Esthetics practice posibilities using hybrid ceramic

Summary The hybrid ceramic ESTENIA (Kuraray-Dental) combines the advantages of porcelain (esthetic, strengthens) with composite (elasticity, low abrasive effect upon the opposite teeth, way of work). This study tries to solve some clinical cases with reduced partial edentulous using mixed bridges where the physiognomic part was made from hybrid ceramic. The results show that these types of restorations fulfill the esthetic and biomechanical needs.Rezumat Ceramica hibridă ESTENIA (Kuraray-Dental) reuneşte avantajele porţelanului (estetică, rezistenţă, etc.) cu cele ale compozitului (elasticitate, efect abrazant redus la nivelul dinţilor antagonişti, mod de lucru, etc.).(3,5) In studiul realizat am urmărit rezolvarea unor cazuri clinice care au prezentat edentaţii partiale reduse, prin aplicarea unor punţi conjuncte mixte la care componenta fizionomica a fost realizată din ceramică hibridă. Rezultatele obţinute demonstrează că restaurările de acest tip asigură satisfacerea concomitentă atât a cerinţelor de ordin estetic, cât şi pe cele de ordin biomecanic

Periodontal Changes in Conjunct Prostheses

Introduction. The treatment of reduced partially edentulous patients with gnatprosthetic bridges, linked to the organic substructure, determines on the gum¡¦s tissue many adaptive changes, related to the following factors: previous state of sulcular epithelium, quality of the finishing edges of the microprostheses, material from which the bridge is made, definitive cementing materials, etc. The aim of our study is to assess the impact of the fixed prostheses upon the periodontal health. Material and method. The study includes 112 patients (54 males and 58 females) with ages between 20-60 years. The evaluation was made on 282 conjunct prostheses. The statistical processing was made by the program STATISTIC (dedicated to medical research) and specific tests as ANOVA, Spjotvol/Stoline, Pearson, CHI ¡V square (ƒÓ2), Fisher, Spearman, etc. Results. Periodontal changes appeared in 44.64% of cases. This aspect was correlated with different particularities of the prosthetic device. These can be taken into consideration as potential risk factors for periodontal changes. The study of periodontal health, related to the material that was used, showed a low prevalence in metal ceramic bridges (14.3%) and metal composite bridges (8.9%). Periodontal changes are more important in case of high amplitude and older bridges, and they are influenced by the material and the quality of their finishing. Although, there is a correlation between oral hygiene and periodontal changes of the prosthetic bridges patients. Conclusions. Results show a close relation between periodontal changes and: the amplitude and age of the prosthetic bridges, quality of the finishing edges of the microprostheses, surface texture, axial and transversal adjustment and the materials used for the bridge and final cementation

Influence Of Restaurative Therapy On Marginal Periodontal Tissue

The aim of this study is to evaluate the influence of fixed prosthodontics on the periodontal health status, emphasising the pathological changes induced by the restorative materials. Materials and methods The study group was made by 112 patients with 282 dental fixed bridges evaluated by clinical and paraclinical exams. The clinical evaluation included the age of the dental bridge, the material it was made of, the periodontal changes, the bleeding index. For the statistical processing of the data it was used STATISTICA, a special program for medical research. Results and discussions Periodontal changes consisted of significant values of periodontal bleeding index for 46.43% of the cases, periodontal pockets in 12.5% of the cases, recession in 3.57% of the studied cases. Conclusions There is a significant correlation between the material in use for the dental bridges and the presence of the periodontal damage, especially for the metal-acrylic and cast metal crowns

THE IMPORTANCE OF ARTICULAR MOBILITY TESTING DURING TMJ CLINICAL EXAMINATION TECHNIQUE

Introduction The examination of the temporomandibular joint represents a primary phase in the clinical evaluation of any patient, weighing extremely heavy especially when diagnosing the dysfunctional syndrome. There are 3 directions of examination, but the last one in almost unknown, used neither, although is so important for complex oral rehabilitation. Goal So, we want to describe this method, to make aware all practitioners of its importance. During objective examination of TMJ, we must to do inspection, palpation, auscultation and also to explore the vertical mobility (open-close movements) or the horizontal mobility (propulsory, retropulsory, laterality, latero-pulsory movements). Knowing normal values of measured amplitudes, we can recognize TMJ pathology. Conclusion: Clinical examination of TMJ must be done correctly and following all steps, in this manner the practitioner will be able to detect all evident or less evident signs and to formulate the most precise diagnosis

CENTRIC RELATION BETWEEN CHIMERA AND REALITY- A NARRATIVE REVIEW

Introduction: The multitude of definitions for the centric relation (CR) has sparked extensive scientific debates, marking significant milestones in the evolution of concepts in these fields. The discourse surrounding CR has remained contentious for over a century, and there is still a persistent divergence of perspectives. Aim: This narrative review aims to unravel the evolutionary trajectory of CR definitions, seeking to untangle the existing confusion prevalent within specialized literature. Moreover, it endeavors to provide guiding principles within this contentious domain, offering valuable insights to practitioners, students, educators, and researchers. Discussion: Dentistry has not arrived at a consensus definition and concept of CR. Even in the era of evidence-based dentistry, CR still leaves room for controversy. Conclusion: The evolution of the CR concept and its definition, progressing from the exact specification of the maxillomandibular relationship, temporomandibular joint elements, and hinge axis and to its partial “abandonment” due to the individuality and particularities of the patients, should be contextualized within the functional and adaptable nature of the stomatognathic system

ASPECTS IN TREATING REDUCED EDENTULOUS STATUS BY MINIMALLY INVASIVE BRIDGE FOR A YOUNG PATIENT – CASE REPORT

Aim of the study. For a young patient it is important to re-establish the integrity and the functions of dental arches, quickly and efficient, in optimum conditions, with many advantages. Material and methods The study balanced the possibilities to fabricate a minimally invasive bridge for a young patient in order to appreciate the characteristics of a Maryland bridge in treating a reduced edentulous status. Results The study revealed that a minimally invasive bridge placed in the posterior area of a lower arch, fabricated on a metallic framework and an aesthetic part made by resin composite material represent a favourable option as a temporary reconstruction. Conclusions The precision of such minimally invasive bridges and the variability of the materials and technologies that can be used, determine the young patients to accept them as a treatment for reduced edentulous status

STUDY REGARDING THE INFLUENCE OF PERIODONTAL MAINTENANCE THERAPY ON TOOTH SURVIVAL IN PATIENTS WITH REMOVABLE PARTIAL DENTURES

Aim: Removable partial dentures (RPDs) can influence the oral health and have the potential to cause further tooth loss, especially of abutment teeth. However, no evidence indicates the effective interval of regular periodontal maintenance after RPD provision. This study aimed to examine the impact of regular periodontal maintenance visits on survival of RPD abutment teeth. Materials and Methods: Patients were included if they had been provided with a clasp-retained RPD and had used it for 2 years or more. According to the frequency of periodontal maintenance, study samples were divided into three groups; every 3–6 months (3–6M) group, 1-year (1Y) group and no-maintenance (NM) group. Results: Five-year cumulative survival rates were 82.6% (3–6M), 74.4% (1Y) and 70.8% (NM) respectively. Survival of abutment teeth in the 3–6M group was significantly better than both 1Y and NM groups. Conclusion: The periodontal maintenance at least once in 6 months had the most favorable outcome. Frequent periodontal maintenance after RPD provision could be effective in preventing further tooth loss

INDIRECT COMPOSITE VENEERS AS A SOCIAL THERAPEUTIC SOLUTION. A CASE REPORT

The modern dentistry area addresses high demands for dental restorations, harmoniously integrating into the homeostasis of the dental system. Modern contemporary aesthetic restorations are commonly associated with the latest CAD-CAM biomaterials and technologies, with prep- and no-prep techniques. Current practice often faces us with an important decision-maker, the socio-economic criterion, which limits the therapeutic options. In this context, the chosen therapeutic alternatives need to restore both aesthetics and functionality to optimal parameters in the financial terms which are accessible to the specific social segment. The article presents the case of a young woman that presented to the dental clinic for aesthetic reasons. The therapeutic option consisted in the restoration of the physiognomic function using composite veneers made by indirect method

THE INFLUENCE OF SCALING AND ROOT PLANING ON THE GLICEMIC STATUS IN PATIENTS WITH DIABETES MELLITUS TYPE II

The study proposes an assessment of the influence of the periodontal disease therapy by scaling and root planing on the glicemic status in patients with type II diabetes mellitus. Materials and method: The study was conducted on 21 patients with type I diabetes mellitus (study group) and 10 systemically healthy subjects (control group). We examined: the degree of glycemic control (by measuring the glycated hemoglobin), the periodontal and oral hygiene parameters at the baseline and after 4 weeks, 6 months and 12 months after the periodontal treatment which consisted in scaling and root planning. Results and discussion: The subjects with a poor glycemic control presented a higher percentage of sites with attachment loss, significantly higher amounts of bacterial plaque, sub-gingival calculus and gingival bleeding when compared with the control group or the subjects with good or moderated glycemic control. In the same group we observed a rapid recurrence of the deep periodontal pockets after 12 months. Conclusions: The prolonged poor control of the glycemia and the time elapsed from the debut of the diabetes were closely related with its complications. The comparisons between the diabetes and the control groups demonstrated that diabetes mellitus is a risk factor for the periodontal disease

STUDY REGARDING THE QUANTIFICATION OF RANKL LEVELS IN PATIENTS WITH CHRONIC PERIODONTITIS AND OSTEOPOROSIS

Introduction and aim: Osteoporosis, a systemic skeletal disease characterized by an inflammatory status, can enhance the inflammation on periodontal level, with severe alveolar bone loss. The study proposed an evaluation of local and systemic RANKL levels, pre- and post- periodontal therapy. Materials and method: The clinical study was conducted in patients with chronic periodontitis, divided in osteoporosis group and systemically healthy subjects. The clinical periodontal parameters were determined at baseline and after scaling and root planing. The RANKL levels were investigated pre-therapy in gingival crevicular fluid and post-therapy in serum. Results and discussion: The periodontal tissue loss and the crevicular fluid RANKL were significantly more severe in the osteoporosis group, as image of the local influence of an impaired skeletal system. Both groups had a positive response to the periodontal therapy, with low levels of clinical parameters and serum RANKL. Conclusions: Our results support the relationship between osteoporosis and periodontal inflammatory changes, which can be amended by the conventional therapy