Marginal adaption of two esthetic complete crowns

In an in-vitro study twenty artificial crowns were fabricated. A hardened stainless steel five piece die assembly was used to construct uniformed wax patterns and to record all measurements. The fit of ten PFM crowns before and after the application of porcelain using the porcelain but margin technique was compared to that of ten Dicor crowns. The results of this study indicated best fit with the metal crowns before the application of porcelain, while the PFM crowns were oversized and the Dicor crowns were undersized.     

Antenatal sonographic diagnosis of club foot with particular attention to the implications and outcomes of isolated club foot

OBJECTIVE: This study assessed the clinical performance of dentin-bonded crowns, in which ceramic crowns are bonded to underlying dentin with a resin composite-based luting material and a dentin bonding agent. METHOD AND MATERIALS: Twenty-five patients who had received such restorations more than 1 year previously were recalled for evaluation of their crowns. RESULTS: Sixty dentin-bonded complete-coverage restorations were assessed. Forty-one of the crowns had been placed on incisor teeth. The mean time since placement of the restorations was 2.43 years. Fifty-seven of the 60 restorations were intact. The three failures had resulted from cracks in the restorations, which had not clinically debonded. No secondary caries was detected at the crown margins, and anatomic form was assessed as excellent for 56 crowns. Root canal treatment had been required in one case. Color match was rated very good for 47 crowns. All 25 patients were satisfied with their restorations. CONCLUSION: Dentin-bonded crowns may be found to have a low rate of failure and to provide a high level of patient satisfaction.     

Marginal discrepancy of all-ceramic crowns cemented on implant abutments

PURPOSE: The purpose of this investigation was to determine the mean marginal discrepancy of all-ceramic crowns cemented on implant abutments. MATERIALS AND METHODS: Five Br?nemark CeraOne abutments were connected to implant fixtures embedded in acrylic resin blocks. The marginal discrepancy was measured using a video camera connected to a digitizing board at four locations on each abutment for five samples in each of the following groups: all-ceramic caps (caps), all-ceramic crowns (crowns), and all-ceramic crowns cemented with zinc phosphate cement (cemented crowns). RESULTS: The mean marginal discrepancies were as follows: caps, 99.0 micrometers (SD, 16); crowns, 117.8 micrometers (SD, 20); and cemented crowns, 168.8 micrometers (SD, 23). Statistically significant differences were found between all three groups at the 99% level of confidence. In addition there were two significant differences between abutments. CONCLUSIONS: Subgingival marginal discrepancies of the magnitude measured in this study have been shown to cause periodontal problems. It is probable that the marginal discrepancy of CeraOne restorations, as tested, can be improved. Efforts should be made to enhance the marginal accuracy of these restorations.     

The effect of adhesive luting agent-dentinal surface interactions on compressive strength of two types of all-ceramic crowns

This research compared the compressive strength of two types of all-ceramic crown (Hi-Ceram and Duceram) as affected by selected luting cements (Zn phosphate, glass ionomer and composite resin cement). Thirty crowns of similar size and shape were constructed (15 crowns of each tested material) to fit a standard posterior tooth preparation. Five crowns from each material were cemented by one of the tested cements. The cemented crowns were loaded until catastrophic failure. A two-way analysis of variance was performed and showed that the type of utilized cement had a significant effect on the compressive strength being that Panevia Ex. resin cement the most effective one followed by glass ionomer and then finally zn phosphate cement. Statistical analysis also showed that Hi-Ceram crowns were more resistant to occlusal load than Duceram.     

New players and puzzles in the Hedgehog signaling pathway

STATEMENT OF PROBLEM: Esthetic demands of patients and practitioners for an all-ceramic crown in both anterior and posterior regions of the dental arches has prompted the development of the Procera AllCeram crown. Long-term clinical trials that evaluate the strength and naturalness of the Procera AllCeram crown are lacking. PURPOSE: This prospective study was initiated to evaluate the clinical performance of 100 Procera AllCeram crowns after 5 years in service. MATERIAL AND METHODS: One hundred Procera AllCeram crowns were fabricated for 58 patients (20 men and 38 women). Patients were treated by 4 general dental practitioners. Crown placement involved both the anterior and posterior regions of the dental arches. Crowns were examined at baseline and once a year during the 5 years that followed and evaluated at each appointment with the California Dental Association's quality assessment system. RESULTS: Of the 97 crowns remaining in the study after 5 years, only 3 crowns had experienced a fracture through the veneering porcelain and the aluminum oxide coping material. Two additional crowns were replaced as a result of fractures of only the veneering porcelain. One crown was replaced as a result of recurrent caries. All remaining crowns were ranked as either excellent or acceptable for surface/color, anatomic form, and marginal integrity. CONCLUSION: The 5-year clinical observations and ranking with the California Dental Association's quality assessment criteria supported the conclusion that Procera AllCeram crowns may be used in all areas of the mouth.     

Solitary fibrous tumor of the prostate

The aim of this retrospective study was to record patients' satisfaction with fixed metal ceramic bridges and crowns made by dental students and to evaluate the functioning and condition of the bridges and crowns clinically and radiologically. Out of the 60 patients treated at the Institute of Dentistry during 1984-85, 30 patients attended the follow-up examination (16 women, mean age 39, range 23-62 years and 14 men, mean age 44, range 26-65 years). The anamnestic data and data regarding treatment procedures were collected from the patient files. The patients had been supplied with 41 crowns and 24 bridges (mean 3.9 units, range 3-6 units), which included 61 abutments and 33 pontics or cantilever extensions (abutment/pontic ratio 1.85: 1). Marginal fidelity was unsatisfactory in 13% of the crowns and bridges and gingival bleeding and pockets of 4-6 mm were noted in 27% and 12% of cases, respectively. None of the subjects had caries in the abutments.     

Precision of fit: the Procera AllCeram crown

STATEMENT OF PROBLEM: Strength, color stability, and precision of fit are requirements for all-ceramic restorations. The Procera AllCeram crown system, composed of a densely sintered high-purity alumina core combined with a low fusing surface porcelain, appears to satisfy most of these requirements. However, evaluation of marginal fit has not been reported. PURPOSE: This study measured the precision of fit of the Procera AllCeram crown fabricated with Procera CAD/CAM technology for the premolar and molar teeth fit to a die. MATERIAL AND METHODS: Five ivorine maxillary first premolars and first molars were prepared for full-coverage crowns. Preparations were standardized with a convergence angle of 10 degrees, chamfer margins of 1.3 to 1.5 mm circumferentially, and occlusal reduction of 2.0 mm. AllCeram crowns were fabricated for the dies, and the fit of the crown to the die was determined by using a standardized procedure with a silicone impression material that served a dual role: (1) as a retrievable luting agent, and (2) to replicate the internal aspects of the crown. Laser videography was used to measure the gap dimension between the crowns and the dies at the marginal opening, the axial wall, the cusp tip, and the occlusal adaptation measurement locations. Mean gap dimensions and standard deviations (SDs) were calculated for marginal opening, internal adaptation, and precision of fit. RESULTS: Mean gap dimensions and standard deviations at the marginal opening for the premolar and molar crowns were 56.0 microns SD +/- 21 and 63.0 microns SD +/- 13 microns, respectively. The mean gap dimensions and SDs of the internal adaptation were 69.0 microns SD +/- 17 microns for axial wall, 48.0 microns SD +/- 12 microns for cusp tip, and 36.0 microns SD +/- 7 microns for occlusal adaptation for the premolar crowns; and 49.0 microns SD +/- 3 microns axial wall, 67.0 microns SD +/- 21 microns cusp tip, and 74.0 microns SD +/- 29 microns occlusal adaptation for molar crowns. Precision of fit and SDs for premolar and molar crowns were 52.0 microns SD +/- 19 microns and 63.0 microns SD +/- 20 microns, respectively. Mean marginal openings and precision of fit gap dimensions for the crown groups were not significantly different at the .05 level. However, gap dimensions that defined the internal adaptation at the measurement locations were different (P < or = .05). CONCLUSION: Mean gap dimensions for marginal openings, internal adaptation, and precision of fit for the crown groups were below 70 microns. These findings show that the crowns studied can be prescribed with confidence knowing that the precision of fit will consistently be less than 70 microns.     

Clinical commissioning of Laitinen Stereoadapter for fractionated stereotactic radiotherapy

PURPOSE: The purpose of this study was to investigate the distribution of shades selected for metal ceramic crowns provided at a dental teaching hospital. MATERIALS AND METHODS: Data on the selection of shade for 2,500 metal ceramic crown units, placed over a 5-year period at the University Dental Hospital of Manchester, were collected and analyzed. Only those crowns placed adjacent to minimally restored vital teeth were included in the study. RESULTS: The results indicate that the most frequently chosen shades were in the mid-range of reddish-brown hue. Furthermore, shades in the reddish-grey range of hue were rarely chosen. The selection of more than one shade for a crown ("mixed shades") was generally restricted to the maxillary anterior teeth. CONCLUSION: Knowledge of the distribution of shades selected for permanently luted metal ceramic crowns may be a useful adjunct in shade selection, particularly for the inexperienced operator.     

Blood transfusion practices in Mwanza Region, Tanzania. Bugando Medical Centre

Uncertainty exists about the forces applied by dentists during dental crown cementation. A measuring system was developed based around a commercially available miniature (3.8 mm high and 12.7 mm diameter) load cell. The load cell was mounted in a finger stall and the applied force measured. Experimental results suggest that dentists typically apply a force to metal crowns of about 60 N for a few seconds, followed by the application of a steady force of about 20 to 30 N. Lower forces are applied to porcelain crowns.     

Use of plastic bar molded casting in the modification of variably expanding investment to compensate for casting shrinkage of nickel-chromium alloy

Trial plastic bar molded castings were compared for accuracy with cast crowns by means of a nickel-chromium alloy, which was used to establish the liquid density of variably expanding investments. The plastic bars were invested to evaluate the change of expansion rate in a wide range of six liquid densities from 0% to 100%, and the distances between the sections were measured before and after casting. Wax crowns were cast to obtain a more detailed relation around 0% expansion at seven liquid densities, and the gaps between the base of the die and the margin of the crown were measured before and after casting. The expansion rates of both castings were calculated and thus were proportional to the liquid density; both regression curves indicated high correlation coefficients. As a result of the statistics of the Student's t-test, the difference between the two methods was not significant. The trial plastic bar was useful in establishing the variably expanding investment for precise casting of artificial crowns.     

Epinephrine in digital blocks: revisited

STATEMENT OF PROBLEM: Implant treatment in the United Kingdom has been provided mainly in specialist, regional dental hospitals. However, increasingly, general dentists are providing implant-supported prostheses in a private office setting. PURPOSE: This study investigated the nature, timing, and frequency of complications associated with single tooth implant therapy in a dental hospital and two dental offices. METHODS: The dental records of 58 patients provided with 76 implants during the period of 1989-95 were reviewed retrospectively. Fifty-three single tooth crowns on implants were placed by general dentists and 23 by specialists in the dental hospital. RESULTS: Implant survival rate was 96%. Twenty-eight guided bone regeneration procedures were required, including 13 unplanned ones. Prosthodontic complications included the need for recontouring of three crowns and the recementation of three crowns. Only two abutment screws required retightening. Peri-implant soft tissue inflammation occurred around six crowns and recession around two. CONCLUSION: The single tooth implant-supported crown appears to be an effective and durable restorative treatment with a relatively low prevalence of postoperative complications.     

Human herpesvirus-6 infection in liver transplant recipients: documentation of pathogenicity

In the posterior partially edentulous jaw, implants may be used to supplement existing natural dentition. Frequently, the maxillary sinuses and the mandibular nerve preclude the fabrication of freestanding implant-retained prostheses. However, if an implant and a natural abutment are combined, a fixed prosthesis can be fabricated, restoring the arch into the premolar area. The histories of three patients with attachments connecting implant-retained ceramotitanium crowns with crowns on natural abutments are described. A design for a rigid custom-made attachment for the Br?nemark system, using standard components with a machine-duplication, spark-erosion technique, is suggested.     

Effect of tooth surface roughness on marginal seating and retention of complete metal crowns

STATEMENT OF PROBLEM: Retention and marginal adaptation factors have major influence on the failure of cemented complete veneer crowns. PURPOSE: This study investigated the effect of axial surface roughness on the marginal seating and retention of silver-palladium crowns luted with zinc phosphate, glass ionomer, and resin cements. MATERIAL AND METHODS: Coarse and fine diamond stones were used to create various surface roughnesses of premolars. A milling machine was used to control the height and angle of the axial walls of tooth preparations. Ten cast metal crowns in 6 subgroups were luted with 3 cements (Phosphacap, Fuji Cap I, and Panavia 21). Marginal seating was recorded with a Digimatic indicator. Retention was determined by measuring the tensile force required to remove a metal crown with a Lloyd testing machine. RESULTS: Two-way analysis of variance revealed statistically significant differences (P <.001) in retention for both luting cements and surface roughness. No significant difference was recorded for marginal seating relative to roughness (P =.860) and interaction effects (P =.204). Tukey-HSD tests revealed substantial differences in retention among Phosphacap, Fuji Cap I, and Panavia 21 cements. Significant differences were not confirmed in marginal seating between Fuji Cap I and Phosphacap cements with coarse diamonds, and Phosphacap and Panavia 21 cements with fine diamonds. CONCLUSIONS: The best retention for complete metal crown was demonstrated for tooth preparations ground with coarse diamonds and cemented with Panavia 21 cement. Differences in axial surface roughness had no effect on the marginal seating of the complete metal crowns.     

Pulpotomy as an alternative to canine tooth extraction in monkeys [Macaca mulatta]

An effective method for sealing pulp canals after partial removal of canine tooth crowns from adult rhesus monkeys is described.     

Regeneration of gingival papillae after single-implant treatment

An index to assess the size of the interproximal gingival papillae adjacent to single implant restorations was described and preliminary tested in a pilot study of retrospective material comprising 25 crowns in 21 patients. The result indicated a significant spontaneous regeneration of papillae (P < .001) after a mean follow-up period of 1.5 years. Based on these results, the general conclusion was made that the proposed index allows scientific assessment of soft tissue contour adjacent to single-implant restorations. The results also indicated that soft tissue changed in a systematic manner during the time period between insertion of the crowns and follow-up 1 to 3 years later.     

Allosteric nicotinic receptors, human pathologies

The purpose of this study was to investigate the biomechanical significance of major connectors and base mucosal contacts on the mechanical behaviour of maxillary removable partial dentures in vivo. Six subjects wearing maxillary dentures retained by conical crowns were selected for the study. Reflective photoelasticity and strain gauges were used to monitor the development of strain/stress during functional loading. Loading tests were performed initially with a denture design including a palatal major connector and denture bases and then repeated after removal of the major connectors and denture base alveolar muccosa contacts. The palatal major connector and the denture bases mucosal contacts contribute significantly to the rigidity and stability of removable partial dentures retained by conical crowns.     

The fracture resistance of all-ceramic crowns on supporting structures with different elastic moduli

This in vitro study evaluated the fracture resistance of all-ceramic crowns as a function of the elastic modulus of the supporting die. All-ceramic crowns were made for dies with three different elastic moduli and two different crown lengths. The occlusal surface was loaded in compression with a 12.7-mm steel ball. The fracture load increased markedly with the increase in elastic modulus. The largest increase was seen when only the occlusal surface of the crown was covered. The characteristic fracture load of the complete-crown restorations was more than double that of the occlusal-cover restorations in the dies with the lowest modulus of elasticity, while for the dies with the highest modulus of elasticity the difference in the characteristic fracture load for the two configurations was not significant.     

Periodontal and dental considerations in clinical crown extension: a rational basis for treatment

When the clinical crowns of teeth are dimensionally inadequate, esthetically and biologically acceptable restoration of these dental units is difficult. Often an acceptable restoration cannot be accomplished without first surgically increasing the length of the existing clinical crowns; therefore, successful management requires an understanding of both the dental and periodontal parameters of treatment. This report provides further insight into this interdependence by examining the effects of tooth form on the periodontal morphology and surgical treatment, while relating them to requirements for esthetically and biologically acceptable full-coverage dental restorations. This report also explains the role that restoration margin location and emergence profile play in the maintenance of periodontal and dental symbiosis. The effects of violation of the supracrestal gingivae by improper full-coverage restorations is also illustrated.     

Circadian rhythm of breath hydrogen in young women

PURPOSE: The retention forces of a newly developed compomer cement (Dyract Cem), a glass ionomer cement (Ketac Cem Aplicap), and a resin cement (F21) were examined. MATERIAL AND METHODS: Cemented cast gold crowns were removed along the path of insertion with a Zwick universal testing device. The impact of both a cured and a noncured additional bonding layer that were applied to the inner surface of the crowns was examined across the Dyract Cem group. RESULTS: The mean adhesive strength was measured at 2.36 +/- 0.69 N/mm2 in the Ketac Cem group, at 0.60 +/- 0.28 N/mm2 in the F21 group, and at 1.85 +/- 0.94 N/mm2 in the Dyract Cem group, respectively. The application of an additional bonding layer to the inner surface of the crowns did not significantly improve the retentive strength of Dyract Cem; the respective mean strengths were observed at 1.46 +/-0.33 N/mm2 for the uncured and at 1.70 +/- 0.76 N/mm2 for the cured bonding layers. CONCLUSIONS: Dyract Cem and Ketac Cem showed significantly higher retentive strengths than F21 (p < 0.001, Wilcoxon test, 5% level). No significant difference was found in bond strength between Ketac Cem and Dyract Cem.     

Changes in esophageal function after vertical banded gastroplasty as demonstrated by esophageal scintigraphy

STATEMENT OF PROBLEM: Earlier studies on orthodontic brackets have shown a loss of bond strength after a sonic toothbrush was used. PURPOSE: This in vitro study evaluated the difference in bond strength of single complete veneer crowns after being subjected to the equivalent of 2 years of brushing with sonic and counterrotational toothbrushes. MATERIAL AND METHODS: Complete gold crowns were fabricated with a conventional indirect technique for 30 extracted, intact, prepared human premolar teeth. Castings were then luted to the teeth with glass ionomer cement. Teeth were randomly divided into 3 groups of 10 teeth each, 1 group to be brushed with Sonicare sonic toothbrush, 1 group to be brushed with Interplak counterrotational mechanical toothbrush, and 1 group as the control. Groups 1 and 2 were then brushed for the equivalent of 2 years per tooth. A uniform force of 50 g for the sonic toothbrush and 120 g for the counterrotational toothbrush was used. Control specimens were not brushed. Brush heads and sample teeth in contact with the toothbrush were kept moist at all times. Tensile dislodgment force was determined with an Instron universal testing machine. RESULTS: The castings brushed with a sonic toothbrush required a mean of 43.22 kg (+/- 11.16) force to remove the crowns from the teeth, whereas the counterrotational group required a mean of 42.87 kg (+/- 10.42) and the control group a mean of 42.12 kg (+/- 6.61). Analysis of variance on the force data indicated no differences among the 3 groups in the force needed to remove the castings (F[2,24] = 0.031, P = .97). CONCLUSION: This in vitro study demonstrated no significant differences between groups in the amount of tensile dislodgment force required to remove cemented full veneer crowns from prepared teeth after brushing for the equivalent of 2 years time with a sonic toothbrush or a counterrotational toothbrush.