1,720,969 research outputs found
Restaurationsreparatur – Wo stehen wir heute?
No full textZahnmedizinische Restaurationen aller Art haben nur eine begrenzte Lebensdauer. Daher liegt der Hauptanteil zahnmedizinischer Tätigkeit in der wiederholten Behandlung von Zähnen, die bereits mit Restaurationen versorgt wurden. Der vollständige Ersatz einer partiell insuffizienten Restauration geht in den meisten Fällen mit Nachteilen wie beispielsweise längeren Behandlungszeiten, höheren Kosten und vermehrten Komplikationen einher. Als minimalinvasive Alternative bietet sich die Reparatur der bestehenden Restauration an. Je nach Restaurationsmaterial sollte eine angepasste Konditionierung der bestehenden Restauration erfolgen, um Reparaturmaßnahmen langfristig erfolgreich im Praxisalltag umzusetzen
Restaurationsreparatur – Wo stehen wir heute?
No full textZahnmedizinische Restaurationen aller Art haben nur eine begrenzte Lebensdauer. Daher liegt der Hauptanteil zahnmedizinischer Tätigkeit in der wiederholten Behandlung von Zähnen, die bereits mit Restaurationen versorgt wurden. Der vollständige Ersatz einer partiell insuffizienten Restauration geht in den meisten Fällen mit Nachteilen wie beispielsweise längeren Behandlungszeiten, höheren Kosten und vermehrten Komplikationen einher. Als minimalinvasive Alternative bietet sich die Reparatur der bestehenden Restauration an. Je nach Restaurationsmaterial sollte eine angepasste Konditionierung der bestehenden Restauration erfolgen, um Reparaturmaßnahmen langfristig erfolgreich im Praxisalltag umzusetzen
Adhesion to eroded enamel and dentin: systematic review and meta-analysis
No full textObjective: The aim of this systematic review and meta-analysis was to compare the bond strength between eroded and sound permanent enamel and dentin and to assess whether bonding performance (immediate and after aging) differs between etch&rinse and self-etch adhesives and can be improved by surface pretreatment prior to bonding.
Methods: Electronic databases (PubMed, Scopus, Embase, Web of Science, CENTRAL, LILACS, BBO) were searched by two reviewers. Random-effect meta-analyses were performed to compare bond strength to sound and eroded dental hard tissues without and with surface pretreatment prior to bonding, respectively. The effect of adhesive mode (etch&rinse vs. self-etch) and aging (immediate vs. aged) was compared using subgroup analyses. Statistical heterogeneity was assessed using Cochran’s Q and I2-statistic. Funnel plots and Egger’s regression intercept tests were used to evaluate publication bias. Quality and risk of bias of included studies were also assessed.
Results: Fourty-seven studies (45 in vitro, 2 in situ) were included in the systematic review and meta-analyses. Erosion impairs bond strength to dentin (p < 0.001; mean difference: −10.2 MPa [95%CI: −11.9 to −8.6 MPa]), but not to enamel (p = 0.260). Surface pretreatment measures removing or stabilizing the collagenous matrix can improve dentin bond strength (maximum mean difference: +12.4 MPa). Etch&rinse and self-etch adhesives did not perform significantly different on eroded enamel (p = 0.208) and dentin (p = 0.353). The majority of studies (32 of 47) presented a medium risk of bias.
Significance: Data from in vitro and in situ studies showed that erosion impairs dentin bonding of etch&rinse and self-etch adhesives and makes surface pretreatment prior to bonding of composite restorations necessary
Clinical performance of CAD-CAM partial-coverage restorations: Experienced versus less-experienced operators
No full textStatement of problem: Less-experienced operators have been shown to require additional training to achieve results similar to those of experienced operators. However, clinical data comparing the survival and success of ceramic restorations by experienced and less-experienced operators by using the computer-aided design and computer-aided manufacturing (CAD-CAM) technology are lacking.
Purpose: The purpose of this retrospective clinical study was to analyze and compare the clinical performance of CAD-CAM lithium disilicate restorations fabricated by less-experienced (predoctoral dental students) and experienced (dentists) operators.
Material and methods: Patients who received an adhesively luted CAD-CAM lithium disilicate restoration between 2011 and 2019 were included in the study. Clinical performance was assessed by calibrated examiners by using World Dental Federation (FDI) criteria. Success and survival were calculated by the Kaplan-Meier method and statistically compared by log-rank tests and univariate Cox regression analyses. FDI criteria were compared by using Mann-Whitney-U tests (α=.05).
Results: Ninety-two restorations (students: n=65, dentists: n=27) were assessed (mean ±standard deviation time from insertion: 4.04 ±1.55 years). The survival rates after 2 years (students: 93.8%, mean annual failure rate [mAFR]: 3.1%; dentist: 96.3%, mAFR: 1.9%) and after 4 years (students: 87.3%, mAFR: 3.3%; dentists: 88.3%, mAFR: 3.1%) were not significantly different (P=.525). Also, success rates after 2 (students: 90.8%, mAFR: 4.7%; dentists: 92.6%, mAFR: 3.8%) and 4 years (students: 82.4%, mAFR: 4.7%; dentists: 76.1%, mAFR: 6.6%) were not significantly different (P=.778). FDI criteria were also not significantly different between less-experienced and experienced operators (P≥.110).
Conclusions: Operator experience did not affect the short-term clinical performance of CAD-CAM lithium disilicate restorations
Two-year evaluation of periodontal parameters following deep-margin-elevation and CAD/CAM partial lithium disilicate restorations – a prospective controlled clinical trial
No full textSystematic review and meta-analysis on prevalence and risk factors for gingival recession
No full textRepair of partially defective restorations: Systematic review and meta-analysis of patient acceptance
No full textObjectives: This systematic review attempted to assess patient acceptance of repairs instead of complete replacement for partially defective restorations and to identify factors affecting patients’ decision-making for or against repairs.
Study selection: Observational and qualitative studies reporting on (1) the proportion of patients accepting or preferring repairs, (2) the proportion of dentists / dental students / dental schools stating that their patients accept or prefer repairs, (3) factors affecting patients’ decision-making for or against repairs.
Sources: Electronic databases (MEDLINE via PubMed, Scopus, EMBASE via Ovid, and Web of Science) were last searched in August 2024 (PROSPERO database: CRD42023449437).
Data: Twenty-one sources reporting on 20 survey studies addressing individual dentists / dental students and dental schools were included. None of the included studies directly addressed patients (e.g., by interviewing patients). Of the surveyed dentists and dental students, 86.3 % (95 %-CI: 77.8–91.8 %) reported that their patients accept or prefer repairs. Dental schools rated patient acceptance as high as 93.0 % (95 %-CI: 82.3–97.4 %). None of the included studies reported factors affecting patients’ decision-making for or against repairs.
Conclusions: Repairs of partially defective restorations instead of complete replacement seem to be associated with a high level of patient acceptance as most dentists, dental students, and dental schools stated that their patients accept or even prefer repairs instead of complete replacement.
Clinical significance: Within the shared decision-making process, dentists can expect their patients to accept or even prefer repairs instead of complete replacement
Periodontal health in teeth treated with deep-margin-elevation and CAD/CAM partial lithium disilicate restorations—a prospective controlled trial
No full textObjectives: This prospective controlled clinical trial aimed to compare periodontal parameters of proximal deep-margin-elevation (DME) restoration margins with supragingival/equigingival restoration margins (control) on the opposite proximal surface of the same tooth.
Materials and methods: Subgingival one-sided proximal defects (mesial or distal) on (pre-)molars were restored with composite DME and CAD/CAM-manufactured lithium disilicate ceramic partial-coverage restorations. Periodontal parameters (bleeding on probing (BOP), periodontal probing depths (PPD), plaque index (PI)) were recorded after insertion of the ceramic restoration (baseline) and at 1-year recall visit and compared between DME and control on the same tooth (Fisher’s exact test and Wilcoxon signed rank test, p < 0.05).
Results: Sixty-eight patients with 77 restorations were included. At baseline, periodontal parameters did not differ between DME and control. Sixty-two restorations could be examined after 1 year. BOP was significantly increased for DME (padj. = 0.003), but not for control (padj. = 0.714). Surfaces with DME showed a significantly higher proportion of BOP than control surfaces (DME: 45 restorations (73.8%), control: 27 restorations (44.3%); padj. = 0.005). PI increased significantly on all tooth surfaces (padj.<0.001), but did not differ between DME and control side (padj. = 0.162). Probing depths did not differ between baseline and follow-up (DME: padj. = 0.199, control: padj. = 0.116). Two restorations were replaced due to a ceramic fracture and secondary caries.
Conclusion: Proximal DME is associated with increased gingival inflammation compared to supragingival or equigingival restoration margins.
Clinical relevance: DME is a promising treatment approach for indirect restoration of teeth with deep proximal defects, but gingival inflammation should be expected
Effect of Different Working Settings of Sandblasting on Resin Composite Repair Bond Strength
No full textTo investigate the effect of different sandblasting settings on the shear bond strength (SBS) in the repair of resin composite, specimens (resin composite, enamel, and dentin; each group n = 16) were sandblasted by varying the parameters of air pressure (0.2/0.3/0.4 MPa), angle (45/90°), particle size (27/50 μm), tip size (0.8/1.2 mm), and distance (2/5/10 mm) prior to the application of a universal adhesive (Adhese Universal) and resin composite (adhesive area: 7.07 mm2). The specimens were subjected to artificial aging (10,000 cycles, 5–55 °C) prior to (resin composite only) and after repair. Groups without mechanical pretreatment and resin composite incremental bond strength served as controls. Statistical analysis was performed using ANOVAs, post hoc tests, and Chi2-tests (p < 0.05). Only air pressure and distance impacted SBS (p ≤ 0.049). However, resin composite SBS did not differ from the resin composite incremental SBS within all sandblasting settings (positive control: 21.0 ± 5.0 MPa, p ≥ 0.566). While sandblasting did not impact bond strength on enamel (control: 20.5 ± 5.1 MPa, p ≥ 0.999), most settings resulted in a lower bond strength on dentin (control: 20.1 ± 4.7 MPa, p ≤ 0.027). In conclusion, sandblasting significantly improves resin composite repair bond strength, while application parameters are of minor relevance
The use of smart glasses for remote or virtual instruction in CAD-CAM dentistry: A randomized controlled trial
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