Journal of Dental Medicine

Amelogenesis imperfecta is an inherited disease that disturbs the formation of the enamel. It occurs as two main categories, hypomineralized and hypoplastic. Both deciduous and permanent teeth are affected, and the disorder may create unaesthetic appearance, dental sensitivity, and severe attrition. In this article through performing a structured literature review, numerous treatment modalities which so far advocated in rehabilitation of amelogenesis imperfecta in adults and children is discussed. The progressive changes on open bite, the problem of bonding during restorative phase of treatment , the rehabilitation difficulties of deciduous as well as permanent teeth is also discussed in detail and finally the interdisciplinary approach for treatment of this disability is demonstrated and some points for decision making in treatment protocols are suggested.

Background and Aim: By definition, pontic is an artificial replacement of missing tooth (teeth) which is essentially used to establish function and esthetics. In order to this fact that, pontic(s) is not completely the same as tooth (teeth) to be replaced, it may not be concern as a simple type of restoration to achieve the best result, it must be design from the esthetically and hygienically point of view as well as comfort, demand and tissue health of patient. The main purpose of this study is to investigate the pontic designs and their relationship to edentulous partial aras.

Materials and Methods: 73 pontics in 57 patients have been included in this cross-sectional study. These patients were under treatment in the department of prosthodontics. A primary cast was achieved from each patient and then the cross-sectional contour of edentulous ridge was depicted. For each patient the type of pontic design was derived from textbook standards and then compared with the design of actual verified Prosthesis at delivery. The shape of tissue surface of each denture was determined by a low viscous impression material. The result of each comparison was recorded in a chart data set.

Results: The most common pontic design was Modified ridge lap with frequency of 93.2%. The type of ridge was %45.2 normal, %19.2 class I, %8.2 class II and %27.4 class III, respectively. %72.6 of pontics tested have inappropriate design in tissue surface.

Conclusion: It seems that in a high percentage of cases the tissue surface contour of prescribed pontics in department of prosthodontics was incorrect and more attention must be paid to the education of students and technicians.

It is quite often for general practitioners who want to use implants in their routine treatments to face with the problem of unfamiliar radiographic techniques commonly prescribed in modern implantology. These types of radiograph, which could show the jaws in multiple aspects, are not routinely used by general practitioners. However, for sophisticated very delicate treatment options like implantology, the main problem is that "a metal object want to be placed in an undercut-full and zigzag area like bone", and the so called plain radiographs cannot be used for this purposes without difficulty. In this literature review, based on the data of the most powerful databases including COCHRANE and PUBMED, the necessity of using cross-sectional techniques in pre-implant treatment discussed in detail.

Surgical and prosthodontic implant complications are often the case of inadvertent improper diagnosis, planning, and placement. These complications always pose a significant challenge in implant dentistry. In this article, it is attempted to depict a new technique in which advanced software program along with newly developed CAD/CAM technology called rapid prototyping will be used. This technology permits graphic and complex 3D implant simulation and then fabrication of computer-generated surgical templates. The best position of implants planned at first by taking into consideration of encased bone density of each implants and then existing occlusion. In this paper, the evolution of Computer Guided Implantology and the many benefits achieved from this very sophisticated technology described as a literature review.

Background and Aims: Freestanding fixed partial prosthesis is considered the first choice whenever possible. However, anatomical limitations for implants and other reasons may create situation in which it would be preferable to connect the implants to teeth. A biomechanical dilemma in a tooth/implant-supported system comes from dissimilar mobility. This disparity cause the bridge to function as a cantilever and a series of potential problems such as osseointegration loss, screw loosening arise. The aim of this study was to analyze the tooth-implant supported bridges in rigid/non-rigid connectors in cemented prostheses using finite element stress analysis.

Materials and Methods: In this study four three-dimensional models were simulated by use of Solid works software. These models are: 1-RCCP: rigid connector between tooth and implant, 2-NRC CP1: non-rigid connector at mesial side of implant, 3-NRC CP2: non-rigid connector at distal side of second premolar, 4-NRC CP3: non-rigid connector at the middle of pontic, The stress values of four models loaded with vertical forces (150 N) were analyzed.

Results: The maximum stress concentration was located at the crestal bone around implant and stress distribution was more balanced around the teeth except in the model of NRCCP2. Stress distribution was imbalanced in non-rigid connection especially in the NRCCP1 model. The presence of non-rigid connector in bridge increases the stress values in suprastructure and transfers to the adjacent structures. Conclusion: The tooth-implant supported prosthesis should be considered as a valuable prosthetic option. It could be suggested that if tooth and implant abutments are to be used together as fixed prostheses supports, rigid connector is the choice because the prosthesis and implant possess the inherent flexibility to accommodate dissimilar mobility characteristics.

Background and Aims: Reliable bonding between tooth substrate and zirconia-based ceramic restorations is always of great importance. The laser might be useful for treatment of ceramic surfaces. The aim of the present study was to investigate the effect of laser irradiation on the shear bond strength of zirconia ceramic surface to dentin.

Materials and Methods: In this experimental in vitro study, 40 Cercon zirconia ceramic blocks were fabricated. The surface treatment was performed using sandblasting with 50-micrometer Al2O3, CO₂ laser, or Nd:YAG laser in each test groups. After that, the specimens were cemented to human dentin with resin cement. The shear bond strength of ceramics to dentin was determined and failure mode of each specimen was analyzed by stereo-microscope and SEM investigations. The data were statistically analyzed by one-way analysis of variance and Tukey multiple comparisons. The surface morphology of one specimen from each group was investigated under SEM.

Results: The mean shear bond strength of zirconia ceramic to dentin was 7.79±3.03, 9.85±4.69, 14.92±4.48 MPa for CO₂ irradiated, Nd:YAG irradiated, and sandblasted specimens, respectively. Significant differences were noted between CO₂ (P=0.001) and Nd:YAG laser (P=0.017) irradiated specimens with sandblasted specimens. No significant differences were observed between two laser methods (P=0.47). The mode of bond failure was predominantly adhesive in test groups (CO₂ irradiated specimens: 75%, Nd:YAG irradiated: 66.7%, and sandblasting: 41.7%).

Conclusion: Under the limitations of the present study, surface treatment of zirconia ceramics using CO₂ and Nd:YAG lasers was not able to produce adequate bond strength with dentin surfaces in comparison to sandblasting technique. Therefore, the use of lasers with the mentioned parameters may not be recommended for the surface treatment of Cercon ceramics.

Background and Aims: The marginal integrity of fixed restorations always is a major matter of concern for dental clinicians. Any cause of distortion, including veneering processes, in the marginal integrity is supposed to be detrimental for long-term success of fixed dental prostheses. The aim of this in vitro study was to compare the marginal adaptation of two different full ceramic restoration systems (Zirkouzahu&Cercon) and possible changes in marginal integrity following the multiple veneering process.

Materials and Methods: Twelve all-ceramic crowns in the form of coping were fabricated on a pre-made standard metal die with finish line of shoulder preparation from two commercial systems: Cercon® and Zirkonzahn®. The specimens were not cemented. The Crown/Die discrepancy were measured by means of a precise stereo microscope (accuracy±0.1 μm), at various points (n=12) selected along circumferential margin of the restorations. Same procedure was accomplished after applying the veneering porcelain. The mean gap dimensions were calculated and data were analyzed by multivariate (b) test.

Results: Mean marginal gap dimensions before and after veneering porcelain firing cycles, for Cercon® were (59.67±13.46 µm) and (63.75±14.16 µm) and for Zirkonzahn® were (65.81±24.37 µm) and (64.74±21.94 µm), respectively. Hotelling trace Multivariate(b) test method showed that the rate of mismatching marginal integrity in two groups (Cercon® and Zirkonzahn®) had no significant difference before and after porcelain firing (P>0.05).

Conclusion: Within the limitation of this study, the marginal integrity of both systems were seems to be within the clinically acceptable standard dimension, i.e. 120μm.The marginal gap of both all-ceramic systems were not affected by veneering porcelain firing cycles.

  Background and Aims: The aim of this review article was to present the information have been published, regarding the functional properties of Zirconia until today.

  Materials and Methods: A review of the literature was carried out in MEDLINE database using key words (Dental ceramic, Zirconia, 3Y-TZP, Clinical performance, Machining and Transformation toughening). These searches were limited to the articles published after the year 2000.

  Conclusion: Despite excellent clinical results in short-term studies, there is still a major need to have more clinical and laboratory long-term information about zirconia restorations.