A survey of failed post-retained restorations

Survival of endodontically treated, post-restored teeth depends on a multitude of factors, all of which are practically impossible to include in a randomized, controlled clinical study. The purpose of this survey was to characterize and analyze reported failures of post-retained restorations to identify factors critical to failure and to type of failure. A questionnaire was mailed to private practitioners in Denmark with a request to complete the questionnaire whenever a patient presented with a failed post-retained restoration. Information was gathered on factors related to the patient, the tooth, the restorative materials, and the techniques. Two-hundred and sixty questionnaires were collected from 171 practitioners over a 3-year period. Functioning time until failure varied between 3 months and 38 years. Mean survival time until failure was 11 years. Of the failed restorations, 61% had functioned for 10 years or less. Fracture of the tooth was the most common type of failure reported, followed by loosening of the post and fracture of the post. Tapered posts implied an increased risk of tooth fracture compared to loosening or fracture of the post, and the relative risk of tooth fracture increased with the functioning time until failure. Fracture of the post was more common among male than female patients. On the basis of this survey of failed post-retained restorations, it was concluded that tapered posts were associated with a higher risk of tooth fracture than were parallel-sided posts

Comprehensive treatment concept in a young adult patient with severe periodontal disease: a case report.

This case report describes the comprehensive treatment of generalized, advanced periodontal disease in a young patient. In view of the necessary reconstruction, the extensive destruction of the periodontal tissues required a systematic approach to determine the possibilities and the expectations of the patient. The subsequent oral rehabilitation was accomplished with fixed prosthodontics. In the mandible, strategically important anchor teeth were replaced with implants, allowing smaller units to be inserted. The long-term treatment result, however, can only be ensured with the full cooperation of the patient and consistent periodontal maintenance care.link_to_subscribed_fulltex

Marginal fit of porcelain crowns with galvanized frames.

Twenty extracted premolars were prepared for artificial crowns with a beveled shoulder. Ten porcelain-fused-to-galvanized-gold (PFGG) and ten porcelain-fused-to-metal (PFM) crowns were made according to the manufacturer's instructions by independent experienced dental technicians. Six sites per crown were selected for analysis. Photographs of these regions were projected on a screen for a total magnification of x 120. After cementation, the crowns were sectioned in the mesio-distal direction. The polished sections were analyzed for marginal accuracy and thickness of the cement. Measurements were recorded using the procedures described above. Before cementation, PFGG crowns exhibited primarily overextended margins, while 80% of the PFM crowns revealed short margins. The PFM crowns depicted a significantly smaller marginal gap (36 microns) than the PFGG crowns (53.7 microns). After cementation, the difference in the marginal gap was not statistically significant. The assessment of the thickness of the cement resulted in a significantly thinner cemental layer for the PFM crowns (PFM 40.2 microns, PFGG 48.5 microns). Although the results of this study demonstrated a diminished marginal gap and cement line for PFM crowns, this difference is too minimal to be clinically significant.link_to_subscribed_fulltex

Short-term effects of initial periodontal therapy (hygienic phase).

The aim of the present study was to evaluate the effect of non-surgical periodontal therapy on probing pocket depths and probing attachment levels using a patient group with moderate to advanced periodontitis. 68 patients with moderate to advanced periodontitis underwent hygienic phase therapy including oral hygiene instructions, scaling and root planing and elimination of plaque retentive factors. Assessments of the plaque control record (PCR), bleeding on probing (BoP), probing depths and probing attachment levels were performed at baseline examination and 3 to 5 months following active treatment. The measurements were obtained at 4 interproximal aspects of each tooth with a thin calibrated probe. Mean BoP values decreased from 63.2 +/- 21.9% at baseline to 16.6 +/- 7.3% after therapy, and mean PCR decreased from 78.6 +/- 16.4% to 12.7 +/- 7.1%, respectively. A reduction in mean probing pocket depth from 3.96 +/- 1.39 mm at baseline to 3.30 +/- 1.16 mm after therapy was noted. Sites with initial probing depths of 1-3 mm showed no change, sites with initial values of 4-6 mm revealed a reduction of 1.03 +/- 1.04 mm, while initial pockets of 7-9 mm decreased in depth by 2.28 +/- 1.62 mm. A gain in the mean probing attachment level from 4.16 +/- 1.80 mm to 3.74 +/- 1.71 mm was observed as a result of treatment. The group with the shallow initial probing depths of 1-3 mm showed no alteration in probing attachment level. Pockets with baseline values of 4-6 mm showed gain of clinical attachment of 0.69 +/- 1.43 mm. The greatest gain in clinical attachment of 1.51 +/- 1.75 mm was obtained in sites with initially deep pockets of 7-9 mm. From the results of this study, it can be concluded that non-surgical periodontal therapy is an effective means to reduce probing pocket depths and to improved clinical attachment levels in patients with moderate to advanced periodontitis.link_to_subscribed_fulltex

Osseous healing of experimentally created defects in the calvaria of rabbits using guided bone regeneration. A pilot study.

The aim of this study was to test whether healing of extensive transosseous defects in the calvaria can successfully be achieved using guided bone regeneration. The results demonstrated complete osseous bridging of the skull defect in the test specimen. In the control specimen, fibrous connective tissue occupied the area of the skull defect.link_to_subscribed_fulltex

Immediate transmucosal implants using the principle of guided tissue regeneration. I. Rationale, clinical procedures and 30-month results.

The installation of implants directly into extraction sockets offers considerable advantages over other treatment modalities for both practitioners and patients. Usually, immediate implants are placed and subsequently covered by mucosa allowing a submerged healing mode. This report presents the rationale, clinical procedures and results for immediate transmucosal implants. Following an intracrevicular incision and flap elevation, the tooth to be extracted is carefully luxated by means of small elevators to preserve the entire bony housing of the tooth. A titanium plasma-sprayed implant (ITI Bonefit) is then installed at the bottom or in the wall of the extraction socket. An expanded polytetrafluoroethylene barrier membrane (Gore-Tex GTAM) is tightly adapted around the implant post and over the bony margins of the alveolus. The flaps are then replaced, adapted around the neck of the implant and sutured. During nonsubmerged, transmucosal healing of the site, meticulous plaque control is performed by mechanical and chemical means. Membranes are removed after 5-7 months. Since infection was prevented, the implants obtained stability, healthy peri-implant mucosal tissues were observed and missing bone in the alveoli regenerated. Of 21 transmucosal implants placed into fresh extraction sockets, 20 yielded complete bone fill and coverage of the entire plasma-coated implants surface at the time of membrane removal. This documentation suggests that the immediate nonsubmerged installation of an implant into an extraction socket is a predictable treatment modality with good long-term prognosis.link_to_subscribed_fulltex

Supraplant, a novel implant system based on the principle of guided bone generation. A preliminary study in the rabbit.

Supraplant, a novel implant system is tested on the top of the skull i n 6 rabbits. The results demonstrate that an implant which is placed on top of bone can be osseointegrated by the guided generation of new bone using membrane barriers.link_to_subscribed_fulltex