Restorative Space Research Articles

A Case Series of Tooth Autotransplantation in Three Children with Different Presenting Complaints

This case series presents three successful cases of autotransplantation in paediatric patients at Glasgow Dental Hospital with differing clinical presentations. It successfully demonstrates the versatility of the technique. CPD/Clinical Relevance: Autotransplantation of teeth is a viable treatment option for the replacement of teeth in children and can be an excellent method of maintaining space and bone for restoration with an implant in adulthood.

Implementation of a "Serenity Room": Promoting resiliency in the ED.

Work-related stress is common within the nursing profession, especially in the ED. Studies have shown that interventions to improve hospital working environments positively impact retention and help prevent burnout. This nursing practice innovation project describes the development, implementation, and evaluation of a restorative space (the "Serenity Room") in a busy regional ED. The evaluation of this project focused on the effectiveness of the room at reducing stress and the value ED staff place on having access to a restorative space. Data were gathered through pre- and postimplementation surveys.

Digital workflow of orthodontic and prosthetic treatment for subgingival residual root preservation guided by target restoration space

The use of orthodontic traction to preserve healthy subgingival residual root is a classical method combining the treatment of restoration and orthodontics. Based on the target restoration space (TRS), by establishing a TRS digital model, the final traction position of the subgingival residual root can be preset. After evaluating the key parameters such as crown-to-root ratio and minimum crown height, clinicians can estimate the treatment time and exclude cases with bad preset position. The time of traction treatment can be effectively reduced, and the efficiency and efficacy of the entire treatment can also be improved.

Effect of increasing occlusal vertical dimension on lower facial form and perceived facial esthetics: A digital evaluation

Statement of problemIncreasing occlusal vertical dimension (OVD) is often indicated in complex prosthodontic rehabilitations to gain restorative space and improve the occlusal relationship and esthetics. The effect of increasing occlusal vertical dimension on lower facial height (distance from subnasale to soft-tissue menton) and perceived facial esthetics is not well understood. PurposeThe purpose of this clinical study was to investigate the effect of incremental increases in the occlusal vertical dimension on lower facial height and perceived facial esthetics by using a digital approach. Material and methodsTwenty-five participants with Class I jaw relationship and no loss of OVD participated in the study. Custom mandibular devices were digitally designed and 3-dimensionally printed to increase the OVD by 3, 6, and 9 mm in each participant. Three-dimensional facial scans and frontal photographs were made with the participants wearing a specific device to achieve the desired OVD increase. The lower facial height, total facial height (distance between nasion to soft-tissue menton), nasolabial angle, lip width, and lip height were digitally measured on facial scans. All measurements were recorded in a computer-aided design (CAD) software program and were repeated 3 times. Subsequently, frontal photographs of 10 participants were randomly selected for survey. Three groups each of 10 prosthodontists, general dentists, or laypersons participated in the survey and were asked to detect OVD difference in 2 photographs of the same participant and to rank facial esthetics at varying OVDs. One-way repeated measures ANOVA (α=.05) for the facial measurements and descriptive statistics for the survey results were used. ResultsLower facial height, the ratio of lower facial height to total facial height, lip height, and nasolabial angle increased with an OVD increase, whereas lip width decreased (P<.001). Bonferroni corrected paired t tests revealed all groups of OVD increase to be significantly different from each other (P<.001) except for an OVD increase to 6 mm versus 9 mm in lip height (P=.540) and lip width (P=.019), respectively. Prosthodontists, general dentists, and laypersons could detect a +3 mm OVD increase 63.9%, 62.5%, and 56.5% of the time, respectively. The participants’ original OVD was considered the most esthetic (60.0%, 45.0%, and 68.0%) by prosthodontists, general dentists, and laypersons, respectively. ConclusionsIncreased OVD increases lower facial height, the ratio of lower facial height to total facial height, lip height, and nasolabial angle but decreases lip width. Prosthodontists are more sensitive to a smaller increase in OVD, closely followed by general dentists and then laypersons. In case of no loss of OVD, a vertical increase as small as 3 mm can be detected by both dentists and the general public and perceived as less esthetic. The larger the increase in OVD, the more detectable the difference and the less the faces are perceived as esthetic.

Peek (Polyether Ether Ketone) – A Review Article

This article is aimed to review the applications of Polyether Ether Ketone (PEEK) in dentistry. The evolving desire for functions and aesthetics, few drawbacks with existing materials and clinicians shifting their paradigms towards metal free restorations led space for the metal-free restorations in today’s restorative practice. PEEK is a polymer based innovative material, that can be used in either fixed or removable prosthetics. This literature review discusses various applications and uses of PEEK.

Precise tooth preparation technique guided by 3D printing guide plate with quantitative hole

The minimum amount of tooth preparation that can be fully controlled is crucial in achieving long-term, stable, and effective aesthetic restoration, which is also a major difficulty in aesthetic restoration. The tooth preparation can be imple-mented efficiently and accurately through digital technology based on the fixed-deep hole guiding technology. Prior the actual tooth preparation, the technology first designs the virtual contour, layering, and virtual occlusion of the prosthesis on the computer. Then, virtual tooth preparation is carried out by cutting back according to the virtual prosthesis. Next, the virtual drilling operation plan is designed according to the shape of the virtual tooth preparation and the contour of the abutment tooth. Finally, the tooth preparation guide plate is designed and printed in 3D. It realizes the whole process of quantitative and precise guidance of dental preparation, visualizes the restoration space, reduces the clinical operation time, and guarantees the quality of dental preparation. It also promotes the improvement of the teaching quality of digital practical exercises.

The institutional challenge to co-deliver migrant integration and urban greening—evidence from Haizhu Wetland Park Project in Guangzhou, China

We aim to investigate the governance challenges of many Chinese urban governments to co-deliver migrant integration and urban green space provision. In specific, we examine the existing institutional arrangements applied in the Haizhu Wetland Park Project in Guangzhou and the consequential marginality. Why is it challenging for many urban governments to take social marginality into account in the conservation of urban green spaces? We approach this research question with the concepts of marginality, complex social-ecological systems, and institutional fit. We construct a conceptual framework to identify and explain the types of marginality emerged and to analyze the institutional fit in the case study. Our analysis reveals a segregative effect in the current institutional arrangements. On the one hand, they are cost-efficient in ecological restoration and urban green space conservation; on the other, not effective in addressing migrant integration and wellbeing. Current institutional arrangements segregate these two interconnected issues, leading to the marginalization of urban migrants. The current institutional segregativity reveals the degree of challenge to balance the pursuits between social equity and ecological benefits. For more collaborative and inclusive urban governance, future research is needed to understand whether the lacking integration of urban migrants is an institutional blind spot.

Monolithic CAD/CAM Complete Overdentures for a Pedodontic Patient with Dentinogenesis Imperfecta and Limited Prosthetic Space: A Clinical Report.

Children affected by dentinogenesis imperfecta (DI) require restorative techniques or prosthodontic management to minimize the functional and psychosocial impacts of the condition. In cases of excessive wear of the deciduous dentition and moderate cooperation from the child, removable complete overdenture prostheses are the most suitable treatment option. However, limited restorative space is a technical challenge for the placement of such prostheses. Advances in digital technologies can help assist in the fabrication of monolithic prostheses with reduced thickness. The present clinical report describes the management of a moderately cooperative 7-year-old patient suffering from DI with severe tooth wear, reduced restorative space, and a high smile line. The design and fabrication of complete overdentures were performed using a digital workflow. This innovative monochromatic monolithic approach combined with the use of gingiva-shade composite resin respected the available restorative space while obtaining a natural esthetic appearance. Such a strategy requires regular denture replacement according to the child's growth and loss of deciduous dentition. An additional aim is to obtain the cooperation needed for a future global fixed rehabilitation over time.

Fabrication of hollow maxillary complete denture: A simplified technique

Residual ridge resorption is the reduction in size of the bony ridge under the mucoperiosteum. Prosthetic rehabilitation of severely atrophic ridges has always been difficult for the clinician due to decreased retention, stability and support. Because of such severe resorption the restorative space between maxillary and mandibular residual ridges is increased. Rehabilitation in such cases may result in increased height and weight of the prosthesis further compromising its retention and stability. This in turn overloads the underlying hard and soft tissues that cause further ridge resorption so, in order to keep down this undesirable sequence, the weight of the prosthesis needs to be reduced which can be achieved by making hollow prosthesis. This article describes a simple technique of fabricating a hollow maxillary complete denture. Keywords: Hollow denture, Inter-ridge distance, Simple technique

Knowledge, Awareness and Attitudes on the use of Magnification Devices among General Dental Practitioners and Prosthodontists in Makkah Region, Saudi Arabia - A Questionnaire Based Study

Restorative space refers to the amount of space needed vertically and horizontally between the occluding surface of the teeth and between the crest of the residual ridge so that the prosthesis (fixed and/or removable) can be fabricated without compromising their strength and esthetics. Inadequate restorative space can result in prosthetic rehabilitation with poor esthetics, inadequate contours, and decreased stability. Therefore the amount of available restorative space must be carefully assessed prior to initiating prosthetic treatment. Optimal restoration of a patient with restorative space issues depends on several interdependent factors such as the amount of restorative space available, amount of restorative space required for the proposed dental restorations and prosthesis, quality, and quantity of remaining dentition and residual alveolar ridge and esthetic and functional patient demands. Accurate clinical and radiographic examinations, careful determination of VDO and systematic treatment planning using a diagnostic wax-up is key to predictable and successful treatment for patients with restorative space issues. This case report presented here to discuss the challenges and management of a patient with inadequate restorative space.

Comparison of Fracture Load and Surface Wear of Microhybrid Composite and Ceramic Occlusal Veneers.

To compare in vitro fracture load, surface wear, and roughness after thermal cycling and cyclic mechanical fatigue loading among cemented microhybrid resin-based composite and ceramic occlusal veneers fabricated at two thicknesses (1.5 and 2.5 mm). Sixty-four extracted premolars without root canal treatment were prepared and restored with occlusal veneers of two thicknesses (1.5 and 2.5 mm), using four different materials: microhybrid composite (MC), fiber-reinforced microhybrid composite (FMC), heat-pressed lithium disilicate ceramic (HPC), and computer-aided design/computer-aided manufactured lithium disilicate ceramic (CCC). The specimens underwent thermal cycling and cyclic mechanical fatigue loading, and were then subjected to fracture testing, with loads at failure recorded as fracture load. Wear and surface roughness were recorded before and after fatigue loading. Results were analyzed using one-way ANOVA, two-way ANOVA (α= 0.05). All specimens survived thermal cycling and cyclic mechanical fatigue loading. At 1.5-mm thickness, the mean fracture load of FMC was highest (3926.48± 556.54 N), while that of CCC was highest (3066.45± 559.94 N) at 2.5 mm. Regardless of thickness, the fracture load of CCC was higher than that of HPC (p= 0.004 and p= 0.023). The wear of MC and FMC was significantly higher than those of HPC and CCC (p≤ 0.001), but was similar in terms of the wear rate of tooth enamel. HPC exhibited the lowest surface roughness after fatigue loading (p≤ 0.001). All tested occlusal veneers exhibited a fracture load considerably exceeding the maximum occlusal force in the posterior dentition. When the attainable space for restoration varies, different occlusal veneer materials should be considered. The surface wear and roughness also need to be considered when selecting materials.

Impact of crown-to-implant ratio of marginal bone loss around implant-supported single crowns. A 5 years retrospective study

Aim The success of implant-supported restorations depends on the stability of osseointegration and the amount of bone-to-implant contact. The aim of the present study is to assess the influence of the crown-to-implant ratio on marginal bone loss in prosthetic restorations with single implant-supported crowns. Materials and methods Retrospectively, 65 patients with one missing tooth in the mandibular molar area were collected. All prosthetic restorations were made with single crowns, and all implants used were “bone level” type having a diameter in the range of 3.9 to 4.0 mm and a length of 10.0 to 13.0 mm. Cone beam computed tomography (CBCT) were performed in central occlusion. The height of restorative space was measured over the cross-sections from the level of the alveolar ridge to the corresponding antagonist crowns. Available bone height, width and length were also evaluated prior to implantation. Marginal bone loss was measured on pre-calibrated periapical radiographs, using ImageJ 1.52 (National Institutes of Health, Bethesda, Maryland, USA), in third and fifth year after the functional load. Results Positive linear correlation, statistically significant, has been determined between the crown-to-implant ratio and the amount of crestal resorption. The highest peri-implant bone loss was recorded in cases with crown-to-implant ratio of 1.5/1 and higher. Conclusion The results of this study indicate that prosthetic restorations with higher crown-to-implant ratio tend to cause higher marginal bone loss than those with lower one, in the mandibular molar area.

Data Restoration by Linear Estimation of the Principal Components From Lossy Data

In this article, we propose a method based on principal component analysis (PCA) to restore data after the occurrence of data loss due to sensor defects or environmental factors. In the L2-PCA feature space, the feature vector, which consists of principal components of the data, converges to a point known as the “convergence point” as the extent of data loss increases. Using these characteristics, we approximately linearly estimated the principal components of the original data from the feature vectors of the lossy data. The estimated principal components are used as coefficients in the linear combination of the projection vectors of the PCA feature space for data restoration. The restoration performance of the proposed method is not only superior; the method is also computationally more efficient than other data restoration methods. Experimental results for gas measurement data and facial image data confirm the excellent data restoration performance of the proposed method.

Stereographic analog application in implant-supported complete rehabilitation: A dental technique

This article describes the application of stereographic analogs in complete mouth rehabilitation with implant-supported prostheses. The interarch restorative space and immobile support provided by dental implants allow the fabrication of a recording apparatus for the analysis of mandibular movement. An implant-supported fixed detachable recording apparatus was fabricated, and a stereographic tracing made to reproduce the patient's mandibular border movements.

A Study on the Users' Evaluation of the Space Design of Cultural Restoration Space

A Study on the Users' Evaluation of the Space Design of Cultural Restoration Space

Hierarchy of restorative space required for different types of dental implant prostheses

BackgroundManagement of the full and partially edentulous arch requires an understanding regarding the amount of vertical and horizontal restorative space that is needed for different types of dental implant prostheses. Failure to design a prosthetic construct without considering space issues can result in a rehabilitation with diminished stability, poor esthetics, and inadequate contours. Therefore, available restorative volume must be computed before initiating therapy to ensure proper prosthesis design. Types of Studies ReviewedThe authors searched the dental literature for articles that addressed space requirements for different types of dental implant prostheses and found a few on this subject. ResultsThe dental literature indicates there is a 3-dimensional hierarchy of restorative space necessary for different types of implant constructs. The minimum amount of vertical space required for implant prostheses is as follows: fixed screw-retained (implant level): 4 through 5 millimeters; fixed screw-retained (abutment level): 7.5 mm; fixed cement-retained: 7 through 8 mm; unsplinted overdenture: 7mm; bar overdenture: 11 mm; and fixed screw-retained hybrid: 15mm. These dimensions represent the minimal amount of vertical rehabilitative space that can accommodate the above implant prostheses. With respect to horizontal space, computations are needed to account for the discrepancy between an implant and tooth position. Conclusions and Practical ImplicationsRestorative spaces for each type of prostheses are restoration specific and should be considered during treatment planning to facilitate proper case selection and enhance patient satisfaction.

Complex Cases of Restorative Justice after Serious Crime: Creative and Enabling Spaces for Those with Disability

This chapter explores the potential of restorative justice to meet the needs of participants in complex cases following crime. What is meant by ‘complex’? The Oxford dictionary defines ‘complex’ as ‘consisting of many different and connected parts’ and ‘not easy to analyse or understand; complicated or intricate’ (English Oxford Living Dictionary, accessed 2017). Most simply, what makes something ‘complex’ is the increased number of components, the nature of those components and the subsequently multifarious network that exists between components. In one sense, all crime is ‘complex’ because each event involves different individuals, different harms, different circumstances and impact; each event is completely idiosyncratic. In the restorative justice literature ‘complex’ is generally understood to mean cases where in addition to a crime having occurred, there are particular risks in addressing the harm (e.g. see Gavrielides, 2012). This may be because there is little practice in that area, and/or less documented around what works. Usually though, complexity is seen to relate to situations where the differentials in power (inherent in some crimes, and in some cases) make the potential for further harm more likely. This chapter focuses on restorative justice and disability, which is an area where little is known and the potential for further harm does exist because of the particular power dynamics in the restorative space.

Attention Restoration Space on a University Campus: Exploring Restorative Campus Design Based on Environmental Preferences of Students.

Students studying for a long time frequently suffer from attentional fatigue; however, campuses lack specific spaces in which to restore attention. This study aimed to explore the significant perceptual factors related to student selection of landscape types that they perceive as most relaxing on a university campus. To understand the design factors of an attention restoration space, this study examined the preference of students regarding restorative environments on university campuses at six universities in northeastern China using a questionnaire survey (n = 360). Place-mapping revealed the spatial characteristics of the preferences of students for relaxing in the available space. The primary perceptual factors were obtained using correlation analysis and keyword frequency. A relationship model of landscape types and perceptual factors was established using categorical regression (CATREG). Results showed that waterfront spaces have the optimal perceived attention restoration effect, followed by vegetation spaces, courtyard spaces and square spaces. Visibility, accessibility, comfort, recognition and sense of belonging are significant perceptual factors that should be first considered. Moreover, the optimal selection of design factors depends on the interaction of landscape types and perceptual factors. The design implications may assist designers to gain a new perspective on student requirements for a healthy environment.

Minimal invasive microscopic tooth preparation based on endodontic, periodontal and functional health

Tooth preparation is the primary and core operation technique for dental esthetic restoration treatment, due to its effect of providing restoration space, bonding interfaces and marginal lines for dental rehabilitation after tooth tissue reduction. The concept of microscopic minimal invasive dentistry put forward the issue of conducting high-quality tooth preparation, conserve tooth-structure, protect vital pulp and periodontal tissue simultaneously. This study reviewed the concepts, physiology background, design and minimal invasive microscopic tooth preparation, and in the meantime, individualized strategies and the two core elements of tooth preparation (quantity and shape) are listed.

Management of Amelogenesis Imperfecta in Adolescent Patients: Clinical Report.

The oral rehabilitation of adolescent patients with amelogenesis imperfecta (AI) is complex due to the presence of mixed dentition with altered eruption sequence. In this article, the interdisciplinary treatment approach for adolescent patients with AI is discussed. The types and timing of treatments at various stages of growth are described through a literature review on this topic. AI is an inherited condition that disturbs the development of the enamel structure. Because of the presence of mixed dentition, definitive treatment options often have to be delayed until eruption of permanent dentition is complete, requiring careful treatment coordination and proper sequencing between different dental disciplines starting at a young age. Adolescent patients require prosthodontic treatment design that can be adapted to the changes in arch shapes, sizes, interarch relationship, and esthetic needs. AI patients are often challenged with both excessive and limited restorative spaces within the same arch due to the abnormal growth patterns, enamel structure, tooth size, and tooth shape. Therefore, careful determination of the required restorative space is critical to ensure optimal prognosis. This clinical report discusses treatment recommendations, timing of various treatment modalities, and involvement of appropriate interdisciplinary teams for managing adolescent patients.