinical trials in English in the period between 1998 and 2013. Full texts of only 35 articles were available.Conclusion: Considering the sensitivity and specificity reported in the different studies, it seems that DIAGNOdent is an appropriate modality for caries detection as a complementary method beside other methods and its use alone to obtain treatment plan is not enough

Effect of Repeated Use of Different Types of Scan Bodies on Transfer Accuracy of Implant Position

Statement of the Problem: Some components of implant treatment are reusable. Therefore, possible changes during fixation, removal, and sterilization process should be tested. Many studies have examined the reuse of implant parts, but the impact of repeated use of scan bodies on the accuracy of implant position has not been well investigated.Purpose: The aim of this in vitro study was to compare the effect of repeated use of two different types of scan bodies on the accuracy of implant position.Materials and Method: In this in vitro experimental study, two acrylic resin maxillary models, each with two implant analogues inserted at the site of missing first and second molars were used. Two types of scan bodies including titanium and polyetheretherketone (PEEK) were used for digital impression. Then they were ten times removed and autoclaved for sterilization. The first scan was considered as a reference to be compared with the other next nine scans. Values of linear distance between two scan bodies, diameter changes of each scan body, and three-dimensional linear displacement (ΔR) were measured. These values were compared between the two types of scan bodies using t-test (α=.05). Results: There was significant difference between titanium and PEEK scan bodies regarding inter-implant distance variation (p=.006) and diameter change (p< .001) in repeated use. However, for the ΔR, there was no significant difference between them (p= 0.759).Conclusion: The results demonstrated that type of scan body could affect the accuracy of implant position transfer after repeated use. PEEK scan body performed better after 9 cycles of reuse in comparison with titanium scan body