Provisional anterior tooth replacement using nonimpregnated fiber and fiber-reinforced composite resin materials: a clinical report

The loss of anterior teeth is often a serious esthetic concern. While conventional fixed partial dentures and implant-supported restorations may be the treatments of choice, nonimpregnated fibers (NFs) and fiber-reinforced composite (FRC) resins offer a conservative alternative for improving esthetics. This article describes 2 clinical situations in which NF glass ribbon and FRC were successfully used to provisionally restore anterior edentulous areas in an esthetic, functional, and timely manner.     

Deterioration of anterior resin composite restorations in moderate to severe tooth wear patients: 3-year results

Clinical Oral Investigations - Deterioration in anterior resin composite restorations placed in tooth wear patients was investigated after 36 months. Data collected prospectively for 47...     

纤维黏结桥以天然牙牙冠作桥体修复上颌前牙1例

前牙缺失无论给患者生理功能还是心理健康均造成影响,对于前牙缺失的修复也是临床医生一直面临的挑战。本文介绍以自体天然牙牙冠作为纤维黏结桥桥体修复上颌缺失牙1例。     

Direct composite resin restoration of an anterior tooth: effect of fiber-reinforced composite substructure

The aim of the study was to determine the static load-bearing capacity of fractured incisal teeth restored with the conventional adhesive-composite technique or by using fiber reinforced composites (FRC). Upper incisal teeth were prepared by cutting the incisal part of the crown horizontally. Restorations were made by three techniques. Group A (control group) was restored by reattaching the original incisal edge to the tooth. Group B was restored using composite resin. Group C was restored with composite and FRC. Restored teeth were statically loaded until fracture. Results suggest that an incisally fractured tooth restored with a combination of composite resin and FRC-structure provide the highest load bearing capacity.     

Hybrid type anterior fibre-reinforced composite resin prosthesis: a case report

A variety of therapeutic modalities, from implant to conventional Maryland prosthesis, can be used for the replacement of a missing anterior tooth. In patients refusing implant treatment, when minimal teeth reduction is preferred, a fibre reinforced composite (FRC) prosthesis can be a good alternative to conventional prosthetic techniques. The purpose of this case report is to describe the clinical procedure for fabricating hybrid type FRC prosthesis with pre-impregnated unidirectional E-glass fibres. Fibre-reinforced composite, in combination with adhesive technology, appears promising treatment option for replacing missing teeth. However, further clinical investigation will be required to provide additional information on this technique.     

The survival and clinical performance of resin-based composite restorations used to treat localised anterior tooth wear

OBJECTIVE: To examine the clinical performance of resin-based composite restorations placed at an increased vertical dimension when used to manage localised anterior tooth wear. DESIGN: A retrospective analysis of cases treated at a single centre. SETTING: UK Hospital setting in the year 2000. SUBJECTS AND METHODS: Two hundred and twenty five restorations placed in 31 subjects were included. Assessment was made following examination of study casts and projected slides. Modified United States Public Health Services criteria were used and data analysed using the software Statistical Programme for Social Sciences (SPSS). Survival analysis was carried out at two levels, major failure only and all types of failure. Kaplan-Meier survival plots were produced against different variables and modes of failure were also noted. RESULTS: Major failure requiring replacement of the restoration was uncommon within the first five years. Minor failure requiring repair or refinishing presented mainly as wear, marginal discolouration or marginal fracture. Median survival was 4 years 9 months when all types of failure were considered. The restorations have good appearance and are well tolerated. CONCLUSION: Placement of resin-based composite restorations at an increased vertical dimension to treat localised anterior tooth wear, has good short to medium term survival. The technique is conservative and relatively easy to maintain.     

后牙病理性磨损树脂修复的临床效果探讨

目的:观察用直接树脂充填法和间接树脂充填法修复后牙病理性磨损的临床效果。方法:选择后牙牙合面有病理性磨损且具有充填空间的患者48例,患牙144颗,其中有牙本质过敏症状者38例98颗牙。患者按门诊顺序随机分为直接法修复组和间接法修复组2组各24例,在不备洞的情况下分别采用可乐丽菲露复合树脂直接或间接修复,比较治疗3个月及1年后树脂充填的临床效果、牙本质敏感情况和咀嚼效率改变情况。结果:治疗后3个月时复查,直接法和间接法两组患牙树脂充填体A级率无显著性差异(卡方检验,P>0.05);治疗1年后复查,间接法组患牙树脂充填体A级率优于直接法组,两组差异有统计学意义(卡方检验,P<0.05)。间接法组牙本质敏感治疗总有效率优于直接法组,两组差异有统计学意义(卡方检验,P<0.05)。治疗3个月及治疗1年后,间接法组的咀嚼效率高于直接法,两组差异有统计学意义(t检验,P<0.01)。结论:间接树脂法比直接树脂充填法修复后牙病理性磨损有较好的临床效果。     

Fabrication of an individual set of composite resin anterior teeth duplicated from a preserved stone cast: a clinical report

It is often difficult to satisfactorily restore the esthetics of patients' teeth if commercially available artificial acrylic or composite resin anterior teeth are used. A technique for fabrication of an individual set of composite resin teeth for an edentulous patient is described in this clinical report. A diagnostic cast, made before extraction of the original anterior teeth and kept by the patient for over 10 years, was duplicated with a silicone matrix. This technique results in an esthetic match of shape, size, and positioning of the teeth. It also enables the teeth of the prosthesis to be closer to the appearance of the patient's natural teeth than is achievable with premanufactured artificial teeth.     

One-year clinical evaluation of an anterior composite resin.

An anterior composite resin was evaluated in a clinical study of 93 Class III and Class IV restorations placed in patients aged 12 to 50 years. The restorations were evaluated at baseline, 6 months, and 1 year. Sixty-four (79%) of the 81 restorations examined at the 1-year recall were unchanged. Marginal discoloration and changes in surface appearance and marginal adaptation accounted for most of the changes. All changes appeared in patients younger than 14 years, which may indicate that the patients had problems in oral hygiene. Replicas of randomly selected restorations showed smooth surfaces and well-sealed margins with a smooth transition from restoration to enamel. Some restorations showed marginal breakdown and a pitted irregular surface.     

Direct restoration of worn maxillary anterior teeth with a combination of composite resin materials: a case report

Tooth loss, alterations on tooth structure, and reduced vertical dimension are known to severely compromise the stomatognathic system. This case report describes the treatment of a patient who presented with an extremely worn maxillary anterior dentition with a loss of posterior support owing to the loss of almost all the posterior teeth, except the mandibular premolars. Provisional removable partial dentures were used to create an optimum maxillomandibular relationship and to provide restorative space prior to the restoration of the remaining teeth. This restoration was accomplished with a combination of layered hybrid and microfilled composite materials, which restored the maxillary anterior teeth to optimum esthetics and function.     

Use of a pin and bar-retained composite bridge in anterior tooth loss: a case report

A pin and bar-retained composite bridge can be used to replace missing teeth in cases when minimal tooth reduction is desired and patients refuse implant surgery for psychological reasons. This case report describes the clinical procedure for a pin and bar-retained composite bridge as a conservative solution for replacing missing teeth. The location and width of the toothless region, the patient's occlusion state, and poor oral habits may significantly affect the success of this alternative treatment. Compared with other restorative systems, this conservative approach is a minimally invasive technique that has a minimal effect on adjacent teeth.     

Restoration of anterior teeth with indirect composite partial coverage crowns: a clinical report

When an esthetic restoration with minimal tooth reduction is desired, for example in patients with uncomplicated tooth fractures, composite partial coverage crowns may be a therapeutic option. The indirect composite restoration allows restoration of the original tooth anatomy, function, and esthetics to be reproduced while preserving tooth structure. The use of composite partial coverage crowns to restore fractured anterior teeth is described.     

Direct restorative treatment of peg-shaped maxillary lateral incisors with resin composite: a clinical report

This clinical report describes a treatment approach for esthetically restoring peg-shaped lateral incisors. Four patients with peg-shaped lateral incisors were restored with direct resin composite laminate veneers.     

Two-year clinical evaluation of nonvital tooth whitening and resin composite restorations

Background: Adhesive systems, resin composites, and light curing systems underwent continuous improvement in the past decade. The number of patients asking for ultraconservative treatments is increasing; clinicians are starting to reevaluate the dogma of traditional restorative dentistry and look for alternative methods to build up severely destroyed teeth. Purpose: The purpose of this study was to evaluate the efficacy of nonvital tooth whitening and the clinical performance of direct composite restorations used to reconstruct extensive restorations on endodontically bleached teeth. Materials and Methods: Twenty‐one patients 18 years or older were included in this clinical trial, and 26 endodontically treated and bleached maxillary and mandibular teeth were restored using a microhybrid resin composite. Patients with severe internal (tetracycline stains) and external discoloration (fluorosis), smokers, and pregnant and nursing women were excluded from the study. Only patients with A3 or darker shades were included. Teeth having endodontic access opening only to be restored were excluded; conversely, teeth having a combination of endodontic access and Class III/IV cavities were included in the study. A Vita shade guide (Vita Zahnfabrik, Bad Sackingen, Germany) arranged by value order was used to record the shade for each patient. Temporary or existing restorations were removed, along with a 1 mm gutta‐percha below the cementoenamel junction (CEJ), and a resin‐modified glass ionomer barrier was placed at the CEJ. Bleaching treatment was performed using a combination of in‐office (Opalescencextra, Ultradent Products, South Jordan, UT, USA) and at‐home (Opalescence 10% PF, Ultradent Products) applications. Two weeks after completion of the bleaching, the teeth were restored using a combination of PQ1 adhesive system and Vit‐1‐escence microhybrid resin composite (Ultradent Products). Wedge‐shaped increments were placed and cured using the VIP Light (Bisco, Inc Schaumburg, IL, USA) through a combination of pulse and progressive curing techniques. Results: All but one restoration were evaluated by two independent evaluators every 6 months during a 2‐year period using modified US Public Health Service criteria. No restoration failed and “alpha” scores were recorded for all parameters but color stability, which was scored “bravo”. Analysis of variance showed a significant shade change between baseline (mean = 14.4 ± 1.9) versus 2 weeks (mean = 1.6 ± 0.7) and 2 years (mean = 2.8 ± 1.7) (p < .0001). Although a significant shade change was observed between 2 weeks and the 2‐year follow‐up (p= .008), no significant difference was reported between the baseline and 2 weeks (12.9 ± 2) versus baseline and 2 years (11.9 ± 2.3). Conclusions: Significant tooth lightening was reported after the completion of whitening therapy on devitalized teeth; shade rebound was reported in less than 50% of the treated teeth and was limited to a maximum of four shades. A microhybrid resin composite demonstrated excellent clinical performance in the restoration of all endodontically treated and bleached teeth after a 2‐year evaluation period.     

Orthodontic extrusion of an extensively broken down anterior tooth: a clinical report.

A predictable esthetic restoration is not limited to the restored teeth; it has to include the gingival unit and its interface with the teeth involved. Failure to deliver restorations that maintain gingival health jeopardizes the success of any restorative procedure and creates potential for periodontal problems. Perforations, fractures, root resorption, or caries in the cervical area of the tooth, especially in the anterior part of the mouth, present many challenges to the clinician. Failure to place the crown margins on sound tooth material may violate the biologic width and should be considered a restorative failure. Orthodontic root extrusion or forced eruption is a well-documented clinical method for altering the relation between a nonrestorable tooth and its attachment apparatus, elevating sound tooth material from within the alveolar socket. It has some advantages over surgical crown lengthening, which is less conservative considering the sacrifice of supporting bone and the negative change in the length of the clinical crowns of both the tooth and its neighbors. This article presents a case of a maxillary right lateral incisor, extensively broken down following trauma, treated with orthodontic extrusion combined with gingival fiberotomy, without a need for a corrective surgical procedure.