Factors influencing survival of reconstructions. Consensus report of Working Group 2

Abstract: In order to evaluate the level of evidence of factors influencing the survival of reconstructions, systematic reviews of the relevant literature were prepared by a group of rapporteurs. The review papers were circulated to the members of the group before the conference and formed the basis for group and panel discussions. Subsequently, modifications were added to the review papers, and suggestions for consensus statements concerning the following topics were prepared and again critically reviewed in the group and in the plenum: Impact of (i) periodontal disease on the survival of tooth-supported reconstructions, (ii) post-surgical factors as supportive therapy on the survival of implant supported reconstructions, (iii) technical and/or biological complications on the survival of different types of reconstructions, (iiii) material choice for reconstructions on the survival of single crowns and fixed dental prostheses.     

高频电刀龈成形术后烤瓷冠修复的牙周情况分析

目的:观察烤瓷冠修复前行高频电刀龈成形术对基牙牙周组织的影响.方法:收集需行高频电刀龈成形术后再作烤瓷冠修复的患者91例135颗牙,修复后1年复查牙周情况,分析患者术后1年牙龈成形效果、牙龈指数、牙菌斑指数、牙周探诊深度、牙齿动度.结果:龈成形术后烤瓷冠修复1年5.9%患者出现牙龈增生或退缩;牙龈指数轻度上升,有显著性差异;菌斑指数、牙周探诊深度、牙齿动度无明显差异.结论:高频电刀龈成形术对其后烤瓷冠修复基牙牙龈成形效果良好,对基牙牙周健康无明显不良影响.     

Oral Rehabilitation of a Patient With Amelogenesis Imperfecta

A patient with Type I hypoplastic patterned amelogenesis imperfecta, subtype D, presented for prosthodontic evaluation. This article describes the developmental and pathophysiological background of this disease. A clinical report describing the diagnosis, treatment planning, and dental rehabilitation of the patient is reviewed.     

口腔修复陶瓷材料的磨损性能北大核心

背景:陶瓷材料因具有优良的机械性能、与口腔组织良好的生物相容性及高度美观性广泛应用于口腔修复领域,良好的磨损性能对修复体临床应用有重要意义。目的:综述口腔修复陶瓷材料磨损性能机制及临床研究,以期为临床选择适宜的陶瓷材料提供思路。方法:应用计算机在PubMed和Web of Science数据库检索在2016年1月至2021年4月期间涉及口腔修复陶瓷材料磨损性能的相关研究。英文检索词为“dental ceramic material,wear property”,最终共纳入36篇文献进行分析。结果与结论:①全瓷材料自身耐磨性均高于树脂陶瓷复合材料,全瓷材料中氧化锆陶瓷磨损性能最佳,美学性能较弱。②玻璃陶瓷中氧化锆加强型硅酸锂玻璃陶瓷磨损性能较好,但应用时间较短,长期疗效还有待更多的研究证实。③树脂陶瓷复合材料中树脂纳米陶瓷材料磨损性能优于聚合物渗透陶瓷。④在后牙区全冠修复可选择氧化锆陶瓷,前牙区全冠修复可以根据患者的美学需求选择高透性氧化锆陶瓷或玻璃陶瓷。⑤贴面、嵌体和高嵌体修复可选择长石瓷、玻璃陶瓷和树脂陶瓷复合材料,但树脂陶瓷复合材料耐磨性差,需避免用于高应力承载区。⑥对牙本质暴露、氟斑牙和牙齿酸蚀症患者可考虑树脂纳米陶瓷材料,但这类患者适宜的陶瓷材料相关研究较少。⑦表面粗糙度对陶瓷材料的磨损性能有显著影响,临床口腔修复应用中采用良好的抛光表面可提高陶瓷材料磨损性能,而且对修复体进行定期复查也至关重要。     

Dental abnormalities in individuals with pathogenic germline variation in DICER1

Pathogenic germline variation in the microRNA processing gene DICER1 gives rise to an autosomal dominant, tumor‐predisposition disorder. Conditional deletion of Dicer1 in murine dental epithelium shows that it controls tooth patterning, size, number, and shape. The human dental phenotype of people with germline pathogenic variation in DICER1 is unknown. DICER1‐carriers (n = 57) and family controls (n = 55) were evaluated at the NIH Clinical Center dental clinic as part of a comprehensive medical evaluation. Digital panoramic radiographs, bite‐wing radiographs, and oral photographs were collected. A single observer, blind to DICER1 status, reviewed the dental records and determined the presence or absence of 11 dental characteristics as described in the clinic notes, radiographs, or oral photographs. Subjective phenotypes were reviewed on radiographs by two examiners (blind to DICER1 status) for the presence or absence of the dental characteristics to reduce inconsistencies. By simple association, bulbous crown, periodontitis, and taurodontism were all significant (p < .05). Logistic regression with chi‐square maximum likelihood estimates showed that bulbous crown and periodontitis remained significant. Recognition of these phenotypes may aid identification of individuals and families at risk for DICER1‐associated neoplasms. These findings may also guide dental care for individuals with germline DICER1 pathogenic variation.     

牙科着色氧化钇稳定四方多晶氧化锆陶瓷的制备及颜色性能

目的添加不同着色剂组合配制着色的牙科氧化钇稳定四方多晶氧化锆（3Y-TZP）陶瓷,并测定其颜色性能。方法将TZ-3Y-S粉体与一定组分的着色剂球磨混合后,在200 MPa压力下等静压成型,在1 500 ℃烧结2 h,烧制5种具有一定颜色的氧化锆材料,每个颜色组分别制备10 mm×10 mm×0.5 mm和10 mm×10 mm×1 mm着色氧化锆陶瓷片,在黑色背景下用柯尼卡美能达CM-2600d分光光度计进行颜色测定,并与VITA In-Ceram YZ染色液比色板颜色作比较。结果通过对粉体进行着色,配制出具有一定颜色的本体着色氧化锆陶瓷材料,颜色明度逐级降低,饱和度逐渐增大,2种厚度3Y-TZP陶瓷的颜色片色差较小,颜色空间范围是L*：67.76～77.78;a*：-2.19～3.80;b*：12.13～25.01。与VITA In-Ceram YZ染色液比色板相比,颜色空间近似,但明度的最低值仍较高。结论着色氧化锆陶瓷材料适宜用于临床上与饰面瓷颜色匹配,有必要再进一步研究低明度的着色氧化锆色片。     

Discoloration Improvement by Mechanically-Milled Binary Oxides as Radiopacifier for Mineral Trioxide Aggregates

Mineral trioxide aggregates (MTA) have been widely used in endodontic treatments, but after some time, patients suffer tooth discoloration due to the use of bismuth oxide (Bi₂O₃) as a radiopacifier. Replacement of Bi₂O₃ with high energy ball-milled single (zirconia ZrO₂; hafnia, HfO₂; or tantalum pentoxide, Ta₂O₅) or binary oxide powder was attempted, and corresponding discoloration improvement was investigated in the present study. Bi₂O₃-free MTA is expected to exhibit superior discoloration. The radiopacity, diametral tensile strength, and discoloration of MTA-like cements prepared from the as-milled powder were investigated. Experimental results showed that MTA-like cements prepared using Ta₂O₅ exhibited a slightly higher radiopacity than that of HfO₂ but had a much higher radiopacity than ZrO₂. Milling treatment (30 min to 3 h) did not affect the radiopacities significantly. These MTA-like cements exhibited superior color stability (all measured ΔE₀₀ < 1.0) without any perceptible differences after UV irradiation. MTA-like cements prepared using ZrO₂ exhibited the best color stability but the lowest radiopacity, which can be improved by introducing binary oxide. Among the investigated samples, MTA-like cement using (ZrO₂)₅₀(Ta₂O₅)₅₀ exhibited excellent color stability and the best overall performance with a radiopacity of 3.25 mmAl and a diametral tensile strength of 4.39 MPa.     

Translucency and masking ability of translucent zirconia; comparison with conventional zirconia and lithium disilicate

PURPOSEThe purpose of this study is to evaluate translucency and masking ability of translucent zirconia compared to conventional zirconia and lithium disilicate materials.MATERIALS AND METHODSThree types of zirconia blocks with different yttria contents (3Y, 4Y, 5.5Y) and LS blocks (Rosetta SM) were used. Ten specimens for each group were fabricated with 10 mm diameter, with both 0.8 mm and 1.5 mm thicknesses (± 0.02 mm). All groups of zirconia specimens were sintered and polished according to the manufacturer’s instructions. To calculate the translucency parameter (TP), CIELAB value was measured with a spectrophotometer on black and white backgrounds. To investigate the color masking abilities, background shades of A2, normal dentin, discolored dentin, and titanium were used. The color difference (ΔE) was calculated with the CIELAB values of A2 shade background as a reference compared with the values in the various backgrounds. One-way ANOVA and Bonferroni tests were conducted (P < .05).RESULTSThe TP values of zirconia specimens increased as the yttria content increased. All materials used in the study were able to adequately mask normal dentin shade (ΔE < 5.5), but were incapable of masking severely discolored dentin (ΔE > 5.5). On the titanium background, all materials of 1.5 mm thickness were able to mask the background shade, but with a thickness of 0.8 mm, only 3Y-TZP and 4Y-PSZ were able to mask titanium background.CONCLUSIONAll zirconia materials and lithium disilicate specimens used in this study were unable to adequately mask the shade of severely discolored dentin. It is recommended to use 3Y-TZP or 4Y-PSZ with a sufficient thickness of 0.8 mm or more to mask titanium.     

Effect of Non-Thermal Plasma Treatment of Contaminated Zirconia Surface on Porphyromonas gingivalis Adhesion and Osteoblast Viability

Plasma treatment on a zirconia surface prevents bacterial contamination and maintains osteoblast activity. To assess the degree of adhesion of Porphyromonas gingivalis on a zirconia surface after non-thermal plasma (NTP) treatment, specimens were treated with plasma for 60, 300, and 600 s, after which P. gingivalis was inoculated onto the surface and incubated for 48 h. To assess osteoblast activity after NTP treatment, osteoblasts (MC3T3-E1) were dispensed onto the specimens contaminated with P. gingivalis immediately after NTP for 60 and 120 s, followed by incubation for 48, 72, and 96 h. P. gingivalis was cultured after 60 s of NTP treatment of zirconia. The NTP and control groups showed no significant difference (p = 0.91), but adhesion was significantly increased following NTP treatment for 300 s or longer (300, 600 s groups) (p < 0.05). After NTP treatment of P. gingivalis-contaminated zirconia, osteoblast activity significantly increased at 72 and 96 h (I60 and I120 s group) in the groups treated with plasma (p < 0.017). Application of NTP to dental zirconia implants for 60 s not only inhibits the proliferation of P. gingivalis, which causes peri-implantitis but also increases osseointegration on zirconia surfaces contaminated with P. gingivalis.     

Effects of UV Absorber on Zirconia Fabricated with Digital Light Processing Additive Manufacturing

This study evaluated the effect of UV absorbers on the dimensional accuracy of zirconia specimens fabricated by additive manufacturing using a digital light process. Zirconia suspension for additive manufacturing was prepared by setting the volume fractions (0, 0.005, 0.05, and 0.1%) of various UV absorbers. The effect of UV absorber content was evaluated through curing thickness, geometric overgrowth model design, linear deviation, and microstructure evaluation before and after sintering. Statistical analysis was performed by Kruskal–Wallis H and post-tested by the Bonferroni correction method. There was no significant difference in the cure depth according to the presence or absence of the UV absorber, the difference in geometric overgrowth was from 2.1 to 12.5%, and the overgrowth significantly decreased as the amount of added UV absorber increased. This result may contribute to improved precision of 3D multilayer ceramic products.