Dental prostheses and tooth‐related factors

Abstract

Tooth anatomic factors, such as root abnormalities and fractures, and tooth relationships in the dental arch and with the opposing dentition can enhance plaque retention. Restoration margins located within the gingival sulcus do not cause gingivitis if patients are compliant with self-performed plaque control and periodic maintenance. Tooth-supported and/or tooth-retained restorations and their design, fabrication, delivery, and materials have often been associated with plaque retention and loss of attachment. Hypersensitivity reactions can occur to dental materials. Restoration margins placed within the junctional epithelium and supracrestal connective tissue attachment can be associated with inflammation and, potentially, recession. However, the evidence in several of the reviewed areas, especially related to the biologic mechanisms by which these factors affect the periodontium, is not conclusive. This highlights the need for additional well-controlled animal studies to elucidate biologic mechanisms, as well as longitudinal prospective human trials. Adequate periodontal assessment and treatment, appropriate instructions, and motivation in self-performed plaque control and compliance to maintenance protocols appear to be the most important factors to limit or avoid potential negative effects on the periodontium caused by fixed and removable prostheses.

A new classification scheme for periodontal and peri‐implant diseases and conditions – Introduction and key changes from the 1999 classification

“…The term biologic width was replaced by supracrestal attached tissues . Clinical procedures involved in the fabrication of indirect restorations was added because of new data indicating that these procedures may cause recession and loss of clinical attachment (Table ) …”

Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions

“…Several conditions, associated with prostheses and teeth, may predispose to diseases of the periodontium and were extensively reviewed in a background paper. 4 The extent to which these conditions contribute to the disease process may be dependent upon the susceptibility of the individual patient.…”

“…In preparation, four position papers were provided, that had been accepted for publication. Discussions were based on these four reviews covering 1) periodontal manifestions of systemic diseases and conditions; 2) mucogingival conditions around natural teeth; 3) traumatic occlusal forces and occlusal trauma; and 4) dental prostheses and tooth‐related factors . This consensus report is based on the results of these reviews and on expert opinions of the participants.…”

“…Results: Key findings included the following: 1) there are mainly rare systemic conditions (such as Papillon-Lefevre Syndrome, leucocyte adhesion deficiency, and others) with a major effect on the course of periodontitis and more common conditions (such as diabetes mellitus) with variable effects, as well as conditions affecting the periodontal apparatus independently of dental plaque biofilm-induced inflammation (such as neoplastic diseases); 2) diabetes-associated periodontitis should not be regarded as a distinct diagnosis, but diabetes should be recognized as an important modifying factor and included in a clinical diagnosis of periodontitis as a descriptor; 3) likewise, tobacco smoking -now considered a dependence to nicotine and a chronic relapsing medical disorder with major adverse effects on the periodontal supporting tissues -is an important modifier to be included in a clinical diagnosis of periodontitis as a descriptor; 4) the importance of the gingival phenotype, encompassing gingival thickness and width in the context of mucogingival conditions, is recognized and a novel classification for gingival recessions is introduced; 5) there is no evidence that traumatic occlusal forces lead to periodontal attachment loss, non-carious cervical lesions, or gingival recessions; 6) traumatic occlusal forces lead to adaptive mobility in teeth with normal support, whereas they lead to progressive mobility in teeth with reduced support, usually requiring splinting; 7) the term biologic width is replaced by supracrestal tissue attachment consisting of junctional epithelium and supracrestal connective tissue; 8) infringement of restorative margins within the supracrestal connective tissue attachment is associated with inflammation and/or loss of periodontal supporting tissue. However, it is not evident whether the negative effects on the periodontium are caused by dental plaque biofilm, trauma, toxicity of dental materials or a combination of these factors; 9) tooth anatomical factors are related to dental plaque biofilm-induced gingival inflammation and loss of periodontal supporting tissues.…”

Fracture Resistance of New Metal-Free Materials Used for CAD-CAM Fabrication of Partial Posterior Restorations

“…Partial coverage restorations make it possible to preserve an additional 20%-30% more dental structure than other more invasive restoration techniques, such as full coverage crowns [1]. The incidence of complications, both pulp (1.3% after 12.6 years) and periodontal, is lower with inlay, onlay, and overlay incrustations than complete coverage crowns [2][3][4]. The current survival rate of incrustations varies between 75 and 98% after 5 years, offering an effective therapeutic alternative to conventional techniques [5,6].…”