Replacement Of Defective Restorations Research Articles

Сучасні аспекти захворюваності гінгівітом та пародонтитом дітей та підлітків України, ефективність лікування та профілактики

The purpose of the work was to study modern aspects of the incidence of gingivitis and periodontitis in children and adolescents in Ukraine and to create an algorithm for treatment and prevention tactics in this pathology. It has been established that the high prevalence of gingivitis and periodontitis among children and adolescents makes this problem one of the most important problems of modern dentistry. The problem of periodontal pathology in children and adolescents is due to both the prevalence of diseases and the fact that poor-quality treatment of diseases in childhood and adolescence will lead to severe irreversible damage to periodontal tissues in adults. Modern prevention of inflammatory periodontal diseases in children and adolescents should be carried out on the basis of an algorithm of therapeutic and preventive measures: elimination of local traumatic factors, restoration of the anatomical shape of the teeth, high-quality treatment of the root system, replacement of defective restorations, professional oral hygiene, selection and correction of means and methods of individual hygiene. Results and discussion. The results of the study of oral hygiene and periodontal condition in patients with chronic limited catarrhal gingivitis and chronic localized periodontitis showed that the average value of most of the studied parameters in patients had significant differences when compared with healthy individuals in the control group, as well as between groups of patients. Index evaluation of the functional state of the peripheral circulation in the periodontal tissues of young patients revealed a significant decrease in capillary resistance. Based on literature data and the results of our own research and an objective method for predicting the localization of inflammatory diseases of periodontitis, a therapeutic and prophylactic tactic was developed in young patients with indications of diseases and risk factors for their development. Evaluation of the effectiveness of the developed method of treatment and prevention of localized periodontal tissue damage in patients of the main group was carried out on the basis of the results of clinical, physicochemical and functional research methods in comparison with groups of patients who underwent therapeutic and preventive measures in the traditional way. The results of treatment of localized inflammatory periodontal diseases were analyzed in 34 patients of the main group with chronic limited catarrhal gingivitis, 26 patients with chronic localized periodontitis of degree I and in a similar number of patients in the comparison group with an identical diagnosis. Conclusion. The results of treatment of 60 patients of the main group showed the high efficiency of the developed method. At the same time, a significant improvement in the subjective and objective symptoms of diseases was found. Complete clinical recovery with the elimination of the inflammatory process in the gums was found in 94.1% of patients with chronic limited catarrhal gingivitis of degree I. The obtained positive results of treatment of the main group of young patients with localized inflammatory lesions of periodontal tissues in terms of hygienic and periodontal indices and the state of peripheral circulation confirm the high efficiency of the developed algorithm for the treatment and prevention of these diseases

Evaluation of temporomandibular joint dysfunction by a mandibular tracing system: A case report

Objective: The purpose of this case report was to present a digital mandibular tracing technique that is used to evaluate a patient with temporomandibular joint dysfunction (TMD). Clinical features: A 65-year-old Caucasian female patient presented with chronic jaw pain in her temporomandibular joint (TMJ) area. The patient describes a dental history of orthodontic and prosthodontic treatment. Orally patient exhibits super erupted teeth, multiply fractured restorations, facial gingival recession, and rotated teeth. The patient also had an uneven occlusal plane and non-working side contact at maxillary first and mandibular second molars. Evaluation and outcome: A digital mandibular tracing technique, cone beam computed tomography, and full-arch optical impressions were used to evaluate the patient’s condition. The left condyle was slightly flat compared with the right one on the anterior surface. Limited protrusion and lateral movements and asymmetric border movements were detected. Apparently, an incomplete orthodontic treatment at the patient’s early age, iatrogenic mandibular anterior restorations, and hit and slight effect are considered causes of temporomandibular joint problems. The recommended treatment plan sequence for this patient is an occlusal adjustment, replacement of defective restorations, and fabrication of an occlusal guard for one of the arches. Conclusion: A digital mandibular tracing system can help the dentist to diagnose and analyze the causes of TMD patients specifically and individually. It also provides quick resolution and management for patients with TMD.

Evaluation of Temporomandibular Joint Dysfunction by a Mandibular Tracing System: A Case Report

Objective. The purpose of this case report was to present a digital mandibular tracing technique that is used to evaluate a patient with temporomandibular joint dysfunction (TMD). Clinicalfeatures.A65-year-oldCaucasianfemalepatientpresentedwithchronicjawpaininhertemporomandibularjoint(TMJ)area.Thepatientdescribesadentalhistoryoforthodonticandprosthodontictreatment.Orallypatient exhibitssupereruptedteeth,multiplyfracturedrestorations,facialgingivalrecession,androtatedteeth.Thepatient also had an uneven occlusal plane and non-working side contact at maxillary first and mandibular second molars. Evaluation and outcome. A digital mandibular tracing technique, cone beam computed tomography, and full-arch optical impressions were used to evaluate the patient’s condition. The left condyle was slightly flat compared with the right one on the anterior surface. Limited protrusion and lateral movements and asymmetric border movements were detected. Apparently, an incomplete orthodontic treatment at the patient’s early age, iatrogenic mandibular anterior restorations, and hit and slight effect are considered causes of temporomandibular joint problems. The recommended treatment plan sequence for this patient is an occlusal adjustment, replacement of defective restorations, and fabrication of an occlusal guard for one of the arches. Conclusion. A digital mandibular tracing system can help the dentist to diagnose and analyze the causes of TMD patients specifically and individually. It also provides quick resolution and management for patients with TMD.

Evaluation of Temporomandibular Joint Dysfunction by A Mandibular Tracing System: A Case Report

Objective. The purpose of this case report is to present a digital mandibular tracing technique used to evaluate a patient with temporomandibular joint dysfunction (TMD). Clinical features. A 65-year-old Caucasian female patient presented with chronical jaw pain in her temporomandibular joint (TMJ) area. The patient describes a dental history of orthodontic and prosthodontic treatment. Orally patient exhibits super erupted teeth, multiply fractured restorations, facial gingival recession, and rotated teeth. The patient also had an uneven occlusal plane and non-working side contact at maxillary first and mandibular second molars. Evaluation and outcome. A digital mandibular tracing technique, cone beam computed tomography, and full-arch optical impressions were used to evaluate the patient's condition. The left condyle was slightly flat compared to the right one on the anterior surface. Limited protrusion and lateral movements and asymmetric border movements were detected. Apparently, an incomplete orthodontic treatment at the patient's early age, iatrogenic mandibular anterior restorations, and hit and slight effect are considered as causes for Temporo-mandibular joint problems. The recommended treatment plan sequence for this patient is an occlusal adjustment, replacement of defective restorations and fabrication of an occlusal guard for one of the arches. Conclusion. Digital mandibular tracing system can help the dentist to diagnose and analyze the causes of TMD patient specifically and individually. It also provides quick resolution and management for patients with TMD.

Abordagem conservadora em restaurações posteriores com compósitos: acompanhamento clínico de 2 anos

A substituição de restaurações defeituosas por novas vem sendo um dos principais motivos de procedimentos restauradores. Porém sabe-se que durante a remoção do material antigo há um progressivo aumento do tamanho da cavidade, fragilizando o remanescente dental sadio. A odontologia moderna e o advento dos protocolos adesivos permitem que o odontólogo opte por um plano de tratamento mais conservador. Como uma alternativa à substituição total da restauração pode-se realizar tanto o re-polimento superficial devolvendo lisura e brilho ou ainda o reparo restaurador, que com adição de compósito é possível reanatomizar e regularizar a cor de restaurações de resinas antigas, porém bem adaptadas. O presente artigo tem como objetivo fazer um relato de caso clínico de uma abordagem conservadora em restaurações posteriores com compósitos, demonstrando a técnica e o sucesso clínico após um acompanhamento de dois anos.

Repair or replacement of defective restorations by dentists in The Dental Practice-Based Research Network

The authors aimed to determine whether dentists in practices belonging to The Dental Practice-Based Research Network (DPBRN) were more likely to repair or to replace a restoration that they diagnosed as defective; to quantify dentists' specific reasons for repairing or replacing restorations; and to test the hypothesis that certain dentist-, patient- and restoration-related variables are associated with the decision between repairing and replacing restorations. This cross-sectional study had a consecutive patient and restoration recruitment design. Practitioner-investigators (P-Is) recorded data for consecutively seen restorations in permanent teeth that needed repair or replacement. The DPBRN is a consortium of dental practitioners and dental organizations in the United States and Scandinavia. The collected data included the primary reason for repair or replacement, tooth surface or surfaces involved, restorative materials used and patients' demographic information. P-Is collected data regarding 9,484 restorations from 7,502 patients in 197 practices. Seventy-five percent (7,073) of restorations were replaced and 25 percent (2,411) repaired. Secondary caries was the main reason (43 percent, n = 4,124) for treatment. Factors associated with a greater likelihood of repairing versus replacing restorations (P < .05) included having graduated from dental school more recently, practicing in a large group practice, being the dentist who placed the original restoration, patient's being of an older age, the original restorative material's being something other than amalgam, restoration of a molar and the original restoration's involving fewer tooth surfaces. DPBRN dentists were more likely to replace than to repair restorations. Secondary caries was the most common reason for repairing or replacing restorations. Certain dentist-, patient- and restoration-related variables were associated with the repair-or-replace decision. The selection of minimally invasive treatment for an existing restoration is critical, as it may affect the longevity of the tooth.

Reactive Lesions of the Gingiva: Diagnosis and Treatment Options

Reactive lesions found on the gingiva are common and tend to be non-neoplastic growths. They are usually not painful and are often overlooked by the patient until they become symptomatic or are identified by their dental healthcare provider. Since they may be present for weeks to months, it is common to see ulceration of the surface tissue due to trauma. They have a recurrence rate of 5 - 20% after excision depending on the diagnosis, the completeness of the surgical removal, and the ability to address the local irritating factors associated with their etiology. It is recommended to obtain histologic diagnoses for the lesions since their clinical appearances can be similar amongst various lesions, but the recurrence rates are different. The treatment for all common reactive lesions includes surgical excision by scalpel, laser, or radial/ electrosurgery. Treatment should also include removal of the underlying etiology through curettage of tooth accretions, replacement of defective restorations, and elimination of traumatic habits. Regular dental hygiene maintenance with professional follow-up care should reduce the incidence of recurrence for most types of gingival lesions. This review of identification and treatment of gingival lesions includes the newly recognized localized juvenile spongiotic gingival hyperplasia, which should become part of the differential diagnosis for reactive lesions in juvenile patients.

Deterioration of Restorative Materials and the Risk for Secondary Caries

This article reviews the literature related to marginal deterioration of amalgam restorations and the risk for secondary caries. Background information on this characteristic material failure is provided, including how it is measured clinically, its rate of progress with time, and the responsible microstructural mechanisms. The association between degree of marginal fracture and recurrent or secondary caries is reviewed in clinical and in vitro studies. Earlier clinical investigations and a more recent laboratory study demonstrated a strong correlation between gap size and recurrent caries for a caries-active environment, supporting replacement of defective restorations for preventive reasons. However, more recent clinical data show the complex and equivocal nature of this association. Poor specificity and validity for detection of recurrent caries with an explorer and mirror further complicate interpretation of some trials and decision-making in clinical practice. Improved methods of diagnosing recurrent caries and further studies of the factors influencing its initiation and progression are needed.