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Concept: Restorative dentistry


In dental applications, precision attachments have been used to retain removable partial dentures (RPDs) for several decades. Various types of extracoronal attachments are commonly used in combination with fixed partial dentures and RPDs to achieve retention and stability. Fracture of the framework, fracture of the roots or teeth, and irretrievable decrease of retention are common reasons for a failed attachment-retained RPD. Another complication of metal ceramic crowns with precision attachment is decementation of the crowns. When fixed components of the attachment-retained RPD fail, the traditional treatment approach requires remaking both the fixed and removable components of the attachment-retained RPD. This technique describes retrofitting of a metal ceramic crown to a resilient attachment-retained RPD.

Concepts: The Roots, Crown, Oral hygiene, Dentures, Restorative dentistry, Removable partial denture, Prosthodontology, Precision attachment


Aim of the study was to evaluate the long-term reliability and effectiveness of inlays and onlays in ceramic and composite material, examining scientific studies published from 2004 to 2013. The results of this review were analyzed and compared with the important literature review proposed by Manhart in 2004.

Concepts: Scientific method, Science, Composite material, Cultural studies, Dental restoration, Restorative dentistry, Inlays and onlays


Preclinical dental students must demonstrate aptitude in the preparation of teeth for treatment with several types of fixed dental prostheses. The optimal sequence of instruction and examination of these crown preparations in preclinical fixed prosthodontics is unknown. The aim of this study was to determine if grading scores by faculty and students were affected by changing the sequence of crown type preparations. Practical exams of two successive student cohorts (n=89 in 2014; n=92 in 2015) at one U.S. dental school using three crown preparations (full cast, porcelain fused to metal, and all-ceramic) in different order were analyzed by faculty grades and student self-assessment. All of the models indicated that the sequence in which the crown type preparations were taught did have an effect on the grades. The 2014 cohort had overall higher grades and particularly higher grades for the all-ceramic crown preparations. Evaluation scores were affected by the sequence in which the different crown type preparations were taught and tested. Although the overall results suggested that students may perform better if the all-ceramic crown preparation is taught last, this tendency may differ between years.

Concepts: Crown, Dental restoration, Restorative dentistry, CAD/CAM Dentistry, Bridge, Prosthodontology, Inlays and onlays, Fixed prosthodontics


Background Regular good denture hygiene by individuals with removable partial dentures (RPDs) is an important component of oral health and in the prevention of further dental problems. These individuals should be provided with advice on the importance of denture care and be aware of this information.Aim To establish deficiencies in patient knowledge surrounding denture hygiene by RPD wearers.Methodology The study was undertaken as an audit. Data was collected from April 2012 to October 2012 via a questionnaire completed by 196 RPD wearers attending as patients at the University Dental Hospital Wales and the dental units at St David’s Hospital and Cynon Valley Hospital. The audit criterion was patients with RPDs should have knowledge of denture hygiene, with the standard set at 100%.Results While 91.8% of participants stated they were provided with instructions on denture hygiene when provided with their current prosthesis, 60.2% were shown to have less than an appropriate level of denture cleanliness, with 9.2% reporting that they slept wearing their prosthesis.Conclusion The audit criterion and standard set were not achieved. A lack of knowledge surrounding denture hygiene was demonstrated among participants. As a part of the audit process the health education of RPD wearers' hygiene needs to be improved and awareness levels of the whole dental team needs to be raised. All partial dentures should receive information and regular reinforcement of key dental hygiene messages.

Concepts: Health, Patient, Prosthesis, Oral hygiene, Dentures, Restorative dentistry, Removable partial denture, Prosthodontology


Today, post-mortem computed tomography (CT) is routinely used for forensic identification. Mobile energy-dispersive X-ray fluorescence (EDXRF) spectroscopy of a dentition is a method of identification that has the potential to be easier and cheaper than CT, although it cannot be used with every dentition. In challenging cases, combining both techniques could facilitate the process of identification and prove to be advantageous over chemical analyses. Nine dental restorative material brands were analyzed using EDXRF spectroscopy. Their differentiability was assessed by comparing each material’s x-ray fluorescence spectrum and then comparing the spectra to previous research investigating differentiability in CT. To verify EDXRF’s precision and accuracy, select dental specimens underwent comparative electron beam excited x-ray spectroscopy (EDS) scans, while the impact of the restorative surface area was studied by scanning a row of dental specimens with varying restorative surface areas (n = 10). EDXRF was able to differentiate all 36 possible pairs of dental filling materials; however, dual-energy CT was only able to differentiate 33 out of 36. The EDS scans showed correlating x-ray fluorescence peaks on the x-ray spectra compared to our EDXRF. In addition, the surface area showed no influence on the differentiability of the dental filling materials. EDXRF has the potential to facilitate corpse identification by differentiating and comparing restorative materials, providing more information compared to post-mortem CT alone. Despite not being able to explicitly identify a brand without a control sample or database, its fast and mobile use could accelerate daily routines or mass victim identification processes. To achieve this goal, further development of EDXRF scanners for this application and further studies evaluating the method within a specific routine need to be performed.

Concepts: Fluorescence, Electron, Spectroscopy, X-ray fluorescence, Dental restoration, Restorative dentistry, Dental materials, Dental restorative materials


The aim of this study was to synthesize and characterize mesoporous materials SBA-15 and SBA-15 modified with 3-(methacryloxy)-propyl-trimethoxysilane (MPS) to be used as inorganic filler in restorative dental composites and adhesives, and evaluate the main physical-chemical properties of the resulting material. The SBA-15 and SBA-15/MPS were characterized by FTIR, BET and X-Ray and combined with TEGDMA, bis-GMA and commercial spherical silica to produce dental composites. Afterwards, the mesoporous materials were combined with TEGDMA, bis-GMA and HEMA to make adhesives. To compare the results, composites and adhesives containing only commercial spherical silica were investigated. Some physical-chemical properties such as degree of conversion (DC), flexural strength (FS) and modulus (FM), water sorption and solubility (Wspand Wsl), specific area (BET), and the leachable components were evaluated. The SBA-15/MPS can be used to prepare dental restorative materials, with some foreseeable advantages compared with pure SBA-15 dental materials and with improved properties compared with commercial spherical silica dental materials. An important improvement was that the dental materials based on modified SBA-15 presented a reduction of approximately 60% in leaching of unreacted monomers extracted by solvent compared to the control group.

Concepts: Improve, Materials, Mesoporous material, Silicon compounds, Dental restoration, Restorative dentistry, Dental materials, Dental restorative materials


The aim of this study was to compare the perceived competence for treating prosthodontic patients of two samples of fourth-year dental students: those educated using traditional methodologies and those educated using problem-based learning (PBL). Two cohorts of fourth-year dental students at a dental school in Spain were surveyed: the traditional methods cohort (n=46) was comprised of all students in academic years 2012 and 2013, and the PBL cohort (n=57) was comprised of all students in academic years 2014 and 2015. Students in both cohorts reported the number of prosthodontic treatments they carried out per year and their perceived level of competence in performing such treatments. The results showed that the average number of treatments performed was similar for the two cohorts, except the number of metal-based removable partial dentures was significantly higher for students in the traditional (0.8±1.0) than the PBL (0.4±0.6) cohort. The level of perceived competence to treat complete denture patients for the combined cohorts was significantly higher (7.3±1.1) than that for partial acrylic dentures (6.7±1.5) and combined dentures (5.7±1.3). Students' clinical competence in prosthodontics mainly depended on number of treatments performed as the operator as well as the assistant. Students in the traditional methods cohort considered themselves to be significantly more competent at treating patients for removable partial and fixed prostheses (7.8±1.1 and 7.6±1.1, respectively) than did students in the PBL cohort (6.4±1.5 and 6.6±1.5, respectively). Overall, however, the study found that practical experiences were more important than the teaching method used to achieve students' perceived competence.

Concepts: Education, Dentures, Restorative dentistry, Removable partial denture, American Dental Association, Prosthodontology, Prosthodontics, Palatal obturator


This study compared stability, removal torque, bone implant contact (BIC) and area (BA) of implants installed simultaneously with onlay autografts or allografts in rabbits' tibias.

Concepts: Implants, Dental implant, Dentistry, Osseointegration, Dental restoration, Restorative dentistry, CAD/CAM Dentistry


Today, a substantial part of the dental crown production uses computer-aided design and computer-aided manufacturing (CAD/CAM) technology. A recent step in restorative dentistry is the replacement of natural tooth structure with pre-polymerized and machined resin-based methacrylic polymers. Recently, a new CAD/CAM composite was launched for the crown indication in the load-bearing area, but the clinical reality forced the manufacturer to withdraw this specific indication. In parallel, a randomized clinical trial of CAD/CAM composite crowns luted on zirconia implant abutments revealed a high incidence of failure within the first year of service. Fractured crowns of this clinical trial were retrieved and submitted to a fractographic examination. The aim of the case series presented in this article was to identify failure reasons for a new type of CAD/CAM composite crown material (Lava Ultimate; 3M Oral Care, St. Paul, Minnesota, USA) via fractographic examinations and analytical assessment of luting surfaces and water absorption behavior. As a result, the debonding of the composite crowns from the zirconia implant abutments was identified as the central reason for failure. The adhesive interface was found the weakest link. A lack of silica at the zirconia surface certainly has compromised the bonding potential of the adhesive system from the beginning. Additionally, the hydrolytic stress released from swelling of the resin-based crown (water absorption) and transfer to the luting interface further added to the interfacial stress and most probably contributed to a great extend to the debonding failure.

Concepts: Epidemiology, Clinical trial, Computer-aided design, Crown, Dental restoration, Restorative dentistry, Bridge, The Weakest Link


To determine the ideal position of a dental implant to assist a posterior extended partial removable dental prosthesis (PRDP), through stress values, displacement values, and deformation of periodontal ligament (PDL).

Concepts: Finite element method, Implants, Prosthetics, Dental implant, Partial differential equation, Osseointegration, Dentures, Restorative dentistry