Use of an Immediate Provisional Implant to Support a Full-Arch Interim Restoration: A Clinical Report

The use of provisional implants as the sole or adjunct mean of stabilization for interim fixed partial dentures has gained popularity in implant prosthodontic treatment. These implants can be used between submerged implants during the healing phase to provide support for interim fixed or removable partial dentures. In this clinical report, a provisional implant used to provide support for a full-arch fixed interim restoration is described. Positioned between adjacent conventional implants, the provisional implant was placed during the same surgical procedure. As a result, an immediate acrylic fixed partial denture supported by natural teeth and the provisional implant provided a comfortable and esthetic interim restoration during the osseointegration period.     

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。     

Multidisciplinary Approach for Autotransplantation and Restoration of a Maxillary Premolar into an Area of an Avulsed Anterior Tooth: A Case Report with a 6-Year Follow-up

The loss of an anterior tooth because of avulsion has been reported in up to 3% of dental injuries. Management alternatives, such as implant-supported restorations and a fixed partial denture, are contraindicated in growing patients because of the continuous growth of the alveolar process. At the same time, orthodontic treatment for gap closure will result in asymmetry and will require adjustment of the adjacent healthy teeth. Therefore, restoring a missing tooth imposes a treatment challenge, especially in children and young adults. Tooth autotransplantation is a treatment modality with high reported survival and success rates that overcome these mentioned limitations. It might also help to preserve the alveolar bone and the soft tissues. This case report describes a multidisciplinary approach for managing a 13-year-old boy who lost his right maxillary central incisor because of a fall. Management included autotransplantation of the left maxillary second premolar to the site of the lost right maxillary central incisor, management of external inflammatory resorption with an endodontic treatment, orthodontic treatment, and aesthetic restoration of the area with composite resin crowns that can be adapted to the expected changes of the jaws during the craniofacial growing period. At the 6-year follow-up, the teeth demonstrated a positive outcome.     

Intrusion of Supraerupted Maxillary Molar Using a High Interim Restoration on the Defective Opposing Tooth: A Clinical Report

Wear, extraction, or fracture of all or part of a mandibular first molar can lead to the supraeruption of the opposing maxillary molar, resulting in occlusal interference and lack of restoration space. This report describes a method to gain sufficient vertical space for permanent restoration. A direct composite resin restoration was placed on the occlusal surface of a lower molar, intentionally making the interim restoration high and intruding the maxillary molar. After 6 weeks, the extruded tooth returned to the desired position, and functional occlusion was restored, enabling a ceramic restoration on the mandibular molar. No marked adverse sensory reaction was reported in this therapeutic process, and no deleterious signs were detected in the teeth, periodontium, or temporomandibular joints. The simple treatment type was effective, noninvasive, and time saving, while also preserving maximum tooth structures.     

Provisional implants: a clinical prospective study in 45 patients, from implant placement to delivery of the final bridge

Background: Protocols for submerged healing of dental implants often require the patient to have no teeth until suture removal and to wear a removable prosthesis during the remaining healing period. This may be inconvenient for the patient, and healing may be influenced negatively by the removable prosthesis. Purpose: The aim of the present prospective clinical study was to evaluate the use of provisional implants (PIS) to provide patients with a provisional fixed bridge during the healing of permanent implants. Materials and Methods: Twenty female and 25 male patients were consecutively included in the study. The 45 patients were treated for either partial (16 patients) or total (29 patients) edentulism in the maxilla. The permanent implants were placed first; as many PIS as possible were then installed between the permanent implants. After suturing, impressions from which to manufacture provisional bridges (to be cemented to the PIS) were taken. The patients were monitored with clinical and radiographic follow‐up from implant placement to delivery of the final prosthesis. Results: Five (2.2%) of the 230 permanent Brånemark System® implants (Nobel Biocare AB, Gothenburg, Sweden) did not integrate. None of the failures could be related to the presence of PIS between the permanent implants. Seven PIS failed during the observation period. In addition, 17 (9%) of the 192 PIS showed mobility at the second‐stage surgery although they had supported the provisional bridges without clinical symptoms. Forty‐four of 45 patients showed stabile PI bridges at the time of second‐stage surgery. Conclusion: Based on our experiences we concluded that provisional implants can be successfully used to provide patients with a fixed provisional bridge during the healing of permanent implants.     

A Novel Approach to Repositioning and Stabilization of a Luxated Tooth With Displacement Using a 3D Printed Guide

The management of traumatic dental injury aims at functional and esthetic rehabilitation. After luxation injury, a displaced tooth must be replaced into its normal position as soon as possible. Incorrect tooth repositioning can cause discomfort to the patient and compromise the outcome. This report documents a novel digital technology–based approach for the management of teeth following luxation injury with displacement. A 25-year-old female reported 2 days after traumatic dental injury to her maxillary right central incisor tooth #8. After clinical and radiographic examination, a diagnosis of lateral luxation of tooth #8 was made. The preoperative high-resolution cone-beam computed tomography (CBCT) image data set confirmed palatal luxation of tooth #8 with fractured and displaced labial cortical plate. The CBCT data were imported into a medical image processing software program, and a segmentation tool was used to segment the fractured cortical plate, luxated tooth, and alveolar process. The socket is reconstructed by realigning fractured cortical bone over the alveolar process and repositioning the tooth in the virtual planning software. A three-dimensional (3D) guiding template was designed over the repositioned tooth and adjacent teeth and printed. This 3D printed guide was used for the repositioning of luxated tooth #8 and stabilizing it during the splinting procedure. This technique of using CBCT and 3D guide for repositioning is an objective, precise, and predictable approach. The 3D printed model of the dental arch after virtual tooth alignment can be used by the dentist to determine the exact splint length and contour before splinting.     

Fracture Strength and Failure Mode of Maxillary Implant-Supported Provisional Single Crowns: A Comparison of Composite Resin Crowns Fabricated Directly Over PEEK Abutments and Solid Titanium Abutments

Background: Polyetheretherketone (PEEK) temporary abutments have been recently introduced for making implant‐supported provisional single crowns. Little information is available in the dental literature on the durability of provisional implant‐supported restorations. Purpose: The objectives of this study were to evaluate the fracture strength of implant‐supported composite resin crowns on PEEK and solid titanium temporary abutments, and to analyze the failure types. Material and Methods: Three types of provisional abutments, RN synOcta Temporary Meso Abutment (PEEK; Straumann), RN synOcta Titanium Post for Temporary Restorations (Straumann), and Temporary Abutment Engaging NobRplRP (Nobel Biocare) were used, and provisional screw‐retained crowns using composite resin (Solidex) were fabricated for four different locations in the maxilla. The specimens were tested in a universal testing machine at a crosshead speed of 1 mm/minute until fracture occurred. The failure types were analyzed and further categorized as irreparable (Type 1) or reparable (Type 2). Results: No significant difference was found between different abutment types. Only for the position of the maxillary central incisor, composite resin crowns on PEEK temporary abutments showed significantly lower (p < 0.05) fracture strength (95 ± 21 N) than those on titanium temporary abutments (1,009 ± 94 N). The most frequently experienced failure types were cohesive fractures of the composite resin crowns (75 out of 104), followed by screw loosening (18 out of 104). According to reparability, the majority of the specimens were classified as Type 1 (82 out of 104). Type 2 failures were not often observed (22 out of 104). Conclusions: Provisional crowns on PEEK abutments showed similar fracture strength as titanium temporary abutments except for central incisors. Maxillary right central incisor composite resin crowns on PEEK temporary abutments fractured below the mean anterior masticatory loading forces reported to be approximately 206 N.     

Tooth autotransplantation using an interdisciplinary approach to rehabilitation in a young patient: Case report with 7-year follow-up

This case report demonstrates the possibility of functional and aesthetic rehabilitation using an interdisciplinary approach in a child following avulsion of a tooth. Autotransplantation after the development of calcific metamorphosis of the pulp and acute apical periodontitis provided satisfactory repair after root canal treatment. A 7-year-old white boy avulsed the right maxillary central incisor (tooth 11). The extra-alveolar time exceeded 60 minutes, and this triggered external replacement resorption of the avulsed tooth. At 11 years of age, the child underwent tooth autotransplantation. After 4 years of follow-up, intraoral clinical and radiographic examination led to the diagnosis of calcific metamorphosis of the pulp and acute apical periodontitis. The patient had minimally invasive root canal treatment, orthodontic treatment and esthetic rehabilitation with a porcelain crown. Control periapical radiography and tomography of the autotransplanted tooth after 7 years revealed bone repair in the periapical region. This case report indicates that tooth autotransplantation can be used to replace anterior teeth after avulsion followed by replacement resorption. Interdisciplinary management helped to maintain the esthetics and function of the rehabilitated area.     

Tooth splinting: a review of the literature and consideration of the versatility of a wire-composite splint

Abstract The principles of tooth luxation splinting have been changed since the animal and human tests conducted in the early 1970s showed that masticatory stimulus promotes healing of luxated teeth and normally exerted occlusal forces are able to prevent and eliminate small resorption cavities on the root surface. It has also been shown that fixation of only one week is enough to achieve the clinical healing of repositioned teeth. Apart from esthetic and hygienic components, present-day demands on tooth fixation techniques also include ease of construction and removal and the use of devices which allow slight movement of the fixed teeth. This paper presents the history of tooth splinting, our present-day knowledge of the subject, and introduces various splinting techniques. The wide range of indications for a flexible wire-composite splint are analyzed more thoroughly.     

Evaluation of Colour Stability of Provisional Restorative Materials Exposed to Different Mouth Rinses at Varying Time Intervals: An In Vitro Study

The most important factor affecting esthetics is colour. Whether a definitive prosthesis or a provisional restoration, maintenance of esthetics is of prime concern along with restoration of function. Colour stability of provisional prosthesis is affected by various factors and various studies are documented in the literature on this. The purpose of this study was to evaluate the colour stability of provisional restorative materials exposed to different mouth rinses at varying time intervals. 120 discs, each of self cure tooth moulding material, Protemp 4 and Revotek LC were prepared and immersed in two mouth rinses, hexidine and periogard and evaluated for their colour stability after 1 week, 1 and 3 months. The data obtained was statistically analysed using ANOVA and Tukey’s post hoc analysis. The results indicate that there is a significant difference in the colour variation of various materials in two different mouth rinses at different time intervals. Revotek LC was found to be the most colour stable material and periogard had the least staining potential at varying time intervals.     

Fabrication of an Implant‐Supported Fixed Interim Prosthesis Using a Duplicate Denture: An Alternative Technique

The fabrication of an implant‐supported fixed complete denture prosthesis involves multiple clinical and laboratory steps. One of the main steps is to provide the patient with an interim fixed prosthesis to evaluate the patient's esthetic and functional needs as well as to enhance the patient's psychology before proceeding to the definitive prosthesis. Different techniques for fabricating interim prostheses have been described in the literature. This report describes an alternative technique that uses a duplicate denture made of self‐curing acrylic resin to fabricate an implant‐supported fixed interim prosthesis. The interim prosthesis was later used as a blueprint for the definitive implant‐supported hybrid prosthesis.     

The Use of 3D Printed Tooth Preparation to Assist in Teaching and Learning in Preclinical Fixed Prosthodontics Courses

Tooth preparation for fixed dental prostheses is not an easy procedure to understand spatially, especially for first‐year dental students. This technical report describes an innovative technique for assisting learning in preclinical fixed prosthodontics courses. Ideal full‐contour tooth preparations are digitally scanned and 3D printed to the exact specifications of the ideal preparation. Students and faculty use these printed tooth preparations as teaching and learning tools to facilitate in 3D visualization for fixed prosthodontics courses.     

Telescopic Overdenture Supported by a Combination of Tooth and an Implant: A Clinical Report

The conventional modality of treatment of partial edentulousness with reduced number of teeth was to render them complete edentulous and provide them complete denture or an overdenture with support of few remaining teeth. The goal of maintenance of roots are to prevent alveolar bone resorption, provide better load transmission, maintain sensory feedback and achieve better stability of denture with emphasis on psychological aspect of not being completely edentulous. Over the recent past titanium dental implants have been successfully used as tooth replacement with predictable results. A combination of tooth and implant support is well documented for fixed partial dentures but rarely for overdentures. This clinical report aims at evaluation of tooth root and implant supported mandibular overdenture treatment with telescopic coping.     

Predictable esthetic treatment of fractured anterior teeth: a clinical report

Dental fractures of the permanent maxillary anterior teeth are relatively frequent accidents during childhood. Placement of direct composite restorations allows clinicians a conservative method of restoring fractured anterior teeth to the original shape and color. A methodical protocol for the restoration of a fractured maxillary left central incisor of a 7-year-old girl is presented. As a temporary treatment, pulpal protection and the use of an acetate crown with glass-ionomer cement were performed. As a definitive treatment, diagnostic waxing and a silicone matrix formed the basis for successful reconstruction of the fractured tooth with composite resin. After finishing and polishing, an esthetic and natural-looking restoration was achieved, which completely satisfied the functional and esthetic expectation of the patient and dental team.     

Tooth loss and intakes of nutrients and foods: a nationwide survey of Japanese dentists

Wakai K, Naito M, Naito T, Kojima M, Nakagaki H, Umemura O, Yokota M, Hanada N, Kawamura T. Tooth loss and intakes of nutrients and foods: a nationwide survey of Japanese dentists. Community Dent Oral Epidemiol 2010; 38: 43–49. © 2009 John Wiley & Sons A/S   Abstract – 
Objectives:  To clarify the association of tooth loss with dietary intakes among dentists, for whom sufficient dental care is available.
Methods:  We analyzed the data from 20 366 Japanese dentists (mean age ± SD, 52.2 ± 12.1 years; women 8.0%) who participated in a nationwide cohort study from 2001 to 2006. The baseline questionnaire included a validated food-frequency questionnaire to estimate intakes of foods and nutrients. We computed the geometric means of daily intakes by the number of teeth, adjusting for age, sex, smoking, physical activity, and history of diabetes.
Results:  The mean intakes of some key nutrients and food groups, such as carotene, vitamins A and C, milk and dairy products, and vegetables including green-yellow vegetables, decreased with the increasing number of teeth lost ( P for trend <0.05). On the contrary, mean intakes of carbohydrate, rice, and confectioneries were increased among those with fewer teeth ( P for trend <0.05). The difference in the geometric mean (%) between totally edentulous subjects and those with ≥25 teeth, that is [(Geometric mean for ≥25 teeth) — (Geometric mean for 0 teeth)]/(Geometric mean for ≥25 teeth) × 100, was 14.3%, 8.6%, 6.1%, and –6.1% for carotene, vitamin C, vitamin A, and carbohydrate, respectively. For food groups, it was 26.3%, 11.9%, 5.6%, –9.5%, and –29.6% for milk and dairy products, green-yellow vegetables, total vegetables, rice, and confectioneries, respectively.
Conclusions:  Tooth loss was linked with poorer nutrition even among dentists.     

Dental and periodontal health in a Swiss population-based sample of older adults: a cross-sectional study

In this cross-sectional study, the prevalences of tooth loss, prosthetic dental restorations, and probing pocket depths (PPD) ≥4 mm, and their relationship to sociodemographic factors, were investigated in older Swiss adults. There were up to 1,673 participants aged ≥55 yr in the fourth survey of the Swiss Cohort Study on Air Pollution And Lung And Heart Disease In Adults (SAPALDIA4). Missing teeth, prosthetic dental restorations, and PPD ≥4 mm were recorded in clinical examinations conducted by field workers and compared with self-reported information from questionnaires. Examination data showed that participants were missing five teeth on average, 74.8% had a prosthetic dental restoration, and 21.1% had PPD of ≥4 mm. The mean number of missing teeth and the prevalences of tooth loss, fixed dental prostheses, and removable dental prostheses were associated with age, education level, smoking status, and time since last visit to a dentist. Comparison of data obtained by field workers and that from self-reports show a high level of agreement for the number of missing teeth and the prevalence of removable dental prostheses, but a lower level of agreement for self-reports of fixed dental prostheses and periodontitis.