A Conservative Approach to the Management of a Dental Trauma for Immediate Natural Esthetics.

PubMed

Mahesh Patni, Pallav; Jain, Pradeep; Jain Patni, Mona

2016-06-01

The fracture of front teeth is one of the routine presentations of traumatic injuries. The treatment of a fractured tooth involving the pulp includes root canal therapy and post placement followed by core build-up or by the extraction of the fractured tooth if it is not restorable. We report a case of an adult male who had traumatized both his maxillary central incisors following a blow experienced during domestic violence. He had lost a fractured fragment of the right central incisor, while the left incisor had complicated fractures with fragments retained attached to the soft tissue. Following radiovisiography (RVG), both incisors were conservatively treated in a single visit by reattachment and post and core techniques. The treatment reported for reattachment of the tooth fractures and post and core techniques are reasonably easy while providing immediate and lasting results in patients' regaining of social confidence and functionality.

Influence of a parafunctional oral habit on root fracture development after trauma to an immature tooth.

PubMed

dos Santos, Cláudia Letícia Vendrame; Saito, Célia Tomiko Matida Hamata; Luvizzuto, Eloá Rodrigues; Poi, Wilson Roberto; Panzarini, Sônia Regina; Sonoda, Celso Koogi

2011-07-01

Root fractures in immature teeth are rare because the resilience of the alveolar bone is more favorable to the occurrence of luxation. This article reports a case of traumatic injury in an immature permanent tooth that progressed to root fracture, having a parafunctional oral habit as the possible modifying factor of case evolution. A 12-year-old boy presented for treatment complaining of a defective restoration and mild pain on the maxillary right central incisor. The patient had a history of crown fracture in this tooth due to trauma 2 years before. The clinical examination showed healthy gingival tissues and no abnormal tooth mobility, whereas radiographic projections revealed healthy periradicular tissues, incomplete root formation, and no visible root fracture. As pulp necrosis was diagnosed, calcium hydroxide therapy was started for canal disinfection and subsequent obturation. However, after 4 weeks of treatment, a horizontal fracture line was observed radiographically in the root's middle third. The patient denied a new traumatic injury, but revealed the habit of chewing on a pencil. Refraining from the deleterious oral habit was strongly advised, and root canal filling with mineral trioxide aggregate was performed to treat the root fracture. After 4 years of follow-up, the tooth has normal function and no abnormal mobility. Images suggestive of remodeling at the apical end of the coronal segment and replacement resorption of the apical segment are seen radiographically. This case demonstrates the need of following cases of dental trauma and the possible influence of parafunctional oral habits as modifying factors of case progression.

The behaviour of post-retained core materials supported by coronal tooth structure in vitro.

PubMed

Russell, M D; Masood, M; Cunningham, L

1997-11-01

This study was designed to investigate the effect of retaining coronal tooth substance on the performance of post-retained core materials, and to compare the fracture resistance of the system with an intact tooth prepared to similar dimensions. Ten teeth restored with post-retained silver amalgam, and 10 teeth restored with silver-glass cermet, all with a retained single wall of coronal tooth substance, were compared with 10 unrestored teeth prepared to similar dimensions when subjected to a shearing load. The results showed no statistically significant difference between the unrestored teeth and those restored with a silver-glass cermet. Whilst the teeth restored with silver amalgam had a significantly higher fracture resistance (P > 0.01) there was greater tendency to root fracture.

An Innovative Approach for Management of Vertical Coronal Fracture in Molar: Case Report

PubMed Central

Kathuria, Ambica; Kavitha, M.; Ravishankar, P.

2012-01-01

Unlike anterior teeth, acute exogenous trauma is an infrequent cause of posterior coronal vertical tooth fractures. Endodontic and restorative management of such fractures is a great challenge for the clinician. Newer advancements in adhesive techniques can provide successful intracoronal splinting of such teeth to reinforce the remaining tooth structure. This paper describes the diagnosis and management of a case of complicated vertical coronal fracture in mandibular first molar induced by a traffic accident. PMID:22567453

Fracture behavior of human molars.

PubMed

Keown, Amanda J; Lee, James J-W; Bush, Mark B

2012-12-01

Despite the durability of human teeth, which are able to withstand repeated loading while maintaining form and function, they are still susceptible to fracture. We focus here on longitudinal fracture in molar teeth-channel-like cracks that run along the enamel sidewall of the tooth between the gum line (cemento-enamel junction-CEJ) and the occlusal surface. Such fractures can often be painful and necessitate costly restorative work. The following study describes fracture experiments made on molar teeth of humans in which the molars are placed under axial compressive load using a hard indenting plate in order to induce longitudinal cracks in the enamel. Observed damage modes include fractures originating in the occlusal region ('radial-median cracks') and fractures emanating from the margin of the enamel in the region of the CEJ ('margin cracks'), as well as 'spalling' of enamel (the linking of longitudinal cracks). The loading conditions that govern fracture behavior in enamel are reported and observations made of the evolution of fracture as the load is increased. Relatively low loads were required to induce observable crack initiation-approximately 100 N for radial-median cracks and 200 N for margin cracks-both of which are less than the reported maximum biting force on a single molar tooth of several hundred Newtons. Unstable crack growth was observed to take place soon after and occurred at loads lower than those calculated by the current fracture models. Multiple cracks were observed on a single cusp, their interactions influencing crack growth behavior. The majority of the teeth tested in this study were noted to exhibit margin cracks prior to compression testing, which were apparently formed during the functional lifetime of the tooth. Such teeth were still able to withstand additional loading prior to catastrophic fracture, highlighting the remarkable damage containment capabilities of the natural tooth structure.

[An in vitro study of the fracture strength of tooth preparations for Empress 2 veneers and crowns and mandibular incisors restored with Empress 2 veneers and crowns].

PubMed

Wei, Xue; Li, Yan

2009-12-01

To compare the fracture resistance of mandibular incisors' preparations for veneers and crowns, mandibular incisors restored with Empress 2 veneers and crowns. 50 human mandibular incisors were randomly divided into five groups. Each group consisted of ten teeth and the treatment obtained as follows: A, tooth preparations for veneers; B, tooth preparations for crowns; C, teeth restored with veneers; D, teeth restored with crowns; E, untreated group. The teeth received standardized preparation and the restorations were manufactured with Empress 2 system and cemented with resin luting agent. The fracture resistances of teeth were measured by Instron universal testing machine and statistically analyzed with one-way ANOVA. The fracture resistances of A, B, C, D, E were (576.11 +/- 91.53), (204.13 +/- 85.88), (451.50 +/- 116.81), (386.16 +/- 117.75) and (566.05 +/- 121.37) N, respectively. The statistical analysis demonstrated significant differences between five groups. There were no significant differences between group A and E, group C and D. Tooth preparations for veneers did not significantly reduce the fracture resistance of mandibular incisor. The fracture resistance of teeth restored with Empress 2 veneers and crowns did not significantly differ from each other.

Vertical root fractures and their management

PubMed Central

Khasnis, Sandhya Anand; Kidiyoor, Krishnamurthy Haridas; Patil, Anand Basavaraj; Kenganal, Smita Basavaraj

2014-01-01

Vertical root fractures associated with endodontically treated teeth and less commonly in vital teeth represent one of the most difficult clinical problems to diagnose and treat. In as much as there are no specific symptoms, diagnosis can be difficult. Clinical detection of this condition by endodontists is becoming more frequent, where as it is rather underestimated by the general practitioners. Since, vertical root fractures almost exclusively involve endodontically treated teeth; it often becomes difficult to differentiate a tooth with this condition from an endodontically failed one or one with concomitant periodontal involvement. Also, a tooth diagnosed for vertical root fracture is usually extracted, though attempts to reunite fractured root have been done in various studies with varying success rates. Early detection of a fractured root and extraction of the tooth maintain the integrity of alveolar bone for placement of an implant. Cone beam computed tomography has been shown to be very accurate in this regard. This article focuses on the diagnostic and treatment strategies, and discusses about predisposing factors which can be useful in the prevention of vertical root fractures. PMID:24778502

Structural optimization of dental restorations using the principle of adaptive growth.

PubMed

Couegnat, Guillaume; Fok, Siu L; Cooper, Jonathan E; Qualtrough, Alison J E

2006-01-01

In a restored tooth, the stresses that occur at the tooth-restoration interface during loading could become large enough to fracture the tooth and/or restoration and it has been estimated that 92% of fractured teeth have been previously restored. The tooth preparation process for a dental restoration is a classical optimization problem: tooth reduction must be minimized to preserve tooth tissue whilst stress levels must be kept low to avoid fracture of the restored unit. The objective of the present study was to derive alternative optimized designs for a second upper premolar cavity preparation by means of structural shape optimization based on the finite element method and biological adaptive growth. Three models of cavity preparations were investigated: an inlay design for preparation of a premolar tooth, an undercut cavity design and an onlay preparation. Three restorative materials and several tooth/restoration contact conditions were utilized to replicate the in vitro situation as closely as possible. The optimization process was run for each cavity geometry. Mathematical shape optimization based on biological adaptive growth process was successfully applied to tooth preparations for dental restorations. Significant reduction in stress levels at the tooth-restoration interface where bonding is imperfect was achieved using optimized cavity or restoration shapes. In the best case, the maximum stress value was reduced by more than 50%. Shape optimization techniques can provide an efficient and effective means of reducing the stresses in restored teeth and hence has the potential of prolonging their service lives. The technique can easily be adopted for optimizing other dental restorations.

The Coronal Tooth Fractures: Preliminary Evaluation of a Three-Year Follow-Up of the Anterior Teeth Direct Fragment Reattachment Technique Without Additional Preparation.

PubMed

Giudice G, Lo; A, Alibrandi; F, Lipari; A, Lizio; F, Lauritano; G, Cervino; M, Cicciù

2017-01-01

The aim of this research is to describe and to analyse the long-term results and the clinical steps of direct fragment reattachment technique with no additional tooth preparation, used to treat crown fracture. This technique achieves the clinical success, combining satisfactory aesthetic and functional results with a minimally invasive approach. The 3 years follow-up included 9 patients (5 males, 4 females) with coronal fracture. In all the cases the fragment was available and intact. The authors illustrate the adhesive procedure used. Under local anaesthesia and after positioning the rubber dam, both the tooth and the fragment surface were etched, rinsed and applied by the adhesive system in order to obtain the retention of the fractured part to the tooth without additional tooth preparation or resin cement. The statistical analysis shows the good performances of direct fragment reattachment technique. After 36 months, in 22.2% of the cases, the detachment was observed of the bonded fragment and in 11.1% of patients, complications were recorded. Our clinical experience shows how the ultra-conservative procedure used is fast, easy and offers a long term predictability; it also allows good functional and aesthetic outcomes.

Surgical removal of coronal fragment of tooth embedded in lower lip and esthetic management of fractured crown segment.

PubMed

Avinash, Alok; Dubey, Alok; Singh, Rajeev Kumar; Prasad, Swati

2014-01-01

Dental fractures of the permanent maxillary anterior teeth are relatively frequent accidents during childhood. The Efficient diagnosis and treatment of dental injury are important elements in clinical dentistry. This article describes a case of trauma in permanent right central maxillary incisors with tooth fragments embedded in the lower lip. Thorough clinical examination followed by soft tissue radiographs confirmed the presence of a fractured incisal fragment, which was surgically retrieved under local anesthesia. Direct composite restoration was placed. After finishing and polishing, an esthetic and natural-looking restoration was achieved; this completely satisfied the functional and esthetic expectation of the patient and dental team. How to cite this article: Avinash A, Dubey A, Singh RK, Prasad S. Surgical Removal of Coronal Fragment of Tooth Embedded in Lower Lip and Esthetic Management of Fractured Crown Segment. Int J Clin Pediatr Dent 2014;7(1):65-68.

Accuracy of a Computer Assisted Program for ’Classic’ Presentations of Dental Pain

DTIC Science & Technology

1989-04-11

prognosis Displace/mobility of tooth, guarded prognosis Endo / perio combined problem Enamel fracture Food impaction Fractured crown, small pulp...34 presentations. Abscess/infection/cellulitis* Endo / perio combined problem Myofascial pain/muscle spasms Reversible pulpitis *For Abscess/infection...spasms Necrotizing ulcerative gingivitis Neurologic injury Osseous sequestrum Occlusal trauma Periodontal abscess Periocoronitis/erupting tooth

Autogenous transplantation of mandibular third molar to replace tooth with vertical root fracture

PubMed Central

Asgary, Saeed

2009-01-01

Autogenous tooth transplantation (ATT) can be considered when there is a hopeless molar tooth and suitable donor present. This report presents an unconventional case of successful ATT of a third molar replacing the adjacent fractured second molar in a 33 year old woman. This wisdom tooth had completely developed roots. Root-end filling with Calcium Enriched Mixture (CEM) cement was performed in the third molar. The second molar was extracted non-traumatically without any bone removal; the wisdom tooth was immediately transplanted into the recipient socket. No endodontic treatment was carried out either during or after the ATT. At six-month and 2-year clinical examination the patient was asymptomatic; the transplanted tooth was still functional, with no evidence of marginal periodontal pathosis. At the same follow ups, radiographic evaluation illustrated bone regeneration, normal PDL, and absence of external root resorption. Transplantation of mature third molar seems to be a promising method for replacing a lost permanent molar tooth and restoring aesthetics and function. PMID:24003333

Autotransplantation of a maxillary third molar to replace a maxillary premolar with vertical root fracture.

PubMed

Tsurumachi, T; Kakehashi, Y

2007-12-01

To report the successful autotransplantation of a fully developed third molar that required nonsurgical and surgical interventions for tooth adaptation. This case report describes the autotransplantation of a third molar with complete root development after the loss of a fractured premolar in a 47-year-old male. To allow better adaptation of the donor tooth, the buccal roots of the third molar were removed using a diamond bur and the canal entrances were filled. Recall examination 6 years after completion of root-canal treatment showed normal periodontal healing with absence of infection, ankylosis or progressive resorption. The transplantation of a third molar is seen as a promising method to replace a lost permanent tooth, and to restore aesthetics and function. *Autotransplantation is a viable option for the treatment of a missing tooth or for replacement of traumatized tooth when there is a donor tooth available. *Fully developed third molars are potentially reliable candidates in the absence of other suitable donor teeth.

Detecting Tooth Damage in Geared Drive Trains

NASA Technical Reports Server (NTRS)

Nachtsheim, Philip R.

1997-01-01

This paper describes a method that was developed to detect gear tooth damage that does not require a priori knowledge of the frequency characteristic of the fault. The basic idea of the method is that a few damaged teeth will cause transient load fluctuations unlike the normal tooth load fluctuations. The method attempts to measure the energy in the lower side bands of the modulated signal caused by the transient load fluctuations. The method monitors the energy in the frequency interval which excludes the frequency of the lowest dominant normal tooth load fluctuation and all frequencies above it. The method reacted significantly to the tooth fracture damage results documented in the Lewis data sets which were obtained from tests of the OH-58A transmission and tests of high contact ratio spiral bevel gears. The method detected gear tooth fractures in all four of the high contact ratio spiral bevel gear runs. Published results indicate other detection methods were only able to detect faults for three out of four runs.

Dental trauma management awareness among primary school teachers in the Emirate of Ajman, United Arab Emirates.

PubMed

Hashim, R

2011-06-01

To assess, by means of self-administered structured questionnaire, the level of knowledge of primary schools teachers in Ajman with regards to the immediate emergency management of dental trauma. The questionnaire was sent to teachers in randomly selected primary schools in Ajman. A total of 161 teachers responded (response rate 84.4%). The questionnaire surveyed teachers' background, knowledge and management of tooth fracture, avulsion, and also investigated teachers' attitudes and self-assessed knowledge. Ninety-one percent of the teachers were females, 51.6% in their thirties and 61.5% had university qualification. Fifty teachers had received formal first aid training, and only thirteen of them recalled that they had received training on the management of dental trauma. Concerning the management of tooth fracture, 138 respondents (85.8%) gave the appropriate management for fractured tooth. One hundred twenty-one (75%) of the respondents indicated that is very urgent to seek professional assistance if a permanent tooth is avulsed, but they had little knowledge on the correct media for transporting the avulsed tooth. Most teaches were unsatisfied with their level of knowledge for dental trauma and the majority were interested in having further education on the topic. The findings revealed that the level of knowledge of management of dental trauma (especially tooth avulsion) among school teachers in Ajman is inadequate, and education campaigns are necessary to improve their emergency management of dental injuries.

Association of dental trauma experience and first-aid knowledge among rugby players in Malaysia.

PubMed

Abdullah, Dalia; Liew, Amy Kia Cheen; Wan Noorina, Wan Ahmad; Khoo, Selina; Wee, Fay Chwee Lin

2015-10-01

To assess and compare the knowledge of rugby players regarding first-aid measures for dental injuries. A cross-sectional study was conducted at rugby tournaments in 2009 and 2010 on players aged 16 and over. Convenient sampling was performed. A total of 456 self-administered questionnaires were returned. Data collected were analysed using SPSS 21. Descriptive analysis was undertaken for the demographic data. The subjects were classified according to their experience of sustaining each type of injury. Cross-tabulation and chi-square tests were carried out to compare the responses. When the expected cell count was less than five, Fisher's exact test was used. The level of significance was set at P < 0.05. The prevalence of self-reported dental injuries was as follows: tooth fracture (19.3%), luxation (6.6%) and avulsion (1.1%). Significant differences were found, whereby 52.2% of those who had no history of tooth fracture were more likely to seek immediate treatment (P < 0.001), whereas 42% of those who previously experienced tooth fracture claimed that they would only visit a dentist if they experienced pain (P = 0.001). Management of luxation and avulsion did not differ significantly between the groups. However, about half of those who did not have a history of tooth avulsion admitted to not knowing the correct answer, while three of five casualties would keep the tooth iced. Knowledge of the management of tooth fracture and storage medium differs between previous casualties and non-casualties. Overall, knowledge of dental trauma management was insufficient, suggesting the need to educate and train the players. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The United States Army Medical Department Journal, January - March 2009

DTIC Science & Technology

2009-03-01

and performing routine chemistry testing for moisture, protein, fat , and solids. Chemistry methods range from simple extractions for percent fat ...States and abroad. The risk for food and waterborne disease is greatest in regions with fractured public health and veterinary infrastructure, lack of a...surgery during the deployment. Two aural hematoma repairs, an extraction of an abscessed tooth, and a root canal on a fractured canine tooth were

Rapid orthodontic extrusion using an interocclusal appliance for the reestablishment of biologic width: a case report.

PubMed

Kim, Sung Hyun; Tramontina, Vinicius Augusto; Papalexiou, Vula; Luczyszyn, Sônia Mara; Grassi, Maria Bibiana; de Fatima Scarpim, Maria; Tanaka, Orlando Motohiro

2011-03-01

A multidisciplinary treatment of a case of subgingival fracture in a maxillary anterior tooth is presented. This case report describes a simple method involving an interocclusal appliance and an elastic band for rapid orthodontic extrusion to reestablish biologic width. In addition, a simple technique for surgical recontouring following the coronal displacement of the gingival margin prior to restoration of fractured tooth is explained.

Seismic determination of saturation in fractured reservoirs

USGS Publications Warehouse

Brown, R.L.; Wiggins, M.L.; Gupta, A.

2002-01-01

Detecting the saturation of a fractured reservoir using shear waves is possible when the fractures have a geometry that induces a component of movement perpendicular to the fractures. When such geometry is present, vertically traveling shear waves can be used to examine the saturation of the fractured reservoir. Tilted, corrugated, and saw-tooth fracture models are potential examples.

Anesthetic and Surgical Management of a Bilateral Mandible Fracture in a Patient With Charcot-Marie-Tooth Disease: A Case Report.

PubMed

Smith, Jeffrey D; Minkin, Patton; Lindsey, Sean; Bovino, Brian

2015-10-01

This report describes the case of a 74-year-old man who had been diagnosed with Charcot-Marie-Tooth disease as a child. Because the patient had serious motor and sensory neuropathy associated with his disease, special anesthetic and surgical recommendations had to be considered before he underwent general anesthesia to repair his mandibular fracture. Repair of the mandible was performed under general anesthesia with a nasal endotracheal tube and the use of the nondepolarizing muscle relaxant rocuronium. Open reduction and internal fixation through extraoral approaches were used to fixate the displaced right subcondylar and symphyseal fractures. A closed reduction approach using maxillary fixation screws and a mandibular arch bar with light elastic guidance was used to treat a nondisplaced fracture of the left mandibular ramus. Rigid fixation allowed for avoidance of a period of intermaxillary fixation. General anesthesia and muscle relaxant were administered without complication. Treatment of bilateral mandibular fractures with combined open and closed approaches resulted in restoration of premorbid occlusion and masticatory function. Repair of mandibular fractures under general anesthesia appears to be a safe procedure in patients with Charcot-Marie-Tooth disease when appropriate anesthetic and surgical methods are used. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Overlays or ceramic fragments for tooth restoration: an analysis of fracture resistance.

PubMed

Tavarez, Rudys Rodolfo de Jesus; Firoozmand, Leily Macedo; Silva, Mônica Barros; Malheiros, Adriana Santos; Bandéca, Matheus Coelho

2014-01-01

The aim of this study was to evaluate the mode of fracture and resistance of partial ceramic restorations of posterior teeth. Thirty healthy upper premolars were selected and divided into three groups (n = 10): Group 1- control, healthy unrestored teeth, group 2-teeth restored with ceramic fragments; and group 3-teeth restored with ceramic overlays. The restorations were manufactured with feldspathic ceramic and cemented with RelyX ARC resin cement. After being stored in distilled water for 7 days, the teeth were subjected to axial compression mechanical testing with a universal testing machine. Force was applied to the long axis of the tooth at a speed of 0.5 mm/min until fracture. The data were analyzed with one-way ANOVA and Tukey's test (5%). The mode of fracture was scored according to the degree of involvement of the tooth structure and the type of restoration. A significant difference (p < 0.05) was showed between groups 2 (1155 N) and 3 (846.6 N), but there was no significant difference between group 1 and the other groups (1046 N), More extensive fractures were prevalent in the healthy teeth group (Group 1), which had no occlusal coverage; less severe fractures were found in groups 2 and 3. We conclude that teeth restored with ceramic fragments may offer greater resistance to fractures compared to teeth that have overlay restorations.

Teeth: Among Nature's Most Durable Biocomposites

NASA Astrophysics Data System (ADS)

Lawn, Brian R.; Lee, James J.-W.; Chai, Herzl

2010-08-01

This paper addresses the durability of natural teeth from a materials perspective. Teeth are depicted as smart biocomposites, highly resistant to cumulative deformation and fracture. Favorable morphological features of teeth at both macroscopic and microscopic levels contribute to an innate damage tolerance. Damage modes are activated readily within the brittle enamel coat but are contained from spreading catastrophically into the vulnerable tooth interior in sustained occlusal loading. Although tooth enamel contains a multitude of microstructural defects that can act as sources of fracture, substantial overloads are required to drive any developing cracks to ultimate failure—nature's strategy is to contain damage rather than avoid it. Tests on model glass-shell systems simulating the basic elements of the tooth enamel/dentin layer structure help to identify important damage modes. Fracture and deformation mechanics provide a basis for analyzing critical conditions for each mode, in terms of characteristic tooth dimensions and materials properties. Comparative tests on extracted human and animal teeth confirm the validity of the model test approach and point to new research directions. Implications in biomechanics, especially as they relate to dentistry and anthropology, are outlined.

Effect of remaining coronal structure on the resistance to fracture of crowned endodontically treated maxillary first premolars.

PubMed

Nissan, Joseph; Barnea, Eitan; Bar Hen, Doron; Assif, David

2008-09-01

Endodontically treated maxillary first premolars present a restorative challenge. The objective of the present study was to assess the resistance to fracture of crowned endodontically treated maxillary first premolars under simulated occlusal load, while preserving various degrees of remaining coronal structure. The study consisted of 50 intact maxillary first premolars with bifurcated roots and similar root diameter and length, randomly divided into 5 equal experimental groups. All dowels were luted with Flexi-Flow titanium-reinforced composite resin cement. TiCore titanium-reinforced composite resin was used to fabricate the core. Complete cast crowns were fabricated and cemented with zinc phosphate cement. Forces at fracture and mode of failure were recorded. Statistically significant differences (P < .05) were found among mean failure forces for all tested groups in their resistance to fracture under load with the Kruskal-Wallias test and among all combinations of the 5 groups (Z = -1.56/-2.34; P > .05) with the Mann-Whitney test. This indicates that crowned maxillary first premolars with varying degrees of remaining coronal structure differ significantly in their resistance to fracture under occlusal load. There was increased protection against fracture under occlusal loads with more remaining tooth structure. Within the limitations of this study, remaining coronal structure influenced the fracture resistance of crowned endodontically treated maxillary first premolars. Preservation of tooth structure is important for its protection against fracture under occlusal loads and may influence the tooth prognosis.

A successful treatment of vertical root fracture: a case report and 4-year follow-up.

PubMed

Oztürk, Mine; Unal, Gül Celik

2008-10-01

This case report describes a successful treatment of vertically fractured tooth which was reconstructed with a self-etching dual-cured adhesive resin cement and intentionally replanted without using rotation in conjunction with a bio-absorbable barrier membrane. At a follow-up consultation 4 years later, the tooth was asymptomatic, and attachment gain and bone regeneration were observed. In addition, no ankylosis was detected clinically or radiographically.

Fracture modes in human teeth.

PubMed

Lee, J J-W; Kwon, J-Y; Chai, H; Lucas, P W; Thompson, V P; Lawn, B R

2009-03-01

The structural integrity of teeth under stress is vital to functional longevity. We tested the hypothesis that this integrity is limited by fracture of the enamel. Experiments were conducted on molar teeth, with a metal rod loaded onto individual cusps. Fracture during testing was tracked with a video camera. Two longitudinal modes of cracking were observed: median cracking from the contact zone, and margin cracking along side walls. Median cracks initiated from plastic damage at the contact site, at first growing slowly and then accelerating to the tooth margin. Margin cracks appeared to originate from the cemento-enamel junction, and traversed the tooth wall adjacent to the loaded cusp from the gingival to the occlusal surface. All cracks remained confined within the enamel shell up to about 550 N. At higher loads, additional crack modes--such as enamel chipping and delamination--began to manifest themselves, leading to more comprehensive failure of the tooth structure.

Evaluation of a Computer-Assisted Dental Diagnostic System by Navy Hospital Corpsmen

DTIC Science & Technology

1989-06-23

hypersensitivity 1 Defective restoration Displace/mobility of tooth, favorable prognosis Displace/mobility of tooth, guarded prognosis 2 Endo / perio ... injury Osseous sequestrum 2 Occlusal trauma _1 Periodontal abscess 3 Periocoronitis/erupting tooth 2 Reversible pulpitis Root fracture Total...Trauma Related Injury 1 1 0 *Tooth, Specific 18 26 17 *Teeth, Generalized 1 1 0 *Gingiva, Specific Area 6 1 1 *Gingiva, Generalized Area 2 2 2 *Oral

Delayed wound healing after tooth extraction and self-reported kyphosis in Japanese men and women

PubMed Central

Taguchi, Akira; Kamimura, Mikio; Nakamura, Yukio; Sugino, Noriyuki; Ichinose, Akira; Maezumi, Hisayoshi; Fukuzawa, Takashi; Ashizawa, Ryouhei; Takahara, Kenji; Gushiken, Susumu; Mukaiyama, Keijiro; Ikegami, Shota; Uchiyama, Shigeharu; Kato, Hiroyuki

2016-01-01

It is unclear whether osteoporosis itself is a main risk factor for delayed wound healing after tooth extraction in humans. In this study, we evaluated the association between experience of delayed wound healing after last tooth extraction and self-reported kyphosis, with the possibility of having vertebral fractures, in Japanese patients. Among the 1,504 patients who responded to the structured questionnaire survey, 518 patients (134 men and 384 women) aged 55–97 years finally participated in this study. Patients who self-reported mild-moderate kyphosis were more likely to have problematic delayed wound healing after last tooth extraction than those who reported severe kyphosis (odds ratio [OR] 4.98; 95% confidence interval [CI], 1.86–13.38 and OR 2.30; 95% CI, 0.52–10.22, respectively) (p for trend = 0.005). Japanese patients with vertebral fractures may have a higher risk of having problematic delayed wound healing after tooth extraction. PMID:27848958

Delayed wound healing after tooth extraction and self-reported kyphosis in Japanese men and women.

PubMed

Taguchi, Akira; Kamimura, Mikio; Nakamura, Yukio; Sugino, Noriyuki; Ichinose, Akira; Maezumi, Hisayoshi; Fukuzawa, Takashi; Ashizawa, Ryouhei; Takahara, Kenji; Gushiken, Susumu; Mukaiyama, Keijiro; Ikegami, Shota; Uchiyama, Shigeharu; Kato, Hiroyuki

2016-11-16

It is unclear whether osteoporosis itself is a main risk factor for delayed wound healing after tooth extraction in humans. In this study, we evaluated the association between experience of delayed wound healing after last tooth extraction and self-reported kyphosis, with the possibility of having vertebral fractures, in Japanese patients. Among the 1,504 patients who responded to the structured questionnaire survey, 518 patients (134 men and 384 women) aged 55-97 years finally participated in this study. Patients who self-reported mild-moderate kyphosis were more likely to have problematic delayed wound healing after last tooth extraction than those who reported severe kyphosis (odds ratio [OR] 4.98; 95% confidence interval [CI], 1.86-13.38 and OR 2.30; 95% CI, 0.52-10.22, respectively) (p for trend = 0.005). Japanese patients with vertebral fractures may have a higher risk of having problematic delayed wound healing after tooth extraction.

Long-term cumulative survival and mechanical complications of single-tooth Ankylos Implants: focus on the abutment neck fractures

PubMed Central

2015-01-01

PURPOSE To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth Ankylos® implants. MATERIALS AND METHODS This was a retrospective clinical study that analyzed 450 single Ankylos® implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position. RESULTS The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all P<.05). CONCLUSION The Ankylos® implant is suitable for single-tooth restoration in Koreans. However, relatively frequent abutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture. PMID:26813443

Long-term cumulative survival and mechanical complications of single-tooth Ankylos Implants: focus on the abutment neck fractures.

PubMed

Shim, Hye Won; Yang, Byoung-Eun

2015-12-01

To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth Ankylos® implants. This was a retrospective clinical study that analyzed 450 single Ankylos® implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position. The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all P<.05). The Ankylos® implant is suitable for single-tooth restoration in Koreans. However, relatively frequent abutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture.

Stabilization and treatment of dental avulsions and fractures by emergency physicians using just-in-time training.

PubMed

McIntosh, Mark S; Konzelmann, Jason; Smith, Jeffrey; Kalynych, Colleen J; Wears, Robert L; Schneider, Howard; Wylie, Todd; Kaminski, Anne; Matar-Joseph, Madeline

2009-10-01

The objective of this investigation is to use a dental simulation model to compare splinting and bandaging methods for managing tooth avulsions and fractures, as measured by dentist evaluators for quality and time to complete each stabilization procedure. This was a randomized crossover study comparing 3 splinting techniques for managing a traumatically avulsed tooth (periodontal pack, wire, and bondable reinforcement ribbon) and 2 bandage techniques for managing a fractured tooth (calcium hydroxide paste and light-cured composite). After viewing a Just-in-Time training video, a convenience sample of emergency physicians performed the 5 stabilization techniques on dental models containing extracted teeth embedded in clay to simulate a segment of the human dentition. Data collected included time to complete each procedure, the evaluation of dentists about whether the procedure was performed satisfactorily or unsatisfactorily, and the ranking of dentists' and participants' preferred technique. Twenty-five emergency physicians participated in the study: 17 residents, 2 pediatric emergency medicine fellows, and 6 attending physicians. Reported median time, as well as minimum and maximum times to complete each splinting technique for an avulsed tooth, was as follows: periodontal pack 4.4 minutes (2.5 to 6.5 minutes), wire 8.6 minutes (5.8 to 12.9 minutes), and bondable reinforcement ribbon 8.9 minutes (5.6 to 15 minutes). Median time (and minimum and maximum times) to complete each protective bandaging technique for a fractured tooth was calcium hydroxide paste 4.6 minutes (3 to 9.6 minutes) and light-cured composite 7.1 minutes (5.5 to 14.1 minutes). When asked to choose a preferred splinting and bandaging technique according to the performance of the physicians, the dentists chose the bondable reinforcement ribbon 96% (24/25) and the light-cured composite 100% (25/25) of the time. Study participants had no measurable or agreeable preference for a particular splinting or bandaging technique. The results of this study suggest that of the stabilization procedures completed by emergency physicians, dentists preferred the bondable reinforcement ribbon for managing an avulsed tooth and the light-cured composite technique for managing a fractured tooth over the commonly taught and more frequently used procedures in emergency medicine.

Treatment of tooth fracture by medium-energy CO2 laser and DP-bioactive glass paste: the interaction of enamel and DP-bioactive glass paste during irradiation by CO2 laser.

PubMed

Lin, C P; Tseng, Y C; Lin, F H; Liao, J D; Lan, W H

2001-03-01

Acute trauma or trauma associated with occlusal disturbance can produce tooth crack or fracture. Although several methods are proposed to treat the defect, however, the prognosis is generally poor. If the fusion of a tooth fracture by laser is possible, it will offer an alternative to extraction or at least serve as an adjunctive treatment in the reconstruction. We have tried to use a continuous-wave CO2 laser and a newly developed DP-bioactive glass paste (DPGP) to fuse or bridge tooth crack or fracture lines. Both the DP-bioactive glass paste and tooth enamel have strong absorption bands at the wavelength of 10.6 microm. Therefore, under CO2 laser, DPGP and enamel should have an effective absorption and melt together. The interface between DPGP and enamel could be regarded as a mixture of DPGP and enamel (DPG-E). The study focused on the phase transformation, microstructure, functional group and thermal behavior of DPG-E with or without CO2 laser irradiation, by the analytical techniques of XRD, FTIR, DTA/TGA, and SEM. The results of XRD showed that the main crystal phase in the DPG-E was dicalcium phosphate dihydrate (CaHPO4.2H2O). It changed into CaHPO4, gamma-Ca2P2O7, beta-Ca2P2O7 and finally alpha-Ca2P2O7 with increasing temperature. In the FTIR analysis, the 720 cm(-1) absorption band ascribed to the P-O-P linkage in pyrophosphate rose up and the intensities of the OH- bands reduced after laser irradiation. In regard to the results of DTA/TGA after irradiation, the weight loss decreased due to the removal of part of absorption water and crystallization water by the CO2 laser. SEM micrographs revealed that the melted masses and the plate-like crystals formed a tight chemical bond between the enamel and DPGP. We expect that DPGP with the help of CO2 laser can be an alternative to the treatment of tooth crack or fracture.

Autotransplantation of Mandibular Third Molar with Buccal Cortical Plate to Replace Vertically Fractured Mandibular Second Molar: A Novel Technique.

PubMed

Zufía, Juan; Abella, Francesc; Trebol, Ivan; Gómez-Meda, Ramón

2017-09-01

Tooth replacement often leads to inadequate vertical volume in the recipient site bone when a tooth has been extracted because of a vertical root fracture (VRF). This case report presents the autotransplantation of a mandibular third molar (tooth #32) with the attached buccal cortical plate to replace a mandibular second molar (tooth #31) diagnosed with a VRF. After extraction of tooth #31, the recipient socket was prepared based on the size measured in advance with cone-beam computed tomographic imaging. The precise and calculated osteotomy of the cortical bone of tooth #32 allowed for the exact placement of the donor tooth in the position of tooth #31. The total extraoral time was only 25 minutes. The block was fixed to the recipient socket with an osteosynthesis screw and splinted with a double resin wire for 8 weeks. At the 6-month follow-up, the screw was removed, and the stability of the tooth and the regeneration obtained throughout the vestibular area were confirmed. At the 2-year follow-up, the transplanted tooth was asymptomatic and maintained a normal bone level. Advantages of autotransplantation over dental implants include maintenance of proprioception, possible orthodontic movements, and a relatively low cost. This case report demonstrates that an autotransplantation of a third molar attached to its buccal cortical plate is a viable option to replace teeth with a VRF. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Fracture rates of IPS Empress all-ceramic crowns--a systematic review.

PubMed

Heintze, Siegward D; Rousson, Valentin

2010-01-01

The aim of this study was to evaluate the clinical fracture rate of crowns fabricated with the pressable, leucite-reinforced ceramic IPS Empress, and relate the results to the type of tooth restored. The database SCOPUS was searched for clinical studies involving full-coverage crowns made of IPS Empress. To assess the fracture rate of the crowns in relation to the type of restored tooth and study, Poisson regression analysis was used. Seven clinical studies were identified involving 1,487 adhesively luted crowns (mean observation time: 4.5+/-1.7 years) and 81 crowns cemented with zinc-phosphate cement (mean observation time: 1.6+/-0.8 years). Fifty-seven of the adhesively luted crowns fractured (3.8%). The majority of fractures (62%) occurred between the third and sixth year after placement. There was no significant influence regarding the test center on fracture rate, but the restored tooth type played a significant role. The hazard rate (per year) for crowns was estimated to be 5 in every 1,000 crowns for incisors, 7 in every 1,000 crowns for premolars, 12 in every 1,000 crowns for canines, and 16 in every 1,000 crowns for molars. One molar crown in the zinc-phosphate group fractured after 1.2 years. Adhesively luted IPS Empress crowns showed a low fracture rate for incisors and premolars and a somewhat higher rate for molars and canines. The sample size of the conventionally luted crowns was too small and the observation period too short to draw meaningful conclusions.

Role of multiple cusps in tooth fracture.

PubMed

Barani, Amir; Bush, Mark B; Lawn, Brian R

2014-07-01

The role of multiple cusps in the biomechanics of human molar tooth fracture is analysed. A model with four cusps at the bite surface replaces the single dome structure used in previous simulations. Extended finite element modelling, with provision to embed longitudinal cracks into the enamel walls, enables full analysis of crack propagation from initial extension to final failure. The cracks propagate longitudinally around the enamel side walls from starter cracks placed either at the top surface (radial cracks) or from the tooth base (margin cracks). A feature of the crack evolution is its stability, meaning that extension occurs steadily with increasing applied force. Predictions from the model are validated by comparison with experimental data from earlier publications, in which crack development was followed in situ during occlusal loading of extracted human molars. The results show substantial increase in critical forces to produce longitudinal fractures with number of cuspal contacts, indicating a capacity for an individual tooth to spread the load during mastication. It is argued that explicit critical force equations derived in previous studies remain valid, at the least as a means for comparing the capacity for teeth of different dimensions to sustain high bite forces. Copyright © 2014 Elsevier Ltd. All rights reserved.

Oral trauma and dental emergency management recommendations of first-aid textbooks and manuals.

PubMed

Zadik, Yehuda

2007-10-01

The recommendations of oral trauma and dental emergencies management of nine first-aid textbooks and manuals from the last two decades were evaluated. Only one book includes all the relevant topics: dental anatomy, management of tooth luxations and avulsion, tooth fracture, mandible dislocation, jaw fracture, intraoral bleeding and dental pain. Two books recommend self-replantation of an avulsed tooth, but four books detail the storage media and evaluate the importance of a quick referral to a dental surgery. In three first-aid books, the only mention of oral trauma is the hazard of choking from tooth fragments, and in one other book, only mandible dislocation is mentioned as oral trauma. The insufficient information of oral trauma management in these first-aid texts partly explains the previous reports of poor and inadequate knowledge in that topic among medics, teachers and the general public.

An in vitro study of the effect of different restorative materials on the reliability of a veneering porcelain.

PubMed

Anderson, Matthew R; Chung, Kwok-Hung; Flinn, Brian D; Raigrodski, Ariel J

2013-12-01

Implant-supported, porcelain veneered restorations experience a greater rate of porcelain fracture than tooth-supported restorations. For completely edentulous patients, one approach to minimizing porcelain fracture is to use acrylic resin in the mandible, although its efficacy is unknown. The purpose of this study was to evaluate the reliability of a veneering porcelain fatigued with different restorative materials in vitro. Fifty-nine veneering porcelain disk specimens were fabricated by layering veneering porcelain on nickel-chromium base metal alloy disks. Four groups of different indenter materials fatigued the porcelain specimens: group WC, tungsten carbide served as a control; group FC, pressed leucite glass ceramic; group NHC, nanohybrid composite resin denture tooth; and group AR, unfilled acrylic resin denture tooth. Porcelain specimens were randomly divided into 4 groups (n=14). A step-stress accelerated life-testing model was used. Use-level probability Weibull plots were generated, and the reliability of each group was estimated for a theoretical completion of 50 000 cycles at 150 N. Nanohybrid composite resin and unfilled acrylic resin denture tooth groups had higher reliability than tungsten carbide and leucite glass ceramic groups. No significant differences existed between the reliability of the tungsten carbide and leucite glass ceramic groups and the nanohybrid composite resin and acrylic resin denture tooth groups. Veneering porcelain disk specimens fatigued with the unfilled acrylic resin and nanohybrid composite resin denture tooth indenters exhibited higher reliability than the specimens fatigued with either the tungsten carbide or leucite glass ceramic indenters. All of the veneering porcelain disk specimens failed with the same mode of fracture, although the surface posttest exhibited different fracture characteristics among specimens fatigued with the 4 different materials. Copyright © 2013 Editorial Council for the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Ten-Year Follow-Up of a Fragment Reattachment to an Anterior Tooth: A Conservative Approach.

PubMed

Mendes, Luiz; Laxe, Laisa; Passos, Leandro

2017-01-01

This report describes the 10-year follow-up data of a patient who underwent fragment reattachment to the maxillary central incisor after coronal fracture with pulp exposure as well as the procedures followed for functional and esthetic adjustments. A 9-year-old female patient presented at the clinic of dentistry at the State University of Rio de Janeiro with a coronal fracture and pulp exposure of the right maxillary central incisor that had occurred immediately after an accident. The intact tooth fragment was recovered at the accident site and stored in milk. The treatment plan followed was to perform direct pulp capping and tooth fragment reattachment. When the patient was 14 years old, adhesion between fragment and remaining tooth was lost, and fragment reattachment was performed. Five years later, the same tooth presented clinical discoloration and absence of sensitivity during pulp vitality tests. Subsequently, a new treatment plan was formulated, which included endodontic treatment, followed by nonvital tooth bleaching and light-cured composite resin restoration. An esthetic and natural-looking restoration was achieved. Tooth fragment reattachment is not a temporary restorative technique and requires functional and esthetic adjustments over time to maintain the biomimetic characteristics of traumatized anterior teeth and predictable outcomes.

Ten-Year Follow-Up of a Fragment Reattachment to an Anterior Tooth: A Conservative Approach

PubMed Central

Mendes, Luiz; Laxe, Laisa

2017-01-01

This report describes the 10-year follow-up data of a patient who underwent fragment reattachment to the maxillary central incisor after coronal fracture with pulp exposure as well as the procedures followed for functional and esthetic adjustments. A 9-year-old female patient presented at the clinic of dentistry at the State University of Rio de Janeiro with a coronal fracture and pulp exposure of the right maxillary central incisor that had occurred immediately after an accident. The intact tooth fragment was recovered at the accident site and stored in milk. The treatment plan followed was to perform direct pulp capping and tooth fragment reattachment. When the patient was 14 years old, adhesion between fragment and remaining tooth was lost, and fragment reattachment was performed. Five years later, the same tooth presented clinical discoloration and absence of sensitivity during pulp vitality tests. Subsequently, a new treatment plan was formulated, which included endodontic treatment, followed by nonvital tooth bleaching and light-cured composite resin restoration. An esthetic and natural-looking restoration was achieved. Tooth fragment reattachment is not a temporary restorative technique and requires functional and esthetic adjustments over time to maintain the biomimetic characteristics of traumatized anterior teeth and predictable outcomes. PMID:28740741

Outcome of Endodontically Treated Teeth Diagnosed With Cracked Tooth

DTIC Science & Technology

2015-06-01

However, variable symptoms complicate the diagnosis (9). In a study of 32 patients presenting with diffuse longstanding orofacial pain eventually...883-92. 22)Byrnjulsen A, Fristad I, Grevstad T, Hals-Kvinnsland I. Incompletely fractured teeth associated with diffuse longstanding orofacial pain ...cracked tooth is highly associated with discomfort. Patients often describe a momentary, sudden, sharp, lancinating pain that results in continuous tooth

Nasolacrimal obstruction caused by root abscess of the upper canine in a cat.

PubMed

Anthony, James M G; Sandmeyer, Lynne S; Laycock, Amanda R

2010-03-01

A 10-year-old, castrated male domestic short hair cat was presented to the Small Animal Clinic at the Western College of Veterinary Medicine with a presenting complaint of chronic, ocular discharge from the left eye. Ocular examination confirmed epiphora and mucopurulent discharge but there were no apparent reasons for the ocular discharge, and nasolacrimal obstruction was suspected. The cat had swelling of the left side of the face, severe periodontal disease and a fractured upper left canine tooth with pulpal exposure. Dacryocystorhinography revealed narrowing of the nasolacrimal duct above the root of the fractured upper left canine and dental radiographs showed a severe periapical lucency at the apex of the upper left canine tooth. The fractured canine tooth was removed. Subsequently, the ocular discharge and facial swelling resolved. After 2 years, the epiphora has never reoccurred. This is a noteworthy case because a suspected root abscess resulted in extralumenal compression of the nasolacrimal duct, which shows the importance of a thorough oral examination when nasolacrimal obstruction is evident.

In vitro study comparing fracture strength recovery of teeth restored with three esthetic bonding materials using different techniques.

PubMed

Rajput, Akhil; Ataide, Ida; Lambor, Rajan; Monteiro, Jeanne; Tar, Malika; Wadhawan, Neeraj

2010-01-01

Reattachment of the fractured fragment of a traumatized tooth (whenever available and usable) has become the treatment of choice in cases of uncomplicated crown fractures. Despite the presence of various bonding materials and techniques, laboratory data evaluating the biomechanical aspects of such procedures is largely lacking in the literature. The objective of this in vitro study was to evaluate the fracture strength recovery of incisors, following fragment restoration with three different techniques. A total of 90 extracted human maxillary central incisors were subjected to crown fractured under standard conditions. This was carried out by applying a compressive force from the buccal aspect of the clinical crown using a universal strength testing machine. The fractured teeth were equality distributed in three groups, defined on the basis of the technique used for reattachment: i) overcontour, ii) internal dentinal groove and iii) direct buildup. Each group was further subdivided into three subgroups on the basis of the intermediate restorative material used for reattachment, namely: i) hybrid composite (Filtek Z100 Universal Restorative, ii) nanocomposite (Filtek Z350) and iii) Ormocer (Voco Admira). Following reattachment, the crowns were re-fractured under standard conditions. The force required for fracture was recorded and was expressed as a percentage of the fracture strength of the intact tooth. The data was expressed as a percentage of the fracture strength of the intact tooth. The data was analyzed using two-way ANOVA and Bonferroni tests for pair-wise comparison. The results showed no statistically significant differences in fractures strength between the three groups (P > 0.05). However, comparison of the subgroups revealed statistically significant higher strength recovery percentages for the hybrid and the nanocomposite compared with the Ormocer material (P < 0.05). It was concluded that material properties have a significant influence on the success of reattachment procedures.

Mechanical Failure of Endocrowns Manufactured with Different Ceramic Materials: An In Vitro Biomechanical Study.

PubMed

Aktas, Guliz; Yerlikaya, Hatice; Akca, Kivanc

2018-04-01

To evaluate the effect of different silica-based ceramic materials on the mechanical failure behavior of endocrowns used in the restoration of endodontically treated mandibular molar teeth. Thirty-six intact mandibular molar teeth extracted because of a loss of periodontal support received root canal treatment. The teeth were prepared with a central cavity to support the endocrowns, replacing the occlusal surface with mesial-lingual-distal walls. Data acquisition of the prepared tooth surfaces was carried out digitally with a powder-free intraoral scanner. Restoration designs were completed on manufactured restorations from three silicate ceramics: alumina-silicate (control), zirconia-reinforced (Zr-R), and polymer-infiltrated (P-I). Following adhesive cementation, endocrowns were subjected to thermal aging, and then, each specimen was obliquely loaded to record the fracture strength and define the mechanical failure. For the failure definition, the fracture type characteristics were identified, and further analytic measurements were made on the fractured tooth and ceramic structure. Load-to-fracture failure did not differ significantly, and the calculated mean values were 1035.08 N, 1058.33 N, and 1025.00 N for control, Zr-R, and P-I groups, respectively; however, the stiffness of the restoration-tooth complex was significantly higher than that in both test groups. No statistically significant correlation was established in paired comparisons of the failure strength, restorative stiffness, and fractured tooth distance parameters. The failure mode for teeth restored with zirconia-reinforced glass ceramics was identified as non-restorable. The resin interface in the control and P-I groups presented similar adhesive failure behavior. Mechanical failure of endocrown restorations does not significantly differ for silica-based ceramics modified either with zirconia or polymer. © 2016 by the American College of Prosthodontists.

Influence of ceramic thickness and ceramic materials on fracture resistance of posterior partial coverage restorations.

PubMed

Bakeman, E M; Rego, N; Chaiyabutr, Y; Kois, J C

2015-01-01

This study evaluated the influence of ceramic thickness and ceramic materials on fracture resistance of posterior partial coverage ceramic restorations. Forty extracted molars were allocated into four groups (n=10) to test for two variables: 1) the thickness of ceramic (1 mm or 2 mm) and 2) the ceramic materials (a lithium disilicate glass-ceramic [IPS e.max] or leucite-reinforced glass ceramic [IPS Empress]). All ceramic restorations were luted with resin cement (Variolink II) on the prepared teeth. These luted specimens were loaded to failure in a universal testing machine, in the compression mode, with a crosshead speed of 1.0 mm/min. The data were analyzed using two-way analysis of variance and the Tukey Honestly Significantly Different multiple comparison test (α =0.05). The fracture resistance revealed a significant effect for materials (p<0.001); however, the thickness of ceramic was not significant (p=0.074), and the interaction between the thickness of ceramic and the materials was not significant (p=0.406). Mean (standard deviation) fracture resistance values were as follows: a 2-mm thickness of a lithium disilicate bonded to tooth structure (2505 [401] N) revealed a significantly higher fracture resistance than did a 1-mm thickness of leucite-reinforced (1569 [452] N) and a 2-mm thickness of leucite-reinforced ceramic bonded to tooth structure (1716 [436] N) (p<0.05). There was no significant difference in fracture resistance values between a lithium disilicate ceramic at 1-mm thickness (2105 [567] N) and at 2-mm thickness. Using a lithium disilicate glass ceramic for partial coverage restoration significantly improved fracture resistance compared to using a leucite-reinforced glass ceramic. The thickness of ceramic had no significant effect on fracture resistance when the ceramics were bonded to the underlying tooth structure.

Force Eruption of Mandibular Second Incisor in an 11- Year Old Boy: A Technical Report

PubMed Central

Sobhnamayan, F; Moazami, F; Hamedi, S; Meshki, R

2013-01-01

There is a great challenge in the treatment of deeply fractured and un-restorable teeth among dentists. Orthodontic force eruption is a method of treatment for these teeth to preserve natural root system and periodontal structures. This technical report is a new modification of this procedure presented in an 11- year old boy with deeply fractured left second mandibular incisor. The fractured teeth were treated with root canal therapy and a file #80 was modified to become a hook cemented into the fractured tooth. Anterior teeth were splinted and used as anchorage to help the root extrusion. 1-year follow up of the tooth showed the convenience of the treatment. This simple and low-cost method can be an acceptable alternative to the current high cost techniques, achieving the same results. PMID:24724126

Fracture analysis of randomized implant-supported fixed dental prostheses

PubMed Central

Esquivel-Upshaw, Josephine F.; Mehler, Alex; Clark, Arthur E.; Neal, Dan; Anusavice, Kenneth J.

2014-01-01

Objective Fractures of posterior fixed dental all-ceramic prostheses can be caused by one or more factors including prosthesis design, flaw distribution, direction and magnitude of occlusal loading, and nature of supporting infrastructure (tooth root/implant), and presence of adjacent teeth. This clinical study of implant-supported, all-ceramic fixed dental prostheses, determined the effects of (1) presence of a tooth distal to the most distal retainer; (2) prosthesis loading either along the non-load bearing or load bearing areas; (3) presence of excursive contacts or maximum intercuspation contacts in the prosthesis; and (4) magnitude of bite force on the occurrence of veneer ceramic fracture. Methods 89 implant-supported FDPs were randomized as either a three-unit posterior metal-ceramic (Au-Pd-Ag alloy and InLine POM, Ivoclar, Vivadent) FDP or a ceramic-ceramic (ZirCAD and ZirPress, Ivoclar, Vivadent) FDP. Two implants (Osseospeed, Dentsply) and custom abutments (Atlantis, Dentsply) supported these FDPs, which were cemented with resin cement (RelyX Universal Cement). Baseline photographs were made with markings of teeth from maximum intercuspation (MI) and excursive function. Patients were recalled at 6 months and 1 to 3 years. Fractures were observed, their locations recorded, and images compared with baseline photographs of occlusal contacts. Conclusion No significant relationship exists between the occurrence of fracture and: (1) the magnitude of bite force; (2) a tooth distal to the most distal retainer; and (3) contacts in load-bearing or non-load-bearing areas. However, there was a significantly higher likelihood of fracture in areas with MI contacts only. Clinical Significance This clinical study demonstrates that there is a need to evaluate occlusion differently with implant-supported prostheses than with natural tooth supported prostheses because of the absence of a periodontal ligament. Implant supported prostheses should have minimal occlusion and lighter contacts than ones supported by natural dentition. PMID:25016139

Dental abnormalities in eight captive giant pandas (Ailuropoda melanoleuca) in China.

PubMed

Jin, Y; Lin, W; Huang, S; Zhang, C; Pu, T; Ma, W; Lin, D

2012-05-01

Dental data from eight adult giant pandas (Ailuropoda melanoleuca) (four females and four males) were collected at the Beijing Zoo from February 2009 to July 2010. Examination findings were recorded in dental charts. All the pandas had different degrees of tooth wear. Incisors, canines and second premolars had the most abnormalities. Five animals had caries; molars were the most affected. Chip fractures were found in seven teeth (incisor, canine and premolar) of five pandas; two had complicated fractures of their canines. Premolars and other teeth were missing in three pandas. Different degrees of dental plaque and calculus were found in all animals. Two pandas had mild gingivitis; the depth of periodontal pockets in all pandas was normal (0-2 mm). Five pandas had abnormal tooth mobility. Samples of dental plaque were collected for microbial culture. Two hundred and fifty-three bacterial strains belonging to 48 species of 23 genera were isolated. Streptococcus, Moraxella, Peptostreptococcus and Porphyromonas were the dominant genera. Further research with larger sample sizes of free-ranging and captive giant pandas will be required in order to demonstrate the absence of the premolar tooth, tooth fractures and the relatively low prevalence of periodontal disease in captive giant pandas. Copyright © 2011 Elsevier Ltd. All rights reserved.

Spiral Bevel Pinion Crack Detection in a Helicopter Gearbox

NASA Technical Reports Server (NTRS)

Decker, Harry J.; Lewicki, David G.

2003-01-01

The vibration resulting from a cracked spiral bevel pinion was recorded and analyzed using existing Health and Usage Monitoring System (HUMS) techniques. A tooth on the input pinion to a Bell OH-58 main rotor gearbox was notched and run for an extended period at severe over-torque condition to facilitate a tooth fracture. Thirteen vibration-based diagnostic metrics were calculated throughout the run. After 101.41 hours of run time, some of the metrics indicated damage. At that point a visual inspection did not reveal any damage. The pinion was then run for another 12 minutes until a proximity probe indicated that a tooth had fractured. This paper discusses the damage detection effectiveness of the different metrics and a comparison of effects of the different accelerometer locations.

Comparisons of modified Vasco X-2 and AISI 9310 gear steels

NASA Technical Reports Server (NTRS)

Townsend, D. P.; Zaretsky, E. V.

1980-01-01

Endurance tests were conducted with four groups of spur gears manufactured from three heats of consumable electrode vacuum melted (CVM) modified Vasco X-2. Endurance tests were also conducted with gears manufactured from CVM AISI 9310. Bench type rolling element fatigue tests were conducted with both materials. Hardness measurements were made to 811 K. There was no statistically significant life difference between the two materials. Life differences between the different heats of modified Vasco X-2 can be attributed to heat treat variation and resultant hardness. Carburization of gear flanks only can eliminate tooth fracture as a primary failure mode for modified Vasco X-2. However, a tooth surface fatigue spall can act as a nucleus of a tooth fracture failure for the modified Vasco X-2.

Esthetic rehabilitation of complicated crown fractures utilizing rapid orthodontic extrusion and two different restoration modalities.

PubMed

Milardovic Ortolan, Sladana; Strujic, Mihovil; Aurer, Andrej; Viskic, Josko; Bergman, Lana; Mehulic, Ketij

2012-01-01

This case report describes the management of a crown-root fractured maxillary right central incisor and a crown fractured maxillary left central incisor using two different techniques. A complex procedure was designed to manage this case including orthodontic extrusion to move the fracture line above the alveolar bone and surgical recontouring of the altered gingival margin. Finally, the right incisor was restored prosthodontically. Prosthetic treatment was based on performing a post and core, and all-ceramic crown on the extruded tooth. The left, less-damaged incisor was restored directly using composite resin. The treatment resulted in good esthetics and secured periodontal health. This case report demonstrates that a multidisciplinary treatment approach is a reliable and predictable option to save a tooth. How to cite this article: Ortolan SM, Strujic M, Aurer A, Viskic J, Bergman L, Mehulic K. Esthetic Rehabilitation of Complicated Crown Fractures Utilizing Rapid Orthodontic Extrusion and Two Different Restoration Modalities. Int J Clin Pediatr Dent 2012;5(1):64-67.

Surgical management of vertical root fractures for posterior teeth: report of four cases.

PubMed

Floratos, Spyros G; Kratchman, Samuel I

2012-04-01

The objective of this article was to present a surgical treatment option for teeth with incomplete vertical root fracture in maxillary and mandibular posterior teeth. Four cases are presented in which 1 endodontically treated maxillary or mandibular molar had an incomplete vertical root fracture involving 1 of the roots. The tooth underwent a flap elevation procedure to visualize the pattern of bone loss and assess the extent of root fracture. The fracture line was eliminated by resecting the root in a beveled manner, after which root-end preparation and root-end filling were performed by using mineral trioxide aggregate. The osteotomy was covered with an absorbable collagen membrane. Cases were followed up for 8-24 months after surgery. The procedure was shown to be predictable and successful in this series. Root length was preserved, and tooth extraction was avoided. The microsurgical treatment option for multirooted teeth with incomplete vertical root fracture resulted in long-term clinical success. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Fractographic features of glass-ceramic and zirconia-based dental restorations fractured during clinical function.

PubMed

Oilo, Marit; Hardang, Anne D; Ulsund, Amanda H; Gjerdet, Nils R

2014-06-01

Fractures during clinical function have been reported as the major concern associated with all-ceramic dental restorations. The aim of this study was to analyze the fracture features of glass-ceramic and zirconia-based restorations fractured during clinical use. Twenty-seven crowns and onlays were supplied by dentists and dental technicians with information about type of cement and time in function, if available. Fourteen lithium disilicate glass-ceramic restorations and 13 zirconia-based restorations were retrieved and analyzed. Fractographic features were examined using optical microscopy to determine crack initiation and crack propagation of the restorations. The material comprised fractured restorations from one canine, 10 incisors, four premolars, and 11 molars. One crown was not categorized because of difficulty in orientation of the fragments. The results revealed that all core and veneer fractures initiated in the cervical margin and usually from the approximal area close to the most coronally placed curvature of the margin. Three cases of occlusal chipping were found. The margin of dental all-ceramic single-tooth restorations was the area of fracture origin. The fracture features were similar for zirconia, glass-ceramic, and alumina single-tooth restorations. Design features seem to be of great importance for fracture initiation. © 2014 Eur J Oral Sci.

Fracture resistance of teeth restored with post-retained restorations: an overview.

PubMed

Al-Omiri, Mahmoud Khaled; Mahmoud, Ahmad Abdelaziz; Rayyan, Mohammad Ramadan; Abu-Hammad, Osama

2010-09-01

Posts have been used efficiently to retain restorations for badly destructed teeth. This article critically analyzes the concerned topics related to the fracture resistance of teeth restored with dowel-retained restorations. A systematic review of PubMed/MEDLINE, Cochrane, and Scopus databases was completed (from 1960 to 2010). Single or combined key words were used to obtain the most possible comprehensive list of articles. Checking the references of the relevant obtained sources completed the review along with a manual search to locate related articles on the topic. In vivo and ex vivo (laboratory, computer-based finite element, and photoelastic stress analysis studies) investigations related to the topic were included. Many factors have been proposed to influence the fracture resistance of post-restored teeth. Recognizing the significance of these factors on the fracture resistance of teeth would aid in choosing the suitable treatment modality for every individual case. Fracture resistance was improved if tooth structure loss was limited, a ferrule was obtained, a post with similar physical properties to natural dentine was used, and adhesive techniques for post luting and coronal restoration were used. Adhesively luted resin/fiber posts with composite cores appear to be the best currently available option in terms of tooth fracture and biomechanical behaviour. Most guidelines were based mainly on ex vivo studies and to a lesser extent on limited in vivo studies. The lack of long-term controlled randomized clinical studies was the main hindrance to reaching a conclusive and undisputable opinion regarding endodontic posts in terms of tooth fracture and biomechanical behaviour. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The Overall Survival, Complication-Free Survival, and Related Complications of Combined Tooth-Implant Fixed Partial Dentures: A Literature Review

PubMed Central

Borg, Peter; Puryer, James; McNally, Lisa; O’Sullivan, Dominic

2016-01-01

This paper reviews the literature regarding possible complications, complication-free survival, and overall survival of fixed dental prostheses that use both implants and natural teeth as abutments. The paper also provides clinical guidelines for treatment based on this literature review. An electronic search utilizing the MEDLINE, BIOSIS Citation Index, and Web of Science™ Core Collection databases was undertaken, and a review of the 25 selected texts studying 22 different patient cohorts was carried out. From a total of 1610 implants reviewed, 40 were lost (33 due to loss of integration and 7 due to fracture), whereas, out of a total of 1301 teeth, 38 were lost, of which 16 were due to fracture. Seventy-three cases of tooth intrusion were detected. From a total of 676 frameworks reviewed (metal n = 645, Zirconia n = 31), 7 fractured, while veneer material fracture occurred in 70 out of 672 bridges. Overall, 502 out of 531 tooth-implant fixed prostheses (TIPFs) remained functional, and 336 out of 439 prostheses showed no technical or biological complications and remained functional. Rigid TIFPs permanently cemented to teeth with sufficient coronal structure and with limited use of prosthetic attachments offer a good long-term treatment option to patients with good oral hygiene following sound implant placement. This mode of treatment should be used when free-standing implant-supported options may not be possible. Larger randomized control studies and other clinical studies comparing tooth-to-implant-connected treatment with other forms of treatment are needed to better understand the place of TIFP treatment in oral rehabilitation. PMID:29563458

Impact of Various Irrigating Agents on Root Fracture: An in vitro Study.

PubMed

Tiwari, Sukriti; Nikhade, Pradnya; Chandak, Manoj; Sudarshan, C; Shetty, Priyadarshini; Gupta, Naveen K

2016-08-01

Irrigating solutions are used for cleaning and removing dentinal debris, and the other remains from pulpal space during biomechanical preparation. Therefore, we evaluated the impact of various irrigating agents on root fracture at 5-minute time exposure. We sectioned 60 permanent maxillary premolars with fully formed root structures transversely maintaining the root length of approximately 14 mm. Five study groups were made comprising ethylenediaminetetraacetic acid (EDTA), cetrimide, citric acid, and so on as various irrigating agents. A universal force test machine was used to calculate the force which was enough to fracture each root. Analysis of variance (ANOVA) test was used to access the level of significance. About 10% citric acid solution as an irrigating agent showed minimal fracture opposing results, whereas 10% EDTA solution showed the maximum fracture resistance of root portion. Selection of suitable EDTA concentration that has minimal adverse effect on the mechanical properties of the tooth is very important for the successful management of tooth fracture. About 10% EDTA provided the highest fracture resistance, necessitating the use of irrigating solution in root canal therapy (RCT). Further research with higher and different study groups is required to search for more efficient irrigating solution to improve the outcome of RCT.

Regenerative treatment of an immature, traumatized tooth with apical periodontitis: report of a case.

PubMed

Cotti, Elisabetta; Mereu, Manuela; Lusso, Daniela

2008-05-01

This case report describes the treatment of a necrotic immature permanent central incisor with complete crown fracture, suspected root fracture, and sinus tract, which was not treated with conventional apexification techniques. Instead, a regenerative approach based on the trauma literature's methods for revascularization was provided. The root canal was gently debrided of necrotic tissue with a sharp spoon excavator and irrigated for only one third of its length with NaOCl and then medicated with calcium hydroxide. After 15 days the sinus tract had healed, and the tooth was asymptomatic. The tooth was accessed, calcium hydroxide was removed, bleeding was stimulated to form an intracanal blood clot, and mineral trioxide aggregate was placed coronally to the blood clot. After 8 months, a coronal calcified barrier was radiographically evident and accompanied with progressive thickening of the root wall and apical closure. Two and a half years after treatment was initiated, the tooth remained asymptomatic, and the sinus tract had not reappeared. The progressive increase in the thickness of the dentinal walls and subsequent apical development suggest that appropriate biologic responses can occur with this type of treatment of the necrotic immature permanent tooth with sinus tract.

Influence of artificial aging on the load-bearing capability of straight or angulated zirconia abutments in implant/tooth-supported fixed partial dentures.

PubMed

Nothdurft, Frank P; Doppler, Klaus E; Erdelt, Kurt J; Knauber, Andreas W; Pospiech, Peter R

2010-01-01

The aim of the study was to evaluate the influence of artificial aging on the fracture behavior of straight and angulated zirconia implant abutments used in ZirDesign (Astra Tech) implant/tooth-supported fixed partial dentures (FPDs) in the maxilla. Four different test groups (n = 8) representing anterior implant/tooth-supported FPDs were prepared. Groups 1 and 2 simulated a clinical situation with an ideal implant position (maxillary left central incisor) from a prosthetic point of view, which allowed for the use of a straight, prefabricated zirconia abutment. Groups 3 and 4 simulated a situation with a compromised implant position that required an angulated (20-degree) abutment. OsseoSpeed implants (4.5 3 13 mm, Astra Tech) as well as metal tooth analogs (maxillary right lateral incisor) with simulated periodontal mobility were mounted in polymethyl methacrylate. The FPDs (chromium-cobalt alloy) were cemented with glass ionomer. Groups 2 and 4 were thermomechanically loaded and subjected to static loading until failure. Statistical analysis of force data at the fracture site was performed using nonparametric tests. All samples survived thermomechanical loading. Artificial aging did not lead to a significant decrease in load-bearing capacity in either the straight abutments or the angulated abutments. The restorations that used angulated abutments exhibited higher fracture loads than the restorations with straight abutments (group 1: 209.13 ± 39.11 N; group 2: 233.63 ± 30.68 N; group 3: 324.62 ± 108.07 N; group 4: 361.75 ± 73.82 N). This difference in load-bearing performance was statistically significant, both with and without artificial aging. All abutment fractures occurred below the implant shoulder. Compensation for angulated implant positions with an angulated zirconia abutment is possible without reducing the load-bearing capacity of implant/tooth-supported anterior FPDs.

A case of tooth fracture occurred upon medicating bisphosphonate for an elderly person: Preservation therapy and responses for Stage 0 of bisphosphonate-related osteonecrosis of jaw

PubMed Central

Suzuki, Noriko; Oguchi, Hitoshi; Yamauchi, Yu; Karube, Yasuyo; Suzuki, Yukimi; Hosoya, Noriyasu

2017-01-01

This case report aimed to report the progress of preservation therapy and response of symptoms and signs for Stage 0 of bisphosphonate-related osteonecrosis of jaw (BRONJ). A 68-year-old female was recognized having a tooth at the left upper first molar fracture upon medicating bisphosphonate (BP) in 2007. At that time, the extraction of the tooth was an absolute contraindication. Therefore, we performed preservation therapy. We observed the symptoms and signs every month. After 5 months, swelling and redness in the entire first molar tooth were seen and fistula formed partly. Bone exposure was not seen. We administrated antibiotics immediately. As a result, symptoms disappeared. On April 10, 2009, the patient visited us as she felt a sense of incongruity in the lower left first and second molar teeth. Clinically, there were no symptoms of pain. However, we observed the radiolucent finding in about 5 mm diameter at apical position by X-ray photography; we considered a possibility of Stage 0 for BRONJ. We immediately administered medicine for 5 days and the symptoms disappeared. At present, no inflammation with signs and symptoms at the upper left first molar and lower left first, second molar parts is shown. We performed preservation therapy for tooth fracture case medicating of BP. Immediate responses for inflammation and symptoms of the Stage 0 of BRONJ have led to success. Hence, dentists should perform regular clinical observation, and enough education to the patient for BRONJ is necessary. PMID:28729804

Management of a midroot and complicated crown fracture: a case report.

PubMed

Sheikh-Nezami, M; Mokhber, N; Shamsian, Kh; Saket, S

2009-05-01

This case report illustrates the management of a permanent right central maxillary incisor with midroot fracture and complicated crown fracture, which was treated by cervical pulpotomy and fixation of the fragments. After 4-month follow-up, radiography showed healing with interproximal bone and connective tissue at the fracture line at midroot. After 3 years, the tooth was still functional without any clinical sign and symptom.

Clinical success of implant-supported and tooth-implant-supported double crown-retained dentures.

PubMed

Bernhart, Gunda; Koob, Andreas; Schmitter, Marc; Gabbert, Olaf; Stober, Thomas; Rammelsberg, Peter

2012-08-01

The objective of this retrospective study was to compare biological and technical complications of implant-supported and tooth-implant-supported double crown-retained dentures (DCRDs) with those of tooth-supported DCRDs. Sixty-three DCRDs were monitored. One study group included 16 prostheses with a combination of implants and natural teeth as double crowns (ti group), whereas in the second study group, 19 dentures were retained exclusively on implants (ii group); a third study group with 28 exclusively tooth-supported dentures served as controls (tt group). Tooth loss, implant failure, and technical complications (loss of retention of primary crown, abutment screw loosening, loss of facing, fracture of resin denture teeth and fracture of saddle resin) were analysed. During the observation period of 24 months, no implants or teeth were lost in the ti group and three technical complications were recorded. In the ii group, two implants were lost, two cases of peri-implantitis occurred and four technical complications were observed. In the tt group, two cases of tooth loss and seven technical complications were observed. At the time of the last examination, all prostheses of the ti group and the ii group were functional. Patients of these two study groups reported high satisfaction with both function and aesthetics with no significant difference between the two groups. Treatment with DCRDs showed comparable results in the three study groups. The 2-year results indicate that double crowns can be recommended for implant and combined tooth-implant-retained dentures.

Influence of different transitional restorations on the fracture resistance of premolar teeth.

PubMed

Qualtrough, A J; Cawte, S G; Wilson, N H

2001-01-01

Controversy exists over the most favorable material and type of restoration to be used to transitionally restore teeth destined to be crowned. This in vitro study uses fracture resistance testing to compare eight different transitional restorations in maxillary premolars. Ninety sound maxillary premolars were randomly selected and allocated to nine groups, each comprising 10 teeth. One group remained unrestored and was used as the control. Teeth in the remaining groups were prepared to a standard cavity form using: a copy milling process removing the palatal cusp. Restorations were placed using amalgam with dentin pins and cavity varnish; amalgam with an amalgam bonding agent; resin composite with dentin pins and a dentin bonding agent; resin composite with a dentin bonding agent only; resin-modified glass ionomer with dentin pins; resin-modified glass ionomer cement alone and cermet with dentin pins and cermet alone. Each restored tooth was then subjected to axial loading via a bar contacting the buccal and restored palatal cusps until failure of the restored tooth occurred. The mean load-to-fracture values were statistically compared and the modes of failure recorded. It was found that the choice of restorative material and type of restoration had little effect on the fracture resistance of the restored tooth with the exception of those teeth restored with reinforced glass ionomer cement alone, which exhibited a significantly lower resistance to fracture than the other restored teeth. However, the choice of restorative material/technique did influence the mode of failure. Failure in teeth restored with resin-modified glass ionomer cement alone produced the least damage to the remaining tooth tissue when failure occurred. Consequently, this material may offer the most favorable range of properties for the transitional restoration of extensively broken-down maxillary premolar teeth destined to be crowned. Furthermore, the findings of this study fail to support the use of dentin pins in the placement of bonded build-up restorations.

The influence of third molars in the line of mandibular angle fractures on wound and bone healing.

PubMed

Ulbrich, N; Ettl, T; Waiss, W; Gosau, M; Moralis, A; Reichert, T E; Mueller, S

2016-07-01

The objective of this study was to evaluate postoperative complications after removal or retention of the third molar in the line of mandibular angle fractures. This retrospective study included the data of 98 patients with a molar in the line of a mandibular angle fracture treated with internal reduction and mini-plate fixation at our department over 9 years. Patients were classified into two groups: tooth removal during osteosynthesis (n = 45) and tooth retention (n = 55). The primary target criterion was the incidence of minor (outpatient treatment, local measures) and major (surgical revision, rehospitalisation) complications. Time between trauma and surgery was 1.4 days (range 0 to 12), and the average follow-up 291 days (range 66 to 863). Regarding the eruption status, 26 of 52 (50.0 %) impacted third molars, 11 of 19 (57.9 %) incompletely erupted and 8 of 27 (29.6 %) completely erupted molars had been removed during open reduction. Overall, 17 (17.3 %) patients had postoperative minor (n = 7) or major (n = 10) complications, in detail 10/45 (22.0 %) patients after tooth removal and 7/55 (13 %) patients after tooth retention (p = 0.286). Complication rates between impacted and incompletely erupted third molars (impacted molars 15.0 %, incompletely erupted molars 10.0 %) did not differ significantly, but completely erupted molars had a complication rate of 26.0 %. Mandibular angle fractures with a completely erupted third molar show the highest complication rate after open reduction and osteosynthesis. Retention of a non-infectious third molar facilitates open reduction and does not increase the complication risk. The study helps with the decision of removing or retention of a third molar during surgical treatment of a mandibular angle fracture.

Tooth loss in well-maintained patients with chronic periodontitis during long-term supportive therapy in Brazil.

PubMed

Chambrone, Luiz A; Chambrone, Leandro

2006-10-01

The objective of this retrospective study was to assess the reasons for tooth loss in a sample of patients who underwent periodontal therapy and supportive periodontal therapy (SPT) in a Brazilian private periodontal practice. A sample of 120 subjects who had been treated and maintained for 10 years or longer was selected from patients attending a periodontal practice. All patients followed a similar treatment: basic procedures, re-evaluation and periodontal surgery where indicated. Reasons for tooth loss were categorized as periodontal, caries, endodontal, root fractures and extraction of retained or partially erupted third molars. Of the 2927 teeth present at the completion of active periodontal treatment, 53 (1.8%) were lost due to periodontal disease, 16 (0.5%) for root fracture, six (0.2%) to caries, five (0.2%) for endodontic reasons and 31 (1.0%) were lost to extraction of retained or partially erupted third molars. Logistic regression analysis was performed to investigate the association between five independent variables with tooth loss due to periodontitis. Only age (> 60 years) and smoking were statistically significant (p < 0.05). The findings of this survey were consistent with previous studies. Older subjects and smokers were more susceptible to periodontal tooth loss. In addition, patients with generalized chronic periodontitis were treated and maintained for long-term periods with low rates of tooth loss.

An assessment of fracture resistance of three composite resin core build-up materials on three prefabricated non-metallic posts, cemented in endodontically treated teeth: an in vitro study

PubMed Central

Pal, Bhupinder; Pujari, Prashant

2015-01-01

Endodontically treated teeth with excessive loss of tooth structure would require to be restored with post and core to enhance the strength and durability of the tooth and to achieve retention for the restoration. The non-metallic posts have a superior aesthetic quality. Various core build-up materials can be used to build-up cores on the posts placed in endodontically treated teeth. These materials would show variation in their bonding with the non-metallic posts thus affecting the strength and resistance to fracture of the remaining tooth structure. Aims. The aim of the study was to assess the fracture resistance of three composite resin core build-up materials on three prefabricated non-metallic posts, cemented in extracted endodontically treated teeth. Material and Methods. Forty-five freshly extracted maxillary central incisors of approximately of the same size and shape were selected for the study. They were divided randomly into 3 groups of 15 each, depending on the types of non-metallic posts used. Each group was further divided into 3 groups (A, B and C) of 5 samples each depending on three core build-up material used. Student’s unpaired ‘t’ test was also used to analyse and compare each group with the other groups individually, and decide whether their comparisons were statistically significant. Results. Luxacore showed the highest fracture resistance among the three core build-up materials with all the three posts systems. Ti-core had intermediate values of fracture resistance and Lumiglass had the least values of fracture resistance. PMID:25755926

Hidden contributions of the enamel rods on the fracture resistance of human teeth.

PubMed

Yahyazadehfar, M; Bajaj, Devendra; Arola, Dwayne D

2013-01-01

The enamel of human teeth is generally regarded as a brittle material with low fracture toughness. Consequently, the contributions of this tissue in resisting tooth fracture and the importance of its complex microstructure have been largely overlooked. In this study an experimental evaluation of the crack growth resistance of human enamel was conducted to characterize the role of rod (i.e. prism) orientation and degree of decussation on the fracture behavior of this tissue. Incremental crack growth was achieved in-plane, with the rods in directions longitudinal or transverse to their axes. Results showed that the fracture resistance of enamel is both inhomogeneous and spatially anisotropic. Cracks extending transverse to the rods in the outer enamel undergo a lower rise in toughness with extension, and achieve significantly lower fracture resistance than in the longitudinal direction. Though cracks initiating at the surface of teeth may begin extension towards the dentin-enamel junction, they are deflected by the decussated rods and continue growth about the tooth's periphery, transverse to the rods in the outer enamel. This process facilitates dissipation of fracture energy and averts cracks from extending towards the dentin and vital pulp. Copyright © 2012 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Abutment tooth loss in patients with overdentures.

PubMed

Ettinger, Ronald L; Qian, Fang

2004-06-01

Since the 1960s, the use of natural teeth as overdenture abutments has become part of accepted clinical practice. Several longitudinal studies have been conducted, but tooth loss has not been reported to be a significant problem. The aim of this study was to identify the incidence and causes of tooth loss in a prospective cohort study of subjects wearing overdentures. The study, conducted between 1973 and 1994, evaluated 273 subjects (62.3 percent male) with a mean age of 59.6 years. Of the 273 subjects with 666 abutments, 74 lost 133 abutments. The most common cause of tooth loss was periodontal disease (29.3 percent) followed by periapical lesions (18.8 percent) and caries (16.5 percent). Through logistic regression, the authors found that subjects who lost teeth were more likely to have medical problems that could cause soft-tissue lesions of the oral mucosa, were less likely to use fluoride daily and were less likely to return for yearly recall visits. The authors found 22 vertical fractures in 17 subjects. Chi2 analysis revealed that overdenture teeth in the maxillary arch that were opposed by natural teeth were more likely to experience vertical fractures. In a study that followed up some patients for as long as 22 years, the rate of tooth loss was 20.0 percent. Many of these failures could have been prevented if patients had practiced better oral hygiene. The findings suggest that if a dentist recommends overdenture therapy, the patient needs to be examined regularly to reduce the risk of experiencing caries and periodontal disease. Also, if the abutments are in the maxilla and are opposed by natural teeth, the dentist should consider using thimble crowns to reduce the risk of vertical fractures.

Shear bond strengths of tooth coating materials including the experimental materials contained various amounts of multi-ion releasing fillers and their effects for preventing dentin demineralization.

PubMed

Arita, Shoko; Suzuki, Masaya; Kazama-Koide, Miku; Shinkai, Koichi

2017-10-01

We examined shear bond strengths (SBSs) of various tooth-coating-materials including the experimental materials to dentin and demineralization resistance of a fractured adhesive surface after the SBS testing. Three resin-type tooth-coating-materials (BC, PRG Barrier Coat; HC, Hybrid Coat II; and SF, Shield force plus) and two glass-ionomer-type tooth-coating-materials (CV, Clinpro XT Varnish; and FJ, Fuji VII) were selected. The experimental PRG Barrier Coat containing 0, 17, and 33 wt% S-PRG filler (BC0, BC17, and BC33, respectively) were developed. Each tooth-coating-material was applied to flattened dentin surfaces of extracted human teeth for SBS testing. After storing in water for 32 days with 4000 thermal cycling, the specimens were subjected to the SBS test. Specimens after SBS testing were subjected to a pH cycling test, and then, demineralization depths were measured using a polarized-light microscope. ANOVA and Tukey's HSD test were used for statistical analysis. The SBS value of FJ and CV was significantly lower than those of other materials except for BC (p < 0.01). The lesion depth of FJ was significantly shallower than those of other materials (p < 0.01); that of CV was significantly shallower than those of BC, HC, SF, and the control; and those of BC0 and BC17 were significantly shallower than that of the control (p < 0.05). The resin-type tooth-coating-materials demonstrated significantly higher SBS for dentin than the glass-ionomer-type tooth-coating-materials; however, they were inferior to the glass ionomer-type tooth-coating-materials in regards to the acid resistance of the fractured adhesion surface.

Clinical, radiographic, and histological observation of a human immature permanent tooth with chronic apical abscess after revitalization treatment.

PubMed

Shimizu, Emi; Ricucci, Domenico; Albert, Jeffrey; Alobaid, Adel S; Gibbs, Jennifer L; Huang, George T-J; Lin, Louis M

2013-08-01

Revitalization procedures have been widely used for the treatment of immature permanent teeth with apical periodontitis. The treatment procedures appear to be capable of encouraging continued root development and thickening of the canal walls. The nature of tissues formed in the canal space and at the root apex after revitalization has been shown histologically in several animal studies; similar studies in humans were recently reported. A 9-year-old boy had a traumatic injury to his upper anterior teeth. Tooth #9 suffered a complicated crown fracture with a pulp exposure, which was restored with a composite resin. The tooth developed a chronic apical abscess. Revitalization procedures were performed on tooth #9 because it was an immature permanent tooth with an open apex and thin canal walls. Twenty-six months after revitalization, the tooth had a horizontal crown fracture at the cervical level and could not be restored. The tooth was extracted and processed for routine histological and immunohistochemical examination to identify the nature of tissues formed in the canal space. Clinically and radiographically, the revitalization of the present case was successful because of the absence of signs and symptoms and the resolution of periapical lesion as well as thickening of the canal walls and continued root development. The tissue formed in the canal was well-mineralized cementum- or bone-like tissue identified by routine histology and immunohistochemistry. No pulp-like tissue characterized by the presence of polarized odontoblast-like cells aligning dentin-like hard tissue was observed. The tissues formed in the canal of revitalized human tooth are similar to cementum- or bone-like tissue and fibrous connective tissue. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

In vitro study of fracture load and fracture pattern of ceramic crowns: a finite element and fractography analysis.

PubMed

Campos, Roberto Elias; Soares, Carlos José; Quagliatto, Paulo S; Soares, Paulo Vinícius; de Oliveira, Osmir Batista; Santos-Filho, Paulo Cesar Freitas; Salazar-Marocho, Susana M

2011-08-01

This in vitro study investigated the null hypothesis that metal-free crowns induce fracture loads and mechanical behavior similar to metal ceramic systems and to study the fracture pattern of ceramic crowns under compressive loads using finite element and fractography analyses. Six groups (n = 8) with crowns from different systems were compared: conventional metal ceramic (Noritake) (CMC); modified metal ceramic (Noritake) (MMC); lithium disilicate-reinforced ceramic (IPS Empress II) (EMP); leucite-reinforced ceramic (Cergogold) (CERG); leucite fluoride-apatite reinforced ceramic (IPS d.Sign) (SIGN); and polymer crowns (Targis) (TARG). Standardized crown preparations were performed on bovine roots containing NiCr metal dowels and resin cores. Crowns were fabricated using the ceramics listed, cemented with dual-cure resin cement, and submitted to compressive loads in a mechanical testing machine at a 0.5-mm/min crosshead speed. Data were submitted to one-way ANOVA and Tukey tests, and fractured specimens were visually inspected under a stereomicroscope (20×) to determine the type of fracture. Maximum principal stress (MPS) distributions were calculated using finite element analysis, and fracture origin and the correlation with the fracture type were determined using fractography. Mean values of fracture resistance (N) for all groups were: CMC: 1383 ± 298 (a); MMC: 1691 ± 236 (a); EMP: 657 ± 153 (b); CERG: 546 ± 149 (bc); SIGN: 443 ± 126 (c); TARG: 749 ± 113 (b). Statistical results showed significant differences among groups (p < 0.05) represented by different lowercase letters. Metal ceramic crowns presented fracture loads significantly higher than the others. Ceramic specimens presented high incidence of fractures involving either the core or the tooth, and all fractures of polymer crown specimens involved the tooth in a catastrophic way. Based on stress and fractographic analyses it was determined that fracture occurred from the occlusal to the cervical direction. Within the limitations of this study, the results indicated that the use of ceramic and polymer crowns without a core reinforcement should be carefully evaluated before clinical use due to the high incidence of failure with tooth involvement. This mainly occurred for the polymer crown group, although the fracture load was higher than normal occlusal forces. High tensile stress concentrations were found around and between the occlusal loading points. Fractographic analysis indicated fracture originating from the load point and propagating from the occlusal surface toward the cervical area, which is the opposite direction of that observed in clinical situations. © 2011 by The American College of Prosthodontists.

Fracture mode during cyclic loading of implant-supported single-tooth restorations.

PubMed

Hosseini, Mandana; Kleven, Erik; Gotfredsen, Klaus

2012-08-01

Fracture of veneering ceramics in zirconia-based restorations has frequently been reported. Investigation of the fracture mode of implant-supported ceramic restorations by using clinically relevant laboratory protocols is needed. This study compared the mode of fracture and number of cyclic loads until veneering fracture when ceramic and metal ceramic restorations with different veneering ceramics were supported by implants. Thirty-two implant-supported single-tooth restorations were fabricated. The test group was composed of 16 ceramic restorations of zirconia abutment-retained crowns with zirconia copings veneered with glass-ceramics (n=8) and feldspathic ceramics (n=8). The control group was composed of 16 metal ceramic restorations of titanium abutment-retained crowns with gold alloy copings veneered with glass (n=8) and feldspathic ceramics (n=8). The palatal surfaces of the crowns were exposed to cyclic loading of 800 N with a frequency of 2 Hz, which continued to 4.2 million cycles or until fracture of the copings, abutments, or implants. The number of cycles and the fracture modes were recorded. The fracture modes were analyzed by descriptive analysis and the Mann-Whitney test (α=.05). The differences in loading cycles until veneering fracture were estimated with the Cox proportional hazards analysis. Veneering fracture was the most frequently observed fracture mode. The severity of fractures was significantly more in ceramic restorations than in metal ceramic restorations. Significantly more loading cycles until veneering fracture were estimated with metal ceramic restorations veneered with glass-ceramics than with other restorations. The metal ceramic restorations demonstrated fewer and less severe fractures and resisted more cyclic loads than the ceramic restorations, particularly when the metal ceramic crowns were veneered with glass-ceramics. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Surgical management of fractured orthodontic mini- implant- a case report.

PubMed

Desai, Manthan; Jain, Anoop; Sumra, Nida

2015-01-01

The idea of absolute anchorage has always been an elusive goal for clinicians. Orthodontic mini-implants or temporary anchorage devices allow tooth movements previously thought to be impossible or difficult. Although extensive literature exists on use of temporary anchorage devices, their failures have been hardly focused upon, especially implant fracture. The following case report describes successful management of fractured orthodontic mini-implant.

Properties of tooth enamel in great apes.

PubMed

Lee, James J-W; Morris, Dylan; Constantino, Paul J; Lucas, Peter W; Smith, Tanya M; Lawn, Brian R

2010-12-01

A comparative study has been made of human and great ape molar tooth enamel. Nanoindentation techniques are used to map profiles of elastic modulus and hardness across sections from the enamel-dentin junction to the outer tooth surface. The measured data profiles overlap between species, suggesting a degree of commonality in material properties. Using established deformation and fracture relations, critical loads to produce function-threatening damage in the enamel of each species are calculated for characteristic tooth sizes and enamel thicknesses. The results suggest that differences in load-bearing capacity of molar teeth in primates are less a function of underlying material properties than of morphology. Published by Elsevier Ltd.

Intentional Replantation of an Immature Incisor with a Transverse Root Fracture and Endo-Perio Condition: 4 Year Follow-Up.

PubMed

Oishi, Atsushi

This case report describes the importance of continual examination for dental trauma and the efficacy of intentional replantation with retrograde root canal filling for a transverse root fracture in an immature incisor accompanied by subsequent periodontal-endodontic disease. In the treatment of traumatically fractured roots in immature incisors, continual examination is indispensable for the final diagnosis because roots in immature teeth are less calcified, resulting in less detailed radiological examinations. Thus, common dental trauma complications such as pulp necrosis may appear months after the initial examination. Endodontic treatment for transverse root fracture is mainly determined according to radiographic examination findings; for fractured immature roots, apexification with calcium hydroxide of the coronal fragment is generally applied. However, this method requires removal of considerable amounts of enamel and dentin to allow access to the cavity for preparation, which may increase the risk of future fractures. In contrast, intentional replantation with retrograde root canal filling does not require the removal or long-term application of calcium hydroxide. However, it requires careful extraction of the tooth, maintenance of root wetness during the extraoral procedure, rigid splinting, and oral hygiene control. Management of tooth mobility is also important in the post-replantation course.

The Role of Organic Proteins on the Crack Growth Resistance of Human Enamel

PubMed Central

Yahyazadehfar, Mobin; Arola, Dwayne

2015-01-01

With only 1% protein by weight, tooth enamel is the most highly mineralized tissue in mammals. The focus of this study was to evaluate contributions of the proteins on the fracture resistance of this unique structural material. Sections of enamel were obtained from the cusps of human molars and the crack growth resistance was quantified using a conventional fracture mechanics approach with complementary finite element analysis. In selected specimens the proteins were extracted using a potassium hydroxide treatment. Removal of the proteins resulted in approximately 40% decrease in the fracture toughness with respect to the fully proteinized control. The loss of organic content was most detrimental to the extrinsic toughening mechanisms, causing over 80% reduction in their contribution to the total energy to fracture. This degradation occurred by embrittlement of the unbroken bridging ligaments and consequent reduction in the crack closure stress. Although the organic content of tooth enamel is very small, it is essential to crack growth toughening by facilitating the formation of unbroken ligaments and in fortifying their potency. Replicating functions of the organic content will be critical to the successful development of bio-inspired materials that are designed for fracture resistance. PMID:25805107

[A maxillary premolar reconstruction with a glass fiber reinforced post].

PubMed

Viţalariu, Anca Mihaela; Antohe, Magda; Bahrim, Delia; Tatarciuc, Monica

2006-01-01

This paper presents the case of a 37 years old female patient who needed a reconstruction of an endodontic treated' second maxillary premolar. The patient presented large areas of occlusal abrasion caused by bruxism, therefore the solution consisted of a reconstruction with a non-metallic post reinforced with glass fibers. In such cases, the excessive occlusal forces developed by bruxism can produce a radicular fracture if the tooth would be reconstructed with a rigid metallic post. The glass-fiber reinforced post has some important qualities, which render it more suitable in most clinical cases: it is easy to use; has the ability to bond with restorative resins; decreases the risk of tooth fracture and provides better esthetics.

Silicone index: an alternative approach for tooth fragment reattachment.

PubMed

Alvares, Isana; Sensi, Luis Guilherme; Araujo, Edson Medeiros; Araujo, Elito

2007-01-01

Tooth fragment reattachment is a simple, conservative, fast, and affordable treatment option for fractured teeth when the fragment is available. However, this technique can present some difficulties, among which is the possibility of the fragment being positioned and bonded inadequately. To avoid this situation, it is necessary to establish a reference for the adequate positioning of the fragment using a silicone index. This article presents an alternative approach for better handling of tooth fragments resulting from trauma by using a silicone index as a guide to proper positioning and bonding.

Dental extrusion with orthodontic miniscrew anchorage: a case report describing a modified method.

PubMed

Horliana, Ricardo Fidos; Horliana, Anna Carolina Ratto Tempestini; Wuo, Alexandre do Vale; Perez, Flávio Eduardo Guillin; Abrão, Jorge

2015-01-01

In recent years, the skeletal anchorage through miniscrews has expanded the treatment options in orthodontics (Yamaguchi et al., 2012). We hereby present a modified method for tooth extrusion for cases where crown-lengthening surgery is contraindicated for aesthetic reasons. This modified method uses three orthodontic appliances: a mini-implant, an orthodontic wire, and a bracket. The aim of this case report was to increase the length of the clinical crown of a fractured tooth (tooth 23) by means of an orthodontic extrusion with the modified method of Roth and Diedrich.

Evaluation of MEMS-Based Wireless Accelerometer Sensors in Detecting Gear Tooth Faults in Helicopter Transmissions

NASA Technical Reports Server (NTRS)

Lewicki, David George; Lambert, Nicholas A.; Wagoner, Robert S.

2015-01-01

The diagnostics capability of micro-electro-mechanical systems (MEMS) based rotating accelerometer sensors in detecting gear tooth crack failures in helicopter main-rotor transmissions was evaluated. MEMS sensors were installed on a pre-notched OH-58C spiral-bevel pinion gear. Endurance tests were performed and the gear was run to tooth fracture failure. Results from the MEMS sensor were compared to conventional accelerometers mounted on the transmission housing. Most of the four stationary accelerometers mounted on the gear box housing and most of the CI's used gave indications of failure at the end of the test. The MEMS system performed well and lasted the entire test. All MEMS accelerometers gave an indication of failure at the end of the test. The MEMS systems performed as well, if not better, than the stationary accelerometers mounted on the gear box housing with regards to gear tooth fault detection. For both the MEMS sensors and stationary sensors, the fault detection time was not much sooner than the actual tooth fracture time. The MEMS sensor spectrum data showed large first order shaft frequency sidebands due to the measurement rotating frame of reference. The method of constructing a pseudo tach signal from periodic characteristics of the vibration data was successful in deriving a TSA signal without an actual tach and proved as an effective way to improve fault detection for the MEMS.

Satisfaction with appearance and the desired treatment to improve aesthetics.

PubMed

Al-Zarea, Bader K

2013-01-01

Objective. To identify participants' satisfaction with appearance and the desired treatment to improve aesthetics. Materials and Methods. 220 participants (127 males and 93 females, mean age = 21.4 ± 1.5 years) were recruited into the study. A structured questionnaire was used to assess patients' satisfaction with appearance and what treatment they desire to improve aesthetics. Participants scored the level of satisfaction with appearance using visual analogue scale. Results. The VAS mean score of satisfaction with general appearance was 6.8 ± 2.3. Half participants were dissatisfied with tooth appearance and 65.9% were dissatisfied with tooth colour. Higher VAS scores were associated with higher desire for all treatments that improve tooth appearance (P < .05). Dissatisfaction with tooth appearance increased with increased dissatisfaction with teeth colour, feeling of poor tooth alignment, presence of fractured anterior teeth, and increased desire for orthodontic, crowns, and dentures treatments (P < .05). Dissatisfaction with tooth colour was associated with increased desire for tooth whitening and tooth coloured fillings (P < .05). Conclusions. Participants had high levels of dissatisfaction with tooth appearance and tooth colour. Dissatisfaction with tooth colour contributed to the increased dissatisfaction with tooth appearance. Dissatisfaction with tooth appearance, colour, alignment, and condition was significantly related to high desire for aesthetic treatments.

[Aftercare for durability and profitability of single-unit and multi-unit fixed dental prostheses].

PubMed

de Baat, C; van Loveren, C; van der Maarel-Wierink, C D; Witter, D J; Creugers, N H J

2013-01-01

An important aim ofa treatment with single-unit and multi-unit fixed dental prostheses is a durable and profitable treatment outcome. That requires aftercare, too. First, the frequency of routine oral examinations should be assessed, using an individual risk profile. The objectives of the routine oral examinations are the prevention and, when necessary, the treatment of pathological conditions and complications. With regard to prevention, attention should be paid to information and instruction, oral biofilm and calculus, non-functional activities, hard tooth tissues, periodontal and peri-implant tissues, and saliva. Subsequently, it can be determined whether the intended durability and profitability have been achieved or can still be achieved, whether or not through indicated adjustments. Special attention should be paid to endodontically treated teeth. Restorative, repair or replacement treatments may be indicated in case ofcomplications, such as loose single- or multi-unitfixed dental prosthesis, fracture of a fixed dental prosthesis unit, lost tooth pulp vitality, tooth root fracture, and implant or implant abutment problems.

Orthodontic Movement after Regenerative Endodontic Procedure: Case Report and Long-term Observations.

PubMed

Chaniotis, Antonis

2018-03-01

Although regenerative treatment approaches in teeth with incomplete root formation and pulp necrosis have become part of the suggested therapeutic endodontic spectrum, little is known about the effect of orthodontic movement in the tissue that has been regenerated. Furthermore, as the number of adults undergoing orthodontic treatment increases, there is an increasing need to investigate the changes that these tissues may undergo during orthodontic movement. Here we describe the alterations observed after the application of orthodontic forces in a case of an apically root-fractured necrotic immature root that had been managed with regenerative endodontic procedures in the past. A 9-year-old male patient was referred after suffering the third incidence of trauma in the anterior maxilla. Radiographic evaluation revealed a periapical rarefaction associated with an apically root-fractured immature central incisor. Clinical evaluation revealed a buccal abscess and grade 3 tooth mobility. Periodontal probing was within normal limits. The tooth was accessed and disinfected by using apical negative pressure irrigation of 6% NaOCl. Intracanal dentin conditioning was achieved by using 17% EDTA for 5 minutes. A blood clot was induced from the periapical area, and calcium silicate-based cement was placed in direct contact with the blood clot at the same visit. The composite resin restoration was accomplished in the same appointment. Recall radiographic examination after 24 months revealed healing of the periapical lesion and signs of continuous root development despite the apical root fracture. Clinical evaluation revealed normal tooth development, normal mobility, and a resolving buccal infection. The tooth was subjected to orthodontic treatment because of Class II division 1 malocclusion with an overjet of 11 mm. After completion of the orthodontic treatment, 5.5 years after the initial intervention, the radiographic image revealed marked remodeling of the periapical tissues and repair of the apical fractures, and the buccal infection had resolved completely. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

In vitro performance and fracture resistance of CAD/CAM-fabricated implant supported molar crowns.

PubMed

Rosentritt, Martin; Hahnel, Sebastian; Engelhardt, Frank; Behr, Michael; Preis, Verena

2017-05-01

The aim of this study is to investigate the performance and fracture resistance of different CAD/CAM ceramic and composite materials as implant- or tooth-supported single crowns with respect to the clinical procedure (screwed/bonded restoration). One hundred twenty crowns were fabricated on implants or human molar teeth simulating (a) chairside procedure ([CHAIR] implant crown bonded to abutment), (b) labside procedure ([LAB] abutment and implant crown bonded in laboratory, screwed chairside), and (c) reference ([TOOTH] crowns luted on human teeth). Four materials were investigated: ZLS (zirconia-reinforced lithium silicate ceramic; Celtra Duo, Degudent: polished (P)/crystallized (C)), RB (resin-based composite; Cerasmart, GC), and RIC (resin-infiltrated ceramic; Enamic, Vita-Zahnfabrik). LiS (lithiumdisilicate; Emax CAD, Ivoclar-Vivadent) served as reference. Combined thermal cycling and mechanical loading (TCML) was performed simulating a 5-year clinical situation. Fracture force was determined. Data were statistically analyzed (Kolmogorov-Smirnov test, one-way ANOVA; post hoc Bonferroni, α = 0.05). One crown of ZLS_C[LAB] (1,200,000 cycles) and RB[CHAIR] (890 cycles) failed during TCML. Fracture values varied between 977.7 N(RB) and 3070.4 N(LiS)[CHAIR], 1130.6 N(RB) and 2998.1 N(LiS)[LAB], and 1802.4 N(ZLS) and 2664.3 N(LiS)[TOOTH]. Significantly (p < 0.003) different forces were found between the materials in all three groups. ZLS_C, RIC, and RB showed significantly (p < 0.014) different values for the individual groups. Partly ceramic and resin-based materials performed differently on implant or tooth abutments. The insertion of a screw channel reduced the stability for individual crown materials. Insertion of the screw channel should be performed carefully. All restorations were in a range where clinical application seems not restricted, but insertion of a screw channel might reduce stability of individual materials.

Tooth fragment reattachment techniques-A systematic review.

PubMed

Garcia, Fernanda Cristina P; Poubel, Déborah L N; Almeida, Júlio César F; Toledo, Isabela P; Poi, Wilson R; Guerra, Eliete N S; Rezende, Liliana V M L

2018-03-07

Several strategies have been developed for tooth fragment reattachment following fracture. Although many techniques have been reported, there is no consensus on which one has the best results in terms of the bond strength between the fragment and the dentin over time. The aim of this study was to assess the currently reported tooth fragment reattachment techniques for fractured crowns of anterior teeth. The PubMed, LILACS, Web of Science, Cochrane, and Scopus databases were searched in October 2016, and the search was updated in February 2017. A search of the gray literature was performed in Google Scholar and OpenGrey. Reference lists of eligible studies were cross-checked to identify additional studies; gray literature and ongoing trials were investigated. Two authors assessed studies to determine inclusion and undertook data extraction. Case reports/series of three or more cases, cross-sectional studies, cohort studies, and in vivo clinical trials in all languages were included. Five articles remained after screening. These studies predominantly reported on fragment reattachment with composite resin and resin cement. There was little consistency among the studies in regard to the technique used for tooth fragment reattachment and length of the follow-up period. According to the evidence found in the studies included in this review, simple tooth fragment reattachment was the preferred reattachment technique. An increase in the bond strength between tooth fragment and dentin was observed when an intermediate material was used. Further investigation is needed, using standard follow-up periods and larger samples. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Transosseous fixation of pediatric displaced mandibular fractures with polyglactin resorbable suture--a simplified technique.

PubMed

Chandan, Sanjay; Halli, Rajshekhar; Joshi, Samir; Chhabaria, Gaurav; Setiya, Sneha

2013-11-01

Management of pediatric mandibular fractures presents a unique challenge to surgeons in terms of its numerous variations compared to adults. Both conservative and open methods have been advocated with their obvious limitations and complications. However, conservative modalities may not be possible in grossly displaced fractures, which necessitate the open method of fixation. We present a novel and simplified technique of transosseous fixation of displaced pediatric mandibular fractures with polyglactin resorbable suture, which provides adequate stability without any interference with tooth buds and which is easy to master.

Tongue piercing and insertion of metal studs: three cases of dental and oral consequences.

PubMed

Ram, D; Peretz, B

2000-01-01

"Body art" is a fashion that appears to be gaining popularity worldwide. There are many risks and potentially adverse results associated with tongue piercing. Pain (the procedure is performed without anesthetics), post-placement edema and the risk of prolonged bleeding, if the blood vessels are punctured during the piercing, and fracture of tooth structures, are but a few of the risks. The purpose of the present article is to describe the consequences of three cases of tongue piercing in which metallic barbell-shaped studs were inserted: the consequences include the fracture of tooth structure, caused by the device knocking against the teeth; and inflammation and edema occurred as a result of the piercing of the tongue.

Effects of pulp capping materials on fracture resistance of Class II composite restorations

PubMed Central

Kucukyilmaz, Ebru; Yasa, Bilal; Akcay, Merve; Savas, Selcuk; Kavrik, Fevzi

2015-01-01

Objective: The aim of this study was to investigate the effect of cavity design and the type of pulp capping materials on the fracture resistance of Class II composite restorations. Materials and Methods: Sixty freshly extracted, sound molar teeth were selected for the study. A dovetail cavity on the mesio-occlusal and a slot cavity on disto-occlusal surfaces of each tooth were prepared, and the teeth were divided 4 groups which one of them as a control group. The pulp capping materials (TheraCal LC, Calcimol LC, Dycal) applied on pulpo-axial wall of each cavity, and the restoration was completed with composite resin. The teeth were subjected to a compressive load in a universal mechanical testing machine. The surfaces of the tooth and restoration were examined under a stereomicroscope. The data were analyzed using factorial analysis of variance and Tukey's test. Results: For pulp capping materials, the highest fracture load (931.15 ± 203.81 N) and the lowest fracture load (832.28 ± 245.75 N) were calculated for Control and Dycal group, respectively. However, there were no statistically significant differences among all groups (P > 0.05). The fracture load of the dovetail groups was significantly higher than those of the slot cavity groups (P < 0.05). Conclusion: Dovetail cavity design shows better fracture resistance in Class II composite restorations, independent of used or not used pulp capping materials. PMID:26038653

Crown and crown-root fractures: an evaluation of the treatment plans for management proposed by 154 specialists in restorative dentistry.

PubMed

de Castro, Mara Antonio Monteiro; Poi, Wilson Roberto; de Castro, José Carlos Monteiro; Panzarini, Sônia Regina; Sonoda, Celso Koogi; Trevisan, Carolina Lunardelli; Luvizuto, Eloá Rodrigues

2010-06-01

Traumatic tooth injuries involve function and aesthetics and cause damage that range from minimal enamel loss to complex fractures involving the pulp tissue and even loss of the tooth crown. Technical knowledge and clinical experience are essential to establish an accurate diagnosis and provide a rational treatment. The purpose of this study was to evaluate the knowledge of Restorative Dentistry specialists about the management of crown and crown-root fractures based on treatment plans proposed by these professionals for these cases. A descriptive questionnaire was mailed to 245 Restorative Dentistry specialists with questions referring to their professional profile and the treatment plans they would propose for the management of crown and crow-root fractures resulting from dental trauma. One hundred and fifty-four questionnaires were returned properly filled. The data were subjected to descriptive statistics and the chi-square test was used to determine the frequency and the level of the significance among the variables. The analysis of data showed that in spite of having a specialist title, all interviewees had great difficulty in planning the treatments. As much as 42.8% of the participants were unable to treat all types of dental trauma. Complicated and uncomplicated crown-root fractures posed the greatest difficulties for the dentists to establish adequate treatment plans because these fractures require multidisciplinary knowledge and approach for a correct case planning and prognosis.

Implant/tooth-connected restorations utilizing screw-fixed attachments: a survey of 3,096 sites in function for 3 to 14 years.

PubMed

Fugazzotto, P A; Kirsch, A; Ackermann, K L; Neuendorff, G

1999-01-01

Numerous problems have been reported following various therapies used to attach natural teeth to implants beneath a fixed prosthesis. This study documents the results of 843 consecutive patients treated with 1,206 natural tooth/implant-supported prostheses utilizing 3,096 screw-fixed attachments. After 3 to 14 years in function, only 9 intrusion problems were noted. All problems were associated with fractured or lost screws. This report demonstrates the efficacy of such a treatment approach when a natural tooth/implant-supported fixed prosthesis is contemplated.

Treatment of multiple traumatized anterior teeth associated with an alveolar bone fracture in a 20-year-old patient: A 3-year follow up

PubMed Central

Faus-Matoses, Vicente; Alegre-Domingo, Teresa; Faus-Matoses, Ignacio; Faus-Llácer, Vicente J.

2014-01-01

Intrusive luxation is a type of recognizable luxation injury represented by a deeper axial displacement of the tooth toward the alveolar bone. Treatment strategies include waiting for the tooth to return to its position, immediate surgical repositioning, and repositioning through dental traction by orthodontic devices. The aim of this case report was to present the management of severe dental trauma and later restoration following IADT. A 20-year-old patient was presented after fainting at home four hours before, resulting in a dento-alveolar trauma. Clinical examinations revealed a traumatic intrusion, in 1.2, 1.1 and 2.1, uncomplicated crown fractures in 1.1 and 2.1 and a complicated crown-root fracture in 2.2. The diagnosis was confirmed with CBCT. Following IADT protocol, the emergency treatment consisted of the surgical repositioning and semi-rigid splinting using orthodontic wire-composite, replacing the buccal bone plate, and postoperative instructions to the patient regarding oral hygiene. After 2 weeks the root canal treated and filled with fiberglass posts in 1.2, 1.1, 2.1 and 2.2. Splint was removed after 4 weeks and the IADT reassessment protocol followed, with revisions at 6-8 weeks, 6 months, a year and annual reviews for 5 years. A year after the treatment, the traumatized teeth were restored with minimally invasive preparations of feldspathic ceramic. Esthetics and function were recorded with a 3-year follow-up period. Key words:Intrusive luxation, dental trauma, crown-root fracture, dento-alveolar trauma, permanent tooth, CBCT. PMID:25593668

Treatment of multiple traumatized anterior teeth associated with an alveolar bone fracture in a 20-year-old patient: A 3-year follow up.

PubMed

Faus-Matoses, Vicente; Martínez-Viñarta, María; Alegre-Domingo, Teresa; Faus-Matoses, Ignacio; Faus-Llácer, Vicente J

2014-10-01

Intrusive luxation is a type of recognizable luxation injury represented by a deeper axial displacement of the tooth toward the alveolar bone. Treatment strategies include waiting for the tooth to return to its position, immediate surgical repositioning, and repositioning through dental traction by orthodontic devices. The aim of this case report was to present the management of severe dental trauma and later restoration following IADT. A 20-year-old patient was presented after fainting at home four hours before, resulting in a dento-alveolar trauma. Clinical examinations revealed a traumatic intrusion, in 1.2, 1.1 and 2.1, uncomplicated crown fractures in 1.1 and 2.1 and a complicated crown-root fracture in 2.2. The diagnosis was confirmed with CBCT. Following IADT protocol, the emergency treatment consisted of the surgical repositioning and semi-rigid splinting using orthodontic wire-composite, replacing the buccal bone plate, and postoperative instructions to the patient regarding oral hygiene. After 2 weeks the root canal treated and filled with fiberglass posts in 1.2, 1.1, 2.1 and 2.2. Splint was removed after 4 weeks and the IADT reassessment protocol followed, with revisions at 6-8 weeks, 6 months, a year and annual reviews for 5 years. A year after the treatment, the traumatized teeth were restored with minimally invasive preparations of feldspathic ceramic. Esthetics and function were recorded with a 3-year follow-up period. Key words:Intrusive luxation, dental trauma, crown-root fracture, dento-alveolar trauma, permanent tooth, CBCT.

The role of organic proteins on the crack growth resistance of human enamel.

PubMed

Yahyazadehfar, Mobin; Arola, Dwayne

2015-06-01

With only 1% protein by weight, tooth enamel is the most highly mineralized tissue in mammals. The focus of this study was to evaluate contributions of the proteins on the fracture resistance of this unique structural material. Sections of enamel were obtained from the cusps of human molars and the crack growth resistance was quantified using a conventional fracture mechanics approach with complementary finite element analysis. In selected specimens the proteins were extracted using a potassium hydroxide treatment. Removal of the proteins resulted in approximately 40% decrease in the fracture toughness with respect to the fully proteinized control. The loss of organic content was most detrimental to the extrinsic toughening mechanisms, causing over 80% reduction in their contribution to the total energy to fracture. This degradation occurred by embrittlement of the unbroken bridging ligaments and consequent reduction in the crack closure stress. Although the organic content of tooth enamel is very small, it is essential to crack growth toughening by facilitating the formation of unbroken ligaments and in fortifying their potency. Replicating functions of the organic content will be critical to the successful development of bio-inspired materials that are designed for fracture resistance. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Pediatric maxillary fractures.

PubMed

Yu, Jack; Dinsmore, Robert; Mar, Philip; Bhatt, Kirit

2011-07-01

Pediatric craniofacial structures differ from those of adults in many ways. Because of these differences, management of pediatric craniofacial fractures is not the same as those in adults. The most important differences that have clinical relevance are the mechanical properties, craniofacial anatomy, healing capacity, and dental morphology. This article will review these key differences and the management of pediatric maxillary fractures. From the mechanical properties' perspective, pediatric bones are much more resilient than adult bones; as such, they undergo plastic deformation and ductile failure. From the gross anatomic perspective, the relative proportion of the cranial to facial structures is much larger for the pediatric patients and the sinuses are not yet developed. The differences related to dentition and dental development are more conical crowns, larger interdental spaces, and presence of permanent tooth buds in the pediatric population. The fracture pattern, as a result of all the above, does not follow the classic Le Fort types. The maxillomandibular fixation may require circum-mandibular wires, drop wires, or Ivy loops. Interfragmentary ligatures using absorbable sutures play a much greater role in these patients. The use of plates and screws should take into consideration the future development with respect to growth centers and the location of the permanent tooth buds. Pediatric maxillary fractures are not common, require different treatments, and enjoy better long-term outcomes.

An investigation of new metal framework design for metal ceramic restorations.

PubMed

O'Boyle, K H; Norling, B K; Cagna, D R; Phoenix, R D

1997-09-01

Metal ceramic restorations have been implicated in the discoloration of associated gingival tissues. Attempts to remedy this by altering the design of the metal frameworks for such restorations may lead to unacceptable decreases in fracture resistance. This study evaluated a new metal framework design for metal-ceramic restorations. Twenty artificial crowns were fabricated with various degrees of facial metal reduction; 0, 1, 2, and 3 mm. The study was conducted in two parts. The first part evaluated changes in light transmission into adjacent root tissue. A light box was fabricated so sample crowns could be illuminated on a mounted natural tooth. The root of the tooth remained outside the light box, and the light transmitted through the crowns into root tissue was measured with a light meter. The second part of the study evaluated changes in fracture strength. The sample crowns were subjected to a vertical load until fracture with use of an Instron machine at a crosshead speed of 1 mm per minute. The load at fracture was recorded. Results indicated a statistically significant increase in light transmission with 1 mm framework reduction or greater, and fracture strengths did not decrease with up to 1 mm of framework reduction. A 1 mm facial axial reduction of the metal framework may be indicated for anterior metal-ceramic restorations.

[The management of 126 cases of posterior cracked crown of tooth and its effective observation].

PubMed

Chen, L L

2000-06-01

To detect the treatment and effect of posterior cracked tooth. 162 posterior cracked teeth of 158 cases, including enamel fissure and dentin fissure, all there cases undergone the synthetical treatment and follow up in different period, the longest observation period was 2.5 years. The healing and improved rate of 162 cracked teeth 90.74%. Among cases of failure, we have founded 6 cases of acute pulpitis (3.7%), 3 cases of alveodental abscess (1.85%), 2 cases of chronic apical periodontitis (1.24%), 4 cases of tooth fracture (2.4%). Cracked tooth was caused by multiple factors. Early diagnosis, synthetical treatment, and follow up in different period are 3 main factors in treatment.

Applying extrusive orthodontic force without compromising the obturated canal space.

PubMed

Keinan, David; Szwec, Jerard; Matas, Avital; Moshonov, Joshua; Yitschaky, Oded

2013-08-01

Complicated tooth fractures can be the unfortunate result of orofacial trauma and can offer a therapeutic challenge for the dentist. A conservative solution for gaining supragingival sound tooth structure often includes orthodontic forced eruption. Usually, this procedure is carried out by applying extrusive force after placing a provisional acrylic Richmond crown on the tooth. However, this long-lasting dental treatment may jeopardize the coronal seal of the root canal space, leading to microleakage and endodontic failure. Orthodontic forced eruption demands application of force to an attachment connected to the remaining short clinical crown. In this article, the authors describe a case in which they used a new technique for orthodontic forced eruption of a traumatized tooth, using an extracanal attachment to apply extrusion force, and discuss its possible advantages and limitations. An extracanal attachment approach for orthodontic forced eruption without compromising the obturated canal space can be a solution for posttraumatic crown fracture. Practical Implications. The described procedure for forced eruption by using an extracanal pin attachment is efficient and convenient and does not require the clinician to apply force directly to the provisional crown. Therefore, during the application of force, there is less risk of loosening the provisional crown, and the canal space is kept intact with either the final restoration or dressing material.

A simple model for enamel fracture from margin cracks.

PubMed

Chai, Herzl; Lee, James J-W; Kwon, Jae-Young; Lucas, Peter W; Lawn, Brian R

2009-06-01

We present results of in situ fracture tests on extracted human molar teeth showing failure by margin cracking. The teeth are mounted into an epoxy base and loaded with a rod indenter capped with a Teflon insert, as representative of food modulus. In situ observations of cracks extending longitudinally upward from the cervical margins are recorded in real time with a video camera. The cracks appear above some threshold and grow steadily within the enamel coat toward the occlusal surface in a configuration reminiscent of channel-like cracks in brittle films. Substantially higher loading is required to delaminate the enamel from the dentin, attesting to the resilience of the tooth structure. A simplistic fracture mechanics analysis is applied to determine the critical load relation for traversal of the margin crack along the full length of the side wall. The capacity of any given tooth to resist failure by margin cracking is predicted to increase with greater enamel thickness and cuspal radius. Implications in relation to dentistry and evolutionary biology are briefly considered.

A demographic analysis of vertical root fractures.

PubMed

Cohen, Stephen; Berman, Louis H; Blanco, Lucia; Bakland, Leif; Kim, Jay S

2006-12-01

Teeth with vertical root fractures (VRFs) have complete or incomplete fractures that extends through the enamel, dentin and pulp, down the long axis of the tooth. Several different variables were investigated and statistically evaluated as to their correlation with the presence of VRFs. Specifically analyzed were gender, tooth location, age, radiographic and clinical findings, bruxism, and pulpal status. The data were collected from three different endodontists, from three different geographic locations, comprising a total of 227 teeth. Although VRFs may occur in conjunction with any of the parameters investigated, only certain factors were found to occur in a significant number of cases. The results indicate that VRFs are statistically more prevalent in mandibular molars and maxillary premolars. They are associated with periradicular bone loss, pain to percussion, extensive restorations, and seem to occur more often in females and older patients. However, VRFs are not necessarily related to periapical bone loss, a widening of the periodontal ligament space, associated periodontal pockets, a sinus tract, particular pulpal status, or bruxism.

Management of an uncomplicated crown fracture by reattaching the fractured fragment-Case report.

PubMed

Martos, Josué; Pinto, Karoline V A; Miguelis, Tiago M F; Xavier, Cristina B

2017-12-01

Coronal fractures of the anterior teeth are common sequelae of traumatic dental injuries. Reattachment of fractured tooth fragments using dental adhesive techniques offers some advantages, including restoration of the function, esthetics, shape, texture, and brightness of the surface. The present report describes a clinical case of reattachment with a 4-year clinical and radiographic follow up in a permanent maxillary central incisor with an uncomplicated crown fracture. Fragment reattachment is a conservative procedure, preserving esthetics and functionality, and it can provide an immediate positive emotional response from the patient. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Failure strengths of denture teeth fabricated on injection molded or compression molded denture base resins.

PubMed

Robison, Nathan E; Tantbirojn, Daranee; Versluis, Antheunis; Cagna, David R

2016-08-01

Denture tooth fracture or debonding remains a common problem in removable prosthodontics. The purpose of this in vitro study was to explore factors determining failure strengths for combinations of different denture tooth designs (shape, materials) and injection or compression molded denture base resins. Three central incisor denture tooth designs were tested: nanohybrid composite (NHC; Ivoclar Phonares II), interpenetrating network (IPN; Dentsply Portrait), and microfiller reinforced polyacrylic (MRP; VITA Physiodens). Denture teeth of each type were processed on an injection molded resin (IvoBase HI; Ivoclar Vivadent AG) or a compression molded resin (Lucitone 199; Dentsply Intl) (n=11 or 12). The denture teeth were loaded at 45 degrees on the incisal edge. The failure load was recorded and analyzed with 2-way ANOVA (α=.05), and the fracture mode was categorized from observed fracture surfaces as cohesive, adhesive, or mixed failure. The following failure loads (mean ±SD) were recorded: NHC/injection molded 280 ±52 N; IPN/injection molded 331 ±41 N; MRP/injection molded 247 ±23 N; NHC/compression molded 204 ±31 N; IPN/compression molded 184 ±17 N; MRP/compression molded 201 ±16 N. Injection molded resin yielded significantly higher failure strength for all denture teeth (P<.001), among which IPN had the highest strength. Failure was predominantly cohesive in the teeth, with the exception of mixed mode for the IPN/compression group. When good bonding was achieved, the strength of the structure (denture tooth/base resin combination) was determined by the strength of the denture teeth, which may be affected by the processing technique. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Indentation damage and mechanical properties of human enamel and dentin.

PubMed

Xu, H H; Smith, D T; Jahanmir, S; Romberg, E; Kelly, J R; Thompson, V P; Rekow, E D

1998-03-01

Understanding the mechanical properties of human teeth is important to clinical tooth preparation and to the development of "tooth-like" restorative materials. Previous studies have focused on the macroscopic fracture behavior of enamel and dentin. In the present study, we performed indentation studies to understand the microfracture and deformation and the microcrack-microstructure interactions of teeth. It was hypothesized that crack propagation would be influenced by enamel rods and the dentino-enamel junction (DEJ), and the mechanical properties would be influenced by enamel rod orientation and tooth-to-tooth variation. Twenty-eight human third molars were used for the measurement of hardness, fracture toughness, elastic modulus, and energy absorbed during indentation. We examined the effect of enamel rod orientation by propagating cracks in the occlusal surface, and in the axial section in directions parallel and perpendicular to the occlusal surface. The results showed that the cracks in the enamel axial section were significantly longer in the direction perpendicular to the occlusal surface than parallel. The cracks propagating toward the DEJ were always arrested and unable to penetrate dentin. The fracture toughness of enamel was not single-valued but varied by a factor of three as a function of enamel rod orientation. The elastic modulus of enamel showed a significant difference between the occlusal surface and the axial section. It is concluded that the cracks strongly interact with the DEJ and the enamel rods, and that the mechanical properties of teeth are functions of microstructural orientations; hence, single values of properties (e.g., a single toughness value or a single modulus value) should not be used without information on microstructural orientation.

Effect of tooth substrate and porcelain thickness on porcelain veneer failure loads in vitro.

PubMed

Ge, Chunling; Green, Chad C; Sederstrom, Dalene A; McLaren, Edward A; Chalfant, James A; White, Shane N

2017-12-19

Bonded porcelain veneers are widely used esthetic restorations. High success and survival rates have been reported, but failures do occur. Fractures are the commonest failure mode. Minimally invasive or thin veneers have gained popularity. Increased enamel and porcelain thickness improve the strength of veneers bonded to enamel, but less is known about dentin or mixed substrates. The purpose of this in vitro study was to measure the influences of tooth substrate type (all-enamel, all-dentin, or half-dentin-half-enamel) and veneer thickness on the loads needed to cause initial and catastrophic porcelain veneer failure. Model discoid porcelain veneer specimens of varying thicknesses were bonded to the flattened facial surfaces of incisors with different enamel and dentin tooth substrates, artificially aged, and loaded to failure with a small sphere. Initial and catastrophic fracture events were identified and analyzed statistically and fractographically. Fracture events included initial Hertzian cracks, intermediate radial cracks, and catastrophic gross failure. All specimens retained some porcelain after catastrophic failure. Cement failure occurred at the cement-porcelain interface not at the cement-tooth interface. Porcelain veneers bonded to enamel were substantially stronger and more damage-tolerant than those bonded to dentin or mixed substrates. Increased porcelain thickness substantially raised the loads to catastrophic failure on enamel substrates but only moderately raised the loads to catastrophic failure on dentin or mixed substrates. The veneers bonded to half-dentin-half-enamel behaved remarkably like those bonded wholly to dentin. Porcelain veneers bonded to enamel were substantially stronger and more damage-tolerant than those bonded to dentin or half-enamel-half dentin. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Cracked tooth syndrome: A report of three cases.

PubMed

Sadasiva, Kadandale; Ramalingam, Sathishmuthukumar; Rajaram, Krishnaraj; Meiyappan, Alagappan

2015-08-01

Cracked tooth syndrome (CTS), the term was coined by Cameron in 1964, which refers to an incomplete fracture of a vital posterior tooth extending to the dentin and occasionally into the pulp. CTS has always been a nightmare to the patient because of its unpredictable symptoms and a diagnostic dilemma for the dental practitioner due to its variable, bizarre clinical presentation. The treatment planning and management of CTS has also given problems and challenges the dentist as there is no specific treatment option. The management of CTS varies from one case to another or from one tooth to another in the same individual based on the severity of the symptoms and depth of tooth structure involved. After all, the prognosis of such tooth is still questionable and requires continuous evaluation. This article aims at presenting a series three cases of CTS with an overview on the clinical presentation, diagnosis and the different treatment options that varies from one case to another.

Cracked tooth syndrome: A report of three cases

PubMed Central

Sadasiva, Kadandale; Ramalingam, Sathishmuthukumar; Rajaram, Krishnaraj; Meiyappan, Alagappan

2015-01-01

Cracked tooth syndrome (CTS), the term was coined by Cameron in 1964, which refers to an incomplete fracture of a vital posterior tooth extending to the dentin and occasionally into the pulp. CTS has always been a nightmare to the patient because of its unpredictable symptoms and a diagnostic dilemma for the dental practitioner due to its variable, bizarre clinical presentation. The treatment planning and management of CTS has also given problems and challenges the dentist as there is no specific treatment option. The management of CTS varies from one case to another or from one tooth to another in the same individual based on the severity of the symptoms and depth of tooth structure involved. After all, the prognosis of such tooth is still questionable and requires continuous evaluation. This article aims at presenting a series three cases of CTS with an overview on the clinical presentation, diagnosis and the different treatment options that varies from one case to another. PMID:26538947

The restoration of a maxillary central incisor fracture with the original crown fragment using a glass fiber-reinforced post: a clinical report.

PubMed

Durkan, Rukiye Kaplan; Ozel, M Birol; Celik, Davut; Bağiş, Bora

2008-12-01

This report describes an esthetic, conservative, and economical alternative restoration technique for a fractured central incisor using the patient's own tooth crown piece and a bondable reinforcement glass fiber. Although the long-term durability of this adhesive post core restoration remains unknown, it remains successful after 1 year.

Effect of Endocrown Pulp Chamber Extension Depth on Molar Fracture Resistance.

PubMed

Hayes, A; Duvall, N; Wajdowicz, M; Roberts, H

The purpose of this study was to evaluate the effect of endocrown pulp chamber extension on mandibular molar fracture resistance. A total of 36 recently extracted mandibular third molars of approximate equal size were sectioned at the facial lingual height of contour followed by endodontic access into the pulp chamber. The specimens were then randomly divided into three groups (n=12) and pulpal and root canal contents removed. Pulp chamber floors were established at 2, 3, and 4 mm from the occlusal table using a three-step etch-and-rinse adhesive and a flowable resin composite. The prepared specimens were then embedded in auto-polymerizing denture base resin with surface area available for adhesive bonding determined using a digital recording microscope. Specimens were restored using a standardized template with a chairside computer-aided design/computer-aided manufacturing unit with the endocrown milled from a lithium disilicate glass-ceramic material. Restoration parameters of occlusal table anatomy and thickness were standardized with the only parameter difference being the pulp chamber extension depth. The endocrown restorations were luted with a self-adhesive resin luting agent and tested to failure after 24 hours on a universal testing machine, with force applied to the facial cusps at a 45° angle to the long axis of the tooth. The failure load was converted into stress for each specimen using the available surface area for bonding. Mean failure load and stress among the three groups was first subjected to the Shapiro-Wilk and Bartlett tests and then analyzed with an analysis of variance with the Tukey post hoc test at a 95% confidence level (p=0.05). The 2- and 4-mm chamber extension groups demonstrated the highest fracture resistance stress, with the 3-mm group similar to the 2-mm group. The 3- and 4-mm chamber extension group specimens demonstrated nearly universal catastrophic tooth fracture, whereas half the 2-mm chamber extension group displayed nonrestorable root fractures. Under the conditions of this study, mandibular molars restored with the endocrown technique with 2- and 4-mm pulp chamber extensions displayed greater tooth fracture resistance force as well as stress. All groups demonstrated a high number of catastrophic fractures, but these results may not be clinically significant because the fracture force results are higher than normal reported values of masticatory function.

Management of fractures of the mandibular body and symphysis.

PubMed

Goodday, Reginald H B

2013-11-01

Mandibular fracture, specifically in the symphysis and body regions combined, is the most common facial fracture requiring hospitalization in North America. The primary treatment objective is to restore form and function by achieving anatomic reduction and placing fixation that eliminates mobility of the bone fragments. Several treatment options and surgical techniques are available for performing closed or open reduction. Special considerations are necessary when treating pediatric patients and fractures of the edentulous mandible. Complications relating to the tooth and denture-bearing regions of the mandible include infection, nonunion, and neurosensory changes. Copyright © 2013 Elsevier Inc. All rights reserved.

Fracture resistance of a selection of full-contour all-ceramic crowns: an in vitro study.

PubMed

Zesewitz, Tim F; Knauber, Andreas W; Nothdurft, Frank P

2014-01-01

This study aimed to evaluate the fracture resistance of monolithic single crowns made from zirconia (ZI), lithium disilicate (LS2), or feldspar ceramic (FC). Five groups of crowns representing a maxillary first molar were made with the appropriate dimensions according to the manufacturer's instructions. The ZI and LS2 crowns were luted adhesively or cemented conventionally on a metal abutment tooth analog. The feldspar ceramic crowns were luted adhesively. All specimens underwent axial loading until fracture. The crowns in the ZI groups possessed the highest fracture resistance independent of the mode of fixation.

Development of a device to simulate tooth mobility.

PubMed

Erdelt, Kurt-Jürgen; Lamper, Timea

2010-10-01

The testing of new materials under simulation of oral conditions is essential in medicine. For simulation of fracture strength different simulation devices are used for test set-up. The results of these in vitro tests differ because there is no standardization of tooth mobility in simulation devices. The aim of this study is to develop a simulation device that depicts the tooth mobility curve as accurately as possible and creates reproducible and scalable mobility curves. With the aid of published literature and with the help of dentists, average forms of tooth classes were generated. Based on these tooth data, different abutment tooth shapes and different simulation devices were designed with a CAD system and were generated with a Rapid Prototyping system. Then, for all simulation devices the displacement curves were created with a universal testing machine and compared with the tooth mobility curve. With this new information, an improved adapted simulation device was constructed. A simulations device that is able to simulate the mobility curve of natural teeth with high accuracy and where mobility is reproducible and scalable was developed.

Endurance and failure characteristics of modified Vasco X-2, CBS 600 and AISI 9310 spur gears. [aircraft construction materials

NASA Technical Reports Server (NTRS)

Townsend, D. P.; Zaretsky, E. V.

1980-01-01

Gear endurance tests and rolling-element fatigue tests were conducted to compare the performance of spur gears made from AISI 9310, CBS 600 and modified Vasco X-2 and to compare the pitting fatigue lives of these three materials. Gears manufactured from CBS 600 exhibited lives longer than those manufactured from AISI 9310. However, rolling-element fatigue tests resulted in statistically equivalent lives. Modified Vasco X-2 exhibited statistically equivalent lives to AISI 9310. CBS 600 and modified Vasco X-2 gears exhibited the potential of tooth fracture occurring at a tooth surface fatigue pit. Case carburization of all gear surfaces for the modified Vasco X-2 gears results in fracture at the tips of the gears.

Ribbond for treatment of complicated crown fractures: report of 3 cases.

PubMed

Akgun, Ozlem Marti; Altun, Ceyhan; Guven, Gunseli; Basak, Feridun

2012-01-01

Dental trauma is relatively common and can occur secondary to sporting injuries, falls, fights, or accidents. According to the International Association of Dental Traumatology, 50% of children experience dental trauma between the ages of 8 to 12. There are many options for endodontic and restorative treatments of traumatized teeth. Ribbond, which was introduced in the market in 1992, consists of bondable, reinforced ultra-high strength polyethylene fibers. Ribbond may be an option for the treatment of traumatized teeth because of its aesthetic properties; absence of additional tooth preparation; and its high resistance to traction, which allows it to easily adapt to tooth morphology. In this report, we describe endodontic and restorative treatments using Ribbond for 3 female patients with horizontal complicated crown fractures of the maxillary incisors.

Treatment Options: Biological Basis of Regenerative Endodontic Procedures

PubMed Central

Hargreaves, Kenneth M.; Diogenes, Anibal; Teixeira, Fabricio B.

2013-01-01

Dental trauma occurs frequently in children and often can lead to pulpal necrosis. The occurrence of pulpal necrosis in the permanent but immature tooth represents a challenging clinical situation since the thin and often short roots increase the risk of subsequent fracture. Current approaches for treating the traumatized immature tooth with pulpal necrosis do not reliably achieve the desired clinical outcomes, consisting of healing of apical periodontitis, promotion of continued root development and restoration of the functional competence of pulpal tissue. An optimal approach for treating the immature permanent tooth with a necrotic pulp would be to regenerate functional pulpal tissue. This review summarizes the current literature supporting a biological rationale for considering regenerative endodontic treatment procedures in treating the immature permanent tooth with pulp necrosis. PMID:23439043

Fracture Resistance of Teeth Restored with Direct and Indirect Composite Restorations

PubMed Central

Torabzadeh, Hassan; Ghasemi, Amir; Dabestani, Atoosa; Razmavar, Sara

2013-01-01

Objective: Tooth fracture is a common dental problem. By extension of cavity dimensions, the remaining tooth structure weakens and occlusal forces may cause tooth fracture. The aim of this study was to evaluate and compare the fracture resistance of teeth restored with direct and indirect composite restorations. Materials and Methods: Sixty-five sound maxillary premolar teeth were chosen and randomly divided into five groups each comprising thirteen. Fifty-two teeth received mesio-occluso-distal (MOD) cavities with 4.5mm bucco-lingual width, 4mm pulpal depth and 3mm gingival depth and were divided into the following four groups. G-1: restored with direct composite (Z-250, 3M/ESPE) with cusp coverage, G-2: restored with direct composite (Z-250) without cusp coverage, G-3: restored with direct composite (Gradia, GC-international) with cusp coverage, G-4: restored with indirect composite (Gradia, GC-International) with cusp coverage. Intact teeth were used in G-5 as control. The teeth were subjected to a compressive axial loading using a 4 mm diameter rod in a universal testing machine with 1 mm/min speed. Data were analyzed using one-way ANOVA and Tukey tests. Results: The mean fracture strength recorded was: G-1: 1148.46N±262, G-2: 791.54N±235, G-3: 880.00N±123, G-4: 800.00N±187, G-5: 1051.54N±345. ANOVA revealed significant differences between groups (p<0.05). Tukey test showed significant difference between group 1 and the other groups. There was no significant difference among other groups. Conclusion: Direct composite (Z-250) with cusp coverage is a desirable treatment for weakened teeth. Treatment with Z-250 without cusp coverage, direct and indirect Gradia with cusp coverage restored the strength of the teeth to the level of intact teeth. PMID:24910649

Extensively remodeled, fractured cetacean tympanic bullae show that whales can survive traumatic injury to the ears.

PubMed

Yamato, Maya; Khidas, Kamal; Pyenson, Nicholas D; Fordyce, R Ewan; Mead, James G

2016-01-01

Underwater human activities and anthropogenic noise in our oceans may be a major source of habitat degradation for marine life. This issue was highlighted by the opening of the United States Eastern Seaboard for seismic oil and gas exploration in 2014, which generated massive media coverage and widespread concern that seismic surveys could kill or deafen whales. We discovered 11 new specimens of fractured and healed cetacean ear bones, out of a survey of 2127 specimens housed in museum collections. This rare condition has been previously reported only in two specimens of blue whales (Balaenoptera musculus) from the early 1900s, summarized by Fraser & Purves (1953). All of our new specimens are represented by species for which this condition had never been reported previously, including both baleen and toothed whales. The baleen whale specimens (Balaenoptera physalus, Balaenoptera borealis, Balaenoptera acutorostrata) were collected during Canadian commercial whaling operations in the Atlantic Ocean in the 1970s; the specimens include ear bones with well-healed fractures, demonstrating that baleen whales are capable of overcoming traumatic injury to the ears. The toothed whale specimens (Delphinus sp., Berardius bairdii) were found dead on beaches in 1972 and 2001, respectively, with less remodeled fractures. Thus, ear injuries may be more lethal to the echolocating toothed whales, which rely on hearing for navigation and foraging. We explore several hypotheses regarding how these injuries could have occurred, and conclude that the most parsimonious explanations appear to be both direct and indirect effects of lytic processes from disease or calcium depletion, or damage from external pressure waves. Although further research is required to confirm whether the fractures resulted from natural or human-induced events, this study underscores the importance of museum collections and the work of stranding networks in understanding the potential effects of modern human activities on marine mammal health. © 2015 Anatomical Society.

Biological and technical complications and failures with fixed partial dentures (FPD) on implants and teeth after four to five years of function.

PubMed

Brägger, U; Aeschlimann, S; Bürgin, W; Hämmerle, C H; Lang, N P

2001-02-01

The aim of this study was to compare the frequency of biological and technical complications with fixed partial dentures (FPDs) on implants, teeth and as mixed tooth-implant supported FPDs over 4 to 5 years of function. All implants belonged to the ITI Dental Implant System. Group I-I (implant FPD) included 33 patients with 40 FPDs, group T-T (tooth FPDs) 40 patients with 58 FPDs, group I-T (mixed tooth-implant FPDs) 15 with 18 FPD. Of the bridge abutments 144 were teeth and 105 were implants. The median number of units replaced by the FPDs was 3 (range 2-14). The mean age of the patients was 55.7 years (range 23-83). Complete failures resulted in the loss of one FPD in each group. Two implants were lost due to fracture secondarily to development of a bone defect. One tooth had a vertical fracture and 1 tooth was lost due to periodontitis. Biological complications (peri-implantitis, PPD > or = 5 mm and BOP+) occurred at 9.6% (10) of the implants. This number was, however, reduced to 5% if the threshold for definition of peri-implantitis was set at PPD > or = 6 mm and BOP+. Biological complications occurred in 11.8% (17) of the abutment teeth (NS compared to implants); 2.8% (4) had secondary caries, 4.9% (7) endodontic problems and 4.1% (6) had periodontitis (PPD > or = 5 mm, BOP+). Ten out of 32 patients with a general health problem indicated a biological complication, whereas 9 out of 53 patients with no general health problem had a biological complication (chi 2: NS). Statistically significantly more technical complications were found in FPDs on implants (chi 2, P < or = 0.05). The technical complications were associated with bruxism. Out of 10 bruxers 6 had a technical complication whereas 13 out of 75 non-bruxers had such a complication (chi 2 < or = 0.01). Extensions were associated with more technical complications (13 out of 35 with extensions versus 9 out of 81 without). In conclusion, favourable clinical conditions were found at tooth and implant abutments after 4-5 years of function. Loss of FPD over 4-5 years occurred at a similar rate with mixed, implant or tooth supported reconstructions. Significantly more porcelain fractures were found in FPDs on implants. Impaired general health status was not significantly associated with more biological failures but bruxism as well as extensions were associated with more technical failures.

D-tecting Disease - From Exposure to Vitamin D During Critical Periods of Life

ClinicalTrials.gov

2017-11-02

Vitamin D Deficiency; Obesity; Diabetes Mellitus; Pre-Eclampsia; Arthritis; Asthma; Bone Fracture; Tooth Diseases; Birth Weight; Birth Disorder; Pregnancy Complications; Mental Disorder; Cancer; Congenital Disorders

Tooth damage in captive orcas (Orcinus orca).

PubMed

Jett, John; Visser, Ingrid N; Ventre, Jeffrey; Waltz, Jordan; Loch, Carolina

2017-12-01

Tooth damage as a result of oral stereotypies is evident in captive orca, yet little research on the topic exists. This study examines the associations between dental pathology, sex, facility, duration of captivity and other factors in captive orca. We evaluated mandibular and maxillary teeth from dental images of 29 captive orca owned by a US-based theme park. Each tooth was scored for coronal wear, wear at or below gum line and bore holes. Fractured and missing teeth were also noted. Summary statistics described the distribution and severity of pathologies; inferential statistics examined how pathologies differed between sexes, between wild-captured and captive-born orcas and between captive orca at four facilities. We also evaluated how dental pathology and duration of captivity were related. Approximately 24% of whales exhibited "major" to "extreme" mandibular coronal tooth wear, with coronal wear and wear at or below gum line highly correlated. More than 60% of mandibular teeth 2 and 3 exhibited fractures. Bore holes were observed primarily among anterior mandibular teeth, with more than 61% of teeth 2 and 3 bearing evidence of having been drilled. Four of five orca with the highest age-adjusted tooth pathology indices were captive-born. Various dental pathologies were observed across all whales, with pathologies beginning at a young age. Oral stereotypies exhibited by captive orca contributed to the observed dental damage. By making dental and health records of captive whales publicly available, the theme park industry is uniquely positioned to provide further insight into dental pathology and resultant health consequences in captive orca. Copyright © 2017 Elsevier Ltd. All rights reserved.

Impact of educational posters on the lay knowledge of school teachers regarding emergency management of dental injuries.

PubMed

Lieger, Olivier; Graf, Christoph; El-Maaytah, Mohammed; Von Arx, Thomas

2009-08-01

The purpose of this study was to investigate the knowledge of school teachers about the emergency management of dental trauma, after an educational poster campaign. A total of 1000 questionnaires were sent to 100 schools in the area where the poster had been distributed. This was compared to another 100 schools (1000 questionnaires) in an area, Where the poster had not been distributed. The questionnaire surveyed demographic data, basic knowledge of emergency management of tooth fracture, luxation and avulsion injuries. A total of 511 questionnaires were returned (25.5%) and analyzed. Results showed differences between the two assessed areas. Teachers, who worked in the area with poster distribution, had better knowledge in handling tooth injuries. For the management of tooth fractures the portion of teachers, who knew the correct handling procedure, was 78.9% (area with poster campaign) vs 72.1% (area with no poster campaign), for the management of tooth luxation it was 87% vs 84% and for the management of tooth avulsion it was 71% vs 54%. In the area with the poster campaign 49% (n = 90 out of 185) of the teachers stated to have gained some knowledge about this topic beforehand. Out of these, 75 teachers (75/90 = 83%), had gained their information from the educational poster. Out of the 75 teachers, who had seen a poster on this topic, 68 (68/75 = 91%) would have managed such an emergency correctly. The present study shows the positive effect of educational poster campaigns. It therefore should encourage professionals in this field to embark on similar projects.

Detection of Naturally Occurring Gear and Bearing Faults in a Helicopter Drivetrain

DTIC Science & Technology

2014-01-01

comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE...resistance to gear tooth fracture under power levels exceeding the maximum continuous rating. During posttest inspection, it was found that a tooth...accessible, a trial and error approach was taken to find the band that best captured the bearing fault. Figure 11b shows the magnitude of the

Assessing the Accuracy and Reliability of Root Crack and Fracture Detection in Teeth Using Sweep Imaging with Fourier Transform (SWIFT) Magnetic Resonance Imaging (MRI)

NASA Astrophysics Data System (ADS)

Schuurmans, Tyler J.

Introduction: Magnetic Resonance Imaging (MRI) has the potential to aid in determining the presence and extent of cracks/fractures in teeth due to more advantageous contrast, without ionizing radiation. An MRI technique called Sweep Imaging with Fourier Transform (SWIFT) has overcome many of the inherent difficulties of conventional MRI with detecting fast-relaxing signals from densely mineralized dental tissues. The objectives of this in vitro investigation were to develop MRI criteria for root crack/fracture identification in teeth and to establish intra- and inter-rater reliabilities and corresponding sensitivity and specificity values for the detection of tooth-root cracks/fractures in SWIFT MRI and limited field of view (FOV) CBCT. Materials and Methods: MRI-based criteria for crack/fracture appearance was developed by an MRI physicist and 6 dentists, including 3 endodontists and 1 Oral and Maxillofacial (OMF) radiologist. Twenty-nine human adult teeth previously extracted following clinical diagnosis by a board-certified endodontist of a root crack/fracture were frequency-matched to 29 non-cracked controls. Crack/fracture status confirmation was performed with magnified visual inspection, transillumination and vital staining. Samples were scanned with two 3D imaging modalities: 1) SWIFT MRI (10 teeth/scan) via a custom oral radiofrequency (RF) coil and a 90cm, 4-T magnet; 2) Limited FOV CBCT (1 tooth/scan) via a Carestream (CS) 9000 (Rochester, NY). Following a training period, a blinded 4-member panel (3 endodontists, 1 OMF radiologist) evaluated the images with a proportion randomly re-tested to establish intra-rater reliability. Overall observer agreement was measured using Cohen's kappa and levels of agreement judged using the criteria of Landis and Koch. Sensitivity and specificity were computed with 95% confidence interval (CI); statistical significance was set at alpha ≤ 0.05. Results: MRI-based crack/fracture criteria were defined as 1-2 sharply-delineated, high-signal (bright/white) line shape(s) that must be visible on multiple contiguous image slices. The line shape(s) must present as: single entities, or parallel pairs in close proximity, or pairs in close proximity exhibiting convergence or divergence extending from the external boundary of the tooth to the pulpal cavity. Intra-rater reliability for MRI was fair-to-almost perfect (kappa = 0.38-1.00) and for CBCT was moderate-to-almost perfect (kappa = 0.66-1.00). Inter-rater reliability for MRI was fair (kappa = 0.21; 95% CI: 0.10-0.31; p < 0.001) and for CBCT was moderate (kappa = 0.45; 95% CI: 0.34-0.56; p < 0.001). Sensitivity: MRI = 0.59 (95% CI: 0.39-0.76; p = 0.46); CBCT = 0.59 (95% CI: 0.59-0.76; p = 0.46). Specificity: MRI = 0.83 (95% CI: 0.64-0.94; p < 0.01); CBCT = 0.90 (95% CI: 0.73-0.98; p < 0.01). Conclusions: Education and training for both imaging modalities is needed to improve reliabilities for the identification of tooth-root crack/fractures. Despite the advantages of increased contrast and absence of artifact from radio-dense materials in MRI, comparable measures of sensitivity and specificity (in relation to CBCT) suggest quality MRI improvements are needed, specifically in image acquisition and post-processing parameters. Given the early stage of technology development and multiple available pathways to optimize MR imaging of teeth, there may be a use for SWIFT MRI in detecting cracks and fractures in teeth.

Remarkable resilience of teeth.

PubMed

Chai, Herzl; Lee, James J-W; Constantino, Paul J; Lucas, Peter W; Lawn, Brian R

2009-05-05

Tooth enamel is inherently weak, with fracture toughness comparable with glass, yet it is remarkably resilient, surviving millions of functional contacts over a lifetime. We propose a microstructural mechanism of damage resistance, based on observations from ex situ loading of human and sea otter molars (teeth with strikingly similar structural features). Section views of the enamel implicate tufts, hypomineralized crack-like defects at the enamel-dentin junction, as primary fracture sources. We report a stabilization in the evolution of these defects, by "stress shielding" from neighbors, by inhibition of ensuing crack extension from prism interweaving (decussation), and by self-healing. These factors, coupled with the capacity of the tooth configuration to limit the generation of tensile stresses in largely compressive biting, explain how teeth may absorb considerable damage over time without catastrophic failure, an outcome with strong implications concerning the adaptation of animal species to diet.

Effect of property gradients on enamel fracture in human molar teeth.

PubMed

Barani, Amir; Bush, Mark B; Lawn, Brian R

2012-11-01

A model for the fracture of tooth enamel with graded elastic modulus and toughness is constructed using an extended finite element modeling (XFEM) package. The property gradients are taken from literature data on human molars, with maximum in modulus at the outer enamel surface and in toughness at the inner surface. The tooth is modeled as a brittle shell (enamel) and a compliant interior (dentin), with occlusal loading from a hard, flat contact at the cusp. Longitudinal radial (R) and margin (M) cracks are allowed to extend piecewise along the enamel walls under the action of an incrementally increasing applied load. A simple stratagem is deployed in which fictitious temperature profiles generate the requisite property gradients. The resulting XFEM simulations demonstrate that the crack fronts become more segmented as the property gradients become more pronounced, with enhanced propagation at the outer surface and inhibited propagation at the inner. Whereas the growth history of the cracks is profoundly influenced by the gradients, the ultimate critical loads required to attain full fractures are relatively unaffected. Some implications concerning dentistry are considered. Copyright © 2012 Elsevier Ltd. All rights reserved.

Orthodontic extrusion of Ellis Class VIII fracture of maxillary lateral incisor - The sling shot method.

PubMed

Felicita, A Sumathi

2018-07-01

The aim of this paper is to evaluate the efficacy of forced extrusion using the sling shot elastic. A 21 year adult patient reported with an Ellis Class VIII fracture of the maxillary right lateral incisor. Root canal treatment followed by a fiber reinforced composite post was placed and core build up was done. A metal button was bonded to the tooth. Begg brackets were placed from the second premolar on one side to the second premolar on the opposite side. 0.016″ × 0.025″ stainless steel was placed in ribbon mode. The ligature wire was placed as a sling shot from the button on the fractured tooth to the two adjacent teeth. 4 mm of extrusion was achieved and there was no evidence of root resorption. Forced extrusion was achieved in four months. The sling shot method is a very effective method of ligation. Light forces are delivered over a long duration with definitive results as compared to the inconsistent force delivery with conventional extrusion mechanics.

The compression dome concept: the restorative implications.

PubMed

Milicich, Graeme

2017-01-01

Evidence now supports the concept that the enamel on a tooth acts like a compression dome, much like the dome of a cathedral. With an overlying enamel compression dome, the underlying dentin is protected from damaging tensile forces. Disruption of a compression system leads to significant shifts in load pathways. The clinical restorative implications are significant and far-reaching. Cutting the wrong areas of a tooth exposes the underlying dentin to tensile forces that exceed natural design parameters. These forces lead to crack propagation, causing flexural pain and eventual fracture and loss of tooth structure. Improved understanding of the microanatomy of tooth structure and where it is safe to cut teeth has led to a revolution in dentistry that is known by several names, including microdentistry, minimally invasive dentistry, biomimetic dentistry, and bioemulation dentistry. These treatment concepts have developed due to a coalescence of principles of tooth microanatomy, material science, adhesive dentistry, and reinforcing techniques that, when applied together, will allow dentists to repair a compromised compression dome so that it more closely replicates the structure of the healthy tooth.

Influence of remaining coronal tooth structure on fracture resistance and failure mode of restored endodontically treated maxillary incisors.

PubMed

Santos Pantaleón, Domingo; Morrow, Brian R; Cagna, David R; Pameijer, Cornelis H; Garcia-Godoy, Franklin

2018-03-01

Limited information is available on the effect of an incomplete ferrule because of the varying residual axial wall heights and the volume of residual tooth structure on the fracture resistance of endodontically treated and restored maxillary incisors. The purpose of this in vitro investigation was to examine the effect of varying residual axial wall heights, residual coronal tooth structure, and the absence of 1 proximal axial wall on the fracture resistance and failure mode of endodontically treated teeth restored with metal posts. Sixty intact human maxillary central incisors were divided into 6 groups (n=10): no ferrule (NF), 2-mm complete ferrule (CF2), 2-mm (IF2), 3-mm (IF3), and 4-mm (IF4) incomplete ferrules missing a single interproximal wall, and a control group that had a 6-mm incomplete ferrule (IF6). Cast metal post-and-cores were placed in all experimental specimens except for controls. Control specimens received 1 interproximal cavity preparation extending to the root canal access and a composite resin restoration. Complete metal crowns were then cemented on all specimens. Completed specimens were subjected to thermocycling (6000 cycles, 5°C/55°C) followed by the immediate testing of fracture resistance. Failed specimens were sectioned buccolingually and evaluated to identify the failure mode. The data were analyzed with an analysis of variance (ANOVA) and the Student-Newman-Keuls multiple comparison test (α=.05). An incomplete ferrule (IF2) with 1 interproximal wall missing had significantly reduced fracture resistance (697 N) compared with a complete ferrule (932 N). An increase of 3 to 4 mm of remaining wall height improved fracture resistance, from 844 N (IF3) to 853 N (IF4). Partial decementation was noticed in 8 NF and 5 IF2 specimens. IF3 and IF4 had no decementations. Radicular fractures and cracks (catastrophic failure) were observed in all IF2, IF3, and IF4, 9 CF2, and 6 NF specimens. In 7 specimens without posts (IF6, control), composite resin foundation and/or coronal dentin fracture were observed and the failure was considered repairable. The results of this in vitro study indicated that specimens with a 2-mm ferrule of uniform height were more resistant to fracture than specimens with a 2-mm ferrule and 1 missing interproximal wall. An increased wall height of 3 or 4 mm was associated with a significant increase in fracture resistance and can compensate for the missing interproximal wall. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Cusp Fracture Resistance of Maxillary Premolars Restored with the Bonded Amalgam Technique Using Various Luting Agents

PubMed Central

Marchan, Shivaughn M.; Coldero, Larry; White, Daniel; Smith, William A. J.; Rafeek, Reisha N.

2009-01-01

Objective. This in vitro study uses measurements of fracture resistance to compare maxillary premolars restored with the bonded amalgam technique using a new resin luting cement, glass ionomer, and resin-modified glass ionomer as the bonding agents. Materials. Eighty-five sound maxillary premolars were selected and randomly assigned to one of five test groups of 17 teeth each. One group of intact teeth served as the control. The remaining groups were prepared to a standard cavity form relative to the dimensions of the overall tooth and restored with amalgam alone or a bonded amalgam using one of three luting agents: RelyX Arc (a new resin luting cement), RelyX luting (a resin-modified glass ionomer), or Ketac-Cem μ (a glass ionomer) as the bonding agents. Each tooth was then subjected to compressive testing until catastrophic failure occurred. The mean loads at failure of each group were statistically compared using ANOVA with a post hoc Bonferroni test. Results. It was found that regardless of the luting cement used for the amalgam bonding technique, there was little effect on the fracture resistance of teeth. Conclusion. Cusp fracture resistance of premolars prepared with conservative MOD cavity preparations is not improved by using an amalgam-bonding technique compared to similar cavities restored with amalgam alone. PMID:20339450

Effect of tooth bleaching agents on protein content and mechanical properties of dental enamel.

PubMed

Elfallah, Hunida M; Bertassoni, Luiz E; Charadram, Nattida; Rathsam, Catherine; Swain, Michael V

2015-07-01

This study investigated the effect of two bleaching agents, 16% carbamide peroxide (CP) and 35% hydrogen peroxide (HP), on the mechanical properties and protein content of human enamel from freshly extracted teeth. The protein components of control and treated enamel were extracted and examined on sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Marked reduction of the protein matrix and random fragmentation of the enamel proteins after bleaching treatments was found. The mechanical properties were analyzed with Vickers indentations to characterize fracture toughness, and nanoindentation to establish enamel hardness, elastic modulus and creep deformation. Results indicate that the hardness and elastic modulus of enamel were significantly reduced after treatment with CP and HP. After bleaching, the creep deformation at maximum load increased and the recovery upon unloading reduced. Crack lengths of CP and HP treated enamel were increased, while fracture toughness decreased. Additionally, the microstructures of fractured and indented samples were examined with field emission gun scanning electron microscopy (FEG-SEM) showing distinct differences in the fracture surface morphology between pre- and post-bleached enamel. In conclusion, tooth bleaching agents can produce detrimental effects on the mechanical properties of enamel, possibly as a consequence of damaging or denaturing of its protein components. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

A Simplified Way for the Stabilization of Pediatric Mandibular Fracture With an Occlusal Splint.

PubMed

Demirkol, Mehmet; Demirkol, Nermin; Abdo, Omar Hasan; Aras, Mutan Hamdi

2016-06-01

The management of pediatric mandibular fractures is challenging for maxillofacial surgeons due to ongoing mandibular growth involving tooth buds. The treatment of such fractures has been a topic of much research. Generally accepted methods for the treatment of mandibular parasymphyseal or symphyseal fractures in children are conservative approaches involving the use of acrylic splints, lateral compression with an open-cap splint stabilized by circummandibular wiring, and maxillomandibular fixation with an arch bar and eyelet wiring. The aim of this technical note was to describe a straightforward approach to the treatment of pediatric mandibular fractures, in which an occlusal splint is secured to prevent trauma to the soft tissue, without the need for general anesthesia.

Unsuccessful Treatment of Atrophic Mandible Fracture by Use of Improper Materials.

PubMed

de Moraes Ferreira, Ana Carulina Rezende; Garcia Junior, Idelmo Rangel; Silva, Adalberto Novaes; de Carvalho Reis, Erik Neiva Ribeiro; Pires, Willian Ricardo; Bonardi, João Paulo; Borba, Alexandre Meireles

2016-06-01

Fractures of atrophic mandibles are present on the day by day of buccomaxillofacial surgeons. Mandible atrophy occurs due to tooth loss, which over time induces bone resorption leading to a fragile and susceptible to fracture structure. This paper reports the case of a patient victim of face trauma resulting in atrophic mandible fracture with treatment failure through the use of shared load miniplate. Therefore, a new treatment was performed with miniplate of system 2.4 along with bone graft. After 6 months, the patient was rehabilitated with implant-supported prosthesis installation. It is concluded that for successful treatment of atrophic mandible fractures, the use of rigid plates is necessary, allowing an excellent rehabilitation of the stomatognathic system.

Comparative in vitro evaluation of CAD/CAM vs conventional provisional crowns

PubMed Central

ABDULLAH, Adil Othman; TSITROU, Effrosyni A; POLLINGTON, Sarah

2016-01-01

ABSTRACT Objective This study compared the marginal gap, internal fit, fracture strength, and mode of fracture of CAD/CAM provisional crowns with that of direct provisional crowns. Material and Methods An upper right first premolar phantom tooth was prepared for full ceramic crown following tooth preparation guidelines. The materials tested were: VITA CAD-Temp®, Polyetheretherketone “PEEK”, Telio CAD-Temp, and Protemp™4 (control group). The crowns were divided into four groups (n=10), Group1: VITA CAD-Temp®, Group 2: PEEK, Group 3: Telio CAD-Temp, and Group 4: Protemp™4. Each crown was investigated for marginal and internal fit, fracture strength, and mode of fracture. Statistical analysis was performed using GraphPad Prism software version 6.0. Results The average marginal gap was: VITA CAD-Temp® 60.61 (±9.99) µm, PEEK 46.75 (±8.26) µm, Telio CAD-Temp 56.10 (±5.65) µm, and Protemp™4 193.07(±35.96) µm (P<0.001). The average internal fit was: VITA CAD-Temp® 124.94 (±22.96) µm, PEEK 113.14 (±23.55) µm, Telio CAD-Temp 110.95 (±11.64) µm, and Protemp™4 143.48(±26.74) µm. The average fracture strength was: VITA CAD-Temp® 361.01 (±21.61) N, PEEK 802.23 (±111.29) N, Telio CAD-Temp 719.24 (±95.17) N, and Protemp™4 416.40 (±69.14) N. One-way ANOVA test showed a statistically significant difference for marginal gap, internal gap, and fracture strength between all groups (p<0.001). However, the mode of fracture showed no differences between the groups (p>0.05). Conclusions CAD/CAM fabricated provisional crowns demonstrated superior fit and better strength than direct provisional crowns. PMID:27383707

Fracture resistance of simulated immature tooth roots reinforced with MTA or restorative materials.

PubMed

Karapinar-Kazandag, Meric; Basrani, Bettina; Tom-Kun Yamagishi, Valerie; Azarpazhooh, Amir; Friedman, Shimon

2016-04-01

Immature endodontically treated teeth may require reinforcing to reduce the risk of root fracture. This study assessed the fracture resistance of simulated immature tooth roots reinforced with mineral trioxide aggregate (MTA) or two composite resin (CR) materials. One hundred extracted roots of mature human maxillary incisors were decoronated and sectioned 9 mm further apically from the decoronation line and randomly divided into five groups (n = 20). In Group 1 (negative control), roots received no treatment. In groups 2-5, canals were enlarged to 2.1 mm diameter to simulate immature roots, dressed with calcium hydroxide (Ca(OH)2 ) and incubated for 7 days. After removal of Ca(OH)2 , canals in Group 2 (positive control) were left unfilled. Canals in groups 3, 4 and 5 were filled with MTA, BisFil 2B flowable CR or BisFil II posterior CR, respectively. After further incubation for 30 days, specimens were embedded in acrylic cylinders and horizontally loaded in a universal testing machine at cross head speed of 5 mm min(-1) until fracture occurred. Load (N) at and pattern of fracture were recorded. Load at fracture was significantly lower (t-test, P = 0.003) in Group 2 (630 ± 199.12) than in Group 1 (896.98 ± 311.79). It did not differ significantly among groups 1, 3, 4 and 5 (anova, P > 0.07). Pattern of fracture did not differ among the groups either. Within the limitations of this study, root canal filling with MTA and two CR materials affected reinforcement of simulated immature roots to levels comparable with intact roots. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparative in vitro evaluation of CAD/CAM vs conventional provisional crowns.

PubMed

Abdullah, Adil Othman; Tsitrou, Effrosyni A; Pollington, Sarah

2016-01-01

This study compared the marginal gap, internal fit, fracture strength, and mode of fracture of CAD/CAM provisional crowns with that of direct provisional crowns. An upper right first premolar phantom tooth was prepared for full ceramic crown following tooth preparation guidelines. The materials tested were: VITA CAD-Temp®, Polyetheretherketone "PEEK", Telio CAD-Temp, and Protemp™4 (control group). The crowns were divided into four groups (n=10), Group1: VITA CAD-Temp®, Group 2: PEEK, Group 3: Telio CAD-Temp, and Group 4: Protemp™4. Each crown was investigated for marginal and internal fit, fracture strength, and mode of fracture. Statistical analysis was performed using GraphPad Prism software version 6.0. The average marginal gap was: VITA CAD-Temp® 60.61 (±9.99) µm, PEEK 46.75 (±8.26) µm, Telio CAD-Temp 56.10 (±5.65) µm, and Protemp™4 193.07(±35.96) µm (P<0.001). The average internal fit was: VITA CAD-Temp® 124.94 (±22.96) µm, PEEK 113.14 (±23.55) µm, Telio CAD-Temp 110.95 (±11.64) µm, and Protemp™4 143.48(±26.74) µm. The average fracture strength was: VITA CAD-Temp® 361.01 (±21.61) N, PEEK 802.23 (±111.29) N, Telio CAD-Temp 719.24 (±95.17) N, and Protemp™4 416.40 (±69.14) N. One-way ANOVA test showed a statistically significant difference for marginal gap, internal gap, and fracture strength between all groups (p<0.001). However, the mode of fracture showed no differences between the groups (p>0.05). CAD/CAM fabricated provisional crowns demonstrated superior fit and better strength than direct provisional crowns.

Fracture Resistance of Endodontically Treated Teeth Restored with Biodentine, Resin Modified GIC and Hybrid Composite Resin as a Core Material.

PubMed

Subash, Dayalan; Shoba, Krishnamma; Aman, Shibu; Bharkavi, Srinivasan Kumar Indu; Nimmi, Vijayan; Abhilash, Radhakrishnan

2017-09-01

The restoration of a severely damaged tooth usually needs a post and core as a part of treatment procedure to provide a corono - radicular stabilization. Biodentine is a class of dental material which possess high mechanical properties with excellent biocompatibility and bioactive behaviour. The sealing ability coupled with optimum physical properties could make Biodentine an excellent option as a core material. The aim of the study was to determine the fracture resistance of Biodentine as a core material in comparison with resin modified glass ionomer and composite resin. Freshly extracted 30 human permanent maxillary central incisors were selected. After endodontic treatment followed by post space preparation and luting of Glass fibre post (Reforpost, Angelus), the samples were divided in to three groups based on the type of core material. The core build-up used in Group I was Biodentine (Septodont, France), Group II was Resin-Modified Glass Ionomer Cement (GC, Japan) and Group III was Hybrid Composite Resin (TeEconom plus, Ivoclar vivadent). The specimens were subjected to fracture toughness using Universal testing machine (1474, Zwick/Roell, Germany) and results were compared using One-way analysis of variance with Tukey's Post hoc test. The results showed that there was significant difference between groups in terms of fracture load. Also, composite resin exhibited highest mean fracture load (1039.9 N), whereas teeth restored with Biodentine demonstrated the lowest mean fracture load (176.66 N). Resin modified glass ionomer exhibited intermediate fracture load (612.07 N). The primary mode of failure in Group I and Group II was favourable (100%) while unfavourable fracture was seen in Group III (30%). Biodentine, does not satisfy the requirements to be used as an ideal core material. The uses of RMGIC's as a core build-up material should be limited to non-stress bearing areas. Composite resin is still the best core build-up material owing to its high fracture resistance and bonding to tooth.

Fractography and fracture toughness of human dentin.

PubMed

Yan, J; Taskonak, B; Mecholsky, J J

2009-10-01

Dentin, the mineralized tissue forming the bulk of the tooth, serves as an energy-absorbing cushion for the hard, wear-resistant enamel and protects the inner soft tissues. Several studies used fracture mechanics methods to study the fracture toughness of dentin. However, all of them utilized precracks and cannot be used to estimate the intrinsic critical flaw size of dentin. We applied quantitative fractography to study the fracture pattern and fracture toughness of human dentin. Sixteen specimens were prepared from the coronal dentin and fractured in three-point flexure. Fracture surfaces were examined using a scanning electron microscope and the fracture toughness was calculated using a fracture mechanics equation. It was found that human dentin has a fracture surface similar to those of brittle materials. Twist hackle markings were observed and were used to identify the fracture origins. Average fracture toughness of all specimens was found to be 2.3 MPa m(1/2) and the average critical flaw size was estimated to 120 mum. It is suggested that fractography is a promising technique in analyzing the fracture of dentin under catastrophic failure.

Impact of adhesive surface and volume of luting resin on fracture resistance of root filled teeth.

PubMed

Krastl, G; Gugger, J; Deyhle, H; Zitzmann, N U; Weiger, R; Müller, B

2011-05-01

To investigate the correlation between geometric parameters of severely compromised root filled (RCT) pre-molar teeth with irregular root canals and their fracture resistance. The null hypothesis tested was that the fracture resistance of root filled teeth is not influenced by: (i) the adhesive surface of the post-space preparation (A(PS) ), (ii) the coronal tooth surface (A(A) ), (iii) the amount of resin cement (V(C) ) and (iv) the Young's modulus of the specimens. A total of 48 noncarious human pre-molar teeth with irregular root canals were decoronated, root filled and adhesively restored with post-retained direct composite crowns. After thermomechanical loading (1,200,000×, 5-50° C), static load was applied until failure. The geometric parameters of the tooth were evaluated by microcomputed tomography (μCT) using impressions taken after post-space preparation. Linear regression analyses were performed to correlate the geometric parameters of the specimens with their fracture resistance. The amount of resin cement (V(C) ) comprised up to 88% of the entire post-space (mean 67%) and had no impact on the maximal load (P = 0.88). The latter was significantly influenced by post-space preparation (P = 0.003). Amongst the geometric parameters tested, the surface area in the root canal had the greatest impact on fracture resistance of root filled pre-molars restored with posts and composite crowns, whilst the fit of the post was less important. © 2011 International Endodontic Journal.

Caries, Periodontal Disease, Supernumerary Teeth and Other Dental Disorders in Swedish Wild Boar (Sus scrofa).

PubMed

Malmsten, A; Dalin, A-M; Pettersson, A

2015-07-01

Between January and December 2013, the dental and periodontal health of 99 Swedish wild boars (Sus scrofa) was investigated. Sampling occurred in conjunction with routine hunting at six large estates in the southern and middle parts of Sweden. All six of the estates use supplemental feeding. The weight of the animals, their sex and their dates of death were noted. Age was estimated using tooth eruption and tooth replacement patterns. The oral cavity was inspected and abnormalities were recorded on a dental chart modified for wild boars. The findings included supernumerary teeth, absence of teeth, mild class II malocclusion, severe tooth wear, periodontitis, calculus, caries, tooth fractures and the presence of enamel defects. Swedish wild boars suffer from different dental lesions and the impact of supplemental feeding on dental and periodontal health is still to be investigated. Copyright © 2015 Elsevier Ltd. All rights reserved.

Autogenous bonding of tooth fragment retained in lower lip after trauma

PubMed Central

Lips, Andrea; da Silva, Luciana Pereira; Tannure, Patricia Nivoloni; Farinhas, João Alfredo; Primo, Laura Guimarães; de Araújo Castro, Gloria Fernanda

2012-01-01

In cases of trauma, dental fragments occasionally penetrate into the soft-tissues and may cause severe complications, if neglected. Clinical and radiographic examinations can provide a diagnosis and help in the surgical removal of any dental fragment embedded in soft-tissue. This case report concerns an 8-year-old boy who was diagnosed with a fragment of a fractured permanent central incisor crown located in the lower lip. The patient was seen initially at a general hospital, where the dental fragment went unnoticed. After 2 days, the patient was seen at the pediatric dentistry clinic, where a fragment embedded in the lower lip, causing a large swelling, was diagnosed. The fragment was removed surgically and bonded to the fractured tooth. A mouth guard was prescribed for sports. The importance of soft-tissue exploration even post-trauma was highlighted in this paper. PMID:23633815

Clinical performance of long-span zirconia frameworks for fixed dental prostheses: 5-year results.

PubMed

Schmitter, M; Mussotter, K; Rammelsberg, P; Gabbert, O; Ohlmann, B

2012-07-01

The purpose of this prospective cohort study was to assess the performance of tooth-supported, long-span, zirconia fixed dental prostheses (FDPs). Thirty FDPs with span lengths from 36 to 46 mm (mean 40·33 mm), with 4-7 units and with connector dimensions ∼9 mm(2) were inserted (19 in the posterior region, 11 including anterior teeth) using glass-ionomer cement. The performance of the FDPs was assessed (aesthetic evaluation, failures, hypersensitivity/tooth vitality, secondary caries, pocket depth, decementation, and chipping) at baseline and after 5 years. Cox regression analysis was performed to identify risk factors. There were 16 failures after 5 years. Framework fracture occurred for two FDPs, four FDPs had to be re-cemented, one abutment tooth had to be treated endodontically, one abutment tooth fractured and cohesive failure of the veneer occurred for eight. Four FDPs had to be replaced, so survival was 82%. The aesthetics were rated as excellent by the patients at baseline and good at the 5-year recall. Cox regression analysis showed that both length [P = 0·05, exp(B) = 1·22] and location [P = 0·019, exp(B) = 4·09] of the FDP were risk factors for failure. Compared with the previously published 2-year results, the incidence of complications increased dramatically. Additionally, it was shown that long-span FDPs in the molar region are at greater risk of failure than FDPs in the anterior region. © 2012 Blackwell Publishing Ltd.

Prevalence of vertical root fracture as the reason for tooth extraction in dental clinics.

PubMed

Yoshino, Koichi; Ito, Koji; Kuroda, Masahiko; Sugihara, Naoki

2015-07-01

The aim of this study was to investigate the prevalence, by gender, of vertical root fracture (VRF) as the main reason for the extraction of permanent teeth in dental clinics in Tokyo. Participating dentists were requested to provide information about extractions of permanent teeth they had performed from 1 January 2013 to 30 June 2013. The main reasons for extraction were categorized as follows: VRF, caries (horizontal root fracture included), periodontal disease and others. At a total of 24 clinics, 736 teeth were extracted from 626 patients during the 6-month period. A total of 233 teeth were extracted by VRF (31.7%), and 93.6% of these were endodontically treated teeth. Among non-vital extracted teeth, 82.1% (179/218) had cast posts or screw posts. The percentage of extraction due to VRF was 29.4% in males and 34.7% in females. In females, the percentage of extractions due to VRF (34.7%) was higher than for periodontal disease (28.1%). In males, the percentage of extractions due to VRF increased with age (p < 0.05). The tooth types with the highest percentage of extractions due to VRF were the upper canine (46.7%), lower second premolar (48.0%) and lower first molar (50.0%) in males and the upper first premolar (43.3%), upper second premolar (44.4%), lower second premolar (53.8%) and lower first molar (54.5%) in females. These results indicate that we need to pay more attention to maintaining vital teeth while being aware of the particular tooth types in which VRF most frequently occurs.

Fracture resistance of metal-free composite crowns-effects of fiber reinforcement, thermal cycling, and cementation technique.

PubMed

Lehmann, Franziska; Eickemeyer, Grit; Rammelsberg, Peter

2004-09-01

The improved mechanical properties of contemporary composites have resulted in their extensive use for the restoration of posterior teeth. However, the influence of fiber reinforcement, cementation technique, and physical stress on the fracture resistance of metal-free crowns is unknown. This in vitro study evaluated the effect of fiber reinforcement, physical stress, and cementation methods on the fracture resistance of posterior metal-free Sinfony crowns. Ninety-six extracted human third molars received a standardized tooth preparation: 0.5-mm chamfer preparation and occlusal reduction of 1.3 to 1.5 mm. Sinfony (nonreinforced crowns, n=48) and Sinfony-Vectris (reinforced crowns, n=48) crowns restoring original tooth contour were prepared. Twenty-four specimens of each crown type were cemented, using either glass ionomer cement (GIC) or resin cement. Thirty-two crowns (one third) were stored in humidity for 48 hours. Another third was exposed to 10,000 thermal cycles (TC) between 5 degrees C and 55 degrees C. The remaining third was treated with thermal cycling and mechanical loading (TCML), consisting of 1.2 million axial loads of 50 N. The artificial crowns were then vertically loaded with a steel sphere until failure occurred. Significant differences in fracture resistance (N) between experimental groups were assessed by nonparametric Mann-Whitney U-test (alpha=.05). Fifty percent of the Sinfony and Sinfony-Vectris crowns cemented with glass ionomer cement loosened after thermal cycling. Thermal cycling resulted in a significant reduction in the mean fracture resistance for Sinfony crowns cemented with GIC, from 2037 N to 1282 N (P=.004). Additional fatigue produced no further effects. Fiber reinforcement significantly increased fracture resistance, from 1555 N to 2326 N (P=.001). The minimal fracture resistance was above 600 N for all combinations of material, cement and loading. Fracture resistance of metal-free Sinfony crowns was significantly increased by fiber reinforcement. Adhesive cementation may be recommended to avoid cementation failure.

The grinding tip of the sea urchin tooth exhibits exquisite control over calcite crystal orientation and Mg distribution

PubMed Central

Ma, Yurong; Aichmayer, Barbara; Paris, Oskar; Fratzl, Peter; Meibom, Anders; Metzler, Rebecca A.; Politi, Yael; Addadi, Lia; Gilbert, P. U. P. A.; Weiner, Steve

2009-01-01

The sea urchin tooth is a remarkable grinding tool. Even though the tooth is composed almost entirely of calcite, it is used to grind holes into a rocky substrate itself often composed of calcite. Here, we use 3 complementary high-resolution tools to probe aspects of the structure of the grinding tip: X-ray photoelectron emission spectromicroscopy (X-PEEM), X-ray microdiffraction, and NanoSIMS. We confirm that the needles and plates are aligned and show here that even the high Mg polycrystalline matrix constituents are aligned with the other 2 structural elements when imaged at 20-nm resolution. Furthermore, we show that the entire tooth is composed of 2 cooriented polycrystalline blocks that differ in their orientations by only a few degrees. A unique feature of the grinding tip is that the structural elements from each coaligned block interdigitate. This interdigitation may influence the fracture process by creating a corrugated grinding surface. We also show that the overall Mg content of the tooth structural elements increases toward the grinding tip. This probably contributes to the increasing hardness of the tooth from the periphery to the tip. Clearly the formation of the tooth, and the tooth tip in particular, is amazingly well controlled. The improved understanding of these structural features could lead to the design of better mechanical grinding and cutting tools. PMID:19332795

The grinding tip of the sea urchin tooth exhibits exquisite control over calcite crystal orientation and Mg distribution.

PubMed

Ma, Yurong; Aichmayer, Barbara; Paris, Oskar; Fratzl, Peter; Meibom, Anders; Metzler, Rebecca A; Politi, Yael; Addadi, Lia; Gilbert, P U P A; Weiner, Steve

2009-04-14

The sea urchin tooth is a remarkable grinding tool. Even though the tooth is composed almost entirely of calcite, it is used to grind holes into a rocky substrate itself often composed of calcite. Here, we use 3 complementary high-resolution tools to probe aspects of the structure of the grinding tip: X-ray photoelectron emission spectromicroscopy (X-PEEM), X-ray microdiffraction, and NanoSIMS. We confirm that the needles and plates are aligned and show here that even the high Mg polycrystalline matrix constituents are aligned with the other 2 structural elements when imaged at 20-nm resolution. Furthermore, we show that the entire tooth is composed of 2 cooriented polycrystalline blocks that differ in their orientations by only a few degrees. A unique feature of the grinding tip is that the structural elements from each coaligned block interdigitate. This interdigitation may influence the fracture process by creating a corrugated grinding surface. We also show that the overall Mg content of the tooth structural elements increases toward the grinding tip. This probably contributes to the increasing hardness of the tooth from the periphery to the tip. Clearly the formation of the tooth, and the tooth tip in particular, is amazingly well controlled. The improved understanding of these structural features could lead to the design of better mechanical grinding and cutting tools.

Dentin-like versus Rigid Endodontic Post: 11-year Randomized Controlled Pilot Trial on No-wall to 2-wall Defects.

PubMed

Naumann, Michael; Sterzenbach, Guido; Dietrich, Thomas; Bitter, Kerstin; Frankenberger, Roland; von Stein-Lausnitz, Manja

2017-11-01

This is the first long-term randomized controlled trial to evaluate dentin-like glass fiber posts (GFPs) compared with rather rigid titanium posts (TPs) for post-endodontic restoration of severely damaged endodontically treated teeth with 2 or fewer remaining cavity walls. Ninety-one subjects in need of post-endodontic restorations were randomly assigned to receive either a tapered GFP (n = 45) or TP (n = 46). Posts were adhesively luted by using self-adhesive resin cement, followed by composite core build-up and preparation of 2-mm ferrule design. Primary end point was loss of restoration for any reason. Kaplan-Meier curves were constructed, and log-rank test was calculated (P < .05). After a follow-up of 132 months, 17 GFP and 20 TP restorations survived, and 19 failed (12 GFP, 7 TP). Failure modes for GFP were root fracture (n = 4), core fracture (n = 1), secondary caries (n = 1), endodontic failure (n = 2), extraction because of tooth mobility grade III associated with insufficient design of removable partial denture (n = 1), tooth fracture (n = 1), and changes in treatment plan (n = 2); failure modes for TP were endodontic failure (n = 5), root fracture (n = 1), and 1 extraction for other reasons. Cumulative survival probability was 58.7% for GFP and 74.2% for TP. When using self-adhesively luted prefabricated posts, resin composite core build-up, and 2-mm ferrule to reconstruct severely damaged endodontically treated teeth, tooth survival is not influenced by post rigidity. Survival decreased rapidly after 8 years of observation in both groups. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chinn, D J

This month's issue has the following articles: (1) The Edward Teller Centennial--Commentary by George H. Miller; (2) Edward Teller's Century: Celebrating the Man and His Vision--Colleagues at the Laboratory remember Edward Teller, cofounder of Lawrence Livermore, adviser to U.S. presidents, and physicist extraordinaire, on the 100th anniversary of his birth; (3) Quark Theory and Today's Supercomputers: It's a Match--Thanks to the power of BlueGene/L, Livermore has become an epicenter for theoretical advances in particle physics; and (4) The Role of Dentin in Tooth Fracture--Studies on tooth dentin show that its mechanical properties degrade with age.

Structure-property relations and crack resistance at the bovine dentin-enamel junction.

PubMed

Lin, C P; Douglas, W H

1994-05-01

The present report is a study of the fracture behavior of the dentin-enamel complex, involving enamel, dentin, and the dentin-enamel junction (DEJ), that combines experimental design, computational finite element analysis, and fractography. Seven chevron-notched short-bar bovine DEJ specimens were utilized in this study. The general plane of the DEJ was approximately perpendicular to the fracture plane. All specimens were stored at 37 degrees C and 100% relative humidity for 24 h prior to being tested. A fracture test set-up was designed for application of tensile load on the DEJ specimens to initiate a crack at the vertex of the chevron in the enamel, across the DEJ zone and into the bulk dentin. During fracture testing, a water chamber was used to avoid dehydration of the specimen. The results showed that the lower boundary value of the fracture toughness of the DEJ perpendicular to its own plane was 3.38 +/- 0.40 MN/m1.5 and 988.42 +/- 231.39 J/m2, in terms of KIC and GKC, respectively. In addition, there was an extensive plastic deformation (83 +/- 12%) collateral to the fracture process at the DEJ zone. The fractography revealed that the deviation of the crak path involved an area which was approximately 50-100 microns deep. The parallel-oriented coarse collagen bundles with diameters of 1-5 microns at the DEJ zone may play a significant role in resisting the enamel crack. This reflects the fact, that in the intact tooth, the multiple full thickness cracks commonly found in enamel do not typically cause total failure of the tooth by crack extension into the dentin.

Fracture strength testing of crowns made of CAD/CAM composite resins.

PubMed

Okada, Ryota; Asakura, Masaki; Ando, Akihiro; Kumano, Hirokazu; Ban, Seiji; Kawai, Tatsushi; Takebe, Jun

2018-03-28

The purpose of this study was to ascertain whether computer aided design/computer aided manufacturing (CAD/CAM) composite resin crowns have sufficient strength to withstand the bite force of the molar teeth. The null hypothesis was that the fracture strength of CAD/CAM composite resin crowns is lower than the average maximum bite force of the molar tooth. The crowns, which shape is the right maxillary first molar, were fabricated using four CAD/CAM blanks made of composite resins (Block HC: HC, KZR-CAD HR: HR, KZR-CAD HR2: HR2, Avencia Block: AVE) and one CAD/CAM blank made of lithium disilicate glass-ceramic (IPS e.max CAD: IPS), which was used as a control. Fracture strength of fabricated crowns bonded to metal abutment and biaxial flexural strength of the materials were evaluated. The results of fracture strength test and biaxial flexural strength test showed different tendencies. The fracture strength of CAD/CAM composite resin crowns except HC ranged from 3.3kN to 3.9kN, and was similar to that of IPS (3.3kN). In contrast, biaxial flexural strength of CAD/CAM composite resins ranged from 175MPa to 247MPa, and was significantly lower than that of IPS (360MPa). All CAD/CAM composite resin crowns studied presented about 3-4 times higher fracture strength than the average maximum bite force of the molar tooth (700-900N), which result leads to the conclusion that CAD/CAM composite resin crowns would have sufficient strength to withstand the bite force of the molar teeth. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

[Evaluation of the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction].

PubMed

Yang, Ying-yang; DU, Sheng-nan; Lv, Zong-kai

2015-08-01

To compare the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction. From May 2011 to May 2014, 83 patients undergoing impacted mandibular third molar extraction were enrolled into the study and randomly divided into 2 groups: 42 patients in group A (experimental group) and 41 patients in group B (control group). Group B underwent extraction with traditional method and group A underwent high-speed handpiece and minimally invasive extraction of the impacted mandibular third molar. The occurrences of the root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture and dislocation of temporomandibular joint during operation and lower lip numbness, dry socket, facial swelling and limitation of mouth opening after operation were observed and compared between 2 groups. The operation time, integrity of extraction sockets, VAS pain score and satisfaction from patients were collected and compared. SPSS 19.0 software package was used for statistical analysis. The occurrences of root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture, and dislocation of temporomandibular joint during operation in group A significantly decreased compared with group B (P<0.05). The occurrences of lower lip numbness, dry socket, facial swelling and limitation of mouth opening after operation in group A significantly decreased compared with group B (P<0.05). The operation time, integrity of extraction sockets, VAS pain scores and satisfaction scores in group A improved significantly compared with group B (P<0.05). High-speed handpiece and minimally invasive extraction should be widely used in impacted mandibular third molar extraction, due to the advantages of simple operation, high efficiency, minimal trauma, and few perioperative complications.

Repair of a pediatric bilateral condylar and symphyseal fracture using a transfacial Steinman pin.

PubMed

Grow, Jacob N; Flores, Roberto L; Tholpady, Sunil S

2014-01-01

The proper management of complex pediatric mandibular fractures remains a topic of debate because of the relatively uncommon presentation of these fractures, combined with concerns related with deciduous teeth, tooth buds, and growth inhibition. In this current study, we present a novel approach to the repair of bilateral condylar fractures with concomitant symphyseal fracture in a 4-year-old girl. Manual closed reduction was first obtained, followed by placement of a transfacial Steinman pin through the angles of the mandible and placement of circummandibular wires. Maxillomandibular fixation remained for 2 weeks and the Steinman pin was removed after 11 weeks. At 3 months of postsurgical follow-up, the patient displayed class I occlusion, facial symmetry, full range of jaw motion, and absence of deviation or pain on full oral excursion. Radiographic findings also revealed complete resolution of the symphyseal fracture with appropriate condylar healing and alignment.

Survey on Restoration of Endodontically Treated Anterior Teeth: A Questionnaire Based Study

PubMed Central

Ratnakar, P; Bhosgi, Rashmi; Metta, Kiran Kumar; Aggarwal, Kanika; Vinuta, S; Singh, Navneet

2014-01-01

Background: The aim of endodontic and restorative dentistry is the conservation of natural tooth structure. Endodontically treated tooth (ETT) undergoes loss of tooth structure and changes in physical characteristics. Therefore, proper selection of restoration for ETT is mandatory. The clinical approach of restoring ETT needs taking into considerations several issues. However, the best way to restore teeth after root canal treatment has long been and still a controversial subject to debate. Therefore, this study was carried out to detect the frequency of preferred methods of restoring ETT under different conditions. Materials and Methods: A questionnaire was framed and distributed among prosthodontists, endodontist and general practitioners of north India region to find out the frequency of best suitable material and method regarding restoration of ETT. 220 questionnaires were sent by electronic mail out of which 110 were received back. The questionnaire contained different methods of restoration of endodontically treated anterior teeth at different conditions (percentages) of remaining sound tooth structure. Respondents were asked to indicate their preferred method of restoration of those teeth. Results: Results showed that majority of respondents (51.82%) preferred to restore the tooth only with a tooth-color restorative material in condition A. In condition B, majority of respondents preferred to use tooth colored crown (44.55%) and prefabricated post and tooth colored restoration (24.5%). Whereas in condition C, most of the respondents preferred to use a cast post and core/crown (80.91%). Conclusion: From the findings of the present study, it can be concluded that the unrestored ETT is susceptible to fracture, which could lead to loss of tooth and that the maximum preservation of healthy tooth structure and use of restorative materials with mechanical properties similar to dental structure favor greater longevity of tooth restoration complex. PMID:25628482

Orthodontic treatment for oral rehabilitation after multiple maxillofacial bone fractures.

PubMed

Nakamura, Yoshiki; Ogino, Tomoko Kuroiwa; Hirashita, Ayao

2008-09-01

We present the orthodontic treatment of a patient with occlusal dysfunction after plastic surgery for multiple maxillofacial bone fractures caused by a traffic accident. The patient had mandibular deviation to the right because of inappropriate repositioning and fixation of the fractured bone and complete avulsion of both mandibular central incisors. The bilateral mandibular incisors, canines, and premolars were also suspected of partial avulsion or alveolar bone fracture. Several tests, including percussion and dental computed tomography, were performed on these teeth to rule out ankylosis and confirm tooth movement. Camouflage orthodontic treatment was carried out with expansion of the maxillary arch, alignment of both arches, and space closure between the mandibular lateral incisors to improve the occlusion. Good occlusion and interdigitation were obtained. Orthodontic treatment is useful for the rehabilitation of occlusal dysfunction caused by multiple maxillofacial bone fractures.

Experimental and numerical study on the strength of all-ceramic crowns

NASA Astrophysics Data System (ADS)

Lu, Chenglin; Zhang, Xiuyin; Zhang, Dongsheng

2008-11-01

Two types of sectioned tooth-like ceramic crowns (IPS Empress 2) were prepared along lingual-facial direction and the fracture process of crowns under contact load was directly monitored with the use of imaging system. The displacement filed resulted from digital image correlation indicate that the fracture mode of real crown is more complicated while the flat crown has the same rupture mode as described by other investigators. Meanwhile numerical simulation was also carried out to support the experiments. Stress distributions in individual layer and interface were presented. Results indicate that the presented experimental and numerical methods are efficient in studying the fracture mechanism of all-ceramic crowns.

Rootless eruption of a mandibular permanent canine.

PubMed

Shapira, Yehoshua; Kuftinec, Mladen M

2011-04-01

The purpose of this article was to describe the rootless eruption of a mandibular permanent canine in a 10-year-old boy; his mandible had been fractured in a car accident. The fracture was at the region of the developing canine, resulting in arrested root formation and causing abnormal, rootless eruption. Current theories on tooth eruption and the important role of the dental follicle in the process of eruption are discussed. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Oral cutaneous sinus tract, vertical root fracture, and bisphosphonate-related osteonecrosis: a case report.

PubMed

Wigler, Ronald; Steinbock, Nelly; Berg, Tal

2013-08-01

Oral cutaneous sinus tracts (OCSTs) of dental origin are often initially misdiagnosed and inappropriately treated. Accurate diagnosis is especially important in cases of bisphosphonate (BP) therapy because extraction may lead to a risk of osteonecrosis. A case report of misdiagnosis related to a tooth with a vertical root fracture in an oncologic patient treated with BPs is reported here. In 2011, a 75-year-old woman was examined at the oral medicine clinic because of pain and swelling of the left submandibular area. The patient's medical history included oral and intravenous BP therapy because she was diagnosed with metastatic breast cancer and left maxillary stage 1 antiresorptive agent-induced osteonecrosis of the jaw. The lower left odontogenic region showed no signs or symptoms, and no apical pathosis was observed on imaging. Although antibiotics were applied, clinical symptoms worsened and an OCST appeared. Intravenous antibiotic treatment was pursued. Biopsy and direct smear from fistula were not conclusive. A diagnosis of a nonexposed variant of stage 3 antiresorptive agent-induced osteonecrosis of the jaw was established. Symptoms resolved after 2 weeks of antibiotic treatment and reappeared a month later. Endodontic examination revealed that the origin of the OCST was tooth no. 18 caused by a vertical root fracture, and the tooth was extracted. The patient was scheduled for routine checkups because of the fact that osteonecrosis may occur in intravenous BP-treated patients. Early correct diagnosis can prevent unnecessary and ineffective antibiotic therapy and surgical intervention, which is not recommended in intravenous BP cases. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Hunter-Schreger Band patterns in human tooth enamel

PubMed Central

Lynch, Christopher D; O’Sullivan, Victor R; Dockery, Peter; McGillycuddy, Catherine T; Sloan, Alastair J

2010-01-01

Using light microscopy, we examined Hunter-Schreger Band (HSB) patterns on the axial and occlusal/incisal surfaces of 160 human teeth, sectioned in both the buccolingual and mesiodistal planes. We found regional variations in HSB packing densities (number of HSBs per mm of amelodentinal junction length) and patterns throughout the crown of each class of tooth (maxillary and mandibular: incisor, canine, premolar, and molar) examined. HSB packing densities were greatest in areas where functional and occlusal loads are greatest, such as the occlusal surfaces of posterior teeth and the incisal regions of incisors and canines. From this it is possible to infer that the behaviour of ameloblasts forming enamel prisms during amelogenesis is guided by genetic/evolutionary controls that act to increase the fracture and wear resistance of human tooth enamel. It is suggested that HSB packing densities and patterns are important in modern clinical dental treatments, such as the bonding of adhesive restorations to enamel, and in the development of conditions, such as abfraction and cracked tooth syndrome. PMID:20579171

The effects of relative food item size on optimal tooth cusp sharpness during brittle food item processing

PubMed Central

Berthaume, Michael A.; Dumont, Elizabeth R.; Godfrey, Laurie R.; Grosse, Ian R.

2014-01-01

Teeth are often assumed to be optimal for their function, which allows researchers to derive dietary signatures from tooth shape. Most tooth shape analyses normalize for tooth size, potentially masking the relationship between relative food item size and tooth shape. Here, we model how relative food item size may affect optimal tooth cusp radius of curvature (RoC) during the fracture of brittle food items using a parametric finite-element (FE) model of a four-cusped molar. Morphospaces were created for four different food item sizes by altering cusp RoCs to determine whether optimal tooth shape changed as food item size changed. The morphospaces were also used to investigate whether variation in efficiency metrics (i.e. stresses, energy and optimality) changed as food item size changed. We found that optimal tooth shape changed as food item size changed, but that all optimal morphologies were similar, with one dull cusp that promoted high stresses in the food item and three cusps that acted to stabilize the food item. There were also positive relationships between food item size and the coefficients of variation for stresses in food item and optimality, and negative relationships between food item size and the coefficients of variation for stresses in the enamel and strain energy absorbed by the food item. These results suggest that relative food item size may play a role in selecting for optimal tooth shape, and the magnitude of these selective forces may change depending on food item size and which efficiency metric is being selected. PMID:25320068

Smartphones and dental trauma: the current availability of apps for managing traumatic dental injuries.

PubMed

Djemal, Serpil; Singh, Parmjit

2016-02-01

There is a general consensus regarding the lack of awareness regarding the emergency management of traumatic dental injuries amongst laypersons and dental professionals. This article aims to provide an overview of the apps available for traumatic dental injuries using smartphones. These apps may serve as a gateway for raising awareness of traumatic dental injuries. Three smartphone devices were used to access their respective app stores (Nokia Lumia 635 with Windows Phone OS 8.1; iPhone 5 with iOS 8.1; Samsung Galaxy Ace II with Android OS v2.3.6 Gingerbread). Nine phrases were searched: broken tooth/teeth; chipped tooth/teeth; dental emergency; dental injury; dental trauma; fractured tooth/teeth; knocked-out tooth/teeth; tooth/teeth injury; and tooth/teeth trauma. Seven apps for the Android and one app for the Apple operating system were relevant. The only Apple iOS app retrieved (Dental Trauma) was also found for the Android OS (Dental Trauma First Aid) and had the endorsement of the International Association of Dental Traumatology. AcciDent was the only app dedicated to traumatic dental injuries targeted solely towards dental professionals. Five other apps (Chipped Tooth Solution, Dental Crown Repair, Fixing Cracked Tooth, Repairing the Front Tooth and Solution to Broken Tooth) appeared to come from the same source (KBES). No traumatic dental injury apps were found for the Windows Phone OS. There are apps available for both patients and dentists that range in quality and on the whole lack real-life photographs. Future apps should continue to provide good quality, evidence-based and validated material. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of CBS 600 carburized steel as a gear material

NASA Technical Reports Server (NTRS)

Townsend, D. P.; Parker, R. J.; Zaretsky, E. V.

1979-01-01

Gear endurance tests were conducted with one lot of consumable-electrode vacuum-melted (CVM) AISI 9310 gears and one lot of air-melt CBS 600 gears. The gears were 8 pitch with a pitch diameter of 8.89 centimeters (3.5 in.). Bench-type rolling-element fatigue tests were also conducted with one lot of CVM AISI 9310, three lots of CVM CBS 600, and one of air-melt CBS 600 material. The rolling-element bars were 0.952 centimeter (0.375 in.) in diameter. The CBS 600 material exhibited pitting fatigue lives in both rolling-element specimens and gears at least equivalent to that of CVM AISI 9310. Tooth fracture failure occurred with the CBS 600 gears after overrunning a fatigue spall, but it did not occur with the CVM AISI 9310 gears. Tooth fracture in the CBS 600 was attributed to excessive carbon content in the case, excessive case depth, and a higher than normal core hardness.

Gear crack propagation investigations

NASA Technical Reports Server (NTRS)

Lewicki, David G.; Ballarini, Roberto

1996-01-01

Analytical and experimental studies were performed to investigate the effect of gear rim thickness on crack propagation life. The FRANC (FRacture ANalysis Code) computer program was used to simulate crack propagation. The FRANC program used principles of linear elastic fracture mechanics, finite element modeling, and a unique re-meshing scheme to determine crack tip stress distributions, estimate stress intensity factors, and model crack propagation. Various fatigue crack growth models were used to estimate crack propagation life based on the calculated stress intensity factors. Experimental tests were performed in a gear fatigue rig to validate predicted crack propagation results. Test gears were installed with special crack propagation gages in the tooth fillet region to measure bending fatigue crack growth. Good correlation between predicted and measured crack growth was achieved when the fatigue crack closure concept was introduced into the analysis. As the gear rim thickness decreased, the compressive cyclic stress in the gear tooth fillet region increased. This retarded crack growth and increased the number of crack propagation cycles to failure.

Impact of oral conditions on the quality of life of secondary schoolchildren in Nigeria.

PubMed

Oziegbe, Elizabeth O; Esan, Temitope A; Adesina, Bola A

2012-01-01

Oral health problems have been increasingly recognized as important factors causing a negative impact on daily performance and quality of life. The purpose of this study was to assess the impact of tooth extraction with no replacement, untreated fractured anterior teeth, malocclusion, dental restorations, and orthodontic braces on the quality of life in Nigerian schoolchildren. A total of 197 9- to 17-year-old schoolchildren completed the Oral Health Impact Profile (OHIP) index/questionnaire. Students who had tooth extraction with no replacement and untreated fractured incisors had significantly higher mean OHIP scores for functional limitations, physical pain, psychological discomfort, physical, psychological, and social disabilities, and handicaps (P<.001) when compared to other groups and the control. The mean OHIP scores of students with features of malocclusion were significantly higher for functional limitations, psychological discomfort, and psychological disability compared to the control group (P<.001). Untreated dental problems had some negative impact on the quality of life on the 7 subscales of the OHIP.

Prevalence of crown trauma in free-ranging maned wolves (Chrysocyon brachyurus) in central Brazil.

PubMed

Furtado, Mariana Malzoni; Kashivakura, Cyntia Kayo; Ferro, Claudia; Jácomo, Anah Tereza de Almeida; Silveira, Leandro; Astete, Samuel; Lopes, Fernanda Maria

2007-12-01

Nineteen free-ranging maned wolves (Chrysocyon brachyurus) were captured in central Brazil from April through November 2003. Oral cavity examination revealed 34 teeth with crown trauma in twelve animals. Canine teeth were most commonly affected (44.2%), followed by premolar (29.4%) and incisor teeth (26.5%). Trauma to maxillary teeth (67.7%) was more frequent compared with mandibular teeth (32.3 %). The majority of dental fractures were located at the cuspid portion of the crown (56.0%). Slab fractures were the most frequent type (37.0%), followed by horizontal (24.0%), oblique (24.0%) and longitudinal fractures (15.0%). Complicated crown fracture (pulp exposure) was diagnosed in 13 (38.2%) of these teeth while pulpitis noted by tooth discoloration was diagnosed in 8 (23.5%) teeth.

The functional significance of morphological changes in the dentitions of early mammals.

PubMed

Conith, Andrew J; Imburgia, Michael J; Crosby, Alfred J; Dumont, Elizabeth R

2016-11-01

The Mesozoic marked a time of experimentation in the tooth morphology of early mammals. One particular experiment involved the movement of three points, or cusps, on the surface of a molar tooth from a line into a triangle. This transition is exemplified by two extinct insectivorous mammals, Morganucodon (cusps in a line) and Kuehneotherium (cusps in a triangle). Here we test whether this difference in cusp arrangement, alongside cusp heights and angles between cusps, is associated with differences in the ability of the teeth to fracture proxy-insect prey. We gathered measurements from molar teeth of both species and used them to create physical models. We then measured the force, time and energy at fracture and peak force, and the amount of damage inflicted by the models on hard and soft gels encased in a tough film that mimicked the material properties of insects. The Morganucodon model required less force and energy to fracture hard gels and reach peak force compared with Kuehneotherium Kuehneotherium required a similar time, force and energy to fracture soft gels but reduced the time, force and energy to reach peak force. More importantly, Kuehneotherium also inflicted more damage to both the hard and the soft gels. These results suggest that changes in dental morphology in some early mammals was driven primarily by selection for maximizing damage, and secondarily for maximizing biomechanical efficiency for a given food material property. © 2016 The Author(s).

On the R-curve behavior of human tooth enamel.

PubMed

Bajaj, Devendra; Arola, Dwayne D

2009-08-01

In this study the crack growth resistance behavior and fracture toughness of human tooth enamel were quantified using incremental crack growth measures and conventional fracture mechanics. Results showed that enamel undergoes an increase in crack growth resistance (i.e. rising R-curve) with crack extension from the outer to the inner enamel, and that the rise in toughness is a function of distance from the dentin enamel junction (DEJ). The outer enamel exhibited the lowest apparent toughness (0.67+/-0.12 MPam(0.5)), and the inner enamel exhibited a rise in the growth toughness from 1.13 MPam(0.5)/mm to 3.93 MPam(0.5)/mm. The maximum crack growth resistance at fracture (i.e. fracture toughness (K(c))) ranged from 1.79 to 2.37 MPam(0.5). Crack growth in the inner enamel was accompanied by a host of mechanisms operating from the micro- to the nano-scale. Decussation in the inner enamel promoted crack deflection and twist, resulting in a reduction of the local stress intensity at the crack tip. In addition, extrinsic mechanisms such as bridging by unbroken ligaments of the tissue and the organic matrix promoted crack closure. Microcracking due to loosening of prisms was also identified as an active source of energy dissipation. In summary, the unique microstructure of enamel in the decussated region promotes crack growth toughness that is approximately three times that of dentin and over ten times that of bone.

Fracture Forces of Dentin after Surface Treatment with High Speed Drill Compared to Er:YAG and Er,Cr:YSGG Laser Irradiation

PubMed Central

Franzen, Rene; Kianimanesh, Nasrin; Marx, Rudolf; Ahmed, Asma; Gutknecht, Norbert

2016-01-01

Dental tooth restorative procedures may weaken the structural integrity of the tooth, with the possibility of leading to fracture. In this study we present findings of coronal dentin strength after different techniques of surface modification. The fracture strength of dentin beams after superficial material removal with a fine diamond bur high speed drill hand piece, Er:YAG (2.94 μm, 8 J/cm2), and Er,Cr:YSGG (2.78 μm, 7.8 J/cm2) laser irradiation slightly above the ablation threshold was measured by a four-point bending apparatus. Untreated dentin beams served as a control. A total of 58 dentin beams were manufactured from sterilized human extracted molars using the coronal part of the available dentin. Mean values of fracture strength were calculated as 82.0 ± 27.3 MPa for the control group (n = 10), 104.5 ± 26.3 MPa for high speed drill treatment (n = 10), 96.1 ± 28.1 MPa for Er,Cr:YSGG laser irradiation (n = 20), and 89.1 ± 36.3 MPa for Er:YAG laser irradiation (n = 18). Independent Student's t-tests showed no significant difference between each two groups (p > 0.05). Within the parameter settings and the limits of the experimental setup used in this study, both lasers systems as well as the high speed drill do not significantly weaken coronal dentin after surface treatment. PMID:26962473

Diagnosis and Managment of Maxillary Incisor with Vertical Root Fracture: A Clinical Report with Three-Year Follow-Up

PubMed Central

Moussaoui, Eya; Chtioui, Fadwa; Douki, Nabiha

2018-01-01

According to the American Association of Endodontists, “a ‘true' vertical root fracture is defined as a complete or incomplete fracture initiated from the root at any level, usually directed buccolingually.” Vertical root fracture (VRF) usually starts from an internal dentinal crack and develops over time, due to masticatory forces and occlusal loads. When they occur in teeth, those types of fractures can present difficulties in diagnosis, and there are however many clinic and radiographical signs which can guide clinicians to the existence of the fracture. Prognosis, most often, is hopeless, and differential diagnosis from other etiologies may be difficult sometimes. In this paper, we present a case of VRF diagnosed after surgical exploration; the enlarged fracture line was filled with a fluid resin. A 36-month clinical and radiological follow-up showed an asymptomatic tooth, reduction of the periodontal probing depth from 7 mm prior to treatment to 4 mm with no signs of ankylosis. In this work, the diagnosis and treatment alternatives of vertical root fracture were discussed through the presented clinical case. PMID:29552361

Diagnosis and Managment of Maxillary Incisor with Vertical Root Fracture: A Clinical Report with Three-Year Follow-Up.

PubMed

Kallel, Ines; Moussaoui, Eya; Chtioui, Fadwa; Douki, Nabiha

2018-01-01

According to the American Association of Endodontists, "a 'true' vertical root fracture is defined as a complete or incomplete fracture initiated from the root at any level, usually directed buccolingually." Vertical root fracture (VRF) usually starts from an internal dentinal crack and develops over time, due to masticatory forces and occlusal loads. When they occur in teeth, those types of fractures can present difficulties in diagnosis, and there are however many clinic and radiographical signs which can guide clinicians to the existence of the fracture. Prognosis, most often, is hopeless, and differential diagnosis from other etiologies may be difficult sometimes. In this paper, we present a case of VRF diagnosed after surgical exploration; the enlarged fracture line was filled with a fluid resin. A 36-month clinical and radiological follow-up showed an asymptomatic tooth, reduction of the periodontal probing depth from 7 mm prior to treatment to 4 mm with no signs of ankylosis. In this work, the diagnosis and treatment alternatives of vertical root fracture were discussed through the presented clinical case.

Cemental tear: To know what we have neglected in dental practice.

PubMed

Jeng, Po-Yuan; Luzi, Arlinda Luzi; Pitarch, Rocio Marco; Chang, Mei-Chi; Wu, Yu-Hsueh; Jeng, Jiiang-Huei

2018-04-01

Cemental tear is a special kind of root surface fracture, contributing to periodontal and periapical breakdown. However, it is a challenge for doctors to diagnose, resulting in delayed or improper treatment. We reviewed the predisposing factors, location, radiographic/clinical characteristics, diagnosis and treatments of cemental tears. From the literature, patients with cemental tear were mainly males, over 60 year-old. Possible predisposing factors include gender, age, tooth type, traumatic occlusal force and vital teeth. Cemental tears were common in upper and lower anterior teeth, single or multiple, and can be present in cervical, middle and apical third of roots. Morphology of cemental tears can be either piece-shaped or U-shaped. Clinically, cemental tear shows a unitary periodontal pocket and signs/symptoms mimicking localized periodontitis, apical periodontitis and vertical root fractures. Treatment of cemental tears include scaling, root planning, root canal treatment, periodontal/periapical surgery, guided tissue regeneration, bone grafting, and intentional replantation. Recurrence of cemental tear is possible especially when the fracture involves root apex. Extraction is recommended for teeth with poor prognosis. In conclusion, cemental tears can involve both periodontal and periapical area. Dentists should understand the predisposing factors and clinical features of cemental tears for early diagnosis/treatment to prevent bone loss/tooth extraction. Copyright © 2017. Published by Elsevier B.V.

Comparative fracture strength analysis of Lava and Digident CAD/CAM zirconia ceramic crowns.

PubMed

Kwon, Taek-Ka; Pak, Hyun-Soon; Yang, Jae-Ho; Han, Jung-Suk; Lee, Jai-Bong; Kim, Sung-Hun; Yeo, In-Sung

2013-05-01

All-ceramic crowns are subject to fracture during function. To minimize this common clinical complication, zirconium oxide has been used as the framework for all-ceramic crowns. The aim of this study was to compare the fracture strengths of two computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crown systems: Lava and Digident. Twenty Lava CAD/CAM zirconia crowns and twenty Digident CAD/CAM zirconia crowns were fabricated. A metal die was also duplicated from the original prepared tooth for fracture testing. A universal testing machine was used to determine the fracture strength of the crowns. THE MEAN FRACTURE STRENGTHS WERE AS FOLLOWS: 54.9 ± 15.6 N for the Lava CAD/CAM zirconia crowns and 87.0 ± 16.0 N for the Digident CAD/CAM zirconia crowns. The difference between the mean fracture strengths of the Lava and Digident crowns was statistically significant (P<.001). Lava CAD/CAM zirconia crowns showed a complete fracture of both the veneering porcelain and the core whereas the Digident CAD/CAM zirconia crowns showed fracture only of the veneering porcelain. The fracture strengths of CAD/CAM zirconia crowns differ depending on the compatibility of the core material and the veneering porcelain.

Virtual experiments, physical validation: dental morphology at the intersection of experiment and theory

PubMed Central

Anderson, P. S. L.; Rayfield, E. J.

2012-01-01

Computational models such as finite-element analysis offer biologists a means of exploring the structural mechanics of biological systems that cannot be directly observed. Validated against experimental data, a model can be manipulated to perform virtual experiments, testing variables that are hard to control in physical experiments. The relationship between tooth form and the ability to break down prey is key to understanding the evolution of dentition. Recent experimental work has quantified how tooth shape promotes fracture in biological materials. We present a validated finite-element model derived from physical compression experiments. The model shows close agreement with strain patterns observed in photoelastic test materials and reaction forces measured during these experiments. We use the model to measure strain energy within the test material when different tooth shapes are used. Results show that notched blades deform materials for less strain energy cost than straight blades, giving insights into the energetic relationship between tooth form and prey materials. We identify a hypothetical ‘optimal’ blade angle that minimizes strain energy costs and test alternative prey materials via virtual experiments. Using experimental data and computational models offers an integrative approach to understand the mechanics of tooth morphology. PMID:22399789

Examination of ceramic restoration adhesive coverage in cusp-replacement premolar using acoustic emission under fatigue testing.

PubMed

Chang, Yen-Hsiang; Yu, Jin-Jie; Lin, Chun-Li

2014-12-13

This study investigates CAD/CAM ceramic cusp-replacing restoration resistance with and without buccal cusp replacement under static and dynamic cyclic loads, monitored using the acoustic emission (AE) technique. The cavity was designed in a typical MODP (mesial-occlusal-distal-palatal) restoration failure shape when the palatal cusp has been lost. Two ceramic restorations [without coverage (WOC) and with (WC) buccal cuspal coverage with 2.0 mm reduction in cuspal height] were prepared to perform the fracture and fatigue tests with normal (200 N) and high (600 N) occlusal forces. The load versus AE signals in the fracture and fatigue tests were recorded to evaluate the restored tooth failure resistance. The results showed that non-significant differences in load value in the fracture test and the accumulated number of AE signals under normal occlusal force (200 N) in the fatigue test were found between with and without buccal cuspal coverage restorations. The first AE activity occurring for the WOC restoration was lower than that for the WC restoration in the fracture test. The number of AE signals increased with the cyclic load number. The accumulated number of AE signals for the WOC restoration was 187, higher than that (85) for the WC restoration under 600 N in the fatigue test. The AE technique and fatigue tests employed in this study were used as an assessment tool to evaluate the resistances in large CAD/CAM ceramic restorations. Non-significant differences in the tested fracture loads and accumulated number of AE signals under normal occlusal force (200 N) between different restorations indicated that aggressive treatment (with coverage preparation) in palatal cusp-replacing ceramic premolars require more attention for preserving and protecting the remaining tooth.

Crown-root Fracture Restoration on a Patient with Autism Spectrum Disorder.

PubMed

Perez, Edna; Behar-Horenstein, Linda S; Guelmann, Marcio

2016-09-01

Children with intellectual and physical disabilities including autism are susceptible to dental trauma as a sequela from falls due to poor muscular coordination. In addition, their altered muscle tonus often results in an open bite with labial flaring of the maxillary incisors and lip incompetence, predisposing these teeth to fractures. This case report describes an alternative approach of restoring a fractured maxillary permanent central incisor with a composite strip crown during surgical repositioning of the periodontium on an autistic patient. The prognosis of the incisor is guarded due to the probability of re-injury. However, the decision to maintain the tooth clinically was esthetically preferable in comparison to an extraction or decoronation.

The combination of a mineral trioxide aggregate and an adhesive restorative approach to treat a crown-root fracture coupled with lateral root perforation in a mandibular second molar: a case report.

PubMed

Wang, P; Wang, S; Ni, L

2009-01-01

The current paper describes a modified treatment procedure for a traumatized mandibular left second molar resulting in a crown-root fracture and root perforation with the fracture line below the gingival attachment and alveolar bone crest. After the mobile crown-root fragment was extracted, the root perforation was obturated with mineral trioxide aggregate (MTA), and the subgingival defect was directly repaired with polyacid-modified resin composites (Ionosite Baseline). A 24-month recall showed no evidence of periodontal inflammation and no adverse symptoms, and the treated tooth exhibited good healing and normal function.

CHIPPING FRACTURE RESISTANCE OF DENTURE TOOTH MATERIALS

PubMed Central

Quinn, G. D.; Giuseppetti, A. A.; Hoffman, K. H.

2014-01-01

Objective The applicability of the edge chipping method to denture tooth materials was assessed. These are softer materials than those usually tested by edge chipping. The edge chipping fracture resistances of polymethylmethacrylate (PMMA) based and two filled resin composite denture tooth materials were compared. Methods An edge chipping machine was used to chip rectangular blocks and flattened anterior denture teeth. Force versus edge distance data were collected over a broad range of forces and distances. Between 20 and 65 chips were made per condition depending upon the material, the scatter, and the indenter type. Different indenter types were used including Rockwell C, sharp conical 120°, Knoop, and Vickers. The edge toughness, Te, was evaluated for different indenter types. Results The edge chipping data collected on the blocks matched the data collected from flattened teeth. High scatter, particularly at large distances and loads, meant that many tests (up to 64) were necessary to compare the denture tooth materials and to ascertain the appropriate data trends. A linear force – distance trend analysis was adequate for comparing these materials. A power law trend might be more appropriate, but the large scatter obscured the definitive determination of the precise trend. Different indenters produce different linear trends, with the ranking of: sharp conical 120°, Rockwell C, and Knoop, from lowest to highest edge toughness. Vickers indenter data were extremely scattered and a sensible trend could not be obtained. Edge toughness was inversely correlated to hardness. Significance Edge chipping data collected either from simple laboratory scale test blocks or from actual denture teeth may be used to evaluate denture materials. The edge chipping method’s applicability has been extended to another class of restorative materials. PMID:24674342

A Study on Prevalence of Dental Attrition and its Relation to Factors of Age, Gender and to the Signs of TMJ Dysfunction.

PubMed

Yadav, Sangeeta

2011-06-01

A study was planned to determine the severity of dental attrition in adults of both sexes in different age groups and its possible relationship to temporomandibular disorders. 500 subjects comprising of 260 females and 240 males in the age group of 18-55 years were clinically examined for bruxism, attrition, and signs of temporomandibular disorders. Tooth sensitivity, tooth or restoration fracture, scalloping of tongue, ridging of buccal mucosa, TMJ sounds, muscle tenderness, TMJ tenderness, referred pain, pain on mouth opening and limitation of mouth opening were recorded along with attrition score in a proforma. The basic data was then analysed to arrive at certain conclusions. A high prevalence of attrition (88.0%) with increase in age (P < 0.00) and was seen more in males as compared to females (P < 0.01). On comparing attrition with some of the signs of bruxism it was shown that tooth or restoration fracture and scalloping of tongue had no relation to the severity of attrition score. Whereas a significant relation was seen between attrition and tooth sensitivity (P < 0.00), and ridging of buccal mucosa (P < 0.05). Muscle tenderness (P < 0.00), pain on mouth opening (P < 0.05) and deviation of mandible on mouth opening (P < 0.00) had significant relation to attrition. Other signs of temporomandibular disorders such as joint tenderness, referred pain, joint sounds and limitation of mouth opening had no relation to attrition score. This study showed a limited association between the severity of attrition and TMJ dysfunction.

Reduced wear of enamel with novel fine and nano-scale leucite glass-ceramics.

PubMed

Theocharopoulos, Antonios; Chen, Xiaohui; Hill, Robert; Cattell, Michael J

2013-06-01

Leucite glass-ceramics used to produce all-ceramic restorations can suffer from brittle fracture and wear the opposing teeth. High strength and fine crystal sized leucite glass-ceramics have recently been reported. The objective of this study is to investigate whether fine and nano-scale leucite glass-ceramics with minimal matrix microcracking are associated with a reduction in in vitro tooth wear. Human molar cusps (n=12) were wear tested using a Bionix-858 testing machine (300,000 simulated masticatory cycles) against experimental fine crystal sized (FS), nano-scale crystal sized (NS) leucite glass-ceramics and a commercial leucite glass-ceramic (Ceramco-3, Dentsply, USA). Wear was imaged using Secondary Electron Imaging (SEI) and quantified using white-light profilometry. Both experimental groups were found to produce significantly (p<0.05) less volume and mean-height tooth loss compared to Ceramco-3. The NS group had significantly (p<0.05) less tooth mean-height loss and less combined (tooth and ceramic) loss than the FS group. Increased waviness and damage was observed on the wear surfaces of the Ceramco-3 glass-ceramic disc/tooth group in comparison to the experimental groups. This was also indicated by higher surface roughness values for the Ceramco-3 glass-ceramic disc/tooth group. Fine and nano-sized leucite glass-ceramics produced a reduction in in vitro tooth wear. The high strength low wear materials of this study may help address the many problems associated with tooth enamel wear and restoration failure. Copyright © 2013 Elsevier Ltd. All rights reserved.

Outside-the-(Cavity-prep)-Box Thinking

PubMed Central

Thompson, V.P.; Watson, T.F.; Marshall, G.W.; Blackman, B.R.K.; Stansbury, J.W.; Schadler, L.S.; Pearson, R.A.; Libanori, R.

2013-01-01

Direct placement restorative materials must interface with tooth structures that are often compromised by caries or trauma. The material must seal the interface while providing sufficient strength and wear resistance to assure function of the tooth for, ideally, the lifetime of the patient. Needed are direct restorative materials that are less technique-sensitive than current resin-based composite systems while having improved properties. The ideal material could be successfully used in areas of the world with limited infrastructure. Advances in our understanding of the interface between the restoration adhesive system and the stages of carious dentin can be used to promote remineralization. Application of fracture mechanics to adhesion at the tooth-restoration interface can provide insights for improvement. Research in polymer systems suggests alternatives to current composite resin matrix systems to overcome technique sensitivity, while advances in nano- and mesoparticle reinforcement and alignment in composite systems can increase material strength, toughness, and wear resistance, foreshadowing dental application. PMID:24129814

Successful Ultra-Conservative Management of a Mandibular Premolar with Dens Invaginatus.

PubMed

Abazarpour, Ramin; Parirokh, Masoud; Farhadi, Aida; Jalali, Zahra; Kheirabadi, Nasir

2017-01-01

Dens invaginatus is one of the most common anomalies of tooth structure. It is caused by the invagination of the crown surface during odontogenesis that enters the pulp chamber of the affected tooth. Depending on the complexity of invagination, the tooth might present with pulp necrosis, open apex and a complicated root canal system. This case report presents an Oehlers' type 2 dens-invaginatus in a mandibular premolar with chronic apical abscess. In most cases, dens invaginatus is removed during treatment. However, in this case report, based on cone-beam computed tomography (CBCT) evaluation, non-surgical treatment and maintenance of the invaginated segment was chosen in order to prevent compromising the tooth structure and its susceptibility to future root fracture. This is a new treatment approach and has not been performed in previous reports. Calcium-enriched mixture (CEM) cement was used as an apical plug followed by gutta-percha in warm vertical compaction for root canal obturation. The case was followed up for 36 months after treatment. This report highlights the importance of selecting the appropriate treatment approach based on CBCT evaluation.

Successful Ultra-Conservative Management of a Mandibular Premolar with Dens Invaginatus

PubMed Central

Abazarpour, Ramin; Parirokh, Masoud; Farhadi, Aida; Jalali, Zahra; Kheirabadi, Nasir

2017-01-01

Dens invaginatus is one of the most common anomalies of tooth structure. It is caused by the invagination of the crown surface during odontogenesis that enters the pulp chamber of the affected tooth. Depending on the complexity of invagination, the tooth might present with pulp necrosis, open apex and a complicated root canal system. This case report presents an Oehlers’ type 2 dens-invaginatus in a mandibular premolar with chronic apical abscess. In most cases, dens invaginatus is removed during treatment. However, in this case report, based on cone-beam computed tomography (CBCT) evaluation, non-surgical treatment and maintenance of the invaginated segment was chosen in order to prevent compromising the tooth structure and its susceptibility to future root fracture. This is a new treatment approach and has not been performed in previous reports. Calcium-enriched mixture (CEM) cement was used as an apical plug followed by gutta-percha in warm vertical compaction for root canal obturation. The case was followed up for 36 months after treatment. This report highlights the importance of selecting the appropriate treatment approach based on CBCT evaluation. PMID:28808472

Retrospective analysis of porcelain failures of metal ceramic crowns and fixed partial dentures supported by 729 implants in 152 patients: patient-specific and implant-specific predictors of ceramic failure.

PubMed

Kinsel, Richard P; Lin, Dongming

2009-06-01

Porcelain fracture associated with an implant-supported, metal ceramic crown or fixed partial denture occurs at a higher rate than in tooth-supported restorations, according to the literature. Implant-specific and patient-specific causes of ceramic failure have not been fully evaluated. The purpose of this retrospective study was to evaluate the potential statistical predictors for porcelain fracture of implant-supported, metal ceramic restorations. Over a 6-month period, a consecutive series of patients having previously received implant-supported, metal ceramic fixed restorations were examined during periodic recall appointments. The number of supporting implants, number of dental units, type of restoration, date of prosthesis insertion, location in the dental arch, opposing dentition, type of occlusion, presence of parafunctional habits, use of an occlusal protective device, presence or absence of ceramic fractures, gender, and age were recorded for each patient. The generalized estimating equation (GEE) approach was used for the intrasubject correlated measurements analysis of categorical outcomes (presence or absence of ceramic fractures) to determine which patient- and implant-specific factors would predict porcelain fracture (alpha=.05). Data were collected from 152 patients representing 998 dental units (390 single crowns and 94 fixed partial dentures) supported by 729 implants. Porcelain fractures of 94 dental units occurred in 35 patients. The fractures were significantly (P<.05) associated with opposing implant-supported metal ceramic restorations, bruxism, and not wearing a protective occlusal device. Metal ceramic prostheses (single crown or fixed partial dentures) had approximately 7 times higher odds of porcelain fracture (odds ratio (OR)=7.06; 95% confidence interval (CI): 2.57 to 19.37) and 13 times greater odds of a fracture requiring either repair or replacement (OR=13.95; 95% CI: 2.25 to 86.41) when in occlusion with another implant-supported restoration, as compared to opposing a natural tooth. In addition, patients exhibiting bruxism or not wearing an occlusal device had approximately 7 times higher odds (OR=7.23; 95% CI: 3.86 to 13.54), and 2 times higher odds (OR=1.92; 95% CI: 1.01 to 3.67) of porcelain fracture when compared to patients without bruxism and patients not wearing an occlusal device. Implant-supported metal ceramic single crowns and fixed partial dentures were found to have a significantly higher risk of porcelain fracture in patients with bruxism habits, when a protective occlusal device was not used, and when the restoration opposed another implant-supported metal ceramic restoration.

Comparative fracture strength analysis of Lava and Digident CAD/CAM zirconia ceramic crowns

PubMed Central

Kwon, Taek-Ka; Pak, Hyun-Soon; Han, Jung-Suk; Lee, Jai-Bong; Kim, Sung-Hun

2013-01-01

PURPOSE All-ceramic crowns are subject to fracture during function. To minimize this common clinical complication, zirconium oxide has been used as the framework for all-ceramic crowns. The aim of this study was to compare the fracture strengths of two computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crown systems: Lava and Digident. MATERIALS AND METHODS Twenty Lava CAD/CAM zirconia crowns and twenty Digident CAD/CAM zirconia crowns were fabricated. A metal die was also duplicated from the original prepared tooth for fracture testing. A universal testing machine was used to determine the fracture strength of the crowns. RESULTS The mean fracture strengths were as follows: 54.9 ± 15.6 N for the Lava CAD/CAM zirconia crowns and 87.0 ± 16.0 N for the Digident CAD/CAM zirconia crowns. The difference between the mean fracture strengths of the Lava and Digident crowns was statistically significant (P<.001). Lava CAD/CAM zirconia crowns showed a complete fracture of both the veneering porcelain and the core whereas the Digident CAD/CAM zirconia crowns showed fracture only of the veneering porcelain. CONCLUSION The fracture strengths of CAD/CAM zirconia crowns differ depending on the compatibility of the core material and the veneering porcelain. PMID:23755332

A Life Study of Ausforged, Standard Forged and Standard Machined AISI M-50 Spur Gears

NASA Technical Reports Server (NTRS)

Townsend, D. P.; Bamberger, E. N.; Zaretsky, E. V.

1975-01-01

Tests were conducted at 350 K (170 F) with three groups of 8.9 cm (3.5 in.) pitch diameter spur gears made of vacuum induction melted (VIM) consumable-electrode vacuum-arc melted (VAR), AISI M-50 steel and one group of vacuum-arc remelted (VAR) AISI 9310 steel. The pitting fatigue life of the standard forged and ausforged gears was approximately five times that of the VAR AISI 9310 gears and ten times that of the bending fatigue life of the standard machined VIM-VAR AISI M-50 gears run under identical conditions. There was a slight decrease in the 10-percent life of the ausforged gears from that for the standard forged gears, but the difference is not statistically significant. The standard machined gears failed primarily by gear tooth fracture while the forged and ausforged VIM-VAR AISI M-50 and the VAR AISI 9310 gears failed primarily by surface pitting fatigue. The ausforged gears had a slightly greater tendency to fail by tooth fracture than the standard forged gears.

Post and core build-ups in crown and bridge abutments: Bio-mechanical advantages and disadvantages.

PubMed

Mamoun, John

2017-06-01

Dentists often place post and core buildups on endodontically treated abutments for crown and bridge restorations. This article analyzes the bio-mechanical purposes, advantages and disadvantages of placing a core or a post and core in an endodontically treated tooth and reviews literature on post and core biomechanics. The author assesses the scientific rationale of the claim that the main purpose of a post is to retain a core, or the claim that posts weaken teeth. More likely, the main function of a post is to help prevent the abutment, on which a crown is cemented, from fracturing such that the abutment separates from the tooth root, at a fracture plane that is located approximately and theoretically at the level of the crown (or ferrule) margin. A post essentially improves the ferrule effect that is provided by the partial fixed denture prosthesis. This paper also explores the difference between bio-mechanical failures of crowns caused by lack of retention or excess taper, versus failures due to a sub-optimal ferrule effect in crown and bridge prostheses.

Dental implants as strategic supplementary abutments for implant-tooth-supported telescopic crown-retained maxillary dentures: a retrospective follow-up study for up to 9 years.

PubMed

Krennmair, Gerald; Krainhöfner, Martin; Waldenberger, Otmar; Piehslinger, Eva

2007-01-01

The aim of this retrospective study was to present the results of implants and natural teeth used as combined abutments to support maxillary telescopic prostheses. Between 1997 and 2004, 22 patients with residual maxillary teeth underwent prosthodontic rehabilitation with supplementary implant placement of implant-tooth-supported telescopic prostheses. A total of 60 supplementary implants (mean: 2.9 implants; SD: 1.6; range: 1 to 5 per patient) were placed in strategic position and connected with 48 natural abutment teeth (mean: 2.2 teeth; SD: 0.9; range: 1 to 4 per patient) using telescopic crowns. The follow-up registration included implant and natural tooth survival rates and peri-implant and periodontal parameters, along with prosthodontic maintenance. Natural tooth abutments were additionally followed to compare their periodontal parameters at baseline to the follow-up examination. After a mean of 38 months (12 to 108 months) no implants or natural tooth abutments were lost (survival rate: 100%). There was no fracture, endodontic treatment, loss, or intrusion of natural teeth used for telescopic abutments. Implant abutments showed high stability and excellent periimplant soft tissue conditions. Natural tooth abutments used for double crowns also showed uneventful progress. A low rate of prosthodontic maintenance was seen, with implant screw abutment loosening as the most severe complication (3 of 60 implants; 5%). On the basis of this retrospective clinical review, the following conclusions were drawn: (1) successful function over a prolonged period and a minor complication rate of implant-tooth-supported telescopic maxillary dentures may be anticipated, and (2) the great variety of treatment modalities offered by tooth-implant support for telescopic prostheses appears to be useful as a treatment option for the maxilla in elderly patients.

Reasons for Placement of Restorations on Previously Unrestored Tooth Surfaces by Dental PBRN Dentists

PubMed Central

Nascimento, Marcelle M.; Gordan, Valeria V.; Qvist, Vibeke; Litaker, Mark S.; Rindal, D. Brad; Williams, O.D.; Fellows, Jeffrey L.; Ritchie, Lloyd K.; Mjör, Ivar A.; McClelland, Jocelyn; Gilbert, Gregg H.

2010-01-01

Objective To identify and quantify the reasons for placing restorations on unrestored permanent tooth surfaces and the dental materials used by Dental Practice-Based Research Network (DPBRN; www.DentalPBRN.org) dentists. Methods A total of 229 DPBRN practitioner-investigators collected data on 9,890 consecutive restorations from 5,810 patients. Information included: (1) reasons for restoring; (2) tooth and surfaces restored; and (3) restorative materials employed. Results Primary caries (85%) and non-carious defects (15%), which included abrasion/ abfraction/ erosion lesions and tooth fracture, were the main reasons for placement of restorations. Restorations due to caries were frequently placed on occlusal surfaces (49%), followed by distal, mesial, buccal/facial, lingual/palatal, and incisal surfaces. Amalgam was used for 46% of the molar and 45% of the premolar restorations. Directly placed resin-based composite (RBC) was used for 48% of the molar, 49% of the premolar, and 92% of the anterior restorations. Conclusion Dental caries on occlusal and proximal surfaces of molar teeth are the main reasons for placing restorations on previously unrestored tooth surfaces by DPBRN practitioner-investigators. RBC is the material most commonly used for occlusal and anterior restorations. Amalgam remains the material of choice to restore proximal caries in posterior teeth, although there are significant differences by DPBRN region. PMID:20354094

Relationship of Number of Missing Teeth to Hip Fracture in Elderly Patients: A Cohort Pilot Study.

PubMed

Priebe, Jennifer; Wermers, Robert A; Sems, Stephen A; Viozzi, Christopher F; Koka, Sreenivas

2017-09-15

To determine the relationship between the number of missing natural teeth or remaining natural teeth and osteoporotic hip fracture in elderly patients and to determine the relationship between the number of missing teeth or remaining teeth and osteoporotic fracture risk assessment (FRAX) probability. Number of missing teeth was determined by clinical oral exam on a total of 100 subjects, 50 with hip fractures and 50 without. Ten-year fracture risk and hip fracture risk probabilities were calculated using the FRAX tool. Statistical analyses were performed to determine strength of associations between number of missing natural teeth and likelihood of experiencing a fracture. Degree of correlation between number of missing natural teeth and FRAX probabilities were calculated. There appears to be an association between the number of missing natural teeth and hip fractures. For every 5-tooth increase in the number of missing teeth, the likelihood of being a subject in the hip fracture group increased by 26%. Number of missing natural teeth was positively correlated with FRAX overall fracture and hip fracture probability. Number of missing natural teeth may be a valuable tool to assist members of medical and dental teams in identifying patients with higher FRAX scores and higher likelihood of experiencing a hip fracture. Additional research is necessary to validate these findings. © 2017 by the American College of Prosthodontists.

Domestic Violence and its Effect on Oral Health Behaviour and Oral Health Status

PubMed Central

P, Basavaraj; Singla, Ashish; Kote, Sunder; Singh, Shilpi; Jain, Swati; Singh, Khushboo; Vashishtha, Vaibhav

2014-01-01

Introduction: Violence against women is one of the major public health and human rights problem in the world today. Hence, the present study was conducted with the aim to assess the effect of domestic violence on oral health behavior and oral health status of females attending community outreach programmes in and around Modinagar. Materials and Methods: A cross-sectional study was conducted through the community outreach programmes organized in Modinagar. A structured questionnaire was used to illicit information regarding socio demographic characteristics, oral health behavior and domestic violence. The dental health examination was done to record dental health status, intraoral and extraoral soft tissue injury, tooth fracture and tooth avulsion due to the injury. Results: Out of the total 304 women, 204(67.1%) reported positive domestic violence. Psychological violence was found to be severe whereas sexual violence was found to be mild in most of the cases. Significant difference was found between oral hygiene aids used , frequency of tooth brushing, periodontal status, missing teeth, intraoral soft tissue injuries and fractures between both the groups (p<0.05). Conclusion: The present study confirmed that domestic violence had significant influence on oral health behavior and oral health status of women. Thus, the dental professionals also should make an attempt to help victims gain access to support and referral services and to provide adequate treatment to them so as to make a positive difference in their lives. PMID:25584297

Prevalence of dental trauma and use of mouthguards in professional handball players.

PubMed

Bergman, Lana; Milardović Ortolan, Slađana; Žarković, Davor; Viskić, Joško; Jokić, Dražen; Mehulić, Ketij

2017-06-01

Published data about orofacial injuries and mouthguard use by professional handball players are scarce. The aim of this study was to investigate the prevalence of orofacial trauma and mouthguard use in professional handball players. Data were collected from 100 professional handball players through a questionnaire, which contained 17 questions about age, experience in playing handball, playing position, orofacial trauma experience during the past 12 months, type of injury and mouthguard use. Almost half (49%) of the interviewed players experienced head and/or facial trauma during the past year. The most common injuries were soft tissue lacerations (39.6%). Dental injuries occurred in 22% of the participants, with socket bleeding being the most frequent injury (14%). Of the affected teeth, 76.9% were upper incisors. Mouthguards had a statistically significant protective role regarding tooth fractures and tooth avulsion (P=.043). Players who wore a mouthguard had a 5.55 times less chance of suffering dental injuries. Almost 76% of dental injuries resulted in complications afterward. Sixty-seven percentage of the players knew that mouthguards could prevent injuries, but only 28% used them regularly. Of the players who wore a mouthguard regularly, 76.9% were advised to do so by their dentists. The incidence of head and orofacial injuries among professional handball players is high. Mouthguards prevented severe dental injuries such as tooth fracture and avulsion, but their use was still limited. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prospective assessment of CAD/CAM zirconia abutment and lithium disilicate crown restorations: 2.4 year results.

PubMed

Cooper, Lyndon F; Stanford, Clark; Feine, Jocelyne; McGuire, Michael

2016-07-01

Single-tooth implant restorations are commonly used to replace anterior maxillary teeth. The esthetic, functional, and biologic outcomes are, in part, a function of the abutment and crown. The purpose of this clinical study was to describe the implant, abutment, and crown survival and complication rates for CAD/CAM zirconia abutment and lithium disilicate crown restorations for single-tooth implants. As part of a broader prospective investigation that enrolled and treated 141 participants comparing tissue responses at the conical interface (CI; AstraTech OsseoSpeed), flat-to-flat interface (FI; NobelSpeedy), and platform-switch interface (PS; NanoTite Certain Prevail) of single-tooth implants, computer-aided design and computer-aided manufacturing (CAD/CAM) zirconia abutments (ATLANTIS Abutment) and cemented lithium disilicate (e.max) crowns were used in the restoration of all implants. After 2.4 years in function (3 years after implant placement), the implant, abutment, and crown of 110 participants were evaluated. Technical and biologic complications were recorded. Demographic results were tabulated as percentages with mean values and standard deviations. Abutment survival was calculated with the Kaplan-Meier method. After 2.4 years, no abutments or crowns had been lost. Abutment complications (screw loosening, screw fracture, fracture) were absent for all 3 implant groups. Crown complications were limited to 2 crowns debonding and 1 with excess cement (2.5%). Five biological complications (4.0%) were recorded. The overall complication rate was 6.5%. CAD/CAM zirconia abutments restored with cemented lithium disilicate crowns demonstrated high survival on 3 different implant-abutment interface designs. No abutment or abutment screw fracture occurred. The technical complications observed after 2.4 years were minor and reversible. The use of CAD/CAM zirconia abutments with cemented lithium disilicate crowns is associated with high technical and biologic success at 2.4 years. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

New Hexactinellid Sponge Chaunoplectella megapora sp. nov. (Lyssacinosida: Leucopsacidae) from Clarion-Clipperton Fracture Zone, Eastern Pacific Ocean.

PubMed

Wang, Chunsheng; Zhang, Yuan; Lu, Bo; Wang, Dexiang

2018-01-23

The new Hexactinellid sponge Chaunoplectella megapora sp. nov. reported in this study was collected from the COMRA contract area, the western part of Clarion-Clipperton Fracture Zone (CCFZ) in the eastern Pacific Ocean at a depth of 5258 m. This sponge's extraordinary multiporous body with the presence of unique codonhexasters, sigmatocomes, toothed discohexasters and hemidiscohexasters, as well as stellate disocohexasters, characterizes it as a new species in the genus Chaunoplectella. This report presents the first record of family Leucopsacidae at this site in the eastern Pacific Ocean.

Impact wear behavior of human tooth enamel under simulated chewing conditions.

PubMed

Zheng, Jing; Zeng, Yangyang; Wen, Jian; Zheng, Liang; Zhou, Zhongrong

2016-09-01

Previous studies mostly focused on the sliding wear behavior of human teeth, and little effort has been made so far to study the impact wear of human teeth. The objective of this study was to investigate the impact wear process and mechanism of human tooth enamel and the influence of water content within enamel. In this paper, the impact wear behaviors of fresh and dried human tooth enamel against SiC ceramic have been investigated using a specially designed impact test machine. Tests lasting up to 5×10(3), 5×10(4), 2.5×10(5), 5.5×10(5), 8×10(5) and 1×10(6) cycles were conducted, respectively. Results showed that for the fresh enamel, the surface damage was dominated by plastic deformation at the early stage of impact wear. Iridescent rings appeared around the impact mark as a result of the accumulation and spread of plastic deformation. As the impact wear progressed, delamination occurred on the surface of enamel, and thus the iridescent rings gradually disappeared. Wear loss increased rapidly with the increase of impact cycles. When a wear particle layer was formed on the enamel surface, the wear rate decreased. It was found that the surface hardness of enamel increased with the impact cycles, and no cracks appeared on the cross section of wear scar. Compared with the fresh enamel, the fracture toughness of dried enamel decreased, and thus there were microcracks appearing on the cross section of wear scar. More obvious delamination occurred on the worn surface of dried enamel, and no iridescent rings were observed. The wear loss of dried enamel was higher than that of fresh enamel. In summary, the impact wear behavior of sound human tooth enamel was metal-like to some degree, and no subsurface cracking occurred. The water content within enamel could increase its fracture toughness and protect the surface from impact wear. The wear mechanism of human tooth enamel is determined by its microstructure. Copyright © 2016 Elsevier Ltd. All rights reserved.

An investigation of the constituent elements and modes of fracture of in vivo fractured metallic posts.

PubMed

Fox, Kathryn; Wood, David J; Youngson, Callum C

2007-01-01

The objective of this investigation was to determine the materials used in metallic post and core construction and investigate and the modes of failure that occurred resulting in post fracture. Eighty-five fractured metal posts were clinically retrieved over a 5-year period. The tooth with the fractured post, and relevant clinical details were recorded. Investigation of the fractured posts was undertaken to determine their constituent elements and modes of fracture using scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDX). The results showed that 77% of the posts were cast and 23% wrought. The modes of fracture were ductile (67%) or brittle (52%) although some posts exhibited both within the same specimen. In addition, evidence of fatigue was present in 20% of posts and porosity in 48%. A large variety of materials were used in the construction of post and cores although low-gold silver-palladium alloy most commonly encountered. Their failure was predominantly ductile in nature although a significant amount of brittle fracture was also noted. Porosity within castings also appeared to be a contributory factor in some cases and this was particularly evident in high-palladium castings. Evidence of fatigue was noted in a minority of posts.

[The application of air abrasion in dentistry].

PubMed

Mandinić, Zoran; Vulićević, Zoran R; Beloica, Milos; Radović, Ivana; Mandić, Jelena; Carević, Momir; Tekić, Jasmina

2014-01-01

One of the main objectives of contemporary dentistry is to preserve healthy tooth structure by applying techniques of noninvasive treatment. Air abrasion is a minimally invasive nonmechanical technique of tooth preparation that uses kinetic energy to remove carious tooth structure. A powerful narrow stream of moving aluminum-oxide particles hit the tooth surface and they abrade it without heat, vibration or noise. Variables that affect speed of cutting include air pressure, particle size, powder flow, tip's size, angle and distance from the tooth. It has been proposed that air abrasion can be used to diagnose early occlusal-surface lesions and treat them with minimal tooth preparation using magnifier. Reported advantages of air abrasion include reduced noise, vibration and sensitivity. Air abrasion cavity preparations have more rounded internal contours than those prepared with straight burs. This may increase the longevity of placed restorations because it reduces the incidence of fractures and a consequence of decreased internal stresses. However, air abrasion cannot be used for all patients, i.e. in cases involving severe dust allergy, asthma, chronic obstructive lung disease, recent extraction or other oral surgery, open wounds, advanced periodontal disease, recent placement of orthodontic appliances and oral abrasions, or subgingival caries removal. Many of these conditions increase the risk of air embolism in the oral soft tissues. Dust control is a challenge, and it necessitates the use of rubber dam, high-volume evacuation, protective masks and safety eyewear for both the patient and the therapist.

Anatomy and Disorders of the Oral Cavity of Ferrets and Other Exotic Companion Carnivores.

PubMed

Johnson-Delaney, Cathy A

2016-09-01

Exotic companion carnivores such as ferrets, skunks, fennec foxes, coatimundis, raccoons, and kinkajous presented in clinical practice share similar dental anatomy, function, and diseases. The domestic ferret serves as the representative species for this group with its anatomy, diseases, and conditions described in detail. Dog and cat guidelines for veterinary and home care seem to be relevant and applicable, including dental endodontic procedures. Annual or biannual dental examinations and prophylaxis are recommended. The most common dental and oral problems are tooth wear, plaque and calculus, teeth fractures, gingivitis and periodontitis, tooth loss, abscesses, oral ulceration, tonsillitis, and neoplasia. Copyright © 2016 Elsevier Inc. All rights reserved.

The Comprehensive AOCMF Classification System: Mandible Fractures-Level 3 Tutorial

PubMed Central

Cornelius, Carl-Peter; Audigé, Laurent; Kunz, Christoph; Rudderman, Randal; Buitrago-Téllez, Carlos H.; Frodel, John; Prein, Joachim

2014-01-01

This tutorial outlines the details of the AOCMF image-based classification system for fractures of the mandibular arch (i.e. the non-condylar mandible) at the precision level 3. It is the logical expansion of the fracture allocation to topographic mandibular sites outlined in level 2, and is based on three-dimensional (3D) imaging techniques/computed tomography (CT)/cone beam CT). Level 3 allows an anatomical description of the individual conditions of the mandibular arch such as the preinjury dental state and the degree of alveolar atrophy. Trauma sequelae are then addressed: (1) tooth injuries and periodontal trauma, (2) fracture involvement of the alveolar process, (3) the degree of fracture fragmentation in three categories (none, minor, and major), and (4) the presence of bone loss. The grading of fragmentation needs a 3D evaluation of the fracture area, allowing visualization of the outer and inner mandibular cortices. To document these fracture features beyond topography the alphanumeric codes are supplied with distinctive appendices. This level 3 tutorial is accompanied by a brief survey of the peculiarities of the edentulous atrophic mandible. Illustrations and a few case examples serve as instruction and reference to improve the understanding and application of the presented features. PMID:25489389

Hidden contributions of the enamel rods on the fracture resistance of human teeth

PubMed Central

Yahyazadehfar, M.; Bajaj, Devendra; Arola, Dwayne D.

2013-01-01

The enamel of human teeth is generally regarded as a brittle material with low fracture toughness. Consequently, the contributions of this tissue in resisting tooth fracture and the importance of its complex microstructure have been largely overlooked. In this study an experimental evaluation of the crack growth resistance of human enamel was conducted to characterize the role of rod (i.e. prism) orientation and degree of decussation on the fracture behavior of this tissue. Incremental crack growth was achieved in-plane, with the rods in directions longitudinal or transverse to their axes. Results showed that the fracture resistance of enamel is both inhomogeneous and spatially anisotropic. Cracks extending transverse to the rods in the outer enamel undergo a lower rise in toughness with extension, and achieve significantly lower fracture resistance than in the longitudinal direction. Though cracks initiating at the surface of teeth may begin extension towards the dentin–enamel junction, they are deflected by the decussated rods and continue growth about the tooth’s periphery, transverse to the rods in the outer enamel. This process facilitates dissipation of fracture energy and averts cracks from extending towards the dentin and vital pulp. PMID:23022547

Use of Orthodontic Mini-Implants for Maxillomandibular Fixation in Mandibular Fracture

PubMed Central

Pires, Mario Sergio Medeiros; Reinhardt, Leandro Calcagno; Antonello, Guilherme de Marco; Torres do Couto, Ricardo

2011-01-01

Orthodontic appliances for skeletal anchorage are becoming increasingly more common in clinical practice. Similarly, different terms such as mini-implants, microimplants, and miniscrews have been used. There is a wide array of appliances currently on the market, in different designs and sizes, diameters, degree of titanium purity, and surface treatment. These appliances have been used for a variety of indications, including tooth retraction, intrusion, and traction. This study aimed to report the clinical case of a 19-year-old patient with a fractured mandible and to propose a novel use of mini-implants: the perioperative placement of mini-implants as anchors for maxillomandibular fixation steel wire ligatures. We concluded that this appliance provides an effective maxillomandibular fixation in patients with mandibular fracture, with little increase in the cost of surgery. PMID:23205173

A novel anatomical short glass fiber reinforced post in an endodontically treated premolar mechanical resistance evaluation using acoustic emission under fatigue testing.

PubMed

Wang, Hsuan-Wen; Chang, Yen-Hsiang; Lin, Chun-Li

2017-01-01

This study evaluates the fracture resistance in an endodontically treated tooth using circular fiber-reinforced composite (FRC) and innovated anatomical short glass fiber reinforced (SGFR) posts under fatigue testing, monitored using the acoustic emission (AE) technique. An anatomical SGFR fiber post with an oval shape and slot/notch design was manufactured using an injection-molding machine. Crown/core maxillary second premolar restorations were executed using the anatomical SGFR and commercial cylindrical fiber posts under fatigue test to understand the mechanical resistances. The load versus AE signals in the fracture and fatigue tests were recorded to evaluate the restored tooth failure resistance. The static fracture resistance results showed that teeth restored using the anatomical SGFR post presented higher resistance than teeth restored using the commercial FRC post. The fatigue test endurance limitation (1.2×10 6 cycles) was 207.1N for the anatomical SGFR fiber post, higher than the 185.3N found with the commercial FRC post. The average accumulated number of AE signals and corresponding micro cracks for the anatomical SGFR fiber post (153.0 hits and 2.44 cracks) were significantly lower than those for the commercial FRC post (194.7 hits and 4.78 cracks) under 40% of the static maximum resistance fatigue test load (pass 1.2×10 6 cycles). This study concluded that the anatomical SGFR fiber post with surface slot/notch design made using precise injection molding presented superior static fracture resistance and fatigue endurance limitation than those for the commercial FRC post in an endodontically treated premolar. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of fracture resistance in simulated immature teeth using Resilon and Ribbond as root reinforcements--an in vitro study.

PubMed

Hemalatha, Hiremath; Sandeep, Metgud; Kulkarni, Sadanand; Yakub, Shoeb Sheikh

2009-08-01

To compare the reinforcement and strengthening ability of resilon, gutta-percha, and ribbond in endodontically treated roots of immature teeth. Sixty five freshly extracted human maxillary anterior teeth were prepared with a Peeso no. 6 to simulate immature teeth (Cvek's stage 3 root development). After instrumentation, each root was irrigated with sodium hypochlorite and with ethylene diamino tetra acetic acid to remove the smear layer. To simulate single visit apexification technique a 4-5 mm white Pro Root mineral trioxide aggregate plug was placed apically using schilder carrier. The teeth were divided into three experimental groups and one control group. Group I--control group (root canals instrumented but not filled); Group II--backfilled with thermoplastisized gutta-percha using AH plus sealer; Group III--reinforced with Resilon using epiphany sealer; Group IV--reinforced with Ribbond fibers using Panavia F luting cement. A Universal Testing Machine was used to apply a load, at the level of the lingual cementoenamel junction with a chisel-shaped tip The peak load to fracture was recorded and statistical analysis was completed using student's t-test. Values of peak load to fracture were 1320.8, 1604.88, 1620, and 1851 newtons for Group I to Group IV respectively. The results of student's t-test, revealed no significant difference (P > 0.05,) between Group II and Group III. Comparison between Group IV and Group III and between Group IV and Group II revealed highly significant difference (P > 0.001). Teeth reinforced with Ribbond fibers using Panavia F luting cement showed the highest resistance to fracture. Resilon could not strengthen the roots and showed no statistically significant difference when compared with thermoplastisized gutta-percha in reinforcing immature tooth when tested with universal testing machine in an experimental model of immature tooth.

Investigation of the effect of different prefabricated intracanal posts on fracture resistance of simulated immature teeth.

PubMed

Dikbas, Idil; Tanalp, Jale; Koksal, Temel; Yalnız, Ayşe; Güngör, Tufan

2014-02-01

The aim of this study was to assess fracture resistances of simulated immature single-rooted teeth whose roots have been backfilled using 3 different post systems after a 4 mm apical mineral trioxide aggregate (MTA) placement. Forty-eight maxillary anterior teeth were assigned into four groups. The lengths of each root were standardized by cutting off the coronal and apical portions to obtain 13 ± 1 mm samples and root canals were enlarged. The #6 Peeso reamers were allowed to protrude 1 mm beyond apex to simulate immature teeth. Apical 4 mm of each tooth was filled using MTA. The remaining portions were treated as follows: Group 1 (Control): AH Plus + Gutta-percha cold lateral compaction. Group 2: Glass fiber posts (FRC Postec Plus post) cemented using self-adhesive resin cement. Group 3: Quartz fiber posts (D.T. Light post) cemented using self-adhesive resin cement. Group 4: Zirconia posts (Cosmopost) were placed using self-adhesive resin cement. Specimens were embedded in self-curing acrylic. A compressive load was applied lingually at a crosshead speed of 1 mm/min at an angle of 45º until fracture in a universal testing machine. The mean fracture resistances were 823.17 ± 188.80, 1155.50 ± 190.37, 1208.00 ± 254.32, and 1153.25 ± 195.71 Newtons for Groups 1, 2, 3, and 4, respectively. All experimental groups had significantly higher fracture resistance compared with the control group (P < 0.01). No statistically significant difference was noted between the experimental groups (P > 0.05). All post systems exerted a similar reinforcing effect to a simulated immature tooth and may be preferred specifically in situations which require additional reinforcement. © 2013 John Wiley & Sons A/S.

Cola beverage consumption delays alveolar bone healing: a histometric study in rats.

PubMed

Teófilo, Juliana Mazzonetto; Leonel, Daniel Vilela; Lamano, Teresa

2010-01-01

Epidemiological studies have suggested that cola beverage consumption may affect bone metabolism and increase bone fracture risk. Experimental evidence linking cola beverage consumption to deleterious effects on bone is lacking. Herein, we investigated whether cola beverage consumption from weaning to early puberty delays the rate of reparative bone formation inside the socket of an extracted tooth in rats. Twenty male Wistar rats received cola beverage (cola group) or tap water (control group) ad libitum from the age of 23 days until tooth extraction at 42 days and euthanasia 2 and 3 weeks later. The neoformed bone volume inside the alveolar socket was estimated in semi-serial longitudinal sections using a quantitative differential point-counting method. Histological examination suggested a decrease in the osteogenic process within the tooth sockets of rats from both cola groups, which had thinner and sparser new bone trabeculae. Histometric data confirmed that alveolar bone healing was significantly delayed in cola-fed rats at three weeks after tooth extraction (ANOVA, p = 0.0006, followed by Tukey's test, p < 0.01). Although the results of studies in rats cannot be extrapolated directly to human clinical dentistry, the present study provides evidence that cola beverage consumption negatively affect maxillary bone formation.

Factors associated with complications of removal of third molars: a transversal study.

PubMed

Barbosa-Rebellato, Nelson-Luis; Thomé, Ana-Carolina; Costa-Maciel, Cássia; Oliveira, Jaina; Scariot, Rafaela

2011-05-01

The purpose of this study is to estimate the overall frequency of complications associated with third molars (M3) removal and to identify the risk factors associated with these complications. To the transversal analysis, a researcher confidentially reviewed the records of all M3 surgery patients. The predictor variables were demographic (i.e. age and gender), localization and position of third molar, bone removal and tooth sectioning. 210 patients had one or more third molars teeth removed, a total of 605 teeth. The sample's mean age was 21.6±9.2 years, with 1,4 woman to 1 man. Postoperative complications were recorded in 54 extractions of third molars. The most common complications were infection (42.6%), followed by radicular fractures (11.1%) and gingival alterations (11.1%). Complications were significantly affected by 3 factors: age over 25 years old (p=0.002--OR 2.21), location (p=0.006--OR 2.36), bone removal (p=0.002--OR 3.03) and tooth sectioning (p=0.00002--OR 3.59). The results of these analyses suggest that age, location of the tooth, bone removal and tooth sectioning appear to be associated with a higher complication rate for M3 extractions.

RDS-21 Face-Gear Surface Durability Tests

NASA Technical Reports Server (NTRS)

Lewicki, David G.; Heath, Gregory F.; Filler, Robert R.; Slaughter, Stephen C.; Fetty, Jason

2007-01-01

Experimental fatigue tests were performed to determine the surface durability life of a face gear in mesh with a tapered spur involute pinion. Twenty-four sets of gears were tested at three load levels: 7200, 8185, and 9075 lb-in face gear torque, and 2190 to 3280 rpm face gear speed. The gears were carburized and ground, shot-peened and vibro-honed, and made from VIM-VAR Pyrowear 53 steel per AMS 6308. The tests produced 17 gear tooth spalling failures and 7 suspensions. For all the failed sets, spalling occurred on at least one tooth of all the pinions. In some cases, the spalling initiated a crack in the pinion teeth which progressed to tooth fracture. Also, spalling occurred on some face gear teeth. The AGMA endurance allowable stress for a tapered spur involute pinion in mesh with a face gear was determined to be 275 ksi for the material tested. For the application of a tapered spur involute pinion in mesh with a face gear, proper face gear shim controlled the desired gear tooth contact pattern while proper pinion shim was an effective way of adjusting backlash without severely affecting the contact pattern.

In vitro evaluation of five core materials.

PubMed

Gu, Steven; Rasimick, Brian J; Deutsch, Allan S; Musikant, Barry L

2007-01-01

This in vitro study determined the fracture strength of five core materials supported by two different endodontic dowels. Diametral tensile strength and microhardness of the three resin composite core materials used in this study were also tested. The fracture strength study used one lanthanide-reinforced flowable resin composite (Ti-Core Auto E), one titanium- and lanthanide-reinforced composite (Ti-Core), one lanthanide-reinforced composite (Ti-Core Natural), and two metal-reinforced glass ionomer core materials (Ketac Silver and GC Miracle Mix). Two types of dowels were used: a multitiered, split-shank threaded dowel with a flange (#1 Flexi-Flange) and one without a flange design (#1 Flexi-Post). The specimens were divided into ten groups. Each tooth/dowel and core specimen was placed in a special jig at 45 degrees and subjected to a load by a universal testing machine. The diametral tensile strength and the microhardness of the three resin composite core materials were measured by a universal testing machine and Barcol hardness tester, respectively. All test groups contained ten specimens. The fracture strength value of the resin composite core materials was significantly larger ( p < 0.0001) than those for the metal-reinforced glass-ionomer core materials. Analysis of variance (ANOVA) also showed that the Flexi-Flange dowel interacted with Ti-Core and Ti-Core Auto E to significantly ( p < 0.0013) increase the fracture strength relative to the Flexi-Post. One-way ANOVA revealed that there were no significant differences between them in terms of diametral tensile strength. The Barcol hardness values of the composite core materials were statistically different ( p < 0.0001), with the Ti-Core the highest, followed by Ti-Core Natural, then Ti-Core Auto E. Resin composite core material performed better than glass ionomer material in this in vitro study. The flowable composite core material performed about the same in terms of fracture strength and diametral tensile strength compared with nonflowable composites. Combined with certain core materials, the flange design increased the fracture strength of the tooth/dowel and core combination.

[Three-dimensional finite analysis of the stress in first mandibular molar with composite class I restoration when various mixing ratios of bases were used].

PubMed

Zhou, Lan; Yang, Jin-Bo; Liu, Dan; Liu, Zhan; Chen, Ying; Gao, Bo

2008-06-01

To analyze the possible damage to the remaining tooth and composite restorations when various mixing ratios of bases were used. Testing elastic modulus and poission's ratio of glass-ionomer Vitrebond and self-cured calcium hydroxide Dycal with mixing ratios of 1:1, 3:4, 4:3. Micro-CT was used to scan the first mandibular molar, and the three-dimensional finite element model of the first permanent mandibular molar with class I cavity was established. Analyzing the stress of tooth structure, composite and base cement under physical load when different mixing ratios of base cement were used. The elastic modulus of base cement in various mixing ratios was different, which had the statistic significance. The magnitude and location of stress in restored tooth made no differences when the mixing ratios of Vitrebond and Dycal were changed. The peak stress and spreading area in the model with Dycal was more than that with Vitrebond. Changing the best mixing ratio of base cement can partially influence the mechanistic character, but make no differences on the magnitude and location of stress in restored tooth. During the treatment of deep caries, the base cement of the elastic modulus which is proximal to the dentin and restoration should be chosen to avoid the fracture of tooth or restoration.

Implant-supported single-tooth restorations. A 12-year prospective study.

PubMed

Donati, Mauro; Ekestubbe, Annika; Lindhe, Jan; Wennström, Jan L

2016-10-01

The aim of this study was to evaluate prospectively the 12-year outcome of implant-supported single-tooth restorations. Originally 45 self-tapping Astra Tech TiOblast ® ST-implants were installed by a two-stage protocol in 40 subjects requiring single-tooth prosthetic replacement for a missing tooth. Clinical and radiologic examinations were performed at completion of the prosthetic treatment 4-7 months after implant installation surgery and after 5 and 12 years in function. At 12 years 31 patients and 35 implants were available for evaluation. The overall failure rate after 12 years was 10.3% on the subject level and 9.1% on the implant level. The mean bone loss amounted to 0.67 mm (SD 2.20) on a subject level and 0.47 mm (1.72) on an implant level. Three subjects (10%) and three implants (8.6%) were diagnosed with peri-implantitis. Five subjects had experienced technical complications; three incidences of loosening of the abutment retention screw during the first 5 years and two minor porcelain fracture of the crown (two patients) between 5- and 12-years of follow-up. The findings reported in this 12-year prospective case series suggest that the use of the Astra Tech dental implants may be a valid treatment alternative for single-tooth replacement prostheses. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Regulated fracture in tooth enamel: a nanotechnological strategy from nature.

PubMed

Ghadimi, Elnaz; Eimar, Hazem; Song, Jun; Marelli, Benedetto; Ciobanu, Ovidiu; Abdallah, Mohamed-Nur; Stähli, Christoph; Nazhat, Showan N; Vali, Hojatollah; Tamimi, Faleh

2014-07-18

Tooth enamel is a very brittle material; however it has the ability to sustain cracks without suffering catastrophic failure throughout the lifetime of mechanical function. We propose that the nanostructure of enamel can play a significant role in defining its unique mechanical properties. Accordingly we analyzed the nanostructure and chemical composition of a group of teeth, and correlated it with the crack resistance of the same teeth. Here we show how the dimensions of apatite nanocrystals in enamel can affect its resistance to crack propagation. We conclude that the aspect ratio of apatite nanocrystals in enamel determines its resistance to crack propagation. According to this finding, we proposed a new model based on the Hall-Petch theory that accurately predicts crack propagation in enamel. Our new biomechanical model of enamel is the first model that can successfully explain the observed variations in the behavior of crack propagation of tooth enamel among different humans. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Application of single-retainer all-ceramic resin-bonded fixed partial denture in replacing single anterior tooth].

PubMed

Lili, Yang; Debiao, Du; Ruoyu, Ning; Deying, Chen; Junling, Wu

2017-08-01

Objective In this study, we aimed to evaluate the clinical effect of single-retainer all-ceramic resin-bonded fixed partial denture (RBFPD) on the single anterior tooth loss patients. Methods A total of 20 single-retainer all-ceramic RBFPD
were fabricated and evaluated in a two-year follow-up observation. The restorations were examined on the basis of the American Public Health Association (APHA) criteria. Results A total of 20 single-retainer all-ceramic RBFPD achieved class A evaluation after a six-month follow-up observation. One single-retainer all-ceramic RBFPD was classified as class B for secondary caries after a one-year follow-up observation. After a two-year follow-up observation, one single-retainer all-ceramic RBFPD was classified as class B because of secondary caries, and one single-retainer all-ceramic RBFPD was classified as class B because of fracture. Conclusion Single-retainer all-ceramic RBFPD is a promising and optional method in replacing single anterior tooth.

An Alternative Method of Intermaxillary Fixation for Simple Pediatric Mandible Fractures.

PubMed

Farber, Scott J; Nguyen, Dennis C; Harvey, Alan A; Patel, Kamlesh B

2016-03-01

Mandibular fractures represent a substantial portion of facial fractures in the pediatric population. Pediatric mandibles differ from their adult counterparts in the presence of mixed dentition. Avoidance of injury to developing tooth follicles is critical. Simple mandibular fractures can be treated with intermaxillary fixation (IMF) using arch bars or bone screws. This report describes an alternative to these methods using silk sutures and an algorithm to assist in treating simple mandibular fractures in the pediatric population. A retrospective chart review was performed and the records of 1 surgeon were examined. Pediatric patients who underwent treatment for a mandibular fracture in the operating room from 2011 to 2015 were identified using Common Procedural Terminology codes. Data collected included age, gender, type of fracture, type of treatment used, duration of fixation, and presence of complications. Five patients with a mean age of 6.8 years at presentation were identified. Fracture types were unilateral fractures of the condylar neck (n = 3), bilateral fractures of the condylar head (n = 1), and a unilateral fracture of the condylar head with an associated parasymphyseal fracture (n = 1). IMF was performed in 4 patients using silk sutures, and bone screw fixation was performed in the other patient. No post-treatment complications or malocclusion were reported. Average duration of IMF was 18.5 days. An algorithm is presented to assist in the treatment of pediatric mandibular fractures. Silk suture fixation is a viable and safe alternative to arch bars or bone screws for routine mandibular fractures. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth.

PubMed

Garcia-Godoy, Franklin; Murray, Peter E

2012-02-01

The regeneration of immature permanent teeth following trauma could be beneficial to reduce the risk of fracture and loss of millions of teeth each year. Regenerative endodontic procedures include revascularization, partial pulpotomy, and apexogenesis. Several case reports give these procedures a good prognosis as an alternative to apexification. Care is needed to deliver regenerative endodontic procedures that maintain or restore the vitality of teeth, but which also disinfect and remove necrotic tissues. Regeneration can be accomplished through the activity of the cells from the pulp, periodontium, vascular, and immune system. Most therapies use the host's own pulp or vascular cells for regeneration, but other types of dental stem cell therapies are under development. There are no standardized treatment protocols for endodontic regeneration. The purpose of this article is to review the recent literature and suggest guidelines for using regenerative endodontic procedures for the treatment of permanent immature traumatized teeth. Recommendations for the selection of regenerative and conventional procedures based on the type of tooth injury, fracture type, presence of necrosis or infection, periodontal status, presence of periapical lesions, stage of tooth development, vitality status, patient age, and patient health status will be reviewed. Because of the lack of long-term evidence to support the use of regenerative endodontic procedures in traumatized teeth with open apices, revascularization regeneration procedures should only be attempted if the tooth is not suitable for root canal obturation, and after apexogenesis, apexification, or partial pulpotomy treatments have already been attempted and have a poor prognosis. © 2011 John Wiley & Sons A/S.

Evaluation of fracture toughness of human dentin using elastic-plastic fracture mechanics.

PubMed

Yan, Jiahau; Taskonak, Burak; Platt, Jeffrey A; Mecholsky, John J

2008-01-01

Dentin, the mineralized tissue forming the bulk of the tooth, lies between the enamel and the pulp chamber. It is a rich source of inspiration for designing novel synthetic materials due to its unique microstructure. Most of the previous studies investigating the fracture toughness of dentin have used linear-elastic fracture mechanics (LEFM) that ignores plastic deformation and could underestimate the toughness of dentin. With the presence of collagen (approximately 30% by volume) aiding the toughening mechanisms in dentin, we hypothesize that there is a significant difference between the fracture toughness estimated using LEFM (Kc) and elastic-plastic fracture mechanics (EPFM) (KJc). Single-edge notched beam specimens with in-plane (n=10) and anti-plane (n=10) parallel fractures were prepared following ASTM standard E1820 and tested in three-point flexure. KJc of the in-plane parallel and anti-plane parallel specimens were found to be 3.1 and 3.4 MPa m 1/2 and Kc were 2.4 and 2.5 MPa m 1/2, respectively. The fracture toughness estimated based on KJc is significantly greater than that estimated based on Kc (32.5% on average; p<0.001). In addition, KJc of anti-plane parallel specimens is significantly greater than that of in-plane parallel specimens. We suggest that, in order to critically evaluate the fracture toughness of human dentin, EPFM should be employed.

Restoration of a fractured central incisor.

PubMed

Olson, Bradley J

2012-03-01

The treatment of a traumatically damaged single central incisor poses significant challenges relative to function and esthetics to the restoring clinician. Providing a good long-term prognosis is paramount when determining whether to maintain or extract a structurally compromised tooth. Successful restoration demands timely and thorough risk assessment along with excellent communication with both the patient and the laboratory fabricating the restoration.

Estimation of Ultimate Tensile Strength of dentin Using Finite Element Analysis from Endodontically Treated Tooth

NASA Astrophysics Data System (ADS)

Sinthaworn, S.; Puengpaiboon, U.; Warasetrattana, N.; Wanapaisarn, S.

2018-01-01

Endodontically treated teeth were simulated by finite element analysis in order to estimate ultimate tensile strength of dentin. Structures of the endodontically treated tooth cases are flared root canal, restored with different number of fiber posts {i.e. resin composite core without fiber post (group 1), fiber post No.3 with resin composite core (group 2) and fiber post No.3 accessory 2 fiber posts No.0 with resin composite core (group 3)}. Elastic modulus and Poisson’s ratio of materials were selected from literatures. The models were loaded by the average fracture resistances load of each groups (group 1: 361.80 N, group 2: 559.46 N, group 3: 468.48 N) at 135 degree angulation in respect to the longitudinal axis of the teeth. The stress analysis and experimental confirm that fracture zone is at dentin area. To estimate ultimate tensile strength of dentin, trial and error of ultimate tensile strength were tested to obtain factor of safety (FOS) equal to 1.00. The result reveals that ultimate tensile strength of dentin of group 1, 2, 3 are 38.89, 30.96, 37.19 MPa, respectively.

Is the glass half empty or half full? A novel "philosophical" approach to the "mystery" of the so-called ferrule effect.

PubMed

Stavridakis, Minos; Brokos, Yiannis; Krejci, Ivo

2018-06-01

The prognosis of endodontically treated teeth has traditionally been associated with the presence of the so-called ferrule effect that is generally related with the presence of a minimum of 1-2 mm of sound tooth structure at the cervical area of parallel axial walls that totally encircle the tooth. Even though all of these factors are well desired, one should question if their absence should condemn a tooth and compel extraction as the only logical treatment plan option. For this reason an hypothesis is being formed that associates the aforementioned factors not with the presence of the so-called ferrule effect, but rather with the resistance form of the preparation that is being provided by the sound tooth structure at the cervical area of the tooth. When the desired resistance form is provided by sound tooth structure of endodontically treated teeth, then less lateral forces are being transferred to the post & core and subsequently to the root of the teeth, thus minimizing the chances of decementation of the post & core or worst fracture of the root. Even more important, if this hypothesis may be further entertained, then even when the so-called ferrule effect is not present, the teeth may not be extracted, but alternative strategies for post & core restorations may be investigated, such a more flexible carbon- or glass-fiber posts & core build ups made from flowable resin composite that may accommodate for the increased lateral forced exerted to the post & core complex during function. Copyright © 2018 Elsevier Ltd. All rights reserved.

Shrinkage Stresses Generated during Resin-Composite Applications: A Review

PubMed Central

Schneider, Luis Felipe J.; Cavalcante, Larissa Maria; Silikas, Nick

2010-01-01

Many developments have been made in the field of resin composites for dental applications. However, the manifestation of shrinkage due to the polymerization process continues to be a major problem. The material's shrinkage, associated with dynamic development of elastic modulus, creates stresses within the material and its interface with the tooth structure. As a consequence, marginal failure and subsequent secondary caries, marginal staining, restoration displacement, tooth fracture, and/or post-operative sensitivity are clinical drawbacks of resin-composite applications. The aim of the current paper is to present an overview about the shrinkage stresses created during resin-composite applications, consequences, and advances. The paper is based on results of many researches that are available in the literature. PMID:20948573

The Evaluation of Root Fracture with Cone Beam Computed Tomography (CBCT): An Epidemiological Study.

PubMed

Doğan, Mehmet-Sinan; Callea, Michele; Kusdhany, Lindawati S; Aras, Ahmet; Maharani, Diah-Ayu; Mandasari, Masita; Adiatman, Melissa; Yavuz, Izzet

2018-01-01

The aim of this study was evaluation of the cone-beam computed tomography (CBCT) image of 50 patients at the ages of 8-15 suspecting root fracture and root fracture occurred, exposed to dental traumatic. In additionally, this study was showed effect of crown fracture on root fracture healing. All of the individuals included in the study were obtained images with the cone-beam computed tomography range of 0,3 voxel and 8.9 seconds.(i-CAT®, Model 17-19, Imaging SciencesInternational, Hatfield, Pa USA).The information obtained from the history and CBCT images of patients were evaluated using chi-square test statistical method the mean and the distribution of the independent variables. 50 children, have been exposed to trauma, was detected root fracture injury in 97 teeth. Horizontal root fracture 63.9% of the 97 tooth, the oblique in 31.9%, both the horizontal and oblique in 1.03%, partial fracture in 2.06% ,and both horizontally and vertical in 1.03% was observed.The most affected teeth, respectively of, are the maxillary central incisor (41.23% left, right, 37.11%), maxillary left lateral incisor (9.27%), maxillary right lateral incisor (11.34%), and mandibular central incisor (1.03%). Crown fractures have negative effects on spontaneous healing of root fractures. CBCT are used selected as an alternative to with conventional radiography for diagnosis of root fractures. In particular, ıt's cross-sectional image is quite useful and has been provided more conveniences seeing the results of diagnosis and treatment for clinician. Key words: Root fracture, CBCT, Epidemiolog.

Numerical Modelling of Extended Leak-Off Test with a Pre-Existing Fracture

NASA Astrophysics Data System (ADS)

Lavrov, A.; Larsen, I.; Bauer, A.

2016-04-01

Extended leak-off test (XLOT) is one of the few techniques available for stress measurements in oil and gas wells. Interpretation of the test is often difficult since the results depend on a multitude of factors, including the presence of natural or drilling-induced fractures in the near-well area. Coupled numerical modelling of XLOT has been performed to investigate the pressure behaviour during the flowback phase as well as the effect of a pre-existing fracture on the test results in a low-permeability formation. Essential features of XLOT known from field measurements are captured by the model, including the saw-tooth shape of the pressure vs injected volume curve, and the change of slope in the pressure vs time curve during flowback used by operators as an indicator of the bottomhole pressure reaching the minimum in situ stress. Simulations with a pre-existing fracture running from the borehole wall in the radial direction have revealed that the results of XLOT are quite sensitive to the orientation of the pre-existing fracture. In particular, the fracture initiation pressure and the formation breakdown pressure increase steadily with decreasing angle between the fracture and the minimum in situ stress. Our findings seem to invalidate the use of the fracture initiation pressure and the formation breakdown pressure for stress measurements or rock strength evaluation purposes.

The Comprehensive AOCMF Classification System: Midface Fractures - Level 3 Tutorial

PubMed Central

Cornelius, Carl-Peter; Audigé, Laurent; Kunz, Christoph; Buitrago-Téllez, Carlos H.; Rudderman, Randal; Prein, Joachim

2014-01-01

This tutorial outlines the details of the AOCMF image-based classification system for fractures of the midface at the precision level 3. The topography of the different midface regions (central midface—upper central midface, intermediate central midface, lower central midface—incorporating the naso-orbito-ethmoid region; lateral midface—zygoma and zygomatic arch, palate) is subdivided in much greater detail than in level 2 going beyond the Le Fort fracture types and its analogs. The level 3 midface classification system is presented along with guidelines to precisely delineate the fracture patterns in these specific subregions. It is easy to plot common fracture entities, such as nasal and naso-orbito-ethmoid, and their variants due to the refined structural layout of the subregions. As a key attribute, this focused approach permits to document the occurrence of fragmentation (i.e., single vs. multiple fracture lines), displacement, and bone loss. Moreover, the preinjury dental state and the degree of alveolar atrophy in edentulous maxillary regions can be recorded. On the basis of these individual features, tooth injuries, periodontal trauma, and fracture involvement of the alveolar process can be assessed. Coding rules are given to set up a distinctive formula for typical midface fractures and their combinations. The instructions and illustrations are elucidated by a series of radiographic imaging examples. A critical appraisal of the design of this level 3 midface classification is made. PMID:25489392

A System Approach to Navy Medical Education and Training. Appendix 29. Competency Curriculum for Advanced General Duty Corpsman.

DTIC Science & Technology

1974-08-31

c. Perform qualitative tests for fecal fat , bilirubin, urobilirubin and starch granules by staining methods PERFORMANCE OBJECTIVE f (Stimulus) Upon...myocardial infarction, pulmonary embolism Gastrointestinal: gastroenteritis, stomatitis, appendicitis, ulcer, gastritis, intestinal obstruction, cholecystitis... fractured tooth J. Reinsert temporary crown k. Treat dry socket, cellulitis, gingivitis, etc. 1. Evaluate patient’s progress/response to therapeutic regime M

Assessment of reliability of CAD-CAM tooth-colored implant custom abutments.

PubMed

Guilherme, Nuno Marques; Chung, Kwok-Hung; Flinn, Brian D; Zheng, Cheng; Raigrodski, Ariel J

2016-08-01

Information is lacking about the fatigue resistance of computer-aided design and computer-aided manufacturing (CAD-CAM) tooth-colored implant custom abutment materials. The purpose of this in vitro study was to investigate the reliability of different types of CAD-CAM tooth-colored implant custom abutments. Zirconia (Lava Plus), lithium disilicate (IPS e.max CAD), and resin-based composite (Lava Ultimate) abutments were fabricated using CAD-CAM technology and bonded to machined titanium-6 aluminum-4 vanadium (Ti-6Al-4V) alloy inserts for conical connection implants (NobelReplace Conical Connection RP 4.3×10 mm; Nobel Biocare). Three groups (n=19) were assessed: group ZR, CAD-CAM zirconia/Ti-6Al-4V bonded abutments; group RC, CAD-CAM resin-based composite/Ti-6Al-4V bonded abutments; and group LD, CAD-CAM lithium disilicate/Ti-6Al-4V bonded abutments. Fifty-seven implant abutments were secured to implants and embedded in autopolymerizing acrylic resin according to ISO standard 14801. Static failure load (n=5) and fatigue failure load (n=14) were tested. Weibull cumulative damage analysis was used to calculate step-stress reliability at 150-N and 200-N loads with 2-sided 90% confidence limits. Representative fractured specimens were examined using stereomicroscopy and scanning electron microscopy to observe fracture patterns. Weibull plots revealed β values of 2.59 for group ZR, 0.30 for group RC, and 0.58 for group LD, indicating a wear-out or cumulative fatigue pattern for group ZR and load as the failure accelerating factor for groups RC and LD. Fractographic observation disclosed that failures initiated in the interproximal area where the lingual tensile stresses meet the compressive facial stresses for the early failure specimens. Plastic deformation of titanium inserts with fracture was observed for zirconia abutments in fatigue resistance testing. Significantly higher reliability was found in group ZR, and no significant differences in reliability were determined between groups RC and LD. Differences were found in the failure characteristics of group ZR between static and fatigue loading. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

On the evolutionary advantage of multi-cusped teeth

PubMed Central

Bush, Mark B.; Barani, Amir; Lawn, Brian R.

2016-01-01

A hallmark of mammalian evolution is a progressive complexity in postcanine tooth morphology. However, the driving force for this complexity remains unclear: whether to expand the versatility in diet source, or to bolster tooth structural integrity. In this study, we take a quantitative approach to this question by examining the roles of number, position and height of multiple cusps in determining sustainable bite forces. Our approach is to use an extended finite-element methodology with due provision for step-by-step growth of an embedded crack to determine how fracture progresses with increasing occlusal load. We argue that multi-cusp postcanine teeth are well configured to withstand high bite forces provided that multiple cusps are contacted simultaneously to share the load. However, contact on a single near-wall cusp diminishes the strength. Location of the load points and cusp height, rather than cusp number or radius, are principal governing factors. Given these findings, we conclude that while complex tooth structures can enhance durability, increases in cusp number are more likely to be driven by the demands of food manipulation. Structural integrity of complex teeth is maintained when individual cusps remain sufficiently distant from the side walls and do not become excessively tall relative to tooth width. PMID:27558851

Impact of Dental Disorders and its Influence on Self Esteem Levels among Adolescents.

PubMed

Kaur, Puneet; Singh, Simarpreet; Mathur, Anmol; Makkar, Diljot Kaur; Aggarwal, Vikram Pal; Batra, Manu; Sharma, Anshika; Goyal, Nikita

2017-04-01

Self esteem is more of a psychological concept therefore, even the common dental disorders like dental trauma, tooth loss and untreated carious lesions may affect the self esteem thus influencing the quality of life. This study aims to assess the impact of dental disorders among the adolescents on their self esteem level. The present cross-sectional study was conducted among 10 to 17 years adolescents. In order to obtain a representative sample, multistage sampling technique was used and sample was selected based on Probability Proportional to Enrolment size (PPE). Oral health assessment was carried out using WHO type III examination and self esteem was estimated using the Rosenberg Self Esteem Scale score (RSES). The descriptive and inferential analysis of the data was done by using IBM SPSS software. Logistic and linear regression analysis was executed to test the individual association of different independent clinical variables with self esteem. Total sample of 1140 adolescents with mean age of 14.95 ±2.08 and RSES of 27.09 ±3.12 were considered. Stepwise multiple linear regression analysis was applied and best predictors in relation to RSES in the descending order were Dental Health Component (DHC), Aesthetic Component (AC), dental decay {(aesthetic zone), (masticatory zone)}, tooth loss {(aesthetic zone), (masticatory zone)} and anterior fracture of tooth. It was found that various dental disorders like malocclusion, anterior traumatic tooth, tooth loss and untreated decay causes a profound impact on aesthetics and psychosocial behaviour of adolescents, thus affecting their self esteem.

Prevention of neurological injuries during mandibular third molar surgery: technical notes

PubMed Central

La Monaca, Gerardo; Vozza, Iole; Giardino, Rita; Annibali, Susanna; Pranno, Nicola; Cristalli, Maria Paola

2017-01-01

Summary Surgery to the mandibular third molar is common, and injuries to the inferior alveolar nerve and the lingual nerve are well-recognized complications of this procedure. The aim of these technical notes is to describe operative measures for reducing neurological complications during mandibular third molar surgery. The following procedure should be used to prevent damage to the inferior alveolar nerve: a well-designed mucoperiosteal flap, to obtain appropriate access to the surgical area; a conservative ostectomy on the distal and distal-lingual side; tooth sectioning, to facilitate its removal by decreasing the retention zones; tooth dislocation in the path of withdrawal imposed by the curvature of the root apex; and careful socket debridement, when the roots of the extracted tooth are in intimate contact with the mandibular canal. To prevent injury to the lingual nerve, it is important (I) to assess the integrity of the mandibular inner cortex and exclude the presence of fenestration, which could cause the dislocation of the tooth or its fragment into the sublingual or submandibular space; (II) to avoid inappropriate or excessive dislocation proceedings, in order to prevent lingual cortex fracture; (III) to perform horizontal mesial-distal crown sectioning of the lingually inclined tooth; (IV) to protect the lingual flap with a retractor showing the cortical ridge; and (V) to pass the suture not too apically and from the inner side in a buccal-lingual direction in the retromolar area. PMID:29299188

Fracture performance of computer-aided manufactured zirconia and alloy crowns.

PubMed

Rosentritt, Martin; Behr, Michael; Thaller, Christian; Rudolph, Heike; Feilzer, Albert

2009-09-01

To compare the fracture resistance and fracture performance of CAD/CAM zirconia and alloy crowns. One electrophoretic deposition alumina ceramic (Wolceram, Wolceram) and 4 zirconia-based systems (ce.novation, ce.novation; Cercon, DeguDent; Digizon, Amann Girrbach; and Lava, 3M ESPE) were investigated. A porcelain-fused-to-metal method (Academy, Bego Medical) was used in either conventional casting technique or laser sintering. Sixteen crowns of each material were fabricated and veneered with glass-ceramic as recommended by the manufacturers. Crown and root dimensions were measured, and 8 crowns of each system were adhesively bonded or conventionally cemented. After the crowns were artificially aged in a simulated oral environment (1,200,000 mechanical loads with 50 N; 3,000 thermal cycles with distilled water between 5 degrees C and 55 degrees C; 2 minutes per cycle), fracture resistance and fracture patterns were determined and defect sizes investigated. The fracture force varied between 1,111 N and 2,038 N for conventional cementation and between 1,181 N and 2,295 N for adhesive bonding. No significant differences were found between adhesive and conventional cementations. Fracture patterns presented mostly as a chipping of the veneering, in single cases as a fracture of the core, and in 1 case as a fracture of the tooth. Crown material and cementation do not have any significant influence on the fracture force and fracture performance of all-ceramic and metal-based crowns. Therefore, it may be concluded that adhesive bonding is not necessary for the application of high-strength ceramics.

Morphology and fracture of enamel.

PubMed

Myoung, Sangwon; Lee, James; Constantino, Paul; Lucas, Peter; Chai, Herzl; Lawn, Brian

2009-08-25

This study examines the inter-relation between enamel morphology and crack resistance by sectioning extracted human molars after loading to fracture. Cracks appear to initiate from tufts, hypocalcified defects at the enamel-dentin junction, and grow longitudinally around the enamel coat to produce failure. Microindentation corner cracks placed next to the tufts in the sections deflect along the tuft interfaces and occasionally penetrate into the adjacent enamel. Although they constitute weak interfaces, the tufts are nevertheless filled with organic matter, and appear to be stabilized against easy extension by self-healing, as well as by mutual stress-shielding and decussation, accounting at least in part for the capacity of tooth enamel to survive high functional forces.

Periodontal tissue repair after sealing of the gap in vertical root fracture.

PubMed

Sugaya, Tsutomu; Tomita, Mahito; Motoki, Youji; Zaman, Khurshiduz; Miyaji, Hirofumi; Kawanami, Masamitsu

2017-04-01

The aim of this study was to determine whether sealing of fracture gap using adhesive resin through the root canal can prevent inflammation of periodontal tissue, and resealing the incompletely sealed fracture gap from outside can resolve such inflammation in experimentally created vertical root fractures. Vertical root fractures were created in incisor of beagles. In the experimental group, the fracture gap was sealed through the root canal with adhesive resin. After 5 weeks, sites with the clinical attachment level ≥4 mm were further divided randomly into the poor-replanting group and the poor-untreated group. In the poor-replanting group, the tooth was extracted and replanted after resealing the fracture gap with adhesive resin from the outer surface. Sites with clinical attachment level ≤3 mm after 5 weeks were considered as the satisfactory group. The poor-untreated group and the satisfactory group were subjected to no further treatment. The clinical attachment level was evaluated at baseline and after 2, 5, and 9 weeks. After 9 weeks, histological measurements were made to determine the length of the epithelial downgrowth and the area of alveolar bone resorption. The clinical attachment level and the area of bone resorption were significantly smaller in the poor-replanting group and the satisfactory group than in the poor-untreated group (p < 0.05). The results indicate the possibility that periodontal inflammation along the fracture line can be prevented and improved if the fracture gap is sealed.

Treatment Recommendations for Single-Unit Crowns: Findings from The National Dental Practice-Based Research Network

PubMed Central

McCracken, Michael S.; Louis, David R.; Litaker, Mark S.; Minyé, Helena M.; Mungia, Rahma; Gordan, Valeria V.; Marshall, Don G.; Gilbert, Gregg H.

2016-01-01

Background Objectives were to: (1) quantify practitioner variation in likelihood to recommend a crown; and (2) test whether certain dentist, practice, and clinical factors are significantly associated with this likelihood. Methods Dentists in the National Dental Practice-Based Research Network completed a questionnaire about indications for single-unit crowns. In four clinical scenarios, practitioners ranked their likelihood of recommending a single-unit crown. These responses were used to calculate a dentist-specific “Crown Factor” (CF; range 0–12). A higher score implies a higher likelihood to recommend a crown. Certain characteristics were tested for statistically significant associations with the CF. Results 1,777 of 2,132 eligible dentists responded (83%). Practitioners were most likely to recommend crowns for teeth that were fractured, cracked, endodontically-treated, or had a broken restoration. Practitioners overwhelmingly recommended crowns for posterior teeth treated endodontically (94%). Practice owners, Southwest practitioners, and practitioners with a balanced work load were more likely to recommend crowns, as were practitioners who use optical scanners for digital impressions. Conclusions There is substantial variation in the likelihood of recommending a crown. While consensus exists in some areas (posterior endodontic treatment), variation dominates in others (size of an existing restoration). Recommendations varied by type of practice, network region, practice busyness, patient insurance status, and use of optical scanners. Practical Implications Recommendations for crowns may be influenced by factors unrelated to tooth and patient variables. A concern for tooth fracture -- whether from endodontic treatment, fractured teeth, or large restorations -- prompted many clinicians to recommend crowns. PMID:27492046

Tooth form and function: insights into adaptation through the analysis of dental microwear.

PubMed

Ungar, Peter S

2009-01-01

Mammalian molar form is clearly adapted to fracture foods with specific material properties. Studies of dental functional morphology can therefore offer important clues about the diets of fossil taxa. That said, analyses of tooth form provide insights into ability to fracture resistant foods rather than the food preferences of individuals. Recent work suggests that specialized occlusal morphology can relate to either preferred foods, or to occasionally eaten fallback items critical for survival. This paper reviews dental microwear texture analysis, a new approach that can be used to infer fracture properties of foods eaten in life. High-resolution 3D point clouds of microwear surfaces are collected and analyzed using scale-sensitive fractal analyses. Resulting data are free from operator measurement error, and allow the characterization and comparison of within-species variation in microwear texture attributes. Examples given here include four extant primate species (two folivores and two hard object fallback feeders), and two fossil hominin taxa. All groups show at least some individuals with simple microwear surfaces that suggest a lack of consumption of hard and brittle abrasive foods during the last few meals. On the other hand, some hard object fallback specimens have very complex surfaces consistent with consumption of hard, brittle foods. The latter pattern is also found in one hominin species. These results suggest that dental microwear texture analysis can help us determine whether craniodental specializations in fossil species are adaptations to preferred foods, or to less often but still critical fallback items. Copyright (c) 2009 S. Karger AG, Basel.

Comparison of Metal-Ceramic and All-Ceramic Three-Unit Posterior Fixed Dental Prostheses: A 3-Year Randomized Clinical Trial.

PubMed

Nicolaisen, Maj H; Bahrami, Golnosh; Schropp, Lars; Isidor, Flemming

2016-01-01

The aim of this randomized clinical study was to compare the 3-year clinical outcome of metal-ceramic fixed dental prostheses (MC-FDPs) and zirconia all-ceramic fixed dental prostheses (AC-FDPs) replacing a posterior tooth. A sample of 34 patients with a missing posterior tooth were randomly chosen to receive either a MC-FDP (n = 17) or an AC-FDP (n = 17). The FDPs were evaluated at baseline and yearly until 3 years after cementation. They were assessed using the California Dental Association assessment system. Periodontal parameters were measured at the abutment teeth, and the contralateral teeth served as control. The statistical unit was the FDP/patient. The survival rates for MC-FDPs and AC-FDPs were 100%. The success rate was 76% and 71% for MC-FDPs and AC-FDPs, respectively. Three technical complications were observed in the MC-FDP group and five in the AC-FDP group, all chipping fractures of the ceramic veneer. Furthermore, one biologic complication in the MC-FDP group (an apical lesion) was observed. No framework fractures occurred. All patients had optimal oral hygiene and showed no bleeding on periodontal probing at any of the recalls. Only minor changes in the periodontal parameters were observed during the 3 years of observation. Three-unit posterior MC-FDPs and AC-FDPs showed similar high survival rates and acceptable success rates after 3 years of function, and ceramic veneer chipping fracture was the most frequent complication for both types of restorations.

Three-dimensional finite element analysis of the stress distribution pattern in a mandibular first molar tooth restored with five different restorative materials.

PubMed

D'souza, Kathleen Manuela; Aras, Meena Ajay

2017-01-01

Badly broken or structurally compromised posterior teeth are frequently associated with crown/root fracture. Numerous restorative materials have been used to fabricate indirect full-coverage restorations for such teeth. This study aims to evaluate and compare the effect of restorative materials on the stress distribution pattern in a mandibular first molar tooth, under varying loading conditions and to compare the stress distribution pattern in five commonly used indirect restorative materials. Five three-dimensional finite element models representing a mandibular first molar tooth restored with crowns of gold, porcelain fused to metal, composite (Artglass), alumina-based zirconia (In-Ceram Zirconia [ICZ]), and double-layered zirconia-based materials (zirconia core veneered with porcelain, Lava) were constructed, using a Finite Element Analysis Software (ANSYS version 10; ANSYS Inc., Canonsburg, PA, USA). Two loading conditions were applied, simulating maximum bite force of 600 N axially and normal masticatory bite force of 225 N axially and nonaxially. Both all-ceramic crowns allowed the least amount of stress distribution to the surrounding tooth structure. In maximum bite force-simulation test, alumina-based all-ceramic crown displayed the highest von Mises stresses (123.745 MPa). In the masticatory bite force-simulation test, both all-ceramic crowns (122.503-133.13 MPa) displayed the highest von Mises stresses. ICZ crown displayed the highest peak von Mises stress values under maximum and masticatory bite forces. ICZ and Lava crowns also allowed the least amount of stress distribution to the surrounding tooth structure, which is indicative of a favorable response of the underlying tooth structure to the overlying full-coverage indirect restorative material. These results suggest that ICZ and Lava crowns can be recommended for clinical use in cases of badly damaged teeth.

Emergency management of dental trauma: knowledge of Hong Kong primary and secondary school teachers.

PubMed

Young, Cecilia; Wong, K Y; Cheung, L K

2012-10-01

OBJECTIVES. To investigate the level of knowledge about emergency management of dental trauma among Hong Kong primary and secondary school teachers. DESIGN. Questionnaire survey. SETTING. A teachers' union that unites 90% of teachers in Hong Kong. PARTICIPANTS. Randomly selected primary and secondary school teachers. RESULTS. Only 32.8% of respondents correctly stated that a person sustaining dental trauma should go to dentists directly. In all, 73.1% of teachers correctly stated that a dental trauma patient should go for treatment immediately. Only 32.5% knew that a fractured tooth should be put in liquid. Even fewer (23.2%) realised that the displaced tooth should be repositioned back to the original position. Relatively more respondents (74.7%) understood that an avulsed baby tooth should not be put back. Disappointingly, only 16.3% of teachers knew that an avulsed permanent tooth should be replanted. Furthermore, only 29.6% of teachers thought that they were able to distinguish between deciduous teeth and permanent teeth, whilst 20.4% correctly identified at least one of the appropriate mediums: milk, physiological saline or saliva, for storing an avulsed tooth. Teachers who previously received first-aid training with dental content or acquired dental injury information from other sources, scored significantly higher than teachers without such training or acquired information. CONCLUSION. The knowledge on emergency management of dental trauma among primary and secondary school teachers in Hong Kong is insufficient, particularly on the handling of permanent tooth avulsion and the appropriate storage medium for avulsed teeth. Receipt of first-aid training with dental contents and acquisition of dental injury information from other sources were positively correlated with knowledge in managing dental trauma.

Dental Glass Ionomer Cements as Permanent Filling Materials? —Properties, Limitations Future Trends

PubMed Central

Lohbauer, Ulrich

2009-01-01

Glass ionomer cements (GICs) are clinically attractive dental materials that have certain unique properties that make them useful as restorative and luting materials. This includes adhesion to moist tooth structures and base metals, anticariogenic properties due to release of fluoride, thermal compatibility with tooth enamel, biocompatibility and low toxicity. The use of GICs in a mechanically loaded situation, however, has been hampered by their low mechanical performance. Poor mechanical properties, such as low fracture strength, toughness and wear, limit their extensive use in dentistry as a filling material in stress-bearing applications. In the posterior dental region, glass ionomer cements are mostly used as a temporary filling material. The requirement to strengthen those cements has lead to an ever increasing research effort into reinforcement or strengthening concepts.

Low-Cost Intra-Articular Distraction Technique Using Kirschner Wires and a Toothed Lamina Spreader.

PubMed

Shymon, Stephen Joseph; Harris, Thomas Gregory

We describe a low-cost (instrument cost) technique for joint distraction using 2 Kirschner wires and a toothed lamina spreader in lieu of a Hintermann distractor. The described technique allows for temporary intra-articular distraction and visualization and preservation of the articular surface with extra-articular instrumentation. The technique can also allow for closed reduction and percutaneous treatment in cases of soft tissue compromise. Additionally, the technique uses common orthopedic surgical instruments, leading to a minimal learning curve for novice surgeons. We have found this distraction technique to be most effective for intra-articular preparation of hindfoot and midfoot arthrodeses and for navicular fracture reduction. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Near-IR imaging of erbium laser ablation with a water spray

NASA Astrophysics Data System (ADS)

Darling, Cynthia L.; Maffei, Marie E.; Fried, William A.; Fried, Daniel

2008-02-01

Near-IR (NIR) imaging can be used to view the formation of ablation craters during laser ablation since the enamel of the tooth is almost completely transparent near 1310-nm1. Laser ablation craters can be monitored under varying irradiation conditions to assess peripheral thermal and transient-stress induced damage, measure the rate and efficiency of ablation and provide insight into the ablation mechanism. There are fundamental differences in the mechanism of enamel ablation using erbium lasers versus carbon dioxide laser systems due to the nature of the primary absorber and it is necessary to have water present on the tooth surface for efficient ablation at erbium laser wavelengths. In this study, sound human tooth sections of approximately 2-3-mm thickness were irradiated by free running and Q-switched Er:YAG & Er:YSGG lasers under varying conditions with and without a water spray. The incision area in the interior of each sample was imaged using a tungsten-halogen lamp with a band-pass filter centered at 1310-nm combined with an InGaAs area camera with a NIR zoom microscope. Obvious differences in the crater evolution were observed between CO2 and erbium lasers. Ablation stalled after a few laser pulses without a water spray as anticipated. Efficient ablation was re-initiated by resuming the water spray. Micro-fractures were continuously produced apparently driven along prism lines during multi-pulse ablation. These fractures or fissures appeared to merge together as the crater evolved to form the leading edge of the ablation crater. These observations support the proposed thermo-mechanical mechanisms of erbium laser involving the strong mechanical forces generated by selective absorption by water.

All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part II: Multiple-unit FDPs.

PubMed

Pjetursson, Bjarni Elvar; Sailer, Irena; Makarov, Nikolay Alexandrovich; Zwahlen, Marcel; Thoma, Daniel Stefan

2015-06-01

To assess the 5-year survival of metal-ceramic and all-ceramic tooth-supported fixed dental prostheses (FDPs) and to describe the incidence of biological, technical and esthetic complications. Medline (PubMed), Embase and Cochrane Central Register of Controlled Trials (CENTRAL) searches (2006-2013) were performed for clinical studies focusing on tooth-supported FDPs with a mean follow-up of at least 3 years. This was complemented by an additional hand search and the inclusion of 10 studies from a previous systematic review [1]. Survival and complication rates were analyzed using robust Poisson's regression models to obtain summary estimates of 5-year proportions. Forty studies reporting on 1796 metal-ceramic and 1110 all-ceramic FDPs fulfilled the inclusion criteria. Meta-analysis of the included studies indicated an estimated 5-year survival rate of metal-ceramic FDPs of 94.4% (95% CI: 91.2-96.5%). The estimated survival rate of reinforced glass ceramic FDPs was 89.1% (95% CI: 80.4-94.0%), the survival rate of glass-infiltrated alumina FDPs was 86.2% (95% CI: 69.3-94.2%) and the survival rate of densely sintered zirconia FDPs was 90.4% (95% CI: 84.8-94.0%) in 5 years of function. Even though the survival rate of all-ceramic FDPs was lower than for metal-ceramic FDPs, the differences did not reach statistical significance except for the glass-infiltrated alumina FDPs (p=0.05). A significantly higher incidence of caries in abutment teeth was observed for densely sintered zirconia FDPs compared to metal-ceramic FDPs. Significantly more framework fractures were reported for reinforced glass ceramic FDPs (8.0%) and glass-infiltrated alumina FDPs (12.9%) compared to metal-ceramic FDPs (0.6%) and densely sintered zirconia FDPs (1.9%) in 5 years in function. However, the incidence of ceramic fractures and loss of retention was significantly (p=0.018 and 0.028 respectively) higher for densely sintered zirconia FDPs compared to all other types of FDPs. Survival rates of all types of all-ceramic FDPs were lower than those reported for metal-ceramic FDPs. The incidence of framework fractures was significantly higher for reinforced glass ceramic FDPs and infiltrated glass ceramic FDPs, and the incidence for ceramic fractures and loss of retention was significantly higher for densely sintered zirconia FDPs compared to metal-ceramic FDPs. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Pitting and Bending Fatigue Evaluations of a New Case-Carburized Gear Steel

NASA Technical Reports Server (NTRS)

Krantz, Timothy; Tufts, Brian

2007-01-01

The power density of a gearbox is an important consideration for many applications and is especially important for gearboxes used on aircraft. One approach to improving power density of gearing is to improve the steel properties by design of the alloy. The alloy tested in this work was designed to be case-carburized with surface hardness of Rockwell C66 after hardening. Test gear performance was evaluated using surface fatigue tests and single-tooth bending fatigue tests. The performance of gears made from the new alloy was compared to the performance of gears made from two alloys currently used for aviation gearing. The new alloy exhibited significantly better performance in surface fatigue testing, demonstrating the value of the improved properties in the case layer. However, the alloy exhibited lesser performance in single-tooth bending fatigue testing. The fracture toughness of the tested gears was insufficient for use in aircraft applications as judged by the behavior exhibited during the single tooth bending tests. This study quantified the performance of the new alloy and has provided guidance for the design and development of next generation gear steels.

The Use of MMF Screws: Surgical Technique, Indications, Contraindications, and Common Problems in Review of the Literature

PubMed Central

Cornelius, Carl-Peter; Ehrenfeld, Michael

2010-01-01

Mandibulo-maxillary fixation (MMF) screws are inserted into the bony base of both jaws in the process of fracture realignment and immobilisation. The screw heads act as anchor points to fasten wire loops or rubber bands connecting the mandible to the maxilla. Traditional interdental chain-linked wiring or arch bar techniques provide the anchorage by attached cleats, hooks, or eyelets. In comparison to these tooth-borne appliances MMF screws facilitate and shorten the way to achieve intermaxillary fixation considerably. In addition, MMF screws help to reduce the hazards of glove perforation and wire stick injuries. On the downside, MMF screws are attributed with the risk of tooth root damage and a lack of versatility beyond the pure maintenance of occlusion such as stabilizing loose teeth or splinting fragments of the alveolar process. The surgical technique of MMF screws as well as the pros and cons of the clinical application are reviewed. The adequate screw placement to prevent serious tooth root injuries is still an issue to rethink and modify conceptual guidelines. PMID:22110819

Evaluation of load at fracture of Procera AllCeram copings using different luting cements.

PubMed

Al-Makramani, Bandar M A; Razak, A A A; Abu-Hassan, M I

2008-02-01

The current study investigated the effect of different luting agents on the fracture resistance of Procera AllCeram copings. Six master dies were duplicated from the prepared maxillary first premolar tooth using nonprecious metal alloy (Wiron 99). Thirty copings (Procera AllCeram) of 0.6-mm thickness were manufactured. Three types of luting media were used: zinc phosphate cement (Elite), glass ionomer cement (Fuji I), and dual-cured composite resin cement (Panavia F). Ten copings were cemented with each type. Two master dies were used for each group, and each of them was used to lute five copings. All groups were cemented according to manufacturer's instructions and received a static load of 5 kg during cementation. After 24 hours of distilled water storage at 37 degrees C, the copings were vertically compressed using a universal testing machine at a crosshead speed of 1 mm/min. ANOVA revealed significant differences in the load at fracture among the three groups (p < 0.001). The fracture strength results showed that the mean fracture strength of zinc phosphate cement (Elite), glass ionomer cement (Fuji I), and resin luting cement (Panavia F) were 1091.9 N, 784.8 N, and 1953.5 N, respectively. Different luting agents have an influence on the fracture resistance of Procera AllCeram copings.

Fracture resistance exhibited by endodontically treated and retreated teeth shaped by ProTaper NEXT versus WaveOne: An in vitro study

PubMed Central

Khalap, Neha Deepak; Hegde, Vibha; Kokate, Sharad

2015-01-01

Aim: To compare the fracture resistance exhibited by teeth after primary endodontic treatment and retreatment. Materials and Methods: One hundred freshly extracted human teeth were selected. 20 samples served as control (untreated). Eighty experimental samples were divided into two groups (n = 40) for instrumentation using rotary Protaper NEXT (PTN) or reciprocating WaveOne (WO) files and obturated using warm lateral compaction. Half of the samples (n = 20) from each group were subjected to a load. The remaining half were subjected to retreatment using Protaper universal retreatment files (RFs) followed by a file larger than the master apical file used in groups 1 and 2 and reobturated. Group A: Control, Group B: PTN + obturation, Group C: WO + obturation, Group D: RF + PTN + obturation and Group E: RF + WO + obturation. The retreatment specimens were also subjected to load and the readings acquired were statistically analyzed. Result: When compared between the groups, control group exhibited the highest fracture resistance (P < 0.01). When multiple tests were performed, Group E exhibited significantly less fracture resistance (P < 0.01). Conclusion: Endodontic treatment and retreatment both results in lowering the fracture resistance of a tooth. PMID:26752838

Fracture resistance exhibited by endodontically treated and retreated teeth shaped by ProTaper NEXT versus WaveOne: An in vitro study.

PubMed

Khalap, Neha Deepak; Hegde, Vibha; Kokate, Sharad

2015-01-01

To compare the fracture resistance exhibited by teeth after primary endodontic treatment and retreatment. One hundred freshly extracted human teeth were selected. 20 samples served as control (untreated). Eighty experimental samples were divided into two groups (n = 40) for instrumentation using rotary Protaper NEXT (PTN) or reciprocating WaveOne (WO) files and obturated using warm lateral compaction. Half of the samples (n = 20) from each group were subjected to a load. The remaining half were subjected to retreatment using Protaper universal retreatment files (RFs) followed by a file larger than the master apical file used in groups 1 and 2 and reobturated. Group A: Control, Group B: PTN + obturation, Group C: WO + obturation, Group D: RF + PTN + obturation and Group E: RF + WO + obturation. The retreatment specimens were also subjected to load and the readings acquired were statistically analyzed. When compared between the groups, control group exhibited the highest fracture resistance (P < 0.01). When multiple tests were performed, Group E exhibited significantly less fracture resistance (P < 0.01). Endodontic treatment and retreatment both results in lowering the fracture resistance of a tooth.

Fracture Resistance of Premolars Restored by Various Types and Placement Techniques of Resin Composites

PubMed Central

Moosavi, Horieh; Zeynali, Mahsa; Pour, Zahra Hosseini

2012-01-01

To verify the fracture resistance of premolars with mesioocclusodistal preparations restored by different resin composites and placement techniques. Sixty premolars were randomly divided into two groups based on type of composite resin: Filtek P60 or Nulite F, and then each group was separated into three subgroups: bulk, centripetal, and fiber insert according to the type of placement method (n = 10). Single-bond adhesive system was used as composite bonding according to the manufacturer's instructions. Specimens were restored in Groups 1, 2, and 3 with Filtek P60 and in Groups 4, 5, and 6 with Nulite F. After being stored 24 hours at 37°C, a 4 mm diameter steel sphere in a universal testing machine was applied on tooth buccal and lingual cusps at a cross-head speed of 5 mm/min until fracture occurred. Groups 3 and 6 showed higher fracture resistance than Groups 1, 2, 4, and 5. Among the placement techniques, the fiber insert method had a significant effect, but the type of composite was ineffective. The insertion technique in contrast to the type of material had a significant influence on the fracture resistance of premolar teeth. PMID:22666255

Mandibular body fracture repair with wire-reinforced interdental composite splint in small dogs.

PubMed

Guzu, Michel; Hennet, Philippe R

2017-11-01

To report the outcome of mandibular body fractures treated with a wire-reinforced interdental composite splint (WRICS) in small breed dogs. Retrospective case series. Client-owned small breed dogs (n = 24). Medical records (1998-2012) of small breed dogs (<10 kg) with mandibular body fractures treated by WRICS were reviewed for signalment, history, type of fracture, treatment, and clinical and radiological follow-up. The angle of the fracture line (ANG) was measured on dental radiographs. A mandibular injury severity score (MISS) and a dental injury score (DIS) were evaluated as potential prognostic factors. Fractures most commonly involved P4-M1 (56%), and healed in a mean time of 2.37 ± 0.7 months. Healing was slower (P = .012) if teeth were present in the fracture line and required extraction, hemisection, or root canal therapy prior to WRICS placement (2.39 ± 0.7 months) than if no dental treatment was required (1.46 ± 0.8 months). Contrary to the MISS, the DIS was associated with longer time to bone healing (P = .001; r = .63) and risk of complications (P = .004). Bone healing time was decreased (P = .003; r = .61) with increasing fracture angles. WRICS can be considered to treat mandibular body fractures in small breed dogs if the fracture is not severely comminuted, and if at least the canine and first molar tooth can be used for anchorage. More severe lesions, such as those with teeth in the fracture line and a shorter fracture surface, are associated with prolonged bone healing. © 2017 The American College of Veterinary Surgeons.

The Evaluation of Root Fracture with Cone Beam Computed Tomography (CBCT): An Epidemiological Study

PubMed Central

Doğan, Mehmet-Sinan; Callea, Michele; Kusdhany, Lindawati S.; Aras, Ahmet; Maharani, Diah-Ayu; Mandasari, Masita; Adiatman, Melissa

2018-01-01

Background The aim of this study was evaluation of the cone-beam computed tomography (CBCT) image of 50 patients at the ages of 8-15 suspecting root fracture and root fracture occurred, exposed to dental traumatic. In additionally, this study was showed effect of crown fracture on root fracture healing. Material and Methods All of the individuals included in the study were obtained images with the cone-beam computed tomography range of 0,3 voxel and 8.9 seconds.(i-CAT®, Model 17-19, Imaging SciencesInternational, Hatfield, Pa USA).The information obtained from the history and CBCT images of patients were evaluated using chi-square test statistical method the mean and the distribution of the independent variables. Results 50 children, have been exposed to trauma, was detected root fracture injury in 97 teeth. Horizontal root fracture 63.9% of the 97 tooth, the oblique in 31.9%, both the horizontal and oblique in 1.03%, partial fracture in 2.06% ,and both horizontally and vertical in 1.03% was observed.The most affected teeth, respectively of, are the maxillary central incisor (41.23% left, right, 37.11%), maxillary left lateral incisor (9.27%), maxillary right lateral incisor (11.34%), and mandibular central incisor (1.03%). Conclusions Crown fractures have negative effects on spontaneous healing of root fractures. CBCT are used selected as an alternative to with conventional radiography for diagnosis of root fractures. In particular, ıt’s cross-sectional image is quite useful and has been provided more conveniences seeing the results of diagnosis and treatment for clinician. Key words:Root fracture, CBCT, Epidemiolog. PMID:29670714

Prevalence and patterns of combat sport related maxillofacial injuries.

PubMed

Shirani, Gholamreza; Kalantar Motamedi, Mohammad Hosein; Ashuri, Alireza; Eshkevari, Pooyan Sadr

2010-10-01

This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai) who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referred to us by the physician team. The type of injury (facial laceration, facial fractures, jaw dislocation, etc.), site of facial injury (jaw, nose, malar bone, teeth, etc.), dental injuries (tooth fracture, displacement, luxation, and avulsion), causative sport (boxing, taekwondo, kickboxing, and Muay Thai) as well as demographic data were recorded. Injuries were examined clinically and radiographically, and treated accordingly by a specialist. Treatment data and demographics were recorded for each subject. Recorded data were assessed, and χ(2), ANOVA, and Kruskal-Wallis tests were used to statistically analyze and compare the data. Of 120 subjects, 95 male subjects (79.2%), aged 18-25 years (avg. 20 years), had at least one traumatic injury to the face requiring medical treatment. These injuries included facial laceration, bone fractures (nose, mandible, and zygoma), dental injuries (displacement, luxation, fracture, and avulsion), and mandibular dislocation which were recorded in 83 (69.2%), 55 (45.1%), 53 (44.2%), and 8 (6.7%) cases respectively. Statistically significant differences were encountered among various injuries and the sports; kickboxing caused the most maxillofacial injuries and was identified as more injurious. Tooth fractures (59.7%) were the most common dental injuries, and the nose (84.7%) was the most frequently fractured facial bone. Lacerations were more common in Thai-boxers (93.3%). Injuries were significantly greater in professional rather than amateur athletes. In this study, prevalence of facial injuries from combat sports professionals was significantly high (roughly 80%), especially in kickboxing (in part due to use of less protective gear). Because the nose and teeth sustained the most injuries, they require more attention with regard to prevention. Kickboxing was the most injurious of these combat sports and caused the most significant number of maxillofacial trauma. More safety apparel and protective guards seem warranted in athletes of combat sports if facial injury is to be prevented.

Comparison of fracture strength and failure mode of different ceramic implant abutments.

PubMed

Elsayed, Adham; Wille, Sebastian; Al-Akhali, Majed; Kern, Matthias

2017-04-01

The whitish color of zirconia (ZrO 2 ) abutments offers favorable esthetics compared with the grayish color of titanium (Ti) abutments. Nonetheless, ZrO 2 has greater opacity, making it difficult to achieve natural tooth color. Therefore, lithium disilicate (LaT) abutments have been suggested to replace metal abutments. The purpose of this in vitro study was to evaluate the fracture strength and failure mode of single-tooth implant restorations using ZrO 2 and LaT abutments, and to compare them with titanium (Ti) abutments. Five different types of abutments, Ti; ZrO 2 with no metal base; ZrO 2 with a metal base (ZrT); LaT; and LaT combination abutment and crown (LcT) were assembled on 40 Ti implants and restored with LaT crowns. Specimens were subjected to quasistatic loading using a universal testing machine, until the implant-abutment connection failed. As bending of the metal would be considered a clinical failure, the values of force (N) at which the plastic deformation of the metal occurred were calculated, and the rate of deformation was analyzed. Statistical analysis was done using the Mann-Whitney U test (α=.05). Group ZrO 2 revealed the lowest resistance to failure with a mean of 202 ±33 N. Groups ZrT, LaT, and LaC withstood higher forces without fracture or debonding of the ceramic suprastructure, and failure was due to deformation of metal bases, with no statistically significant differences between these groups regarding the bending behavior. Within the limitations of this in vitro study, it was concluded that LaT abutments have the potential to withstand the physiological occlusal forces that occur in the anterior region and that ZrO 2 abutments combined with Ti inserts have much higher fracture strength than pure ZrO 2 abutments. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Lack of cooperation between physicians and dentists during osteoporosis treatment may increase fractures and osteonecrosis of the jaw.

PubMed

Taguchi, Akira; Shiraki, Masataka; Sugimoto, Toshitsugu; Ohta, Hiroaki; Soen, Satoshi

2016-07-01

Our previous questionnaire-based survey suggested that discontinuation of antiresorptive agents before tooth extraction may increase adverse events and disturb osteoporosis treatment without completely preventing osteonecrosis of the jaw (O.N.J.). We also found little cooperation between physicians and dentists in Japan. However, limitations of our previous study included a survey of doctors belonging to small clinics and a small sample size. Our current study aimed to confirm the results of our previous survey in doctors mainly belonging to academia. A structured questionnaire including 14 key clinical queries was sent to 1812 physicians of the Japan Osteoporosis Society, and 629 responses were received. Dentists requested discontinuation of many medications that were not associated with the incidence of O.N.J. A total of 523 respondents had received discontinuation requests from dentists. Of these, 97 respondents experienced 119 adverse events including 25 fractures and seven incidences of O.N.J. The ratios of valid responses for fractures were 3.6% and 5.3% in patients with a discontinuation of <3 and ≥3 months, respectively. Those for O.N.J. were 0.7% and 1.6%, respectively. Respondents who refused discontinuation requests reported no cases of O.N.J. Approximately 17% of respondents had patients who discontinued osteoporosis treatment following a requested drug discontinuation after tooth extraction. Approximately 62% of respondents did not request oral health care by a dentist before antiresorptive therapy, and 72% reported no cooperation between physicians and dentists in their region. This study reconfirms the results of our previous survey. Discontinuation of antiresorptive treatment may increase both fractures and O.N.J. Immediate development of a strategy for sharing information about O.N.J. among physicians, dentists, and patients is required to reduce the incidence of both O.N.J. and skeletal events in osteoporosis treatment. Study limitations were selection bias due to low response rate and possible inaccurate responses to the questionnaire.

The use of resorbable plates in association with dental arch stabilization in the treatment of mandibular fractures in children.

PubMed

Li, Zhi; David, Ongodia; Li, Zu-Bing

2014-07-01

The purpose of this study was to investigate the effect of resorbable plate fixation in association with dental arch stabilization in the treatment of displaced mandibular fractures in children. Thirteen children (5 girls and 8 boys, age range 2 years 5 months to 12 years 2 months) with displaced mandibular fractures were included in this case series. Open reduction by intraoral approach was performed on these patients, and the fractures were fixed using resorbable plates and monocortical screws placed at the lower border of the mandible. At the same time, an arch bar or orthodontic wire splint was anchored using stainless steel wires or resin on the teeth to stabilize the whole mandibular dental arch. Postoperatively, follow-up was undertaken to evaluate the fracture healing, mandible movement, and mandible growth. Postoperatively, all patients achieved uneventful healing; premorbid occlusion restoration and wound healing were achieved, along with unimpaired function and normal growth and development of the mandible. Complications such as damage to tooth buds, infection, malunion, and nonunion were not encountered in these patients. Resorbable plates use in association with dental arch stabilization can provide good stabilization for mandibular fractures and is a promising approach for the treatment of displaced mandibular fractures in children. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

A simple method to estimate restoration volume as a possible predictor for tooth fracture.

PubMed

Sturdevant, J R; Bader, J D; Shugars, D A; Steet, T C

2003-08-01

Many dentists cite the fracture risk posed by a large existing restoration as a primary reason for their decision to place a full-coverage restoration. However, there is poor agreement among dentists as to when restoration placement is necessary because of the inability to make objective measurements of restoration size. The purpose of this study was to compare a new method to estimate restoration volumes in posterior teeth with analytically determined volumes. True restoration volume proportion (RVP) was determined for 96 melamine typodont teeth: 24 each of maxillary second premolar, mandibular second premolar, maxillary first molar, and mandibular first molar. Each group of 24 was subdivided into 3 groups to receive an O, MO, or MOD amalgam preparation design. Each preparation design was further subdivided into 4 groups of increasingly larger size. The density of amalgam used was calculated according to ANSI/ADA Specification 1. The teeth were weighed before and after restoration with amalgam. Restoration weight was calculated, and the density of amalgam was used to calculate restoration volume. A liquid pycnometer was used to calculate coronal volume after sectioning the anatomic crown from the root horizontally at the cementoenamel junction. True RVP was calculated by dividing restoration volume by coronal volume. An occlusal photograph and a bitewing radiograph were made of each restored tooth to provide 2 perpendicular views. Each image was digitized, and software was used to measure the percentage of the anatomic crown restored with amalgam. Estimated RVP was calculated by multiplying the percentage of the anatomic crown restored from the 2 views together. Pearson correlation coefficients were used to compare estimated RVP with true RVP. The Pearson correlation coefficient of true RVP with estimated RVP was 0.97 overall (P

The pediatric mandible: II. Management of traumatic injury or fracture.

PubMed

Smartt, James M; Low, David W; Bartlett, Scott P

2005-08-01

After studying this article, the participant should be able to: 1. Describe the changing epidemiology of mandibular fractures in children and adolescents. 2. Discuss the appropriate use of internal fixation in the treatment of pediatric mandibular fractures. 3. Describe the difficulties posed by the deciduous dentition in the use of interdental wiring. 4. Understand reasons why techniques specific to adult fractures may not be applicable to the growing mandible. 5. Understand the etiology and epidemiology of pediatric mandibular fractures. 6. Understand the reasons for conservative (closed) versus aggressive (open) treatment of mandibular injury. Fractures of the pediatric mandible are complicated by the anatomic complexity of the developing mandible, particularly by the presence of tooth buds and the eruption of deciduous and permanent teeth. Traditional methods of fracture reduction and fixation employed in adults have little applicability in the pediatric population. The authors describe the surgical techniques that have been used at their institution and those that can be used safely in the pediatric setting. In most cases, "conservative" management is the preferred option, especially in the treatment of condylar fractures. In cases requiring surgical intervention, interdental wiring, drop wires in combination with circummandibular wires, and acrylic splints are suited well to specific phases of dental maturation. Open reduction and internal fixation using monocortical screws and microplates or resorbable plates and screws are acceptable techniques in the pediatric patient, but they require special safeguards. Algorithms are presented to simplify management of these complicated injuries.

In vitro comparison of fracture load of implant-supported, zirconia-based, porcelain- and composite-layered restorations after artificial aging.

PubMed

Komine, Futoshi; Taguchi, Kohei; Fushiki, Ryosuke; Kamio, Shingo; Iwasaki, Taro; Matsumura, Hideo

2014-01-01

This study evaluated fracture load of single-tooth, implant-supported, zirconia-based, porcelain- and indirect composite-layered restorations after artificial aging. Forty-four zirconia-based molar restorations were fabricated on implant abutments and divided into four groups, namely, zirconia-based all-ceramic restorations (ZAC group) and three types of zirconia-based composite-layered restorations (ZIC-P, ZIC-E, and ZIC groups). Before layering an indirect composite material, the zirconia copings in the ZIC-P and ZIC-E groups were primed with Clearfil Photo Bond and Estenia Opaque Primer, respectively. All restorations were cemented on the abutments with glass-ionomer cement and then subjected to thermal cycling and cyclic loading. All specimens survived thermal cycling and cyclic loading. The fracture load of the ZIC-P group (2.72 kN) was not significantly different from that of the ZAC group (3.05 kN). The fracture load of the zirconia-based composite-layered restoration primed with Clearfil Photo Bond (ZIC-P) was comparable to that of the zirconia-based all-ceramic restoration (ZAC) after artificial aging.

The dentin-enamel junction and the fracture of human teeth.

PubMed

Imbeni, V; Kruzic, J J; Marshall, G W; Marshall, S J; Ritchie, R O

2005-03-01

The dentin-enamel junction (DEJ), which is the interfacial region between the dentin and outer enamel coating in teeth, is known for its unique biomechanical properties that provide a crack-arrest barrier for flaws formed in the brittle enamel1. In this work, we re-examine how cracks propagate in the proximity of the DEJ, and specifically quantify, using interfacial fracture mechanics, the fracture toughness of the DEJ region. Careful observation of crack penetration through the interface and the new estimate of the DEJ toughness ( approximately 5 to 10 times higher than enamel but approximately 75% lower than dentin) shed new light on the mechanism of crack arrest. We conclude that the critical role of this region, in preventing cracks formed in enamel from traversing the interface and causing catastrophic tooth fractures, is not associated with the crack-arrest capabilities of the interface itself; rather, cracks tend to penetrate the (optical) DEJ and arrest when they enter the tougher mantle dentin adjacent to the interface due to the development of crack-tip shielding from uncracked-ligament bridging.

The dentin-enamel junction and the fracture of human teeth

NASA Astrophysics Data System (ADS)

Imbeni, V.; Kruzic, J. J.; Marshall, G. W.; Marshall, S. J.; Ritchie, R. O.

2005-03-01

The dentin-enamel junction (DEJ), which is the interfacial region between the dentin and outer enamel coating in teeth, is known for its unique biomechanical properties that provide a crack-arrest barrier for flaws formed in the brittle enamel1. In this work, we re-examine how cracks propagate in the proximity of the DEJ, and specifically quantify, using interfacial fracture mechanics, the fracture toughness of the DEJ region. Careful observation of crack penetration through the interface and the new estimate of the DEJ toughness (~5 to 10 times higher than enamel but ~75% lower than dentin) shed new light on the mechanism of crack arrest. We conclude that the critical role of this region, in preventing cracks formed in enamel from traversing the interface and causing catastrophic tooth fractures, is not associated with the crack-arrest capabilities of the interface itself; rather, cracks tend to penetrate the (optical) DEJ and arrest when they enter the tougher mantle dentin adjacent to the interface due to the development of crack-tip shielding from uncracked-ligament bridging.

Fracturing across the multi-scales of diverse materials

PubMed Central

Armstrong, R. W.; Antolovich, S. D.; Griffiths, J. R.; Knott, J. F.

2015-01-01

Everyone has to deal with fracturing of materials at one level or another, beginning from normal household chores and extending to the largest scale of observations reported for catastrophic events occurring on a geological level or even expanded to events in outer space. Such wide perspective is introduced in the current introduction of this theme issue. The follow-on organization of technical articles provides a flavour of the range in size scales at which fracturing occurs in a wide diversity of materials—from ‘fracking’ oil extraction and earth moving to laboratory testing of rock material and extending to the cracking of tooth enamel. Of important scientific interest are observations made and analysed at the smallest dimensions corresponding to the mechanisms by which fracture is either enhanced or hindered by permanent deformation or other processes. Such events are irrevocably linked to the atomic structure in all engineering materials, a sampling of which is presented, including results for crystalline and amorphous materials. Hooray for the broad subject description that is hoped to be appealing to the interested reader. PMID:25713460

Fracture toughness of dentin/resin-composite adhesive interfaces.

PubMed

Tam, L E; Pilliar, R M

1993-05-01

The reliability and validity of tensile and shear bond strength determinations of dentin-bonded interfaces have been questioned. The fracture toughness value (KIC) reflects the ability of a material to resist crack initiation and unstable propagation. When applied to an adhesive interface, it should account for both interfacial bond strength and inherent defects at or near the interface, and should therefore be more appropriate for characterization of interface fracture resistance. This study introduced a fracture toughness test for the assessment of dentin/resin-composite bonded interfaces. The miniature short-rod specimen geometry was used for fracture toughness testing. Each specimen contained a tooth slice, sectioned from a bovine incisor, to form the bonded interface. The fracture toughness of an enamel-bonded interface was assessed in addition to the dentin-bonded interfaces. Tensile bond strength specimens were also prepared from the dentin surfaces of the cut bovine incisors. A minimum of ten specimens was fabricated for each group of materials tested. After the specimens were aged for 24 h in distilled water at 37 degrees C, the specimens were loaded to failure in an Instron universal testing machine. There were significant differences (p < 0.05) between the dental adhesives tested. Generally, both the fracture toughness and tensile bond strength measurements were highest for AllBond 2, intermediate for 3M MultiPurpose, and lowest for Scotchbond 2. Scanning electron microscopy of the fractured specimen halves confirmed that crack propagation occurred along the bond interface during the fracture toughness test. It was therefore concluded that the mini-short-rod fracture toughness test provided a valid method for characterization of the fracture resistance of the dentin-resin composite interface.

Fracture Strength of Endodontically Treated Teeth with Different Access Cavity Designs.

PubMed

Plotino, Gianluca; Grande, Nicola Maria; Isufi, Almira; Ioppolo, Pietro; Pedullà, Eugenio; Bedini, Rossella; Gambarini, Gianluca; Testarelli, Luca

2017-06-01

The purpose of this study was to compare in vitro the fracture strength of root-filled and restored teeth with traditional endodontic cavity (TEC), conservative endodontic cavity (CEC), or ultraconservative "ninja" endodontic cavity (NEC) access. Extracted human intact maxillary and mandibular premolars and molars were selected and assigned to control (intact teeth), TEC, CEC, or NEC groups (n = 10/group/type). Teeth in the TEC group were prepared following the principles of traditional endodontic cavities. Minimal CECs and NECs were plotted on cone-beam computed tomographic images. Then, teeth were endodontically treated and restored. The 160 specimens were then loaded to fracture in a mechanical material testing machine (LR30 K; Lloyd Instruments Ltd, Fareham, UK). The maximum load at fracture and fracture pattern (restorable or unrestorable) were recorded. Fracture loads were compared statistically, and the data were examined with analysis of variance and the Student-Newman-Keuls test for multiple comparisons. The mean load at fracture for TEC was significantly lower than the one for the CEC, NEC, and control groups for all types of teeth (P < .05), whereas no difference was observed among CEC, NEC, and intact teeth (P > .05). Unrestorable fractures were significantly more frequent in the TEC, CEC, and NEC groups than in the control group in each tooth type (P < .05). Teeth with TEC access showed lower fracture strength than the ones prepared with CEC or NEC. Ultraconservative "ninja" endodontic cavity access did not increase the fracture strength of teeth compared with the ones prepared with CEC. Intact teeth showed more restorable fractures than all the prepared ones. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Testing functional and morphological interpretations of enamel thickness along the deciduous tooth row in human children.

PubMed

Mahoney, Patrick

2013-08-01

The significance of a gradient in enamel thickness along the human permanent molar row has been debated in the literature. Some attribute increased enamel thickness from first to third molars to greater bite force during chewing. Others argue that thicker third molar enamel relates to a smaller crown size facilitated by a reduced dentin component. Thus, differences in morphology, not function, explains enamel thickness. This study draws on these different interpretive models to assess enamel thickness along the entire human deciduous tooth row. Average enamel thickness (AET), the area and proportion of crown enamel and dentin, and a crown size proxy are calculated for incisors, canines, and molars. Allometric scaling relationships are assessed within each tooth class, and then comparisons are undertaken along the row. Generally, AET was correlated with crown size and scaled with isometry, except for second molars which scaled with positive allometry. Mean AET increased along the row and was greater on molars, where bite forces are reported to be higher. Second molars combined the largest crown size with the thickest enamel and the smallest proportion of dentin, which is consistent with a reduction in the potential for cusp fracture under high bite forces. Resistance to wear may also account for some enamel thickness variation between tooth classes. Dental reduction did not explain the trend in AET from central to lateral incisors, or from first to second molars. The gradient in AET along the deciduous tooth row is partly consistent with a functional interpretation of enamel thickness. Copyright © 2013 Wiley Periodicals, Inc.

Fracture resistance of pulpless teeth restored with post-cores and crowns.

PubMed

Hayashi, Mikako; Takahashi, Yutaka; Imazato, Satoshi; Ebisu, Shigeyuki

2006-05-01

The present study was designed to test the null hypothesis that there is no difference in the fracture resistance of pulpless teeth restored with different types of post-core systems and full coverage crowns. Extracted human upper premolars were restored with a fiber post, prefabricated metallic post or cast metallic post-core. Teeth with full crown preparations without post-core restorations served as a control. All teeth were restored with full coverage crowns. A 90-degree vertical or 45-degree oblique load was applied to the restored teeth with a crosshead speed of 0.5 mm/min, and the fracture loads and mode of fracture were recorded. Under the condition of vertical loading, the fracture load of teeth restored with the cast metallic post-cores was greatest among the groups (two-factor factorial ANOVA and Scheffe's F test, P<0.05). All fractures in teeth restored with all types of post-core systems propagated in the middle portions of roots, including the apices of the posts. Under the condition of oblique loading, the fracture load of teeth restored with pre-fabricated metallic posts was significantly smaller than that in other groups. Two-thirds of fractures in the fiber post group propagated within the cervical area, while most fractures in other groups extended beyond the middle of the roots. From the results of the present investigations, it was concluded that under the conditions of vertical and oblique loadings, the combination of a fiber post and composite resin core with a full cast crown is most protective of the remaining tooth structure.

Influence of clinical baseline findings on the survival of 2 post systems: a randomized clinical trial.

PubMed

Schmitter, Marc; Rammelsberg, Peter; Gabbert, Olaf; Ohlmann, Brigitte

2007-01-01

The aim of this prospective randomized controlled trial was to evaluate the influence of clinical baseline characteristics on the survival of 2 post systems. One hundred patients needing a post were included. Half the patients received a glass fiber-reinforced post (FRP), and the other half received metal screw posts (MSP). The posts were assigned randomly. In addition to demographic data, the following parameters were recorded: type of tooth (incisor/canine versus molar/premolar), length of the post in relation to root length (percentage), extent of coronal tooth destruction (percentage), ferrule height (in millimeters), type of restoration (fixed or removable partial denture), and presence of antagonistic contacts (yes/no). After at least 1 year (mean: 13.84 months), the patients were recalled. Statistical analysis was performed using the log-rank test and Cox regression analysis. The survival rate of FRPs was 93.5%. In the MSP group, the survival rate was significantly lower (75.6%; log-rank test, P = .049). Additionally, the metal posts were associated with more unfavorable complications, for example, root fracture. The type of the tooth and the degree of coronal tooth destruction influenced the survival of MSPs, whereas no influence of these variables could be seen for FRPs. FRPs are superior to MSPs with respect to short-term clinical performance. Especially for MSPs, clinical survival depends on several variables.

Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year

PubMed Central

GARGARI, M.; PRETE, V.; PUJIA, M.; CERUSO, F. M.

2013-01-01

SUMMARY Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year. Objective The aim of this study is to compare functional efficiency and patients satisfaction between tooth-supported and implant-supported overdenture through a questionnaire that accurately reflects the real concerns of patients with dental prosthesis. Methods Forty-three patients were selected from the out patient clinic, Department of Dentistry “Fra G.B. Orsenigo Ospedale San Pietro F.B.F.”, Rome, Italy. Their age were ranging from 61 to 83 years. Eighteen patients were rehabilitated with overdentures supported by natural teeth and twenty-five with overdentures implant-supported. Discussion and Result The questionnaire proposed one year after the insertion of the prosthetis has showed that there isn’t difference statistically significant in terms of function, phonetics and aesthetics between overdenture implant-supported and tooth-supported. Conclusions The results of the questionnaire showed that the patients generally had a high level of satisfaction concern to the masticatory function, esthetics and phonetics. In addition, on average, they haven’t difficulty in removal and insertion of the denture and in oral hygiene. They haven’t in both groups problems related to fractures. PMID:23741602

Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year.

PubMed

Gargari, M; Prete, V; Pujia, M; Ceruso, F M

2012-10-01

Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year. The aim of this study is to compare functional efficiency and patients satisfaction between tooth-supported and implant-supported overdenture through a questionnaire that accurately reflects the real concerns of patients with dental prosthesis. Forty-three patients were selected from the out patient clinic, Department of Dentistry "Fra G.B. Orsenigo Ospedale San Pietro F.B.F.", Rome, Italy. Their age were ranging from 61 to 83 years. Eighteen patients were rehabilitated with overdentures supported by natural teeth and twenty-five with overdentures implant-supported. DISCUSSION AND RESULT: The questionnaire proposed one year after the insertion of the prosthetis has showed that there isn't difference statistically significant in terms of function, phonetics and aesthetics between overdenture implant-supported and tooth-supported. The results of the questionnaire showed that the patients generally had a high level of satisfaction concern to the masticatory function, esthetics and phonetics. In addition, on average, they haven't difficulty in removal and insertion of the denture and in oral hygiene. They haven't in both groups problems related to fractures.

CAD/CAM ZIRCONIA VS. SLIP-CAST GLASS-INFILTRATED ALUMINA/ZIRCONIA ALL-CERAMIC CROWNS: 2-YEAR RESULTS OF A RANDOMIZED CONTROLLED CLINICAL TRIAL

PubMed Central

Çehreli, Murat Cavit; Kökat, Ali Murat; Akça, Kivanç

2009-01-01

The aim of this randomized controlled clinical trial was to compare the early clinical outcome of slip-cast glass-infiltrated Alumina/Zirconia and CAD/CAM Zirconia all-ceramic crowns. A total of 30 InCeram® Zirconia and Cercon® Zirconia crowns were fabricated and cemented with a glass ionomer cement in 20 patients. At baseline, 6-month, 1-year, and 2-year recall appointments, Californian Dental Association (CDA) quality evaluation system was used to evaluate the prosthetic replacements, and plaque and gingival index scores were used to explore the periodontal outcome of the treatments. No clinical sign of marginal discoloration, persistent pain and secondary caries was detected in any of the restorations. All InCeram® Zirconia crowns survived during the 2-year period, although one nonvital tooth experienced root fracture coupled with the fracture of the veneering porcelain of the restoration. One Cercon® Zirconia restoration fractured and was replaced. According to the CDA criteria, marginal integrity was rated excellent for InCeram® Zirconia (73%) and Cercon® Zirconia (80%) restorations, respectively. Slight color mismatch rate was higher for InCeram® Zirconia restorations (66%) than Cercon® Zirconia (26%) restorations. Plaque and gingival index scores were mostly zero and almost constant over time. Time-dependent changes in plaque and gingival index scores within and between groups were statistically similar (p>0.05). This clinical study demonstrates that single-tooth InCeram® Zirconia and Cercon® Zirconia crowns have comparable early clinical outcome, both seem as acceptable treatment modalities, and most importantly, all-ceramic alumina crowns strengthened by 25% zirconia can sufficiently withstand functional load in the posterior zone. PMID:19148406

Effect of ferrule on the fracture resistance of mandibular premolars with prefabricated posts and cores

PubMed Central

2017-01-01

PURPOSE This study evaluated fracture resistance with regard to ferrule lengths and post reinforcement on endodontically treated mandibular premolars incorporating a prefabricated post and resin core. MATERIALS AND METHODS One hundred extracted mandibular premolars were randomly divided into 5 groups (n=20): intact teeth (NR); endodontically treated teeth (ETT) without post (NP); ETT restored with a prefabricated post with ferrule lengths of either 0 mm (F0), 1 mm (F1), or 2 mm (F2). Prepared teeth were restored with metal crowns. A thermal cycling test was performed for 1,000 cycles. Loading was applied at an angle of 135 degrees to the axis of the tooth using a universal testing machine with a crosshead speed of 2.54 mm/min. Fracture loads were analyzed by one-way ANOVA and Tukey HSD test using a statistical program (α=.05). RESULTS There were statistical differences in fracture loads among groups (P<.001). The fracture load of F2 (237.7 ± 83.4) was significantly higher than those of NP (155.6 ± 74.3 N), F0 (98.8 ± 43.3 N), and F1 (152.8 ± 78.5 N) (P=.011, P<.001, and P=.008, respectively). CONCLUSION Fracture resistance of ETT depends on the length of the ferrule, as shown by the significantly increased fracture resistance in the 2 mm ferrule group (F2) compared to the groups with shorter ferrule lengths (F0, F1) and without post (NP). PMID:29142639

Effect of luting cements on the compressive strength of Turkom-Cera all-ceramic copings.

PubMed

Al-Makramani, Bandar M A; Razak, Abdul A A; Abu-Hassan, Mohamed I

2008-02-01

The objective of this study is to investigate the effect of different luting agents on the fracture strength of Turkom-Cera all-ceramic copings. Standardized metal dies were duplicated from a prepared maxillary first premolar tooth using non-precious metal alloy (Wiron 99). Thirty Turkom-Cera copings of 0.6 mm thickness were then fabricated. Three types of luting agents were used: zinc phosphate cement (Elite), glass-ionomer cement (Fuji I), and a dual-cured composite resin cement (Panavia F). Ten copings were cemented with each type. All copings were cemented to their respective dies according to manufacturer's instructions and received a static load of 5 kg for ten minutes. After 24 hours of storage in distilled water at 37 degrees C, the copings were vertically loaded until fracture using an Instron Universal Testing Machine at a crosshead speed of 1 mm/minute. The mode of fracture was then determined. Statistical analysis carried out using analysis of variance (ANOVA) revealed significant differences in the compressive strength between the three groups (P<0.001). The mean fracture strength (in Newtons) of Turkom-Cera copings cemented with Elite, Fuji I, and Panavia F were 1537.4 N, 1294.4 N, and 2183.6 N, respectively. Luting agents have an influence on the fracture resistance of Turkom-Cera copings.

Mini dental implants retaining mandibular overdentures: A dental practice-based retrospective analysis.

PubMed

Schwindling, Franz Sebastian; Schwindling, Franz-Peter

2016-07-01

The purpose of this study was to assess the survival of mini dental implants (MDI) and to measure prosthetic maintenance needs in a dental practice-based setting. Patients with mandibular removable dentures were provided with MDI to improve denture retention. Complications and maintenance were analyzed by use of patient records and evaluated with Kaplan-Meier curves and the log rank test at a significance level of 0.05. Ninety-nine MDI were placed in 25 patients (mean age: 72 years). Two MDI fractured during placement and eight implants failed during the first weeks. No more implants were lost for up to seven years, resulting in 92% survival. Implant survival differed significantly depending on whether the maxilla was provided with complete dentures (94.9%) or with partial dentures (81%). All prostheses were in use at the time of data extraction. Denture base fractures were observed in six cases, an incidence of fractures of 24%. Some minor intervention was necessary: one resin tooth fractured, retention rings were changed in five cases, and repeated relining was required for 16% of the dentures. After mid-term observation, survival of MDI was good. However, the incidence of denture base fractures and of minor prosthetic complications should not be under-estimated. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Fracture resistance of endodontically treated teeth restored with a bulkfill flowable material and a resin composite

PubMed Central

Isufi, Almira; Plotino, Gianluca; Grande, Nicola Maria; Ioppolo, Pietro; Testarelli, Luca; Bedini, Rossella; Al-Sudani, Dina; Gambarini, Gianluca

2016-01-01

Summary Aim To determine and compare the fracture resistance of endodontically treated teeth restored with a bulk fill flowable material (SDR) and a traditional resin composite. Methods Thirty maxillary and 30 mandibular first molars were selected based on similar dimensions. After cleaning, shaping and filling of the root canals and adhesive procedures, specimens were assigned to 3 subgroups for each tooth type (n=10): Group A: control group, including intact teeth; Group B: access cavities were restored with a traditional resin composite (EsthetX; Dentsply-Italy, Rome, Italy); Group C: access cavities were restored with a bulk fill flowable composite (SDR; Dentsply-Italy), except 1.5 mm layer of the occlusal surface that was restored with the same resin composite as Group B. The specimens were subjected to compressive force in a material static-testing machine until fracture occurred, the maximum fracture load of the specimens was measured (N) and the type of fracture was recorded as favorable or unfavorable. Data were statistically analyzed with one-way analysis of variance (ANOVA) and Bonferroni tests (P<0.05). Results No statistically significant differences were found among groups (P<0.05). Fracture resistance of endodontically treated teeth restored with a traditional resin composite and with a bulk fill flowable composite (SDR) was similar in both maxillary and mandibular molars and showed no significant decrease in fracture resistance compared to intact specimens. Conclusions No significant difference was observed in the mechanical fracture resistance of endodontically treated molars restored with traditional resin composite restorations compared to bulk fill flowable composite restorations. PMID:27486505

Fracture resistance of endodontically treated teeth restored with a bulkfill flowable material and a resin composite.

PubMed

Isufi, Almira; Plotino, Gianluca; Grande, Nicola Maria; Ioppolo, Pietro; Testarelli, Luca; Bedini, Rossella; Al-Sudani, Dina; Gambarini, Gianluca

2016-01-01

To determine and compare the fracture resistance of endodontically treated teeth restored with a bulk fill flowable material (SDR) and a traditional resin composite. Thirty maxillary and 30 mandibular first molars were selected based on similar dimensions. After cleaning, shaping and filling of the root canals and adhesive procedures, specimens were assigned to 3 subgroups for each tooth type (n=10): Group A: control group, including intact teeth; Group B: access cavities were restored with a traditional resin composite (EsthetX; Dentsply-Italy, Rome, Italy); Group C: access cavities were restored with a bulk fill flowable composite (SDR; Dentsply-Italy), except 1.5 mm layer of the occlusal surface that was restored with the same resin composite as Group B. The specimens were subjected to compressive force in a material static-testing machine until fracture occurred, the maximum fracture load of the specimens was measured (N) and the type of fracture was recorded as favorable or unfavorable. Data were statistically analyzed with one-way analysis of variance (ANOVA) and Bonferroni tests (P<0.05). No statistically significant differences were found among groups (P<0.05). Fracture resistance of endodontically treated teeth restored with a traditional resin composite and with a bulk fill flowable composite (SDR) was similar in both maxillary and mandibular molars and showed no significant decrease in fracture resistance compared to intact specimens. No significant difference was observed in the mechanical fracture resistance of endodontically treated molars restored with traditional resin composite restorations compared to bulk fill flowable composite restorations.

Dental abrasion as a cutting process.

PubMed

Lucas, Peter W; Wagner, Mark; Al-Fadhalah, Khaled; Almusallam, Abdulwahab S; Michael, Shaji; Thai, Lidia A; Strait, David S; Swain, Michael V; van Casteren, Adam; Renno, Waleed M; Shekeban, Ali; Philip, Swapna M; Saji, Sreeja; Atkins, Anthony G

2016-06-06

A mammalian tooth is abraded when a sliding contact between a particle and the tooth surface leads to an immediate loss of tooth tissue. Over time, these contacts can lead to wear serious enough to impair the oral processing of food. Both anatomical and physiological mechanisms have evolved in mammals to try to prevent wear, indicating its evolutionary importance, but it is still an established survival threat. Here we consider that many wear marks result from a cutting action whereby the contacting tip(s) of such wear particles acts akin to a tool tip. Recent theoretical developments show that it is possible to estimate the toughness of abraded materials via cutting tests. Here, we report experiments intended to establish the wear resistance of enamel in terms of its toughness and how friction varies. Imaging via atomic force microscopy (AFM) was used to assess the damage involved. Damage ranged from pure plastic deformation to fracture with and without lateral microcracks. Grooves cut with a Berkovich diamond were the most consistent, suggesting that the toughness of enamel in cutting is 244 J m(-2), which is very high. Friction was higher in the presence of a polyphenolic compound, indicating that this could increase wear potential.

Knowledge, attitude and practice in emergency management of dental injury among physical education teachers: a survey in Bangalore urban schools.

PubMed

Mohandas, U; Chandan, G D

2009-01-01

The purpose of this study was to assess, by means of a self administered structured questionnaire, the level of Knowledge, Attitude and Practice of physical education teachers in Bangalore city with regards to emergency management of dental injuries. The questionnaire surveyed the physical education teacher's background, knowledge of management of tooth fracture, avulsion, luxation injuries, it also investigated physical education teacher's attitude and the way they handle the injuries. The sample consisted 580 teachers from 700 selected schools in Bangalore city. Chi-square test was applied to test the significance between trained and untrained teachers. Among the population 70% were males physical education teachers 30% were females. 95% of the teachers had physical education training and 5% did not have the training. 95% of the population had first aid component and 5% did not have. Only 25% of trained physical education teachers had correct knowledge about tooth identification and 17% among untrained teachers. 81% of trained teachers answered correctly regarding management of fractured anterior teeth against 27.5% of untrained teachers (P< 0.0002). The present report indicates that there is lack of knowledge and practice among physical education teachers in Bangalore city regarding emergency management of dental trauma. Educational programs to improve the knowledge and awareness among the teachers have to be implemented.

Surface modulation of dental hard tissues

NASA Astrophysics Data System (ADS)

Tantbirojn, Daranee

Tooth surfaces play a central role in the equilibrium of dental hard tissues, in which contrasting processes lead to loss or deposition of materials. The central interest of this Thesis was the modulation of tooth surfaces to control such equilibrium. Four specific studies were carried out to investigate different classes of surface modulating agents. These are: (1) Ionic modulation of the enamel surface to enhance stain removal . Dental stain is the most apparent form of tooth surface deposit. The nature of extrinsic stain in terms of spatial chemical composition was studied by using electron probe microanalysis. An ionic surface modulating agent, sodium tripolyphosphate (STPP), was evaluated. Image analysis methodologies were developed and the ability of STPP in stain removal was proved. (2) Thin film modulation with substantive polymeric coating and the effect on in vitro enamel de/re-mineralization . A novel polymeric coating that formed a thin film on the tooth surface was investigated for its inhibitory effect on artificial enamel caries, without interfering with the remineralization process. The preventive effect was distinct, but the mineral redeposition was questionable. (3) Thick film modulation with fluoride containing sealants and the effect on in vitro enamel and root caries development. Fluoride incorporated into resin material is an example of combining different classes of surface modulating agents to achieve an optimal outcome. A proper combination, such as in resin modified glass ionomer, showed in vitro caries inhibitory effect beyond the material boundary in both enamel and dentin. (4) Thick film modulation with dental adhesives and the determination of adhesion to dentin. Dentin adhesives modulate intracoronal tooth surfaces by enhancing adhesion to restorative materials. Conventional nominal bond tests were inadequate to determine the performance of current high strength adhesives. It was shown that interfacial fracture toughness test was more appropriate. In general, this Thesis evaluates diverse tooth surface modulations, for which several experimental methodologies had to be developed. These will be invaluable for the development of succeeding generations of surface modulating agents.

Modeling and monitoring of tooth fillet crack growth in dynamic simulation of spur gear set

NASA Astrophysics Data System (ADS)

Guilbault, Raynald; Lalonde, Sébastien; Thomas, Marc

2015-05-01

This study integrates a linear elastic fracture mechanics analysis of the tooth fillet crack propagation into a nonlinear dynamic model of spur gear sets. An original formulation establishes the rigidity of sound and damaged teeth. The formula incorporates the contribution of the flexible gear body and real crack trajectories in the fillet zone. The work also develops a KI prediction formula. A validation of the equation estimates shows that the predicted KI are in close agreement with published numerical and experimental values. The representation also relies on the Paris-Erdogan equation completed with crack closure effects. The analysis considers that during dN fatigue cycles, a harmonic mean of ΔK assures optimal evaluations. The paper evaluates the influence of the mesh frequency distance from the resonances of the system. The obtained results indicate that while the dependence may demonstrate obvious nonlinearities, the crack progression rate increases with a mesh frequency augmentation. The study develops a tooth fillet crack propagation detection procedure based on residual signals (RS) prepared in the frequency domain. The proposed approach accepts any gear conditions as reference signature. The standard deviation and mean values of the RS are evaluated as gear condition descriptors. A trend tracking of their responses obtained from a moving linear regression completes the analysis. Globally, the results show that, regardless of the reference signal, both descriptors are sensitive to the tooth fillet crack and sharply react to tooth breakage. On average, the mean value detected the crack propagation after a size increase of 3.69 percent as compared to the reference condition, whereas the standard deviation required crack progressions of 12.24 percent. Moreover, the mean descriptor shows evolutions closer to the crack size progression.

In-vitro performance and fracture strength of thin monolithic zirconia crowns

PubMed Central

Weigl, Paul; Wu, Yanyun; Felber, Roland; Lauer, Hans-Christoph

2018-01-01

PURPOSE All-ceramic restorations required extensive tooth preparation. The purpose of this in vitro study was to investigate a minimally invasive preparation and thickness of monolithic zirconia crowns, which would provide sufficient mechanical endurance and strength. MATERIALS AND METHODS Crowns with thickness of 0.2 mm (group 0.2, n=32) or of 0.5 mm (group 0.5, n=32) were milled from zirconia and fixed with resin-based adhesives (groups 0.2A, 0.5A) or zinc phosphate cements (groups 0.2C, 0.5C). Half of the samples in each subgroup (n=8) underwent thermal cycling and mechanical loading (TCML)(TC: 5℃ and 55℃, 2×3,000 cycles, 2 min/cycle; ML: 50 N, 1.2×106 cycles), while the other samples were stored in water (37℃/24 h). Survival rates were compared (Kaplan-Maier). The specimens surviving TCML were loaded to fracture and the maximal fracture force was determined (ANOVA; Bonferroni; α=.05). The fracture mode was analyzed. RESULTS In both 0.5 groups, all crowns survived TCML, and the comparison of fracture strength among crowns with and without TCML showed no significant difference (P=.628). Four crowns in group 0.2A and all of the crowns in group 0.2C failed during TCML. The fracture strength after 24 hours of the cemented 0.2 mm-thick crowns was significantly lower than that of adhesive bonded crowns. All cemented crowns provided fracture in the crown, while about 80% of the adhesively bonded crowns fractured through crown and die. CONCLUSION 0.5 mm thick monolithic crowns possessed sufficient strength to endure physiologic performance, regardless of the type of cementation. Fracture strength of the 0.2 mm cemented crowns was too low for clinical application. PMID:29713427

Evaluation of the fracture resistance of computer-aided design/computer-aided manufacturing monolithic crowns prepared in different cement thicknesses.

PubMed

Sagsoz, N Polat; Yanıkoglu, N

2018-04-01

The purpose of this study was to evaluate the fracture resistance of monolithic computer-aided design/computer-aided manufacturing (CAD/CAM) crowns that are prepared with different cement thickness. For this investigation, a human maxillary premolar tooth was selected. Master model preparation was performed with a demand bur under water spray. Master die was taken to fabricate 105 epoxy resin replicas. The crowns were milled using a CEREC 4 CAD/CAM system (Software Version, 4.2.0.57192). CAD/CAM crowns were made using resin nanoceramic, feldspathic glass ceramic, lithium disilicate, and leucite-reinforced ceramics. Each group was subdivided into three groups in accordance with three different cement thicknesses (30, 90, and 150 μm). Crowns milled out. Then RelyX ™ U200 was used as a luting agent to bond the crowns to the prepared samples. After one hour cementations, the specimens were stored in water bath at 37°C for 1 week before testing. Seven unprepared and unrestored teeth were kept and tested as a control group. A universal test machine was used to assume the fracture resistance of all specimens. The compressive load (N) that caused fracture was recorded for each specimen. Fracture resistance data were statistically analyzed by one-way ANOVA and two-factor interaction modeling test (α = 0.001). There are statistically significant differences between fracture resistances of CAD/CAM monolithic crown materials (P < 0.001). It is seen that cement thickness is not statistically significant for fracture resistance of CAD/CAM monolithic crowns (P > 0.001). CAD/CAM monolithic crown materials affected fracture resistance. Cement thickness (30, 90, and 150 μm) was not effective on fracture resistance of CAD/CAM monolithic crowns.

Immediate, non-submerged, root-analogue zirconia implant in single tooth replacement.

PubMed

Pirker, W; Kocher, A

2008-03-01

This report demonstrates the successful clinical use of a modified root-analogue zirconia implant for immediate single tooth replacement. A right maxillary premolar was removed and a custom-made, root-analogue, roughened zirconia implant with macro-retentions in the interdental space was fabricated and placed into the extraction socket 4 days later. Four months after root implantation a composite crown was cemented. No complications occurred during the healing period. An excellent esthetic and functional result was achieved with the composite crown. No clinically noticeable bone resorption or soft-tissue recession was observed at 26 months follow up. Significant modifications such as macro-retentions seem to indicate that primary stability and excellent osseointegration of immediate root-analogue zirconia implants can be achieved, while preventing unesthetic bone resorption. The macro-retentions must be limited to the interdental space to avoid fracture of the thin buccal cortex. This successful case warrants further clinical research in well controlled trials.

Near-IR imaging of cracks in teeth

NASA Astrophysics Data System (ADS)

Fried, William A.; Simon, Jacob C.; Lucas, Seth; Chan, Kenneth H.; Darling, Cynthia L.; Staninec, Michal; Fried, Daniel

2014-02-01

Dental enamel is highly transparent at near-IR wavelengths and several studies have shown that these wavelengths are well suited for optical transillumination for the detection and imaging of tooth decay. We hypothesize that these wavelengths are also well suited for imaging cracks in teeth. Extracted teeth with suspected cracks were imaged at several wavelengths in the near-IR from 1300-1700-nm. Extracted teeth were also examined with optical coherence tomography to confirm the existence of suspected cracks. Several teeth of volunteers were also imaged in vivo at 1300-nm to demonstrate clinical potential. In addition we induced cracks in teeth using a carbon dioxide laser and imaged crack formation and propagation in real time using near-IR transillumination. Cracks were clearly visible using near-IR imaging at 1300-nm in both in vitro and in vivo images. Cracks and fractures also interfered with light propagation in the tooth aiding in crack identification and assessment of depth and severity.

A case series associated with different kinds of endo-perio lesions.

PubMed

Aksel, Hacer; Serper, Ahmet

2014-02-01

Pulpal and periodontal problems are responsible for more than half of the tooth mortality. There are some articles published in the literature about this issue. Many of them are quite old. There has been also lack of knowledge about the effect of endodontic treatment on the periodontal tissue healing and suitable treatment interval between endodontic and periodontal treatments. In this case report, different kinds of endo-perio lesion were treated with sequential endodontic and periodontal treatment. The follow-up radiographs showed complete healing of the hard and soft tissue lesions. The tooth with endo-perio lesions should be evaluated thoroughly in terms of any cracks and fracture, especially furcation areas for a long term prognosis. In this case report, it was showed that 3 months treatment intervals between endodontic treatment and periodontal surgery has no harmful effect on periodontal tissue healing. Key words:Endo-perio lesion, furcation, mandibular molar, bone graft, crack line, treatment interval.

Adult stem cell-based apexogenesis

PubMed Central

Li, Yao; Shu, Li-Hong; Yan, Ming; Dai, Wen-Yong; Li, Jun-Jun; Zhang, Guang-Dong; Yu, Jin-Hua

2014-01-01

Generally, the dental pulp needs to be removed when it is infected, and root canal therapy (RCT) is usually required in which infected dental pulp is replaced with inorganic materials (paste and gutta percha). This treatment approach ultimately brings about a dead tooth. However, pulp vitality is extremely important to the tooth itself, since it provides nutrition and acts as a biosensor to detect the potential pathogenic stimuli. Despite the reported clinical success rate, RCT-treated teeth are destined to be devitalized, brittle and susceptible to postoperative fracture. Recently, the advances and achievements in the field of stem cell biology and regenerative medicine have inspired novel biological approaches to apexogenesis in young patients suffering from pulpitis or periapical periodontitis. This review mainly focuses on the benchtop and clinical regeneration of root apex mediated by adult stem cells. Moreover, current strategies for infected pulp therapy are also discussed here. PMID:25332909

A simplified technique of orthograde MTA obturation on the elected canals of posterior teeth: Two case reports.

PubMed

Wahengbam, Brucelee; Wahengbam, Pragya; Tikku, Aseem Prakash

2014-01-01

This article suggests a simplified technique of orthograde MTA obturation in less accessible canal(s) of posteriors teeth without using costly ultrasonics or specialised carrier. Essentially few finger pluggers, absorbent points and a simple canal projection method were used. The orifice(s) of the elected canal(s) to be obturated with MTA were projected onto the external occlusal surface for easy delivery and predictive instrumentation. The idea was based on 'easy access', 'working one canal with one mix at one time', 'thorough condensation' and 'removal of excess moisture'. In case I, palatal canal of tooth no. 2 with gross apical perforation and suspected VRF was obturated with MTA. And in Case II, tooth no. 19 presented with incomplete furcal fracture extending into the canal was obturated with MTA in all 3 canals unitarily. Dense homogenous MTA obturation was achieved and both cases healed uneventfully.

Sleep bruxism: Current knowledge and contemporary management

PubMed Central

Yap, Adrian U.; Chua, Ai Ping

2016-01-01

Bruxism is defined as the repetitive jaw muscle activity characterized by the clenching or grinding of teeth. It can be categorized into awake and sleep bruxism (SB). Frequent SB occurs in about 13% of adults. The exact etiology of SB is still unknown and probably multifactorial in nature. Current literature suggests that SB is regulated centrally (pathophysiological and psychosocial factors) and not peripherally (morphological factors). Cited consequences of SB include temporomandibular disorders, headaches, tooth wear/fracture, implant, and other restoration failure. Chairside recognition of SB involves the use of subjective reports, clinical examinations, and trial oral splints. Definitive diagnosis of SB can only be achieved using electrophysiological tools. Pharmacological, psychological, and dental strategies had been employed to manage SB. There is at present, no effective treatment that “cures” or “stops” SB permanently. Management is usually directed toward tooth/restoration protection, reduction of bruxism activity, and pain relief. PMID:27656052

Vibration Signature Analysis of a Faulted Gear Transmission System

NASA Technical Reports Server (NTRS)

Choy, F. K.; Huang, S.; Zakrajsek, J. J.; Handschuh, R. F.; Townsend, D. P.

1994-01-01

A comprehensive procedure in predicting faults in gear transmission systems under normal operating conditions is presented. Experimental data was obtained from a spiral bevel gear fatigue test rig at NASA Lewis Research Center. Time synchronous averaged vibration data was recorded throughout the test as the fault progressed from a small single pit to severe pitting over several teeth, and finally tooth fracture. A numerical procedure based on the Winger-Ville distribution was used to examine the time averaged vibration data. Results from the Wigner-Ville procedure are compared to results from a variety of signal analysis techniques which include time domain analysis methods and frequency analysis methods. Using photographs of the gear tooth at various stages of damage, the limitations and accuracy of the various techniques are compared and discussed. Conclusions are drawn from the comparison of the different approaches as well as the applicability of the Wigner-Ville method in predicting gear faults.

Comparison of fracture resistance and fracture characterization of bilayered zirconia/fluorapatite and monolithic lithium disilicate all ceramic crowns.

PubMed

Altamimi, Abdulaziz M; Tripodakis, Aris Petros; Eliades, George; Hirayama, Hiroshi

2014-01-01

To compare the fracture resistance between bilayered zirconia/ fluorapatite and monolithic lithium disilicate heat-pressed crowns and characterize the mode of fracture failure. Thirty crown samples were sequentially fitted on a mandibular right first molar metal replica of an ivory prepared molar tooth. The crown specimens were divided in three groups (A, B, and C; n = 10 for each group). Group A consisted of bilayered zirconia/fluorhapatite pressed-over crowns with standard design crown copings (0.7 mm uniform thickness), Group B of bilayered zirconia/fluorhapatite with anatomical design crown copings, and Group C of lithium disilicate monolithic crowns. The samples were then dynamically loaded under water for 100,000 cycles with a profile of 250 N maximum load at 1,000 N/s rate and 2.0 Hz frequency. Loading was performed with a steel ball (5 mm in diameter) coming into contact with the test crown, loading to maximum, holding for 0.2 s, unloading and lifting off 0.5 mm. The samples were then fractured under static loading, in order to determine the ultimate crown strength. Analysis of the recorded fracture load values was carried out with one-way analysis of variance (ANOVA) followed by Tukey tests. Fractured specimens were examined by stereomicroscopy and scanning electron microscopy. The fracture loads measured were (N, means and standard deviations): Group A: 561.87 (72.63), Group B: 1,014.16 (70.18) and Group C: 1,360.63 (77.95). All mean differences were statistically significant (P < 0.001). Catastrophic fractures occurred in Group C, whereas mainly veneer fractures were observed in Groups A and B. In the present study, the heat-pressed monolithic lithium-disilicate crowns showed more fracture resistance than zirconia/fluorapatite pressed-over crowns. Within the bilayered groups, the anatomical zirconia coping design presented increased ceramic fracture resistance.

Surface Fatigue Life of High Temperature Gear Materials

NASA Technical Reports Server (NTRS)

Townsend, Dennis P.

1994-01-01

Three high temperature gear materials were evaluated using spur gear surface fatigue tests. These materials were, VASCO max 350, VASCO matrix 2, and nitralloy N and were evaluated for possible use in high temperature gear applications. The fatigue life of the three high temperature gear materials were compared with the life of the standard AISI 9310 aircraft gear material. Surface fatigue tests were conducted at a lubricant inlet temperature of 321 K (120 F), a lubricant outlet temperature of 350 K (170 F), a maximum Hertz stress of 1.71 GPa (248 ksi), a speed of 10,000 rpm, and with a synthetic paraffinic lubricant. The life of the nitralloy N was approximately the same as the AISI 9310, the life of the VASCO max 350 was much less than the AISI 9310 while the life of the VASCO matrix 2 was several times the life of the AISI 9310. The VASCO max 350 also showed very low fracture toughness with approximately half of the gears failed by tooth fracture through the fatigue spall. The VASCO matrix 2 had approximately 10-percent fracture failure through the fatigue spalls indicating moderate to good fracture toughness.

Hollow Abutment Screw Design for Easy Retrieval in Case of Screw Fracture in Dental Implant System.

PubMed

Sim, Bo Kyun; Kim, Bongju; Kim, Min Jeong; Jeong, Guk Hyun; Ju, Kyung Won; Shin, Yoo Jin; Kim, Man Yong; Lee, Jong-Ho

2017-01-01

The prosthetic component of dental implant is attached on the abutment which is connected to the fixture with an abutment screw. The abutment screw fracture is not frequent; however, the retrieval of the fractured screw is not easy, and it poses complications. A retrieval kit was developed which utilizes screw removal drills to make a hole on the fractured screw that provides an engaging drill to unscrew it. To minimize this process, the abutment screw is modified with a prefabricated access hole for easy retrieval. This study aimed to introduce this modified design of the abutment screw, the concept of easy retrieval, and to compare the mechanical strengths of the conventional and hollow abutment screws by finite element analysis (FEA) and mechanical test. In the FEA results, both types of abutment screws showed similar stress distribution in the single artificial tooth system. A maximum load difference of about 2% occurred in the vertical load by a mechanical test. This study showed that the hollow abutment screw may be an alternative to the conventional abutment screws because this is designed for easy retrieval and that both abutment screws showed no significant difference in the mechanical tests and in the FEA.

The importance of cone-beam computed tomography in the management of endodontic problems: a review of the literature.

PubMed

Venskutonis, Tadas; Plotino, Gianluca; Juodzbalys, Gintaras; Mickevičienė, Lina

2014-12-01

To obtain essential information in clinical endodontics, cone-beam computed tomographic (CBCT) imaging can be used in all phases of treatment including diagnosis, treatment planning, during the treatment phase, and through post-treatment assessment and follow-up. The purpose of this article was to review the use of CBCT imaging in the diagnosis, treatment planning, and assessing the outcome of endodontic complications. Literature was selected through a search of PubMed electronic databases for the following keywords: tooth root injuries, tooth root radiography, tooth root perforation, tomography, cone-beam computed tomography, endodontic complications, tooth root internal/external resorption, root fractures, and broken instruments. The research was restricted to articles published in English. One hundred twelve articles met the inclusion criteria and were included in this review. Currently, intraoral radiography is the imaging technique of choice for the management of endodontic disease, but CBCT imaging appears to have a superior validity and reliability in the management of endodontic diagnosis and complications. Endodontic cases should be judged individually, and CBCT imaging should be considered in situations in which information from conventional imaging systems may not yield an adequate amount of information to allow the appropriate management of endodontic problems. CBCT imaging has the potential to become the first choice for endodontic treatment planning and outcome assessment, especially when new scanners with lower radiation doses will be available. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Dental and Temporomandibular Joint Pathology of the Polar Bear (Ursus maritimus).

PubMed

Winer, J N; Arzi, B; Leale, D M; Kass, P H; Verstraete, F J M

2016-01-01

Museum specimens (maxillae and/or mandibles) from 317 polar bears (Ursus maritimus) were examined macroscopically according to predefined criteria and 249 specimens were included in this study. The specimens were acquired between 1906 and 2011. There were 126 specimens (50.6%) from male animals, 93 (37.3%) from female animals and 30 (12.1%) from animals of unknown sex. The ages of the animals ranged from neonate to adult, with 125 adults (50.2%) and 124 young adults (49.8%) included and neonates/juveniles excluded from the study. The number of teeth available for examination was 7,638 (73.5%); 12.3% of teeth were absent artefactually, 0.8% were deemed absent due to acquired tooth loss and 13.4% were absent congenitally. With respect to tooth morphology, 20 teeth (0.26% of available teeth) in 18 specimens (7.2% of available specimens) were small vestigial structures with crowns that were flush with the level of surrounding alveolar bone. One supernumerary tooth and one tooth with enamel hypoplasia were encountered. Persistent deciduous teeth and teeth with an aberrant number of roots were not found. Relatively few teeth (3.7%) displayed attrition/abrasion, 90% of which were the maxillary and mandibular incisor teeth, in 41 polar bears (16.5%). Nearly twice as many adult specimens exhibited attrition/abrasion as those from young adults; significantly more males were affected than females. Dental fractures were noted in 52 polar bears, affecting 20.9% of specimens and 1.3% of the total number of teeth present. More adult polar bears had dental fractures than young adults. There were 21 specimens (8.4%) that displayed overt periapical disease, affecting a total of 24 dental alveoli (0.23%). Some degree of periodontitis was seen in 199 specimens (79.9%); however, only 12.6% of dental alveoli had bony changes indicative of periodontitis. Lesions consistent with temporomandibular joint osteoarthritis (TMJ-OA) were found in 23 specimens (9.2%). TMJ-OA was significantly more common in adults than in young adults and in males than in females. Although the clinical significance of dental and TMJ pathology in the polar bear remains elusive, the occurrence and severity of these lesions may play an important role in the morbidity and mortality of this species. Copyright © 2016 Elsevier Ltd. All rights reserved.

Initial versus final fracture of metal-free crowns, analyzed via acoustic emission.

PubMed

Ereifej, Nadia; Silikas, Nick; Watts, David C

2008-09-01

To discriminate between initial and final fracture failure loads of four metal-free crown systems by the conjoint detection of acoustic emission signals during compressive loading. Teeth were prepared and used for crown construction with four crown systems; Vita Mark II (VM II) (Vita Zahnfabrik), IPS e.max Ceram/CAD (CAD) (Ivoclar-Vivadent), IPS e.max Ceram/ZirCAD (ZirCAD) (Ivoclar-Vivadent) and BelleGlass/EverStick (BGES) (Kerr/Stick Tech Ltd.). All samples were loaded in compression via a Co/Cr maxillary first molar tooth at 0.2mm/min and released acoustic signals were collected and analyzed. A minimum number of 15 crowns per group were loaded to final failure and values of loading at initial and final fracture were compared. Additional four samples per group were loaded till fracture initiation and were fractographically examined under the optical microscope. A lower threshold of 50dB was selected to exclude spurious background signals. Initial fracture forces were significantly lower than those of final fracture (p<0.05) in all groups and initial failure AE amplitudes were lower than those of final fracture. Mean initial fracture force of ZirCAD samples (1029.1N) was higher than those of VMII (744.4N), CAD (808.8 N) and BGES (979.7 N). Final fracture of ZirCAD also occurred at significantly higher force values (2091.7 N) than the rest of the groups; VMII (1120.9 N), CAD (1468.9 N) and BGES (1576.6 N). Significantly higher values of initial failure AE amplitude were found in VMII than CAD and BGES while those of final fracture were similar. All crowns observed under the microscope at initial fracture had signs of failure. Whereas the metal-free crowns examined showed significant variations in final failure loads, acoustic emission data showed that they all manifested initial failures at significantly lower load values.

Comparison of the load at fracture of Turkom-Cera to Procera AllCeram and In-Ceram all-ceramic restorations.

PubMed

AL-Makramani, Bandar M A; Razak, Abdul A A; Abu-Hassan, Mohamed I

2009-08-01

This study investigated the occlusal fracture resistance of Turkom-Cerafused alumina compared to Procera AllCeram and In-Ceram all-ceramic restorations. Sixmaster dies were duplicated from the prepared maxillary first premolar tooth using nonprecious metal alloy (Wiron 99). Ten copings of 0.6 mm thickness were fabricated from each type of ceramic, for a total of thirty copings. Two master dies were used for each group, and each of them was used to lute five copings. All groups were cemented with resin luting cement Panavia F according to manufacturer's instructions and received a static load of 5 kg during cementation. After 24 hours of distilled water storage at 37 degrees C, the copings were vertically compressed using a universal testing machine at a crosshead speed of 1 mm/min. The results of the present study showed the following mean loads at fracture: Turkom-Cera (2184 +/- 164 N), In-Ceram (2042 +/- 200 N), and Procera AllCeram (1954 +/- 211 N). ANOVA and Scheffe's post hoc test showed that the mean load at fracture of Turkom-Cera was significantly different from Procera AllCeram (p < 0.05). Scheffe's post hoc test showed no significant difference between the mean load at fracture of Turkom-Cera and In-Ceram or between the mean load at fracture of In-Ceram and Procera AllCeram. Because Turkom-Cera demonstrated equal to or higher loads at fracture than currently accepted all-ceramic materials, it would seem to be acceptable for fabrication of anterior and posterior ceramic crowns.

THE IMPORTANCE OF MICROSTRUCTURAL VARIATIONS ON THE FRACTURE TOUGHNESS OF HUMAN DENTIN

PubMed Central

Ivancik, J.; Arola, D.

2012-01-01

The crack growth resistance of human dentin was characterized as a function of relative distance from the DEJ and the corresponding microstructure. Compact tension specimens were prepared from the coronal dentin of caries-free 3rd molars. The specimens were sectioned from either the outer, middle or inner dentin. Stable crack extension was achieved under Mode I quasi-static loading, with the crack oriented in-plane with the tubules, and the crack growth resistance was characterized in terms of the initiation (Ko), growth (Kg) and plateau (Kp) toughness. A hybrid approach was also used to quantify the contribution of dominant mechanisms to the overall toughness. Results showed that human dentin exhibits increasing crack growth resistance with crack extension in all regions, and that the fracture toughness of inner dentin (2.2±0.5 MPa•m0.5) was significantly lower than that of middle (2.7±0.2 MPa•m0.5) and outer regions (3.4±0.3 MPa•m0.5). Extrinsic toughening, composed mostly of crack bridging, was estimated to cause an average increase in the fracture energy of 26% in all three regions. Based on these findings, dental restorations extended into deep dentin are much more likely to cause tooth fracture due to the greater potential for introduction of flaws and decrease in fracture toughness with depth. PMID:23131531

Performance of an artificial neural network for vertical root fracture detection: an ex vivo study.

PubMed

Kositbowornchai, Suwadee; Plermkamon, Supattra; Tangkosol, Tawan

2013-04-01

To develop an artificial neural network for vertical root fracture detection. A probabilistic neural network design was used to clarify whether a tooth root was sound or had a vertical root fracture. Two hundred images (50 sound and 150 vertical root fractures) derived from digital radiography--used to train and test the artificial neural network--were divided into three groups according to the number of training and test data sets: 80/120,105/95 and 130/70, respectively. Either training or tested data were evaluated using grey-scale data per line passing through the root. These data were normalized to reduce the grey-scale variance and fed as input data of the neural network. The variance of function in recognition data was calculated between 0 and 1 to select the best performance of neural network. The performance of the neural network was evaluated using a diagnostic test. After testing data under several variances of function, we found the highest sensitivity (98%), specificity (90.5%) and accuracy (95.7%) occurred in Group three, for which the variance of function in recognition data was between 0.025 and 0.005. The neural network designed in this study has sufficient sensitivity, specificity and accuracy to be a model for vertical root fracture detection. © 2012 John Wiley & Sons A/S.

Mechanical properties and ultrastructural characteristics of a glass fiber-reinforced composite.

PubMed

García Barbero, Alvaro Enrique; Vera González, Vicente; García Barbero, Ernesto; Aliaga Vera, Ignacio

2015-06-01

To examine the ultrastructural characteristics of a fiber-reinforced composite (FRC) and its behavior in vitro as a framework for fixed partial dentures (FPDs). A total of 40 specimens were prepared using extracted teeth fixed in methacrylate blocks as supports for the FPD, then the specimens were divided into four groups depending on whether a retaining box was used to fix the FPD to the support teeth, and on whether a composite pontic was assembled on top of the fibers. Fracture testing was performed in a universal testing machine (1 mm/minute). Fracture strength values and failure types were statistically compared for each group. Using retaining boxes did not improve the mechanical behavior of the restorative system. The weakest element of the system was the composite tooth constructed on top of the FRC.

Optimization of Tube Current in Cone-beam Computed Tomography for the Detection of Vertical Root Fractures with Different Intracanal Materials.

PubMed

Gaêta-Araujo, Hugo; Silva de Souza, Gabriela Queiroz; Freitas, Deborah Queiroz; de Oliveira-Santos, Christiano

2017-10-01

There is no consensus about the accuracy of cone-beam computed tomography (CBCT) for detecting vertical root fractures (VRFs), nor is there certainty about the isolated effect of different tube current parameters on the diagnosis of VRF through CBCT scans. This study aimed to evaluate how tube current affects the detection of VRF on CBCT examinations in the absence of intracanal materials and in the presence of gutta-percha (GP) and metal (MP) or fiberglass (FP) intracanal posts. The sample consisted of 320 CBCT scans of tooth roots with and without VRF divided into 8 groups: no fracture/no intracanal material; no fracture + GP; no fracture + MP; no fracture + FP; fracture/no intracanal material; fracture + GP; fracture + MP; fracture + FP. The scans were acquired with an OP300 unit using 4 different milliamperes (4 mA, 8 mA, 10 mA, 13 mA). Five oral radiologists analyzed the images. The area under the receiver operating characteristic curve (Az), sensitivity, specificity, positive and negative predictive values, and interobserver agreement were calculated. Diagnostic performance for the different milliamperes tested was similar for teeth without root filling materials or with FP. Teeth with GP and MP showed the highest Az values for 8 mA and 10 mA, respectively. For teeth with MP, specificity was significantly higher when 10 mA was used. For teeth without root filling materials or with FP, the use of a reduced milliampere does not seem to influence the detection of VRF in a significant manner. For teeth with GP and MP, an increased milliampere may lead to increased diagnostic performance. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Fracture strength and fatigue resistance of all-ceramic molar crowns manufactured with CAD/CAM technology.

PubMed

Zahran, Mohammed; El-Mowafy, Omar; Tam, Laura; Watson, Philip A; Finer, Yoav

2008-07-01

All-ceramic crowns are subject to fracture during function, especially in the posterior area. The use of yttrium-stabilized zirconium-oxide ceramic as a substructure for all-ceramic crowns to improve fracture resistance is unproven. The aim of this study was to compare fracture strength and fatigue resistance of new zirconium-oxide and feldspathic all-ceramic crowns made with computer-aided design/computer-aided manufacturing (CAD/CAM). An ivorine molar was prepared to receive an all-ceramic crown. Using epoxy resin, 40 replication dies were made of the prepared tooth. Twenty feldspathic all-ceramic crowns (Vita Mark II) (VMII) and 20 zirconium-oxide crown copings (In-Ceram YZ) (YZ) were made using CAD/CAM technique (CEREC-3D). The YZ copings were sintered and veneered manually with a fine-particle ceramic (VM9). All crowns were cemented to their respective dies using resin cement (Panavia F 2.0). Ten crowns in each group were subjected to compressive fatigue loading in a universal testing machine (instron). The other ten crowns from each group were loaded to fracture at a crosshead speed of 1 mm/min. Data were statistically analyzed using independent t-test and Fisher's exact test at alpha= 0.05. There was a significant difference between the survival rates of the two materials during the fatigue test (p < 0.001). All VMII crowns survived without any crack formation, while all YZ crowns fractured (40%) or developed cracks (60%). All the YZ crown fractures occurred within the veneering layer during the fatigue test. There was no significant difference in mean fracture load between the two materials (p= 0.268). Mean fracture loads (standard deviation) in N were: 1459 (492) for YZ crowns and 1272 (109) for VMII crowns. The performance of VMII crowns was superior to YZ crowns in the fatigue test. The premature fractures and cracks of the YZ crowns were attributed to weakness in the YZ veneer layer or in the core/veneer bond.

Effect of retained fractured instruments on tooth resistance to vertical fracture with or without attempt at removal.

PubMed

Madarati, A A; Qualtrough, A J E; Watts, D C

2010-11-01

To investigate the effect of retained fractured endodontic instruments on root strength and to evaluate the effectiveness of several root filling materials in reinforcing roots that had undergone unsuccessful attempt at removal of fractured instruments. Seventy five mandibular premolar roots were divided into five groups. In group A (control), canals were prepared to a size F5-ProTaper instrument and filled with gutta-percha and TubliSeal sealer fragments. In the experimental groups (B, C, D and E), 4 mm of F5-ProTaper instruments were fractured in the apical one-third of the canal and then treated as follows: in group B, the fragments were left in situ without attempt at removal, and canals were filled with gutta-percha and TubliSeal sealer (GP No Removal). In groups C, D and E, an attempt at removal of the fragment was simulated by preparing a staging platform coronal to the fragment using modified Gates Glidden burs (No 2-5). Canals in group C were filled with gutta-percha and TubliSeal sealer (GP Removal), group D filled with Resilon (Resilon Removal) and group E with mineral trioxide aggregate (MTA Removal). Roots then underwent vertical fracture. Data were analysed using the one-way anova at P<0.05. Roots in the GP Removal group had significantly lower values for mean force for fracture (404.9 N). There was no significant difference between the control group and GP No Removal (765.2 and 707.8, respectively). Resilon Removal and MTA Removal groups (577.3 and 566.6 N) were not significantly different from the GP No Removal group. Leaving fractured instruments in the apical one-third of the canal does not appear to affect the resistance of the root to vertical fracture; Resilon and MTA appear to compensate for root dentine loss that occurred as a consequence of attempts at retrieval of fractured instruments when used as canal filling materials. © 2010 International Endodontic Journal.

Autotransplantation of mature and immature third molars in 23 Chinese patients: a clinical and radiological follow-up study.

PubMed

Tang, Haozhe; Shen, Zhengyan; Hou, Minhong; Wu, Ligeng

2017-12-28

We investigated the clinical and radiographic outcomes of autotransplanted teeth over a follow-up period of 2 to 8 years, and summarize the findings of other relevant studies with regard to the primary factors that influence a good prognosis in such patients. Twenty-three patients (6 men, 17 women) who attended Tanggu Stomatological Hospital, Tianjin, China, from 2008 through 2013, were included in the study. These patients presented with a variety of dental problems, including tooth loss, residual crowns, missing first or second molars, dental trauma, tooth fracture, and unrestored teeth. A total of 26 third molars, including 2 immature molars, were autotransplanted in these patients. The success rate of autotransplantation was assessed on the basis of clinical and radiographic outcomes after follow-up periods ranging from 2 to 8 years. Clinical examination revealed stability of all 26 transplanted teeth, with satisfactory masticatory function and no patient discomfort. Radiographic examination revealed normal periapical tissues and an intact lamina dura surrounding the tooth root, indicating adequate healing of periodontal tissues. Autotransplantation achieved good results in the Chinese sample population investigated, and was associated with an excellent prognosis. Rigorous case selection, adequate protection of the periodontal ligament, and proper oral hygiene contribute significantly to the long-term success of the procedure.

First Aid Management in Emergency Care of Dental Injuries – Knowledge among Teachers in Rijeka, Croatia

PubMed

Bakarčić, Danko; Hrvatin, Sandra; Maroević, Mia; Ivančić Jokić, Nataša

2017-03-01

The aim of the present cross-sectional study was to investigate the knowledge and attitude regarding emergency treatment of dental trauma among elementary school teachers in the city of Rijeka, Croatia. A total of 144 teachers answered a four-part questionnaire which comprised questions regarding demographic data, role and responsibility at the working place, knowledge about dental trauma, and motivation for further education on the topic. Nearly half of the participants (47.2%) reported having seen at least one dental trauma in their professional careers. They chose to contact the child’s parent first (54.1%) and only 11.1% chose to contact a dentist instead. The majority of teachers (81.9%) were not aware of the meaning of the term avulsio dentis. As to treatment of avulsed tooth, 17.3% of teachers knew the appropriate management, while 14% of them would not even touch it. With regard to transport of avulsed tooth or fractured tooth fragments, only 2% responded correctly. The majority of the responders (87.5%) had never been educated about dental trauma, but were willing to be informed through lectures (53.4%), basic life support courses (15.2%) and brochures (9.7%). Planning teachers’ education through advanced training on the topic is suggested to be part of teachers’ lifetime education.

Osteo-odonto-keratoprosthesis surgery: a combined ocular-oral procedure for ocular blindness.

PubMed

Tay, A B G; Tan, D T H; Lye, K W; Theng, J; Parthasarathy, A; Por, Y-M

2007-09-01

The aim of this retrospective study was to describe the oral procedures used in osteo-odonto-keratoprosthesis (OOKP) surgery, and the demographics and oral findings of candidate patients in Singapore. The OOKP procedure utilizes an autologous tooth-bone complex to mount a poly-methylmethacrylate optical cylinder, as an artificial cornea, stabilized by an overlying autologous buccal mucosal graft. Consecutive patients referred over 3 years for dental evaluation prior to OOKP surgery were included. A total of 21 patients underwent oral clinical and radiographic evaluation. The aetiology of blindness included Stevens-Johnson's syndrome (11 cases), chemical burns (9 cases) and multiple failed corneal grafts (1 case). Evaluation revealed that 12 patients were suitable for OOKP surgery, 8 were at risk of complication or failure and 1 had no usable teeth. Fourteen patients have undergone unilateral OOKP Stage 1 surgery successfully. Complications included fracture of a tooth from its lingual bone necessitating the harvesting of a second tooth (1 case), oronasal perforation (1 case), exposure of adjacent roots (5 teeth), lower lip paresthesia (2 cases) and submucosal scar band formation in the buccal mucosal graft donor site (10 cases). Thirteen patients have completed Stage 2 surgery, with attainment of their best possible visual potential following OOKP surgery.

A solution to the worn tooth conundrum in primate functional anatomy

PubMed Central

Ungar, Peter S.; M'Kirera, Francis

2003-01-01

Worn teeth are a bane to paleobiologists interested in the diets of human ancestors and other fossil primates. Although worn teeth dominate fossil assemblages, their shapes are usually not used to reconstruct the diets of extinct species. The problem is that traditional studies of primate dental functional anatomy have focused on unworn morphology. This has limited most functional analyses to only a few well-represented fossil species. This paper introduces a method to characterize and compare worn occlusal morphology in primates using laser scanning and geographic information systems technologies. A study of variably worn chimpanzee and gorilla molars indicates that differences between these species in tooth shape remain consistent at given stages of wear. Although cusp slope decreases with wear in both taxa, angularity values remain unchanged. These results indicate that African ape teeth wear in a manner that keeps them mechanically efficient for fracturing specific foods. Studies of changes in tooth shape with wear add a new dimension to dental functional anatomy, and offer a more complete picture of dental-dietary adaptations. Also, given how rare unworn teeth are in the fossil record, the ability to include worn specimens in analyses opens the door to reconstructing the diets of many more extinct primate groups, allowing us to better understand the adaptive radiation of our order. PMID:12634426

Growth of second stage mineral in Lytechinus variegatus.

PubMed

Stock, S R; Seto, Jong; Deymier, A C; Rack, A; Veis, A

2017-10-30

Purpose and Aims: Sea urchin teeth consist of calcite and form in two stages with different magnesium contents. The first stage structures of independently formed plates and needle-prisms define the shape of the tooth, and the columns of the second stage mineral cements the first stage structures together and control the fracture behavior of the mature tooth. This study investigates the nucleation and growth of the second stage mineral. Scanning electron microscopy (SEM) and synchrotron microComputed Tomography characterized the structures of the second phase material found in developing of Lytechinus variegatus teeth. Although the column development is a continuous process, defining four phases of column formation captures the changes that occur in teeth of L. variegatus. The earliest phase consists of small 1-2 µm diameter hemispheres, and the second of 5-10 µm diameter, mound-like structures with a nodular surface, develops from the hemispheres. The mounds eventually bridge the syncytium between adjacent plates and form hyperboloid structures (phase three) that appear like mesas when plates separate during the fracture. The mesa diameter increases with time until the column diameter is significantly larger than its height, defining the fourth phase of column development. Energy dispersive x-ray spectroscopy confirms that the columns contain more magnesium than the underlying plates; the ratios of magnesium to calcium are consistent with compositions derived from x-ray diffraction. Columns grow from both bounding plates. The presence of first phase columns interspersed among third stage mesas indicates very localized control of mineralization.

Ceramic and polymeric dental onlays evaluated by photo-elasticity, optical coherence tomography, and micro-computed tomography

NASA Astrophysics Data System (ADS)

Sinescu, Cosmin; Negrutiu, Meda; Topala, Florin; Ionita, Ciprian; Negru, Radu; Fabriky, Mihai; Marcauteanu, Corina; Bradu, Adrian; Dobre, George; Marsavina, Liviu; Rominu, Mihai; Podoleanu, Adrian

2011-10-01

Dental onlays are restorations used to repair rear teeth that have a mild to moderate amount of decay. They can also be used to restore teeth that are cracked or fractured if the damage is not severe enough to require a dental crown. The use of onlays requires less tooth reduction than does the use of metal fillings. This allows dentists to conserve more of a patient's natural tooth structure in the treatment process. The aims of this study are to evaluate the biomechanical comportment of the dental onlays, by using the 3D photo elasticity method and to investigate the integrity of the structures and their fitting to the dental support. For this optical coherence tomography and micro-computed tomography were employed. Both methods were used to investigate 37 dental onlays, 17 integral polymeric and 20 integral ceramic. The results permit to observe materials defects inside the ceramic or polymeric onlays situate in the biomechanically tensioned areas that could lead to fracture of the prosthetic structure. Marginal fitting problems of the onlays related to the teeth preparations were presented in order to observe the possibility of secondary cavities. The resulted images from the optical coherence tomography were verified by the micro-computed tomography. In conclusion, the optical coherence tomography can be used as a clinical method in order to evaluate the integrity of the dental ceramic and polymeric onlays and to investigate the quality of the marginal fitting to the teeth preparations.

Orthograde endodontic retreatment of teeth with individual cast posts: report of two cases.

PubMed

Ramić, Bojana; Stojanac, Igor; Premović, Milica; Drobac, Milan; Petrović, Ljubomir

2012-01-01

The failure of primary endodontic treatment is manifested by various clinical symptoms following endodontic therapy or, more frequently, by the development of chronic inflammatory process in the apex region without any subjective symptoms. In case of unfavorable outcome of the primary endodontic treatment, orthograde endodontic retreatment is the method of choice for a prolonged therapy. Two female patients, 47 and 44 years old, were presented at the Dental Clinic of Vojvodina for endodontic retreatment of teeth 22, 23 and 13, within the repeated prosthetic restoration. Intraradicular individual cast posts were removed using ultrasonic instruments. Remains of gutta-percha were removed by engine driven rotary re-treatment files, root canals were shaped and cleaned using the crown-down technique, and obturated with gutta-percha and epoxy-resin-based sealer using the lateral compaction technique. When there are metal posts or broken instruments in the root canal, the use of ultrasonic instruments is considered a safe method characterized by negligible tooth substance loss and minimal root damage causing fractures and perforations, and the entire procedure is effective and predictable. Non-surgical orthograde endodontic retreatment, when properly performed in accessible and penetrable root canals, achieves a high cure rate, good and lasting results and eliminates the need for radical procedures, such as apical surgery or tooth extraction. When nonsurgical endodontic retreatment is done, treated teeth must be restored by full coronal coverage as soon as possible, to prevent coronal leakage or fracture.

The role of volume of multi-surface restorations in posterior teeth: Treatment options.

PubMed

Janus, Charles; Sbeih, Izzat; Best, Al M

2011-01-01

Teeth containing large defective restorations are frequently indicated to receive crowns to prevent catastrophic fracture. There is a considerable lack of consensus as to when the size of an existing restoration needing retreatment is sufficiently large to warrant a crown. In addition, the treating dentist's gender, age, and location also have been found to influence this decision. An in vitro method was developed to estimate a restoration's volume proportion (VP). This study validates and investigates correlations between the restoration's VP, the decision to indicate a crown, and the responding dentist's demographic information. The coronal portions of occlusal view and bitewing radiographic images of restored posterior teeth were traced to yield four surface areas used in estimating the restoration's VP. An online survey of 15 patients, including intraoral and radiographic images of defective restorations, was created. Dentists were invited to select treatment for each patient's tooth, with options including replacing the restoration only or indicating a crown. Analysis was accomplished using repeated-measures logistic regression. Of the 300 respondents, 17% were female and 14% were from outside the U.S. The relationship between a responding dentist indicating a crown and the restoration's VP, the tooth type (molar or premolar), and nationality (U.S. or foreign dentist) were all deemed statistically significant. Crowns were indicated for molars significantly more often than for premolars, with a significant VP interaction. The final model of tooth, VP, nationality, and the interaction of tooth and VP was used to generate mean predicted proportions for indicating a crown.

Tunnel restorations using glass ionomer or glass cermet: in vitro marginal ridge fracture and microleakage.

PubMed

Shetty, R; Munshi, A K

1996-01-01

The purpose of this in vitro study was to compare the marginal ridge fracture resistance and microleakage following restorations of partial tunnel preparations using glass ionomer and glass cermet cements. Sixty eight sound premolars were selected for this study and were divided randomly into six groups. A standardized partial tunnel preparation was done on all the teeth except specimens belonging to Group I. The partial tunnel preparations of Groups III & V were restored with glass ionomer and that of Groups IV & VI were restored with glass cermet. The teeth belonging to Groups I, II, III & IV were subjected to marginal ridge fracture resistance testing. The teeth of Groups V & VI were tested for microleakage after immersing them in 5% methylene blue solution for 4 hours. The results indicated that the teeth restored with glass cermet were marginally better than that with glass ionomer in terms of marginal ridge fracture resistance. Both the materials failed to reinforce the marginal ridge to the level of an intact tooth. The microleakage which occurred around both the materials were statistically insignificant, but on comparison glass ionomer showed better results. Hence, glass ionomer is preferred as a restorative material for partial tunnel preparations because of additional inherent advantages like superior esthetics and fluoride leachability.

On the Importance of Aging to the Crack Growth Resistance of Human Enamel

PubMed Central

Yahyazadehfar, Mobin; Zhang, Dongsheng; Arola, Dwayne

2016-01-01

With improvements in oral health and an overall increase in quality of life, the percentage of fully or largely dentate seniors is increasing. Understanding the effects of aging on the mechanical properties of teeth is essential to the maintenance of lifelong oral health. In this investigation the effects of aging on the fracture toughness of human enamel were evaluated from incremental crack growth experiments performed on tissue of donor teeth representing “young” (17≤ age ≤ 25) and “old” (age ≥ 55) age groups. Results showed that the old enamel exhibited significantly lower resistance to fracture than that of the young tissue in two orthogonal directions of crack growth. For crack growth transverse to the enamel rods, the fracture toughness of the old enamel (0.37±0.15 MPa•m0.5) was nearly 70% lower than that of tissue from the young teeth (1.23±0.20 MPa•m0.5). Based on results from a mechanistic analysis of crack growth, the reduction in fracture resistance is attributed to a decreased in the degree of extrinsic toughening. The practice of restorative dentistry should account for these changes in tooth tissues in the treatment of senior patients. PMID:26747980

Hollow Abutment Screw Design for Easy Retrieval in Case of Screw Fracture in Dental Implant System

PubMed Central

Kim, Bongju; Shin, Yoo Jin

2017-01-01

The prosthetic component of dental implant is attached on the abutment which is connected to the fixture with an abutment screw. The abutment screw fracture is not frequent; however, the retrieval of the fractured screw is not easy, and it poses complications. A retrieval kit was developed which utilizes screw removal drills to make a hole on the fractured screw that provides an engaging drill to unscrew it. To minimize this process, the abutment screw is modified with a prefabricated access hole for easy retrieval. This study aimed to introduce this modified design of the abutment screw, the concept of easy retrieval, and to compare the mechanical strengths of the conventional and hollow abutment screws by finite element analysis (FEA) and mechanical test. In the FEA results, both types of abutment screws showed similar stress distribution in the single artificial tooth system. A maximum load difference of about 2% occurred in the vertical load by a mechanical test. This study showed that the hollow abutment screw may be an alternative to the conventional abutment screws because this is designed for easy retrieval and that both abutment screws showed no significant difference in the mechanical tests and in the FEA. PMID:29065610

The effect of aging on the fracture toughness of esthetic restorative materials.

PubMed

Bagheri, Rafat; Azar, Mohammad R; Tyas, Martin J; Burrow, Michael F

2010-06-01

To compare the fracture toughness (KIc) of tooth-colored restorative materials based on a four-point bending; to assess the effect of distilled water and a resin surface sealant (G-Coat Plus) on the resistance of the materials to fracture. Specimens were prepared from six materials: Quix Fil; Dyract (Dentsply), Freedom (SDI), Fuji VII (GC), Fuji IX (GC); Fuji II LC (GC). Fuji II LC and Fuji IX were tested both with and without applying G-Coat Plus (GC). The specimens were divided into the three groups which were conditioned in distilled water at 37 degrees C for 48 hours, 4 and 8 weeks. The specimens were loaded in a four-point bending test using a universal testing machine. The maximum load to specimen failure was recorded and the fracture toughness calculated. There were significant differences among most of the materials (P < 0.001). Quix Fil had the highest mean KIc value and Fuji VII the lowest. Immersion in distilled water for the resin composite and polyacid-modified resin composites caused a significant decrease in KIc as the time interval increased. For glass-ionomer cements, KIc decreased significantly after 4 weeks, and after 8 weeks immersion slightly increased. G-Coat Plus affected Fuji II LC positively while it had no effect on the Fuji IX.

An In Vitro Study on the Effects of Post-Core Design and Ferrule on the Fracture Resistance of Endodontically Treated Maxillary Central Incisors.

PubMed

Sreedevi, S; Sanjeev, R; Raghavan, Rekha; Abraham, Anna; Rajamani, T; Govind, Girish Kumar

2015-08-01

Endodontically treated teeth have significantly different physical and mechanical properties compared to vital teeth and are more prone to fracture. The study aims to compare the fracture resistance of endodontically treated teeth with and without post reinforcement, custom cast post-core and prefabricated post with glass ionomer core and to evaluate the ferrule effect on endodontically treated teeth restored with custom cast post-core. A total of 40 human maxillary central incisors with similar dimensions devoid of any root caries, restorations, previous endodontic treatment or cracks were selected from a collection of stored extracted teeth. An initial silicone index of each tooth was made. They were treated endodontically and divided into four groups of ten specimens each. Their apical seal was maintained with 4 mm of gutta-percha. Root canal preparation was done and then post core fabrication was done. The prepared specimens were subjected to load testing using a computer coordinated UTM. The fracture load results were then statistically analyzed. One-way ANOVA was followed by paired t-test. 1. Reinforcement of endodontically treated maxillary central incisors with post and core, improved their fracture resistance to be at par with that of endodontically treated maxillary central incisor, with natural crown. 2. The fracture resistance of endodontically treated maxillary central incisors is significantly increased when restored with custom cast post-core and 2 mm ferrule. With 2 mm ferrule, teeth restored with custom cast post-core had a significantly higher fracture resistance than teeth restored with custom cast post-core or prefabricated post and glass ionomer core without ferrule.

A fractographic study of clinically retrieved zirconia-ceramic and metal-ceramic fixed dental prostheses.

PubMed

Pang, Zhen; Chughtai, Asima; Sailer, Irena; Zhang, Yu

2015-10-01

A recent 3-year randomized controlled trial (RCT) of tooth supported three- to five-unit zirconia-ceramic and metal-ceramic posterior fixed dental prostheses (FDPs) revealed that veneer chipping and fracture in zirconia-ceramic systems occurred more frequently than those in metal-ceramic systems [1]. This study seeks to elucidate the underlying mechanisms responsible for the fracture phenomena observed in this RCT using a descriptive fractographic analysis. Vinyl-polysiloxane impressions of 12 zirconia-ceramic and 6 metal-ceramic FDPs with veneer fractures were taken from the patients at the end of a mean observation of 40.3±2.8 months. Epoxy replicas were produced from these impressions [1]. All replicas were gold coated, and inspected under the optical microscope and scanning electron microscope (SEM) for descriptive fractography. Among the 12 zirconia-ceramic FDPs, 2 had small chippings, 9 had large chippings, and 1 exhibited delamination. Out of 6 metal-ceramic FDPs, 5 had small chippings and 1 had large chipping. Descriptive fractographic analysis based on SEM observations revealed that fracture initiated from the wear facet at the occlusal surface in all cases, irrespective of the type of restoration. Zirconia-ceramic and metal-ceramic FDPs all fractured from microcracks that emanated from occlusal wear facets. The relatively low fracture toughness and high residual tensile stress in porcelain veneer of zirconia restorations may contribute to the higher chipping rate and larger chip size in zirconia-ceramic FDPs relative to their metal-ceramic counterparts. The low veneer/core interfacial fracture energy of porcelain-veneered zirconia may result in the occurrence of delamination in zirconia-ceramic FDPs. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

A fractographic study of clinically retrieved zirconia–ceramic and metal–ceramic fixed dental prostheses

PubMed Central

Pang, Zhen; Chughtai, Asima; Sailer, Irena; Zhang, Yu

2015-01-01

Objectives A recent 3-year randomized controlled trial (RCT) of tooth supported three- to five-unit zirconia–ceramic and metal–ceramic posterior fixed dental prostheses (FDPs) revealed that veneer chipping and fracture in zirconia–ceramic systems occurred more frequently than those in metal–ceramic systems [1]. This study seeks to elucidate the underlying mechanisms responsible for the fracture phenomena observed in this RCT using a descriptive fractographic analysis. Methods Vinyl-polysiloxane impressions of 12 zirconia–ceramic and 6 metal–ceramic FDPs with veneer fractures were taken from the patients at the end of a mean observation of 40.3 ± 2.8 months. Epoxy replicas were produced from these impressions [1]. All replicas were gold coated, and inspected under the optical microscope and scanning electron microscope (SEM) for descriptive fractography. Results Among the 12 zirconia–ceramic FDPs, 2 had small chippings, 9 had large chippings, and 1 exhibited delamination. Out of 6 metal–ceramic FDPs, 5 had small chippings and 1 had large chipping. Descriptive fractographic analysis based on SEM observations revealed that fracture initiated from the wear facet at the occlusal surface in all cases, irrespective of the type of restoration. Significance Zirconia–ceramic and metal–ceramic FDPs all fractured from microcracks that emanated from occlusal wear facets. The relatively low fracture toughness and high residual tensile stress in porcelain veneer of zirconia restorations may contribute to the higher chipping rate and larger chip size in zirconia–ceramic FDPs relative to their metal–ceramic counterparts. The low veneer/core interfacial fracture energy of porcelain-veneered zirconia may result in the occurrence of delamination in zirconia–ceramic FDPs. PMID:26233469

Comparative Evaluation of Fracture Strength of Different Types of Composite Core Build-up Materials: An in vitro Study.

PubMed

Gowda, Srinivasa; Quadras, Dilip D; Sesappa, Shetty R; Maiya, G R Ramakrishna; Kumar, Lalit; Kulkarni, Dinraj; Mishra, Nitu

2018-05-01

The aim of the study was to evaluate the fracture strength of three types of composite core build-up materials. The objectives were to study and evaluate the fracture strength and type of fracture in composite core build-up in restoration of endodonti-cally treated teeth with or without a prefabricated metallic post. A total of 60 freshly extracted mandibular premolars free of caries, cracks, or fractures were end-odontically treated and restored with composite core build-up with prefabricated metallic posts cemented with resin luting cement (group I) and without a post (group II). This was followed by a core build-up of 10 teeth each with three different types of composite materials: Hybrid composite, nanocomposite, and ormocer respectively. The samples were mounted on polyvinyl chloride block and then loaded in the universal load frame at 90° to the long axis of tooth. The fracture strength of the samples was directly obtained from the load indicator attached to the universal load frame. Analysis of variance (ANOVA) test revealed that teeth restored with post exhibited highest fracture strength (1552.32 N) and teeth restored without post exhibited lowest fracture strength (232.20 N). Bonferroni's test revealed that values for hybrid composite (Z-100, 3M ESPE) with post, nanocomposite (Z-350, 3M ESPE) with post, ormocer composite (Admira-VOCO) with post, and nanocomposite (Z-350, 3M ESPE) without post were not significantly different from each other. Teeth restored with post and core using hybrid composite yielded the highest values for fracture strength. Teeth restored with ormocer core without post exhibited the lowest values. Teeth restored with nanocomposite core without post exhibited strength that was comparable with hybrid composite core but higher than that of ormocer. Mutilated endodontically treated teeth can be prosthetically rehabilitated successfully by using adhesive composite core build-up along with post to meet anatomical, functional, and esthetic demands.

The cell biology and role of resorptive cells in diseases: A review.

PubMed

Babaji, Prashant; Devanna, Raghu; Jagtap, Kiran; Chaurasia, Vishwajit Rampratap; Jerry, Jeethu John; Choudhury, Basanta Kumar; Duhan, Dinesh

2017-01-01

Resorptive cells are responsible for the resorption of mineralized matrix of hard tissues. Bone-resorbing cells are called osteoclasts; however, they can resorb mineralized dental tissues or calcified cartilage and then they are called odontoclasts and chondroclasts, respectively. Resorptive cells form when mononuclear precursors derived from a monocyte-macrophage cell lineage are attracted to certain mineralized surfaces and subsequently fuse and adhere onto them for exerting their resorbing activity. These cells are responsible for degradation of calcified extracellular matrix composed of organic molecules and hydroxyapatite. The activity of these cells can be observed in both physiological and pathological processes throughout life and their activity is mainly required in bone turnover and growth, spontaneous and induced (orthodontic) tooth movement, tooth eruption, and bone fracture healing, as well as in pathological conditions such as osteoporosis, osteoarthritis, and bone metastasis. In addition, they are responsible for daily control of calcium homeostasis. Clastic cells also resorb the primary teeth for shedding before the permanent teeth erupt into the oral cavity.

A case series associated with different kinds of endo-perio lesions

PubMed Central

Serper, Ahmet

2014-01-01

Pulpal and periodontal problems are responsible for more than half of the tooth mortality. There are some articles published in the literature about this issue. Many of them are quite old. There has been also lack of knowledge about the effect of endodontic treatment on the periodontal tissue healing and suitable treatment interval between endodontic and periodontal treatments. In this case report, different kinds of endo-perio lesion were treated with sequential endodontic and periodontal treatment. The follow-up radiographs showed complete healing of the hard and soft tissue lesions. The tooth with endo-perio lesions should be evaluated thoroughly in terms of any cracks and fracture, especially furcation areas for a long term prognosis. In this case report, it was showed that 3 months treatment intervals between endodontic treatment and periodontal surgery has no harmful effect on periodontal tissue healing. Key words:Endo-perio lesion, furcation, mandibular molar, bone graft, crack line, treatment interval. PMID:24596642

Investigation on wear characteristic of biopolymer gear

NASA Astrophysics Data System (ADS)

Ghazali, Wafiuddin Bin Md; Daing Idris, Daing Mohamad Nafiz Bin; Sofian, Azizul Helmi Bin; Basrawi, Mohamad Firdaus bin; Khalil Ibrahim, Thamir

2017-10-01

Polymer is widely used in many mechanical components such as gear. With the world going to a more green and sustainable environment, polymers which are bio based are being recognized as a replacement for conventional polymers based on fossil fuel. The use of biopolymer in mechanical components especially gear have not been fully explored yet. This research focuses on biopolymer for spur gear and whether the conventional method to investigate wear characteristic is applicable. The spur gears are produced by injection moulding and tested on several speeds using a custom test equipment. The wear formation such as tooth fracture, tooth deformation, debris and weight loss was observed on the biopolymer spur gear. It was noted that the biopolymer gear wear mechanism was similar with other type of polymer spur gears. It also undergoes stages of wear which are; running in, linear and rapid. It can be said that the wear mechanism of biopolymer spur gear is comparable to fossil fuel based polymer spur gear, thus it can be considered to replace polymer gears in suitable applications.

Modified Y-TZP Core Design Improves All-ceramic Crown Reliability

PubMed Central

Silva, N.R.F.A.; Bonfante, E.A.; Rafferty, B.T.; Zavanelli, R.A.; Rekow, E.D.; Thompson, V.P.; Coelho, P.G.

2011-01-01

This study tested the hypothesis that all-ceramic core-veneer system crown reliability is improved by modification of the core design. We modeled a tooth preparation by reducing the height of proximal walls by 1.5 mm and the occlusal surface by 2.0 mm. The CAD-based tooth preparation was replicated and positioned in a dental articulator for core and veneer fabrication. Standard (0.5 mm uniform thickness) and modified (2.5 mm height lingual and proximal cervical areas) core designs were produced, followed by the application of veneer porcelain for a total thickness of 1.5 mm. The crowns were cemented to 30-day-aged composite dies and were either single-load-to-failure or step-stress-accelerated fatigue-tested. Use of level probability plots showed significantly higher reliability for the modified core design group. The fatigue fracture modes were veneer chipping not exposing the core for the standard group, and exposing the veneer core interface for the modified group. PMID:21057036

The pattern of toothwear amongst 12-18-year-old students in a Nigerian population.

PubMed

Ogunyinka, A; Dosumu, O O; Otuyemi, O D

2001-06-01

The purpose of this study was to investigate the pattern of toothwear in the permanent teeth of 12-18-year-old Nigerian students. The study group comprised 176 individuals (67 males and 109 females) who had no carious cavity, restoration or fracture on any of their permanent teeth. Within the group, 86% had tooth surface loss that was limited to enamel and dentine. No statistically significant differences were observed between the sexes. The most commonly affected tooth was the lower first molar, while the occlusal surface was the most frequently involved. One student had toothwear with a predominantly erosive component as a result of frequent ingestion of low pH drinks, while another displayed toothbrush abrasion. Of those with toothwear, two (13.4%) had parafunctional activities. The cause of toothwear in 73.2% of the study population could not be ascertained. Some of it may be connected with the coarse, abrasive diets that many of the students admitted to consuming on a regular basis.

Dental fragment embedded in the lower lip after facial trauma: Brief review literature and report of a case

PubMed Central

Lauritano, Dorina; Petruzzi, Massimo; Sacco, Gerardo; Campus, Guglielmo; Carinci, Francesco; Milillo, Lucio

2012-01-01

Upper incisors are the most frequently involved teeth in traumatic dental injuries. Soft tissues (lips and/or oral mucosa) adjacent to incisal edge can receive direct and/or indirect traumas. Laceration of the lower lip is a not rare eventuality and teeth fragments could be embedded in labial soft tissue. The reattachment of these fragments, if possible, is the elective treatment choice, thanks to the modern adhesive and restorative techniques. The authors present a case of a white Caucasian 10-year-old child, who attended the dental clinic for the treatment of both upper central incisors’ crown fractures. The fragment of the left incisor was retrieved embedded in the lower lip. It was successfully surgically removed and reattached using a composite adhesive technique. A careful clinical and radiographic examination with the surgical removal of tooth fragments could prevent undesirable foreign body reaction, infection and scarring. The authors also reviewed the most relevant literature concerning tooth fragment reattachment after removal from oral soft tissues. PMID:23814592

Fiber-reinforced resin coating for endocrown preparations: a technical report.

PubMed

Rocca, G T; Rizcalla, N; Krejci, I

2013-01-01

Coronal rehabilitation of endodontically treated posterior teeth is still a controversial issue. Although the use of classical crowns supported by radicular metal posts remains widespread in dentistry, their invasiveness has been largely criticized. New materials and therapeutic options based entirely on adhesion are available nowadays, from direct composite resins to indirect endocrowns. They allow for a more conservative, faster, and less expensive dental treatment. However, the absence of a metal or high-strength ceramic substructure as in full-crown restorations can expose this kind of restoration to a higher risk of irreversible fracture in case of crack propagation. The aim of this case report is to present a technique to reinforce the cavity of an endodontically treated tooth by incorporating a fiber-reinforced composite (FRC) layer into the resin coating of the tooth preparation, before the final impressions of the cavity. This technique allows the use of FRCs in combination with any kind of restorative material for an adhesive overlay/endocrown.

A review of engineered zirconia surfaces in biomedical applications

PubMed Central

Yin, Ling; Nakanishi, Yoshitaka; Alao, Abdur-Rasheed; Song, Xiao-Fei; Abduo, Jaafar; Zhang, Yu

2017-01-01

Zirconia is widely used for load-bearing functional structures in medicine and dentistry. The quality of engineered zirconia surfaces determines not only the fracture and fatigue behaviour but also the low temperature degradation (ageing sensitivity), bacterial colonization and bonding strength of zirconia devices. This paper reviews the current manufacturing techniques for fabrication of zirconia surfaces in biomedical applications, particularly, in tooth and joint replacements, and influences of the zirconia surface quality on their functional behaviours. It discusses emerging manufacturing techniques and challenges for fabrication of zirconia surfaces in biomedical applications. PMID:29130030

Optimizing pediatric interdental fixation by use of a paramedian palatal fixation site.

PubMed

McNichols, Colton H; Hatef, Daniel A; Cole, Patrick D; Hollier, Larry H

2012-03-01

Condylar fractures are the most common injury seen in pediatric mandibular trauma. These injuries often cannot be adequately stabilized by conservative techniques such as splinting. The pediatric condyle fracture often requires a period of intermaxillary fixation. Because of the characteristics of the developing dentition, circumdental wiring is often not possible. Surgeons commonly achieve interdental stabilization by the connection of a circum-mandibular wire and a second wire placed through a drill hole in the piriform aperture. This method can be problematic in the young patient whose palatal suture is still patent. In this brief technical note, the use of a paramedian drill hole through the palate posterior to the maxillary incisors is described. It is believed that this method is superior to other techniques because it avoids injury to the deciduous tooth buds and allows for the maxillary wire to be seated in more structurally sound tissues.

A short-term clinical evaluation of IPS Empress 2 crowns.

PubMed

Toksavul, Suna; Toman, Muhittin

2007-01-01

The aim of this study was to evaluate the clinical performance of all-ceramic crowns made with the IPS Empress 2 system after an observation period of 12 to 60 months. Seventy-nine IPS Empress 2 crowns were placed in 21 patients. The all-ceramic crowns were evaluated clinically, radiographically, and using clinical photographs. The evaluations took place at baseline (2 days after cementation) and at 6-month intervals for 12 to 60 months. Survival rate of the crowns was determined using Kaplan-Meier statistical analysis. Based on the US Public Health Service criteria, 95.24% of the crowns were rated satisfactory after a mean follow-up period of 58 months. Fracture was registered in only 1 crown. One endodontically treated tooth failed as a result of fracture at the cervical margin area. In this in vivo study, IPS Empress 2 crowns exhibited a satisfactory clinical performance during an observation period ranging from 12 to 60 months.

Effects of the Ratio between Pigment and Bleaching Gel on the Fracture Resistance and Dentin Microhardness of endodontically treated Teeth.

PubMed

Galloza, Marina Og; Jordão-Basso, Keren Cf; Bandeca, Matheus C; Costa, Samuel O; Borges, Alvaro H; Tonetto, Mateus R; Tirintan, Fabio C; Keine, Kátia C; Kuga, Milton C

2017-11-01

The aim of this study was to evaluate the effects of bleaching gel using 35% hydrogen peroxide (HP), associated with red carmine pigment (RC), in the 3:1 or 1:1 ratio, on fracture resistance and dentin microhardness of endodontically treated teeth. A total of 40 lower incisors were endodontically treated and divided into four groups (n = 10), according to the bleaching protocol: G1 (HP3), 35% HP + RC (3:1); G2 (HP1), 35% HP + RC (1:1); G3 (positive), 38% HP; and G4 (negative), unbleached. Four dental bleaching sessions were performed. The dental crowns were restored after the last session and submitted to the fracture resistance test. Totally, 60 specimens from the endodontically treated lower incisor crowns were prepared to evaluate the effects on dentin microhardness. The analysis was measured (in Knoop) prior to and after the last dental bleaching session using similar bleaching protocols. G2 presented the lowest fracture resistance (p < 0.05). The other groups were similar to each other (p > 0.05). No difference was observed in the reduction of dentin microhardness among the groups (p > 0.05). A 1:1 ratio (bleaching gel:pigment) caused a significant fracture resistance reduction in relation to the other protocols. No effect on the dentin microhardness reduction was observed. The pigment addition to the bleaching agent accelerates the bleaching chemical reaction. However, no studies have evaluated the ideal proportion to optimize tooth bleaching.

Clinical performance of a lithia disilicate-based core ceramic for three-unit posterior FPDs.

PubMed

Esquivel-Upshaw, Josephine F; Anusavice, Kenneth J; Young, Henry; Jones, Jack; Gibbs, Charles

2004-01-01

The purpose of this research project was to determine the clinical success rate of a lithia disilicate-based core ceramic for use in posterior fixed partial dentures (FPD) as a function of bite force, cement type, connector height, and connector width. Thirty ceramic FPD core frameworks were prepared using a heat-pressing technique and a lithia disilicate-based core ceramic. The maximum clenching force was measured for each patient prior to tooth preparation. Connector height and width were measured for each FPD. Patients were recalled yearly after cementation for 2 years and evaluated using 11 clinical criteria. All FPDs were examined by two independent clinicians, and rankings from 1 to 4 were made for each criterion (4 = excellent; 1 = unacceptable). Two of the 30 ceramic FPDs fractured within the 2-year evaluation period, representing a 93% success rate. One fracture was associated with a low occlusal force and short connector height (2.9 mm). The other fracture was associated with the greatest occlusal force (1,031 N) and adequate connector height. All criteria were ranked good to excellent during the 2-year recall for all remaining FPDs. The performance of the experimental core ceramic in posterior FPDs was promising, with only a 7% fracture rate after 2 years. Because of the limited sample size, it is not possible to identify the maximum clenching force that is allowable to prevent fracture caused by interocclusal forces.

Smile Aesthetics Satisfaction Scale: development and validation of a new brief five-item measure of satisfaction with smile aesthetics in adults and the elderly.

PubMed

Lajnert, Vlatka; Kovacevic Pavicic, Daniela; Pavlic, Andrej; Pokrajac-Bulian, Alessandra; Spalj, Stjepan

2018-06-01

To create and validate a brief questionnaire designed for the assessment of satisfaction with smile aesthetics and to test its efficiency as a patient-centred outcome measure of aesthetic interventions in dentistry. A team of three specialists - two from prosthodontics and one psychologist - used a self-evaluation scale consisting of five elements in order to rate self-perceived smile aesthetics. A total of 671 subjects (63% female), 18-86 years of age, were included in the investigation. The internal consistency, validity and stability of the questionnaire, along with the responsiveness induced by the tooth-whitening procedure, were evaluated. The relationship between self-perceived satisfaction with the smile aesthetics and the clinical status of the dentition was assessed. The questionnaire had one dimension accounting for 64.3% of variance and showed a high level of reliability (Cronbach α = 0.859). It measured a construct similar to concern with tooth appearance and the desire to improve this appearance (r = -0.403 and r = -0.353, respectively; P < 0.001). High test-retest reliability was demonstrated (intraclass correlation coefficient = 0.985). The questionnaire was able to detect an increase in satisfaction with smile aesthetics as a result of the tooth-whitening procedure (P = 0.016). Clinical predictors of greater satisfaction with smile aesthetics were greater tooth display when smiling, decreased chroma and the absence of gingivitis, as well as absence of crowded, fractured and restored teeth in the anterior segment. A new questionnaire, titled the Smile Aesthetics Satisfaction Scale (SASS), showed good psychometric properties and its use can be recommended. © 2018 FDI World Dental Federation.

A study on setting of the fatigue limit of temporary dental implants.

PubMed

Kim, M H; Cho, E J; Lee, J W; Kim, E K; Yoo, S H; Park, C W

2017-07-01

A temporary dental implant is a medical device which is temporarily used to support a prosthesis such as an artificial tooth used for restoring patient's masticatory function during implant treatment. It is implanted in the oral cavity to substitute for the role of tooth. Due to the aging and westernization of current Korean society, the number of tooth extraction and implantation procedures is increasing, leading to an increase in the use and development of temporary dental implants. Because an implant performs a masticatory function in place of a tooth, a dynamic load is repeatedly put on the implant. Thus, the fatigue of implants is reported to be the most common causes of the fracture thereof. According to the investigation and analysis of the current domestic and international standards, the standard for fatigue of implant fixtures is not separately specified. Although a test method for measuring the fatigue is suggested in an ISO standard, it is a standard for permanent dental implants. Most of the test standards for Korean manufacturers and importers apply 250 N or more based on the guidance for the safety and performance evaluation of dental implants. Therefore, this study is intended to figure out the fatigue standard which can be applied to temporary dental implants when measuring the fatigue according to the test method suggested in the permanent dental implant standard. The results determined that suitable fatigue standards of temporary dental implants should be provided by each manufacturer rather than applying 250 N. This study will be useful for the establishment of the fatigue standards and fatigue test methods of the manufacturers and importers of temporary dental implants.

Numerical fatigue 3D-FE modeling of indirect composite-restored posterior teeth.

PubMed

Ausiello, Pietro; Franciosa, Pasquale; Martorelli, Massimo; Watts, David C

2011-05-01

In restored teeth, stresses at the tooth-restoration interface during masticatory processes may fracture the teeth or the restoration and cracks may grow and propagate. The aim was to apply numerical methodologies to simulate the behavior of a restored tooth and to evaluate fatigue lifetimes before crack failure. Using a CAD-FEM procedure and fatigue mechanic laws, the fatigue damage of a restored molar was numerically estimated. Tessellated surfaces of enamel and dentin were extracted by applying segmentation and classification algorithms, to sets of 2D image data. A user-friendly GUI, which enables selection and visualization of 3D tessellated surfaces, was developed in a MatLab(®) environment. The tooth-boundary surfaces of enamel and dentin were then created by sweeping operations through cross-sections. A class II MOD cavity preparation was then added into the 3D model and tetrahedral mesh elements were generated. Fatigue simulation was performed by combining a preliminary static FEA simulation with classical fatigue mechanical laws. Regions with the shortest fatigue-life were located around the fillets of the class II MOD cavity, where the static stress was highest. The described method can be successfully adopted to generate detailed 3D-FE models of molar teeth, with different cavities and restorative materials. This method could be quickly implemented for other dental or biomechanical applications. Copyright © 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Fracture patterns of glass-ionomer cement overlays versus stainless steel bands during endodontic treatment: an ex-vivo study.

PubMed

Pakdeethai, S; Abuzar, M; Parashos, P

2013-12-01

To compare fracture patterns of posterior teeth temporized with: mesio-occlusal-distal (MOD) glass-ionomer cement (GIC) interim restorations, stainless steel (SS) bands, GIC dome overlays and GIC dome overlays with occlusal temporary restorations. The root canals of 92 extracted human premolars and molars were prepared with rotary NiTi instruments and dressed with calcium hydroxide paste prior to cavity preparation for standardized MOD restorations. Teeth were divided into four groups (n = 23) and temporarily restored with: GIC interim restorations (GIC group), stainless steel bands (SS group), GIC dome overlays (GIC-O group) or GIC dome overlays with intermediate restorative material (IRM) in the access cavities (GIC-IRM group). Teeth were subjected to compressive axial load until fracture; fracture forces and fracture modes were recorded. Statistical analysis included Kaplan-Meier plots, Cox proportional hazards model, one-way analysis of variance, chi-square and Fisher's exact tests. There was a significantly higher risk of failure in the GIC group compared with the SS (P < 0.001), GIC-O (P < 0.001) and GIC-IRM (P = 0.001) groups. The mean fracture force for SS was significantly higher than GIC-O (P = 0.03) and GIC-IRM (P < 0.001). GIC fracture force was significantly lower than all other groups (P < 0.001). Significantly fewer unfavourable fractures were observed in SS compared with GIC (P = 0.001), GIC-O (P = 0.007) and GIC-IRM (P < 0.001). Glass-ionomer cement dome overlays with reduced cuspal height and occlusal inclines may be recommended for broken-down posterior teeth, without any risk of poor aesthetics, gingival irritation or further proximal tooth structure loss. Stainless steel bands may only need to be used in extensively broken-down teeth or in the presence of parafunctional habits. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT

PubMed Central

Bilge Gülsüm, NUR; Evren, OK; ALTUNSOY, Mustafa; AĞLARCI, Osman Sami; ÇOLAK, Mehmet; GÜNGÖR, Enes

2014-01-01

Objective This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation. Material and Methods The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test. Results The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth]. Conclusions The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics. PMID:25591019

Effect of chewing speed on the detection of a foreign object in food.

PubMed

Paphangkorakit, J; Ladsena, V; Rukyuttithamkul, T; Khamtad, T

2016-03-01

Accidentally biting hard on a piece of hard foreign object in food is among the causes of tooth fracturing and could be associated with oral sensibility. This study has investigated the effect of chewing speed on the ability to detect a foreign object in food in human. Fourteen healthy subjects were asked to randomly chew one of 10 cooked rice balls, five of which containing a foreign object made from a tiny uncooked rice grain, until they detected the rice grain. Each subject chewed the test foods both at 50 (slow) and 100 (fast) chews min(-1). The accuracy of detection and the number of chews before detection (CBD) were recorded and compared between the two chewing speeds using paired t-tests. The results showed that almost all subjects detected the foreign object by biting. The accuracy of detection was more than 90% and not significantly different between slow and fast chewing but the mean CBD in slow chewing (11·7 ± 1·3 chews) was significantly different from that in fast chewing (20·7 ± 1·9 chews; P < 0·001). The study showed that slow chewers required less number of chews before a foreign object in food could be detected and was, presumably, more effective in detecting the object compared to fast chewers. If each chew bears equal probability of teeth encountering the foreign object, slow chewing might also reduce the chance of accidentally biting hard on the foreign object and fracturing the tooth. © 2015 John Wiley & Sons Ltd.

Genetic and molecular control of Osterix in skeletal formation

PubMed Central

Sinha, Krishna M.; Zhou, Xin

2013-01-01

Osteoblast differentiation is a multi-step process where mesenchymal cells differentiate into osteoblast lineage cells including osteocytes. Osterix (Osx) is an osteoblast-specific transcription factor which activates a repertoire of genes during differentiation of preosteoblasts into mature osteoblasts and osteocytes. The essential role of Osx in the genetic program of bone formation and in bone homeostasis is well established. Osx mutant embryos do not form bone and fail to express osteoblast-specific marker genes. Inactivation of Osx in mice after birth causes multiple skeletal phenotypes including lack of new bone formation, absence of resorption of mineralized cartilage, and defects in osteocyte maturation and function. Since Osx is a major effector in skeletal formation, studies on Osx gained momentum over the last five-seven years and implicated its important function in tooth formation as well as in healing of bone fractures. This review outlines mouse genetic studies that establish the essential role of Osx in bone and tooth formation as well as in healing of bone fractures. We also discuss the recent advances in regulation of Osx expression which is under control of a transcriptional network, signaling pathways, and epigenetic regulation. Finally we summarize important findings on the positive and negative regulation of Osx’s transcriptional activity through protein-protein interactions in expression of its target genes during osteoblast differentiation. In particular, the identification of the histone demethylase NO66 as an Osx-interacting protein which negatively regulates Osx activity opens further avenues in studying epigenetic control of Osx target genes during differentiation and maturation of osteoblasts. PMID:23225263

Fracture resistance of simulated immature teeth after different intra-radicular treatments.

PubMed

Sivieri-Araujo, Gustavo; Tanomaru-Filho, Mario; Guerreiro-Tanomaru, Juliane Maria; Bortoluzzi, Eduardo Antunes; Jorge, Érica Gouveia; Reis, José Maurício Dos Santos Nunes

2015-01-01

The aim of this study was to evaluate the fracture resistance of simulated immature teeth after different intra-radicular treatments. Crowns and roots of bovine incisors were cut transversally and removed to simulate immature teeth. Root canal preparation and flaring were performed using a bur in crown-apex and apex-crown direction. The samples were distributed into 5 groups (n=10): Positive control (PoC) - no root canal flaring or filling; Negative control (NeC) - teeth were sectioned and their root canals were flared; Direct anatomical glass fiber post (RaP) - #2 Reforpost main glass fiber post relined with composite resin; Double tapered conical glass fiber posts (ExP) - #3 Exacto glass fiber post; and #2 Reforpost main glass fiber + Reforpin accessory glass fiber posts (RrP). In RaP, ExP and RrP, 4.0-mm apical plugs were done with MTA Angelus. The specimens were embedded in polystyrene resin inside cylinders and the periodontal ligament was simulated with a polyether-based impression material. The specimens were submitted to compressive fracture strength test (0.5 mm/min at 135° relative to the long axis of the tooth) in a servo-hydraulic mechanical testing machine MTS 810. Data were subjected to one-way ANOVA and Dunnett's C or Tukey's tests (α=0.05). The control groups (PoC and NeC) showed lower fracture strength than the experimental groups. NeC presented the lowest resistance and ExP presented the highest resistance among the experimental groups. The flaring procedures produced a detrimental effect on the fracture resistance of the bovine teeth. Glass fiber intra-radicular posts increased significantly the fracture resistance of simulated immature teeth.

Effect of porcelain and enamel thickness on porcelain veneer failure loads in vitro.

PubMed

Ge, Chunling; Green, Chad C; Sederstrom, Dalene; McLaren, Edward A; White, Shane N

2014-05-01

Bonded porcelain veneers are widely used esthetic restorations. Although high success and survival rates have been reported, failures occur. Fracture is the most common failure mode. Fractures range from incomplete cracks to the catastrophic. Minimally invasive or thin partial veneers have gained popularity. The aim of this study was to measure the influences of porcelain veneer thickness and enamel substrate thickness on the loads needed to cause the initial fracture and catastrophic failure of porcelain veneers. Model discoid porcelain veneer specimens of varying thickness were bonded to the flattened facial surfaces of incisors, artificially aged, and loaded to failure with a small sphere. Individual fracture events were identified and analyzed statistically and fractographically. Fracture events included initial Hertzian cracks, intermediate radial cracks, and catastrophic gross failure. Increased porcelain, enamel, and their combined thickness had like effects in substantially raising resistance to catastrophic failure but also slightly decreased resistance to initial Hertzian cracking. Fractographic and numerical data demonstrated that porcelain and tooth enamel behaved in a remarkably similar manner. As porcelain thickness, enamel thickness, and their combined thickness increased, the loads needed to produce initial fracture and catastrophic failure rose substantially. Porcelain veneers withstood considerable damage before catastrophic failure. Increased enamel thickness, increased porcelain thickness, and increased combined enamel and porcelain thickness all profoundly raised the failure loads necessary to cause catastrophic failure. Enamel and feldspathic porcelain behaved in a like manner. Surface contact damage occurred initially. Final catastrophic failure followed flexural radial cracking. Bonded porcelain veneers were highly damage tolerant. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Bone toughness at the molecular scale: A model for fracture toughness using crosslinked osteopontin on synthetic and biogenic mineral substrates.

PubMed

Cavelier, S; Dastjerdi, A K; McKee, M D; Barthelat, F

2018-05-01

The most prominent structural components in bone are collagen and mineral. However, bone additionally contains a substantial amount of noncollagenous proteins (most notably of the SIBLING protein family), some of which may act as cohesive/adhesive "binders" for the composite hybrid collagen/mineral scaffolding, whether in the bulk phase of bone, or at its interfaces. One such noncollagenous protein - osteopontin (OPN) - appears to be critical to the deformability and fracture toughness of bone. In the present study, we used a reconstructed synthetic mineral-OPN-mineral interface, and a biogenic (natural tooth dentin) mineral/collagen-OPN-mineral/collagen interface, to measure the fracture toughness of OPN on mineralized substrates. We used this system to test the hypothesis that OPN crosslinking by the enzyme tissue transglutaminase 2 (TG2) that is found in bone enhances interfacial adhesion to increase the fracture toughness of bone. For this, we prepared double-cantilever beam substrates of synthetic pure hydroxyapatite mineral, and of narwhal dentin, and directly apposed them to one another under different intervening OPN/crosslinking conditions, and fracture toughness was tested using a miniaturized loading stage. The work-of-fracture of the OPN interface was measured for different OPN formulations (monomer vs. polymer), crosslinking states, and substrate composition. Noncrosslinked OPN provided negligible adhesion on pure hydroxyapatite, whereas OPN crosslinking (by the chemical crosslinker glutaraldehyde, and TG2 enzyme) provided strong interfacial adhesion for both hydroxyapatite and dentin using monomeric and polymeric OPN. Pre-coating of the substrate beams with monomeric OPN further improved the adhesive performance of the samples, likely by allowing effective binding of this nascent OPN form to mineral/matrix components, with this pre-attachment providing a protein layer for additional crosslinking between the substrates. Copyright © 2018 Elsevier Inc. All rights reserved.

Zirconia in fixed prosthesis. A literature review

PubMed Central

Román-Rodríguez, Juan L.; Ferreiroa, Alberto; Solá-Ruíz, María F.; Fons-Font, Antonio

2014-01-01

Statement of problem: Evidence is limited on the efficacy of zirconia-based fixed dental prostheses. Objective: To carry out a literature review of the behavior of zirconium oxide dental restorations. Material and Methods: This literature review searched the Pubmed, Scopus, Medline and Cochrane Library databases using key search words “zirconium oxide,” “zirconia,” “non-metal restorations,” “ceramic oxides,” “veneering ceramic,” “zirconia-based fixed dental prostheses”. Both in vivo and in vitro studies into zirconia-based prosthodontic restoration behavior were included. Results: Clinical studies have revealed a high rate of fracture for porcelain-veneered zirconia-based restorations that varies between 6% and 15% over a 3- to 5-year period, while for ceramo-metallic restorations the fracture rate ranges between 4 and 10% over ten years. These results provoke uncertainty as to the long-term prognosis for this material in the oral medium. The cause of veneering porcelain fractures is unknown but hypothetically they could be associated with bond failure between the veneer material and the zirconia sub-structure. Key words:Veneering ceramic, zirconia-based ceramic restoration, crown, zirconia, tooth-supported fixed prosthesis. PMID:24596638

Morphological Changes Of The Root Surface And Fracture Resistance After Treatment Of Root Fracture By CO2 Laser And Glass Ionomer Or Mineral Trioxide Aggregates

NASA Astrophysics Data System (ADS)

Badr, Y. A.; Abd El-Gawad, L. M.; Ghaith, M. E.

2009-09-01

This in vitro study evaluates the morphological changes of the root surface and fracture resistance after treatment of root cracks by CO2 laser and glass Ionomer or mineral trioxide aggregates (MTA). Fifty freshly extracted human maxillary central incisor teeth with similar dimension were selected. Crowns were sectioned at the cemento-enamel junction, and the lengths of the roots were adjusted to 13 mm. A longitudinal groove with a dimension of 1×5 mm2 and a depth of 1.5 mm was prepared by a high speed fissure bur on the labial surface of the root. The roots were divided into 5 groups: the 10 root grooves in group 1 were remained unfilled and were used as a control group. The 10 root grooves in group 2 were filled with glass Ionomer, 10 root grooves in group 3 were filled with MTA, the 10 root grooves in group 4 were filled with glass Ionomer and irradiated by CO2 laser and the 10 root grooves in group 5 were filled with MTA and irradiated with CO2 laser. Scanning electron microscopy was performed for two samples in each group. Tests for fracture strength were performed using a universal testing machine and a round tip of a diameter of 4 mm. The force was applied vertically with a constant speed of 1 mm min 1. For each root, the force at the time of fracture was recorded in Newtons. Results were evaluated statistically with ANOVA and Turkey's Honestly Significant Difference (HSD) tests. SEM micrographs revealed that the melted masses and the plate-like crystals formed a tight Chemical bond between the cementum and glass Ionomer and melted masses and globular like structure between cementum and MTA. The mean fracture resistance was the maximum fracture resistance in group 5 (810.8 N). Glass Ionomer and MTA with the help of CO2 laser can be an alternative to the treatment of tooth crack or fracture. CO2 laser increase the resistance of the teeth to fracture.

The reduction in fatigue crack growth resistance of dentin with depth.

PubMed

Ivancik, J; Neerchal, N K; Romberg, E; Arola, D

2011-08-01

The fatigue crack growth resistance of dentin was characterized as a function of depth from the dentino-enamel junction. Compact tension (CT) specimens were prepared from the crowns of third molars in the deep, middle, and peripheral dentin. The microstructure was quantified in terms of the average tubule dimensions and density. Fatigue cracks were grown in-plane with the tubules and characterized in terms of the initiation and growth responses. Deep dentin exhibited the lowest resistance to the initiation of fatigue crack growth, as indicated by the stress intensity threshold (ΔK(th) ≈ 0.8 MPa•m(0.5)) and the highest incremental fatigue crack growth rate (over 1000 times that in peripheral dentin). Cracks in deep dentin underwent incremental extension under cyclic stresses that were 40% lower than those required in peripheral dentin. The average fatigue crack growth rates increased significantly with tubule density, indicating the importance of microstructure on the potential for tooth fracture. Molars with deep restorations are more likely to suffer from the cracked-tooth syndrome, because of the lower fatigue crack growth resistance of deep dentin.

A Review of Transmission Diagnostics Research at NASA Lewis Research Center

NASA Technical Reports Server (NTRS)

Zakajsek, James J.

1994-01-01

This paper presents a summary of the transmission diagnostics research work conducted at NASA Lewis Research Center over the last four years. In 1990, the Transmission Health and Usage Monitoring Research Team at NASA Lewis conducted a survey to determine the critical needs of the diagnostics community. Survey results indicated that experimental verification of gear and bearing fault detection methods, improved fault detection in planetary systems, and damage magnitude assessment and prognostics research were all critical to a highly reliable health and usage monitoring system. In response to this, a variety of transmission fault detection methods were applied to experimentally obtained fatigue data. Failure modes of the fatigue data include a variety of gear pitting failures, tooth wear, tooth fracture, and bearing spalling failures. Overall results indicate that, of the gear fault detection techniques, no one method can successfully detect all possible failure modes. The more successful methods need to be integrated into a single more reliable detection technique. A recently developed method, NA4, in addition to being one of the more successful gear fault detection methods, was also found to exhibit damage magnitude estimation capabilities.

Restorative outcomes for endodontically treated teeth in the Practitioners Engaged in Applied Research and Learning network.

PubMed

Spielman, Howard; Schaffer, Scott B; Cohen, Mitchell G; Wu, Hongyu; Vena, Donald A; Collie, Damon; Curro, Frederick A; Thompson, Van P; Craig, Ronald G

2012-07-01

The authors aimed to determine the outcome of and factors associated with success and failure of restorations in endodontically treated teeth in patients in practices participating in the Practitioners Engaged in Applied Research and Learning (PEARL) Network. Practitioner-investigators (P-Is) invited the enrollment of all patients seeking care at participating practices who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years earlier. P-Is classified endodontically reated teeth as restorative failures if the restoration was replaced, the restoration needed replacement or the tooth was cracked or fractured. P-Is from 64 practices enrolled in the study 1,298 eligible patients who had endodontically treated teeth that had been restored. The mean (standard deviation) time to follow-up was 3.9 (0.6) years. Of the 1,298 enrolled teeth, P-Is classified 181 (13.9 percent; 95 percent confidence interval [CI], 12.1-15.8 percent) as restorative failures: 44 (3.4 percent) due to cracks or fractures, 57 (4.4 percent) due to replacement of the original restoration for reasons other than fracture and 80 (6.2 percent) due to need for a new restoration. When analyzing the results by means of multivariate logistic regression, the authors found a greater risk of restorative failure to be associated with canines or incisors and premolars (P = .04), intracoronal restorations (P < .01), lack of preoperative proximal contacts (P < .01), presence of periodontal connective-tissue attachment loss (P < .01), younger age (P = .01), Hispanic/Latino ethnicity (P = .04) and endodontic therapy not having been performed by a specialist (P = .04). These results suggest that molars (as opposed to other types of teeth), full-coverage restorations, preoperative proximal contacts, good periodontal health, non-Hispanic/Latino ethnicity, endodontic therapy performed by a specialist and older patient age are associated with restorative success for endodontically treated teeth in general practice. These results contribute to the clinical evidence base to help guide practitioners when planning the restoration of endodontically treated teeth.

Bicuspid Axial Wall Height Effect on CAD/CAM Crown Fracture Mode on Preparations Containing Advanced Total Occlusal Convergence.

PubMed

Miller, Matthew; DuVall, Nicholas; Brewster, John; Wajdowicz, Michael N; Harris, Ashley; Roberts, Howard W

2018-02-18

To evaluate bicuspid axial wall height effect on the fracture mode of adhesively luted, all-ceramic CAD/CAM crowns with a 20° total occlusal convergence (TOC). Recently extracted premolars were randomly divided into 4 groups (n = 12) with all-ceramic crown preparations accomplished using a high-speed handpiece inserted into a milling device. Specimens were prepared containing occlusogingival axial wall heights of 3, 2, and 1 mm as well as a group containing a flat preparation surface with no axial wall height. All preparations contained a 20° TOC. Completed preparation surface area was determined, and preparation features confirmed using a digital measuring microscope. Scanned preparations (CEREC) were fitted with milled and crystallized lithium disilicate full coverage restorations and luted with a self-etching adhesive resin cement after hydrofluoric acid etching and silanation. All manufacturer recommendations were followed. Specimens were stored at 37°C/98% humidity for 24 hours. Specimens were tested to failure at a 45° angle to the long axis of the tooth root on a universal testing machine. Failure load was converted to MPa using the available bonding surface area with mean data analyzed using Kruskal-Wallis/Dunn's (p = 0.05) RESULTS: The 3 mm preparation height specimens were similar to the 2 mm specimens, and both demonstrated significantly stronger failure load than the 1 mm axial wall height and flat preparation specimens. The flat preparation and 1 mm axial wall height specimens all failed adhesively, while the 2 mm and 3 mm specimens failed largely due to tooth fracture. Further evidence is provided that CAD/CAM adhesive techniques may compensate for less than ideal preparation features. Under the conditions of this study, bicuspid preparations with a 20° TOC restored with adhesively luted, CAD/CAM e.max CAD crowns require at least 2 mm of axial wall height, but further planned fatigue studies are necessary before definitive recommendations can be made. © 2018 by the American College of Prosthodontists.

Influence of nickel-titanium rotary systems with varying tapers on the biomechanical behaviour of maxillary first premolars under occlusal forces: a finite element analysis study.

PubMed

Askerbeyli Örs, S; Serper, A

2018-05-01

To evaluate the effect of three nickel-titanium (Ni-Ti) rotary systems with varying tapers on stress distribution and to analyse potential fracture patterns as well as the volume of fracture-susceptible regions in two-rooted maxillary premolars. The root canals of three single-rooted premolars were prepared with either HeroShaper (Micro-Mega, Besançon, France) to (size 30, .04 taper), Revo-S (Micro-Mega) to AS30 (size 30, .06 taper) or ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland) to F3 (size 30, .09 taper) Ni-Ti files. The three root canals were scanned using micro-computed tomography (μCT) (Skyscan 1174, Skyscan, Kontich, Belgium) and modelled according to the μCT data. An intact tooth model with a root length of 16 mm was also constructed based on μCT images of an extracted maxillary premolar with two roots. New models were constructed by replacing both of the original canals of the intact two-rooted premolar model with the modelled canals prepared with the HeroShaper, Revo-S or ProTaper Universal system. Occlusal forces of 200 N were applied in oblique and vertical directions. Finite element analysis was performed using Abaqus FEA software (Abaqus 6.14, ABAQUS Inc., Providence, RI, USA). Upon the application of oblique occlusal forces, the palatal external cervical root surface and the bifurcation (palatal side of the buccal root) in tooth models experienced the highest maximum principal (Pmax) stresses. The application of vertical forces resulted in minor Pmax stress values. Models prepared using the ProTaper system exhibited the highest Pmax stress values. The intact models exhibited the lowest Pmax stress values followed by the models prepared with the HeroShaper system. The differences in Pmax stress values amongst the different groups of models were mathematically minimal under normal occlusal forces. Rotary systems with varying tapers might predispose the root fracture on the palatal side of the buccal root and cervical palatal root surface in two-rooted premolars. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Regenerative endodontics--biologically-based treatment for immature permanent teeth: a case report and review of the literature.

PubMed

Thomson, A; Kahler, B

2010-12-01

A paradigm shift in the treatment of immature, necrotic teeth has occurred with biologically-based principles and regenerative endodontic protocols replacing traditional 'apexification' procedures. Preliminary research suggests that stem and progenitor cells from the pulp and/or periodontium contribute to continued root development when regenerative procedures are followed. A mandibular premolar tooth with a chronic periapical abscess was irrigated with sodium hypochlorite with minimal instrumentation and then dressed with tri-antibiotic paste consisting of ciprofloxacin, metronidazole and amoxicillin. At a subsequent visit a blood clot was evoked in the canal by irritating periapical tissues and the canal sealed with mineral trioxide aggregate, glass ionomer cement and composite resin. Resolution of apical periodontitis and the draining sinus, continued root maturation and apical closure occurred over an 18-month period. The tooth became responsive to pulp sensibility testing. It is important that dentists recognize the potential of regenerative endodontics in the treatment of necrotic, immature teeth. Initial management should involve irrigation with sodium hypochlorite only. Intra-canal medicaments, such as calcium hydroxide, are contraindicated as they inhibit further root growth. This report uses a variation of the tri-antibiotic paste currently recommended for regenerative procedures that avoided the discolouration of the crown associated with current protocols. Regenerative endodontics with continued root growth may reduce the risk of fracture and premature tooth loss associated with traditional 'apexification' procedures where the root remains thin and weak. © 2010 Australian Dental Association.

Investigation of the effects of manufacturing variations and materials on fatigue crack detection methods in gear teeth

NASA Technical Reports Server (NTRS)

Wheitner, Jeffrey A.; Houser, Donald R.

1994-01-01

The fatigue life of a gear tooth can be thought of as the sum of the number of cycles required to initiate a crack, N(sub i), plus the number of cycles required to propagate the crack to such a length that fracture occurs, N(sub p). The factors that govern crack initiation are thought to be related to localized stress or strain at a point, while propagation of a fatigue crack is a function of the crack tip parameters such as crack shape, stress state, and stress intensity factor. During a test there is no clear transition between initiation and propagation. The mechanisms of initiation and propagation are quite different and modeling them separately produces a higher degree of accuracy, but then the question that continually arises is 'what is a crack?' The total life prediction in a fracture mechanics model presently hinges on the assumption of an initial crack length, and this length can significantly affect the total life prediction. The size of the initial crack is generally taken to be in the range of 0.01 in. to 0.2 in. Several researchers have used various techniques to determine the beginning of the crack propagation stage. Barhorst showed the relationship between dynamic stiffness changes and crack propagation. Acoustic emissions, which are stress waves produced by the sudden movement of stressed materials, have also been successfully used to monitor the growth of cracks in tensile and fatigue specimens. The purpose of this research is to determine whether acoustic emissions can be used to define the beginning of crack propagation in a gear using a single-tooth bending fatigue test.

Mini-interfacial Fracture Toughness of a Multimode Adhesive Bonded to Plasma-treated Dentin.

PubMed

Ayres, Ana Paula Almeida; Pongprueksa, Pong; De Munck, Jan; Gré, Cristina Parise; Nascimento, Fábio Dupart; Giannini, Marcelo; Van Meerbeek, Bart

2017-01-01

To investigate the bonding efficacy of a multimode adhesive to plasma-treated and -untreated (control) dentin using a mini-interfacial fracture toughness (mini-iFT) test. Twenty human molars were used in a split-tooth design (n = 10). The adhesive Scotchbond Universal (SBU; 3M ESPE) was applied in etch-and-rinse (E&R) and self-etch (SE) modes. Mid-coronal dentin was exposed and covered with a standardized smear layer ground to 320 grit. One half of each dentin surface received 15 s of non-thermal atmospheric plasma (NTAP), while the other half was covered with a metallic barrier and kept untreated. Following the E&R mode, dentin was plasma treated immediately after phosphoric acid etching. SBU and a resin-based composite were applied to dentin following the manufacturer's instructions. Six mini-iFT specimens were prepared per tooth (1.5 x 2.0 x 16 to 18 mm), and a single notch was prepared at the adhesive-dentin interface using a 150-μm diamond blade under water cooling. Half of the mini-iFT specimens were immediately loaded until failure in a 4-point bending test, while the other half were first stored in distilled water for 6 months. After testing, the exact dimensions of the notch were measured with a measuring optical microscope, from which ΚIc was determined. Three-way ANOVA revealed higher mini-iFT for SBU applied in E&R than SE mode for both storage times, irrespective of NTAP treatment. Overall, mini-iFT did not decrease for any of the experimental groups upon 6-month aging, while plasma treatment did not show a direct beneficial effect on mini-iFT of SBU applied in either E&R or SE mode.

Computed tomographic features of apical infection of equine maxillary cheek teeth: a retrospective study of 49 horses.

PubMed

Bühler, M; Fürst, A; Lewis, F I; Kummer, M; Ohlerth, S

2014-07-01

Computed tomographic (CT) studies evaluating the relevance of individual CT features of apical infection in maxillary cheek teeth are lacking. To study the prevalence and relationship of single CT features in horses with and without clinical evidence of apical infection in maxillary cheek teeth. Retrospective case-control study. Multislice CT scans of the head of 49 horses were evaluated retrospectively. Changes of the infundibulum, pulp, root, lamina dura, periodontal space and alveolar bone in maxillary cheek teeth were recorded. Single CT changes were much more prevalent in the 28 horses with clinical signs. However, infundibular changes and a nondetectable lamina dura were also common in the 21 horses without clinical evidence of apical infection. Computed tomographic abnormalities of the pulp, root, periapical bone and periodontal space and the presence of a tooth fracture were significantly related. Infundibular changes were not associated with other CT signs of apical infection. Although nondetectable lamina dura was the most frequent CT change in all teeth in both studied groups, it was most commonly a solitary feature in otherwise normal teeth. Apical infections, defined as ≥3 CT changes, occurred mainly in the 108/208, 109/209 and 110/210 (Triadan numbers) and were found only in horses with clinical evidence of apical infection, except in one horse without clinical signs that had one affected root. Combined CT changes of the pulp, root, lamina dura, periapical bone and periodontal space and the presence of a tooth fracture appear to be reliable features to diagnose apical infection in maxillary cheek teeth. As a solitary feature, a nondetectable lamina dura should be interpreted cautiously and may even be considered normal due to its minor thickness and/or too low resolution of the imaging modality. © 2013 EVJ Ltd.

[Bonding strength of resin and tooth enamel after teeth bleaching with cold plasma].

PubMed

Zhu, Meng-meng; Wang, Guo-min; Sun, Ke; Li, Ying-long; Pan, Jie

2016-02-18

To investigate the immediate bond strength and surface structure of resin and the tooth enamel which treated by cold plasma. In the study, 40 bovine incisors were divided into two equal parts. In this sense, all enamel adhesive samples were prepared and then randomly divided into 4 groups (n =20). group 1: acid + single bond 2+resin composite (control group); group 2:beyond bleaching+ acid+single bond 2+resin composite; group 3: treated by cold plasma for 5 minutes+ acid+single bond 2+resin composite; group 4: treated by cold plasma for 5 minutes+single bond 2+resin composite. Single bond 2 bonding system and Filtek Z250 resin were used in this experiment. The shear bond strength was tested by universal testing machine. The surface of the enamel in different processes was observed by scanning electron microscope (SEM). Statistical analyses by the single factor analysis of variance and multiple pairwise comparisons were performed with SPSS 17.0 . The shear bond strength of group 4 (8.60 MPa) was significantly lower than that of the other three groups (P<0.05). The shear bond strength of group 2 (17.89 MPa) was higher than that of group 4, but lower than group 1 and group 3 (P<0.05).There was no significant difference between group 1 (34.82 MPa) and group 3 (34.69 MPa). Scanning electron microscope indicated that the enamel treated by cold plasma had slight molten form, which was different from etched enamel surface.The fractured surface of group 3 was mix fracture, which was similar to the control group (group 1). Compared with the conventional clinic bleaching, immediate bond strength of resin-enamel that treated by cold plasma has not been affected.

Technical Quality of Root Canal Treatment Performed by Undergraduate Clinical Students of Isfahan Dental School.

PubMed

Saatchi, Masoud; Mohammadi, Golshan; Vali Sichani, Armita; Moshkforoush, Saba

2018-01-01

The aim of the present study was to evaluate the radiographic quality of RCTs performed by undergraduate clinical students of Dental School of Isfahan University of Medical Sciences. In this cross sectional study, records and periapical radiographs of 1200 root filled teeth were randomly selected from the records of patients who had received RCTs in Dental School of Isfahan University of Medical Sciences from 2013 to 2015. After excluding 416 records, the final sample consisted of 784 root-treated teeth (1674 root canals). Two variables including the length and the density of the root fillings were examined. Moreover, the presence of ledge, foramen perforation, root perforation and fractured instruments were also evaluated as procedural errors. Descriptive statistics were used for expressing the frequencies of criteria and chi square test was used for comparing tooth types, tooth locations and academic level of students ( P <0.05). The frequency of root canals with acceptable filling was 54.1%. Overfilling was found in 11% of root canals, underfilling in 8.3% and inadequate density in 34.6%. No significant difference was found between the frequency of acceptable root fillings in the maxilla and mandible ( P =0.072). More acceptable fillings were found in the root canals of premolars (61.3%) than molars (51.3%) ( P =0.001). The frequency of procedural errors was 18.6%. Ledge was found in 12.5% of root canals, foramen perforation in 2%, root perforation in 2.4% and fractured instrument in 2%. Procedural errors were more frequent in the root canals of molars (22.5%) than the anterior teeth (12.3%) ( P =0.003) and the premolars (9.5%) ( P <0.001). Technical quality of RCTs performed by clinical students was not satisfactory and incidence of procedural errors was considerable.

FDI World Dental Federation - clinical criteria for the evaluation of direct and indirect restorations. Update and clinical examples.

PubMed

Hickel, Reinhard; Peschke, Arnd; Tyas, Martin; Mjör, Ivar; Bayne, Stephen; Peters, Mathilde; Hiller, Karl-Anton; Randall, Ross; Vanherle, Guido; Heintze, Siegward D

2010-08-01

In 2007, new clinical criteria were approved by the FDI World Dental Federation and simultaneously published in three dental journals. The criteria were categorized into three groups: esthetic parameters (four criteria), functional parameters (six criteria), and biological parameters (six criteria). Each criterion can be expressed with five scores, three for acceptable and two for non-acceptable (one for reparable and one for replacement). The criteria have been used in several clinical studies since 2007, and the resulting experience in their application has led to a requirement to modify some of the criteria and scores. The two major alterations involve staining and approximal contacts. As staining of the margins and the surface have different causes, both phenomena do not appear simultaneously. Thus, staining has been differentiated into marginal staining and surface staining. The approximal contact now appears under the name "approximal anatomic form" as the approximal contour is a specific, often non-esthetic issue that cannot be integrated into the criterion "esthetic anatomical form". In 2008, a web-based training and calibration tool called e-calib (www.e-calib.info) was made available. Clinical investigators and other research workers can train and calibrate themselves interactively by assessing clinical cases of posterior restorations, which are presented as high quality pictures. Currently, about 300 clinical cases are included in the database which is regularly updated. Training for 8 of the 16 clinical criteria is available in the program: "Surface luster"; "Staining (surface, margins)"; "Color match and translucency"; "Esthetic anatomical form"; "Fracture of material and retention"; "Marginal adaptation"; "Recurrence of caries, erosion, abfraction"; and "Tooth integrity (enamel cracks, tooth fractures)". Typical clinical cases are presented for each of these eight criteria and their corresponding five scores.

Use of an intraoperative navigation system for retrieving a broken dental instrument in the mandible: a case report.

PubMed

Sukegawa, Shintaro; Kanno, Takahiro; Shibata, Akane; Matsumoto, Kenichi; Sukegawa-Takahashi, Yuka; Sakaida, Kyosuke; Furuki, Yoshihiko

2017-01-15

A fracture of root canal instruments, with a fractured piece protruding beyond the apex, is a troublesome incident during an endodontic treatment. Locating and retrieving them represents a challenge to maxillofacial surgeons because it is difficult to access due to the proximity between the foreign body and vital structures. Although safe and accurate for surgery, radiographs and electromagnetic devices do not provide a precise three-dimensional position. In contrast, computer-aided navigation provides a correlation between preoperatively collected data and intraoperatively encountered anatomy. However, using a navigation system for mandible treatment is difficult as the mobile nature of the mandible complicates its synchronization with the preoperative imaging data during surgery. This report describes a case of a dental instrument breakage in the mandible during an endodontic treatment for a restorative dental procedure in a 65-year-old Japanese woman. The broken dental instrument was removed using a minimally invasive approach with a surgical navigation system and an interocclusal splint for a stable, identically repeatable positioning of the mandible. Using the three-dimensional position of the navigation probe, a location that best approximated the most anterior extent of the fragment was selected. A minimally invasive vestibular incision was made at this location, a subperiosteal reflection was performed, and the foreign body location was confirmed using a careful navigation system. The instrument was carefully visualized and extruded from the apical to the tooth crown side and was then removed using mosquito forceps through the medullary cavity of the crown side of the tooth. Follow-up was uneventful; her clinical course was good. The use of a surgical navigation system together with an interocclusal splint enabled the retrieval of a broken dental instrument in a safe and minimally invasive manner without damaging the surrounding vital structures.

Influence of retainer design on two-unit cantilever resin-bonded glass fiber reinforced composite fixed dental prostheses: an in vitro and finite element analysis study.

PubMed

Keulemans, Filip; De Jager, Niek; Kleverlaan, Cornelis J; Feilzer, Albert J

2008-10-01

The aim of this study was to evaluate in vitro the influence of retainer design on the strength of two-unit cantilever resin-bonded glass fiber-reinforced composite (FRC) fixed dental prostheses (FDP). Four retainer designs were tested: a proximal box, a step-box, a dual wing, and a step-box-wing. Of each design on 8 human mandibular molars, FRC-FDPs of a premolar size were produced. The FRC framework was made of resin impregnated unidirectional glass fibers (Estenia C&B EG Fiber, Kuraray) and veneered with hybrid resin composite (Estenia C&B, Kuraray). Panavia F 2.0 (Kuraray) was used as resin luting cement. FRC-FDPs were loaded to failure in a universal testing machine. One-way ANOVA and Tukey's post-hoc test were used to evaluate the data. The four designs were analyzed with finite element analysis (FEA) to reveal the stress distribution within the tooth/restoration complex. Significantly lower fracture strengths were observed with inlay-retained FDPs (proximal box: 300 +/- 65 N; step-box: 309 +/- 37 N) compared to wing-retained FDPs (p < 0.05) (step-box-wing: 662 +/- 99 N; dual wing: 697 +/- 67 N). Proximal-box-, step-box-, and step-box-wing-retained FDPs mainly failed with catastrophic cusp fracture (proximal box 100%, step-box 100%, and step-box-wing 75%), while dual-wing-retained FDPs mainly failed at the adhesive interface and/or due to pontic failure (75%). FEA showed more favorable stress distributions within the tooth/restoration complex for dual wing retainers. A dual-wing retainer is the optimal design for replacement of a single premolar by means of a two-unit cantilever FRC-FDPs.

An investigation on the crack growth resistance of human tooth enamel: Anisotropy, microstructure and toughening

NASA Astrophysics Data System (ADS)

Yahyazadehfar, Mobin

The enamel of human teeth is generally regarded as a brittle material with low fracture toughness. Consequently, the contributions of this tissue in resisting tooth fracture and the importance of its complex microstructure have been largely overlooked. The primary objective of this dissertation is to characterize the role of enamel's microstructure and degree of decussation on the fracture behavior of human enamel. The importance of the protein content and aging on the fracture toughness of enamel were also explored. Incremental crack growth in sections of human enamel was achieved using a special inset Compact Tension (CT) specimen configuration. Crack extension was achieved in two orthogonal directions, i.e. longitudinal and transverse to the prism axes. Fracture surfaces and the path of crack growth path were evaluated using scanning electron microscopy (SEM) to understand the fundamental mechanisms of crack growth extension. Furthermore, a hybrid approach was adopted to quantify the contribution of toughening mechanisms to the overall toughness. Results of this investigations showed that human enamel exhibits rising R-curve for both directions of crack extension. Cracks extending transverse to the rods in the outer enamel achieved lower rise in toughness with crack extension, and significantly lower toughness (1.23 +/- 0.20 MPa·m 0.5) than in the inner enamel (1.96 +/- 0.28 MPa· 0.5) and in the longitudinal direction (2.01 +/- 0.21 MPa· 0.5). The crack growth resistance exhibited both anisotropy and inhomogeneity, which arise from the complex hierarchical microstructure and the decussated prism structure. Decussation causes deflection of cracks extending from the enamel surface inwards, and facilitates a continuation of transverse crack extension within the outer enamel. This process dissipates fracture energy and averts cracks from extending toward the dentin and vital pulp. This study is the first to investigate the importance of proteins and the effect of aging on the fracture resistance of this highly mineralized tissue. Results showed that although the organic content is small, it plays an important role in the toughness of enamel. The deproteinized enamel underwent a significant reduction in the crack growth resistance with respect to proteinized control, with fracture toughness in the longitudinal (1.24 +/- 0.24 MPa· 0.5) and transverse directions (0.95 +/- 0.20 MPa· 0.5) approximately 40% lower than the control. Removal of the proteins also resulted in a loss of anisotropy, which reduces enamel's unique ability to invoke crack deflection. Additionally, results showed that aging results in a significant reduction in the fracture toughness. In the longitudinal direction the fracture toughness of old enamel was 1.38 +/- 0.35 MPa· 0.5, which is more than 30% lower than that of the control. Microscopic observation of crack extension in the enamel specimens showed that crack growth toughening occurred by a combination of extrinsic toughening mechanism including crack bridging, crack deflection and crack bifurcation. The cohesive zone analysis confirmed that enamel is primarily extrinsically toughened, with intrinsic and extrinsic toughening contributing approximately 5% and 30% of the total energy to fracture in the decussated enamel, respectively. However, the contribution of the extrinsic toughening in the outer enamel was negligible. For the deproteinized and old enamel, the degree of extrinsic toughening was 75%, and 30% lower, respectively, in comparison to the young proteinized enamel. The degradation in extrinsic toughening was attributed to embrittlement of the bridging ligaments. The organic substance at the rod boundaries was found to be essential in the crack growth toughening of enamel through the formation of unbroken ligaments and crack bridging, microcracking along the rod boundaries and in the process of crack bifurcation. The effectiveness of these mechanisms is most dominant in the decussated enamel due to the higher organic content. Through these findings the present investigation provides new understanding on the fracture resistance of enamel, which is essential to advancements in the field of restorative dentistry, as well as in the design of new restorative and bio-inspired materials.

[Comparison of clinical effects of Co-Cr alloy cast post-core and everStick fiber post in restoration of labially or lingually inclined maxillary central incisor].

PubMed

Qian, Yu-Mei; Zhong, Qun; Chen, Shuang

2017-02-01

To compare the clinical effect of Co-Cr alloy cast post-core and everStick fiber post in restoration of maxillary central incisor with labial or lingual inclination, and provide theoretical basis for clinical application. Ninety-seven labially or lingually inclined maxillary central incisors were treated in our hospital from March 2012 to March 2014. The patients were randomly divided into group A (n=49) and group B (n=48), and received post -core and crown restoration. Patients in group A underwent Co-Cr alloy cast post and core restoration and patients in group B underwent everStick fiber post and core restoration. After two-year of follow-up, root fracture, post break, crown or post dislodgment and gingival marginal discoloration were recorded and analyzed using SPSS 19.0 software package. Chi-square test showed that the success rate of restoration was significantly different between 2 groups (P<0.05). The incidence of root fracture and gingival marginal discoloration of Co-Cr alloy cast post-core was higher than that of everStick fiber post, but there was no significant difference in the incidence of post break, crown or post dislodgment. EverStick fiber post is better than Co-Cr alloy cast post and core to prevent root fracture and gingival marginal discoloration. Its fracture pattern is repairable and favorable for preserving tooth.

On the importance of aging to the crack growth resistance of human enamel.

PubMed

Yahyazadehfar, Mobin; Zhang, Dongsheng; Arola, Dwayne

2016-03-01

With improvements in oral health and an overall increase in quality of life, the percentage of fully or largely dentate seniors is increasing. Understanding the effects of aging on the mechanical properties of teeth is essential to the maintenance of lifelong oral health. In this investigation the effects of aging on the fracture toughness of human enamel were evaluated from incremental crack growth experiments performed on tissue of donor teeth representing "young" (17 ⩽ age ⩽ 25) and "old" (age ⩾ 55) age groups. Results showed that the old enamel exhibited significantly lower resistance to fracture than that of the young tissue in two orthogonal directions of crack growth. For crack growth transverse to the enamel rods, the fracture toughness of the old enamel (0.37 ± 0.15 MPa m(0.5)) was nearly 70% lower than that of tissue from the young teeth (1.23 ± 0.20 MPa m(0.5)). Based on results from a mechanistic analysis of crack growth, the reduction in fracture resistance is attributed to a decrease in the degree of extrinsic toughening. The practice of restorative dentistry should account for these changes in tooth tissues in the treatment of senior patients. The mechanical behavior of enamel has been studied for over 3 decades. Due to the limited volume of tissue available for evaluation, past work has been largely based on indentation methods. In this investigation we have evaluated the resistance to fracture of human enamel using a conventional fracture mechanics approach and incremental crack growth. We compared the fracture resistance of cuspal enamel obtained from the teeth of representative "young" and "old" donor groups. Our results show that there is a substantial reduction in the resistance to fracture with age, that it is anisotropic, and that the degradation is more severe than that which occurs to dentin. As such, we feel this work is a significant contribution to the field. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Immediate loading of unsplinted implants in the anterior mandible for overdentures: 3-year results.

PubMed

Roe, Phillip; Kan, Joseph Y K; Rungcharassaeng, Kitichai; Lozada, Jaime L

2011-01-01

This 3-year study evaluated the implant survival rate, peri-implant tissue response, prosthetic maintenance, and prosthetic complications in a series of patients who received two immediately loaded unsplinted threaded implants to retain a mandibular overdenture. Eight completely edentulous patients were evaluated clinically and radiographically immediately after implant placement, at 3 months, and at 1, 2, and 3 years after implant placement. Data were analyzed using repeated-measures one-way analysis of variance and the Wilcoxon signed rank test at a significance level of α = .05. At 3 years, all implants remained osseointegrated (16/16), with an overall mean marginal bone change of -0.58 ± 0.39 mm and a mean Periotest value of -7.19 ± 0.54. The modified Plaque Index scores showed marked improvement in oral hygiene during the first year, but some relapse was observed thereafter. Prosthetic maintenance and complications included replacement of the attachment inserts, abutment loosening, dislodgement of the attachment housing, overdenture reline, denture tooth fracture, and overdenture base fracture. This 3-year study suggests that, despite less than ideal oral hygiene and a high incidence of complete/partial fracture of overdentures, favorable implant survival rate and peri-implant tissue responses can be achieved in mandibular overdentures retained with two immediately loaded unsplinted threaded implants.

Development of novel self-healing and antibacterial dental composite containing calcium phosphate nanoparticles

PubMed Central

Wu, Junling; Weir, Michael D.; Melo, Mary Anne S.; Xu, Hockin H. K.

2015-01-01

Objectives Fracture and secondary caries are the primary reasons for dental restoration failure. The objective of this study was to develop a self-healing composite to heal cracks, while containing dimethylaminohexadecyl methacrylate (DMAHDM) for antibacterial function and nanoparticles of amorphous calcium phosphate (NACP) for remineralization. Methods Microcapsules were synthesized with poly(urea-formaldehyde) (PUF) shells containing triethylene glycol dimethacrylate (TEGDMA) and N,N-dihydroxyethyl-p-toluidine (DHEPT) as healing liquid. Composite contained 20 mass% of NACP and 35% glass fillers. In addition, composite contained 0%, 2.5%, 5%, 7.5%, or 10% of microcapsules. A single edge V-notched beam method measured fracture toughness (KIC) and self-healing efficiency. A dental plaque microcosm biofilm model was used to test the antibacterial properties. Results Incorporation of microcapsules up to 7.5% into the composite did not adversely affect the mechanical properties (p > 0.1). Successful self-healing was achieved, with KIC recovery of 65–81% (mean ± sd; n = 6) to regain the load-bearing capability after composite fracture. The self-healing DMAHDM-NACP composite displayed a strong antibacterial potency, inhibiting biofilm viability and lactic acid production, and reducing colony-forming units by 3–4 orders of magnitude, compared to control composite without DMAHDM. Conclusions A dental composite was developed with triple benefits of self-healing after fracture, antibacterial activity, and remineralization capability for the first time. Clinical significance The self-healing, antibacterial and remineralizing composite may be promising for tooth cavity restorations to combat bulk fracture and secondary caries. The method of using triple agents (self-healing microcapsules, DMAHDM, and NACP) may have wide applicability to other dental composites, adhesives, sealants and cements. PMID:25625674

Review of research on the mechanical properties of the human tooth

PubMed Central

Zhang, Ya-Rong; Du, Wen; Zhou, Xue-Dong; Yu, Hai-Yang

2014-01-01

‘Bronze teeth' reflect the mechanical properties of natural teeth to a certain extent. Their mechanical properties resemble those of a tough metal, and the gradient of these properties lies in the direction from outside to inside. These attributes confer human teeth with effective mastication ability. Understanding the various mechanical properties of human teeth and dental materials is the basis for the development of restorative materials. In this study, the elastic properties, dynamic mechanical properties (visco-elasticity) and fracture mechanical properties of enamel and dentin were reviewed to provide a more thorough understanding of the mechanical properties of human teeth. PMID:24743065

Multidisciplinary Management of An Unusual Isolated Alveolar Bone Infection- A Rare Case Report

PubMed Central

B, Dixit Mala; S, Kulkarni Rahul; M, Ramugade Manoj

2015-01-01

Restoration of proximal defect of tooth is of paramount importance as its improper restoration usually results in fracture of the restoration or deteriorated periodontal health. The article reports a case with a discreet mass of alveolar bone necrosis closed to the overhanged amalgam restoration in the proximal box of the maxillary molar. As a result of this improper proximal restoration it led to deep periodontal pocket and subsequent alveolar bone necrosis which was managed successfully with combined Endodontic-Periodontic treatment. This article highlights the unfortunate sequelae of bone necrosis as a consequence of an incorrect or overlooked dental treatment and its comprehensive management. PMID:26155587

Er:YAG laser debonding of porcelain veneers

NASA Astrophysics Data System (ADS)

Buu, Natalie; Morford, Cynthia; Finzen, Frederick; Sharma, Arun; Rechmann, Peter

2010-02-01

The removal of porcelain veneers using Er:YAG lasers has not been previously described in the scientific literature. This study was designed to systematically investigate the efficacy of an Er:YAG laser on veneer debonding without damaging the underlying tooth structure, as well as preserving a new or misplaced veneer. Initially, Fourier Transform Infrared Spectroscopy (FTIR) was used on flat porcelain veneer samples (IPS Empress Esthetic; Ivoclar Vivadent, Amherst, NY) to assess which infrared laser wavelengths are transmitted through the veneer. Additionally, FTIR spectra from a veneer bonding cement (RelyX Veneer Cement A1; 3M ESPE, St. Paul, MN) were obtained. While the veneer material showed no characteristic water absorption bands in the FTIR, the bonding cement has a broad H2O/OH absorption band coinciding with the ER:YAG laser emission wavelength. Consequently Er:YAG laser energy transmission through different veneer thicknesses was measured. The porcelain veneers transmitted 11 - 18 % of the incident Er:YAG laser energy depending on their thicknesses (Er:YAG laser: LiteTouch by Syneron; wavelength 2,940 nm, 10 Hz repetition rate, pulse duration 100 μs at 133 mJ/pulse; straight sapphire tip 1,100 μm diameter; Syneron, Yokneam, Israel). Initial signs of cement ablation occurred at approximately 1.8 - 4.0 J/cm2. This can be achieved by irradiating through the veneer with the fiber tip positioned at a distance of 3-6 mm from the veneer surface, and operating the Er:YAG laser with 133 mJ output energy. All eleven veneers bonded on extracted anterior incisor teeth were easily removed using the Er:YAG laser. The removal occurred without damaging underlying tooth structure as verified by light microscopic investigation (Incident Light Microscope Olympus B 50, Micropublisher RTV 3.3 MP, Image Pro software, Olympus). The debonding mainly occurred at the cement/veneer interface. When the samples were stored in saline solution for 5 days and/or an air-waterspray was used during irradiation, there was a high chance that the veneer would fractured during debonding. However if samples were not stored in water and only air spray was used, 75% of the veneers could be removed without any fracture. The use of an Er:YAG laser can be effective in not only debonding porcelain veneers and preserving tooth structure, but also in maintaining veneer integrity.

Type IV collagen is a novel DEJ biomarker that is reduced by radiotherapy.

PubMed

McGuire, J D; Gorski, J P; Dusevich, V; Wang, Y; Walker, M P

2014-10-01

The dental basement membrane (BM) is composed of collagen types IV, VI, VII, and XVII, fibronectin, and laminin and plays an inductive role in epithelial-mesenchymal interactions during tooth development. The BM is degraded and removed during later-stage tooth morphogenesis; however, its original position defines the location of the dentin-enamel junction (DEJ) in mature teeth. We recently demonstrated that type VII collagen is a novel component of the inner enamel organic matrix layer contiguous with the DEJ. Since it is frequently co-expressed with and forms functional complexes with type VII collagen, we hypothesized that type IV collagen should also be localized to the DEJ in mature human teeth. To identify collagen IV, we first evaluated defect-free erupted teeth from various donors. To investigate a possible stabilizing role, we also evaluated extracted teeth exposed to high-dose radiotherapy--teeth that manifest post-radiotherapy DEJ instability. We now show that type IV collagen is a component within the morphological DEJ of posterior and anterior teeth from individuals aged 18 to 80 yr. Confocal microscopy revealed that immunostained type IV collagen was restricted to the 5- to 10-µm-wide optical DEJ, while collagenase treatment or previous in vivo tooth-level exposure to > 60 Gray irradiation severely reduced immunoreactivity. This assignment was confirmed by Western blotting with whole-tooth crown and enamel extracts. Without reduction, type IV collagen contained macromolecular α-chains of 225 and 250 kDa. Compositionally, our results identify type IV collagen as the first macromolecular biomarker of the morphological DEJ of mature teeth. Given its network structure and propensity to stabilize the dermal-epidermal junction, we propose that a collagen-IV-enriched DEJ may, in part, explain its well-known fracture toughness, crack propagation resistance, and stability. In contrast, loss of type IV collagen may represent a biochemical rationale for the DEJ instability observed following oral cancer radiotherapy. © International & American Associations for Dental Research.

Type IV Collagen is a Novel DEJ Biomarker that is Reduced by Radiotherapy

PubMed Central

McGuire, J.D.; Gorski, J.P.; Dusevich, V.; Wang, Y.; Walker, M.P.

2014-01-01

The dental basement membrane (BM) is composed of collagen types IV, VI, VII, and XVII, fibronectin, and laminin and plays an inductive role in epithelial-mesenchymal interactions during tooth development. The BM is degraded and removed during later-stage tooth morphogenesis; however, its original position defines the location of the dentin-enamel junction (DEJ) in mature teeth. We recently demonstrated that type VII collagen is a novel component of the inner enamel organic matrix layer contiguous with the DEJ. Since it is frequently co-expressed with and forms functional complexes with type VII collagen, we hypothesized that type IV collagen should also be localized to the DEJ in mature human teeth. To identify collagen IV, we first evaluated defect-free erupted teeth from various donors. To investigate a possible stabilizing role, we also evaluated extracted teeth exposed to high-dose radiotherapy – teeth that manifest post-radiotherapy DEJ instability. We now show that type IV collagen is a component within the morphological DEJ of posterior and anterior teeth from individuals aged 18 to 80 yr. Confocal microscopy revealed that immunostained type IV collagen was restricted to the 5- to 10-µm-wide optical DEJ, while collagenase treatment or previous in vivo tooth-level exposure to > 60 Gray irradiation severely reduced immunoreactivity. This assignment was confirmed by Western blotting with whole-tooth crown and enamel extracts. Without reduction, type IV collagen contained macromolecular α-chains of 225 and 250 kDa. Compositionally, our results identify type IV collagen as the first macromolecular biomarker of the morphological DEJ of mature teeth. Given its network structure and propensity to stabilize the dermal-epidermal junction, we propose that a collagen-IV-enriched DEJ may, in part, explain its well-known fracture toughness, crack propagation resistance, and stability. In contrast, loss of type IV collagen may represent a biochemical rationale for the DEJ instability observed following oral cancer radiotherapy. PMID:25146181

Biomechanical Assessment of Restored Mandibular Molar by Endocrown in Comparison to a Glass Fiber Post-Retained Conventional Crown: 3D Finite Element Analysis.

PubMed

Helal, Mohammed Abu; Wang, Zhigang

2017-10-25

To compare equivalent and contact stresses in a mandibular molar restored by all-ceramic crowns through two methods: ceramic endocrowns and ceramic crowns supported by fiber-reinforced composite (FRC) posts and core, by using 3D finite element analysis during normal masticatory load. Three 3D models of a mandibular first molar were made and labeled as such: intact molar with no restoration (A); ceramic endocrown-restored molar (B); ceramic crown supported by FRC posts and core restored molar (C). By using 3D FE analysis with contact components, normal masticatory load was simulated. The mvM stresses in all models were calculated. Maximal mvM stresses in the ceramic of restorations, dentin, and luting cement were contrasted among models and to values of materials' strength. Contact shear and tensile stresses in the restoration/tooth interface around restorations were also calculated. The highest mvM stress levels in the enamel and dentin for the tooth restored by ceramic endocrown were lower in the crown ceramic than in tooth restored with FRC posts and all-ceramic crowns; however, in the resin adhesive cement interface it was lower for ceramic crown supported by FRC posts than the in ceramic endocrown restoration. The maximum contact shear and tensile stress values along the restoration/tooth interface of ceramic endocrowns were lower than those with ceramic crowns supported by FRC posts. Ceramic endocrown restorations presented a lower mvM stress level in dentin than the conventional ceramic crowns supported by FRC posts and core. Ceramic endocrown restorations in molars are less susceptible to damage than those with conventional ceramic crowns retained by FRC posts. Ceramic endocrowns properly cemented in molars must not be fractured or loosen during normal masticatory load. Therefore, ceramic endocrowns are advised as practicable, minimally invasive, and esthetic restorations for root canal treated mandibular molars. © 2017 by the American College of Prosthodontists.

Biomechanical interactions of endodontically treated tooth implant-supported prosthesis under fatigue test with acoustic emission monitoring.

PubMed

Huang, Shao-Fu; Chen, Wan-Rung; Lin, Chun-Li

2016-02-24

This study investigated the biomechanical interactions in endodontically treated tooth implant-supported prosthesis (TISP) with implant system variations under dynamic cyclic loads monitored using the acoustic emission (AE) technique. Macrostructure implants using a taper integrated screw-in (TIS; 2-piece implant) and a retaining-screw (RS; 3-piece implant) connected to an abutment were used for this investigation and their corresponding mechanical resistances in conformity with the ISO 14801 standard were evaluated. The endodontically treated TISP samples were constructed containing TIS and RS implants splinted to the second premolar with fatigue tests performed by applying occlusal force onto the premolar simulating the bending moment effect. The numbers of accumulated AE signals in the fatigue tests and failure modes for the sample were recorded to evaluate the mechanical resistance. The maximum load in the static test for RS (3-piece) implant (797N) was significantly higher than that for the TIS (2-piece) implant (559N). Large deformations were found at abutment screws in both RS and TIS implants. Although the numbers of accumulated AE signals for the TIS implant (72511) were higher than those for the RS implant (437), statistical non-significant differences were found between TIS and RS implants. No obvious damage was noted in endodontically treated TISP samples using RS implants but two of the corresponding TIS implants fractured in the abutment screws. Splints with RS (3-piece) implant prosthesis produce better mechanical responses than the TIS (2-piece) implant when connected to an endodontically treated tooth restored with a post core and crown.

Energy output reduction and surface alteration of quartz and sapphire tips following Er:YAG laser contact irradiation for tooth enamel ablation.

PubMed

Eguro, Toru; Aoki, Akira; Maeda, Toru; Takasaki, Aristeo Atsushi; Hasegawa, Mitsuru; Ogawa, Masaaki; Suzuki, Takanori; Yonemoto, Kazuaki; Ishikawa, Isao; Izumi, Yuichi; Katsuumi, Ichiroh

2009-10-01

Despite the recent increase in application of Er:YAG laser for various dental treatments, limited information is available regarding the contact tips. This study examined the changes in energy output and surface condition of quartz and sapphire contact tips after Er:YAG laser contact irradiation for tooth enamel ablation. Ten sets of unused quartz or sapphire contact tips were employed for contact irradiation to sound enamel of extracted teeth. The teeth were irradiated with Er:YAG laser at approximately 75 J/cm(2)/pulse and 20 Hz under water spray for 60 minutes. The energy output was measured before and every 5 minutes after irradiation, and the changes in morphology and chemical composition of the contact surface were analyzed. The energy output significantly decreased with time in both tips. The energy output from the sapphire tips was generally higher on average than that of the quartz. The contact surfaces of all the used quartz tips were concave and irregular. Most of the sapphire tips also appeared rough with crater formation and fractures, except for a few tips in which a high energy output and the original smooth surface were maintained. Spots of melted tooth substances were seen attached to the surface of both tips. In contact enamel ablation, the sapphire tip appeared to be more resistant than the quartz tip. The quartz tips showed similar patterns of energy reduction and surface alteration, whereas the sapphire tips revealed a wider and more characteristic variation among tips. Lasers Surg. Med. 41:595-604, 2009. (c) 2009 Wiley-Liss, Inc.

The advantages of a swept source optical coherence tomography system in the evaluation of occlusal disorders

NASA Astrophysics Data System (ADS)

Marcauteanu, Corina; Bradu, Adrian; Sinescu, Cosmin; Topala, Florin Ionel; Negrutiu, Meda Lavinia; Duma, Virgil Florin; Podoleanu, Adrian Gh.

2014-01-01

Occlusal disorders are characterized by multiple dental and periodontal signs. Some of these are reversible (such as excessive tooth mobility, fremitus, tooth pain, migration of teeth in the absence of periodontitis), some are not (pathological occlusal/incisal wear, abfractions, enamel cracks, tooth fractures, gingival recessions). In this paper we prove the advantages of a fast swept source OCT system in the diagnosis of pathological incisal wear, a key sign of the occlusal disorders. On 15 extracted frontal teeth four levels of pathological incisal wear facets were artificially created. After every level of induced defect, OCT scanning was performed. B scans were acquired and 3D reconstructions were generated. A swept source OCT instrument is used in this study. The swept source is has a central wavelength of 1050 nm and a sweeping rate of 100 kHz. A depth resolution determined by the swept source of 12 μm in air was experimentally measured. The pathological incisal wear is qualitatively observed on the B-scans as 2D images and 3D reconstructions (volumes). For quantitative evaluations of volumes, we used the Image J software. Our swept source OCT system has several advantages, including the ability to measure (in air) a minimal volume of 2352 μm3 and to collect high resolution volumetric images in 2.5 s. By calculating the areas of the amount of lost tissue corresponding to each difference of B-scans, the final volumes of incisal wear were obtained. This swept source OCT method is very useful for the dynamic evaluation of pathological incisal wear.

Clinical and semiquantitative marginal analysis of four tooth-coloured inlay systems at 3 years.

PubMed

Gladys, S; Van Meerbeek, B; Inokoshi, S; Willems, G; Braem, M; Lambrechts, P; Vanherle, G

1995-12-01

The marginal quality of four tooth-coloured inlay systems was clinically investigated and subjected to computer-aided semiquantitative marginal analysis under scanning electron microscopy (SEM) after 3 years of clinical service. Three of the restoration types were made using the Cerec CAD-CAM apparatus: one was milled from preformed glass ceramic blocks, and the two other inlay types were milled from preformed porcelain blocks. The fourth system was based on an experimental indirect resin composite inlay system. Each inlay type was luted with a different luting resin composite. The clinical evaluation was performed with a mirror and explorer by two clinicians separately, and the marginal analysis was conducted microscopically on replicas (SEM x 200). After 3 years in situ, all the restorations were clinically acceptable. No recurrent caries was observed. Marginal analysis under SEM detected a high percentage of submargination for all four systems, which suggests that their respective resin composite luting agents were all subject to wear. The percentage of marginal fractures on the enamel side as well as on the inlay side did not increase dramatically compared to the 6-month results. The first recall after 6 months of clinical service indicated how tooth-coloured inlays behave at their margins. The 3-year results confirmed the early findings, indicating that wear of resin composite lutes is important and present in all systems. The two ceramic materials showed a similar behaviour at the margins. The resin composite inlay performed better at the inlay site than at the enamel site.

Dentinal tubules revealed with X-ray tensor tomography.

PubMed

Jud, Christoph; Schaff, Florian; Zanette, Irene; Wolf, Johannes; Fehringer, Andreas; Pfeiffer, Franz

2016-09-01

Dentin is a mineralized material making up most of the tooth bulk. A system of microtubules, so called dentinal tubules, transverses it radially from the pulp chamber to the outside. This highly oriented structure leads to anisotropic mechanical properties directly connected to the tubules orientation and density: the ultimate tensile strength as well as the fracture toughness and the shear strength are largest perpendicular to dentinal tubules. Consequently, the fatigue strength depends on the direction of dentinal tubules, too. However, none of the existing techniques used to investigate teeth provide access to orientation and density of dentinal tubules for an entire specimen in a non-destructive way. In this paper, we measure a third molar human tooth both with conventional micro-CT and X-ray tensor tomography (XTT). While the achievable resolution in micro-CT is too low to directly resolve the dentinal tubules, we provide strong evidence that the direction and density of dentinal tubules can be indirectly measured by XTT, which exploits small-angle X-ray scattering to retrieve a 3D map of scattering tensors. We show that the mean directions of scattering structures correlate to the orientation of dentinal tubules and that the mean effective scattering strength provides an estimation of the relative density of dentinal tubules. Thus, this method could be applied to investigate the connection between tubule orientation and fatigue or tensile properties of teeth for a full sample without cutting one, non-representative peace of tooth out of the full sample. Copyright © 2016 The Academy of Dental Materials. All rights reserved.

Analysis of the Effects of Surface Pitting and Wear on the Vibrations of a Gear Transmission System

NASA Technical Reports Server (NTRS)

Choy, F. K.; Polyshchuk, V.; Zakrajsek, J. J.; Handschuh, R. F.; Townsend, D. P.

1994-01-01

A comprehensive procedure to simulate and analyze the vibrations in a gear transmission system with surface pitting, 'wear' and partial tooth fracture of the gear teeth is presented. An analytical model was developed where the effects of surface pitting and wear of the gear tooth were simulated by phase and magnitude changes in the gear mesh stiffness. Changes in the gear mesh stiffness were incorporated into each gear-shaft model during the global dynamic simulation of the system. The overall dynamics of the system were evaluated by solving for the transient dynamics of each shaft system simultaneously with the vibration of the gearbox structure. In order to reduce the number of degrees-of-freedom in the system, a modal synthesis procedure was used in the global transient dynamic analysis of the overall transmission system. An FFT procedure was used to transform the averaged time signal into the frequency domain for signature analysis. In addition, the Wigner-Ville distribution was also introduced to examine the gear vibration in the joint time frequency domain for vibration pattern recognition. Experimental results obtained from a gear fatigue test rig at NASA Lewis Research Center were used to evaluate the analytical model.

FRACTURE STRENGTH OF FLARED BOVINE ROOTS RESTORED WITH DIFFERENT INTRARADICULAR POSTS

PubMed Central

Clavijo, Victor Grover Rene; Reis, José Maurício dos Santos Nunes; Kabbach, William; Silva, André Luis Faria e; de Oliveira, Osmir Batista; de Andrade, Marcelo Ferrarezi

2009-01-01

Objective: The aim of this study was to evaluate the fracture strength and failure mode of flared bovine roots restored with different intraradicular posts. Material and Methods: Fifty bovine incisors with similar dimensions were selected and their roots were flared until 1.0 mm of dentin wall remained. Next, the roots were allocated into five groups (n=10): GI-cast metal post-and-core; GII-fiber posts plus accessory fiber posts; GIII- direct anatomic post; GIV- indirect anatomic post and GV- control (specimens without intraradicular post). A polyether impression material was used to simulate the periodontal ligament. After periodontal ligament simulation, the specimens were subjected to a compressive load at a crosshead speed of 0.5 mm/min in a servo-hydraulic testing machine (MTS 810) applied at 135° to the long axis of the tooth until failure. The data (N) were subjected to ANOVA and Tukey's post-hoc test (α=0.05). Results: GI and GIV presented higher fracture strength (p<0.05) than GII. GIII presented intermediate values without statistically significant differences (p>0.05) from GI, GII and GIV. Control specimens (GV) produced the lowest fracture strength mean values (p<0.05). Despite obtaining the highest mean value, GI presented 100% of unfavorable failures. GII presented 20% of unfavorable failures. GIII, GIV and GV presented only favorable failures. Conclusions: Although further in vitro and in vivo studies are necessary, the results of this study showed that the use of direct and indirect anatomic posts in flared roots could be an alternative to cast metal post-and-core. PMID:20027429

Effects of 445-nm Diode Laser-Assisted Debonding of Self-Ligating Ceramic Brackets on Shear Bond Strength.

PubMed

Stein, Steffen; Hellak, Andreas; Schauseil, Michael; Korbmacher-Steiner, Heike; Braun, Andreas

2018-01-01

The aim of this study was to measure the effect of irradiation with a novel 445-nm diode laser on the shear bond strength (SBS) of ceramic brackets before debonding. Thirty ceramic brackets (In-Ovation ® C, GAC) were bonded in standard manner to the planed and polished buccal enamel surfaces of 30 caries-free human third molars. Each tooth was randomly allocated to the laser or control group, with 15 samples per group. The brackets in the laser group were irradiated with the diode laser (SIROLaser Blue ® ; Sirona) on three sides of the bracket bases for 5 sec each (lateral-coronal-lateral, a total of 15 sec) immediately before debonding. SBS values were measured for the laser group and control group. To assess the adhesive remnant index (ARI) and the degree of enamel fractures, micrographs of the enamel surface were taken with 10-fold magnification after debonding. The SBS values were significantly lower statistically in the laser group in comparison with the control group (p < 0.05). The ARI scores were also significantly lower statistically in the laser group in comparison with the control group (p < 0.05). No bracket fractures or enamel fractures occurred in either group after debonding. Irradiation of ceramic brackets with the novel diode laser before debonding significantly reduces the SBS values. This is of clinical importance, as it means that the risk of damage to the teeth, bracket fractures, and the overall treatment time can be reduced.

Fracture load of ceramic restorations after fatigue loading.

PubMed

Baladhandayutham, Balasudha; Lawson, Nathaniel C; Burgess, John O

2015-08-01

A clinician must decide what ceramic coping and veneer material to prescribe based on the amount of tooth reduction possible and the desired esthetic outcome of the restoration. The purpose of this in vitro study was to compare the fracture strength of monolithic and bilayered lithium disilicate (IPS e.max) and zirconia (LAVA) crowns at clinically relevant thicknesses after load cycling. Crowns (n=8) were fabricated from 6 groups: 1.2-mm monolithic lithium disilicate, 1.5-mm monolithic lithium disilicate, 1.5-mm bilayered lithium disilicate with hand-layered veneer, 0.6 mm monolithic zirconia, 1.2-mm bilayered zirconia with hand-layered veneer, and 1.2-mm bilayered zirconia with milled veneer (dimension represents thickness at the occlusal pit). Crowns were cemented to identical milled resin dies with resin-modified glass ionomer cement. Cemented crowns were stored at 37°C for 24 hours and load cycled for 200,000 cycles at 25 N at a rate of 40 cycles/minute. The ultimate fracture load for each specimen was measured in a universal testing machine. Data were analyzed with a 1-way ANOVA and Tukey honest significant difference post hoc analysis (α=.05). Mean ±SD fracture load values were 1465 ±330 N for monolithic lithium disilicate (1.2-mm thickness) and 2027 ±365 N (1.5-mm thickness) and 1732 ±315 N for bilayered hand-veneered lithium disilicate (1.5-mm thickness). Fracture loads were 1669 ±311 N for monolithic zirconia crowns (0.6mm thickness), 2625 ±300 N for zirconia milled-veneered (1.2-mm thickness), and 2655 ±590N for zirconia hand-veneered crowns (1.2mm thickness). One-way ANOVA showed a statistically significant difference among the groups (P<.01). Veneered zirconia crowns showed the highest fracture strength, 1.2-mm hand veneered zirconia was similar to that of 1.5-mm monolithic zirconia, and all other groups were not statistically different. Crowns of 1.2-mm bilayered zirconia had higher fracture loads than 0.6-mm zirconia or 1.2-mm lithium disilicate monolithic crowns. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Alveolar process fractures in the permanent dentition. Part 2. The risk of healing complications in teeth involved in an alveolar process fracture.

PubMed

Lauridsen, Eva; Gerds, Thomas; Andreasen, Jens Ove

2016-04-01

To analyze the risk of pulp canal obliteration (PCO), pulp necrosis (PN), repair-related resorption (RRR), infection-related resorption (IRR), ankylosis-related resorption (ARR), marginal bone loss (MBL), and tooth loss (TL) for teeth involved in an alveolar process fracture and to identify possible risk factors. A total of 91 patients with 223 traumatized teeth. The risks of PCO, PN, RRR, IRR, ARR, MBL, and TL were analyzed separately for teeth with immature and mature root development using Kaplan-Meier and Aalen-Johansen methods. Possible risk factors for PN (age, fracture in relation to apex, displacement, gingival injury, degree of repositioning, type of splint, duration of splinting, treatment delay, and antibiotics) were analyzed for mature teeth using Cox regression. The level of significance was 5%. Immature: No severe complications (PN, IRR, ARR, MBL, or TL) were diagnosed during follow up. Mature: Estimated risk after a 10-year follow up: PN: 56% (95% confidence interval (CI): 48.1-63.9), IRR: 2.5% (95% CI: 0-5.1), ARR: 2.1% (95% CI: 0.1-4.1), MBL: 2.4% (95% CI: 0.3-4.4), and TL: 7.8% (95% CI: 0-15.7). The following factors significantly increased the risk of PN in teeth with mature root development: fracture in relation to apex (hazard ratio (HR): 2.6 (95% CI: 0.2 - 5.7), P = 0.01), displacement in the horizontal part of the fracture >2 mm (HR: 1.8; 95% CI: 1.1-3.2, P = 0.03), incomplete repositioning (HR: 2.1 (95% CI: 1.3-3.5), P = 0.003), and age >30 years (HR: 2.3 (95% CI: 1.1-4.6), P = 0.02). The type of splint (rigid or flexible), the duration of splinting (more or less than 4 weeks), and the administration of antibiotics did not affect the risk of PN. Teeth involved in alveolar process fractures appear, apart from PN, to have a good prognosis. A conservative treatment approach is recommended. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Is there a need of extra fluoride in children?

PubMed

Gupta, Sunil Kumar; Gupta, R C; Gupta, A B

2009-09-01

The issues related to fluoridation of water or fortification of tooth paste with compounds of fluorides are controversial. Fluoride is stored mainly in the bones, where it increases the density and changes the internal architecture, makes it osteoporotic and more prone to fractures. Fluoride consumption by human beings increases the general cancer death rate, disrupts the synthesis of collagen and leads to the breakdown of collagen in bone, tendon, muscle, skin, cartilage, lungs, kidney and trachea, causing disruptive effect on various tissues in the body. It inhibits antibody formation, disturbs immune system and makes the child prone to malignancy. Fluoride has been categorized as a protoplasmic poison and any additional ingestion of fluoride by children is undesirable.

[Osteogenesis imperfecta in monozygotic twins in Burundi].

PubMed

Armstrong, O; Karayuba, R; Ngendahayo, L; Habonimana, E

1994-01-01

Little data is available about osteogenesis imperfecta in Black African children. This defect was diagnosed in monozygotic twins from Rwanda who presented multiple fractures, in particular of the femur, when they began to walk. Osteogenesis imperfecta was confirmed by lower limb deformity, presence of wormian bones in the skull, blue sclera, and tooth defects. In addition to the fact that it is uncommon to encounter this condition in monozygotic twins, this case is interesting for several reasons. Was osteogenesis imperfecta in these patients type I, frequent, or type III, exceptional? More importantly, this case stresses the high prevalence of type III in Black Africa which could constitute a hot-bed in the world.

Considerations for ceramic inlays in posterior teeth: a review

PubMed Central

Hopp, Christa D; Land, Martin F

2013-01-01

This review of ceramic inlays in posterior teeth includes a review of the history of ceramic restorations, followed by common indications and contraindications for their use. A discussion on the potential for tooth wear is followed by a review of recommended preparation design considerations, fabrication methods, and material choices. Despite the improved materials available for fabrication of porcelain inlays, fracture remains a primary mode of inlay failure. Therefore, a brief discussion on strengthening methods for ceramics is included. The review concludes with a section on luting considerations, and offers the clinician specific recommendations for luting procedures. In conclusion, inlay success rates and longevity, as reported in the literature, are summarized. PMID:23750101

Fracture resistance of immature teeth filled with BioAggregate, mineral trioxide aggregate and calcium hydroxide.

PubMed

Tuna, Elif Bahar; Dinçol, Muzaffer Emir; Gençay, Koray; Aktören, Oya

2011-06-01

Abstract -  Background: The aim of this in vitro study was to assess the long-term fracture resistance of human immature permanent teeth filled with BioAggregate (BA), mineral trioxide aggregate (MTA) and calcium hydroxide (CH).  The study consisted of single rooted premolar teeth with immature root formation extracted for orthodontic reasons. A total of 28 immature premolars with average root length of 10.7 mm and apical diameter of 3 mm were included in the study. The pulps were extirpated and the canals were prepared using an apical approach. The teeth were randomly assigned to four groups: Group I: DiaRoot(®) BA (DiaDent, Burnaby, BC, Canada), Group II: Angelus MTA (MTA-A; Angelus, Londrina, Brazil), Group III: ProRoot(®) MTA (MTA-PR; Dentsply, Tulsa, OK, USA), Group IV: CH (Sultan Chemists Inc., Englewood, NJ, USA). The teeth were placed in saline solution at 4°C for 1 year. The root of each tooth was then embedded in an acrylic resin block. All specimens were loaded at a crosshead speed of 1 mm min(-1) in an Instron testing machine and the peak loads up to fracture were recorded. Data were analysed statistically by Kruskal-Wallis and Mann-Whitney U-tests.  Mean (±SD) failure loads (MPa) were: 37.69 ± 14.43 for BA group, 32.94 ± 8.15 for MTA-A group, 28.74 ± 9.49 for MTA-PR group and 23.18 ± 8.48 for CH group. The BA group exhibited the highest fracture resistance and the CH group showed the lowest resistance to fracture. Significant differences (P < 0.05) in fracture resistance were found between the DiaRoot-BA and CH groups, and also between the MTA-A and CH groups.  Within the limitations of this study, data suggest that DiaRoot-BA-filled immature teeth demonstrate higher fracture resistance than other groups at 1 year. Considering the long-term risk of cervical root fracture associated with immature teeth, the use of DiaRoot-BA as a root canal filling material appears to be the most advantageous of the materials tested. © 2011 John Wiley & Sons A/S.

Teachers' knowledge concerning dental trauma and its management in primary schools in Riyadh, Saudi Arabia.

PubMed

Alsadhan, Salwa A; Alsayari, Najla F; Abuabat, Mashael F

2018-02-22

The main aim of this cross-sectional study was to assess knowledge concerning traumatic dental injuries and their management among primary schoolteachers in Riyadh, Saudi Arabia. The secondary objective was to evaluate the effect of gender, nationality, marital status, school type, geographical area, age group, level of education and years of experience on teachers' knowledge. Data were collected, through a self-administered questionnaire, from both male and female teachers employed in public and private primary schools in the five geographical areas of Riyadh City. The total sample size was 1,520 teachers. Data were entered into the Statistical Package for the Social Sciences. Frequencies and percentages were calculated. An independent t-test and a one-way analysis of variance (ANOVA) were used to calculate significance. The total score for the questions assessing knowledge was calculated out of 9, and the highest score was 7 with an average score of 2.85. Over half of the sampled participants stated that they did not know how to manage soft-tissue injuries. Regarding the management of fractured teeth, 38.8% believed that the fractured part is useless; and for the management of an avulsed permanent tooth, only 6.2% of the respondents selected the correct answer. For the question regarding suitable storage medium of an avulsed tooth, only 19.7% chose milk and 3.2% chose the injured person's saliva. Teachers between 41 and 50 years of age and those with longer years of experience had the highest level of knowledge. Teachers in the north area of Riyadh had a higher level of knowledge than teachers in other areas. There was a lack of knowledge among primary schoolteachers in Riyadh concerning traumatic dental injuries and their management. Statistically significant differences were found among geographical areas, age groups and years of experience; no statistically significant differences were found regarding gender, nationality, marital status, level of education and school type (public/private). © 2018 FDI World Dental Federation.

DENTAL WEAR CAUSED BY ASSOCIATION BETWEEN BRUXISM AND GASTROESOPHAGEAL REFLUX DISEASE: A REHABILITATION REPORT

PubMed Central

Machado, Naila Aparecida de Godoi; Fonseca, Rodrigo Borges; Branco, Carolina Assaf; Barbosa, Gustavo Augusto Seabra; Fernandes, Alfredo Júlio; Soares, Carlos José

2007-01-01

Bruxism is a pathological activity of the stomatognathic system that involves tooth grinding and clenching during parafunctional jaw movements. Clinical signs of bruxism are mostly related to dental wear and muscular and joint discomforts, but a large number of etiological factors can be listed, as local, systemic, psychological and hereditary factors. The association between bruxism, feeding and smoking habits and digestive disorders may lead to serious consequences to dental and related structures, involving dental alterations (wear, fractures and cracks), periodontal signs (gingival recession and tooth mobility) and muscle-joint sensivity, demanding a multidisciplinary treatment plan. This paper presents a case report in which bruxism associated with acid feeding, smoking habit and episodes of gastric reflow caused severe tooth wear and great muscular discomfort with daily headache episodes. From the diagnosis, a multidisciplinary treatment plan was established. The initial treatment approach consisted of medical follow up with counseling on diet and smoking habits and management of the gastric disorders. This was followed by the installation of an interocclusal acrylic device in centric relation of occlusion (CRO) for reestablishment of the occlusal stability, vertical dimension of occlusion, anterior guides and return to normal muscle activity (90-day use approximately). After remission of initial symptoms, oral rehabilitation was implemented in CRO by means of full resin composite restorations and new interocclusal device for protection of restorations. Satisfactory esthetics, improved function and occlusal stability were obtained after oral rehabilitation. The patient has attended annual follow-ups for the past 2 years. The multidisciplinary treatment seems to be the key for a successful rehabilitation of severe cases of dental wear involving the association of different health disorders. PMID:19089153

Competing mechanisms in the wear resistance behavior of biomineralized rod-like microstructures

NASA Astrophysics Data System (ADS)

Escobar de Obaldia, Enrique; Herrera, Steven; Grunenfelder, Lessa Kay; Kisailus, David; Zavattieri, Pablo

2016-11-01

The remarkable mechanical properties observed in biological composite materials relative to those of their individual constituents distinguish them from common engineering materials. Some naturally occurring high-performance ceramics, like the external veneer of the Chiton (Cryptochiton stelleri) tooth, have been shown to have superior hardness and impressive abrasion resistance properties. The mechanical performance of the chiton tooth has been attributed to a hierarchical arrangement of nanostructured magnetite rods surrounded with organic material. While nanoindentation tests provide useful information about the overall performance of this biological composite, understanding the key microstructural features and energy dissipation mechanisms at small scales remains a challenging task. We present a combined experimental/numerical approach to elucidate the role of material deformation in the rods, debonding at the rod interfaces and the influence of energy dissipation mechanisms on the ability of the microstructure to distribute damage under extreme loading conditions. We employ a 3D finite element-based micromechanical model to simulate the nanoindentation tests performed in geological magnetite and cross-sections of the chiton tooth. This proposed model is capable of capturing the inelastic deformation of the rods and the failure of their interfaces, while damage, fracture and fragmentation of the mineralized rods is assessed using a probabilistic function. Our results show that these natural materials achieve their abrasion resistant properties by controlling the interface strength between rods, alleviating the tensile stress on the rods near the indentation tip and therefore decreasing the probability of catastrophic failure without significantly sacrificing resistance to penetration. The understanding of these competing energy dissipating mechanisms provides a path to the prediction of new combination of materials. In turns, these results suggest certain guidelines for abrasion resistance rod-like microstructures in composites with high volume fraction of brittle minerals or ceramics with tailored performance for specific applications.

Non-decoupled morphological evolution of the fore- and hindlimb of sabretooth predators.

PubMed

Martín-Serra, Alberto; Figueirido, Borja; Palmqvist, Paul

2017-10-01

Specialized organisms are useful for exploring the combined effects of selection of functional traits and developmental constraints on patterns of phenotypic integration. Sabretooth predators are one of the most interesting examples of specialization among mammals. Their hypertrophied, sabre-shaped upper canines and their powerfully built forelimbs have been interpreted as adaptations to a highly specialized predatory behaviour. Given that the elongated and laterally compressed canines of sabretooths were more vulnerable to fracture than the shorter canines of conical-tooth cats, it has been long hypothesized that the heavily muscled forelimbs of sabretooths were used for immobilizing prey before developing a quick and precise killing bite. However, the effect of this unique adaptation on the covariation between the fore- and the hindlimb has not been explored in a quantitative fashion. In this paper, we investigate if the specialization of sabretooth predators decoupled the morphological variation of their forelimb with respect to their hindlimb or, in contrast, both limbs vary in the same fashion as in conical-tooth cats, which do not show such extreme adaptations in their forelimb. We use 3D geometric morphometrics and different morphological indices to compare the fore- and hindlimb of conical- and sabretooth predators. Our results indicate that the limb bones of sabretooth predators covary following the same trend of conical-tooth cats. Therefore, we show that the predatory specialization of sabretooth predators did not result in a decoupling of the morphological evolution of their fore- and hindlimbs. The role of developmental constraints and natural selection on this coordinate variation between the fore- and the hindlimb is discussed in the light of this new evidence. © 2017 Anatomical Society.

Success, clinical performance and patient satisfaction of direct fibre-reinforced composite fixed partial dentures - a two-year clinical study.

PubMed

Malmstrom, H; Dellanzo-Savu, A; Xiao, J; Feng, C; Jabeen, A; Romero, M; Huang, J; Ren, Y; Yunker, M A

2015-12-01

To evaluate the success, clinical performance and patient satisfaction of directly placed fibre-reinforced composite (FRC) fixed partial dentures (FPDs) in 2 years. One hundred sixty-seven FRC FPDs (120 subjects) were directly fabricated to restore a single missing tooth by six Advanced Education in General Dentistry (AEGD) residents. The FRC FPDs recipients were randomised into two groups according to the fibre materials (pre-impregnated glass or polyethylene). Clinical performance was evaluated at baseline (2 weeks), 6, 12 and 24 months by two calibrated evaluators for prosthesis adaptation, colour match, marginal discoloration, surface roughness, caries and post-operative sensitivity using modified United State Public Health Service (USPHS) criteria. Prosthesis appearance, colour, chewing ability and overall satisfaction were evaluated by patients using a visual analogue scale (VAS). Kaplan-Meier estimation was used to estimate the prosthesis success. Ninety-four patients with 137 FRC FPDs returned (21·67% attrition rate for study subjects, 17·94% for FRC FPDs). Seventeen FRC FPDs failed, due to one-end (n = 4) or two-ends (n = 4) debonding or pontic fracture (n = 9). The cumulative 2-year success rate was 84·32% and survival rate was 92·7%; there were no statistically significant differences between the groups according to different missing tooth location, retention type or fibre materials (P > 0·05). Patient satisfaction regarding prosthesis appearance, col-our, chewing ability and overall satisfaction was rated high on the VAS (mean >80 mm) for all criteria at all time points. The FRC FPDs (restoring single tooth) fabricated by AEGD residents achieved acceptable success and survival rates in a 2-year follow-up. © 2015 John Wiley & Sons Ltd.

Dental wear caused by association between bruxism and gastroesophageal reflux disease: a rehabilitation report.

PubMed

Machado, Naila Aparecida de Godoi; Fonseca, Rodrigo Borges; Branco, Carolina Assaf; Barbosa, Gustavo Augusto Seabra; Fernandes Neto, Alfredo Júlio; Soares, Carlos José

2007-08-01

Bruxism is a pathological activity of the stomatognathic system that involves tooth grinding and clenching during parafunctional jaw movements. Clinical signs of bruxism are mostly related to dental wear and muscular and joint discomforts, but a large number of etiological factors can be listed, as local, systemic, psychological and hereditary factors. The association between bruxism, feeding and smoking habits and digestive disorders may lead to serious consequences to dental and related structures, involving dental alterations (wear, fractures and cracks), periodontal signs (gingival recession and tooth mobility) and muscle-joint sensitivity, demanding a multidisciplinary treatment plan. This paper presents a case report in which bruxism associated with acid feeding, smoking habit and episodes of gastric reflow caused severe tooth wear and great muscular discomfort with daily headache episodes. From the diagnosis, a multidisciplinary treatment plan was established. The initial treatment approach consisted of medical follow up with counseling on diet and smoking habits and management of the gastric disorders. This was followed by the installation of an interocclusal acrylic device in centric relation of occlusion (CRO) for reestablishment of the occlusal stability, vertical dimension of occlusion, anterior guides and return to normal muscle activity (90-day use approximately). After remission of initial symptoms, oral rehabilitation was implemented in CRO by means of full resin composite restorations and new interocclusal device for protection of restorations. Satisfactory esthetics, improved function and occlusal stability were obtained after oral rehabilitation. The patient has attended annual follow-ups for the past 2 years. The multidisciplinary treatment seems to be the key for a successful rehabilitation of severe cases of dental wear involving the association of different health disorders.

Effect of tooth brush abrasion and thermo-mechanical loading on direct and indirect veneer restorations.

PubMed

Rosentritt, Martin; Sawaljanow, Alexander; Behr, Michael; Kolbeck, Carola; Preis, Verena

2015-01-01

This study investigated toothbrush abrasion and in vitro aging on ceramic (indirect technique) and composite veneers (direct technique). Identical composite and individual human incisors were restored with industrially preformed composite veneers, indirectly produced ceramic veneers, and direct composite restorations. Surface roughness was determined before and after tooth brushing. A 5-year period of oral service was simulated by thermal cycling and mechanical loading (TCML). After TCML, all specimens were examined with microscopy and scanning electron microscopy. Specimens without failures during TCML were loaded until failure. analysis of variance; Bonferroni's post hoc analysis, Kaplan-Meier-Log Rank test (α = 0.05). Tooth brushing yielded a non-significant increase (p = 0.560) in roughness in all materials (industrial veneer, 0.12+/-0.07 μm, direct restoration, 0.18+/-0.14 μm, ceramic, 0.35+/-0.16 μm). No significant differences in roughness could be determined between the materials, neither before nor after testing (p < 0.001). After TCML of artificial teeth, direct and preformed composite veneers on composite teeth showed no failures or damages. Two ceramic veneers showed cracking in the labial area. After TCML of human teeth, transmission microscopy indicated a facial crack in a ceramic veneer and chipping in the cervical area of a preformed veneer. Two direct composite veneers lost retention. No significantly different survival rates were found between the three veneer groups. Fracture force on human teeth varied between 527.8+/-132.4 N (ceramic), 478.3+/-165.4 N (preformed composite), and 605.0+/-263.5 N (direct composite). All materials revealed comparable wear resistance. Indirect ceramic, direct restorative composite, and preformed composite veneers showed comparable failure rates and satisfying longevity. The results indicate similar longevity of the chosen materials for veneer restorations.

All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part I: Single crowns (SCs).

PubMed

Sailer, Irena; Makarov, Nikolay Alexandrovich; Thoma, Daniel Stefan; Zwahlen, Marcel; Pjetursson, Bjarni Elvar

2015-06-01

To assess the 5-year survival of metal-ceramic and all-ceramic tooth-supported single crowns (SCs) and to describe the incidence of biological, technical and esthetic complications. Medline (PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL) searches (2006-2013) were performed for clinical studies focusing on tooth-supported fixed dental prostheses (FDPs) with a mean follow-up of at least 3 years. This was complimented by an additional hand search and the inclusion of 34 studies from a previous systematic review [1,2]. Survival and complication rates were analyzed using robust Poisson's regression models to obtain summary estimates of 5-year proportions. Sixty-seven studies reporting on 4663 metal-ceramic and 9434 all-ceramic SCs fulfilled the inclusion criteria. Seventeen studies reported on metal-ceramic crowns, and 54 studies reported on all-ceramic crowns. Meta-analysis of the included studies indicated an estimated survival rate of metal-ceramic SCs of 94.7% (95% CI: 94.1-96.9%) after 5 years. This was similar to the estimated 5-year survival rate of leucit or lithium-disilicate reinforced glass ceramic SCs (96.6%; 95% CI: 94.9-96.7%), of glass infiltrated alumina SCs (94.6%; 95% CI: 92.7-96%) and densely sintered alumina and zirconia SCs (96%; 95% CI: 93.8-97.5%; 92.1%; 95% CI: 82.8-95.6%). In contrast, the 5-year survival rates of feldspathic/silica-based ceramic crowns were lower (p<0.001). When the outcomes in anterior and posterior regions were compared feldspathic/silica-based ceramic and zirconia crowns exhibited significantly lower survival rates in the posterior region (p<0.0001), the other crown types performed similarly. Densely sintered zirconia SCs were more frequently lost due to veneering ceramic fractures than metal-ceramic SCs (p<0.001), and had significantly more loss of retention (p<0.001). In total higher 5 year rates of framework fracture were reported for the all-ceramic SCs than for metal-ceramic SCs. Survival rates of most types of all-ceramic SCs were similar to those reported for metal-ceramic SCs, both in anterior and posterior regions. Weaker feldspathic/silica-based ceramics should be limited to applications in the anterior region. Zirconia-based SCs should not be considered as primary option due to their high incidence of technical problems. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

The effect of finish line preparation and layer thickness on the failure load and fractography of ZrO2 copings.

PubMed

Reich, Sven; Petschelt, Anselm; Lohbauer, Ulrich

2008-05-01

To prevent tooth weakening or pulp irritation, there is a need for a minimally invasive method of preparing single anterior crowns. Restoration dimensions for reduced coping thicknesses or less invasive finish line preparations are required. The purposed of this in vitro was to study investigate the fracture performance of high-strength zirconia copings, compare knife-edge margins with chamfer finish lines, and examine the effect of reducing the layer thickness from 0.5 mm to 0.3 mm. Y-TZP zirconia copings were manufactured on brass dies of a maxillary central incisor. Forty copings, with 2 layer thicknesses (0.5 and 0.3 mm), and 2 finish line preparations (knife edge and chamfer; n=10) were cemented using a conventional glass ionomer cement and stored in distilled water at 37 degrees C for 24 hours. The copings were vertically loaded until fracture using a universal testing machine. Data were analyzed by 2-way ANOVA (alpha=.05). Fractographic examination was performed using scanning electron microscopy and confocal laser scanning microscopy. A significantly higher mean failure load was measured for knife-edge (0.5 mm, 1110 +/-175 N; 0.3 mm, 730 +/-160 N) versus chamfer (0.5 mm, 697 +/-126 N; 0.3 mm, 455 +/-79 N) preparations (P<.001), and for 0.5-mm versus 0.3-mm thickness layers (P<.001). Knife-edge preparations present a promising alternative to chamfer finish lines; the fracture load required for knife-edge preparations was 38% greater than that required for chamfer preparations, regardless of coping thickness. Reducing the thickness of a single crown coping from 0.5 to 0.3 mm resulted in a 35% reduction in fracture load required for either preparation type.

Dental occlusion ties: A rapid, safe, and non‐invasive maxillo‐mandibular fixation technology

PubMed Central

2017-01-01

Objectives For decades, Erich arch bars have been a standard in establishing maxillo‐mandibular fixation (MMF). While reliable, the approach risks sharps injury, consumes operating room time, and inflicts gingival trauma. Newer technologies including screw‐based techniques and “hybrid” techniques have improved MMF by reducing sharps injuries and operating room time, but risk injury to tooth roots, nerves, and gingiva. This study aims to establish the application, strengths, and limitations of dental occlusion ties as a novel alternative in maxillo‐mandibular fixation. Study Design Prospective, non‐blinded, human feasibility clinical trial. Materials and Methods An iterative prototyping process was used to invent dental occlusion ties (brand name: Minne Ties). Development included 3D printing, cadaver prototype testing, human apical embrasure measurement, and ultimately non‐significant risk human clinical trial testing. In the IRB‐approved feasibility clinical trial, the devices were applied to mandible and maxilla fracture candidates with fractures amenable to intra‐operative MMF with open reduction with internal fixation. The ties were removed prior to extubation. Pre‐teens, comminuted fracture patients, and patients requiring post‐operative MMF were excluded. Results Manufactured, sterile prototypes secured MMF successfully in management of unilateral and bilateral mandible and maxilla fractures. All patients reported correction of pre‐operative malocclusion. Application times were typically 12–15 minutes for a single surgeon to achieve MMF. Patients incurred negligible gingival trauma from the technology as the ties require no tissue penetration for application. Conclusions Dental occlusion ties offer a non‐invasive solution featuring operating room efficiency, minimized sharps risk, and less bony and soft tissue trauma than current commercialized solutions. Level of Evidence Therapeutic, IV PMID:28894837

Clinical experiences with laser-welded titanium frameworks supported by implants in the edentulous mandible: a 5-year follow-up study.

PubMed

Ortorp, A; Linden, B; Jemt, T

1999-01-01

The purpose of this study was to report the 5-year clinical performance of implant-supported prostheses with laser-welded titanium frameworks and to compare their performance with that of prostheses provided with conventional cast frameworks. On a routine basis, a consecutive group of 824 edentulous patients were provided with fixed prostheses supported by implants in the edentulous mandible. In addition to conventional gold-alloy castings, patients were at random provided with 2 kinds of laser-welded titanium frameworks. In all, 155 patients were included in the 2 titanium framework groups. A control group of 53 randomly selected patients with conventional gold-alloy castings was used for comparison. Clinical and radiographic 5-year data was collected for the 3 groups. All followed patients still had fixed prostheses in the mandible after 5 years. The overall cumulative success rates were 95.9% and 99.7% for titanium-framework prostheses and implants, respectively. The corresponding success rates for the control group were 100% and 99.6%, respectively. Bone loss was 0.5 mm on average during the 5-year follow-up period. The most common complications for titanium frameworks were resin or tooth fractures, gingival inflammation, and fractures of the metal frames (10%). One of the cast frameworks fractured and was resoldered. Loose and fractured implant screw components were few (< 1%). Even though the cast frameworks had a higher success rate, the overall titanium framework treatment result was well in accordance with the result of the control group. The test groups performed better after clinicians had gained some experience with the technique, and laser-welded titanium frameworks seem to be a viable alternative to conventional castings in the edentulous mandible.

A Comparative Study of 3-Dimensional Titanium Versus 2-Dimensional Titanium Miniplates for Open Reduction and Fixation of Mandibular Parasymphysis Fracture.

PubMed

Mittal, Yogesh; Varghese, K George; Mohan, S; Jayakumar, N; Chhag, Somil

2016-03-01

Three dimensional titanium plating system was developed by Farmand in 1995 to meet the requirements of semi rigid fixation with lesser complication. The purpose of this in vivo prospective study was to evaluate and compare the clinical effectiveness of three dimensional and two dimensional Titanium miniplates for open reduction and fixation of mandibular parasymphysis fracture. Thirty patients with non-comminuted mandibular parasymphysis fractures were divided randomly into two equal groups and were treated with 2 mm 3D and 2D miniplate system respectively. All patients were systematically monitored at 1st, 2nd, 3rd, 6th week, 3rd and 6th month postoperatively. The outcome parameters recorded were severity of pain, infection, mobility, occlusion derangement, paresthesia and implant failure. The data so collected was analyzed using independent t test and Chi square test (α = .05). The results showed that one patient in each group had post-operative infection, occlusion derangement and mobility (p > .05). In Group A, one patient had paresthesia while in Group B, two patients had paresthesia (p > .05). None of the patients in both the groups had implant failure. There was no statistically significant difference between 3D and 2D miniplate system in all the recorded parameters at all the follow-ups (p > .05). 3D miniplates were found to be better than 2D miniplates in terms of cost, ease of surgery and operative time. However, 3D miniplates were unfavorable for cases where fracture line was oblique and in close proximity to mental foramen, where they were difficult to adapt and more chances for tooth-root damage and inadvertent injury to the mental nerve due to traction.

Effect of fiber post length and abutment height on fracture resistance of endodontically treated premolars prepared for zirconia crowns.

PubMed

Lin, Jie; Matinlinna, Jukka Pekka; Shinya, Akikazu; Botelho, Michael George; Zheng, Zhiqiang

2018-04-01

The purpose of this study was to compare the fracture resistance, mode of fracture, and stress distribution of endodontically treated teeth prepared with three different fiber post lengths and two different abutment heights, using both experimental and finite element (FE) approaches. Forty-eight human maxillary premolars with two roots were selected and endodontically treated. The teeth were randomly distributed into six equally sized groups (n = 8) with different combinations of post lengths (7.5, 11, and 15 mm) and abutment heights (3 and 5 mm). All the teeth restored with glass fiber post (Rely X Fiber Post, 3M ESPE, USA) and a full zirconia crown. All the specimens were thermocycled and then loaded to failure at an oblique angle of 135°. Statistical analysis was performed for the effects of post length and abutment height on failure loads using ANOVA and Tukey's honestly significant difference test. In addition, corresponding FE models of a premolar restored with a glass fiber post were developed to examine mechanical responses. The factor of post length (P < 0.01) had a significant effect on failure load. The abutment height (P > 0.05) did not have a significant effect on failure load. The highest mean fracture resistance was recorded for the 15 mm post length and 5 mm abutment height test group, which was significantly more resistant to fracture than the 7.5 mm post and 5 mm abutment height group (P < 0.05). The FE analysis showed the peak compression and tension stress values of 7.5 mm post length were higher than that of 11 and 15 mm post length. The stress value of remaining tooth decreased as the post length was increased. Within the limitations of this experimental and FE analysis study, increasing the post length inside the root of endodontically treated premolar teeth restored with glass-fiber posts increase the fracture resistance to non-axial forces. Failure mode is more favorable with reduced abutment heights.

Contact fatigue of human enamel: Experiments, mechanisms and modeling.

PubMed

Gao, S S; An, B B; Yahyazadehfar, M; Zhang, D; Arola, D D

2016-07-01

Cyclic contact between natural tooth structure and engineered ceramics is increasingly common. Fatigue of the enamel due to cyclic contact is rarely considered. The objectives of this investigation were to evaluate the fatigue behavior of human enamel by cyclic contact, and to assess the extent of damage over clinically relevant conditions. Cyclic contact experiments were conducted using the crowns of caries-free molars obtained from young donors. The cuspal locations were polished flat and subjected to cyclic contact with a spherical indenter of alumina at 2Hz. The progression of damage was monitored through the evolution in contact displacement, changes in the contact hysteresis and characteristics of the fracture pattern. The contact fatigue life diagram exhibited a decrease in cycles to failure with increasing cyclic load magnitude. Two distinct trends were identified, which corresponded to the development and propagation of a combination of cylindrical and radial cracks. Under contact loads of less than 400N, enamel rod decussation resisted the growth of subsurface cracks. However, at greater loads the damage progressed rapidly and accelerated fatigue failure. Overall, cyclic contact between ceramic appliances and natural tooth structure causes fatigue of the enamel. The extent of damage is dependent on the magnitude of cyclic stress and the ability of the decussation to arrest the fatigue damage. Copyright © 2016 Elsevier Ltd. All rights reserved.

Investigation of PDC bit failure base on stick-slip vibration analysis of drilling string system plus drill bit

NASA Astrophysics Data System (ADS)

Huang, Zhiqiang; Xie, Dou; Xie, Bing; Zhang, Wenlin; Zhang, Fuxiao; He, Lei

2018-03-01

The undesired stick-slip vibration is the main source of PDC bit failure, such as tooth fracture and tooth loss. So, the study of PDC bit failure base on stick-slip vibration analysis is crucial to prolonging the service life of PDC bit and improving ROP (rate of penetration). For this purpose, a piecewise-smooth torsional model with 4-DOF (degree of freedom) of drilling string system plus PDC bit is proposed to simulate non-impact drilling. In this model, both the friction and cutting behaviors of PDC bit are innovatively introduced. The results reveal that PDC bit is easier to fail than other drilling tools due to the severer stick-slip vibration. Moreover, reducing WOB (weight on bit) and improving driving torque can effectively mitigate the stick-slip vibration of PDC bit. Therefore, PDC bit failure can be alleviated by optimizing drilling parameters. In addition, a new 4-DOF torsional model is established to simulate torsional impact drilling and the effect of torsional impact on PDC bit's stick-slip vibration is analyzed by use of an engineering example. It can be concluded that torsional impact can mitigate stick-slip vibration, prolonging the service life of PDC bit and improving drilling efficiency, which is consistent with the field experiment results.

Root damage induced by intraosseous anesthesia. An in vitro investigation.

PubMed

Graetz, Christian; Fawzy-El-Sayed, Karim-Mohamed; Graetz, Nicole; Dörfer, Christof-Edmund

2013-01-01

The principle of the intraosseous anesthesia (IOA) relies on the perforation of the cortical plate of the bone for direct application of the local anesthetic solution into the underlying cancellous structures. During this procedure, IOA needles might accidentally come in contact with the tooth roots. The aim of the current in vitro study was to examine the consequences of this 'worst case scenario' comparing five commercially available IOA systems. Extracted human roots were randomly perforated using five different IOA systems with a drilling time ≤5s. To simulate normal in vivo conditions, the roots were kept humid during the drilling procedure. Data was statistically evaluated using F-test (SPSS16, SPSS Inc., Chicago, USA) and the significance level was set at p ≤ 0.05. All examined systems resulted in root perforation. Drill fractures occurred in either none 0% (Quicksleeper, Anesto, Intraflow, Stabident) or 100% (X-Tip) of the applications. Excessive heat generation, as evident by combustion odor as well as metal and tooth discoloration, appeared in 30% (Quicksleeper), 40% (Anesto), 60% (Intraflow), 90% (Stabident) and 100% (X-Tip) of all perforations. Within the limits of in-vitro studies, the results show a potential for irreversible root damage that might be inflicted by an improper use of IOA systems.

[The clinical effect of root amputation in the treatment of periodontal/alveolar abscess].

PubMed

Tan, Baochun; Wu, Wenlei; Sun, Weibin; Xiao, Jianping

2012-06-01

To study the clinical effect of root amputation in the treatment of periodontal/alveolar abscess teeth with one severe lesion root. 30 periodontal/alveolar abscess teeth with one severe lesion root were chosen in the study. After root canal treatment, supragingival scaling, subgingival scaling and root planning, occlusal adjustment were done. Then the teeth were treated by root amputation. The clinical effect was evaluated 3 months, 6 months and 1 year after surgery. One year after surgery, 27 of 30 teeth were successful, 1 mandibular molar occurred root fracture, 1 mandibular molar was removed because of tooth loosening secondary to periodontal damage. 1 patient lost. Root amputation is an effective solution of periodontal/alveolar abscess.

Incidence of dental lesions in musk shrews (Suncus murinus) and their association with sex, age, body weight and diet.

PubMed

Dudley, Emily S; Grunden, Beverly K; Crocker, Conan; Boivin, Gregory P

2013-10-22

Both wild and laboratory strains of the musk shrew (Suncus murinus) have a high incidence of periodontitis. The authors completed necropsy examinations in 51 shrews to identify dental lesions including tooth loss, mobility and fractures. Dental lesions were identified in significantly more females than males, and older animals were more likely to have lesions present. Shrews with one or more dental lesions weighed significantly less than those without lesions present. Dietary supplementation with mealworms did not significantly affect the incidence of dental lesions or the body weight of male or female shrews. The authors recommend routine body weight measurement as a simple, noninvasive method of detecting shrews with an increased likelihood of having dental lesions.

Biologic restoration of a traumatized maxillary central incisor in a toddler: a case report.

PubMed

John, Sheen Ann; Anandaraj, S; George, Sageena

2014-01-01

Trauma to the anterior teeth is relatively common in young children and teenagers. Traumatized anterior teeth require quick functional and aesthetic repair, and poses a challenge to the dental practitioner owing to the lack of co-operation ceded and the longer time invested. Reattachment of tooth fragment should be the first choice to restoring teeth when a usable fragment is available, since it gives a psychological and aesthetic advantage over the conventional technique. With the vast improvement in adhesive technology, reattachment is definitely a predictable treatment option for very young children. This paper describes the treatment of a 2½ year old female child who sustained crown-root fracture, extending subgingivally, in primary upper central incisor.

Randomized clinical study comparing metallic and glass fiber post in restoration of endodontically treated teeth.

PubMed

Gbadebo, Olaide S; Ajayi, Deborah M; Oyekunle, Oyekunle O Dosumu; Shaba, Peter O

2014-01-01

Post-retained crowns are indicated for endodontically treated teeth (ETT) with severely damaged coronal tissue. Metallic custom and prefabricated posts have been used over the years, however, due to unacceptable color, extreme rigidity and corrosion, fiber posts, which are flexible, aesthetically pleasing and have modulus of elasticity comparable with dentin were introduced. To compare clinical performance of metallic and glass fiber posts in restoration of ETT. 40 ETT requiring post retained restorations were included. These teeth were randomly allocated into 2 groups. Twenty teeth were restored using a glass fiber-reinforced post (FRP) and 20 others received stainless steel parapost (PP), each in combination with composite core buildups. Patients were observed at 1 and 6 months after post placement and cementation of porcelain fused to metal (PFM) crown. Marginal gap consideration, post retention, post fracture, root fracture, crown fracture, crown decementation and loss of restoration were part of the data recorded. All teeth were assessed clinically and radiographically. Fisher's exact test was used for categorical values while log-rank test was used for descriptive statistical analysis. One tooth in the PP group failed, secondary to decementation of the PFM crown giving a 2.5% overall failure while none in the FRP group failed. The survival rate of FRP was thus 100% while it was 97.5% in the PP group. This however was not statistically significant (log-rank test, P = 0.32). Glass FRPs performed better than the metallic post based on short-term clinical performance.

Effect of the infrastructure material on the failure behavior of prosthetic crowns.

PubMed

Sonza, Queli Nunes; Della Bona, Alvaro; Borba, Márcia

2014-05-01

To evaluate the effect of infrastructure (IS) material on the fracture behavior of prosthetic crowns. Restorations were fabricated using a metal die simulating a prepared tooth. Four groups were evaluated: YZ-C, Y-TZP (In-Ceram YZ, Vita) IS produced by CAD-CAM; IZ-C, In-Ceram Zirconia (Vita) IS produced by CAD-CAM; IZ-S, In-Ceram Zirconia (Vita) IS produced by slip-cast; MC, metal IS (control). The IS were veneered with porcelain and resin cemented to fiber-reinforced composite dies. Specimens were loaded in compression to failure using a universal testing machine. The 30° angle load was applied by a spherical piston, in 37°C distilled water. Fractography was performed using stereomicroscope and SEM. Data were statistically analyzed with Anova and Student-Newman-Keuls tests (α=0.05). Significant differences were found between groups (p=0.022). MC showed the highest mean failure load, statistically similar to YZ-C. There was no statistical difference between YZ-C, IZ-C and IZ-S. MC and YZ-C showed no catastrophic failure. IZ-C and IZ-S showed chipping and catastrophic failures. The fracture behavior is similar to reported clinical failures. Considering the ceramic systems evaluated, YZ-C and MC crowns present greater fracture load and a more favorable failure mode than In-Ceram Zirconia crowns, regardless of the fabrication type (CAD-CAM or slip-cast). Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Influence of the remaining coronal structure on the resistance of teeth with intraradicular retainer.

PubMed

Pereira, Jefferson Ricardo; Neto, Tatiany de Mendonça; Porto, Vinícius de Carvalho; Pegoraro, Luiz Fernando; do Valle, Accácio Lins

2005-01-01

The aim of this study was to compare the resistance of endodontically treated teeth with intraradicular retainer different amounts of remaining coronal structure. Fifty freshly extracted maxillary canines were endodontically treated and randomly assigned to five groups (n=10), as follows: group 1 (control) = teeth with custom cast post and core; group 2 = teeth without remaining coronal structure; group 3, 4 and 5 = teeth with 1 mm, 2 mm and 3 mm of remaining coronal structure, respectively. All specimens in groups 2 to 5 were restored with prefabricated post and resin core. The teeth were embedded in acrylic resin and the fracture strength was measured on a universal testing machine at 45 degrees to the long axis of the tooth until failure. Data were analyzed statistically by one-way analysis of variance and Tukey's test. There was no significant differences (p>0.05) between the control group and group 2, and between groups 3, 4 and 5 (p>0.05). Control group and group 2 had significantly higher resistance strength than groups 3, 4 and 5 (p<0.00001). The findings of this study showed that teeth without remaining coronal structure had significantly higher fracture strength than those with remaining coronal structure (1 mm, 2 mm and 3 mm). When the dental crown was not completely removed, the amount of remaining coronal dentin did not significantly affect the fracture strength of endodontically treated teeth with intraradicular retainer.

To What Extent is Primate Second Molar Enamel Occlusal Morphology Shaped by the Enamel-Dentine Junction?

PubMed Central

Gilissen, Emmanuel; Thiery, Ghislain

2015-01-01

The form of two hard tissues of the mammalian tooth, dentine and enamel, is the result of a combination of the phylogenetic inheritance of dental traits and the adaptive selection of these traits during evolution. Recent decades have been significant in unveiling developmental processes controlling tooth morphogenesis, dental variation and the origination of dental novelties. The enamel-dentine junction constitutes a precursor for the morphology of the outer enamel surface through growth of the enamel cap which may go along with the addition of original features. The relative contribution of these two tooth components to morphological variation and their respective response to natural selection is a major issue in paleoanthropology. This study will determine how much enamel morphology relies on the form of the enamel-dentine junction. The outer occlusal enamel surface and the enamel-dentine junction surface of 76 primate second upper molars are represented by polygonal meshes and investigated using tridimensional topometrical analysis. Quantitative criteria (elevation, inclination, orientation, curvature and occlusal patch count) are introduced to show that the enamel-dentine junction significantly constrains the topographical properties of the outer enamel surface. Our results show a significant correlation for elevation, orientation, inclination, curvature and occlusal complexity between the outer enamel surface and the enamel dentine junction for all studied primate taxa with the exception of four modern humans for curvature (p<0.05). Moreover, we show that, for all selected topometrical parameters apart from occlusal patch count, the recorded correlations significantly decrease along with enamel thickening in our sample. While preserving tooth integrity by providing resistance to wear and fractures, the variation of enamel thickness may modify the curvature present at the occlusal enamel surface in relation to enamel-dentine junction, potentially modifying dental functionalities such as blunt versus sharp dental tools. In terms of natural selection, there is a balance between increasing tooth resistance and maintaining efficient dental tools. In this sense the enamel cap acts as a functional buffer for the molar occlusal pattern. In primates, results suggest a primary emergence of dental novelties on the enamel-dentine junction and a secondary transposition of these novelties with no or minor modifications of dental functionalities by the enamel cap. Whereas enamel crenations have been reported by previous studies, our analysis do not support the presence of enamel tubercles without dentine relief nuclei. As is, the enamel cap is, at most, a secondary source of morphological novelty. PMID:26406597

Prevalence of traumatic dental injuries to permanent incisors among 12-year-old school children in Davangere, South India.

PubMed

Ravishankar, Telgi Lingesh; Kumar, Mohapatra Ashok; Ramesh, Nagrajappa; Chaitra, Telgi Ravishankar

2010-01-01

To assess the prevalence and factors associated with traumatic injuries to permanent incisors of 12-year-old school children in Davangere, India. In total, 1020 12-year-old school children were selected. Two trained and calibrated clinicians examined the children in the school environment using the World Health Organization Classification of Tooth Fracture (1978). Examination was also done for lip coverage and maxillary overjet using the Community Periodontal Index probe. Children were then interviewed using a structured questionnaire for demographic data and history of the injury. The overall prevalence rate of traumatic dental injuries (TDI) to permanent incisor teeth was 15.1%. The prevalence of TDI was higher in boys compared to girls. The major cause of TDI was falling followed by collision. The maxillary incisors were commonly injured, involving mainly enamel fracture. Children with excessive overjet and inadequate lip coverage were more likely to have injuries. TDI could be a serious dental public health problem among children. Thus, there is an urgent need to collect local data on dental injuries in order to obtain a more comprehensive picture of dental health.

Functional tooth restoration utilising split germs through re-regionalisation of the tooth-forming field

PubMed Central

Yamamoto, Naomi; Oshima, Masamitsu; Tanaka, Chie; Ogawa, Miho; Nakajima, Kei; Ishida, Kentaro; Moriyama, Keiji; Tsuji, Takashi

2015-01-01

The tooth is an ectodermal organ that arises from a tooth germ under the regulation of reciprocal epithelial-mesenchymal interactions. Tooth morphogenesis occurs in the tooth-forming field as a result of reaction-diffusion waves of specific gene expression patterns. Here, we developed a novel mechanical ligation method for splitting tooth germs to artificially regulate the molecules that control tooth morphology. The split tooth germs successfully developed into multiple correct teeth through the re-regionalisation of the tooth-forming field, which is regulated by reaction-diffusion waves in response to mechanical force. Furthermore, split teeth erupted into the oral cavity and restored physiological tooth function, including mastication, periodontal ligament function and responsiveness to noxious stimuli. Thus, this study presents a novel tooth regenerative technology based on split tooth germs and the re-regionalisation of the tooth-forming field by artificial mechanical force. PMID:26673152

The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance.

PubMed

Axelsson, P; Nyström, B; Lindhe, J

2004-09-01

The biofilm that forms and remains on tooth surfaces is the main etiological factor in caries and periodontal disease. Prevention of caries and periodontal disease must be based on means that counteract this bacterial plaque. To monitor the incidence of tooth loss, caries and attachment loss during a 30-year period in a group of adults who maintained a carefully managed plaque control program. In addition, a comparison was made regarding the oral health status of individuals who, in 1972 and 2002, were 51-65 years old. In 1971 and 1972, more than 550 subjects were recruited. Three hundred and seventy-five subjects formed a test group and 180 a control group. After 6 years of monitoring, the control group was discontinued but the participants in the test group was maintained in the preventive program and was finally re-examined after 30 years. The following variables were studied at Baseline and after 3, 6, 15 and 30 years: plaque, caries, probing pocket depth, probing attachment level and CPITN. Each patient was given a detailed case presentation and education in self-diagnosis. Once every 2 months during the first 2 years, once every 3-12 months during years 3-30, the participants received, on an individual need basis, additional education in self-diagnosis and self-care focused on proper plaque control measures, including the use of toothbrushes and interdental cleaning devices (brush, dental tape, toothpick). The prophylactic sessions that were handled by a dental hygienist also included (i) plaque disclosure and (ii) professional mechanical tooth cleaning including the use of a fluoride-containing dentifrice/paste. Few teeth were lost during the 30 years of maintenance; 0.4-1.8 in different age cohorts. The main reason for tooth loss was root fracture; only 21 teeth were lost because of progressive periodontitis or caries. The mean number of new caries lesions was 1.2, 1.7 and 2.1 in the three groups. About 80% of the lesions were classified as recurrent caries. Most sites, buccal sites being the exception, exhibited no sign of attachment loss. Further, on approximal surfaces there was some gain of attachment between 1972 and 2002 in all age groups. The present study reported on the 30-year outcome of preventive dental treatment in a group of carefully monitored subjects who on a regular basis were encouraged, but also enjoyed and recognized the benefit of, maintaining a high standard of oral hygiene. The incidence of caries and periodontal disease as well as tooth mortality in this subject sample was very small. Since all preventive and treatment efforts during the 30 years were delivered in one private dental office, caution must be exercised when comparisons are made with longitudinal studies that present oral disease data from randomly selected subject samples.

Evolution of high tooth replacement rates in sauropod dinosaurs.

PubMed

D'Emic, Michael D; Whitlock, John A; Smith, Kathlyn M; Fisher, Daniel C; Wilson, Jeffrey A

2013-01-01

Tooth replacement rate can be calculated in extinct animals by counting incremental lines of deposition in tooth dentin. Calculating this rate in several taxa allows for the study of the evolution of tooth replacement rate. Sauropod dinosaurs, the largest terrestrial animals that ever evolved, exhibited a diversity of tooth sizes and shapes, but little is known about their tooth replacement rates. We present tooth replacement rate, formation time, crown volume, total dentition volume, and enamel thickness for two coexisting but distantly related and morphologically disparate sauropod dinosaurs Camarasaurus and Diplodocus. Individual tooth formation time was determined by counting daily incremental lines in dentin. Tooth replacement rate is calculated as the difference between the number of days recorded in successive replacement teeth. Each tooth family in Camarasaurus has a maximum of three replacement teeth, whereas each Diplodocus tooth family has up to five. Tooth formation times are about 1.7 times longer in Camarasaurus than in Diplodocus (315 vs. 185 days). Average tooth replacement rate in Camarasaurus is about one tooth every 62 days versus about one tooth every 35 days in Diplodocus. Despite slower tooth replacement rates in Camarasaurus, the volumetric rate of Camarasaurus tooth replacement is 10 times faster than in Diplodocus because of its substantially greater tooth volumes. A novel method to estimate replacement rate was developed and applied to several other sauropodomorphs that we were not able to thin section. Differences in tooth replacement rate among sauropodomorphs likely reflect disparate feeding strategies and/or food choices, which would have facilitated the coexistence of these gigantic herbivores in one ecosystem. Early neosauropods are characterized by high tooth replacement rates (despite their large tooth size), and derived titanosaurs and diplodocoids independently evolved the highest known tooth replacement rates among archosaurs.

Evolution of High Tooth Replacement Rates in Sauropod Dinosaurs

PubMed Central

Smith, Kathlyn M.; Fisher, Daniel C.; Wilson, Jeffrey A.

2013-01-01

Background Tooth replacement rate can be calculated in extinct animals by counting incremental lines of deposition in tooth dentin. Calculating this rate in several taxa allows for the study of the evolution of tooth replacement rate. Sauropod dinosaurs, the largest terrestrial animals that ever evolved, exhibited a diversity of tooth sizes and shapes, but little is known about their tooth replacement rates. Methodology/Principal Findings We present tooth replacement rate, formation time, crown volume, total dentition volume, and enamel thickness for two coexisting but distantly related and morphologically disparate sauropod dinosaurs Camarasaurus and Diplodocus. Individual tooth formation time was determined by counting daily incremental lines in dentin. Tooth replacement rate is calculated as the difference between the number of days recorded in successive replacement teeth. Each tooth family in Camarasaurus has a maximum of three replacement teeth, whereas each Diplodocus tooth family has up to five. Tooth formation times are about 1.7 times longer in Camarasaurus than in Diplodocus (315 vs. 185 days). Average tooth replacement rate in Camarasaurus is about one tooth every 62 days versus about one tooth every 35 days in Diplodocus. Despite slower tooth replacement rates in Camarasaurus, the volumetric rate of Camarasaurus tooth replacement is 10 times faster than in Diplodocus because of its substantially greater tooth volumes. A novel method to estimate replacement rate was developed and applied to several other sauropodomorphs that we were not able to thin section. Conclusions/Significance Differences in tooth replacement rate among sauropodomorphs likely reflect disparate feeding strategies and/or food choices, which would have facilitated the coexistence of these gigantic herbivores in one ecosystem. Early neosauropods are characterized by high tooth replacement rates (despite their large tooth size), and derived titanosaurs and diplodocoids independently evolved the highest known tooth replacement rates among archosaurs. PMID:23874921

Pyogenic granuloma associated with periodontal abscess and bone loss - A rare case report

PubMed Central

Panseriya, Bhrugesh J.; Hungund, Shital

2011-01-01

A diverse group of the pathologic process can produce the enlargement of soft tissues in the oral cavity and often present a diagnostic challenge. This soft tissue enlargement may represent a variation of the normal anatomic structure, inflammatory reaction, cyst, neoplasm, and developmental anomalies. A group of reactive hyperplasias, which develop in response to chronic recurring tissue injury that stimulates an excessive tissue repair response. The pyogenic granuloma (PG) is a reactive enlargement that is an inflammatory response to local irritation such as calculus, a fractured tooth, rough dental restoration, and foreign materials or hormonal (pregnancy tumor) and rarely associated with bone loss. This paper presents a rare case of PG associated with periodontal abscess and bone loss in a 30-year-old male. PMID:22090773

Pyogenic granuloma associated with periodontal abscess and bone loss - A rare case report.

PubMed

Panseriya, Bhrugesh J; Hungund, Shital

2011-07-01

A diverse group of the pathologic process can produce the enlargement of soft tissues in the oral cavity and often present a diagnostic challenge. This soft tissue enlargement may represent a variation of the normal anatomic structure, inflammatory reaction, cyst, neoplasm, and developmental anomalies. A group of reactive hyperplasias, which develop in response to chronic recurring tissue injury that stimulates an excessive tissue repair response. The pyogenic granuloma (PG) is a reactive enlargement that is an inflammatory response to local irritation such as calculus, a fractured tooth, rough dental restoration, and foreign materials or hormonal (pregnancy tumor) and rarely associated with bone loss. This paper presents a rare case of PG associated with periodontal abscess and bone loss in a 30-year-old male.

Gear fatigue crack prognosis using embedded model, gear dynamic model and fracture mechanics

NASA Astrophysics Data System (ADS)

Li, C. James; Lee, Hyungdae

2005-07-01

This paper presents a model-based method that predicts remaining useful life of a gear with a fatigue crack. The method consists of an embedded model to identify gear meshing stiffness from measured gear torsional vibration, an inverse method to estimate crack size from the estimated meshing stiffness; a gear dynamic model to simulate gear meshing dynamics and determine the dynamic load on the cracked tooth; and a fast crack propagation model to forecast the remaining useful life based on the estimated crack size and dynamic load. The fast crack propagation model was established to avoid repeated calculations of FEM and facilitate field deployment of the proposed method. Experimental studies were conducted to validate and demonstrate the feasibility of the proposed method for prognosis of a cracked gear.

Conservative restoration of a traumatically involved central incisor.

PubMed

Bassett, Joyce

2012-04-01

The use of a direct composite material known for excellent polishability, polish retention, and wear resistance is described in this case of a fractured central incisor restoration. The method used enabled the clinician to conserve tooth structure and maintain full control of the outcome while creating an esthetically imperceptible, reliable, and durable restoration for a young male patient. Emphasized in this case are the techniques of layering, contouring, and polishing of a nanocomposite used to maximize esthetics and meet patient expectations. To further ensure imperceptibility, the author recommends first facilitating color shade selection for both body and dentin-especially in two-shade or multiple-shade restorations-by placing the composite in its planned area of the restoration and curing it in its proper thickness to allow a preview and recipe map.

Bioactive Glass Scaffolds for Dental Pulp and Dentin Tissue Engineering

NASA Astrophysics Data System (ADS)

Shawli, Hassan Talat

Current and historical endodontic "root canal" treatments employ inert obturating materials inserted into the teeth's pulp chambers and root canals, often saving teeth but without adequate function. Furthermore, the occurrence of pulpal necrosis in the immature permanent tooth is considered to be a challenging situation, clinically, in treatment because the thin and often short roots increase the risk of fracture. The ideal treatment would be to promote continued root development. This work demonstrated that endodontically-shaped and durable scaffolds of slowly resorbable fibrous (HT) glass and faster-resorbing small-particle Bioglass can be sintered at 900 degrees C for such placement, and that cell growth of osteoblasts in these scaffolds shows good early results. Retained bioactivity in the sintered specimen was revealed by Multiple Attenuated Internal Reflection Infrared Spectroscopy.

Hader bar and clip attachment retained mandibular complete denture

PubMed Central

Singh, Kunwarjeet; Gupta, Nidhi; Kapoor, Vikram; Gupta, Ridhimaa

2013-01-01

Bar and clip attachments significantly improve the level of satisfaction of denture-wearing patients by enhancing the retention and stability of the prosthesis. These attachments have been most commonly used for connecting the prosthesis to implants, but they can be effectively used to retain tooth-supported prosthesis as well. The primary functions of bar attachments are splinting the abutments together, even distribution of forces to the abutments and supporting areas, guiding the prosthesis into place, improving the retention, stability, support and comfort of the patient. The primary requirement for the use of bar attachments is the availability of sufficient vertical and buccolingual space for the proper placement of the bar, sleeves, teeth arrangement and sufficient thickness of acrylic denture base to minimise incidence of denture fracture in the area of bar assembly. PMID:24145505

Hader bar and clip attachment retained mandibular complete denture.

PubMed

Singh, Kunwarjeet; Gupta, Nidhi; Kapoor, Vikram; Gupta, Ridhimaa

2013-10-21

Bar and clip attachments significantly improve the level of satisfaction of denture-wearing patients by enhancing the retention and stability of the prosthesis. These attachments have been most commonly used for connecting the prosthesis to implants, but they can be effectively used to retain tooth-supported prosthesis as well. The primary functions of bar attachments are splinting the abutments together, even distribution of forces to the abutments and supporting areas, guiding the prosthesis into place, improving the retention, stability, support and comfort of the patient. The primary requirement for the use of bar attachments is the availability of sufficient vertical and buccolingual space for the proper placement of the bar, sleeves, teeth arrangement and sufficient thickness of acrylic denture base to minimise incidence of denture fracture in the area of bar assembly.

Advanced Rotorcraft Transmission (ART) program

NASA Technical Reports Server (NTRS)

Heath, Gregory F.; Bossler, Robert B., Jr.

1993-01-01

Work performed by the McDonnell Douglas Helicopter Company and Lucas Western, Inc. within the U.S. Army/NASA Advanced Rotorcraft Transmission (ART) Program is summarized. The design of a 5000 horsepower transmission for a next generation advanced attack helicopter is described. Government goals for the program were to define technology and detail design the ART to meet, as a minimum, a weight reduction of 25 percent, an internal noise reduction of 10 dB plus a mean-time-between-removal (MTBR) of 5000 hours compared to a state-of-the-art baseline transmission. The split-torque transmission developed using face gears achieved a 40 percent weight reduction, a 9.6 dB noise reduction and a 5270 hour MTBR in meeting or exceeding the above goals. Aircraft mission performance and cost improvements resulting from installation of the ART would include a 17 to 22 percent improvement in loss-exchange ratio during combat, a 22 percent improvement in mean-time-between-failure, a transmission acquisition cost savings of 23 percent of $165K, per unit, and an average transmission direct operating cost savings of 33 percent, or $24K per flight hour. Face gear tests performed successfully at NASA Lewis are summarized. Also, program results of advanced material tooth scoring tests, single tooth bending tests, Charpy impact energy tests, compact tension fracture toughness tests and tensile strength tests are summarized.

Immediate, single stage, truly anatomic zirconia implant in lower molar replacement: a case report with 2.5 years follow-up.

PubMed

Pirker, W; Wiedemann, D; Lidauer, A; Kocher, A A

2011-02-01

This report demonstrates the clinical use of a modified, truly anatomic, root-analogue zirconia implant for immediate replacement of a two-rooted, left first mandibular molar. A 50-year-old female patient with chronic apical periodontitis of the left mandibulary first molar was referred and the tooth was extracted. The mesial root had to be removed surgically due to a root fracture. A truly anatomical, root identical, roughened zirconia implant modified by macro-retentions was manufactured and placed into the extraction socket by tapping 7 days later. After 4 months a composite crown was cemented in place. No complications occurred during the healing period. A good functional and aesthetic result was achieved with minimal bone resorption and soft tissue recession at 30 months follow-up. This report describes the successful clinical use of an immediate, single stage, truly anatomical root-analogue zirconia implant for replacement of a two-rooted tooth. Significant modifications such as macro-retentions yielded primary stability and excellent osseointegration. This novel approach is minimally invasive, respects the underlying anatomy, aids socket prevention, is time- and cost-saving with good patient acceptance as there is no need for bone drilling, sinus lift, bone augmentation or other traumatic procedures. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Finite element analysis of the cyclic indentation of bilayer enamel

NASA Astrophysics Data System (ADS)

Jia, Yunfei; Xuan, Fu-zhen; Chen, Xiaoping; Yang, Fuqian

2014-04-01

Tooth enamel is often subjected to repeated contact and often experiences contact deformation in daily life. The mechanical strength of the enamel determines the biofunctionality of the tooth. Considering the variation of the rod arrangement in outer and inner enamel, we approximate enamel as a bilayer structure and perform finite element analysis of the cyclic indentation of the bilayer structure, to mimic the repeated contact of enamel during mastication. The dynamic deformation behaviour of both the inner enamel and the bilayer enamel is examined. The material parameters of the inner and outer enamel used in the analysis are obtained by fitting the finite element results with the experimental nanoindentation results. The penetration depth per cycle at the quasi-steady state is used to describe the depth propagation speed, which exhibits a two-stage power-law dependence on the maximum indentation load and the amplitude of the cyclic load, respectively. The continuous penetration of the indenter reflects the propagation of the plastic zone during cyclic indentation, which is related to the energy dissipation. The outer enamel serves as a protective layer due to its great resistance to contact deformation in comparison to the inner enamel. The larger equivalent plastic strain and lower stresses in the inner enamel during cyclic indentation, as calculated from the finite element analysis, indicate better crack/fracture resistance of the inner enamel.

Optimal mechanical design of anatomical post-systems for endodontic restoration.

PubMed

Maceri, Franco; Martignoni, Marco; Vairo, Giuseppe

2009-02-01

This paper analyses the mechanical behaviour of a new reinforced anatomical post-systems (RAPS) for endodontic restoration. The composite restorative material (CRM) completely fills the root canal (as do the commonly used cast metal posts) and multiple prefabricated composite posts (PCPs) are employed as reinforcements. Numerical simulations based on 3D linearly elastic finite element models under parafunctional loads were performed in order to investigate the influence of the stiffness of the CRM and of the number of PCPs. Periodontal ligament effects were taken into account using a discretised anisotropic nonlinearly elastic spring system, and the full discrete model was validated by comparing the resulting stress fields with those obtained with conventional restorations (cast gold-alloy post, homogeneous anatomical post and cemented single PCP) and with the natural tooth. Analysis of the results shows that stresses at the cervical/middle region decrease as CRM stiffness increases and, for large and irregular root cavities that apical stress peaks disappear when multiple PCPs are used. Accordingly, from a mechanical point of view, an optimal RAPS will use multiple PCPs when CRM stiffness is equal to or at most twice that of the dentin. This restorative solution minimises stress differences with respect to the natural tooth, mechanical inhomogeneities, stress concentrations on healthy tissues, volumes subject to shrinkage phenomena, fatigue effects and risks of both root fracture and adhesive/cohesive interfacial failure.

[Comparison of minimally invasive extraction and traditional method in the extraction of impacted mandibular third molar].

PubMed

Xu, Fang; Zhang, Hui-Xia

2016-10-01

To compare minimally invasive extraction and traditional method in the extraction of impacted mandibular third molar. One hundred and sixty patients with impacted mandibular third molar were equally divided into two groups. Patients in the experimental group were treated with minimally invasive extraction, using implant machine and luxator, while patients in the control group were treated with traditional methods including use of orthodox chisel. The operation time, intraoperative and postoperative complications including deformation of extraction sockets, dry socket, limitation of mouth opening, pain and swelling, and fear were observed and compared between the two groups. The data were analyzed with SPSS18.0 software package. The operation time was (17.32±1.01) min in the experimental group, significantly shorter than the control group which was (33.46±1.12）min (P<0.05); significant difference was found in the incidence of root fracture, medium or severe tooth sockets deformation and incidence of psychological fear during operation between the control group and experimental group(P<0.05); the degree of mouth opening after surgery, the incidence of moderate or severe pain after surgery was significantly lower in the experimental than in the control group(P<0.05). Minimally invasive extraction of mandibular impacted wisdom tooth is better than traditional method, with shorter operation time and less intraoperative and postoperative complications, which should be widely applied in clinic.

Slickenside formation by surface melting during the mechanical excavation of rock

NASA Astrophysics Data System (ADS)

Spray, John G.

This work discusses the nature and origin of slickensides generated by the impingement of high-carbon steel teeth on sandstone during the mechanical excavation of boulders by back shovel and front loader. The slickensides show a number of morphological features that can be related to the direction and sense of tooth displacement, including striations, carrot-shaped grooves, curved fractures and steps. Scanning and transmission electron microscopy reveal that the slickensides comprise a layer of Fe-enriched, glass-bonded gouge (≤150 μm thick). The estimated shear stresses and velocities realized at the tooth-rock interface (175 MPa at 1 m s -1 for the back shovel and 100 MPa at 2 m s -1 for the front loader) indicate that a heat production of 150-200 MW m -2 and mean surface temperature of 1400-1700°C were achieved. XRF and microprobe analyses confirm that localized bulk melting and Fe-enrichment of the surface occurred during slip. The excavator-generated slickensides provide an analogue for the effects of a single co-seismic event in the evolution of a shallow, relatively dry fault surface. From a simple consideration of energetics under these conditions, it is apparent that localized surface melting should be commonplace. Such an analogue may be useful as a guide for recognizing melt features in natural slickensides, features that would otherwise tend to be obscured during lengthier periods of interseismic surface modification.

Root damage induced by intraosseous anesthesia–An in vitro investigation

PubMed Central

Fawzy-El-Sayed, Karim M.; Graetz, Nicole; Dörfer, Christof-Edmund

2013-01-01

Objectives: The principle of the intraosseous anesthesia (IOA) relies on the perforation of the cortical plate of the bone for direct application of the local anesthetic solution into the underlying cancellous structures. During this procedure, IOA needles might accidentally come in contact with the tooth roots. The aim of the current in vitro study was to examine the consequences of this ‘worst case scenario’ comparing five commercially available IOA systems. Material and Methods: Extracted human roots were randomly perforated using five different IOA systems with a drilling time ≤5s. To simulate normal in vivo conditions, the roots were kept humid during the drilling procedure. Data was statistically evaluated using F-test (SPSS16, SPSS Inc., Chicago, USA) and the significance level was set at p≤0.05. Results: All examined systems resulted in root perforation. Drill fractures occurred in either none 0% (Quicksleeper®, Anesto®, Intraflow®, Stabident®) or 100% (X-Tip®) of the applications. Excessive heat generation, as evident by combustion odor as well as metal and tooth discoloration, appeared in 30% (Quicksleeper®), 40% (Anesto®), 60% (Intraflow®), 90% (Stabident®) and 100% (X-Tip®) of all perforations. Conclusion: Within the limits of in-vitro studies, the results show a potential for irreversible root damage that might be inflicted by an improper use of IOA systems. Key words:Intraosseous anesthesia, complication, root damage. PMID:23229260

Effects of different types of tooth movement and force magnitudes on the amount of tooth movement and root resorption in rats.

PubMed

Nakano, Takako; Hotokezaka, Hitoshi; Hashimoto, Megumi; Sirisoontorn, Irin; Arita, Kotaro; Kurohama, Takeshi; Darendeliler, M Ali; Yoshida, Noriaki

2014-11-01

To investigate differences in the amount of tooth movement and root resorption that occurred after tipping and bodily movement of the maxillary first molar in rats. Ten-week-old female Wistar rats were divided into two groups according to type of tooth movement and subdivided into four subgroups according to the magnitude of applied force. Nickel-titanium closed-coil springs exerting forces of 10, 25, 50, or 100 g were applied to the maxillary left first molars to induce mesial tooth movement. We designed a novel orthodontic appliance for bodily tooth movement. Tooth movement distance and root resorption were measured using microcomputed tomography and scanning electron and scanning laser microscopy. The amount of tooth movement in the bodily tooth movement group was less than half that in the tipping tooth movement group. The greatest amount of tooth movement occurred in the 10-g tipping and 50-g bodily tooth movement subgroups, and the amount of tooth movement decreased with the application of an excessive magnitude of force. Conversely, root resorption increased when the heavier orthodontic force was applied in both groups. Root resorption in the tipping tooth movement group was approximately twice that in the bodily tooth movement group. Root resorption in the tipping tooth movement group was more pronounced than that in the bodily tooth movement group. Although the amount of tooth movement decreased when extremely heavy forces were applied, root resorption increased in both the tipping and bodily tooth movement groups in rats.

Biomaterial Selection for Tooth Regeneration

PubMed Central

Yuan, Zhenglin; Nie, Hemin; Wang, Shuang; Lee, Chang Hun; Li, Ang; Fu, Susan Y.; Zhou, Hong

2011-01-01

Biomaterials are native or synthetic polymers that act as carriers for drug delivery or scaffolds for tissue regeneration. When implanted in vivo, biomaterials should be nontoxic and exert intended functions. For tooth regeneration, biomaterials have primarily served as a scaffold for (1) transplanted stem cells and/or (2) recruitment of endogenous stem cells. This article critically synthesizes our knowledge of biomaterial use in tooth regeneration, including the selection of native and/or synthetic polymers, three-dimensional scaffold fabrication, stem cell transplantation, and stem cell homing. A tooth is a complex biological organ. Tooth loss represents the most common organ failure. Tooth regeneration encompasses not only regrowth of an entire tooth as an organ, but also biological restoration of individual components of the tooth including enamel, dentin, cementum, or dental pulp. Regeneration of tooth root represents perhaps more near-term opportunities than the regeneration of the whole tooth. In the adult, a tooth owes its biological vitality, arguably more, to the root than the crown. Biomaterials are indispensible for the regeneration of tooth root, tooth crown, dental pulp, or an entire tooth. PMID:21699433

Fatigue crack propagation path across the dentinoenamel junction complex in human teeth.

PubMed

Dong, X D; Ruse, N D

2003-07-01

The human tooth structures should be understood clearly to improve clinically used restorative materials. The dentinoenamel junction (DEJ) plays a key role in resisting crack propagation in teeth. The aim of this study was to determine the fracture toughness of the enamel-DEJ-dentin complex and to investigate the influence of the DEJ on the fatigue crack propagation path across it by characterizing fatigue-fractured enamel-DEJ-dentin complexes using optical and scanning electron microscopy. The results of this study showed that the fracture toughness of the enamel-DEJ-dentin complex was 1.50 +/- 0.28 Mpa x m(1/2). Based on the results of this investigation, it was concluded that the DEJ complex played a critical role in resisting crack propagation from enamel into dentin. The DEJ complex is, approximately, a 100 to 150 microm broad region at the interface between enamel and dentin. The toughening mechanism of the DEJ complex may be explained by the fact that crack paths were deflected as cracks propagated across it. Understanding the mechanism of crack deflection could help in improving dentin-composite as well as ceramic-cement interfacial qualities with the aim to decrease the risk of clinical failure of restorations. Both can be viewed as being composed from a layer of material of high strength and hardness bonded to a softer but tougher substratum (dentin). The bonding agent or the luting cement layer may play the critical role of the DEJ in improving the strength of these restorations in clinical situations. Copyright 2003 Wiley Periodicals, Inc.

Cuspal reinforcement in endodontically treated molars.

PubMed

Uyehara, M Y; Davis, R D; Overton, J D

1999-01-01

This in vitro study compared the ability of horizontal pins and a dental adhesive to reinforce the facial cusps of endodontically treated mandibular molars. Seventy-two mandibular molars were divided into six groups and mounted in acrylic blocks (n = 12). In Groups 1-5 standardized endodontic access and instrumentation in the coronal one-third of each root canal were completed. In Groups 1-4 the lingual cusps were reduced, leaving the buccal cusps intact. The facial cusps of the teeth in each group received one of the following modes of reinforcement: Group 1--no reinforcement; Group 2--dentin adhesive (Amalgambond Plus); Group 3--two horizontal TMS Minim pins; Group 4--two horizontal TMS Minim pins and Amalgambond Plus. Teeth in Group 5 were prepared for and restored with a complete cuspal coverage amalgam restoration using four vertical TMS Minim pins. Group 6 consisted of intact natural teeth. Using an Instron Universal Testing Machine, the lingual slope of the facial cusp of each specimen was loaded to failure using a compressive force applied at an angle 60 degrees to the long axis of the tooth. The mean fracture strengths for all groups were analyzed using a one-way ANOVA and Student-Newman-Keuls multiple range test (alpha = 0.05). Fracture patterns and modes of failure were also evaluated. The intact teeth (Group 6) were significantly more fracture resistant than all other groups, with the exception of Group 4 (combination of pins and adhesive). Group 1 (non-reinforced teeth) was significantly weaker than all other groups. Groups 2-4 (specimens with reinforced cusps) were not significantly different from each other. The use of horizontal pins or a combination of horizontal pins plus dentin adhesive for cuspal reinforcement resulted in significantly more teeth demonstrating favorable fracture patterns than did the use of adhesives alone. The buccal cusps of endodontically treated mandibular molars reinforced with a combination of horizontal pins and dentin adhesive were not significantly weaker than intact teeth. Of the restored teeth, those which had buccal cusps reinforced with horizontal pins and those treated with complete cuspal coverage amalgam restorations exhibited the most favorable restorative prognosis following cusp fracture.

Clinical survival of indirect, anterior 3-unit surface-retained fibre-reinforced composite fixed dental prosthesis: Up to 7.5-years follow-up.

PubMed

Kumbuloglu, Ovul; Özcan, Mutlu

2015-06-01

This prospective clinical study evaluated the performance of indirect, anterior, surface-retained, fibre-reinforced-composite restorations (ISFRCR). Between June-2003 and January-2011, a total of 134 patients (83 females, 51 males, 16-68 years old) received 175 ISFRCRs (local ethical registration number: 14/9/4). All restorations were made indirectly on a plaster model using unidirectional E-glass fibres (everStick C&B, StickTech) in combination with a laboratory resin composite (Dialogue, Schütz Dental) and cemented according to the instructions of 4 resin cements [(RelyX ARC, 3M-ESPE, n=61), Bifix DC, VOCO, n=45), Variolink II (Ivoclar Vivadent, n=32) and Multilink (Ivoclar Vivadent, n=37)]. After baseline recordings, patients were followed at 6 months and thereafter annually up to 7.5 years. The evaluation protocol involved technical (chipping, debonding or fracture of tooth/restoration) and biological failures (caries). Mean observation period was 58 months. Altogether, 13 failures were observed [survival rate: 97.7%] (Kaplan-Meier). One catastrophic fracture [(cement: RelyX ARC), eight partial debonding (cement: Bifix DC (5), Multilink (1), RelyX ARC (1), Variolink II (1)] and four delaminations of veneering composite [(cement: Bifix DC (2), RelyX ARC (1), Multilink (1)] were observed. Except one replacement, all defective restorations were repaired or recemented. Annual failure rate of ISFRCRs was 1.73%. The survival rates with the four resin cements did not show significant differences (RelyX ARC: 98.3%; Bifix DC: 93.5%; Variolink 2: 100%; Multilink: 100%) (p=0.114). Secondary caries did not occur in any of the teeth. The 3-unit anterior indirect surface-retained resin-bonded FRC FDPs showed similar clinical survival rate when cemented with the resin cements tested. Experienced failures in general were due to debonding of the restoration or delamination of the veneering composite. 3-unit surface retained resin-bonded FRC FDPs could be considered minimal invasive and cost-effective alternatives to conventional tooth- or implant-borne FDPs. Failures were mainly repairable in the form of chipping or debonding depending on the resin cement type. Copyright © 2015 Elsevier Ltd. All rights reserved.

No post-no core approach to restore severely damaged posterior teeth: An up to 10-year retrospective study of documented endocrown cases.

PubMed

Belleflamme, Marcia M; Geerts, Sabine O; Louwette, Marie M; Grenade, Charlotte F; Vanheusden, Alain J; Mainjot, Amélie K

2017-08-01

The objectives of the present study were to (1) retrospectively evaluate documented cases of ceramic and composite endocrowns performed using immediate dentin sealing (IDS); (2) correlate failures with clinical parameters such as tooth preparation characteristics and occlusal parameters. 99 documented cases of endocrowns were evaluated after a mean observation period of 44.7±34.6months. A classification of restorations was established in function of the level of damage of residual tooth tissues after preparation, from 1 to 3. Evaluation was performed according to FDI criteria and endodontic outcomes were analyzed. Occlusal risk factors were examined and fractographic analysis was performed in case of fracture. 48.4% of patients were shown to present occlusal risk factors. 75.8% of restorations were Class 3 endocrowns. 56.6% were performed on molars, 41.4% on premolars and 2.0% on canines. 84.8% were performed in lithium-disilicate glass-ceramic and 12.1% in Polymer-Infiltrated Ceramic Network (PICN) material. The survival and success rates of endocrowns were 99.0% and 89.9% respectively, while the 10-year Kaplan-Meier estimated survival and success rates were 98.8% and 54.9% respectively. Ten failures were detected: periodontal disease (n=3), endocrown debonding (n=2), minor chipping (n=2), caries recurrence (n=2) and major fractures (n=1). Due to the reduced amount of failures, no statistical correlation could be established with clinical parameters. Endocrowns were shown to constitute a reliable approach to restore severely damaged molars and premolars, even in the presence of extensive coronal tissue loss or occlusal risk factors, such as bruxism or unfavorable occlusal relationships. Practitioners should consider the endocrown instead of the post and core approach to restore severely damaged non-vital posterior teeth. This minimally invasive solution reduces the risk of catastrophic failures and is easily performed. The use of IDS procedure and lithium-disilicate glass-ceramic as prosthesis material gave very good results. Copyright © 2017 Elsevier Ltd. All rights reserved.

Preparation Ferrule Design Effect on Endocrown Failure Resistance.

PubMed

Einhorn, Michael; DuVall, Nicholas; Wajdowicz, Michael; Brewster, John; Roberts, Howard

2017-10-06

To evaluate the effect of preparation ferrule inclusion with fracture resistance of mandibular molar endocrowns. Recently extracted mandibular third molars were randomly divided into 3 groups (n = 12) with the coronal tooth structure removed perpendicular to the root long axis approximately 2 mm above the cemento-enamel junction with a slow-speed diamond saw. The pulp chamber was exposed using a diamond bur in a high-speed handpiece with pulpal remnants removed and canals instrumented using endodontic hand instruments. The chamber floor was restored using a resin core material with a two-step, self-etch adhesive and photopolymerized with a visible light-curing unit to create a 2 mm endocrown preparation pulp chamber extension. One and two millimeter ferrule height groups were prepared using a diamond bur in a high-speed handpiece following CAD/CAM guidelines. Completed preparation surface area was determined using a digital measuring microscope. Scanned preparations were restored with lithium disilicate restorations with a self-adhesive resin luting agent. All manufacturer recommendations were followed. Specimens were stored at 37°C/98% humidity and tested to failure after 24 hours at a 45° angle to the tooth long axis using a universal testing machine. Failure load was converted to MPa using the available bonding surface area with mean data analyzed using Kruskal-Wallis/Dunn (p = 0.05). Calculated failure stress found no difference in failure resistance among the three groups; however, failure load results identified that the endocrown preparations without ferrule had significantly lower fracture load resistance. Failure mode analysis identified that all preparations demonstrated a high number of catastrophic failures. Under the conditions of this study, ferrule-containing endocrown preparations demonstrated significantly greater failure loads than standard endocrown restorations; however, calculated failure stress based on available surface area for adhesive bonding found no difference between the groups. Lower instances of catastrophic failure were observed with the endocrown preparations containing 1 mm of preparation ferrule design; however, regardless of the presence of ferrule, this study found that all endocrown restorations suffered a high proportion of catastrophic failures but at loads greater than reported under normal masticatory function. © 2017 by the American College of Prosthodontists.

The prevalence of tooth discolouration and the self-satisfaction with tooth colour in a Chinese urban population.

PubMed

Xiao, J; Zhou, X D; Zhu, W C; Zhang, B; Li, J Y; Xu, X

2007-05-01

To determine the prevalence of tooth discolouration, self-satisfaction with tooth colour, and correlation with socio-demographic-behavioural factors in adults and teenagers in Chengdu, China. A cross-sectional survey. 405 Chinese urban adults and teenagers from a multistage random probability sample. Tooth colour was measured on the maxillary central incisors using a colorimeter. Tooth discolouration was determined according to the discolouration level figure and evaluation criteria. Self-satisfaction with tooth colour was assessed on a five-point qualitative scale. Data were coded and analyzed using SPSS software. The mean values for L*, a* and b* were 70.67 (s.d. 1.91), 4.29 (s.d. 2.05) and 17.51 (s.d. 4.13), respectively. Age and sex were the most important factors associated with tooth colour (P < 0.05). About half of the study population (48.9%) suffered from some tooth discolouration, and 52.6% were dissatisfied with their tooth colour. Education and smoking were significant factors affecting self-satisfaction with tooth colour (P < 0.05). Tooth discolouration is common among the Chinese, and many Chinese are dissatisfied with their tooth colour. Self-satisfaction with tooth colour decreased with increasing severity of discolouration. Further research is needed to determine types of tooth discolouration among broader regions in China.

Shear bond strength of porcelain laminate veneers to enamel, dentine and enamel-dentine complex bonded with different adhesive luting systems.

PubMed

Öztürk, Elif; Bolay, Şükran; Hickel, Reinhard; Ilie, Nicoleta

2013-02-01

The aim of this study was to evaluate the shear bond strength of porcelain laminate veneers to 3 different surfaces by means of enamel, dentine, and enamel-dentine complex. One hundred thirty-five extracted human maxillary central teeth were used, and the teeth were randomly divided into 9 groups (n=15). The teeth were prepared with 3 different levels for bonding surfaces of enamel (E), dentine (D), and enamel-dentine complex (E-D). Porcelain discs (IPS e.max Press, Ivoclar Vivadent) of 2mm in thickness and 4mm in diameter were luted to the tooth surfaces by using 2 light-curing (RelyX Veneer [RV], 3M ESPE; Variolink Veneer [VV], Ivoclar Vivadent) and a dual-curing (Variolink II [V2], Ivoclar Vivadent) adhesive systems according to the manufacturers' instructions. Shear bond strength test was performed in a universal testing machine at 0.5mm/min until bonding failure. Failure modes were determined under a stereomicroscope, and fracture surfaces were evaluated with a scanning electron microscope. The data were statistically analysed (SPSS 17.0) (p=0.05). Group RV-D exhibited the lowest bond strength value (5.42±6.6MPa). There was statistically no difference among RV-D, V2-D (13.78±8.8MPa) and VV-D (13.84±6.2MPa) groups (p>0.05). Group VV-E exhibited the highest bond strength value (24.76±8.8MPa). The type of tooth structure affected the shear bond strength of the porcelain laminate veneers to the 3 different types of tooth structures (enamel, dentine, and enamel-dentine complex). When dentine exposure is necessary during preparation, enough sound enamel must be protected as much as possible to maintain a good bonding; to obtain maximum bond strength, preparation margins should be on sound enamel. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Effect of a tooth-brushing education program on oral health of preschool children].

PubMed

Kang, Bok-Hee; Park, Sun-Nam; Sohng, Kyeong-Yae; Moon, Jung-Soon

2008-12-01

To examine the effect of tooth-brushing education on the oral health of preschoolers. A quasi-experimental design with a non-equivalent control group was used. Two kindergartens were selected and 39 preschoolers from one kindergarten were assigned to the experimental group with tooth-brushing education and 39 from the other kindergarten to the control group. The tooth-brushing education program included 1 session on oral health education, individual tooth-brushing instruction for 1 week and supervised tooth-brushing after lunch for 4 weeks. Oral health behavior including use of tooth paste, tooth-brushing time and method of tooth-brushing, plague, streptococcus mutans, lactobacillus and dental caries were measured before and after the education. Fisher's exact test, t-test and paired t-test with the Window SAS 9.1 program were used to analyze the data. A significant increase in the use of tooth paste, tooth-brushing time and the practice of correct tooth-brushing and a decrease in plague and development of dental caries were observed in the experimental group. This tooth-brushing education was partially effective in improving oral health of preschoolers.

Effect of Intracoronal Depth of Teeth Restored with Endocrowns on Fracture Resistance: In Vitro and 3-dimensional Finite Element Analysis.

PubMed

Dartora, Nereu Roque; de Conto Ferreira, Michele Bertoluzi; Moris, Izabela Cristina Maurício; Brazão, Elisabeth Helena; Spazin, Aloísio Oro; Sousa-Neto, Manoel Damião; Silva-Sousa, Yara Terezinha; Gomes, Erica Alves

2018-07-01

Endodontically treated teeth have an increased risk of biomechanical failure because of significant loss of tooth structure. The biomechanical behavior of endodontically treated teeth restored was evaluated using different extensions of endocrowns inside the pulp chamber by in vitro and 3-dimensional finite element analysis (FEA). Thirty mandibular human molars were endodontically treated. Standardized endocrown preparations were performed, and the teeth were randomly divided into 3 groups (n = 10) according to different endocrown extensions inside the pulp chamber: G-5 mm, a 5-mm extension; G-3 mm, a 3-mm extension; and G-1 mm, a 1-mm extension. After adhesive cementation, all specimens were subjected to thermocycling and dynamic loading. The survival specimens were subjected to fracture resistance testing at a crosshead speed of 1 mm/min in a universal testing machine. All fractured specimens were subjected to fractography. Data were analyzed by 1-way analysis of variance and the Tukey post hoc test (P < .05). Stress distribution patterns in each group were analyzed using FEA. Qualitative analyses were performed according to the von Mises criterion. After dynamic loading, a survival rate of 100% was observed in all groups. For static loading, statistically significant differences among the groups were observed (P < .05) (G-5 mm = 2008.61 N, G-3 mm = 1795.41 N, and G-1 mm = 1268.12 N). Fractography showed a higher frequency of compression curls for G-5 mm and G-3 mm than for G-1 mm. FEA explained the results of fracture strength testing and fractography. Greater extension of endocrowns inside the pulp chamber provided better mechanical performance. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Effects of Internal and External Hydrogen on Inconel 718

NASA Technical Reports Server (NTRS)

Walter, R. J.; Frandsen, J. D.

1999-01-01

Internal hydrogen embrittlement (IHE) and hydrogen environment embrittlement (HEE) tensile and bend crack growth tests were performed on Inconel 718. For the IHE tests, the specimens were precharged to approximately 90 ppm hydrogen by exposure to 34.5 MPa H2 at 650 C. The HEE tests were performed in 34.5 MPa H2. Parameters evaluated were test temperature, strain rate for smooth and notch specimen geometries. The strain rate effect was very significant at ambient temperature for both IHE and HEE and decreased with increasing temperatures. For IHE, the strain rate effect was neglible at 260'C, and for HEE the strain rate effect was neglible at 400 C. At low temperatures, IHE was more severe than HEE, and at high temperatures HEE was more severe than IHE with a cross over temperature about 350 C. At 350 C, the equilibrium hydrogen concentration in Inconel 718 is about 50% lower than the hydrogen content of the precharged IHE specimens. Dislocation hydrogen sweeping of surface absorbed hydrogen was the likely transport mechanism for increasing the hydrogen concentration in the HEE tests sufficiently to produce the same degree of embrittlement as that of the more highly hydrogen charged IHE specimens. The main IHE fracture characteristic was formation of large, brittle flat facets, which decreased with increasing test temperature. The IHE fracture matrix surrounding the large facets ranged between brittle fine faceted to microvoid ductility depending upon strain rate, specimen geometry as well as temperature. The HEE fractures were characteristically fine featured, transgranular and brittle with a significant portion forming a "saw tooth" crystallographic pattern. Both IHE and HEE fractures were predominantly along the {1 1 1) slip and twin boundaries. With respect to embrittlement mechanism, it was postulated that dislocation hydrogen sweeping and hydrogen enhanced localized plasticity were active in HEE and IHE for concentrating hydrogen along (1 1 1) slip and twin planes. Final brittle failure occurred by hydrogen induced planer decohesion.

Influence of Intracanal Materials in Vertical Root Fracture Pathway Detection with Cone-beam Computed Tomography.

PubMed

Dutra, Kamile Leonardi; Pachêco-Pereira, Camila; Bortoluzzi, Eduardo Antunes; Flores-Mir, Carlos; Lagravère, Manuel O; Corrêa, Márcio

2017-07-01

Investigating the vertical root fracture (VRF) pathway under different clinical scenarios may help to diagnose this condition properly. We aimed to determine the capability and intrareliability of VRF pathway detection through cone-beam computed tomographic (CBCT) imaging as well as analyze the influence of different intracanal and crown materials. VRFs were mechanically induced in 30 teeth, and 4 clinical situations were reproduced in vitro: no filling, gutta-percha, post, and metal crown. A Prexion (San Mateo, CA) 3-dimensional tomographic device was used to generate 104 CBCT scans. The VRF pathway was determined by using landmarks in the Avizo software (Version 8.1; FEI Visualization Sciences Group, Burlington, MA) by 1 observer repeated 3 times. Analysis of variance and post hoc tests were applied to compare groups. Intrareliability demonstrated an excellent agreement (intraclass correlation coefficient mean = 0.93). Descriptive analysis showed that the fracture line measurement was smaller in the post and metal crown groups than in the no-filling and gutta-percha groups. The 1-way analysis of variance test found statistically significant differences among the groups measurements. The Bonferroni correction showed statistically significant differences related to the no-filling and gutta-percha groups versus the post and metal crown groups. The VRF pathway can be accurately detected in a nonfilled tooth using limited field of view CBCT imaging. The presence of gutta-percha generated a low beam hardening artifact that did not hinder the VRF extent. The presence of an intracanal gold post made the fracture line appear smaller than it really was in the sagittal images; in the axial images, a VRF was only detected when the apical third was involved. The presence of a metal crown did not generate additional artifacts on the root surface compared to the intracanal gold post by itself. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Bioengineered Tooth Buds Exhibit Features of Natural Tooth Buds.

PubMed

Smith, E E; Angstadt, S; Monteiro, N; Zhang, W; Khademhosseini, A; Yelick, P C

2018-06-01

Tooth loss is a significant health issue currently affecting millions of people worldwide. Artificial dental implants, the current gold standard tooth replacement therapy, do not exhibit many properties of natural teeth and can be associated with complications leading to implant failure. Here we propose bioengineered tooth buds as a superior alternative tooth replacement therapy. We describe improved methods to create highly cellularized bioengineered tooth bud constructs that formed hallmark features that resemble natural tooth buds such as the dental epithelial stem cell niche, enamel knot signaling centers, transient amplifying cells, and mineralized dental tissue formation. These constructs were composed of postnatal dental cells encapsulated within a hydrogel material that were implanted subcutaneously into immunocompromised rats. To our knowledge, this is the first report describing the use of postnatal dental cells to create bioengineered tooth buds that exhibit evidence of these features of natural tooth development. We propose future bioengineered tooth buds as a promising, clinically relevant tooth replacement therapy.

Comprehensive analyses of how tubule occlusion and advanced glycation end-products diminish strength of aged dentin

NASA Astrophysics Data System (ADS)

Shinno, Yuko; Ishimoto, Takuya; Saito, Mitsuru; Uemura, Reo; Arino, Masumi; Marumo, Keishi; Nakano, Takayoshi; Hayashi, Mikako

2016-01-01

In clinical dentistry, since fracture is a major cause of tooth loss, better understanding of mechanical properties of teeth structures is important. Dentin, the major hard tissue of teeth, has similar composition to bone. In this study, we investigated the mechanical properties of human dentin not only in terms of mineral density but also using structural and quality parameters as recently accepted in evaluating bone strength. Aged crown and root dentin (age ≥ 40) exhibited significantly lower flexural strength and toughness than young dentin (age < 40). Aged dentin, in which the dentinal tubules were occluded with calcified material, recorded the highest mineral density; but showed significantly lower flexural strength than young dentin. Dentin with strong alignment of the c-axis in hydroxyapatite exhibited high fracture strength, possibly because the aligned apatite along the collagen fibrils may reinforce the intertubular dentin. Aged dentin, showing a high advanced glycation end-products (AGEs) level in its collagen, recorded low flexural strength. We first comprehensively identified significant factors, which affected the inferior mechanical properties of aged dentin. The low mechanical strength of aged dentin is caused by the high mineral density resulting from occlusion of dentinal tubules and accumulation of AGEs in dentin collagen.

[Tooth wear, a proposal for an evaluation system].

PubMed

Wetselaar, P; van der Zaag, J; Lobbezoo, F

2011-06-01

The present-day terminology and definitions of tooth wear are not unambiguous. For diagnosing tooth wear, however, it is essential that they are unambiguous. In this article a proposal is presented for a tooth wear evaluation system with simplified definitions. This system consists ofa number of modules and can be used for various aspects of the diagnostic procedure. It can be used for the quantification of tooth wear, both for periodic screening and for the monitoring of tooth wear in individual patients. The scoring of occlusal/incisal tooth wear as well as of non-occlusal/non-incisal tooth wear is possible. The evaluative system is also suitable for determining which type of tooth wear, such as attrition, abrasion and erosion, is most likely to have caused any observed loss of hard tooth tissue.

Guided bone regeneration: A novel approach in the treatment of pediatric dentoalveolar trauma

PubMed Central

Murthy, Prashanth Sadashiva; Shivamallu, Avinash Bettahalli; Deshmukh, Seema; Nandlal, Bhojraj; Thotappa, Srilatha K.

2015-01-01

Traumatic injuries in the primary dentition pose major challenges for management. This emergency treatment requires proper planning so as to achieve favorable results. Trauma causing severe dentoalveolar injuries, especially in children, needs an interdisciplinary approach so as to retain normal functional anatomy for that age. This article describes a clinical innovative technique, which utilizes a resorbable membrane in management of pediatric dentoalveolar trauma. The membrane was shaped to cover the multiple alveolar bone fracture, thereby favoring the healing of the bone defects. The use of this resorbable membrane maintained a secluded space for the bone growth and prevented overgrowth of the soft tissue in the region of the defect. This resulted in uneventful healing leading to well-maintained functional bone contour, which further favored the esthetic rehabilitation as well as protected the underlying permanent tooth buds. PMID:26005471

A conservative management of iatrogenically damaged distal root of the mandibular second molar.

PubMed

Bansal, Rashmi; Roy, Sonali; Chandra, Praveen; Gurtu, Anuraag; Pandey, Rahul

2017-01-01

Trauma to the adjacent hard and soft tissue is the most common iatrogenic injury during extraction of the mandibular third molar. As every functional component of the dental arch is of prime importance in contemporary dental practice, the major concern must be in conserving the tooth and its structure as much as possible. The present case discusses the application of this conservative approach for management of iatrogenically damaged distal root of the mandibular second molar during extraction of impacted third molar, in which excessive guttering of alveolar bone and fractured apical third of distal root of 37 was observed radiographically. A conservative and noninvasive approach was successfully achieved to restore the damaged root by the bioactive material. Sealing of the remaining root with mineral trioxide aggregate allowed regeneration of soft and hard tissue around it.

Traditional surgeons in sub-Saharan Africa: images from south Sudan.

PubMed

Miles, Steven H; Ololo, Henry

2003-08-01

Itinerant traditional surgeons work throughout sub-Saharan Africa and perform many procedures including: tooth extraction, abortion, injections, incising and draining abscesses, uvulectomy, circumcision, inguinal hernia surgery, non-invasive cataract luxation, and surgery on closed and open fractures. Cutting and injection equipment are not cleaned and are used on a rapid succession of up to 10 patients in a single clinic session. These procedures cause haemorrhage, septicaemia, tetanus, gangrene, contractures, abscesses, airway obstruction, keloids, iatrogenic fistulae, lacerations of vital organs, loss of limbs, and death. Recent work suggesting that many cases of HIV infection may be caused by medical exposure lend a new urgency to researching the work of traditional surgeons. Collaborative programmes for re-training and re-shaping the work of these practitioners is more likely to be effective in reducing the morbidity than attempts to suppress their work.

Positioning the actual interference fringe pattern on the tooth flank in measuring gear tooth flanks by laser interferometry

NASA Astrophysics Data System (ADS)

Fang, Suping; Wang, Leijie; Liu, Shiqiao; Komori, Masaharu; Kubo, Aizoh

2011-05-01

In measuring form deviation of gear tooth flanks by laser interferometry, the collected interference fringe pattern (IFP) is badly distorted, in the case of shape, relative to the actual tooth flank. Meanwhile, a clear and definite mapping relationship between the collected IFP and the actual tooth flank is indispensable for both transforming phase differences into deviation values and positioning the measurement result on the actual tooth flank. In order to solve these problems, this paper proposes a method using the simulation tooth image as a bridge connecting the actual tooth flank and the collected IFP. The mapping relationship between the simulation tooth image and the actual tooth flank has been obtained by ray tracing methods [Fang et al., Appl. Opt. 49(33), 6409-6415 (2010)]. This paper mainly discusses how to build the relationship between the simulation tooth image and the collected IFP by using a matching algorithm of two characteristic point sets. With the combination of the two above-mentioned assistant mapping relationships, the mapping relationship between the collected IFP and the actual tooth flank can be built; the collected IFP can be positioned on the actual tooth flank. Finally, the proposed method is employed in a measurement of the form deviation of a gear tooth flank and the result proves the feasibility of the proposed method.

A numerical algorithm of tooth profile of non-circular cylindrical gear

NASA Astrophysics Data System (ADS)

Wang, Xuan

2017-08-01

Non-circular cylindrical gear (NCCG) is a common form of non-circular gear. Different from the circular gear, the tooth profile equation of NCCG cannot be obtained. So it is necessary to use a numerical algorithm to calculate the tooth profile of NCCG. For this reason, this paper presents a simple and highly efficient numerical algorithm to obtain the tooth profile of NCCG. Firstly, the mathematical model of tooth profile envelope of NCCG is established based on the principle of gear shaping, and the tooth profile envelope of NCCG is obtained. Secondly, the polar radius and polar angle of shaper cutter tooth profile are chosen as the criterions, by which the points of NCCG tooth cogging can be screened out. Finally, the boundary of tooth cogging points is extracted by a distance criterion and correspondingly the tooth profile of NCCG is obtained.

Practical whole-tooth restoration utilizing autologous bioengineered tooth germ transplantation in a postnatal canine model

PubMed Central

Ono, Mitsuaki; Oshima, Masamitsu; Ogawa, Miho; Sonoyama, Wataru; Hara, Emilio Satoshi; Oida, Yasutaka; Shinkawa, Shigehiko; Nakajima, Ryu; Mine, Atsushi; Hayano, Satoru; Fukumoto, Satoshi; Kasugai, Shohei; Yamaguchi, Akira; Tsuji, Takashi; Kuboki, Takuo

2017-01-01

Whole-organ regeneration has great potential for the replacement of dysfunctional organs through the reconstruction of a fully functional bioengineered organ using three-dimensional cell manipulation in vitro. Recently, many basic studies of whole-tooth replacement using three-dimensional cell manipulation have been conducted in a mouse model. Further evidence of the practical application to human medicine is required to demonstrate tooth restoration by reconstructing bioengineered tooth germ using a postnatal large-animal model. Herein, we demonstrate functional tooth restoration through the autologous transplantation of bioengineered tooth germ in a postnatal canine model. The bioengineered tooth, which was reconstructed using permanent tooth germ cells, erupted into the jawbone after autologous transplantation and achieved physiological function equivalent to that of a natural tooth. This study represents a substantial advancement in whole-organ replacement therapy through the transplantation of bioengineered organ germ as a practical model for future clinical regenerative medicine. PMID:28300208

Tooth-meshing-harmonic static-transmission-error amplitudes of helical gears

NASA Astrophysics Data System (ADS)

Mark, William D.

2018-01-01

The static transmission errors of meshing gear pairs arise from deviations of loaded tooth working surfaces from equispaced perfect involute surfaces. Such deviations consist of tooth-pair elastic deformations and geometric deviations (modifications) of tooth working surfaces. To a very good approximation, the static-transmission-error tooth-meshing-harmonic amplitudes of helical gears are herein expressed by superposition of Fourier transforms of the quantities: (1) the combination of tooth-pair elastic deformations and geometric tooth-pair modifications and (2) fractional mesh-stiffness fluctuations, each quantity (1) and (2) expressed as a function of involute "roll distance." Normalization of the total roll-distance single-tooth contact span to unity allows tooth-meshing-harmonic amplitudes to be computed for different shapes of the above-described quantities (1) and (2). Tooth-meshing harmonics p = 1, 2, … are shown to occur at Fourier-transform harmonic values of Qp, p = 1, 2, …, where Q is the actual (total) contact ratio, thereby verifying its importance in minimizing transmission-error tooth-meshing-harmonic amplitudes. Two individual shapes and two series of shapes of the quantities (1) and (2) are chosen to illustrate a wide variety of shapes. In most cases representative of helical gears, tooth-meshing-harmonic values p = 1, 2, … are shown to occur in Fourier-transform harmonic regions governed by discontinuities arising from tooth-pair-contact initiation and termination, thereby showing the importance of minimizing such discontinuities. Plots and analytical expressions for all such Fourier transforms are presented, thereby illustrating the effects of various types of tooth-working-surface modifications and tooth-pair stiffnesses on transmission-error generation.

Social ranking effects on tooth-brushing behaviour.

PubMed

Maltby, John; Paterson, Kevin; Day, Liz; Jones, Ceri; Kinnear, Hayley; Buchanan, Heather

2016-05-01

A tooth-brushing social rank hypothesis is tested suggesting tooth-brushing duration is influenced when individuals position their behaviour in a rank when comparing their behaviour with other individuals. Study 1 used a correlation design, Study 2 used a semi-experimental design, and Study 3 used a randomized intervention design to examine the tooth-brushing social rank hypothesis in terms of self-reported attitudes, cognitions, and behaviour towards tooth-brushing duration. Study 1 surveyed participants to examine whether the perceived health benefits of tooth-brushing duration could be predicted from the ranking of each person's tooth-brushing duration. Study 2 tested whether manipulating the rank position of the tooth-brushing duration influenced participant-perceived health benefits of tooth-brushing duration. Study 3 used a longitudinal intervention method to examine whether messages relating to the rank positions of tooth-brushing durations causally influenced the self-report tooth-brushing duration. Study 1 demonstrates that perceptions of the health benefits from tooth-brushing duration are predicted by the perceptions of how that behaviour ranks in comparison to other people's behaviour. Study 2 demonstrates that the perceptions of the health benefits of tooth-brushing duration can be manipulated experimentally by changing the ranked position of a person's tooth-brushing duration. Study 3 experimentally demonstrates the possibility of increasing the length of time for which individuals clean their teeth by focusing on how they rank among their peers in terms of tooth-brushing duration. The effectiveness of interventions using social-ranking methods relative to those that emphasize comparisons made against group averages or normative guidelines are discussed. What is already known on this subject? Individual make judgements based on social rank information. Social rank information has been shown to influence positive health behaviours such as exercise. What does this study add? The health benefits of tooth-brushing are predicted by how tooth-brushing duration ranks within a distribution. Focussing on how teeth-cleaning duration ranks among others produces longer teeth-cleaning durations. © 2015 The British Psychological Society.

A numerical simulation of tooth movement by wire bending.

PubMed

Kojima, Yukio; Fukui, Hisao

2006-10-01

In orthodontic treatment, wires are bent and attached to teeth to move them via elastic recovery. To predict how a tooth will move, the initial force system produced from the wire is calculated. However, the initial force system changes as the tooth moves and may not be used to predict the final tooth position. The purpose of this study was to develop a comprehensive mechanical, 3-dimensional, numerical model for predicting tooth movement. Tooth movements produced by wire bending were simulated numerically. The teeth moved as a result of bone remodeling, which occurs in proportion to stress in the periodontal ligament. With an off-center bend, a tooth near the bending position was subjected to a large moment and tipped more noticeably than the other teeth. Also, a tooth far from the bending position moved slightly in the mesial or the distal direction. With the center V-bend, when the second molar was added as an anchor tooth, the tipping angle and the intrusion of the canine increased, and movement of the first molar was prevented. When a wire with an inverse curve of Spee was placed in the mandibular arch, the calculated tendency of vertical tooth movements was the same as the measured result. In these tooth movements, the initial force system changed as the teeth moved. Tooth movement was influenced by the size of the root surface area. Tooth movements produced by wire bending could be estimated. It was difficult to predict final tooth positions from the initial force system.

Molecular Genetics of Supernumerary Tooth Formation

PubMed Central

Wang, Xiu-Ping; Fan, Jiabing

2011-01-01

Summary Despite advances in the knowledge of tooth morphogenesis and differentiation, relatively little is known about the aetiology and molecular mechanisms underlying supernumerary tooth formation. A small number of supernumerary teeth may be a common developmental dental anomaly, while multiple supernumerary teeth usually have a genetic component and they are sometimes thought to represent a partial third dentition in humans. Mice, which are commonly used for studying tooth development, only exhibit one dentition, with very few mouse models exhibiting supernumerary teeth similar to those in humans. Inactivation of Apc or forced activation of Wnt/β(catenin signalling results in multiple supernumerary tooth formation in both humans and in mice, but the key genes in these pathways are not very clear. Analysis of other model systems with continuous tooth replacement or secondary tooth formation, such as fish, snake, lizard, and ferret, is providing insights into the molecular and cellular mechanisms underlying succesional tooth development, and will assist in the studies on supernumerary tooth formation in humans. This information, together with the advances in stem cell biology and tissue engineering, will pave ways for the tooth regeneration and tooth bioengineering. PMID:21309064

Development and growth of compound tooth plates in Callorhinchus milii (chondrichthyes, holocephali).

PubMed

Didier, D A; Stahl, B J; Zangerl, R

1994-10-01

The chimaeroid holocephalian fishes are distinguished among extant chondrichthyans by the possession of three pairs of tooth plates, evergrowing and partially hypermineralized, that are not shed and replaced like the teeth of living elasmobranchs. Although derivation of the chimaeroid tooth plate from the fusion of members of a plesiomorphic chondrichthyan tooth family has been proposed, evidence for this hypothesis has been lacking. A new analysis of the development and structure of the tooth plates in Callorhinchus milii (Holocephali, Chimaeriformes) reveals the compound nature of the tooth plates in a chimaeroid fish. Each tooth plate consists of an oral and aboral territory that form independently in the embryo and maintain separate growth surfaces through life. The descending lamina on the aboral surface of the tooth plate demarcates the growth surface of the aboral territory. Comparison with the tooth plates of Chimaera monstrosa indicates that compound tooth plates may be a feature of all chimaeroids in which a descending lamina is present. The tooth plates in these fishes represent the fusion of two members of a reduced tooth family. The condition of the tooth plates in C. milii is plesiomorphic for chimaeroids and is of evolutionary significance in that it provides further evidence to support a lyodont dentition in chimaeroid fishes similar to that found in other chondrichthyans. © 1994 Wiley-Liss, Inc. Copyright © 1994 Wiley-Liss, Inc.

Experimental investigation of the fracture torque of orthodontic anchorage screws.

PubMed

Reimann, Susanne; Ayubi, Mustafa; McDonald, Fraser; Bourauel, Christoph

2016-07-01

In contrast to dental implants that remain in the bone, orthodontic anchorage screws serve as temporary anchorage for orthodontic tooth movement and are removed after completion of treatment. The aim of the present study was to evaluate the stability of various commercially available orthodontic anchorage screws against torsion. The torsional deflection of ten different orthodontic anchorage screws from different manufacturers [Ortho Easy Pin (Forestadent), Benefit, quattro (both PSM Medical Solutions), Vector TAS (Ormco), AbsoAnchor(®) (DENTOS Inc.), OrthoLox, Dual-Top JA (both Promedia Medizintechnik), TAD (3M Unitek), INFINITAS (ODS) and tomas(®) (Dentaurum)] was tested in vitro in relation to the rotation angle using a self-developed set-up. The screws were positioned in a resin model with bone-like material properties. Shear tests were performed using the manufacturers' own screwdrivers. Ten screws each were turned manually until a sudden drop in the measured torque occurred. At this point, the screw head was twisted off. Fracture torque and the torque at which the screws deformed plastically were evaluated. Mean values and standard deviations were calculated. According to the German industrial standard, the torque of orthodontic anchorage screws should reach at least 20 Ncm. The majority of the screws reached this nominal torque; however, a few screws fractured before reaching this value. Five screw types displayed plastic deformation below the threshold, at approximately 16 Ncm. The results suggest that orthodontic anchorage screws generally meet the requirements of the standard and ensure safe clinical use. However, according to the present data, it may be assumed that a portion of the screws will be plastically deformed upon removal.

Main Clinical Outcomes of Feldspathic Porcelain and Glass-Ceramic Laminate Veneers: A Systematic Review and Meta-Analysis of Survival and Complication Rates.

PubMed

Morimoto, Susana; Albanesi, Rafael Borges; Sesma, Newton; Agra, Carlos Martins; Braga, Mariana Minatel

2016-01-01

The aim of this study was to perform a systematic review and meta-analysis based on clinical trials that evaluated the main outcomes of glass-ceramic and feldspathic porcelain laminate veneers. A systematic search was carried out in Cochrane and PubMed databases. From the selected studies, the survival rates for porcelain and glass-ceramic veneers were extracted, as were complication rates of clinical outcomes: debonding, fracture/chipping, secondary caries, endodontic problems, severe marginal discoloration, and influence of incisal coverage and enamel/dentin preparation. The Cochran Q test and the I(2) statistic were used to evaluate heterogeneity. Out of the 899 articles initially identified, 13 were included for analysis. Metaregression analysis showed that the types of ceramics and follow-up periods had no influence on failure rate. The estimated overall cumulative survival rate was 89% (95% CI: 84% to 94%) in a median follow-up period of 9 years. The estimated survival for glass-ceramic was 94% (95% CI: 87% to 100%), and for feldspathic porcelain veneers, 87% (95% CI: 82% to 93%). The meta-analysis showed rates for the following events: debonding: 2% (95% CI: 1% to 4%); fracture/chipping: 4% (95% CI: 3% to 6%); secondary caries: 1% (95% CI: 0% to 3%); severe marginal discoloration: 2% (95% CI: 1% to 10%); endodontic problems: 2% (95% CI: 1% to 3%); and incisal coverage odds ratio: 1.25 (95% CI: 0.33 to 4.73). It was not possible to perform meta-analysis of the influence of enamel/dentin preparation on failure rates. Glass-ceramic and porcelain laminate veneers have high survival rates. Fracture/ chipping was the most frequent complication, providing evidence that ceramic veneers are a safe treatment option that preserve tooth structure.

Clinical evaluation of ceramic inlays and onlays fabricated with two systems: 12-year follow-up.

PubMed

Santos, Maria Jacinta Moraes Coelho; Freitas, Maria Cristina; Azevedo, Larissa Marinho; Santos, Gildo Coelho; Navarro, Maria Fidela; Francischone, Carlos Eduardo; Mondelli, Rafael Francisco

2016-09-01

The aim of this study was to evaluate the 12-year clinical performance of sintered (Duceram, Dentsply-Degussa, Dentsply International Inc., PA, USA)-D and pressable (IPS Empress, Ivoclar-Vivadent, Schaan, Leichtenstein)-IPS ceramic inlay and onlay restorations. Eighty-six restorations were placed in 35 patients with a median age of 33 years by a single operator. The restorations were luted with dual-cured resin luting material (Variolink II, Ivoclar-Vivadent, Schaan, Leichtenstein) and Syntac Classic adhesive under rubber dam. The evaluations were conducted by two independent investigators at the baseline, 1, 2, 3, 5, and 12 years using the modified USPHS criteria. At the 12-year recall, 22 patients were evaluated (62.86 %), totalling 48 (55.81 %) restorations. Seven restorations were fractured (one from Duceram and six from IPS), eight restorations presented secondary caries (three from Duceram and five from IPS), nine restorations showed unacceptable defects at the restoration margin and needed repair or replacement (two from Duceram and seven from IPS), and four IPS restorations presented pulp sensitivity. Chi-square and Mann-Whitney tests revealed that IPS Empress system showed the best results for color match and surface texture (p < 0.05) but a significant worse result for fracture (p = 0.05). Wilcoxon test showed significant differences in relation to color match, surface texture, marginal discoloration, and marginal integrity between the baseline and 12-year recall for both ceramic systems. This long-term clinical study observed that the main reasons for failure of ceramic restorations were related to fracture, recurrent caries, and decreased marginal integrity over time. Carefully monitoring of the ceramic-tooth interface may extend their clinical longevity.

Load-bearing properties of minimal-invasive monolithic lithium disilicate and zirconia occlusal onlays: finite element and theoretical analyses

PubMed Central

Ma, Li; Guess, Petra C.; Zhang, Yu

2013-01-01

Objectives The aim of this study was to test the hypothesis that monolithic lithium disilicate glass-ceramic occlusal onlay can exhibit a load-bearing capacity that approaches monolithic zirconia, due to a smaller elastic modulus mismatch between the lithium disilicate and its supporting tooth structure relative to zirconia. Methods Ceramic occlusal onlays of various thicknesses cemented to either enamel or dentin were considered. Occlusal load was applied through an enamel-like deformable indenter or a control rigid indenter. Flexural tensile stress at the ceramic intaglio (cementation) surface—a cause for bulk fracture of occlusal onlays—was rigorously analyzed using finite element analysis and classical plate-on-foundation theory. Results When bonded to enamel (supported by dentin), the load-bearing capacity of lithium disilicate can approach 75% of that of zirconia, despite the flexural strength of lithium disilicate (400 MPa) being merely 40% of zirconia (1000 MPa). When bonded to dentin (with the enamel completely removed), the load-bearing capacity of lithium disilicate is about 57% of zirconia, still significantly higher than the anticipated value based on its strength. Both ceramics show slightly higher load-bearing capacity when loaded with a deformable indenter (enamel, glass-ceramic, or porcelain) rather than a rigid indenter. Significance When supported by enamel, the load-bearing property of minimally invasive lithium disilicate occlusal onlays (0.6 to 1.4 mm thick) can exceed 70% of that of zircona. Additionally, a relatively weak dependence of fracture load on restoration thickness indicates that a 1.2 mm thin lithium disilicate onlay can be as fracture resistant as its 1.6 mm counterpart. PMID:23683531

Comparing the Effect of Different Voxel Resolutions for Assessment of Vertical Root Fracture of Permanent Teeth

PubMed Central

Uzun, Ismail; Gunduz, Kaan; Celenk, Peruze; Avsever, Hakan; Orhan, Kaan; Canitezer, Gozde; Ozmen, Bilal; Cicek, Ersan; Egrioglu, Erol

2015-01-01

Background: The teeth with undiagnosed vertical root fractures (VRFs) are likely to receive endodontic treatment or retreatment, leading to frustration and inappropriate endodontic therapies. Moreover, many cases of VRFs cannot be diagnosed definitively until the extraction of tooth. Objectives: This study aimed to assess the use of different voxel resolutions of two different cone beam computerized tomography (CBCT) units in the detection VRFs in vitro. Materials and Methods: The study material comprised 74 extracted human mandibular single rooted premolar teeth without root fractures that had not undergone any root-canal treatment. Images were obtained by two different CBCT units. Four image sets were obtained as follows: 1) 3D Accuitomo 170, 4 × 4 cm field of view (FOV) (0.080 mm3); 2) 3D Accuitomo 170. 6 × 6 cm FOV (0.125 mm3); 3) NewTom 3G, 6˝ (0.16 mm3) and 4) NewTom 3G, 9˝ FOV (0.25 mm3). Kappa coefficients were calculated to assess both intra- and inter-observer agreements for each image set. Results: No significant differences were found among observers or voxel sizes, with high average Z (Az) results being reported for all groups. Both intra- and inter-observer agreement values were relatively better for 3D Accuitomo 170 images than the images from NewTom 3G. The highest Az and kappa values were obtained with 3D Accuitomo 170, 4 × 4 cm FOV (0.080 mm3) images. Conclusion: No significant differences were found among observers or voxel sizes, with high Az results reported for all groups. PMID:26557279

Study of the kinematic and load sharing properties of wormgearing with non-symmetric tooth profiles

NASA Technical Reports Server (NTRS)

Sun, D. C.; Yuan, Qin

1995-01-01

The geometry of non-symmetric tooth profiles, i.e. tooth profiles with different pressure angles on the two sides of the tooth, is studied. A feasible non-symmetric tooth profile for application in helicopter transmissions is laid out as the best compromise among several conflicting factors. The non-symmetric tooth profile is then compared with the symmetric tooth profile studied previously. Based on the detailed comparisons it is concluded that the use of the non-symmetric tooth profile would severely limit the face width of the worm, consequently reduce the number of meshing teeth and cause much higher normal load on the individual gear teeth.

Survival of two post systems--five-year results of a randomized clinical trial.

PubMed

Schmitter, Marc; Hamadi, Khaled; Rammelsberg, Peter

2011-01-01

To assess the survival rate of two different post systems after 5 years of service with a prospective randomized controlled trial. One hundred patients in need of a post were studied. Half of the patients received long glass fiber-reinforced posts, while the other half received long metal screw posts. The posts were assigned randomly. After at least 5 years (mean, 61.37 months), follow-ups were established. When a complication occurred prior to this recall, the type and time of the complication was documented. Statistical analysis was performed using the log-rank test and Kaplan-Meier analysis. Additionally, a Cox regression was performed to analyze risk factors. The survival rate of fiber-reinforced posts was 71.8%. In the metal screw post group, the survival rate was significantly lower, 50.0% (log-rank test, P = .026). Metal posts resulted more often in more unfavorable complications (eg, root fractures); consequently, more teeth (n = 17) had to be extracted. The Cox regression identified the following risk factors: position of the tooth (anterior vs posterior teeth), degree of coronal tooth destruction, and the post system (fiber-reinforced post vs metal screw post). Fiber-reinforced restorations loosened in several patients; in some of these cases (n = 6), patients did not notice this, leading to the extraction of teeth. Long metal screw posts should be used with great care in endodontically treated teeth. Besides the selection of the post system, other factors influence the survival of the restoration.

Stress analysis of different post-luting systems: a three-dimensional finite element analysis.

PubMed

Romeed, S A; Dunne, S M

2013-03-01

The longevity of endodontically treated teeth is usually determined by the adequacy of root canal treatments, coronal seal and favourable stress distribution within the remaining tooth tissues. The aim of this study was to investigate the influence of post material and luting cement on the biomechanics of endodontically treated teeth using three-dimensional finite element analysis (3-D FEA). A 3 mm section of endodontically treated canine tooth was scanned and reconstructed for 3-D modelling and FE analyses. A metal post (MP) and a glass fibre post (GFP) were tested individually with four luting cements [zinc phosphate (ZPH), glass ionomer (GI), resin modified glass ionomer (RMGI) and resin based cements (RC)]. A push-out test was conducted by subjecting all models to 100 N perpendicular loading at the post. The maximum stresses generated along the MP-cement interface were significantly higher than corresponding stresses in the GFP-cement interface regardless of the cement type. GFP generated seven times higher stresses within the root dentine than metal posts when ZPH and GI were used, and three times higher when RMGI and RC were used. The displacement of GFP was double (50 μ) the displacement of MP (20 μ) in all groups. The low elastic modulus of GFP generated lower stresses along its interface and higher stresses within the root dentine, therefore the probability of debonding and root fracture in the GFP group was lower. © 2013 Australian Dental Association.

Influence of enamel preservation on failure rates of porcelain laminate veneers.

PubMed

Gurel, Galip; Sesma, Newton; Calamita, Marcelo A; Coachman, Christian; Morimoto, Susana

2013-01-01

The purpose of this study was to evaluate the failure rates of porcelain laminate veneers (PLVs) and the influence of clinical parameters on these rates in a retrospective survey of up to 12 years. Five hundred eighty laminate veneers were bonded in 66 patients. The following parameters were analyzed: type of preparation (depth and margin), crown lengthening, presence of restoration, diastema, crowding, discoloration, abrasion, and attrition. Survival was analyzed using the Kaplan-Meier method. Cox regression modeling was used to determine which factors would predict PLV failure. Forty-two veneers (7.2%) failed in 23 patients, and an overall cumulative survival rate of 86% was observed. A statistically significant association was noted between failure and the limits of the prepared tooth surface (margin and depth). The most frequent failure type was fracture (n = 20). The results revealed no significant influence of crown lengthening apically, presence of restoration, diastema, discoloration, abrasion, or attrition on failure rates. Multivariable analysis (Cox regression model) also showed that PLVs bonded to dentin and teeth with preparation margins in dentin were approximately 10 times more likely to fail than PLVs bonded to enamel. Moreover, coronal crown lengthening increased the risk of PLV failure by 2.3 times. A survival rate of 99% was observed for veneers with preparations confined to enamel and 94% for veneers with enamel only at the margins. Laminate veneers have high survival rates when bonded to enamel and provide a safe and predictable treatment option that preserves tooth structure.

Therapeutical attitudes in tooth supported overdentures with ball attachements. Case report

PubMed Central

Țâncu, AM; Melescanu Imre, M; Preoteasa, CT; Preoteasa, E

2014-01-01

Tooth supported overdenture with ball attachments has a number of advantages in prosthetics, but presents some difficulties as well, which sometimes make impossible the use of these anchoring systems; these difficulties should be well known. In this regard we present a suggestive case. It is the case of a patient, aged 57, who came for treatment, suffering from subtotal maxillary and mandibular edentulism (present 11 and 21, respectively 33 and 43), previously having an overdenture prosthesis on natural teeth, with special systems – ball attachment type, dissatisfied with the treatment (due to repeated fractures and functional intolerance to dentures). Clinical examination revealed an increase of the vertical dimension of occlusion and reduced prosthetic space at a correct, functional DVO value, aspects that were explaining the patient’s reported complaints. As a therapeutic approach, having into consideration the balance conditions that were favorable for complete dentures and the large ball attachments volume, which did not allow keeping them at a functional DVO at any of the jaws, and the relatively young age of the patient, it was decided to remove the ball attachments and to keep the teeth for a simple overdenture, both to the maxillar and the mandible, over coronary reduced teeth, enough to allow the denture thickness at a functional DVO. Good end result of prosthetics, with stable, functional dentures, which were well tolerated and offered satisfaction to the patient, have led to an increased quality of life. PMID:27057258

Therapeutical attitudes in tooth supported overdentures with ball attachements. Case report.

PubMed

Țâncu, A M; Melescanu Imre, M; Preoteasa, C T; Preoteasa, E

2014-01-01

Tooth supported overdenture with ball attachments has a number of advantages in prosthetics, but presents some difficulties as well, which sometimes make impossible the use of these anchoring systems; these difficulties should be well known. In this regard we present a suggestive case. It is the case of a patient, aged 57, who came for treatment, suffering from subtotal maxillary and mandibular edentulism (present 11 and 21, respectively 33 and 43), previously having an overdenture prosthesis on natural teeth, with special systems - ball attachment type, dissatisfied with the treatment (due to repeated fractures and functional intolerance to dentures). Clinical examination revealed an increase of the vertical dimension of occlusion and reduced prosthetic space at a correct, functional DVO value, aspects that were explaining the patient's reported complaints. As a therapeutic approach, having into consideration the balance conditions that were favorable for complete dentures and the large ball attachments volume, which did not allow keeping them at a functional DVO at any of the jaws, and the relatively young age of the patient, it was decided to remove the ball attachments and to keep the teeth for a simple overdenture, both to the maxillar and the mandible, over coronary reduced teeth, enough to allow the denture thickness at a functional DVO. Good end result of prosthetics, with stable, functional dentures, which were well tolerated and offered satisfaction to the patient, have led to an increased quality of life.

Discoloration Potential of Endodontic Sealers: A Brief Review

PubMed Central

Tour Savadkouhi, Sohrab; Fazlyab, Mahta

2016-01-01

Tooth discoloration induced by endodontic sealers, is a common finding that impairs aesthetic outcome of endodontic treatment. The aim of the present mini literature review, was to summarize the existing data on discoloration potential of different endodontic sealers. The research covered the article published in PubMed and Google Scholar from 2000 to 2015. The searched keywords included ‘tooth discoloration AND endodontic’, ‘tooth discoloration AND sealer, ‘tooth discoloration AND zinc-oxide eugenol sealer’, ‘tooth discoloration AND Calcium Hydroxide Sealer’, ‘tooth discoloration AND Glass Ionomer Sealer’, ‘tooth discoloration AND epoxy-resin Sealer’, ‘tooth discoloration AND Silicon Based Sealer’, ‘tooth discoloration AND Bioceramic Sealer’ and ‘Spectrophotometry’. Conclusion: A total number of 44 articles were gained which reduced to 11 after excluding the repetitive items. The available evidence for discoloration potential of endodontic sealers currently available on the market is scarce. However, it can be concluded that all endodontic sealers can potentially stain the tooth structure to different degrees. PMID:27790251

Tooth colour change with Ozicure Oxygen Activator: a comparative in vitro tooth bleaching study.

PubMed

Grundlingh, A A; Grossman, E S; Witcomb, M J

2012-08-01

This in vitro study compared a new tooth bleaching product, Ozicure Oxygen Activator (O3, RSA) with Opalescence Quick (Ultradent, USA) using a randomised block design to assess tooth colour change. Colour change, stability and relapse in canine, incisor and premolar teeth was assessed following three bleach treatments and subsequent tooth colour assessment. Ninety nine teeth (canines, incisors and premolars), which were caries free, had no surface defects and were within the colour range 1M2 and 5M3 were selected. Teeth were randomly divided into the three experimental groups: Opalescence Quick, Ozicure Oxygen Activator and control. The three experimental groups received three treatments of one hour each over three consecutive days. Tooth colour was assessed using the Vitapan 3D Master Tooth Guide (VITA, Germany). A General Linear Models test for analysis of variance for a fractional design with significance set at P < 0.05 was used to test for significance. Both bleaching methods significantly lightened the teeth (P < 0.0001). Tooth colour change was mainly after the first hour of tooth bleaching. The tooth type was significant in tooth colour change (P = 0.0416). Tooth colour relapse and resistance to colour change were observed. Ozicure Oxygen Activator bleached teeth in a manner and to an extent similar to Opalescence Quick.

Inhibitory effect of interferon-γ on experimental tooth movement in mice.

PubMed

Kohara, Haruka; Kitaura, Hideki; Yoshimatsu, Masako; Fujimura, Yuji; Morita, Yukiko; Eguchi, Toshiko; Yoshida, Noriaki

2012-09-01

The aim of this study was to investigate the effects of interferon (IFN)-γ on experimental tooth movement in mice using a murine experimental tooth movement model. An Ni-Ti closed-coil spring was inserted between the upper-anterior alveolar bones and the upper-left first molars in mice. We evaluated the relationship between local Ifn-γ mRNA levels and orthodontic tooth movement. In other experiments, IFN-γ was injected adjacent to each first molar every other day during tooth movement. After 12 days, the amount of tooth movement was measured. Tartrate-resistant acid phosphatase (TRAP)-positive cells at the pressure side of each experimental tooth were counted as osteoclasts. Local Ifn-γ mRNA expression increased with orthodontic tooth movement. The number of TRAP-positive cells increased on the pressure side of the first molar. In contrast, the degree of tooth movement and the number of TRAP-positive cells on the pressure side in IFN-γ-injected mice were less than those of control mice. IFN-γ was induced in experimental tooth movement, and could inhibit mechanical force-loaded osteoclastogenesis and tooth movement. These results suggest that IFN-γ might be useful in controlling orthodontic tooth movement because of its inhibitory action on excessive osteoclastogenesis during this movement.

Occlusal tooth wear in the general population of Germany: effects of age, sex, and location of teeth.

PubMed

Schierz, Oliver; Dommel, Sandra; Hirsch, Christian; Reissmann, Daniel R

2014-09-01

Tooth wear is an increasing problem in a society where people are living longer. The purpose of this study was to assess the effect of age, sex, and location of teeth on the severity of tooth wear and to determine the prevalence of dentin exposure in the general population of Germany. Tooth wear was measured in casts of both jaws of 836 persons with a 6-point (0-5) ordinal rating scale. Linear random-intercept regression models with the covariates of age, sex, jaw, and tooth group (with the participant as a grouping variable) were computed to determine the association of these covariates with tooth wear of a single tooth. The mean tooth wear score across all age groups, both sexes, and all teeth was 2.9 (standard deviation, 0.8), and the prevalence of teeth with exposed dentin was 23.4%. The participants' age was correlated with the mean tooth wear scores (r=0.51). The tooth wear level among women was on average 0.15 units lower than among men, and tooth wear was on average 0.59 units higher for anterior teeth than for posterior teeth. Increased tooth wear in anterior teeth may be due to the initially predominant guidance by anterior teeth, with age-related linear progress in tooth wear. Occlusal tooth wear scores and dentin exposure increase with age. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Tooth bleaching and young adults in Nigeria: knowledge, experiences and intention.

PubMed

Azodo, C C; Ogbomo, A C; Agbor, M A

2012-12-01

To assess the knowledge, experiences and intention to have tooth bleaching among young adults studying in a Nigerian University. A cross-section of part-time undergraduate students of University of Benin, Benin City, Nigeria were studied in 2010 using a self-administered questionnaire. About three-quarters 289 (72.4%) of the respondents reported awareness of at least one cause of tooth discoloration. A total of 143 (35.8%) of the respondents have heard of tooth bleaching with main sources of information being friends/relatives, dentists and the internet. One-third 132 (33.1%) of the respondents correctly identified that the aim of tooth bleaching was to make the teeth whiter. The respondents that had correct knowledge about mechanism, duration and complications of tooth bleaching were 51 (12.8%), 25 (6.3%) and 35 (8.8%) respectively. The major perceived benefits of tooth bleaching reported by the respondents were self confidence boost 152 (38.1%) and improvement of one's beauty 107 (26.8%). Out of the 68 (17.0%) respondents that have attempted tooth bleaching, 36 (52.9%) used tooth whitening toothpaste. Out of the 151 (37.8%) respondents that expressed intention of having tooth bleaching procedure, 32 (21.2%) would pursue the course, no matter the cost. In the studied population, knowledge of tooth discoloration was high, awareness and experiences of tooth bleaching were low but significant number expressed intention of having tooth bleaching. It is important that dentists increase oral health information particularly tooth bleaching information accessibility to the young adult population to improve the knowledge and prevent adverse effects.

Tooth quality in dental fluorosis genetic and environmental factors.

PubMed

Vieira, A P G F; Hanocock, R; Eggertsson, H; Everett, E T; Grynpas, M D

2005-01-01

Dental fluorosis (DF) affects the appearance and structure of tooth enamel and can occur following ingestion of excess fluoride during critical periods of amelogenesis. This tooth malformation may, depending on its severity, influence enamel and dentin microhardness and dentin mineralization. Poor correlation between tooth fluoride (F) concentration and DF severity was shown in some studies, but even when a correlation was present, tooth fluoride concentration explained very little of DF severity. This fact calls into question the generally accepted hypothesis that the main factor responsible for DF severity is tooth fluoride concentration. It has been shown previously that genetic factors (susceptibility to DF) play an important role in DF severity although DF severity relates to individual susceptibility to fluoride exposure (genetics), tooth fluoride concentration relates to fluoride ingestion (environmental). The objective of this study was to investigate the correlation between tooth fluoride concentration, DF severity, and tooth mechanical and materials properties. Three strains of mice (previously shown to have different susceptibility to DF) at weaning were treated with four different levels of F in their water (0, 25, 50, and 100 ppm) for 6 weeks. Mice teeth were tested for fluoride by instrumental neutron activation analysis (INAA), DF severity determined by quantitative light-induced fluorescence [QLF], and tooth quality (enamel and dentin microhardness and dentin mineralization). Tooth fluoride concentration (environment factor) correlated positively with DF severity (QLF) (rs=0.608), fluoride treatment group (rs=0.952). However, tooth fluoride concentration correlated negatively with enamel microhardness (rs=-0.587), dentin microhardness (rs=-0.268) and dentin mineralization (rs=-0.245). Dental fluorosis (genetic factor) severity (QLF) correlated positively with fluoride treatment (rs=0.608) and tooth fluoride concentration (rs=0.583). DF severity correlated negatively with enamel microhardness (rs=-0.564) and dentin microhardness (rs=-0.356). Genetic factors (DF severity) and the environmental factor (fluoride concentration in tooth structure) have similar influence on tooth biomechanical properties, whereas only the environmental factor has an influence on tooth material property (mineralization).

Tooth - abnormal shape

MedlinePlus

Hutchinson incisors; Abnormal tooth shape; Peg teeth; Mulberry teeth; Conical teeth ... The appearance of normal teeth varies, especially the molars. ... conditions. Specific diseases can affect tooth shape, tooth ...

Prevalence of Tooth Shade and its Correlation with Skin Colour - A Cross-sectional Study.

PubMed

Vadavadagi, Suneel V; Kumari, K V Halini; Choudhury, Gopal Krishna; Vilekar, Abhishek Madhukar; Das, Sitansu Sekhar; Jena, Debkant; Kataraki, Bharat; B L, Bhavana

2016-02-01

Aesthetics has become an important issue in modern society. Tooth shade is one of the factors in determining aesthetics. Studies have revealed that tooth shade is influenced by age, gender, eye colour, skin colour and other factors. The present study was aimed to assess the prevalence of tooth shade and its correlation with skin colour. A total of 300 subjects aged 18-20 years were evaluated for tooth shade using Vitapan - 3D shade guide. Anterior teeth were checked under natural light and facial skin colour by Lakme liquid foundation make up as a shade guide. Data was analysed using chi square test and spearman's correlation. Out of 300 students, 114 (38.00%) had A2 tooth shade; the least prevalent tooth shade among Chitradurga population was C1 (4.00%). There was a positive correlation between tooth shade and skin colour which was found to be statistically significant (p <0.05). The most prevalent tooth shade among Chitradurga population was A2 and least was C1. There was a significant correlation between tooth shade and skin colour with lighter skin tone subjects having lighter tooth shade hence skin colour can be used as a guide for shade selection.

Application of tooth brushing behavior to active rest.

PubMed

Sadachi, Hidetoshi; Murakami, Yoshinori; Tonomura, Manabu; Yada, Yukihiro; Simoyama, Ichiro

2010-01-01

We evaluated the usefulness of tooth brushing with toothpaste as active rest using the flicker value as a physiological parameter and a subjective questionnaire as a psychological parameter. Seventeen healthy, right-handed subjects (12 males and 5 females) aged 22.5 +/- 1.5 yr (mean +/- standard deviation) were randomly divided into tooth brushing with toothpaste (N=9) and non-tooth brushing groups (N=8). The subjects performed a serial calculation task for 20 min using personal computers. Subsequently, the tooth brushing group brushed their teeth, and the flicker value and mood were compared before and after the tooth brushing. The flicker value significantly increased in the tooth brushing group compared with the non-tooth brushing group (p<0.05). Concerning the mood, in the tooth brushing group, the incidence of a "feeling of being refreshed" significantly increased (p<0.05), that of "concentration power" or a "feeling of clear-headedness" tended to increase (p<0.1), and that of "lassitude" or "sleepiness" significantly decreased (p<0.01). Somatosensory stimulation and intraoral tactile stimulation during tooth brushing activated cerebral activity, producing refreshing effects. These results suggest the applicability of tooth brushing to active rest.

[Assessment of tooth bleaching efficacy with spectrophotometer].

PubMed

Zhu, Wenhao; Liu, Chang; Pan, Jie

2014-06-01

To analyze the changes in CIE L*, a*, and b* at cervical, body, and incisal sites after tooth bleaching by using a spectrophotometer. Sixty-seven intact and healthy maxillary central incisors were in-vestigated. These incisors were darker than A3 according to the Vita Classical shade guide. The CIE tooth shade parameters L*, a*, and b* were simultaneously recorded at three tooth areas (cervical, body, and incisal) with a spectrophotometer before and after tooth bleaching (35%H2O2 coordinating with Beyond whitening accelerator irradiating). The shade dif-ferential (DeltaE) was calculated. ANOVA, paired t-test, and Pearson correlation analysis were used for data analysis. The efficacy rates of tooth bleaching were satisfactory, with 86.6%, 86.6%, and 85.1% in the cervical, body, and incisal sites, respectively. The average values of DeltaE were 5.09, 4.44, and 4.40 in the cervical, body, and incisal sites. Tooth bleaching significantly increased L* and significantly decreased a* and b* in all tooth areas (P < 0.01). The decreasing range of Deltab* was more than the increasing range of DeltaL* at the cervical site; opposite results were observed at the incisal site. A positive correlation was detected between baseline b* and DeltaE. The spectrophotometer could objectively evaluate the whitening effect of tooth bleaching at the different tooth sites. The tooth bleaching system (35%H202 coordinating with Beyond whitening accelerator irradiating) exerts powerful bleaching actions in most of the tooth areas investigated. The order of tooth bleaching effectiveness is cervicalbody>incisal. Yellow coloration is decreased mainly at the cervical site, and brightness was increased mostly at theincisal site. The effectiveness of tooth bleaching increases as the baseline b* value increases.

Distinct developmental genetic mechanisms underlie convergently evolved tooth gain in sticklebacks

PubMed Central

Ellis, Nicholas A.; Glazer, Andrew M.; Donde, Nikunj N.; Cleves, Phillip A.; Agoglia, Rachel M.; Miller, Craig T.

2015-01-01

Teeth are a classic model system of organogenesis, as repeated and reciprocal epithelial and mesenchymal interactions pattern placode formation and outgrowth. Less is known about the developmental and genetic bases of tooth formation and replacement in polyphyodonts, which are vertebrates with continual tooth replacement. Here, we leverage natural variation in the threespine stickleback fish Gasterosteus aculeatus to investigate the genetic basis of tooth development and replacement. We find that two derived freshwater stickleback populations have both convergently evolved more ventral pharyngeal teeth through heritable genetic changes. In both populations, evolved tooth gain manifests late in development. Using pulse-chase vital dye labeling to mark newly forming teeth in adult fish, we find that both high-toothed freshwater populations have accelerated tooth replacement rates relative to low-toothed ancestral marine fish. Despite the similar evolved phenotype of more teeth and an accelerated adult replacement rate, the timing of tooth number divergence and the spatial patterns of newly formed adult teeth are different in the two populations, suggesting distinct developmental mechanisms. Using genome-wide linkage mapping in marine-freshwater F2 genetic crosses, we find that the genetic basis of evolved tooth gain in the two freshwater populations is largely distinct. Together, our results support a model whereby increased tooth number and an accelerated tooth replacement rate have evolved convergently in two independently derived freshwater stickleback populations using largely distinct developmental and genetic mechanisms. PMID:26062935

Factors associated with tooth loss and prosthodontic status among Sudanese adults.

PubMed

Khalifa, Nadia; Allen, Patrick F; Abu-bakr, Neamat H; Abdel-Rahman, Manar E

2012-01-01

A study was conducted to determine the degree of tooth loss, factors influencing tooth loss, and the extent of prosthodontic rehabilitation in Sudanese adults (≥ 16 years old) attending outpatient clinics in Khartoum State. Pearson and multivariate analyses were used to examine the relationships between tooth loss and specific characteristics determined through interviews and clinical examinations. The mean number of missing teeth was 3.6 (SD, 4.9) and the prevalence of edentulism was 0.1%. The prevalence of tooth loss (missing at least one tooth) was 78%; 66.9% of tooth loss was due to caries, and 11.2% was attributable to other reasons. Prosthetic replacement of missing teeth was evident in 3%, whereas a need for prosthetic replacement was evident in 57%. Having < 20 teeth was associated with age, gender, and socioeconomic status; tooth loss due to caries was associated with age, tribe, frequency of tooth-brushing, and a low rate of dental consultation. Tooth loss due to other reasons was associated with age, tribe, education, periodontal pocketing, tobacco use, tooth wear, and prosthetic status. The results of the present study indicated that the major cause of tooth loss was dental caries, thus emphasizing the importance of a public prevention-based healthcare program. Replacement of missing teeth was uncommon in the study subjects, which may reflect lack of access to this type of oral healthcare.

Influence of tooth profile on the noncircular gear tooth contact

NASA Astrophysics Data System (ADS)

Cristescu, A.; Andrei, L.; Cristescu, B.

2017-02-01

With noncircular gears, the continuous modification of the tooth meshing, in terms of variation of the tooth profiles and the line of action position and inclination, makes difficult the implementation of a general standard procedure for the analysis of the noncircular gears tooth contact. In this paper, the authors present a graphical approach that enables the tooth contact static pattern to be produced and evaluated in case of a noncircular gear with complex geometry of the pitch curve. The study is virtually developed, in AutoCAD environment, by animating and investigating the gear solid models in mesh. The tooth static contact analysis enables the path of contact area and distribution to be evaluated in correlation with the following variable initial data: gear pitch curve geometry, tooth profile geometry, as a consequence of different generating procedures, and the gear pressure angle. It was found out that the noncircular gear tooth contact could be improved by choosing different procedures for the tooth flank generation in concave and convex zones and by increasing the gear pressure angle.

The prevalence, aetiology and clinical appearance of tooth wear: the Nigerian experience.

PubMed

Oginni, O; Olusile, A O

2002-08-01

To establish the prevalence and severity of tooth wear among Nigerians and to compare the pattern and aetiology with findings of earlier studies in Western populations. Clinical examinations for tooth wear using the tooth wear index (TWI). The Federal Republic of Nigeria. Patients attending the Dental Hospital, Obafemi Awolowo University Teaching Hospital's Complex Ile-Ife. Attrition, abrasion and erosion. Of the 126 patients with tooth wear 81 had attrition, 20 had abrasion, 9 had erosion and 16 had attrition and abrasion combined. A total of 15,480 tooth surfaces were examined. 2,229 (14.4%) surfaces had tooth wear out of which 1,007 (6.5%) were pathologically worn down. The frequency of tooth wear increased with the age of patients. Most of the pathologically worn surfaces were just one point above maximum acceptable value. The aetiological factors associated with tooth wear are not different from those encountered in Western cultures but the pattern of wear differs. Pathological tooth wear presents as an age related phenomenon and is probably more severe in Nigerians.

Ameloglyphics: A possible forensic tool for person identification following high temperature and acid exposure

PubMed Central

Juneja, Manjushree; Juneja, Saurabh; Rakesh, Nagaraju; Bhoomareddy Kantharaj, Yashoda Devi

2016-01-01

Introduction: Forensic odontology is a branch that is evolving over time and has opened newer avenues that may help in the identification of individuals. Tooth prints are the enamel rod end patterns on tooth surface and they are considered as a hard tissue analog to fingerprints. Teeth have the highest resistance to most environmental effects like fire, desiccation, and decomposition, and may be used as a forensic evidence. Aims and Objectives: The aim of the study was to evaluate if the tooth prints could be used for an individual's identification and reproducibility and permanency of these tooth prints after exposing the teeth to acid and various degrees of temperature. Materials and Methods: 90 tooth prints from 20 freshly extracted maxillary premolar teeth were obtained. Cellophane tape technique was used to record enamel rod end patterns on tooth surface. Ten teeth (one from each patient) were immersed in 36.46% hydrochloric acid and the tooth prints were obtained at various intervals (5 min, 10 min, and 20 min). The other 10 teeth (one from each patient) were incinerated and impression was made at various intervals (80° C, 400° C, 600° C, and 750° C). Tooth prints obtained from different teeth (total of 90 tooth prints) were analyzed using Verifinger® standard SDK version 5.0 software. Results: All the 20 original tooth prints were distinct from each other and no inter-individual or intra-individual similarity was found. The tooth prints from the same tooth after it was exposed to acid or heat were reproducible and showed high to very high similarity with the original tooth print of that particular tooth stored in the database. Conclusion: Tooth prints may be used as an effective aid in person identification even in adverse conditions such as burn and acid attack injuries. PMID:27051220

Associations between smoking and tooth loss according to reason for tooth loss

PubMed Central

Mai, Xiaodan; Wactawski-Wende, Jean; Hovey, Kathleen M.; LaMonte, Michael J.; Chen, Chaoru; Tezal, Mine; Genco, Robert J.

2013-01-01

Background Smoking is associated with tooth loss. However, smoking's relationship to the specific reason for tooth loss in postmenopausal women is unknown. Methods Postmenopausal women (n = 1,106) who joined a Women's Health Initiative ancillary study (The Buffalo OsteoPerio Study) underwent oral examinations for assessment of the number of missing teeth, as well as the self-reported reasons for tooth loss. The authors obtained information about smoking status via a self-administered questionnaire. The authors calculated odds ratios (ORs) and 95 percent confidence intervals (CIs) by means of logistic regression to assess smoking's association with overall tooth loss, as well as with tooth loss due to periodontal disease (PD) and with tooth loss due to caries. Results After adjusting for age, education, income, body mass index (BMI), history of diabetes diagnosis, calcium supplement use and dental visit frequency, the authors found that heavy smokers (≥ 26 pack-years) were significantly more likely to report having experienced tooth loss compared with never smokers (OR = 1.82; 95 percent CI, 1.10-3.00). Smoking status, packs smoked per day, years of smoking, pack-years and years since quitting smoking were significantly associated with tooth loss due to PD. For pack-years, the association for heavy smokers compared with that for never smokers was OR = 6.83 (95 percent CI, 3.40-13.72). The study results showed no significant associations between smoking and tooth loss due to caries. Conclusions and Practical Implications Smoking may be a major factor in tooth loss due to PD. However, smoking appears to be a less important factor in tooth loss due to caries. Further study is needed to explore the etiologies by which smoking is associated with different types of tooth loss. Dentists should counsel their patients about the impact of smoking on oral health, including the risk of tooth loss due to PD. PMID:23449901

Algorithm of first-aid management of dental trauma for medics and corpsmen.

PubMed

Zadik, Yehuda

2008-12-01

In order to fill the discrepancy between the necessity of providing prompt and proper treatment to dental trauma patients, and the inadequate knowledge among medics and corpsmen, as well as the lack of instructions in first-aid textbook and manuals, and after reviewing the dental literature, a simple algorithm for non-professional first-aid management for various injuries to hard (teeth) and soft oral tissues, is presented. The recommended management of tooth avulsion, subluxation and luxation, crown fracture and lip, tongue or gingival laceration included in the algorithm. Along with a list of after-hour dental clinics, this symptoms- and clinical-appearance-based algorithm is suited to tuck easily into a pocket for quick utilization by medics/corpsmen in an emergency situation. Although the algorithm was developed for the usage of military non-dental health-care providers, this method could be adjusted and employed in the civilian environment as well.

Unusual complication after genioplasty.

PubMed

Avelar, Rafael Linard; Sá, Carlos Diego Lopes; Esses, Diego Felipe Silveira; Becker, Otávio Emmel; Soares, Eduardo Costa Studart; de Oliveira, Rogerio Belle

2014-01-01

Facial beauty depends on shape, proportion, and harmony between the facial thirds. The chin is one of the most important components of the inferior third and has an important role on the definition of facial aesthetic and harmony in both frontal and lateral views. There are 2 principal therapeutic approaches that one can choose to treat mental deformities, alloplastic implants, and mental basilar ostectomy, also known as genioplasty. The latest is more commonly used because of great versatility in the correction of three-dimensional deformities of the chin and smaller taxes of postoperative complications. Possible transoperative and postoperative complications of genioplasty include mental nerve lesion, bleeding, damage to tooth roots, bone resorption of the mobilized segment, mandibular fracture, ptosis of the lower lip, and failure to stabilize the ostectomized segment. The study presents 2 cases of displacement of the osteotomized segment after genioplasty associated with facial trauma during postoperative orthognathic surgery followed by rare complications with no reports in the literature.

Osteoporosis and Periodontitis.

PubMed

Wang, Chin-Wei Jeff; McCauley, Laurie K

2016-12-01

Osteoporosis and periodontitis are both diseases characterized by bone resorption. Osteoporosis features systemic degenerative bone loss that leads to loss of skeletal cancellous microstructure and subsequent fracture, whereas periodontitis involves local inflammatory bone loss, following an infectious breach of the alveolar cortical bone, and it may result in tooth loss. Most cross-sectional studies have confirmed the association of osteoporosis and periodontitis primarily on radiographic measurements and to a lesser degree on clinical parameters. Multiple shared risk factors include age, genetics, hormonal change, smoking, as well as calcium and vitamin D deficiency. Both diseases could also be risk factors for each other and have a mutual impact that requires concomitant management. Suggested mechanisms underlying the linkage are disruption of the homeostasis concerning bone remodeling, hormonal balance, and inflammation resolution. A mutual interventional approach is emerging with complex treatment interactions. Prevention and management of both diseases require interdisciplinary approaches and warrants future well-controlled longitudinal and interventional studies for evidence-based clinical guidelines.

Lingual orthodontics and forced eruption: a means for osseous and tissue regeneration.

PubMed

Paolone, Maria Giacinta; Kaitsas, Roberto; Paolone, Gaetano; Kaitsas, Vassilios

2008-01-01

An hopeless upper central incisor was subjected to forced eruption in order to improve and develop the implant site by distraction of the periodontal ligament-alveolar bone complex. The orthodontic extrusion was carried out with two aesthetic approaches: lingual orthodontics and a composite resin 2-2 veneer pontic. The first part of the extrusion was realized with lingual orthodontics alone, then, when the crown had been remodelled in its greatest part and the aesthetics was no more acceptable to the patient a composite resin 2-2 veneer pontic was bonded to the vestibular side of the other three incisors to mimetise the extruded tooth and to be anchorage to the lingual mechanics. The orthodontic preparation of the implant site allowed the correction of the periodontal defect due to the fracture, the enhancement of the alveolar bone and the soft tissue remodelling.

Bond strengths evaluation of laser ceramic bracket debonding

NASA Astrophysics Data System (ADS)

Dostalová, T.; Jelinková, H.; Šulc, J.; Němec, M.; Fibrich, M.; Jelínek, M.; Michalík, P.; Bučková, M.

2012-09-01

Ceramic brackets often used for an orthodontic treatment can lead to problems such as enamel tear outs because of their low fracture resistance and high bond strengths. Therefore the aim of our study was to investigate the positive laser radiation effect on bracket debonding. Moreover, the influence of the enamel shape surface under the bracket and laser radiation power on the debonding strength was investigated. The source of the radiation was the longitudinally diode-pumped Tm:YAP laser operating at 1997 nm. To eliminate the tooth surface roughness the flat enamel surface was prepared artificially and the bracket was bonded on it. The debonding was accomplished by Tm:YAP laser radiation with different the power value while recording the temperature rise in the pulp. To simulate the debonding process in vivo the actual bond strength was measured by the digital force gauge. The results were analyzed by scanning electron microscope.

Non-invasive diagnostic methods in dentistry

NASA Astrophysics Data System (ADS)

Todea, Carmen

2016-03-01

The paper, will present the most important non-invasive methods for diagnostic, in different fields of dentistry. Moreover, the laser-based methods will be emphasis. In orthodontics, 3D laser scanners are increasingly being used to establish database for normative population and cross-sectional growth changes but also to asses clinical outcomes in orthognatic surgical and non-surgical treatments. In prevention the main methods for diagnostic of demineralization and caries detection in early stages are represented by laser fluorescence - Quantitative Light Florescence (QLF); DiagnoDent-system-655nm; FOTI-Fiberoptic transillumination; DIFOTI-Digital Imaging Fiberoptic transillumination; and Optical Coherence Tomography (OCT). In odontology, Laser Doppler Flowmetry (LDF) is a noninvasive real time method used for determining the tooth vitality by monitoring the pulp microcirculation in traumatized teeth, fractured teeth, and teeth undergoing different conservative treatments. In periodontology, recently study shows the ability of LDF to evaluate the health of gingival tissue in periodontal tissue diseases but also after different periodontal treatments.

Forced orthodontic extrusion and use of CAD/CAM for reconstruction of grossly destructed crown: A multidisciplinary approach

PubMed Central

Kumar, Rahul; Patil, Suvarna

2012-01-01

The aim of this study is to present a report of a case where forced orthodontic extrusion and computer-aided design and computer-aided manufacturing (CAD/CAM) technique was used for reconstruction of right maxillary central incisor with grossly destructed crown. Aesthetic rehabilitation of a fractured maxillary right central incisor was performed employing a multidisciplinary approach i.e. conventional endodontic treatment followed by orthodontic extrusion and final restoration using CAD-CAM and one piece milled zirconia post and core with full coverage zirconia crown. After the procedure being completed, periapical radiographs taken at 3 month follow up period demonstrated that the post and core remained well adapted to post space and there was a complete healing of periapical lesion. This technique can provide a complete aesthetic rehabilitation of a grossly destructed tooth without hampering the biological width and thus has a better prognosis. PMID:22557823

Inhibition of Wnt signaling by Wise (Sostdc1) and negative feedback from Shh controls tooth number and patterning.

PubMed

Ahn, Youngwook; Sanderson, Brian W; Klein, Ophir D; Krumlauf, Robb

2010-10-01

Mice carrying mutations in Wise (Sostdc1) display defects in many aspects of tooth development, including tooth number, size and cusp pattern. To understand the basis of these defects, we have investigated the pathways modulated by Wise in tooth development. We present evidence that, in tooth development, Wise suppresses survival of the diastema or incisor vestigial buds by serving as an inhibitor of Lrp5- and Lrp6-dependent Wnt signaling. Reducing the dosage of the Wnt co-receptor genes Lrp5 and Lrp6 rescues the Wise-null tooth phenotypes. Inactivation of Wise leads to elevated Wnt signaling and, as a consequence, vestigial tooth buds in the normally toothless diastema region display increased proliferation and continuous development to form supernumerary teeth. Conversely, gain-of-function studies show that ectopic Wise reduces Wnt signaling and tooth number. Our analyses demonstrate that the Fgf and Shh pathways are major downstream targets of Wise-regulated Wnt signaling. Furthermore, our experiments revealed that Shh acts as a negative-feedback regulator of Wnt signaling and thus determines the fate of the vestigial buds and later tooth patterning. These data provide insight into the mechanisms that control Wnt signaling in tooth development and into how crosstalk among signaling pathways controls tooth number and morphogenesis.

Varanoid Tooth Eruption and Implantation Modes in a Late Cretaceous Mosasaur.

PubMed

Liu, Min; Reed, David A; Cecchini, Giancarlo M; Lu, Xuanyu; Ganjawalla, Karan; Gonzales, Carol S; Monahan, Richard; Luan, Xianghong; Diekwisch, Thomas G H

2016-01-01

Erupting teeth are some of the oldest witnesses of developmental processes in the vertebrate fossil record and provide an important resource for vertebrate cladistics. Here, we have examined a mosasaur jaw fragment from central Texas using ultrathin ground section histology and 3D tomographic imaging to assess features critical for the cladistic placement of mosasaurs among varanoids vs. snakes: (i) the orientation of replacement teeth compared to the major tooth axis, (ii) the occurrence of resorption pits, and (iii) the mode of tooth implantation/attachment to the tooth bearing element (TBE). The replacement tooth studied here developed in an inclined position slightly distal of the deciduous parent tooth, similar to another varanoid squamate, the Gila monster Heloderma suspectum. Ground sections and tomographs also demonstrated that the replacement tooth attachment apparatus was entirely intact and that there was no evidence of mechanical deformation. Sections and tomographs further illustrated that the replacement tooth was located within a bony crypt and the inclination of the crypt matched the inclination of the replacement tooth. These preparations also revealed the presence of a resorption pit within the boundaries of the deciduous tooth that surrounded the developing replacement tooth. This finding suggests that developing mosasaur teeth developed within the walls of resorption pits similar to varanoid tooth germs and unlike developing snake teeth which are surrounded by fibrous connective tissue integuments. Finally, mosasaurs featured pseudo-thecodont tooth implantation with teeth anchored within a socket of mineralized tissue by means of a mineralized periodontal ligament. Together, these data indicate that the moderate inclination of the erupting mosasaur tooth studied here is neither a result of postmortem displacement nor a character representative of snakes, but rather a shared character between Mosasaurs and other varanoids such as Heloderma. In conjunction with the presence of resorption pits and the evidence for pseudothecodont tooth implantation, the tooth eruption and implantation characters described in the present study either place mosasaurs among the varanoids or suggest convergent evolution mechanisms between both clades, with mosasaurs evolving somewhat independently from a common varanoid ancestor.

Varanoid Tooth Eruption and Implantation Modes in a Late Cretaceous Mosasaur

PubMed Central

Liu, Min; Reed, David A.; Cecchini, Giancarlo M.; Lu, Xuanyu; Ganjawalla, Karan; Gonzales, Carol S.; Monahan, Richard; Luan, Xianghong

2016-01-01

Erupting teeth are some of the oldest witnesses of developmental processes in the vertebrate fossil record and provide an important resource for vertebrate cladistics. Here, we have examined a mosasaur jaw fragment from central Texas using ultrathin ground section histology and 3D tomographic imaging to assess features critical for the cladistic placement of mosasaurs among varanoids vs. snakes: (i) the orientation of replacement teeth compared to the major tooth axis, (ii) the occurrence of resorption pits, and (iii) the mode of tooth implantation/attachment to the tooth bearing element (TBE). The replacement tooth studied here developed in an inclined position slightly distal of the deciduous parent tooth, similar to another varanoid squamate, the Gila monster Heloderma suspectum. Ground sections and tomographs also demonstrated that the replacement tooth attachment apparatus was entirely intact and that there was no evidence of mechanical deformation. Sections and tomographs further illustrated that the replacement tooth was located within a bony crypt and the inclination of the crypt matched the inclination of the replacement tooth. These preparations also revealed the presence of a resorption pit within the boundaries of the deciduous tooth that surrounded the developing replacement tooth. This finding suggests that developing mosasaur teeth developed within the walls of resorption pits similar to varanoid tooth germs and unlike developing snake teeth which are surrounded by fibrous connective tissue integuments. Finally, mosasaurs featured pseudo-thecodont tooth implantation with teeth anchored within a socket of mineralized tissue by means of a mineralized periodontal ligament. Together, these data indicate that the moderate inclination of the erupting mosasaur tooth studied here is neither a result of postmortem displacement nor a character representative of snakes, but rather a shared character between Mosasaurs and other varanoids such as Heloderma. In conjunction with the presence of resorption pits and the evidence for pseudothecodont tooth implantation, the tooth eruption and implantation characters described in the present study either place mosasaurs among the varanoids or suggest convergent evolution mechanisms between both clades, with mosasaurs evolving somewhat independently from a common varanoid ancestor. PMID:27242535

Kinematics modeling and experimentation of the multi-manipulator tooth-arrangement robot for full denture manufacturing.

PubMed

Zhang, Yong-de; Jiang, Jin-gang; Liang, Ting; Hu, Wei-ping

2011-12-01

Artificial teeth are very complicated in shape, and not easy to be grasped and manipulated accurately by a single robot. The method of tooth-arrangement by multi-manipulator for complete denture manufacturing proposed in this paper. A novel complete denture manufacturing mechanism is designed based on multi-manipulator and dental arch generator. Kinematics model of the multi-manipulator tooth-arrangement robot is built by analytical method based on tooth-arrangement principle for full denture. Preliminary experiments on tooth-arrangement are performed using the multi-manipulator tooth-arrangement robot prototype system. The multi-manipulator tooth-arrangement robot prototype system can automatically design and manufacture a set of complete denture that is suitable for a patient according to the jaw arch parameters. The experimental results verified the validity of kinematics model of the multi-manipulator tooth-arrangement robot and the feasibility of the manufacture strategy of complete denture fulfilled by multi-manipulator tooth-arrangement robot.

Orthodontic Tooth Movement: A Historic Prospective.

PubMed

Will, Leslie A

2016-01-01

The earliest report on orthodontic tooth movement in the English literature was published in 1911. Oppenheim carried out studies on baboons to determine what histologic changes occurred during tooth movement. Reitan and many others carried out research into the nature of tooth movement. The pressure-tension model of tooth movement developed from these studies, whereby the two sides of the tooth responded to forces as if in isolation. A second theory, proposed by Stuteville in 1938, was the hydraulic theory of tooth movement. In this theory, fluid from the vasculature, lymphatic system and intercellular spaces responds to the forces of tooth movement, damping the force and limiting movement. Bien and Baumrind expanded on this theory with their own studies in the 1960s. It is clear that both the pressure-tension and fluid flow concepts have merit, but considerable work needs to be done to ascertain the details so that tooth movement can be managed and controlled. © 2016 S. Karger AG, Basel.

Tooth Eruption without Roots

PubMed Central

2013-01-01

Root development and tooth eruption are very important topics in dentistry. However, they remain among the less-studied and -understood subjects. Root development accompanies rapid tooth eruption, but roots are required for the movement of teeth into the oral cavity. It has been shown that the dental follicle and bone remodeling are essential for tooth eruption. So far, only limited genes have been associated with root formation and tooth eruption. This may be due to the difficulties in studying late stages of tooth development and tooth movement and the lack of good model systems. Transgenic mice with eruption problems and short or no roots can be used as a powerful model for further deciphering of the cellular, molecular, and genetic mechanisms underlying root formation and tooth eruption. Better understanding of these processes can provide hints on delivering more efficient dental therapies in the future. PMID:23345536

Effects of Simulated Functional Loading Conditions on Dentin, Composite, and Laminate Structures

PubMed Central

Walker, Mary P.; Teitelbaum, Heather K.; Eick, J. David; Williams, Karen B.

2008-01-01

Use of composite restorations continues to increase, tempered by more potential problems when placed in posterior dentition. Thus, it is essential to understand how these materials function under stress-bearing clinical conditions. Since mastication is difficult to replicate in the laboratory, cyclic loading is frequently used within in vitro evaluations but often employs traditional fatigue testing, which typically does not simulate occlusal loading because higher stresses and loading frequencies are used, so failure mechanisms may be different. The present investigation utilized relevant parameters (specimen size; loading frequency) to assess the effects of cyclic loading on flexural mechanical properties and fracture morphology of (coronal) dentin, composite, and dentin-adhesive-composite “laminate” structures. Incremental monitoring of flexural modulus on individual beams over 60,000 loading cycles revealed a gradual increase across materials; post-hoc comparisons indicated statistical significance only for 1 versus 60k cycles. Paired specimens were tested (one exposed to 60k loading cycles, one to static loading only), and comparisons of flexural modulus and strength showed statistically significantly higher values for cyclically-loaded specimens across materials, with no observable differences in fracture morphology. Localized reorganization of dentin collagen and polymer chains could have increased flexural modulus and strength during cyclic loading, which may have implications toward the life and failure mechanisms of clinical restorations and underlying tooth structure. PMID:18823019

Structure and scale of the mechanics of mammalian dental enamel viewed from an evolutionary perspective.

PubMed

Lucas, Peter W; Philip, Swapna M; Al-Qeoud, Dareen; Al-Draihim, Nuha; Saji, Sreeja; van Casteren, Adam

2016-01-01

Mammalian enamel, the contact dental tissue, is something of an enigma. It is almost entirely made of hydroxyapatite, yet exhibits very different mechanical behavior to a homogeneous block of the same mineral. Recent approaches suggest that its hierarchical composite form, similar to other biological hard tissues, leads to a mechanical performance that depends very much on the scale of measurement. The stiffness of the material is predicted to be highest at the nanoscale, being sacrificed to produce a high toughness at the largest scale, that is, at the level of the tooth crown itself. Yet because virtually all this research has been conducted only on human (or sometimes "bovine") enamel, there has been little regard for structural variation of the tissue considered as evolutionary adaptation to diet. What is mammalian enamel optimized for? We suggest that there are competing selective pressures. We suggest that the structural characteristics that optimize enamel to resist large-scale fractures, such as crown failures, are very different to those that resist wear (small-scale fracture). While enamel is always designed for damage tolerance, this may be suboptimal in the enamel of some species, including modern humans (which have been the target of most investigations), in order to counteract wear. The experimental part of this study introduces novel techniques that help to assess resistance at the nanoscale. © 2015 Wiley Periodicals, Inc.

The Bulging Behavior of Thick-Walled 6063 Aluminum Alloy Tubes Under Double-Sided Pressures

NASA Astrophysics Data System (ADS)

Cui, Xiao-Lei; Wang, Xiao-Song; Yuan, Shi-Jian

2015-05-01

To make further exploration on the deformation behavior of tube under double-sided pressures, the thick-walled 6063 aluminum alloy tubes with an outer diameter of 65 mm and an average thickness of 7.86 mm have been used to be bulged under the combined action of internal and external pressures. In the experiment, two ends of the thick-walled tubes were fixed using the tooth and groove match. Three levels of external pressure (0 MPa, 40 MPa, and 80 MPa), in conjunction with the internal pressure, were applied on the tube outside and inside simultaneously. The effect of external pressure on the bulging behavior of the thick-walled tubes, such as the limiting expansion ratio, the bulging zone profile, and the thickness distribution, has been investigated. It is shown that the limiting expansion ratio, the bulging zone profile, and the thickness distribution in the homogeneous bulging area are all insensitive to the external pressure. However, the external pressure can make the thick-walled tube achieve a thinner wall at the fracture area. It reveals that the external pressure can only improve the fracture limit of the thick-walled 6063 tubes, but it has very little effect on their homogeneous bulging behavior. It might be because the external pressure can only increase the magnitude of the hydrostatic pressure for the tube but has no effect on the Lode parameter.