Marginal discrepancy dimensions of single unit metal crowns fabricated by using CAD-CAM–milled acrylate resin polymer blocks or a conventional waxing technique

Statement of problem

Because crowns with open margins are a well-known problem and can lead to complications, it is important to assess the accuracy of margins resulting from the use of a new technique. Currently, data regarding the marginal fit of computer-aided design and computer-aided manufacturing (CAD-CAM) technology to fabricate a complete gold crown (CGC) from a castable acrylate resin polymer block are lacking.

Repair bond strength and nanoleakage of artificially aged CAD-CAM composite resin

Statement of problem

The polymerization of computer-aided design and computer-aided manufacturing (CAD-CAM) composite resins during their manufacture enhances their physical properties and biocompatibility but might compromise their reparability.

Periodontal evaluation of canines erupted through grafted alveolar cleft defects

Two to eight years after receiving autogenous iliac crest grafts for treatment of alveolar cleft defects, eighteen patients who had unilateral cleft palate were evaluated for their periodontal status. When cleft-associated canines were compared with contralateral control canines, no statistically significant differences were found between specific surface values for plaque index, gingival index, or probing depths. Attachment loss was found to be greater (less than 0.72 mm) on the mesio-facial, facial, and mesio-palatal surfaces of the cleft-associated canines than on the control canines. Fifty-six per cent of the cleft-associated canines required surgical exposure and 44% also required orthodontic assistance to erupt to a functional occlusion. Osseous grafting of alveolar cleft defects resulted in satisfactory clinical periodontal support for cleft-associated canines.     

Anterior maxillary osteotomy in a patient with congenital port-wine stain

A case of anterior maxillary osteotomy in a patient with facial asymmetry associated with a facial and oral port-wine stain is reported. Consideration of the vascular syndromes associated with port-wine stain, and thorough clinical, conventional radiographic, and arteriographic examinations are essential prior to any major orthognathic surgery.     

Effects on the periodontium of vertical bone cutting for segmental osteotomy

The periodontal response to vertical osteotomy was evaluated in seven males and ten females, aged 14-45 years (mean 26.8), who were scheduled for maxillary and/or mandibular segmental osteotomies. Plaque and gingival indices, pocket depth, clinical attachment level, width of attached gingiva, and osseous support were recorded from teeth adjacent to each osteotomy site prior to and from six months to three years after surgery. In each patient teeth numbers 3, 9, 13, 19, 25, and 29 were used as controls. There was no significant (P less than or equal to 0.05) difference between experimental and control teeth with respect to plaque, gingivitis, pocket depth, or clinical attachment level. Slightly decreased osseous support and width of attached gingiva were found adjacent to osteotomy sites. However, although these decreases were statistically significant (P = 0.005), they were not clinically very large. It was concluded that segmental osteotomies, in general, may be performed without producing significant changes in the periodontal structures.     

A primate model for producing experimental alveolar cleft defects

A simplified surgical technique to create an alveolar cleft defect with oronasal communication was developed in 12 female rhesus monkeys. The defects fulfilled the following criteria: 1) a bilateral alveolar cleft with a minimal width of 1 cm; 2) presence of an oronasal communication lined by epithelium; 3) absence of any clinical signs of inflammation within the cleft defect area; and 4) presence of functional teeth on each side of the created defect.     

Brainstem auditory evoked potentials in atypical facial neuralgia

Atypical facial neuralgia is an ill-defined syndrome of obscure etiology characterized by chronic facial pain. The diagnosis is one of exclusion, made only after carefully ruling out a variety of conditions that may cause orofacial pain. The present study detected brainstem abnormalities on the side of the facial pain through examination of brainstem auditory evoked potentials in two out of 12 patients who were clinically diagnosed as having atypical facial neuralgia. The recording of brainstem auditory evoked potentials provides a simple, well-standardized, noninvasive test that may be of value in the investigation of patients who have chronic facial pain.     

Flap design and the LeFort III osteotomy: Blood flow investigation

The effect on local blood flow of flap design in a LeFort III osteotomy was examined in this study. The radioactive microsphere technique was used to make serial flow determinations in two groups of macaque monkeys. The use of seven skin and mucosal incisions was compared with a coronal flap procedure. Significant blood flow reductions to the midface segment were measured when a coronal incision was the sole access in performance of the osteotomies. The findings indicate that the multiple incision approach is more biologically sound than the coronal incision approach in the LeFort III osteotomy. Important information about the surgical techniques can be determined from the data and applied to a more successful performance of the LeFort III osteotomy.     

The influence of simulated aging on the color stability of composite resin cements

Statement of problem

Data for the color stability of dual-polymerized and light-polymerized resin cements used in esthetic dentistry are lacking.

A 3D-printed guide for lateral approach sinus grafting: A dental technique

Lateral approach sinus grafting has become a routine and predictable surgical method of augmenting the pneumatized sinus for implant placement. Outlining the lateral window access can be a challenging task for the clinician to envision and execute. Improper extension and access to the maxillary sinus can prevent proper placement of graft materials and lead to complications. The purpose of this report was to demonstrate a technique that will allow the precise planning of the lateral approach using radiographic information and 3-dimensional (3D) software to 3D-print a surgical guide.     

Prosthetic rehabilitation of a maxillary defect with a bone anchored prosthesis: A clinical report

Mucormycosis is an opportunistic fungal infection that frequently infects sinuses, brain, or lungs and arises mostly in immunocompromised patients. Although its occurrence in the maxilla is rare, debridement and resection of the infected and necrotic area is often the best treatment but usually results in an extensive maxillary defect. Protocols for prosthetic obturation versus microvascular reconstruction have been established and used effectively in tertiary institutions for patients with such large defects. Aramany Class VI defects involving more than half of the palatal surface can be managed effectively by surgical reconstruction using microvascular free flaps as a platform for supporting bone-anchored prostheses. Providing fixed prostheses may offer advantages over a conventional obturator prosthesis in terms of hygiene, function, and esthetics. Nonetheless, fixed prostheses retained by endosseous implants in patients with reconstructive osteomyocutaneous flaps often require a sequential team approach by the surgeon and prosthodontist. This clinical report describes the reconstruction of a maxilla by using a scapular free flap with subsequent prosthetic rehabilitation in a patient with maxillary sinus infection secondary to mucormycosis.     

Comprehensive digital approach with the Digital Smile System: A clinical report

This clinical report describes a comprehensive digital approach with the Digital Smile System (DSS) and its clinical use in the prosthetic treatment of a patient for whom 6 anterior maxillary porcelain veneers were fabricated. Following this digital protocol, extraoral facial images and a diagnostic intraoral digital scan were obtained. Digital smile analysis, virtual diagnostic waxing, and milled trial restorations were made in the diagnostic phase. After tooth preparation, data from digital scans were used in the computer-aided design and computer-aided manufacturing (CAD-CAM) of the definitive restorations.     

Esthetic abutment design for angulated screw channels: A technical report

Angulated screw channel system abutments (ASCs) have recently been introduced to address the problem with visible screw access that may compromise esthetics. ASCs allow the screw access to be modified up to 25 degrees relative to the implant axis. However, a widened channel, which may cause thinning of the facial ceramic, is needed at the implant screw head to allow for proper engagement of the screwdriver. This technical report introduces a custom titanium insert design, the Satoshi Sakamoto (SS) abutment. The SS abutment consists of a custom titanium metal insert and zirconia coping in which the access hole is located in an esthetic position with an ASC system. The SS abutment results in a crown with more normal crown dimensions that also provides more space for the soft tissues. This SS abutment design allows clinicians to obtain screw-retained restorations with optimal esthetics and mechanical strength.