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1.
Ectodermal dysplasia is a heterogeneous genetic condition affecting 1.6 to 22 per 100 000 people. Oral manifestations associated with this condition include hyperdontia, hypodontia, microdontia, and conical teeth. Traditional treatment consists of a combination of orthodontic and rehabilitation therapies. The initial treatment stage uses removable prostheses and interim crowns for long periods, thus increasing risks for developing secondary caries. This clinical report describes the use of direct composite resin bonding with preheated compactable resins applied to vacuum-formed trays filled with clear silicone. This restorative treatment provides predictable, inexpensive, minimally invasive, functional, and esthetic recovery before orthodontic treatment.  相似文献   

2.

Statement of problem

Clinicians are aware that the vertical dimension of occlusion and the interocclusal rest space (IRS) are 2 major factors that require consideration in the management of patients needing oral reconstructive procedures. However, how the dimensions vary with age and prosthetic status is unclear.

Purpose

The purpose of this clinical study was to analyze the IRS in dentate, partially edentulous, and completely edentulous participants using both conventional and electromyographic (EMG)-based methods. The effect of age and prosthodontic status on the clinical and EMG assessment of the IRS was also explored.

Material and methods

The IRS was determined for a group of dentate (n=31) and partially edentate (n=31) participants, as well as a group of completely edentulous (n=31) participants who had worn dentures for at least 10 years before participating in the study. Clinical and EMG-based assessments (monitoring both elevator and depressor activity) were carried out using 5 different methods: rest, relaxing mask, phonetics, deglutition, and myobalance. Bivariate and multivariate analyses (forward stepwise linear regression models) were performed to compare the effect of age and prosthodontic status on the IRS (α=.05).

Results

The average IRS values obtained from clinical and EMG-based assessments were significantly greater among dentate participants (2.8 ±0.4 mm and 3.6 ±0.6 mm, respectively) than partially edentulous (1.9 ±0.5 mm and 2.6 ±0.5 mm) and completely edentulous participants (1.4 ±0.5 mm and 2.2 ±0.6 mm). The IRS values obtained using the 5 methods of clinical assessment were statistically smaller than those obtained by EMG. Correlation and regression analyses showed that age and extended edentulism significantly decreased the IRS. For the IRS determined clinically, a decrease was found of 0.01 to 0.02 mm/year, based on the age of the participant. However, this decrease became greater (0.05 to 0.6 mm) where the participant had changed from being dentate to partially edentulous and partially edentulous to completely edentulous.

Conclusions

The IRS becomes significantly smaller in relation to age and denture extension. The rest position in the clinical examination was located cranial to the position used to make the EMG-based measurement. Small but significant differences were found between the IRS values obtained in the clinical and EMG-based methods of assessment in all the prosthetic groups.  相似文献   

3.

Statement of problem

Bond strength (BS) values from in vitro studies are useful when dentists are selecting an adhesive system, but there is no ideal measuring method.

Purpose

The purpose of this in vitro study was to investigate the influence of the evaluation method in the BS between dentin and composite resin.

Material and methods

Molars with exposed superficial dentin (N=240) were divided into 3 groups according to the test: microtensile (μTBS), microshear (μSBS), and micropush-out (μPBS). Each one was subdivided into 4 groups according to the adhesive system: total etch, 3- and 2-step; and self-etch, 2- and 1-step). For the μPBS test, a conical cavity was prepared and restored with composite resin. An occlusal slice (1.5 mm in thickness) was obtained from each tooth. For the μSBS test, a composite resin cylinder (1 mm in diameter) was built on the dentin surface of each tooth. For the μTBS test, a 2-increment composite resin cylinder was built on the dentin surface, and beams with a sectional area of 0.5 mm2 were obtained. Each subgroup was divided into 2 (n=10) as the specimens were tested after 7 days and 1 year of water storage. The specimens were submitted to load, and the failure recorded in units of megapascals. Original BS values from the μTBS and μSBS tests were normalized for the area from μPBS specimens. Original and normalized results were submitted to a 3-way ANOVA (α=.05). The correlation among mechanical results, stress distribution, and failure pattern was investigated.

Results

Significant differences (P<.05) were found among the adhesive systems and methods within both the original and normalized data but not between the storage times (P>.05). Within the 7 days of storage, the original BS values from μTBS were significantly higher (P<.001) than those from μPBS and μSBS. After 1 year, μSBS presented significantly lower results (P<.001). However, after the normalization for area, the BS values of the μTBS and μPBS tests were similar, and both were higher (P<.001) than that of μSBS in both storage times. In the μSBS and μTBS specimens, cohesive and adhesive failures were observed, whereas μPBS presented 100% of adhesive failures. The failure modes were compatible with the stress distribution.

Conclusions

The storage time did not affect the results, but differences were found among the adhesives and methods. For comparisons of bond strength from tests with different bonding areas, the normalization for area seemed essential. The microshear bond test should not be used for bond strength evaluation, and the microtensile test needs improvement to enable reliable results regarding stress concentration and failure mode. The micropush-out test may be considered more reliable than the microtensile in the bond strength investigation, as demonstrated by the uniform stress concentration and adhesive failure pattern.  相似文献   

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