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This case report presents the conservative management of a maiposed implant in the maxillary anterior region caused by craniofacial bone remodeling. The patient expressed dissatisfaction with the position and shade of an implant that was placed almost three decades previously. After evaluating different treatment options, the patient opted to replace the implant prosthesis. The selected treatment consisted of a zirconia crown layered with feldspathic porcelain (including pink porcelain) cemented onto a screw-retained customized zirconia abutment with an angled screw channel for the single-unit permanent fixed implant prosthesis. The report highlights the importance of informed decision making and patient preterm e in treatment option selection. It emphasizes the conservative approach of replacing a malposed implant prosthesis with pink porcelain to address the patient's esthetic concerns. Dental photographs and shade-matching protocols were crucial in achieving satisfactory esthetic outcomes. The report also underscores the potential for infraocclusion as well as proclination caused by craniofacial growth in implant therapy, and emphasizes the significance of patient education regarding long-term considerations. [ABSTRACT FROM AUTHOR]

Aim: Current CAD/CAM techniques allow clinicians to design and 3D print tooth reduction guides that facilitate controlled preparations in the esthetic zone. The present case report describes the workflow for designing and printing a tooth reduction guide intended to assist ceramic veneer preparations. This 3D-printed guide divides the facial surface of the teeth into four areas and allows the measuring of all areas, including the incisal edge, with a periodontal probe. Using this 3D-printed appliance can simplify and expedite tooth preparation for ceramic veneers and reduce the risk of excessive tooth reduction. Clinical considerations: A 45-year-old female patient presented at the clinic with the primary concern of the esthetics of her smile, which she wanted to improve. The initial evaluation revealed clinical signs of wear, spaces between the teeth, and the lack of anterior tooth symmetry. Therefore, to improve the appearance of her anterior teeth, a treatment plan that consisted of veneer restorations from the maxillary right second premolar to the left second premolar was formulated and presented. The patient accepted the option of undergoing minimally invasive anterior tooth preparations with a digital tooth reduction guide. Materials and methods: A diagnostic intraoral scan was performed and a tooth reduction guide was digitally designed and 3D printed. Subsequently, the tooth preparations were performed with the aid of the guide. An intraoral scan of the preparations was performed and used to design and manufacture lithium disilicate ceramic veneers using subtractive techniques. Subsequently, the restorations were finished, treated, and cemented under rubber dam isolation. Conclusions: The treatment fulfilled the patient's esthetic demands. This novel 3D-printed tooth reduction guide permits a more comprehensive assessment of the available tooth structure and provides ample access to more tooth surfaces than traditional silicone tooth reduction guides. Overall, this type of guide can significantly assist clinicians in performing tooth preparations in the esthetic zone. [ABSTRACT FROM AUTHOR]

Restorative dentistry often uses ceramic laminate veneers for aesthetic anterior teeth restorations due to their natural appearance and minimal invasiveness. However, the understanding of their clinical performance and how ceramic microstructure and processing affect longevity is limited. Objective: This study aimed to address this gap by determining the mechanical behavior, fracture load, and failure modes of CAD-CAM processed laminate veneers made of either lithium-disilicate-based glass ceramic (IPS e.max CAD) or feldspathic porcelain (Vita Mark II). It also aimed to develop a mechanical cycling methodology capable of determining the lifetime and failure modes of thin ceramic laminate veneers. Materials and Methods: Eighteen human maxillary central incisors were used to create the specimens. Minimal enamel preparation was required to ensure the proper adaptation of the thin ceramic laminates. Ceramic laminates made from lithium disilicate and feldspathic porcelain (Vita Mark II) were produced via CAD-CAM, with the final thicknesses less than 0.5 mm, then cemented with resin cement. Results: The mean fracture load for the glass ceramic was 431.8 ± 217.9 N, while for the porcelain, it was 454.4 ± 72.1 N. Failure modes differed considerably: porcelain showed more chipping, while lithium disilicate was associated with tooth structure failure. Conclusion: The material used did not significantly affect the fracture load of thin ceramic laminates in static tests. However, failure modes differed considerably. It was not possible to determine a set of mechanical cycling parameters that could establish the fatigue properties of thin ceramic laminates, as the maximum number of cycles reached was 536,818. [ABSTRACT FROM AUTHOR]

The incorporation of silver nanoparticles (AgNPs) into alginate–gelatin (Alg-Gel) hydrogels can enhance the properties of these materials for bone regeneration applications, due to the antimicrobial properties of AgNPs and non-cytotoxic concentrations, osteoinductive properties, and regulation of stem cell proliferation and differentiation. Here, the hydrogel formulation included 2% (w/v) sodium alginate, 4 µg/mL AgNPs, and 2.5% (w/v) gelatin. AgNPs were synthesized using a 2% (w/v) aqueous extract of roasted green tea with silver nitrate. The aqueous extract of roasted green tea for AgNP synthesis was characterized using HPLC and UHPLC-ESI-QTOF-MS/MS, and antioxidant capacity was measured in Trolox equivalents (TE) from 4 to 20 nmol/well concentrations. Stem cells from human exfoliated deciduous tooth cells were used for differentiation assays including positive (SHEDs/hydrogel with AgNPs) and negative controls (hydrogel without AgNPs). FTIR was used for hydrogel chemical characterization. Statistical analysis (p < 0.05, ANOVA) confirmed significant findings. Roasted green tea extract contained caffeine (most abundant), (−)-Gallocatechin, gallic acid, and various catechins. XRD analysis revealed FCC structure, TEM showed quasispheroidal AgNPs (19.85 ± 3 nm), and UV–Vis indicated a plasmon surface of 418 nm. This integration of nanotechnology and biomaterials shows promise for addressing bone tissue loss in clinical and surgical settings. [ABSTRACT FROM AUTHOR]

Combined Kelly syndrome, also known as anterior hyperfunction syndrome, is a complex pathological condition of the stomatognathic system, originally established by five characteristics but primarily triggered by edentulism, specifically, the absence of the upper and posterior mandibular teeth. This condition is characterized by a series of clinical features, such as bone loss, tuberosity growth, enamel wear, periodontal damage, muscle fatigue, pain, and temporomandibular joint issues. However, these features are not unique and rather reflect an oral hyperfunction state. There is a lack of consensus on the best way to assess and diagnose this condition, which is proposed to be understood as an "oral hyperfunction state" rather than a syndrome. This study aims to conduct a literature review to analyze the available information on anterior hyperfunction syndrome in dentistry, with the goal of proposing a conceptual model of the etiological risk factors that contribute to early diagnosis and the prevention of complications. This approach has important clinical implications, as it would allow for the early identification and management of risk factors, thus improving the quality of life of patients and preventing malpractice that could compromise their oral health. [ABSTRACT FROM AUTHOR]

Purpose: To determine the fracture resistance of chairside computer‐aided design and computer‐aided manufacturing (CAD‐CAM) zirconia surveyed crowns for a mandibular first molar without occlusal rest and with four different rest seat designs. Materials and Methods: Seventy CAD‐CAM zirconia 4Y‐PSZ (IPS e.max ZirCAD MT for CEREC A1, C15, Ivoclar Vivadent) crowns (14 specimens/group) were designed and fabricated with a dental chairside CAD‐CAM system (CEREC PrimeScan, and CEREC MCXL Dentsply Sirona). The restorations were divided into groups according to the following rest seat designs: (1) Surveyed crown without rest seat, (2) surveyed crowns with disto‐occlusal rest seat, (3) surveyed crowns with disto‐occlusal extended rest seat, (4) surveyed crowns with interproximal rest seat, and (5) continuous rest seat. Crowns were treated with a primer system (Monobond Plus, Ivoclar Vivadent) and cemented using resin luting cement (Multilink Automix, Ivoclar Vivadent) to resin‐printed dies (Grey Resin V4, FormLabs). Subsequently, the crowns were subjected to 200,000 load cycles at 1 Hz with 20 N force and then loaded with a steel indenter until fracture. The test results were analyzed with one‐way Analysis of Variance (ANOVA) and HSD Tukey post‐Hoc test. Results: The mean fracture resistance of surveyed crowns without and with different rest seats was significantly different from each other. Surveyed crowns with no rest seat displayed the highest resistance (4238 N) followed by crowns with continuous rest seat (3601 N), crowns with disto‐occlusal extended rest seat (3283 N), and crowns with disto‐occlusal rest seat (3257 N). Crowns with interproximal rest seat displayed the lowest fracture resistance (2723 N). Conclusions: Surveyed crowns without rest seats had a higher fracture resistance than crowns with rest seats Surveyed crowns with interproximal rest seats presented the lowest fracture resistance among all rest seat designs. Crowns with disto‐occlusal rest seats, disto‐occlusal extended rest seats, and continuous rest seats displayed similar fracture resistance. [ABSTRACT FROM AUTHOR]

Objectives: The present case report describes the atraumatic extraction of a primary maxiiiary right canine followed by immediate implant placement with a customized zirconia abutment and monolithic uitra-trans- iucent zirconia (5Y-PSZ) crown. Clinical considerations: A 31-year-oid patient presented to the ciinic with the primary concern of mo- biiity and gingival inflammation around the maxiiiary right canine. After ciinicai evaluation, the tooth was found to be a primary retained tooth that presented grade 3 mobility and gingival inflammation. Atraumatic tooth extraction was performed, followed by immediate implant placement of a screw-retained provisional restoration with the use of a surgical guide. The soft tissue was contoured untii ideai architecture was obtained. The final restoration included a customized zirconia and titanium abutment and a characterized impiant-supported monolithic 5Y-PSZ crown. Conclusions: Weii-pianned surgicai and restorative procedures inciuding atraumatic extraction, 3D im- piant pianning for surgicai guide fabrication, impiant piacement, and a customized zirconia abutment with a monoiithic 5Y-PSZ crown can achieve high esthetic re- suits in repiacing a primary tooth in the esthetic zone. (Int J Esthet Dent 2024;19:34-44) [ABSTRACT FROM AUTHOR]

Milling complete dentures is becoming a popular option for clinicians because subtractive technology can make the fabrication of high-quality dentures faster and easier. Additive technology is one of the newest techniques for making complete dentures, and its primary advantage is that a printer is more financially accessible than a milling machine. Printing and milling technologies as methods for denture fabrication have similar steps and time frames for their processes. The production of immediate complete dentures also follows similar procedures for both systems. The aim of this article is to compare subtractive and additive technologies for the manufacture of immediate complete dentures and to present two case reports. [ABSTRACT FROM AUTHOR]

Clinical decision-making regarding retention and treatment vs extraction and replacement of teeth can be a significant challenge. This systematic review and meta-analysis aimed to assess decision-making in clinical practice related to the retention and endodontic treatment of natural dentition vs extraction and replacement with implant-assisted restorations. The PubMed/ MEDLINE, Scopus, Web of Science, and Education Resources Information Center (ERIC) databases were comprehensively searched for studies published through May 31, 2019. All randomized controlled trials and cohort studies that assessed the effect of endodontic treat-ment/retreatment and implant treatment were included. Primary outcomes included success, survival, and failure rates. Meta-analysis software was used for data analysis. Of 1550 identified articles, 5 were eligible for qualitative and quantitative analyses. All 5 of the included studies reported that both therapies are viable and predictable treatment options. The meta-analysis showed no significant difference between therapies when survival rates were considered to be successes, while a significant difference was found in favor of endodontic therapy when survival rates were considered to be failures. The available evidence suggests that both therapies have approximately similar outcomes, but endodontic therapy provides moderately better outcomes. Endodontic therapy should be considered the first option when possible. [ABSTRACT FROM AUTHOR]

Objective: The combination of partial edentulism and a worn anterior tooth in the esthetic zone can be a challenge for the dentist. This clinical situation requires extensive knowledge of soft and hard tissue management, surgical planning and execution for implant therapy, and conservative tooth preparation with ideal bonding protocols for the tooth-supported prosthesis. Moreover, an optimal selection of the final restorative materials is imperative to manage occlusal forces and fulfill the patient's esthetic demands. Materials and methods: The patient presented with partial edentulism on site 11, a worn incisal edge, and facial defects on tooth 21. Minimally invasive implant therapy for site 11 was performed with a papilla-sparing flap design that only included the edentulous site and the soft tissue contouring was started for an immediate provisional restoration. A suturing technique was executed that aimed at maintaining an interproximal papilla. Conservative veneer preparation was performed on tooth 21 in order to bond the restoration to the enamel structure. Final restorations included a custom abutment with a lithium disilicate fused to zirconia crown for the implant on site 11 and a lithium disilicate veneer on tooth 21. Conclusions: A well-planned single implant and a ceramic veneer restoration was able to fulfill the patient's esthetic expectations. The selection of materials for the final restoration was crucial to manage the occlusal forces and to mimic the shade and shape of the adjacent teeth. (Int J Esthet Dent 2020;15:2-11) [ABSTRACT FROM AUTHOR]

Post and core fabrication is important in the restoration of endodontically treated teeth. Significant coronal and radicular dentin destruction commonly occurs in endodontically treated teeth. As a result, preserving all the remaining tooth structure is imperative in order to improve the prognosis of the restorative treatment. Core height and width need to be carefully designed and built in order to receive the final restoration. Direct freehand composite resin core buildup in increments may be a challenging and time-consuming procedure in the dental chair. The case report presented in this article describes a clinical technique using a clear matrix to receive composite resin injections in order to achieve an ideal shape and core size. [ABSTRACT FROM AUTHOR]

Focal microdontia is a dental anomaly characterized by the presence of a single abnormally small anterior or posterior tooth. The objective of this article is to provide an updated review of the literature on the advanced restorative management of focal microdontia, and to document a clinical case where the reviewed advanced restorative approaches were applied to treat a young adult presenting with a non-syndromic asymmetrical focal microdontia.We conducted a preliminary examination of the existing literature on the advanced restorative management of focal microdontia. Additionally, we presented a minimally invasive approach to the treatment of an 18-year-old female patient with non-syndromic asymmetrical focal microdontia. The primary advantage of adhesive dentistry is that it can better preserve the structure of smaller teeth. A review of literature reveals a paucity of reports on localized microdontia in the maxillary anterior region of the mouth. However, novel minimally invasive restorative procedures satisfy patients' aesthetic and functional preferences. Well-executed additive diagnostic wax-ups and intraoral mock-ups can serve as a permanent restoration blueprint, providing predictable results for focal dental anomalies in the aesthetic zone. In conclusion, the use of minimally invasive dental approaches in young patients with focal microdontia can result in long-term satisfactory aesthetic outcomes.

Purpose: To compare the fracture resistance of five different groups of chairside CAD/CAM molar crowns fabricated from various lithium disilicate ceramic materials (LDC): one conventional precrystallized CAD/CAM LDC, two novel precrystallized LDCs, and one fully crystallized LDC tested both with and without optional sintering., Materials and Methods: A total of 60 chairside CAD/CAM lithium disilicate molar crowns (n = 12 per group) with 1.5-mm occlusal thickness and a 1.0-mm chamfer finish were designed and fabricated with a chairside CAD/CAM system (CEREC, Dentsply Sirona). The restorations were divided into five groups: (1) IPS e.max CAD; (2) Amber Mill; (3) Straumann n!ce; (4) Straumann n!ce with optional sintering; and (5) Supreme CAD. Restorations were cemented using conventional resin luting cement and primer system to 3D-printed resin dies. Bonded restorations were loaded for 100,000 cycles with 275-N force, and the load at break (LB) and peak load (PL) until fracture were measured. SEM images of fracture surfaces on the printed dies were obtained., Results: Fracture resistance was significantly different depending on the material. Supreme CAD showed the highest fracture resistance (LB: 1,557.2 N; PL: 1,785.8 N), followed by Amber Mill (LB: 1,393.0 N; PL: 1,604.2 N) and IPS e.max CAD (LB: 1,315.7 N; PL: 1,461.9 N). Straumann n!ce without (LB: 862.4 N; PL: 942.9 N) and with the optional sintering (LB: 490.4 N; PL: 541.0 N) showed significantly lower fracture resistance than the others., Conclusion: The fracture resistance of chairside CAD/CAM lithium disilicate molar crowns varied depending on the material, and the novel materials did not perform as well as the conventional equivalents. Fully crystallized lithium disilicate ceramic block materials showed lower fracture resistance than precrystallized counterparts and should be used with caution in the clinic, especially with optional sintering.

Milling complete dentures is becoming a popular option for clinicians because subtractive technology can make the fabrication of high-quality dentures faster and easier. Additive technology is one of the newest techniques for making complete dentures, and its primary advantage is that a printer is more financially accessible than a milling machine. Printing and milling technologies as methods for denture fabrication have similar steps and time frames for their processes. The production of immediate complete dentures also follows similar procedures for both systems. The aim of this article is to compare subtractive and additive technologies for the manufacture of immediate complete dentures and to present two case reports.