Survival analysis of crown margin repair: A retrospective study in a dental school setting

BackgroundRepairing crowns with defective margins is minimally invasive and cost-effective compared with replacement. The authors’ objectives were to examine the survival trajectory of crown margin repairs and to determine the factors associated with survival.MethodsRecords of adult patients from January 2008 through August 2019 were reviewed for crown margin repairs completed at University of Iowa College of Dentistry. A total of 1,002 crown margin repairs were found. Each repair was followed through the end of study in 2019 or until an event (for example, additional repair, endodontic treatment, crown replacement, or extraction). A Cox proportional hazards model was used to study the relationship between selected covariates and time to event.ResultsDuring the follow-up period, 32.8% of the repairs needed reintervention. In the final model, repair material was the only significant covariate. No difference was found between the survival of repairs done with resin-modified glass ionomer and amalgam. However, the repairs done with resin-based composite and conventional glass ionomer were more likely (1.5 times: 95% CI, 1.02 to 2.10 times; and 2 times: 95% CI, 1.40 to 2.73 times, respectively) to need reintervention than were those done with amalgam.ConclusionsMedian survival time of crown margin repairs was 5.1 years (95% CI, 4.48 to 5.72 years). Median survival times for amalgam, resin-modified glass ionomer, resin-based composite, and glass ionomer repair materials were 5.7 years (95% CI, 4.80 to 6.25 years), 5.3 years (95% CI, 4.73 to 6.34 years), 3.2 years (95% CI, 2.51 to 6.19 years), and 3.0 years (95% CI, 2.53 to 3.62 years), respectively.Practical ImplicationsWhen considering crown margin repairs, resin-modified glass ionomer or amalgam is preferable to resin-based composite or glass ionomer.     

Selective Laser Melting of Al-Based Matrix Composites with Al2O3 Reinforcement: Features and Advantages

Aluminum matrix composites (AMC) are of great interest and importance as high-performance materials with enhanced mechanical properties. Al₂O₃ is a commonly used reinforcement in AMCs fabricated by means of various technological methods, including casting and sintering. Selective laser melting (SLM) is a suitable modern method of the fabrication of net-shape fully dense parts from AMC with alumina. The main results, achievements, and difficulties of SLM applied to AMCs with alumina are discussed in this review and compared with conventional methods. It was shown that the initial powder preparation, namely the particle size distribution, sphericity, and thorough mixing, affected the final microstructure and properties of SLMed materials drastically. The distribution of reinforcing particles tends to consolidate the near-melting pool-edges process because of pushing by the liquid–solid interface during the solidification process that is a common problem of various fabrication methods. The achievement of an homogeneous distribution was shown to be possible through both the thorough mixing of the initial powders and the precise optimization of SLM parameters. The strength of the AMCs fabricated by the SLM method was relatively low compared with materials produced by conventional methods, while for superior relative densities of more than 99%, hardness and tribological properties were obtained, making SLM a promising method for the Al-based matrix composites with Al₂O₃.     

Development of a protocol for maintaining viability while shipping organoid‐derived retinal tissue

Retinal organoid technology enables generation of an inexhaustible supply of three‐dimensional retinal tissue from human pluripotent stem cells (hPSCs) for regenerative medicine applications. The high similarity of organoid‐derived retinal tissue and transplantable human fetal retina provides an opportunity for evaluating and modeling retinal tissue replacement strategies in relevant animal models in the effort to develop a functional retinal patch to restore vision in patients with profound blindness caused by retinal degeneration. Because of the complexity of this very promising approach requiring specialized stem cell and grafting techniques, the tasks of retinal tissue derivation and transplantation are frequently split between geographically distant teams. Delivery of delicate and perishable neural tissue such as retina to the surgical sites requires a reliable shipping protocol and also controlled temperature conditions with damage‐reporting mechanisms in place to prevent transplantation of tissue damaged in transit into expensive animal models. We have developed a robust overnight tissue shipping protocol providing reliable temperature control, live monitoring of the shipment conditions and physical location of the package, and damage reporting at the time of delivery. This allows for shipping of viable (transplantation‐competent) hPSC‐derived retinal tissue over large distances, thus enabling stem cell and surgical teams from different parts of the country to work together and maximize successful engraftment of organoid‐derived retinal tissue. Although this protocol was developed for preclinical in vivo studies in animal models, it is potentially translatable for clinical transplantation in the future and will contribute to developing clinical protocols for restoring vision in patients with retinal degeneration.     

Objective evaluation of abutment tooth preparation for preformed metal crowns for primary molars in Japanese preclinical training

Evaluation of abutment tooth shape for preformed metal crowns for primary teeth in preclinical training depends on the subjective opinion of the instructor providing the training. Thus, the student's grade will likely vary according to teacher grading. In this study, we explored the potential for objective evaluation by comparing evaluations performed by teaching personnel (teacher grading) of abutment teeth for preformed metal crowns for primary teeth prepared by students at a dental school with evaluation by a three-dimensional (3D) laser morphometric system (system grading). The subjects of the evaluations were 139 abutment teeth for preformed metal crowns for primary teeth that had been prepared by fourth-year students at Asahi University School of Dentistry during preclinical pediatric dentistry training. A tooth prepared by a teacher following instruction criteria was used as the reference tooth, and system grade points were calculated from deductions made for insufficient and excessive cutting. Teacher grade points varied among teachers. We found that teachers prioritized contours of the margin, buccal and lingual sides, and adjacent surfaces in their evaluations. System grading showed that most students carried out insufficient cutting. The mean (SD) teacher and system grade points were 57.7 (9.7) and 75.7 (4.7), respectively, and these grade points were positively correlated (r = 0.500). System grading provides a simple 3D visual assessment of insufficient and excessive cutting that can be used for instructing students.     

Current status and perspective of CAD/CAM-produced resin composite crowns: a review of clinical effectiveness

The purpose of the present review was to survey the available literature on computer-aided design/computer-aided manufacturing (CAD/CAM)-produced resin composite materials to provide clinicians with a current overview of the key components necessary for daily clinical use. An electronic search was conducted in the PubMed database. Peer-reviewed articles in English language on the use of resin composites in CAD/CAM dental crowns were included. A total of 122 full-text articles were identified, 15 of which were selected during the initial review. Two additional articles were also discovered through a manual search, to obtain a final total of 17 articles included in the present review. Of these, 16 were to in vitro studies, and one was an in vivo study. Findings from the in vitro studies indicate that resin composite block materials for CAD/CAM applications demonstrate excellent physical properties and are appropriate for the clinical restoration of premolars and molars. However, the in vivo study reported a low 3-year success rate, but high survival rate for resin composite CAD/CAM crowns placed in the premolar region. The key to ensuring the successful prognosis of a resin composite CAD/CAM crown is to ensure that all steps—such as proper case selection, abutment tooth preparation, occlusal adjustment, and bonding—are accurately performed.     

All-ceramic restorations: A review of the literature

ObjectivesCeramics can simulate the visual character of the tooth substance successfully and are biocompatible materials. However, a wide range of ceramic materials and systems on the market are available for use in dentistry. Therefore, it is the aim of this article to provide an overview of dental ceramics, their classifications, methods of construction, and clinically relevant aspects that enable the reader to select the most appropriate ceramic for a particular clinical situation.Material and methodsThe PubMed (MEDLINE) search engine was used to gather the most recent information on dental ceramics. The search was restricted to a ten-year period (January 1, 2010–December 31, 2019) and only English-language studies. A Boolean search of the PubMed data set was implemented to combine a range of keywords: (ceramics OR all-ceramics OR dental porcelain OR polycrystalline OR porcelain fused to metal OR ceramometal OR procera OR e max OR zirconia OR In-ceram OR Inlays OR Onlays OR Overlays OR Endocrown) AND (survival rate OR success rate OR clinical outcomes OR classification) AND (humans). Studies were also obtained by manual searches and from Google Scholar.ResultsBy using this process, 2173 articles and studies were obtained. More studies were also obtained by manual searches and from Google Scholar. The most relevant published studies were chosen and used in the current review.ConclusionAll-ceramic restoration use has increased in recent years. This increase has been attributed to patients’ demand for good aesthetics and an improvement in the materials’ mechanical and aesthetic properties as well as to required minimally invasive tooth preparation and the methods of fabrication. The success of ceramic restorations depends on several factors, such as selection of material, restoration design, occlusion, and cementation media.