Restoration Of Anterior Teeth Research Articles

Fracture Resistance and Push-Out Bond Strength of Three Post Types in the Restoration of Anterior Primary Teeth - A In Vitro study.

Restoration fractures and displacement are the two main causes of failure after the rehabilitation of severely worn primary anterior teeth. Compare the effect of three post types on the fracture and push-out bond strength. Sixty undamaged maxillary anterior primary teeth were allocated into three groups according to post type: (I) Tetric N Ceram composite post, (II) prefabricated glass fiber post, and (III) high viscous glass ionomer post. Each group was further subdivided into two sub-groups depending on the test used: fracture resistance test and push-out bond strength test. The all specimens were mounted in acrylic resin blocks and tested using a universal testing machine. The fracture and failure mode were determined by a stereomicroscope inspection of all the specimens. Data were analyzed by one-way analysis of variance (ANOVA) and the Bonferroni post hoc test (P < 0.05). There was a statistically significant difference between fracture resistance and push-out bond strength values for the experimental groups (P < 0.05). The most significant fracture resistance value was in Group II and core/post fracture (restorable fracture) was the most obvious fracture in the three groups with the highest percentage in Group I. The most significant push-out bond strength value was in Group I and adhesive failure between dentin and luting cement/post was the most common type in the groups. The fracture resistance and push-out bond strength were affected by the type of post (P = 0.000). Prefabricated glass fiber posts showed the highest fracture resistance in this study. However, Tetric N Ceram composite posts had the most restorable fracture. Tetric N Ceram composite posts had the highest bond strength with adhesive failure mode.

Finite Element Analysis of Anterior Implant-Supported Restorations with Different CAD-CAM Restorative Materials.

Due to the lack of literature concerning the selection of crown materials for the restoration of anterior teeth, this study aimed to investigate the effects of six distinct computer-aided design and computer-aided manufacturing (CAD-CAM) crown materials on stress and strain distribution within implant-supported maxillary central incisor restorations, employing finite element analysis (FEA). Furthermore, a comparative analysis was conducted between models that incorporated adjacent natural teeth and those that did not, intending to guide the selection of the most suitable modeling approach. Crown materials, including Lava Ultimate, Enamic, Emax CAD, Suprinity, Celtra Duo, and Cercon xt ML, were the subjects of the investigation. FEA models incorporating Coulomb friction were developed. These models were subjected to an oblique load, simulating the average maximum bite force experienced by anterior teeth. The potential for failure in titanium implant components and the prosthesis crown was evaluated through von Mises and principal stress, respectively. Furthermore, the failure of crestal bone was assessed through principal strain values. Stress values for each implant component and strain values of the bone were extracted from the models. To assess the impact of the six groups of crown materials, Kruskal-Wallis analysis of variance and post-hoc comparisons were conducted. Additionally, a statistical comparison between the two groups with Lava Ultimate and Cercon xt ML was performed using the Mann-Whitney U test to determine the difference in the two modeling approaches. Higher crown material stiffness led to decreased stress in the abutment, fixture, and retaining screw, along with reduced strain in the surrounding bone. However, the decrease in stress and strain values became less significant with increasing crown stiffness. Additionally, the model with adjacent teeth showed significantly lower stress and strain concentrations compared to the model without adjacent teeth. Crowns with a high elastic modulus were the optimal choice for anterior teeth restoration. Constructing FEA models with adjacent teeth was highly recommended to gain a deeper understanding of the mechanical behavior of dental implant restorations.

A comparative study of the use of digital technology in the anterior smile experience

Objectivesthis study aims to compare the clinical outcomes of traditional and digital crown extension guides in the aesthetic restoration of anterior teeth. Additionally, the study will analyze the differences in the results of various digital crown extension guides in anterior aesthetic restorations.MethodsSixty-two patients who required aesthetic restoration of their anterior teeth were selected for this study. The patients had a total of 230 anterior teeth and were randomly divided into three groups: a control group of 22 cases who received diagnostic wax-up with pressure film, an experimental group 1 of 20 cases who received 3D printed digital models with pressure film, and an experimental group 2 of 20 patients who received digital dual-positioning guides. The control group had a total of 84 anterior teeth, experimental group 1 had 72 anterior teeth, and experimental group 2 had 74 anterior teeth. The study compared three methods for fabricating crown extension guides: the control group used the diagnostic wax-up plus compression film method, while experimental group 1 used compression film on 3D printed models and experimental group 2 used 3D printed digital dual-positioning crown extension guides. After the crown lengthening surgery, the control group patients wore DMG resin temporary crown material for gingival contouring, while the experimental group patients wore 3D printed resin temporary crowns for the same purpose. The patients were followed up in the outpatient clinic after wearing temporary crowns for 1 month, 3 months, and 6 months, respectively. The clinical results were evaluated in terms of marginal fit, red aesthetic index, and white aesthetic index.ResultsBased on the statistical analysis, the experimental group required significantly fewer follow-up visits and less time for guide design and fabrication compared to the control group. Additionally, the surgical time for the experimental group was significantly shorter than that of the control group. During the postoperative period between the 1st and 3rd month, the PES index scores for the marginal gingival level, proximal, and distal mesiodistal gingival papillae of the experimental group showed a trend of superiority over those of the control group. By the 6th month, the marginal gingival level exhibited a significant difference between the experimental and control groups. The experimental group demonstrated superior results to the control group in terms of shape, contour, and volume of the teeth, color, surface texture, and transparency of the restorations, and features during the 1st and 3rd postoperative months. In the 6th month, the comparative results indicated that the experimental group continued to exhibit superior outcomes to the control group in terms of the shape, color, surface texture, and transparency of the restorations, as well as the characteristics of the teeth. Additionally, the experimental group demonstrated significantly fewer gingival alterations than the control group at 1 month, 3 months, and 6 months post-procedure, with this difference being statistically significant. Furthermore, the combination of 3D printing technology and restorative techniques was utilized, resulting in consistent patient satisfaction.ConclusionDigitalisation plays an important role in anterior aesthetic restorations. The use of digital technology to manage the entire process of anterior cosmetic restorations can improve restorative results, reduce the number of follow-up appointments, shorten consultation time, and achieve better patient satisfaction.

Antibacterial Agents for Composite Resin Restorative Materials: Current Knowledge and Future Prospects.

Resin composites became the material of choice for direct restorations in anterior and posterior teeth. Despite the revolutionary improvement in the material, restoration failure is still a major drawback due to the material's inherent negative properties, including a lack of antibacterial effects. Therefore, many attempts have been made to incorporate antibacterial agents into resin composite materials to improve their antimicrobial properties and prevent secondary caries formation. Multiple laboratory studies have been conducted using different antibacterial agents, such as quaternary ammonium compounds, methacryloyloxydodecylpyridinium bromide, magnesium oxide nanoparticles, chlorhexidine, and chitosan. This review provides a glance at the current status of these materials and the research directions needed in the future.

Restoration of Anterior Teeth Using Minimal Invasive Esthetic Techniques with Opalusture and Composite Restoration: A Clinical Technique

Discoloration is one of the important reasons for restoration of anterior teeth in esthetic zone. Dental fluorosis is among common discoloration. Main reason for fluorosis is that concerned person residing in area with high fluoride content in community drinking water supply. In this case report, a 45year old male patient reported with esthetic concern due to discoloration in anterior teeth which was in turn diagnosed to be fluorosis and eventually treated with minimal invasive techniques including combination of microabrasion ,macroabrasion and direct composite veneers. KEYWORDS: Fluorosis,Tooth discoloration,Enamel microabrasion,Dental veneers

3D printing of ultra-thin veneers made of lithium disilicate using the LCM method in a digital workflow: A feasibility study.

This article highlights the feasibility of the additive fabrication of ultra-thin veneers made of lithium disilicate using the lithography-based ceramic manufacturing (LCM) method. An esthetical appealing restoration of anterior teeth with thin ceramic veneers is considered one of the ultimate challenges in restorative dental prosthetics. These sophisticated restorations can be fabricated in different ways. Both analog and digital subtractive manufacturing processes have been used to date. Either of the methods is highly demanding for the dental technician and dental engineering due to the required low ceramic layer thickness. Modern additive manufacturing methods, for example LCM technology, enable the production of ultra-thin lithium disilicate veneers with layer thicknesses of down to 0.2 mm and could therefore represent a viable alternative for this indication in the future. Digital technologies can help streamline workflows, make the outcome more predictable and reproducible, and even further optimize therapeutic restorative options such as highly esthetic veneers for anterior teeth. The reduced material thickness allows for a true non-prep solution or minimally invasive preparation.

Longevity of Anterior Composite Restorations for Localized Tooth Wear: A Scoping Review.

(1) Objective: This scoping review evaluates composite restorations as a treatment modality for anterior tooth surface loss and investigates the longevity of the direct and indirect composites used herein. (2) Method: The search encompassed Medline, Embase, Web of Science, the Cochrane Library, and hand search utilizing the PICO framework. (3) Results: Eight studies were included in this review, comprising one randomized controlled trial, one retrospective, and six prospective studies. Some studies reported favorable outcomes for composite restorations in anterior teeth. Although not statistically significant, evidence supported the anterior composite as a viable short- to medium-term solution for managing tooth wear. Direct resin composites were deemed clinically and cost-effective when managing localized anterior tooth wear. However, limitations and inconsistencies in this scoping review limited definitive clinical recommendations. (4) Conclusions: Further research, including well-managed randomized controlled trials using standardized protocols and longer follow-up periods, is essential to reconfirm the long-term efficacies of anterior composite restorations when managing tooth wear. A robust research design and exacting protocols could facilitate more meaningful clinical conclusions.

Toward esthetically and biomechanically reliable anterior resin composite restorations: Current clinical experiences among dental practitioners in Saudi Arabia.

Background: Esthetic anterior composite restorations are very challenging. They constitute a main part of the clinical practice of restoring teeth with resin composites. Distinctive variations in composite material selection and technique of application in anterior teeth exist when compared to the practice of restoring posterior teeth with resin composites. In a continuation of a previous assessment of class II resin composite practice, a cross-sectional survey study was performed to determine the awareness of general dental practitioners in Saudi Arabia about resin composite restorations in anterior teeth and to provide evidence-based recommendations to improve their practice. Methods: A total of 500 dental practitioners from different provinces in Saudi Arabia were invited to participate in an online questionnaire which comprised four domains and included a total of sixteen questions addressing aspects regarding the selection of resin composites, cavity configuration, etching protocol, light-curing technique, liner application, application of poly-chromatic composite, as well as finishing and polishing procedures. Chi square testing and descriptive statistics were used to analyze the attained data. Results: From 250 respondents, the greatest participation was from the Eastern and Middle provinces of Saudi Arabia. Female dentists participated less than males. There was no general agreement between participants regarding the resin composite material or the employed technique of application in restoring anterior tooth defects. Respondents indicated that discoloration and hypersensitivity were the most common reasons for patient's dissatisfaction with resin composites in anterior teeth. Conclusions: Dental practitioners are highly encouraged to improve their clinical practice of restoring anterior teeth using resin composites with the focus upon continuous education programs, online webinars, and workshops.

ANTERIOR AESTHETIC REHABILITATION WITH GINGIVECTOMY AND COMPOSITE RESIN VENEERS

The advancement of surgical procedures for gingival repair and restorative treatments for anterior teeth, which stand out in the scientific community, has been fundamentally influenced by the pursuit of aesthetics. The purpose of the current study is to describe the clinical behaviour of a patient who has small teeth and a gummy smile. The goal was to use a clinical case to illustrate how anterior cosmetic rehabilitation, which includes gingivectomy and composite resin veneers, can be accomplished. The restoration of anterior teeth involves using better shades, colours, opacities, translucency, and anatomical onformation, while treatments that combine dentistry and periodontics are capable of producing good results, enabling normalisation of the gums, correcting their deformities, and restoring the interdental grooves and papillae. Periodontal surgery called a gingivectomy involves removing extra gum tissue. The purpose of the procedure is to change the tooth’s contour, which generates an increase in the clinical crown, providing a smile with adequate protection and support for the oral environment. Resin veneers or direct restoration on anterior teeth are the dental remodelling treatment that guarantees longevity and satisfactory results, in addition to being minimally invasive. The adhesive systems and composite resins available are of high quality, do not impose aesthetic limits, and allow a natural effect determined by the excellence and technical knowledge of the operator. The plan accomplishment allowed reaching the aesthetic principles and establishing a better contour shape and size, both of the gingival tissue and of the anterior teeth. Thus, the procedure was always performed prioritising the demands and satisfaction of the patient, generating excellent clinical results. This research is duly authorized by Opinion: 6.275.546 CEP/CONEP.

CLINICAL ASSESSMENT OF THE EFFECTIVENESS OF ESTHETIC RESTORATION OF ANTERIOR TEETH

Purpose: Clinical evaluation of the effectiveness of the aesthetic restoration of the anterior teeth. Materials and Methods: The study included 128 adult patients in need of aesthetic restoration of the anterior teeth. Digital information about the patient's teeth surrounding the soft tissues was captured by a digital camera and scanner. Aesthetic analysis and design were performed using 3shape software and demonstrated to patients. Through communication with patients, an optimized treatment plan was provided. After the aesthetic restoration, the design, color of the restoration, and patient satisfaction were evaluated. Aesthetic evaluation was performed according to the form of anterior aesthetic evaluation. Patient satisfaction scores were recorded on a questionnaire containing six items of aesthetic index and doctor-patient communication. Patients were interviewed and reviewed at 1, 3, 6 and 12 months, respectively, and the clinical effects of the restorations were assessed. Results: All 128 patients had satisfactory clinical results. Aesthetic defects of patients were effectively eliminated using a minimally invasive approach to the restoration protocol for the restoration of anterior teeth with a composite material using adhesive systems. All procedures met the requirements of preoperative digital design. Conclusions: Results data indicate that the functional and aesthetic restoration of anterior teeth defects can be restored without the removal of healthy tooth tissue Proper choice of indications, accurate design of the restoration, contributes to a satisfactory aesthetic restoration of the anterior teeth. For patients with anterior aesthetic defect, digital design plays an important role in optimizing the treatment plan and guiding the entire treatment process. This design can help clinicians achieve predictable, satisfactory esthetic results.

Layering Technique of Resin Composite Method for Direct Anterior Teeth Restorations: A New Appraisal

Introduction: Composite resins can be effectively recycled to progress the patient's esthetics concluded minimally invasive, low cost and high clinical presentation managements. The layering techniques of composite resins in different thicknesses, with varying grades of opacity and translucency, permit to create esthetic restorations with dental structures physical appearance. Aim: The intention of the training was to appraise the characteristics, values and approaches of stratification of resins composite materials and to demonstrate these approaches with clinical cases. Materials and method: An electronic search of scientific articles referring to the stratification of composite materials was done using a single medical database. The attention on the choice of keywords as well as the presence and elimination criteria were the directorial elements of the research. All articles were included after the title, the abstract and finally, the full text was checked. Only relevant research has been reviewed. Based on the results, several methods of stratifications have been used in clinical practice. Results and discussion: The concept of natural stratification, anatomical stratification, the stratification of the anterior teeth using a dentine hue and a predefined thickness of enamel, or a single layer of material and the correct placement of pigments and opacities, lead to the achievement of esthetic and predictable direct restorations of nanocomposite resins. Conclusions: Within the limit of this study, it is concluded that, to achieve aesthetic excellence, dentists should understand and apply artistic and scientific principles when layering materials, respecting the optical properties of natural dental structures.

Evaluation of Yazd Dentist’s Knowledge, Attitude and Performance of Aesthetic Management of Anterior Composite Restorations in 2020

Introduction: Nowadays, due to the rapid development of new resin restorative materials and extensive media advertising concerning the importance and impact of a beautiful smile, there is an increased demand for the restoration of anterior teeth; thus, the beauty of smile is rendered as a major concern for patients and dentists.&#x0D; Methods: In this cross-sectional descriptive study, 165 general dentists in Yazd City, Iran were selected by random sampling. Of these, 158 dentists completed the study questionnaire, including 5 demographic items and 38 more items in three parts: knowledge, attitude and performance. Gleaned data were analyzed with SPSS 16 using T-test, one-way ANOVA, descriptive statistics (frequency/percentage).&#x0D; Results: In this study, 39.9% of dentists were male and 60.1% were female. There was no statistically significant correlation between the scores of attitude and knowledge with gender, age, history of activity, and the university of dentists' study (P&gt;0.05). Yet, a statistically significant correlation was observed between the average attitude scores of dentists who participated in training courses and the dentists who did not participate in training courses (P&lt;0.05).&#x0D; Conclusion: Based on the results of the present study, dentists had average knowledge and poor attitude regarding the aesthetic management of anterior composite restorations. However, participation in courses and workshops on aesthetic management of anterior composite restorations had a great impact on dentists' attitudes. Moreover, most dentists were not satisfied with the Dental School's training regarding anterior composite restorations.

Investigating the impact of flowable composite liner on the fracture strength and microleakage of large composite resin restorations of primary anterior teeth.

To investigate the effect of pre-cured and co-cured flowable composite liner on fracture strength and microleakage of primary anterior teeth with extended composite resin restorations. In the current in vitro experimental study, the crowns of 54 extracted primary canine teeth were cut 1mm above the CEJ, and a pulpectomy procedure was performed. The samples were randomly divided into three groups to restore the coronal part up to 4mm above the CEJ. In group 1, the samples were built up with Filtek Z250 packable composite resin. In group 2 (pre-cure), first, 1mm of Filtek Z350 XT flowable liner was applied to the sample, and after curing, the restoration process continued using packable composite resin. In group 3 (co-cure), the flowable composite liner was cured while the first layer of packable composite resin was applied; then, the same restorative procedure similar to the other groups was followed. The samples' cross-sectional area in the fracture strength test was calculated by AutoCAD software. Subsequently, the samples were subjected to a force in a universal testing machine. The samples related to the microleakage experiment were cut vertically, and then, the dye penetration percentage (10% methylene blue) was measured under a stereomicroscope. ANOVA was used to analyze the data. Mean fracture strength in group 2 was significantly higher than in group 1 (P = 0.016). The microleakage mean in group 3 was significantly lower than in groups 1 (P = 0.000) and 2 (P = 0.026). The flowable composite liner and its relevant separate curing increased the fracture strength of composite resin restorations. However, less microleakage was reported in the group where the liner was applied as a co-cure.

Longevity of Indirect and Direct Restorations in Anterior Teeth.

It is the aim of this paper to present data on the survival of direct and indirect restorations in anterior teeth. Two sources of information are used: previously-published analysis of data from 1990 to 2006 from a 13 million restoration dataset from England and Wales; and evidence from published literature from 2011 to the time of writing (March 2022). The findings suggest that: (1) directly-placed resin composite materials may provide satisfactory survival of restorations in anterior teeth; (2) crowns provide better survival to re-intervention: however, crowning an incisor or canine tooth, as opposed to placement of a direct restoration, will lead to an earlier time to extraction of the restored tooth; (3) veneers perform more favourably than other restorations in terms of time to extraction of the restored tooth, but may have a less favourable time to re-intervention than crowns; (4) lithium disilicate crowns may be considered to perform satisfactorily with regard to time to re-intervention when placed in anterior teeth, but less satisfactorily in posterior teeth; and (5) operator factors influence survival of restorations.

Frequency of screw-retained angulated screw channel single crown following immediate implant placement and provisionalization in the esthetic zone: A cone beam computed tomography study.

The purpose of this cone beam computed tomography (CBCT) study was to determine the frequency percentage of screw-retained crown using angulated screw channel (ASC) abutment for single immediate implant placement and provisionalization (IIPP) in the esthetic zone. The CBCT images of 200 patients without disease and without metal restorations in maxillary anterior teeth were evaluated. The mid-sagittal-sectional CBCT images of maxillary anterior teeth (#6-#11) were created in an implant planning software, screen-captured, and transferred to a presentation program. Template of tapered implants with diameter of 3.5 mm (for central and lateral incisors) and 4.3 mm (for central incisors and canines) and lengths of 13, 15, and 18 mm were applied to the sagittal images to identify the IIPP cases. To qualify for IIPP, the implant must engage >35% bone with at least 1 mm of surrounding bone and no perforations. The IIPP cases were further divided into straight screw channel (IIPPSSC) abutment or 25-degree angulated screw channel abutment (IIPPASC), based upon its restorability. The frequency percentages of possible IIPP, IIPPSSC, and IIPPASC were reported and compared among all maxillary anterior teeth. A total of 1200 maxillary anterior teeth sagittal images from 200 patients (88 male and 112 female) with a mean age of 51.3 years (range 20-83 years) were evaluated in this study. The overall frequency percentages of IIPP, IIPPSSC, and IIPPASC possibility were 84% (74%-92%), 14% (10%-24%), and 75% (66%-87%), respectively. Within the limitations of this CBCT study, 90% of single IIPP in the esthetic zone can be restored with screw-retained crown when utilizing ASC. In addition, the possibility of using a screw-retained restoration following IIPP increases about five times with ASC abutment compared to the SSC abutment.

Clinical application of direct composite resin in esthetic restoration

The direct composite resin bonding is widely used in the esthetic restorations of anterior teeth. Due to the technique sensitive procedure, the esthetic effect and long-term clinical performance of direct composite resin restoration have long been the focus of dental clinicians. This article will analyze the influencing factors of esthetic effect of composite resin from three aspects, including materials, teeth and technology. Also, it will summarize the clinical performance of direct composite resin from the perspective of esthetic evaluation. Eventually, this article will provide guidance for the clinical application of esthetic restoration of direct composite resin bonding.

Minimally Invasive Restoration of Root-filled Anterior Teeth

Minimally Invasive Restoration of Root-filled Anterior Teeth

Indirect Anterior Restorations with no-prep technique: Aesthetic and Biological Effectiveness

AbstractThe aesthetic result in the ceramic restoration of anterior teeth has always been a challenge in clinical practice and, in these cases, success depends on the skills of both the clinician and the dental technician. In current dentistry, the main objective is to pursue aesthetic results while preserving biological structures. Among the various conservative techniques available for anterior restorations, veneers are the most advantageous, compared to traditional crown preparation, both for the amount of tooth structure preserved in the preparation phase and for the direct adhesion on the enamel in the cementation. This article presents a clinical case of no-prep porcelain veneers (no-prep technique) for smile frame restoration.

Anterior teeth restoration after endodontic treatment and vital teeth with porcelain veneers and eLab Prime system

Anterior teeth restoration after endodontic treatment and vital teeth with porcelain veneers and eLab Prime system

In Vitro Comparison of Fracture Resistance of Severely Damaged Primary Anterior Teeth Restored with Different Post and Core Systems.

This study aimed to compare the fracture resistance (FR) of severely damaged primary anterior teeth restored with five different post and core systems. This in vitro, experimental study evaluated 60 extracted primary maxillary central incisors. The teeth were horizontally sectioned at 1 mm above their cementoenamel junction (CEJ), underwent pulpectomy, and their root canals were filled with Metapex paste. After post space preparation and sealing of root fillings with light-cure glass ionomer (1 mm thickness), the teeth were randomly assigned to five groups (n = 12) of (1) glass fiber post and everX composite (reinforced with short fibers), (2) glass fiber post and bulk-fill composite, (3) everX composite post and core, (4) bulk-fill composite post and core, and (5) Filtek conventional composite post and core. The teeth underwent 5,000 thermal cycles between 5°C and 55°C, and their FR was measured in a universal testing machine (0.5 mm/min, 148°). The mode of failure was also determined. Data were analyzed by ANOVA and Tukey's test at 0.05 level of significance. The FR was the highest in fiber post and everX composite, and the lowest in Z250 conventional composite post and core group (P < 0.001). The FR of fiber post and everX composite group was significantly higher than that of everX composite post and core (P = 0.04), bulk-fill composite post and core (P = 0.001), and Z250 composite post and core (P < 0.001) groups. The frequency of repairable fractures was the highest in glass fiber post plus everX composite (91.66%) and the lowest in Filtek conventional post and core group (66.66%) (P > 0.05). Within the limitations of this in vitro study, the results showed that restoration of severely damaged primary maxillary central incisors with glass fiber post and everX composite reinforced with short fibers enhanced their FR, and increased the chance of reparability in case of restoration fracture. This technique may be recommended for the restoration of primary anterior teeth since it is simple and saves time.