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1.
Sonia K. Makhija James D. Bader Daniel A. Shugars Mark S. Litaker Sanket Nagarkar Valeria V. Gordan D. Brad Rindal Daniel J. Pihlstrom Rahma Mungia Cyril Meyerowitz Gregg H. Gilbert 《Journal of the American Dental Association (1939)》2018,149(4):299-307.e1
Background
A suspicious occlusal carious lesion (SOCL) can be defined as a lesion with no cavitation and no radiographic radiolucency but for which caries is suspected. The authors evaluated whether using a device changed the percentage of SOCLs that were opened surgically and, among those SOCLs that were opened, the proportion that had penetrated into dentin.Methods
Eighty-two dentists participated. In phase 1 of the study, dentists identified approximately 20 SOCLs, obtained patient consent, and recorded information about the lesion, treatment or treatments, and depth, if opened. Dentists were then randomly assigned into 1 of 3 groups: no device, DIAGNOdent (KaVo), and Spectra (Air Techniques). In phase 2, dentists enrolled approximately 20 additional patients and recorded the same phase 1 information while using the assigned device to help make their treatment decisions. A mixed-model logistic regression was used to determine any differences after randomization in the proportion of lesions opened and, if opened, the proportion of lesions that penetrated into dentin.Results
A total of 1,500 SOCLs were enrolled in each phase. No statistically significant difference was found in the change in proportion of lesions receiving invasive treatment from phase 1 to phase 2 across the 3 groups (P = .33) or in the change in proportion of percentage of opened lesions that extended into dentin (P = .31).Conclusion
Caries-detecting devices in the study did not change substantially dentists’ decisions to intervene or the accuracy of the intervention decision in predicting lesion penetration into dentin.Practical Implications
The caries-detecting devices tested may not improve dentists’ clinical decision making for SOCLs. 相似文献2.
Mahshid Majlessi Koopaeei Marita R. Inglehart Neville McDonald Margherita Fontana 《Journal of the American Dental Association (1939)》2017,148(2):64-74
Background
There is a large variation among clinicians when managing deep carious lesions (DCLs). The purpose of this study was to assess general dentists’ (GDs), pediatric dentists’ (PDs), and endodontists’ (EDs) diagnostic methods, clinical decision-making considerations, treatment strategies, and knowledge, behavior, and attitudes related to the diagnosis and treatment of DCLs.Methods
A total of 175 GDs, 511 PDs, and 377 EDs responded to a nationwide Web-based survey.Results
Most EDs (68%) and GDs (47%) practiced complete caries removal. PDs (31%) were more likely than GDs (12%) and EDs (4%) to remove carious tissues partially. Dentin hardness was the most important diagnostic criterion used during caries excavation (GDs, 90%; PDs, 72%; EDs, 88%). Only 30% of GDs, 17% of PDs, and 90% of EDs used diagnostic tests (for example, a cold test) when assessing pupal health. A substantial percentage of respondents considered endodontic treatment as a choice for treating DCLs in asymptomatic teeth in young patients (GDs, 40%; PDs, 30%; EDs, 40%). GDs rarely used a rubber dam when treating these lesions.Conclusions
Most respondents practiced complete caries removal until hard dentin was felt, using hardness as the primary excavation criterion, and did not use pulp diagnostic tests routinely before making decisions about treatment of teeth with DCLs.Practical Implications
Efforts should be made to translate the growing body of evidence supporting the use of conservative caries removal criteria to preserve pulpal health and tooth structure integrity when managing DCLs. 相似文献3.
Maria Auxiliadora Pereira Reginaldo Batista dos Santos-Júnior Johnny Alexandre Tavares Alaíde Hermínia Oliveira Pollyana Caldeira Leal Wilton Mitsunari Takeshita Antônio Márcio Barbosa-Júnior Luiz Eduardo Braga Bertassoni André Luis Faria-e-Silva 《Journal of the American Dental Association (1939)》2017,148(6):369-376
Background
Clinicians often use calcium hydroxide liners during stepwise treatment of advanced caries. In this randomized clinical trial, the authors compared the short-term outcome of stepwise caries removal with and without use of a calcium hydroxide liner in conjunction with provisional resin-modified glass ionomer (RMGI) restorations.Methods
The authors included in the trial 98 patients aged 15 to 30 years who had a deep carious lesion in a posterior tooth. The authors measured the dentin thickness radiographically and recorded its color, consistency, and moisture, as well as the bacterial count of the lesions. After partial caries removal, the authors assigned patients randomly to have their caries provisionally restored using RMGI with (control group) or without (test group) a calcium hydroxide liner. The primary outcome measure was tooth vitality after 90 days. Secondary outcomes included changes in dentinal, radiographic, and microbiological characteristics of the lesions.Results
The authors found no statistically significant difference between the test and control groups in tooth vitality after 90 days. Irrespective of calcium hydroxide liner use, the authors observed darker, harder, drier, and less contaminated dentin after the provisional restorations, but dentin thickness remained unchanged.Conclusions
On the basis of this 3-month clinical trial’s results, the use of a calcium hydroxide liner during stepwise caries excavation and provisional restoration did not provide any additional benefit.Practical Implications
After 3 months, using a calcium hydroxide liner does not appear to offer any additional benefit when clinicians use RMGI provisional restorations during stepwise caries removal. Longer studies are needed to confirm these results. 相似文献4.
Bruce A. Dye Gabriela Lopez Mitnik Timothy J. Iafolla Clemencia M. Vargas 《Journal of the American Dental Association (1939)》2017,148(8):550-565.e7
Background
Except for a small increase in caries prevalence in young children from 1999 through 2004, the prevalence of pediatric caries in the United States has remained consistent for the past 3 decades.Methods
The authors used data from the National Health and Nutrition Examination Survey (NHANES) (from 1999 through 2004 and from 2011 through 2014) to ascertain changes in caries prevalence in youth aged 2 to 19 years. The authors evaluated changes in the prevalence of caries experience, untreated caries, and severe caries (3 or more teeth with untreated caries) in the primary, mixed, and permanent dentition according to poverty status.Results
Untreated dental caries in the primary dentition decreased (24% versus 14%) for children aged 2 to 8 years regardless of poverty status from the period from 1999 through 2004 to the period from 2011 through 2014. Severe caries in primary teeth decreased between the period from 1999 through 2004 and the period from 2011 through 2014 for 2- to 8-year-olds (10% versus 6%). Among preschool-aged children in families with low incomes, caries experience decreased from nearly 42% to 35%, and untreated caries decreased from 31% to 18%. Furthermore, there were significant reductions in the number of carious dental surfaces and significant increases in the number of restored dental surfaces. Overall, there was little change in the prevalence of caries in older children and adolescents.Conclusions
The prevalence of caries in primary teeth in preschool-aged children has improved in the previous decade in the United States; however, the prevalence of having no caries experience in permanent teeth in children and adolescents remains unchanged.Practical Implications
Although the oral health status of young children has improved in the previous decade, few changes have occurred for many older children and adolescents. 相似文献5.
Ramon Targino Firmino Fernanda Morais Ferreira Saul Martins Paiva Ana Flávia Granville-Garcia Fabian Calixto Fraiz Carolina Castro Martins 《Journal of the American Dental Association (1939)》2017,148(8):604-613
Background
The authors systematically reviewed the scientific evidence regarding an association between oral health literacy (OHL) and oral conditions.Types of Studies Reviewed
The authors performed an electronic search of 8 databases up through October 2016, as well as a manual search. The authors included studies in which the investigators evaluated oral conditions and measured OHL through a validated tool and studies in which OHL was an explanatory variable. The authors assessed risk of bias by using the Newcastle-Ottawa Scale.Results
The authors included 10 cross-sectional studies. Risk of bias was high in most studies (n = 6). Dental caries and periodontal status were the most common oral conditions reported (each outcome was reported in 5 studies). Investigators in 4 studies found a statistically significant association between dental caries and lower levels of OHL (P < .05), with investigators in 3 of the studies finding this in primary teeth. A reduced number of teeth and loss of attachment were associated with lower levels of OHL (P < .05). Findings for deep periodontal pockets, bleeding on probing, severity of periodontal disease, history of extractions, dental treatment need, and dental plaque were inconclusive. Investigators barely reported other clinical conditions such as temporomandibular joint problems, oral mucosal lesions, enamel opacities, dental fluorosis, and use of and need for dental prostheses.Conclusions and Practical Implications
There seems to be a weak association between lower levels of OHL and dental caries in primary teeth. Similar findings for adults and between OHL and other oral conditions remain unsubstantiated because the results are controversial, with considerable clinical and statistical heterogeneity between studies. 相似文献6.
Jason Clague Thomas R. Belin Vivek Shetty 《Journal of the American Dental Association (1939)》2017,148(6):377-386
Background
The authors clarified the causal mechanisms underlying the high prevalence of dental disease encountered in people who habitually use methamphetamine (meth).Methods
Using a stratified sampling approach, the authors conducted comprehensive oral examinations and psychosocial assessments for 571 study participants who used meth. Three calibrated dentists, who used National Health and Nutrition Examination Survey (NHANES) protocols, characterized the study participants’ dental disease. The authors also collected data related to study participants’ history of meth use and other attributes linked to dental disease.Results
Study participants who used meth manifested higher rates of xerostomia and caries experience compared with NHANES control participants. Participants who used meth had a higher level of daily consumption of sugary beverages compared with NHANES control participants. Smoking meth did not increase caries experience over other modes of intake. Dental hygiene was a significant determinant of dental health outcomes.Conclusions
Mode of intake and frequency of meth use have a minimal impact on dental health outcomes. Behaviors, such as sugary beverage consumption and poor oral hygiene, better explain dental health outcomes.Practical Implications
Having a better understanding of the causal mechanisms of “meth mouth” sets the stage for clinicians to provide more personalized interventions and management of dental disease in people who use meth. 相似文献7.
Michael T. Brennan Nathaniel S. Treister Thomas P. Sollecito Brian L. Schmidt Lauren L. Patton Kusha Mohammadi Leslie Long Simpson Helen Voelker James S. Hodges Rajesh V. Lalla 《Journal of the American Dental Association (1939)》2017,148(12):868-877
Background
No evidence-based guidelines exist for preventive dental care before radiation therapy (RT) in patients with head and neck cancer (HNC). An ongoing multicenter, prospective cohort study, Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients (OraRad), is addressing this knowledge gap. The authors evaluated the level of dental disease before RT in the OraRad cohort, factors associated with dental disease, and dental treatment recommendations made before RT.Methods
As part of OraRad, the authors assessed caries, periodontal disease, dental recommendations, and dental interventions performed before RT.Results
Baseline measures were reported for 356 participants (77% men) with mean (standard deviation) age of 59.9 (11.0) years. Measures included mean number of teeth (22.9), participants with at least 1 tooth with caries (37.2%), and participants with at least 1 tooth with probing depth 5 millimeters or greater (47.4%). Factors associated with less extensive dental disease before RT included having at least a high school diploma, having dental insurance, history of routine dental care, and a smaller tumor size (T1 or T2). Based on the dental examination before RT, 163 (49.5%) participants had dental treatment recommended before RT, with extractions recommended most frequently.Conclusion
Many patients with HNC require dental treatment before RT; more than one-third require extractions.Practical Implications
Most patients have some level of dental disease at the start of RT, indicating the importance of dental evaluation before RT. By observing dental outcomes after RT, OraRad has the potential to determine the best dental treatment recommendations for patients with HNC. 相似文献8.
Jun Wang Alison M. Muir Yinshi Ren Dawiyat Massoudi Daniel S. Greenspan Jian Q. Feng 《Journal of endodontics》2017,43(1):109-115
Introduction
Mutations in the proteinase bone morphogenetic protein-1 (BMP1) were recently identified in patients with osteogenesis imperfecta, which can be associated with type 1 dentinogenesis imperfecta. BMP1 is co-expressed in various tissues and has overlapping activities with the closely related proteinase mammalian tolloid-like 1 (TLL1). In this study we investigated whether removing the overlapping activities of BMP1 and TLL1 affects the mineralization of tooth root dentin.Methods
Floxed alleles of the BMP1 and TLL1 genes were excised via ubiquitously expressed Cre induced by tamoxifen treatment beginning at 3 days of age (harvested at 3 weeks of age) or beginning at 4 weeks of age (harvested at 8 weeks of age). Multiple techniques, including x-ray analysis, double-labeling with calcein and alizarin red stains for measurement of dentin formation rate, and histologic and immunostaining assays, were used to analyze the dentin phenotype.Results
BMP1/TLL1 double knockout mice displayed short and thin root dentin, defects in dentin mineralization, and delayed tooth eruption. Molecular mechanism studies revealed accumulation of collagens in dentin and a sharp reduction in non-collagenous proteins such as dentin matrix protein 1 and dentin sialophosphoprotein. Furthermore, we found a strong reduction in tartrate-resistant acid phosphatase, which is likely caused by defects in bone cells.Conclusions
BMP1/TLL1 appear to play crucial roles in maintaining extracellular matrix homeostasis essential to root formation and dentin mineralization. 相似文献9.
Cameron G. Estrich Stephen E. Gruninger Ruth D. Lipman 《Journal of the American Dental Association (1939)》2017,148(3):164-171
Background
In this study, the authors compared the odds of exposure to Legionella pneumophila among currently active dental practitioners with that of nonpractitioners and evaluated demographic and clinical practice predictors of exposure.Methods
The authors obtained demographic characteristics and dental practice behaviors from participants in the annual American Dental Association Health Screening Program survey administered from 2002 through 2012. The authors assayed serum samples obtained from participants for L pneumophila antibodies. The authors used an adjusted logit model to evaluate predictors of positive results.Results
Among 5,431 participants, approximately 10% were positive for L pneumophila, with no significant differences between dental practitioners and nonpractitioners. Geographic location was the only significant predictor of seropositivity, with no increased risk of being exposed to L pneumophila associated with age, race, sex, years in practice, hours of practice per week, use of barrier protection, or infection control practices.Conclusions
Prevalence of L pneumophila antibodies was 10.4% among dental and nondental personnel. US Census division was the only significant predictor of seropositivity. The authors conclude that provision of dental care did not increase the risk of being exposed to Legionella.Practical Implications
Dentists should be aware of the prevalence of Legionella species in their practice areas to understand their personal risk of developing an infection. 相似文献10.
R. Constance Wiener Chan Shen Patricia A. Findley Usha Sambamoorthi Xi Tan 《Journal of the American Dental Association (1939)》2017,148(7):500-509.e4
Background
Sugar-sweetened beverages (SSBs) are dietary sources of sugar that are factors in caries development and tooth loss. Dietary sugar also is linked to diabetes mellitus (DM). There is limited research related to SSBs and tooth loss in people with DM. The authors investigated the association between SSBs and tooth loss as it related to the presence or absence of DM.Methods
The authors used a cross-sectional design with data reported by adults (18 years and older) who responded to the 2012 Behavior Risk Factor Surveillance System questionnaire, which was used in 18 states (N = 95,897; 14,043 who had DM and 81,854 who did not have DM). The authors conducted χ2 and logistic regression analyses to determine associations related to DM status.Results
Overall, 12.3% of the survey respondents had DM, 15.5% had 6 or more teeth extracted, and 22.6% reported that they consumed 1 or more SSB daily. In the adjusted analyses, among adults who had DM, those who consumed at least 2 SSBs daily were more likely to have had 6 or more teeth extracted than those who reported that they did not consume SSBs (adjusted odds ratio, 2.35; 95% confidence interval, 1.37 to 4.01; P = .0018). Among adults who did not have DM, those who consumed more than 1 but fewer than 2 SSBs per day were more likely to have had at least 6 teeth extracted (adjusted odds ratio, 1.46; 95% confidence interval, 1.21 to 1.77; P < .0001).Conclusions
The authors found that, among adults with DM, consuming 2 or more SSBs per day was associated with having had 6 or more teeth extracted.Practical Implications
Dietary sugar is a concern for oral and systemic health; however, a strong, independent relationship between the number of teeth extracted and a single source of dietary sugar is not adequate to explain the complexity of tooth loss. Clinicians should use broadly worded dietary messages when discussing caries assessment with patients. 相似文献11.
Yasmi O. Crystal Malvin N. Janal Dylan S. Hamilton Richard Niederman 《Journal of the American Dental Association (1939)》2017,148(7):510-518.e4
Background
The caries arrest that can be achieved by using silver diamine fluoride (SDF) offers a minimally invasive and inexpensive alternative to traditional restorative caries treatment. The authors evaluated how the dentinal staining that is associated with SDF influences the acceptance of this treatment among parents of young children in the New York City metropolitan area.Methods
The authors invited the parents of children who had experienced dental caries and who had appointments at the New York University Pediatric Dentistry Clinic and at several private clinics in New Jersey to participate in a Web-based survey designed to assess parents’ demographics, perceptions of photographs of SDF-treated carious teeth, and acceptability of treatment in different behavior management scenarios.Results
Ninety-eight mothers and 22 fathers from diverse backgrounds participated. Most parents (67.5%) judged SDF staining on the posterior teeth to be esthetically tolerable, but only 29.7% of parents made this same judgment about anterior teeth (P < .001). In the absence of their child having behavioral barriers to conventional restorations, 53.6% of parents reported that they were likely to choose SDF to treat their child’s posterior teeth, but only 26.9% of parents were likely to choose SDF to treat their child’s anterior teeth. As the number of children’s behavioral barriers increased, so did the parents’ level of acceptance. In extreme cases, in which parents had to decide whether their children should undergo general anesthesia during treatment, parents’ acceptance rate of SDF as a treatment method increased to 68.5% on posterior teeth and to 60.3% on anterior teeth. Parents’ acceptance of the treatment also varied according to their socioeconomic status.Conclusions
Staining on posterior teeth was more acceptable than staining on anterior teeth. Although staining on anterior teeth was undesirable, most parents preferred this option to advanced behavioral techniques such as sedation or general anesthesia.Practical Implications
Clinicians need to understand parental sensitivities regarding the staining effect of SDF to plan adequately for the use of SDF as a method of caries management in pediatric patients. 相似文献12.
Gary Goldstein Mark Andrawis Mijin Choi Jonathan Wiens Malvin N. Janal 《The Journal of prosthetic dentistry》2017,117(3):426-429
Statement of problem
The definition of centric relation (CR) has been both controversial and divisive, with little consensus.Purpose
The purpose of this study was to determine whether agreement can be reached on a definition for CR among the Fellows of the Academy of Prosthodontics, the organization that writes the Glossary of Prosthodontic Terms.Material and methods
A survey of the Fellows of the Academy of Prosthodontics was conducted at the organization’s annual business meeting.Results
Of the 83 eligible Fellows in attendance, 72 responded to the survey, a response rate of 86%. Of those, the 5 responders who did not indicate a preferred definition and the 2 that chose 2 definitions were censored, yielding an analyzable sample of 65 for the definitions. The most common definition received 19 votes, the next 16, and the third 13, with the other 6 definitions receiving from 2 to 5 votes. Some of the variability in definition depended on the era of training.Conclusions
Disagreement and confusion continues regarding the definition of centric relation. Some of this disagreement can be explained by training era. 相似文献13.
Travis Nelson Amelia Chim Barbara L. Sheller Christy M. McKinney JoAnna M. Scott 《Journal of the American Dental Association (1939)》2017,148(7):485-492
Background
The authors evaluated the effectiveness of a dental desensitization program for children with autism spectrum disorder (ASD) and determined characteristics associated with a successful dental examination.Methods
The authors performed a retrospective review of clinical behavioral data and previsit questionnaires for 168 children with ASD who attended a university-based dental desensitization program. Data elements included demographic, treatment, and behavioral characteristics. The primary outcome was receiving a minimal threshold examination (MTE) while seated in a dental chair.Results
An MTE was achieved for 77.4% of all children within 1 to 2 visits and 87.5% in 5 visits or less. Several factors predicted a successful dental examination: ability to be involved in group activities (relative risk [RR], 1.18; P = .02), ability to communicate verbally (RR, 1.17; P < .01), understanding of most language (RR, 1.14; P = .02), moderate versus severe caregiver-rated ASD severity (RR, 1.24; P = .04), and ability to dress self (RR, 1.27; P = .04).Conclusions
Desensitization was effective in achieving an MTE for most children. Those with characteristics consistent of a milder presentation of ASD were more likely to be successful.Practical Implications
Desensitization can be a successful approach to providing dental care for children with ASD. 相似文献14.
Min Chen Kaiyu Fu Feng Qiao Xu Zhang Yi Fan Lijun Wang Peng Li Zhou Wu Ligeng Wu 《Journal of the American Dental Association (1939)》2017,148(10):737-742
Background
In this study, the authors investigated whether extension of a tooth crack into the root can be predicted by the appearance of the crack in the crown in vitro.Methods
The authors obtained 22 cracked teeth from 22 patients who underwent extraction, and they scanned the teeth using microcomputed tomography. The length and width of the crack on the occlusal surface (LOS and WOS, respectively) and the length of the crack on the proximal surface (LCPS) were measured on 3-dimensional reconstruction images. The pulp chamber roof was penetrated and removed. A crack line visible under the microscope only on the access cavity wall rather than extending to the bottom of the pulp chamber was termed a “nonroot crack.” A crack seen at the bottom of the pulp chamber or root wall was termed a “root crack.” The authors analyzed the data using Pearson correlation coefficients and receiver operating characteristic curves.Results
There was a significant correlation between the LOS and LCPS (correlation coefficient, 0.782; P < .001) and between the WOS and LCPS (correlation coefficient, 0.651; P < .05). The LCPS increased by 1.195 millimeters for every 1-mm increase in the LOS. The area under the receiver operating characteristic curve was 0.839 (95% confidence interval, 0.659 to 1.000) for LOS and 0.760 (95% confidence interval, 0.557 to 0.964) for WOS.Conclusions
The extent of a crown crack may indicate how far the crack extends to the root. Both the LOS and WOS may be valuable for assessing whether a crack involves the root, although the LOS seems to be more useful.Practical Implications
The dimensions of a crack in a crown provide a helpful approach for predicting the depth of the crack and its likely prognosis. 相似文献15.
16.
Marcelo Coelho Goiato Henrique Rinaldi Matheus Rodrigo Antonio de Medeiros Daniela Micheline dos Santos Sandro Basso Bitencourt Aldiéris Alves Pesqueira 《The Journal of prosthetic dentistry》2017,117(5):685-689
Statement of problem
The rehabilitation of patients after a maxillectomy involves the use of an obturator to seal oral-nasal-sinus communication and to facilitate mastication, swallowing, and speech.Purpose
The purpose of this in vitro study was to evaluate different attachment systems used for implant-retained obturators at dissipation loads and under shear forces.Material and methods
Photoelastic models were fabricated with 3 external hexagon implants at the incisor, canine, and first molar regions. Subsequently, overdentures were made, and metal hooks were placed at the incisor and first molar regions to displace the prostheses in the vertical, anterior, and posterior directions, with a constant speed of 50 mm/min. A photoelastic model with an O-ring or bar-clip system was placed in a circular polariscope, and tested with a universal testing machine. The images were recorded and high-intensity fringes were counted using software. For strain gauge analysis, each strain gauge was placed horizontally at the mesial and distal sides of the implants. The registered strains were submitted to 2-way ANOVA (α=.05).Results
The O-ring showed the lowest number of high-intensity fringes in photoelastic imaging, while the strain gauge analysis showed the lowest stress values in the bar-clip group (P=.007).Conclusions
The stress around titanium implant necks was more damaging to surrounding bone, while the bar-clip attachment system had a better biomechanical performance. The bar-clip presented the lowest strain values around the dental implants and few high-intensity fringes. 相似文献17.
Wenzhi Niu Penglai Wang Shaoyue Zhu Zongxiang Liu Ping Ji 《The Journal of prosthetic dentistry》2017,117(1):34-40
Statement of problem
Whether microthreads in the crestal portion can reduce the amount of marginal bone loss (MBL) around implants has not yet been determined.Purpose
The purpose of this systematic review was to investigate the marginal bone loss around dental implants with and without microthreads in the neck.Material and methods
This review was based on the PRISMA guidelines. An electronic search with no restrictions on language was performed from inception to August 19, 2015, in PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Web of Sciences, and AMED (Ovid) databases. A manual search was also performed. Randomized clinical trials (RCTs) that compared the MBL between implants with and without microthreads in the neck were included. Qualitative synthesis and meta-analysis were performed. MBL was measured by using the mean difference (MD). Review Manager v5.3 software was used for meta-analysis (α=.05).Results
Five articles were included in the qualitative synthesis, and 3 articles were included in the meta-analysis. Four studies found that a microthread design can significantly reduce MBL under functional loading, whereas 1 study found no signi?cant difference. The homogeneity test of meta-analysis confirmed acceptable heterogeneity among the 3 studies (I2=0.49). A random-effects model was used. The result shows that MBL around implants with microthread design can be reduced signi?cantly (P=.030; MD: ?0.09; CI: ?0.18 to ?0.01).Conclusions
Meta-analysis showed that microthread design in the implant neck can reduce the amount of MBL; however, RCTs included in the review were few and the difference was small. In clinical practice, an implant with a roughened surface and microthreaded neck could be selected to maintain bone level. 相似文献18.
Bjørn Einar Dahl Hans Jacob Rønold Jon E. Dahl 《The Journal of prosthetic dentistry》2017,117(3):400-404
Statement of problem
Whether single crowns produced by computer-aided design and computer-aided manufacturing (CAD-CAM) have an internal fit comparable to crowns made by lost-wax metal casting technique is unknown.Purpose
The purpose of this in vitro study was to compare the internal fit of single crowns produced with the lost-wax and metal casting technique with that of single crowns produced with the CAD-CAM technique.Material and methods
The internal fit of 5 groups of single crowns produced with the CAD-CAM technique was compared with that of single crowns produced in cobalt-chromium with the conventional lost-wax and metal casting technique. Comparison was performed using the triple-scan protocol; scans of the master model, the crown on the master model, and the intaglio of the crown were superimposed and analyzed with computer software. The 5 groups were milled presintered zirconia, milled hot isostatic pressed zirconia, milled lithium disilicate, milled cobalt-chromium, and laser-sintered cobalt-chromium.Results
The cement space in both the mesiodistal and buccopalatal directions was statistically smaller (P<.05) for crowns made by the conventional lost-wax and metal casting technique compared with that of crowns produced by the CAD-CAM technique.Conclusions
Single crowns made using the conventional lost-wax and metal casting technique have better internal fit than crowns produced using the CAD-CAM technique. 相似文献19.
Yooseok Shin Sungho Park Jeong-Won Park Kwang-Mahn Kim Young-Bum Park Byoung-Duck Roh 《The Journal of prosthetic dentistry》2017,117(1):109-115
Statement of problem
The marginal and internal discrepancies of computer-aided design and computer-aided manufacturing (CAD-CAM) endocrowns are unknown.Purpose
The purpose of this in vitro study was to evaluate the marginal and internal discrepancies of endocrowns with different cavity depths by measuring them with microcomputed tomography (μCT).Material and methods
Endocrowns (n=48) of 2 different cavity depths (2 mm and 4 mm) were fabricated in 2 different chairside CAD-CAM systems (CEREC AC and E4D). A μCT scan was made before and after cementation. For analysis of the marginal and internal discrepancies, reference points were selected in 2-dimensional views of 3 buccolingual cross-sections and 3 mesiodistal cross-sections. To calculate the total discrepancy volume, the μCT sections were reconstructed 3-dimensional views, and changes in volume and surface area were examined. Statistical analysis was performed using 2-way ANOVA with Bonferroni correction (α=.05).Results
An endocrown with a 4-mm cavity showed a larger marginal and internal volume than one with a 2-mm cavity. Cementation did not show significant differences in total discrepancy thickness. Discrepancies on the pulpal floor were largest in other sites. Both chairside CAD-CAM systems showed similar discrepancy in the endocrowns.Conclusions
Based on the present study, marginal and internal discrepancies increased depending on cavity depth. Cementation did not increase the dimension of the discrepancy between the restoration and the cavity wall. The discrepancy on the pulpal floor appeared to affect these results. 相似文献20.