This study shows that although the taper achieved by dental students in the University of the West Indies when preparing teeth for full-veneer crowns was outside the ideal range of 4° to 14°, it is comparable to those achieved by dental students in other schools.
The remarkable similarity in the tooth size and morphology of monozygotic twins suggests a strong inheritability factor to tooth size and shape and that these may be useful as additional tools for zygosity determination along with other dental traits.
Background
Periodontal intrabony defects are usually treated surgically with the aim of increasing attachment and bone levels and reducing risk of progression. However, recent studies have suggested that a minimally invasive non-surgical therapy (MINST) leads to considerable clinical and radiographic defect depth reductions in intrabony defects. The aim of this study is to compare the efficacy of a modified MINST approach with a surgical approach (modified minimally invasive surgical therapy, M-MIST) for the treatment of intrabony defects.
Methods
This is a parallel-group, single-centre, examiner-blind non-inferiority randomised controlled trial with a sample size of 66 patients. Inclusion criteria are age 25–70, diagnosis of periodontitis stage III or IV (grades A to C), presence of ≥ 1 ‘intrabony defect’ with probing pocket depth (PPD) > 5 mm and intrabony defect depth ≥ 3 mm. Smokers and patients who received previous periodontal treatment to the study site within the last 12 months will be excluded. Patients will be randomly assigned to either the modified MINST or the M-MIST protocol and will be assessed up to 15 months following initial therapy. The primary outcome of the study is radiographic intrabony defect depth change at 15 months follow-up. Secondary outcomes are PPD and clinical attachment level change, inflammatory markers and growth factors in gingival crevicular fluid, bacterial detection, gingival inflammation and healing (as measured by geometric thermal camera imaging in a subset of 10 test and 10 control patients) and patient-reported outcomes.
Discussion
This study will produce evidence about the clinical efficacy and potential applicability of a modified MINST protocol for the treatment of periodontal intrabony defects, as a less invasive alternative to the use of surgical procedures.
Trial registration
ClinicalTrials.gov,
NCT03797807
. Registered on 9 January 2019.
Objectives: Various techniques have been suggested to enable the operator to produce an even reduction of 0.5 mm of labial tooth enamel during preparation for a porcelain veneer. For example, in addition to the traditional free hand method, longitudinal or horizontal depth orientation grooves and the use of small round burs to produce dimples as depth guides have been suggested. However, there is no published data that compares how effective these techniques are at producing the 'ideal' veneer preparation. In this study three techniques were compared using the technique of co-ordinate metrology. Method: A single operator using the above three techniques prepared 84 extracted teeth. Impressions of the prepared and unprepared teeth were scanned using a co-ordinate measuring machine (CMM). Measurements of maximum labial reduction along the mid-labial plane were taken and analysed. Results: The study showed that among the three techniques studied the use of small round burs (D001-012), when used side on at an angle of 45°t o the tooth surface to produce dimples as depth guides, resulted in the greatest frequency of tooth reductions closer to the 'ideal' depth chosen for this study, ie within the 0.4 mm -0.6 mm range.
Conclusion:The study concluded that even after using techniques designed to produce consistent preparations, a single operator still produced preparations with considerable variation from the ideal. The study showed that among the three techniques compared the use of small round burs, when used side on at an angle of 45° to the tooth surface to produce dimples as depth guides, resulted in the greatest frequency of tooth reduction closer to the 'ideal' depth chosen for this study only, ie within the 0.4 mm -0.6 mm range. It is stressed that this range may not be the ideal in all clinical situations.It is commonly accepted that, to satisfy the biologic needs of the periodontium, the technical needs of the ceramist and the aesthetic demands of the patient, some form of tooth preparation, confined within the enamel, is mandatory for veneering a tooth. 1,2,3 Such a 1* PhD Student, 2 Senior Lecturer, 3
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