Porcelain veneers for primary incisors: a case report

A 4-year-old boy with severely discolored primary maxillary incisors was treated with bonded porcelain veneer restorations. Two years previously, the child had been treated with topical application of sodium fluoride-silver nitrate solution to arrest dental caries associated with a nursing bottle habit. With minimal chair time, the incisors were restored with laboratory-processed porcelain veneer restorations that were bonded with resin cement. This is perhaps the only report to date of the use of porcelain veneer restorations for primary anterior teeth.     

Microleakage of oral microflora for porcelain and some porcelain repair materials--in vitro study

Repairing porcelain fractures has become of interest to the dentist. The intra oral fracture of metal-ceramic restorations may be due to inadequate metal support, excessive porcelain thickness, technical flaws, and occlusal forces. Various techniques for intra oral porcelain repair have been suggested. The resin-porcelain junction has been in question since the advent of the porcelain veneer for cast metal restorations. To enhance this, several intermediary products and techniques have been developed to increase the chemical bond between the fractured porcelain and the repair materials. Clinical procedures for porcelain repair has required roughening of porcelain surface with a rotary abrasives, application of silane followed by composite to replace the contour of the restoration (2, 13, 14). Laboratory data suggested that the strong bond of the repair materials was developed.     

Laboratory procedures for fabricating pressable all-ceramic restorations

All-ceramic restorations have been recognized and accepted as being esthetically superior to porcelain-fused-to-metal or all-cast restorations. However, gains in esthetics achieved with an all-ceramic crown often meant sacrifices in strength, fit or both. Recent developments in the pressed ceramic format continue to secure the pressed all-ceramic restoration as a viable alternative to porcelain-to-metal and all-cast restorations. This article focuses on the most updated techniques and considerations of this type of system and its effectiveness in providing esthetics, strength and fit through "technician-friendly" procedures, materials and equipment.     

Contemporary developments in the utilization of metal-ceramic restorations: a review

Numerous porcelain systems and techniques are currently available for utilization in full-coverage anterior crown restorations. Significant improvements have been made in the placement of margins and the reduction of the metal framework in order to enhance the optical effects (e.g., illumination, warmth, and vitality) of these porcelain systems. This article presents several recent developments in the fabrication of metal-ceramic crown restorations, and demonstrates the use of these principles in the aesthetic oral rehabilitation.     

Use of provisional restorations to enhance soft-tissue contours for implant restorations

The objective of restoring missing teeth with implant-supported restorations should not merely be achieving osseointegration with an implant and a biomechanically sound restoration. The objective must be the esthetic and functional restoration of the missing teeth. To achieve this, proper treatment planning is critical. Precise implant placement and delicate soft-tissue manipulation during surgery will allow the restorative dentist to enhance the peri-implant soft-tissue contours with the use of provisional restorations. Empirically, it seems that the earlier the provisional restoration is delivered in the treatment process the more ideal the esthetics. Several methods of using provisional restorations to enhance soft-tissue contours are presented. The concept of immediately delivering provisional restorations on placement of an implant is discussed.     

Why should physicians worry about patient satisfaction? Applying some of the principles used in the emergency department to hospital and office-based practices

Dental porcelain has superior esthetics but may be subject to fracture during mastication. Residual compressive stresses on the porcelain surface after cooling enhance resistance of porcelain to crack initiation, as quantified by its fracture toughness (Kc). The effect of different cooling rates on Kc and hardness of a glazed porcelain reinforced with approximately 2% aluminum oxide was examined in 45 porcelain disks that were divided into three groups. After final glaze firing, one group was cooled rapidly, the second was cooled at a medium rate, and the third was cooled slowly. Fracture toughness was determined with a microindentation procedure. The mean Kc recorded for rapidly cooled porcelain (1.74 +/- 0.09 MN/m3/2), for medium-cooled porcelain (1.41 +/- 0.07 MN/m3/2), and for slow-cooled porcelain (1.29 +/- 0.07 MN/m3/2) was statistically different (p < 0.001, analysis of variance and Bonferroni post hoc test). No statistically significant differences in Vickers hardness values were recorded when porcelain was cooled at different rates (530 to 540) (analysis of variance). The faster cooling rate of a glazed alumina reinforced porcelain resulted in greater fracture toughness but had no effect on hardness.     

Serum ferritin determination: is it useful in the early diagnosis of renal carcinoma?

Highly filled luting resins are recommended for bonding porcelain restorations to tooth structure. This in vitro investigation was undertaken to determine the degree of cure of a 82 per cent filled dual-curing luting resin, after it was cured through various thicknesses of Cerec Vita Mark II porcelain. Infrared, as well as micro-Raman spectroscopy were used to determine the degree of cure of the cement at different time intervals after mixing and exposure to the curing light. The results indicated that Cerec porcelain thicknesses greater than 3 mm adversely affected the degree of cure of the luting resin, even at 24 hours after mixing the cement.     

Functional recovery and timing of hospital discharge after primary total hip arthroplasty

BACKGROUND: Dental porcelain has found an increased number of applications in recent years with the development of new methods for the construction of porcelain veneers and intracoronal restorations. In addition, it is used in metal-ceramic and all-porcelain crowns and bridges for the restoration of anterior and posterior teeth. METHODS: This paper presents a review of a number of studies that have examined the visual and microscopic appearance and roughness of glazed, unglazed and polished porcelain surfaces using techniques such as, scanning electron microscopy and surface profilometry. FINDINGS: All have agreed that glazed porcelain provides a smooth and dense surface. Many have shown that polishing can produce an equally smooth surface, which may even be esthetically better. Some studies supported the use of polishing as an alternative to glazing. However, reports have shown that unglazed porcelain is more abrasive than glazed. CLINICAL SIGNIFICANCE: This paper aims to guide general practitioners in the proper polishing of adjusted porcelain in the dental office. The recommendations of various authors are summarized in Table I.     

Building laminate veneers and fixed bridges with polymer glass technology

A new type of material is being introduced to American dentistry. The material is a polymer glass, tested in Europe as Artglass. The material is purported to be equal to or better than porcelain for esthetic dentistry. The strength, color translucency, and color vitality allow minimal destruction of enamel for esthetics. An Artglass occlusal is less abrasive to enamel than porcelain and approximates gold. The characteristics of this material system introduces "minimal invasive dentistry" to routine dental repair and reconstruction. A case study of the senior author's reconstruction of his anterior teeth is presented.     

Longevity in glass-ionomer restorations: review of a successful technique

It is just 20 years since glass-ionomer cements were introduced to the profession as a restorative material capable of an ion exchange adhesion to tooth structure as well as a continuing fluoride release. At the time of presentation there was considerable publicity, but, in retrospect, it is likely that the materials were marketed prematurely, before there had been a great deal of clinical investigation. The clinical short-term results were rather disappointing, particularly in relation to esthetics, because the original version lacked translucency. In the next few years, some manufacturers worked to refine the product and improve the properties and achieved reasonable results. In the early 1980s, it was shown that the main problem with both esthetics and physical properties was the need to maintain a proper water balance in the material during the early setting phase. Once this problem was identified and overcome, it became possible to achieve excellent results, but these have not been reported frequently. This article discusses a method of placement that will lead to acceptable glass-ionomer restorations and shows a series of restorations that are up to 15 years old.     

The dependence of the intensity of emotional feeling on the intensity of the need and of its probability of satisfaction: subjective and objective estimates

The ability of porcelain veneers to be conservative in dentistry has tremendous advantages for patients. Being less invasive with both the gingiva and pulp results in better gingival health, easier maintenance, and less postoperative sensitivity. The use of porcelain laminate veneers to reestablish function and enhance aesthetics results in minimally invasive restorations. The patient was very pleased with the results. With proper care, she will have many years of beauty and newly restored function.     

A clinical technique for temporization of teeth to receive porcelain laminate veneers

Temporization of teeth prepared for porcelain laminate veneers is sometimes necessary to preserve occlusal relationships, prevent sensitivity or maintain esthetics. The literature describes several techniques which satisfy different requirements for temporization. A modified technique is presented that satisfies at once: occlusion, sensitivity and esthetic needs. Clinical time spent with the patient is minimized by fabricating a matrix on a diagnostic cast prior to the preparation/ impression appointment.     

Biological influence of some crown and bridge restorative materials finished and polished by different techniques

Fixed restorations should satisfy certain biologic requirements and they must not be injurious to the surrounding living tissues as pulp, periodontal ligament, alveolar bone and gingiva. It is best to terminate preparations above the gingival margin but for retention and esthetics considerations the margins of the fixed restorations could be placed subgingivally. In recent years, the biologic effects of dental restorative materials on the gingiva and periodontal tissues have been better appreciated. A rough surface restoration attracts and retains bacterial plaque and irritates the surrounding soft tissues which is injurious to the living supporting structure of the abutments.     

Replacing posterior teeth with freestanding implants: four-year prosthodontic results of a prospective study

This article presents prospective four-year prosthetic results of the placement of 432 posterior freestanding, conventionally cemented prosthetic tooth implants in posterior edentulous spaces using the Bicon Dental Implants system (Bicon Dental Implants). Over four years, 0.74 percent of the abutments loosened, 0.5 percent of the abutments fractured, and 2.47 percent of the crowns experienced porcelain fracture, (all porcelain fractures occurred at time of placement). This low rate of problems appears to make free-standing single-tooth implant restorations a reliable solution to treating posterior edentulism.     

"The view" and the canine connection: an atlas of mandibular anterior tooth esthetics

Restoring splinted mandibular incisors and canines with full crown restorations has always presented a challenge in creating an esthetic illusion of reality of normal individual teeth. This treatise is designed to present the rules for mandibular anterior esthetics that have been distilled from almost 4 decades of clinical practice of restoring dentitions that have been severely compromised by the deformities of disease or accident. The resultant formula systematically creates the desired results with a high degree of predictability.     

Custom characterization of the provisional restoration

The fabrication of esthetic custom provisional restorations that provide optimum esthetics and function accomplished with minimal chairside time is described. The effects of mamelons, translucency, and incisal haloes are reproduced to mimic natural dentition. The technique is based on a provisional shell that is made in the laboratory and relined intraorally for a more precise fit. In addition, it can be characterized chairside to better satisfy the esthetic demands of the patient. The laboratory-processed shell allows us to attain optimal physical characteristics with auto-polymerizing methylmethacrylate resin.     

Intraoral repair of cosmetic restorations

The longevity of porcelain and composite resin restorations can often be prolonged by using sound principles, up-to-date materials, and judicious attention to repair when fracture problems arise. Careful case selection and correct usage of surface treatment agents, followed by the use of a quality bonding system and restorative materials, can result in a repair that exhibits excellent retention and natural color blending. This article outlines procedures and materials to repair both resin composite and porcelain intraorally.     

Incisal edge reattachment: literature review and treatment perspectives

Anterior crown fractures in children and adolescents are a common form of injury, affecting approximately 25% of that population. Common restorative treatments such as composite bonding, laminate veneers, or full-coverage restorations tend to sacrifice healthy tooth structure and challenge dentists to match the adjacent unrestored dentition. Incisal edge fragment reattachment, including the use of current bonding techniques, is a restorative treatment option that offers the advantages of simplicity, immediate esthetics, and conservatism in cases of dental trauma. This article presents a comprehensive literature review on this restorative technique. It also provides diagnostic and treatment algorithms to simplify and clarify the recommended diagnostic and clinical regimens.     

Estradiol, gonadotropins, and tumor markers in ovarian cyst fluid

Amelogenesis imperfecta is a rare dental disease and presents a major challenge to the dentist. With the tremendous advances in the field of esthetic dentistry, especially in bonding to dentin, it is today possible to restore function and esthetics to an acceptable level. The need for full crown preparation has been decreased to an absolute minimum. A case of amelogenesis imperfecta, complicated by a malocclusion, is presented. A combination of periodontal treatment and resin-bonded porcelain onlays and nobel alloys resulted in a highly successful outcome. The virtual absence of enamel was overcome with the aid of dentin bonding.     

The direct/indirect composite resin veneers: a case report

Veneer restorations are well suited for conservative and aesthetic improvement of the anterior dentition. Laboratory fabricated porcelain and composite resin veneers present optimal aesthetics and durability. Although there are disadvantages associated with direct bonding, it provides control of color and contour for the operator, particularly in the case of a single anterior central incisor. Direct/indirect composite resin veneers utilize the advantages of both direct and indirect techniques in reconstruction of restorations with improved physical properties. The learning objective of this article is to review the available composite resins, opaquers, and tints, and present a step-by-step protocol for predictable restoration of discolored anterior dentition with direct/indirect heat-treated composite resin veneers in a single appointment. Patient evaluation, preoperative aesthetic considerations, selection of the restorative composite resins, and the clinical procedure are discussed.