This study evaluated the effect of different chairside polishing systems on the surface roughness and topography of monolithic zirconia. Thirty-five monolithic zirconia specimens (Lava PLUS, 3M ESPE) were fabricated and divided into five groups of seven and polished with the following: Group 1 (WZ)-Dura white stone followed by Shofu zirconia polishing kit; Group 2 (SZ)-Shofu zirconia polishing kit; Group 3 (CE)-Ceramiste porcelain polishers; Group 4 (CM)-Ceramaster porcelain polishers; and Group 5 (KZ)-Komet ZR zirconia polishers. All specimens were ground with a fine-grit diamond bur prior to polishing procedures to simulate clinical finishing. Baseline and post-polishing profilometric readings were recorded and delta Ra values (difference in mean surface roughness before and after polishing) were computed and analyzed using one-way analysis of variance and Scheffe post hoc test (p<0.05). Representative scanning electron microscopy (SEM) images of the ground but unpolished and polished specimens were acquired. Delta Ra values ranged from 0.146 for CE to 0.400 for KZ. Delta Ra values for KZ, WZ, and SZ were significantly greater than for CE. Significant differences in delta Ra values were also observed between KZ and CM. The SEM images obtained were consistent with the profilometric findings. Diamond-impregnated polishing systems were more effective than silica carbide-impregnated ones in reducing the surface roughness of ground monolithic zirconia.
This report describes the clinical and technical aspects in the oral rehabilitation of an edentulous patient with knife-edge ridge at the mandibular anterior edentulous region, using implant-retained overdentures. The application of computer-aided design and computer-aided manufacturing (CAD/CAM) in the fabrication of the overdenture framework simplifies the laboratory process of the implant prostheses. The Nobel Procera CAD/CAM System was utilised to produce a lightweight titanium overdenture bar with locator attachments. It is proposed that the digital workflow of CAD/CAM milled implant overdenture bar allows us to avoid numerous technical steps and possibility of casting errors involved in the conventional casting of such bars.
Diagnosis and management of periodontal-endodontic lesions are often complicated by the close interrelationship between periodontal tissues and dental pulps. Communications between both biological entities may occur through the apical foramen, accessory canals or exposed dentinal tubules, allowing bi-directional spread of infection and/or inflammation. Endodontic and periodontal lesions may occur distinctly or in tandem. Infected pulps may provoke an inflammatory response in adjoining periodontal tissues, and induce tissue destruction, and likewise, periodontal infection may elicit progressive pulpal pathoses. Solely periodontal or solely endodontic lesions are often clinically recognizable as distinct pathologies. However reported pain from pulpal or periodontal tissues may be similar, especially in combined lesions in which both endodontic and periodontal infection co-exist. When combined lesions develop, signs and symptoms such as toothache, tooth mobility, increased probing pocket depths and localized swelling may develop concurrently. As such, appropriate diagnostic tests and detailed clinical examination are required to differentiate periodontal, endodontic and combined pathologies and to arrive at correct diagnoses. Successful treatment outcomes for any periodontal and/or endodontic lesion depend on correct diagnosis and timely implementation of appropriate therapies. In this chapter, available evidence on periodontal-endodontic lesions will be reviewed with classification, clinical presentations, prognoses and treatment modalities discussed collectively.
Introduction The computer‐aided design/computer‐aided manufacturing (CAD/CAM) technology has revolutionised dentistry at present. An operator's skills can affect the overall clinical duration and marginal accuracy of the prosthesis fabricated through this workflow. The aim of this study was to assess the effect of CAD/CAM hands‐on training compared with that of a self‐instructional video on the performance of dental students in digital impression and fabrication of a CAD/CAM crown. Methods In this cross‐sectional study, 30 undergraduate dental students were shown a CEREC demonstration video. Each operator then captured a digital impression using the intra‐oral scanner, and a crown was subsequently milled. All participants underwent a training course before repeating the process. Marginal discrepancy for each crown on its abutment tooth was measured before and after training using a stereomicroscope and was evaluated using Wilcoxon signed rank test. The duration taken for the process was recorded before and after training and evaluated using paired t‐test. Results The overall mean ±standard deviation marginal adaptation for the CEREC crowns was 78.15 ± 42.83 μm before training and 52.41 ± 17.12 μm after training. The Wilcoxon signed rank test found significant difference (p < .05) in terms of marginal adaptation of crowns fabricated before and after training. Paired t‐tests showed that the time efficiency after training significantly improved compared with that before training. Conclusions Training with guided feedback is crucial to improve the time efficiency of making a digital impression and marginal adaptation of fixed prosthesis using the CAD/CAM technology.
The advent of dental implants has been a boon in the field of restorative dentistry. With dental implants, the treatment modalities to replace missing teeth has widened considerably. While the advantages of implants are undeniable, it is not without its own complications. In this series of case presentations, the authors will highlight late complications associated with osseointegrated implants after functional loading and how such problems were managed.
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