This critical review aimed to assess the vertical marginal gap that was present when E.max lithium disilicate-based restoration (Press and CAD) are fabricated in-vitro. Published articles reporting vertical marginal gap measurements of in-vitro restorations that had been fabricated from E.Max lithium disilicate were sought with an electronic search of MEDLINE (PubMed) and hand search of selected dental journals. The outcomes were reviewed qualitatively. The majority of studies that compared the marginal fit of E.max press and E.max CAD restorations, found that the E.max lithium disilicate restorations fabricated with the press technique had significantly smaller marginal gaps than those fabricated with CAD technique. This research indicates that E.max lithium disilicate restorations fabricated with the press technique have measurably smaller marginal gaps when compared with those fabricated with CAD techniques within in-vitro environments. The marginal gaps achieved by the restorations across all groups were within a clinically acceptable range.

Aim The aim of this study was to evaluate and compare conventional and modified lip repositioning surgical techniques used for management of gummy smile involving hyperactive lip elevator muscles. Methods and Materials. A prospective study was conducted between April 2016 and May 2017. Twenty two adult patients aged 18‐38 years with gummy smile ranging from 4 to 6 mm because of soft tissue disorders were included in the study. All patients were treated in the oral and maxillofacial department at Damascus University. The sample was divided into two groups of 11 patients. The first group was treated by the conventional standard technique, and the second group treated by a modified study technique. The amount of gingival display in full smile was evaluated in both groups following each intervention. Results Both groups exhibited a statistically significant reduction in the measurement of gummy smile at month 1 and 6 postoperatively (P < .05), but there was no significant difference in gingival display at 3 months in either group postoperatively (P > .05). The recent study showed a significant difference in gingival display between 3 and 6 months postoperatively in group 1, but no significant difference in group 2. Conclusion This study showed that the modified technique utilized in treating gummy smile has less relapse after surgery, shows excellent cosmesis and compared to the conventional technique, greater sustainability. Clinical significance The recent increase in demand for an esthetic smile has led to the development a modification of conventional lip repositioning for correcting gummy smile by myotomy of lip elevator muscles. This modified technique offers less relapse and greater stability post‐operatively than the conventional technique.

The marginal fit of lithium disilicate crowns: Press vs. CAD/CAM Abstract: This study aimed to compare the vertical marginal gap of teeth restored with lithium disilicate crowns fabricated using CAD/CAM or by pressed ceramic approach. Twenty mandibular third molar teeth were collected after surgical extractions and prepared to receive full veneer crowns. Teeth were optically scanned and lithium disilicate blocks were used to fabricate crowns using CAD/CAM technique. Polyvinyl siloxane impressions of the prepared teeth were made and monolithic pressed lithium disilicate crowns were fabricated. The marginal gap was measured using optical microscope at 200× magnification (Keyence VHX-5000, Japan). Statistical analysis was performed using Wilcoxon test. The lithium disilicate pressed crowns had significantly smaller (p = 0.006) marginal gaps (38 ± 12 µm) than the lithium disilicate CAD/CAM crowns (45 ± 12 µm). This research indicates that lithium disilicate crowns fabricated with the press technique have measurably smaller marginal gaps compared with those fabricated with CAD/CAM technique within in vitro environments. The marginal gaps achieved by the crowns across all groups were within a clinically acceptable range.

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An endosseous implant is described as osseointegrated when it is immobile in function. Objective measures of stability testing have been described. The Periotest is a commercially available device that is used for this purpose. This study was designed to measure stability of endosseous implants placed in the mandible. Implants were placed in the mandibular canine or first premolar area to support an overdenture prosthesis. Stability was evaluated through the use of a Periotest device at the time of implant placement and following one year of functional loading. Implant designs were either a screw-shaped titanium alloy or a hydroxyapatite-coated cylinder. A total of 54 implants were placed, 37 were titanium screw-shaped implants, while the remaining 17 were hydroxyapatite cylinders. Initial measurements of stability showed no difference due to implant type. Following one year of functional loading, titanium screw-shaped implants were more stable than hydroxyapatite implants (P < 0.05). The difference in implant rigidity following a period of functional loading may be an indication of a difference in osseointegration between the two implants used in this study.