bluuebunny/crossref_metadata_2025 huggingface dataset:
Financial Considerations Regarding Acquisition of the Siemens Cerec Computer Reconstruction System
Authors: Altshuler Justin Lee , Jacobs David
Published: July 2007

There has been much interest in the in‐office fabrication of ceramic posterior restorations using computer‐aided design and computer‐aided manufacture (CAD‐CAM) units. One concern that practitioners have concerning the use of one of these systems is the initial expense of the CAD‐CAM unit for the office. This article deals with the financial implications involved when considering the purchase or lease of a CEREC (CAD‐CAM) unit.
Bond Strength of Fiber‐Reinforced Composite Resin Restorations
Authors: Galan Douglas , Lynch Edward , Heath M. Robin
Published: July 2007

Severe tooth wear is common in older dentate individuals, with one treatment option being composite resin restorations reinforced with a suitable matrix. This study evaluated the use of high modulus polyethylene (Celanese) fibers as a reinforcing matrix for composite resin. Human mandibular incisor teeth were sectioned to simulate severe tooth wear. Sectioned surfaces were measured, the teeth paired and assigned to control or test sample groups, and further assigned to be tested with a labial or lingual shearing force. A phosphorylated dentin bonding adhesive was applied to the abraded dentin surface. Labial and lingual intra‐enamel bevel preparations were cut on each specimen. A piece of Celanese fabric was bonded onto the acid‐etched labial and lingual bevels of the test specimens using an enamel bonding agent. Class IV composite resin restorations were then placed onto the test and control specimens. Following water storage, the specimens were subjected to shearing forces. Bond strengths for test specimens were significantly greater (p < 0.03) than the controls. Specimens with a labially applied force also had significantly higher bond strengths (p < 0.001). SEM analysis revealed adhesive bond failures over dentin surfaces, with cohesive bond failures within the composite resin. Celanese fibers maintained the restorations on the teeth, although adhesive failures were seen between the fibers and enamel bonding agent.
Microleakage Evaluation in Amalgam Restorations Used with Bases
Authors: Wieczkowski Gerard , Yu Xin Yi , Joynt Robert B. , Davis Elaine L.
Published: July 2007

Marginal leakage in amalgam restorations often precedes the development of secondary caries. One potential way to improve the marginal seal of such restorations, and thus minimize the risk of carles development, is to apply a glassionomer base prior to amalgam placement.

This study compared microleakage resistance among amalgam restorations placed with and without light‐cured glass‐ionomer base materials. Preparations were made in extracted human molar teeth. Four groups were studied, including copal varnish, which was used as a control. All specimens were restored with amalgam. Results indicated significantly greater leakage at the cavity wall/base interface for restorations with a copal varnish cavity liner than for those with a glass‐ionomer base. Leakage differences among bases were also found at the amalgam/base interface. Best results were obtained with a dual‐cure resin‐based system. These samples showed minimal leakage at both the cavity wall/base and the base/amalgam interfaces. These findings suggest that light‐cured glass‐ionomer bases can be effective in the prevention of microleakage in amalgam restorations.
Addition of Fresh Amalgam to Existing Amalgam: Microleakage Study
Authors: Leelawat C. , Scherer W. , Chang J. , Schulman A. , Vijayaraghavan T.
Published: July 2007

The purpose of this in vitro study was to determine whether adhesive lining materials reduce microleakage in amalgam restorations, and to observe the degree of microleakage at the interface between freshly placed (new) and existing (old) amalgam. Forty‐eight specimens were used in the experimental groups. The materials used to study microleakage in this investigation were: copal varnish, a dentin bonding agent (Clearfil New Bond), and a 4‐META adhesive (Amalgambond). No significant difference in microleakage was found at the interfaces between freshly placed and existing amalgam. Significantly less microleakage was noted in specimens using the 4‐META adhesive and the dentin bonding agent as compared to specimens in which no lining material was placed. Significantly less microleakage was noted in specimens using the 4‐META adhesive compared to specimens using cavity varnish.
Bonding Fresh Amalgam to Existing Amalgam: A Shear and Flexural Strength Study
Authors: Leelawat C. , Scherer W. , Chang J. , Vijayaraghavan T. , LeGeros J.
Published: July 2007

The purpose of this study was to compare the shear and flexural strength obtained when various adhesives or liners were used to bond freshly placed amalgam to existing amalgam. The adhesives used in this study were the following: cavity varnish, 4‐META adhesive (Amalgambond), and a dentin bonding agent (Clearfil New Bond). After samples were fabricated, shear bond strengths were determined by using an Instron Testing Machine, and flexural strengths determined using a Material Test System (MTS) testing machine. All test groups produced shear and flexural strengths less than one half of the control group. The dentin bonding agent and the 4‐META adhesive produced significantly higher shear and flexural strengths than the test group in which no lining material was used.
Bonded Silver Amalgam Restorations
Authors: Balanko Michael
Published: July 2007

Although silver amalgam is a strong, stable, technique‐insensitive material, its use requires the removal of more intact tooth structure than adhesive materials in order to provide long‐term retention. Thus remaining tooth structure is weakened rather than strengthened. Bonded silver amalgam restorations, on the other hand, have excellent retention, don't require pins, strengthen remaining tooth structure, eliminate the likelihood of cuspal fracture, and eliminate postoperative sensitivity.
Bleaching and/or Porcelain Veneers: Case Reports
Authors: Putter Harvey
Published: July 2007

Four case studies are presented in which the concept that bleaching, porcelain veneer restorations, or a combination of both constitute a conservative treatment approach for discolored, malformed, malaligned, and worn dentition. These treatments can be used effectively not only for aging dentitions, but also for the very young, which makes them an attractive treatment modality.
Bleaching Teeth: History, Chemicals, and Methods Used for Common Tooth Discolorations
Authors: Fasanaro Tom S.
Published: July 2007

This article reviews the history of bleaching teeth to lighten tooth color. The last 2 years have seen a dramatic increase in new bleaching methods and bleaching chemicals. The following categorizes bleaching chemicals and methods in relation to their use in treating common tooth discolorations. Special attention is given to home bleaching methods.
At‐Home Bleaching System: Effect on Gingival Tissue
Authors: Scherer Warren , Palat Milton , Hittelman Eugene , Putter Han‐ex , Cooper Harmon
Published: July 2007

This study evaluated the effects of an at‐home vital bleaching system on gingival responses over a 6‐week period. Objective measures were utilized to measure and monitor gingival inflammation over this period of time. Vital bleaching was performed as follows: (1) bleaching gel in a prefabricated mouthguard and (2) an ad‐mix technique – bleaching gel and toothpaste in a 1:1 ratio. In addition a control group used a placebo in a prefabricated mouthguard. The at‐home vital bleaching system produced no adverse gingival tissue responses. Furthermore, the at‐home vital bleaching system helped produce a therapeutic effect on inflamed gingival tissues over the course of the study.
In Vitro Effect of Topical Fluorides on Sealant Materials
Authors: Kula Katherine , Thompson Van , Kula Theodore , Nelson Sharon , Selvaggi Raymond , Liao Ruey
Published: July 2007

The purpose of this study was to determine by visual inspection and by scanning electron microscopy (SEM) whether commercially available, topical, acidulated phosphate fluoride (APF) and neutral sodium fluoride (NaF) agents cause surface roughening of five sealant materials: two unfilled resins, two filled resins, and one glass‐ionomer material. In addition, the effect of treatment with 1.23% APF and sonification on weight of an unfilled and a filled sealant was compared to treatment with controls. Unfilled sealants exhibited no surface changes visually or on micrographs following any treatment. Filled sealants and the glass‐ionomer sealant exhibited visually apparent changes depending on the treatment. SEM inspection of filled sealants with visually apparent changes showed loss of filler particles whereas the glass‐ionomer sealant exhibited apparent destruction both of the matrix and the filler particle. No significant differences in weight were found between sonicated and unsonicated specimens. However, significant loss of weight was found with filled sealant specimens, but not unfilled sealant specimens, treated with 1.23% APF gel as compared with the specimens treated with water. The results of this in vitro study indicate that preventive therapies that combine use of topical fluorides and sealants may cause deterioration of filled sealants and glass‐ionomer sealant material, but not unfilled sealants.
Ranking of Facial Profiles among Asians
Authors: Lew K.K.K. , Soh George , Loh Eugene
Published: July 2007

The purpose of this study was to determine the facial profile preferences in a sample of 1,189 Asian teenagers (aged 15.3 ± 3.2 years). Five facial profile types were computer‐generated by trained personnel (orthodontists and oral maxillofacial surgeons) to represent distinct facial types. Subjects were asked to rank the profiles in descending order of attractiveness. The ranking was as follows: orthognathic profile, bimaxillary retrusive profile, bimaxillary protrusive profile, mandibular retrognathic profile, and mandibular prognathic profile. The differences in rank scores between all the profile types were statistically significant (p < 0.05). Assessment of profile types among lay personnel could provide clinicians an indication into the relative attractiveness among profile types and health care workers in treatment prioritization among dysmorphic facial types.
Porcelain to Dentin Bond Strength with a Dentin Adhesive
Authors: Tseng Eugene Y. , Cooley Robert L. , Evans James G.
Published: July 2007

Adhesion of porcelain to dentin may be important in those cases with little remaining enamel. The purpose of this study was to determine the bond strength of porcelain to dentin using a dentin adhesive (All‐Bond) and compare it to the enamel bond strength. Sixty human molar teeth had either a dentin or enamel bonding site prepared by flat grinding to a 600 grit. The teeth were divided into three groups of 20 each. Sixty porcelain cylinders were prepared, hydrofluoric acid etched on one end and silane treated. Twenty of the cylinders were bonded to enamel, 20 bonded to dentin with a dentin adhesive to be tested at 48 hours, and 20 bonded to dentin with a dentin adhesive to be tested after 24 hours of thermocycling (800 cycles at 6°C to 60°C). The specimens were tested in an Instron at a crosshead speed of 0.5 mm/minute. The following bond strengths were found: enamel (19.0 ± 2.9 MPa), dentin at 48 hours (14.4 ± 5.4 MPa), and dentin after thermocycling (10.1 ± 3.8 MPa). When this data was subjected to statistical analysis (ANOVA), there was a significant difference between the groups. A Scheffe's test found that the dentin‐porcelain bond at 48 hours was stronger than the thermocycled group, and that the enamel bond was significantly stronger than the two dentin bonds.
Effects of pH on the Dentin Surface
Authors: Scherer Warren , Binder David , David Steven , Mercurio Christina , Mello Theresa
Published: July 2007

Amicroleakage and scanning electron microscope (SEM) study was conducted in order to investigate the effects of acidic primers on prepared dentin surfaces. The microleakage study revealed that no significant differences were noted between the five materials tested in regard to leakage at enamel and dentin margins. SEM analyses revealed that the smear layers of all specimens were altered in some manner. Further long‐term clinical studies should be conducted to evaluate acidic treatment of dentin.
Dentin Bond Shear Strength and Microleakage for Syntac/Heliomolar: A Comparison between the Manufacturer's and Total Etch Technique
Authors: Gwinnett A. John , Dickerson William G. , Yu Shuan
Published: July 2007

Recent improvements in formulation have led to significant improvements in the bond strength and clinical performance of dentin bonding agents. The growing interest in the concept of total etch prompted a comparison between manufacturer‐recommended procedure and that of total etch for the product Syntac. An in vitro study to examine shear bond strength to dentin and microleakage and an in vivo component to investigate the micromorphologic relationship between restoration and tissue was conducted. No statistical significance was observed in bond strength values for the nonetched versus the etched group. Significantly, however, a larger number of specimens in the nonetched group exhibited microleakage. In vivo, only the etched group exhibited a zone of hybridization although both nonetched and etched restorations showed no interfacial gaps. It was concluded that total etch does not compromise the shear bond strength of Syntac but it appears to significantly reduce microleakage possibly due to the formation of a hybrid zone and may have merit clinically.
Bite Forming of Occlusal Composite Restoration
Authors: Fusayama Takao
Published: July 2007

The bite‐forming technique of posterior composite restoration is presented. Before preparation, the tooth surface is coated with a separating varnish. The occlusal anatomy of self‐cured composite is bite formed by bare opposing teeth. Subsequent finishing is considerably simplified by the ability to peel excess composite from the varnished tooth surface. Finishing and detailing are further simplified by use of top‐cut and top‐safe superfine diamond points. A “free matrix” is used for Class II restorations.
Biologic Esthetic Restorations
Authors: Santos José Fortunato Ferreira , Bianchi Joel
Published: July 2007

Cases of serious coronal destruction were treated by bonding parts of extracted teeth to the coronal remnants by means of adhesives and photo‐activated composite resins. The long‐term clinical results have revealed very satisfactory clinical performance of the compounded restorations. No detrimental effects have been identified.
Tunnel Restorations: A Review
Authors: Papa Joe , Wilson Peter R. , Tyas Martin J.
Published: July 2007

Conventional cavity designs are coming under increased scrutiny because of an increased emphasis on preservation of tooth substance. The tunnel restoration, when used with glass ionomer, may overcome some of the disadvantages of conventional cavity preparations. Justification for the use of the tunnel restoration is from a limited number of short‐term clinical observations and destructive laboratory testing of marginal ridge strength. The technique is not without shortcomings. Long‐term clinical and nondestructive laboratory trials examining the strength of teeth with tunnel restorations should be undertaken prior to its acceptance as a replacement for techniques in which the marginal ridge is removed.
Effect of Cavity Disinfection on Bond Strength to Dentin
Authors: Gwinnett A. John
Published: July 2007

The application of a disinfecting step in cavity preparation and tooth restoration is gaining wider acceptance. This study examined the effect of two commercially available disinfecting agents on the shear bond strength to dentin using a fourth generation dentin bonding agent. The agent tested permitted an evaluation of both dry and wet bonding techniques. It was found that the commercial preparations did not adversely affect shear bond strength to dentin in either the dry or wet application.
Bonding Composite to Glass lonomer with Adhesive Resin Cements
Authors: Styner Daryl , Scherer Warren , LoPresti James , Penugonda Bapanaiah
Published: July 2007

This study was to determine the bond strength of composite to glass ionomer using the following adhesive resin cements: Imperva Dual, CB Metabond, All‐Bond, Geristore, and Panavia. All materials were mixed following the manufacturer's specifications. Bonded samples were thermocycled for 2000 xbetween 5°C and 55°C. Shear bond strengths were determined using an Instron Testing Machine. No statistical differences were noted between materials at the p < .05 level of significance. In addition, scanning electron micrographs were taken of the primed glass ionomer surfaces. These micrographs revealed varying amounts of matrix dissolution along with roughened surface topographies.
New Technique for the Use of a Precision Attachment in the Fabrication of a Cast Crown/Core and Post Unit: Procedures and Case Report
Authors: Nadler Sheldon , Deutsch Allan S. , Musikant Barry Lee , Cohen Brettl.
Published: July 2007

A case report of a prefabricated cast post system, Flexi‐Cast, is presented. This tech‐nique provides maximium retention of the post in the root and crown to a core by incorporation of a prefabricated split‐shank threaded post with an attachment sleeve. Clinically this appears to be a simple predictable technique for the fabrication of a crown/core as a single unit.
Clinical Evaluation of Castable Ceramic Veneers
Authors: Barnes Douglas M. , Blank Lawrence W. , Gingell James C. , Latta Mark A.
Published: July 2007

Laboratory fabricated veneering of discolored or malformed anterior teeth is becoming a widely used technique. Etched Dicor and Dicor Plus ceramic veneers cemented with Dicor Light Activated Cement with Fluoride is one technique available to the practitioner. The purpose of this study was to evaluate the clinical effectiveness of castable ceramic veneers and the cementation system. Forty‐three Dicor and 18 Dicor Plus veneers were placed in 12 patients. An intraenamel preparation was completed with a bullet‐nosed diamond bur in an ultra‐speed handpiece with air‐water spray, and a polyvinylsiloxane impression was made. All veneers were fabricated on dies by the same laboratory technician and placed by one practitioner. The restorations were examined by two evaluators at baseline, 3 months, and 1 year, using modified Ryge criteria.
Effect of Dentinal Adhesives on Marginal Adaptation and Cavity Sealing with Resin Restorations In Vitro
Authors: Kubo Shisei , Finger Werner J. , Muller Michael , Podszun Wolfgang , Walter Hans F.
Published: July 2007

In a companion article in this issue and a previous article in this journal, two experimental enamel dentin adhesive systems were evaluated and compared with four commercially available resin bonding agents by SEM investigation of the tooth adhesive interfaces and by determination of bond strengths to enamel and dentin under various conditions. In continuation of these screening investigations, the present article describes the results of cavity tests for assessment of marginal adaptation by measurement of gap dimensions, and of cavity sealing by rating of microleakage, when standardized dentin cavities were treated with the adhesive restorative systems. Both tests resulted in the same ranking of the six materials. Gluma, Clearfil Photo Bond, and two experimental compounds showed very narrow gaps and moderate microleakage. In contrast, Prisma Universal Bond 2 (the material has been replaced in the market by Prisma Universal Bond 3) and Scotchbond 2 showed significantly wider marginal gaps and more pronounced microleakage. Final discrimination between the efficacy of adhesive restorative materials by any of the currently used in vitro tests is disputable and prediction of long‐term clinical performance by laboratory test data remains questionable.
Compressive and Diametral Tensile Strength of Titanium‐Reinforced Composites
Authors: Cohen Brett I. , Deutsch Allan S. , Condos Spyridon , Musikant Barry Lee , Scherer Warren
Published: July 2007

This article determines the compressive and diametral tensile strength of two titanium‐reinforced composites (Bis‐GMA‐based), Ti‐Core and Flexi‐Flow cem with titanium and compares their strengths to dentin and commercially available core materials and cements. In addition scanning electron microscope (SEM) photographs were taken of Ti‐Core and Flexi‐Flow cem with titanium. Compressive and tensile loading was performed on a modified universal testing apparatus. Ti‐Core and Flexi‐Flow cem with titanium were measured to have compressive strengths of 41,132 and 41,876 psi and tensile strengths of 5219 and 4930 psi, respectively. Statistically (ANOVA, one‐way analysis of variance), these titanium‐reinforced composites are stronger in compressive and tensile strength than Ketac‐Silver, Fleck's zinc cement, Durelon, Ketac‐Cem, and GC Miracle Mix. Both titanium‐reinforced composite materials approach the compressive and diametral tensile strengths of dentin (43,100 and 6000 psi). SEMs revealed that the titanium was uniformly and homogeneously interspersed within the resin matrix of the material.
Primarily Research
Authors: PAUL STEFAN J. , SCHARER PETER
Published: July 2007

After 40 years of research there is still a discrepancy between in vitro and in vivo bond strength values of dentin bonding agents, which evokes questions with regard to the structure of dentin and the necessary improvements of laboratory testing methods of dentin in vitro.
Conservative Posterior Tooth Restorations
Authors: CHRISTENSEN GORDON J.
Published: July 2007

Conservative restorations for posterior teeth (noncrowns) are in a significant evolution, as tooth‐colored restorations are showing strong competition for traditional silver amalgam and gold alloy restorations. Resin restorations (direct and indirect inlays and onlays, and directly placed) are major preferences, but porcelain inlays and onlays are favored also. Dentists are advised to inform their patients about the availability of the various types of restorations discussed in this paper. This education will stimulate discussion about their choices and will provide optimum patient satisfaction with the result.
Esthetics and Anterior Tooth Position: An Orthodontic Perspective Part II: Vertical Position
Authors: KOKICH VINCENT
Published: July 2007

This article discusses the vertical position of the maxillary incisors and its relationship to esthetics. Two situations are discussed. The first, a discrepancy between the incisal plane and the interpupillary line, is corrected by maxillary surgery, orthodontic intrusion/extrusion, or orthodontics and restorative dentistry. The correct decision depends on the interrelationship of the posterior occlusal plane, incisal plane, interpupillary line, and the crown length of the incisors.

The second discrepancy in the vertical position of the maxillary incisors is the “gummy” smile. This problem, due to either overdevelopment of the entire maxilla or over‐eruption of the maxillary incisors, is solved by maxillary surgery, orthodontic intrusion of the over‐erupted teeth, or orthodontics and restorative dentistry. The proper choice of treatment depends on the interrelationship of the posterior occlusal plane, incisal plane, crown length of the maxillary incisors, and the level of the gingival margins of the maxillary anterior teeth.
Intrapulpal Pressure and Thermal Cycling: Effect on Shear Bond Strength of Eleven Modern Dentin Bonding Agents
Authors: PAUL STEFAN J. , SCHARER PETER
Published: July 2007

This in vitro study reports on a modified method for testing shear bond strengths of dentin bonding agents (DBAs). In order to imitate the surface of vital human dentin better, all DBAs used in this investigation (10 commercially available and one experimental) were tested under intrapulpal pressure (13.6 mm Hg to 25 mm Hg) and exposed to thermal cycling (x 1500, 5° to 55°C).

The difference between this testing method and a commonly used method (applying the DBA onto a dry dentinal surface and then storing in water at 37°C for 24 hours) was highly significant (p <.001, two‐way AN OVA).

In group A (composite group) the bonding agent was light cured before the application of the composite resin. In group B (cementation group) the bonding agent and the composite resin were light cured simultaneously.

The shear bond strengths recorded in this study were generally lower than other published results. A.R.T. Bond and P‐Bond (experimental dentin bonding agent) had the best average results in both testing groups.
Esthetic Provisional Restorations for Porcelain Veneer Preparations
Authors: SHEETS CHERILYN G. , ONO YASUYUKI , TANIGUCHI TADANORI
Published: July 2007

A method to provisionalize porcelain laminate veneers, similar to previously described methods for provi‐sionalizing crowns, is presented. The advantages of this system include the ability to have a prototype restoration for evaluation of esthetics and phonetics, thermal protection, and protection from preparation fracture. Additional advantages include improved tissue health and ease of progressing from the provisionaliza‐tion stage to the final bonding stage.
Effect of Implant Position on Implant Restoration Design
Authors: LAZZARA RICHARD J.
Published: July 2007

SUMMARY

Preoperative discussions among the surgeon, restorative dentist, and the laboratory technician determine exact implant locations based on availability of supporting bone, the size of the tooth being replaced, prosthetic components to be used, and the interproximal soft tissue considerations. Once the ideal location has been determined, a surgical stent is constructed to provide a guide for the surgeon to position the implant in the best prosthetic position for maximum esthetic results.
Esthetics in the Cracked Tooth Syndrome: Steps to Success Using Resin‐Bonded Ceramic Restorations
Authors: LIEBENBERG WILLIAM H.
Published: July 2007

Tooth structure cracks are common in both restored and unrestored teeth. The variables of pathogenesis and clinical presentation have generated an enormous amount of attention in the dental literature. The aim of treatment is to minimize flexure of the compromised cusp and so prevent further propagation of the crack. This goal, prior to the advent of adhesive technology, was primarily achieved with full coverage1; the prognosis was predictably good, providing the crack was truly incomplete.
IMPROVING SELF‐ESTEEM BY IMPROVING PHYSICAL ATTRACTJVENESS
Authors: PATZER GORDON L.
Published: July 2007

This article is the final in a series of articles regarding the psychological and sociological aspects of physical attractiveness. It addresses the dynamic nature of self‐esteem and physical attractiveness, and concludes that improving physical attractiveness through changes in the face and specifically the smile, will lead to improved self‐esteem.
Polyethylene Ribbon and Fixed Orthodontic Retention and Porcelain Veneers: Solving an Esthetic Dilemma
Authors: INIGUEZ ISAIAS , STRASSLER HOWARD E.
Published: July 2007

Abstract: The patient, a 58‐year‐old woman, had started orthodontic treatment to correct spacing between the maxillary anterior teeth 6 year prior to presentation with a chief complaint of tooth discoloration and spacing. The treatment had consisted of the use of a removable appliance to retract the maxillary anterior teeth. The patient continued to wear the appliance sporadically. When she presented, the maxillary incisors were in primary occlusal trauma with Grade 2 mobility. The patient discontinued wearing the appliance. The periodontal condition was addressed with initial therapy. As part of the treatment plan to stabilize the maxillary anterior teeth and provide the patient with an esthetic result, it was decided to do a limited occlusal adjustment of the maxillary anterior teeth to control fremitus, and to place a fixed, composite resin, polyethylene ribbon‐reinforced splint, using a facial approach. The esthetic restoration of these teeth was accomplished with bonded porcelain veneers.
Porcelain Veneers: Adjunct or Alternative to Orthodontic Therapy
Authors: CURRY FRANK T.
Published: July 2007

Abstract: Elective esthetic dentistry defines “art form” within the field of dentistry. Most frequently, a clinical team of skilled professionals is required to satisfy the discriminating patient who presents with an esthetic‐driven agenda. This article describes a patient who has rejected orthodontic therapy but continues to seek esthetic alternatives. Porcelain laminate veneers were an appropriate alternative in this case. The second case demonstrates the synergy of combined therapies that were explained to the patient and strategized from the onset to facilitate a result not obtainable by a singular approach. One should not infer that porcelain laminate veneers are an automatic substitute for orthodontic therapy. There may be instances when this is required; however, in most instances, conservative esthetic therapies, such as porcelain laminate veneers, supplement orthodontic therapy to create a final result not possible with either singular approach.
Esthetic Restoration of Endodontically Treated Teeth: Factors That Affect Prognosis
Authors: CHALIFOUX PAUL R.
Published: July 2007

Abstract: Restoration of endodontically treated teeth involves a complex system of components and component interfaces designed to resist force. Dental materials, forces on teeth, clinical circumstances, and restorative design determine restoration success. A new classification evaluates number of canals, amount of remaining tooth surface, chamber space, canal quality, and canal orientation.
“The View” and the Canine Connection: An Atlas of Mandibular Anterior Tooth Esthetics
Authors: ABRAMS LEONARD , PRESSER F. DAVID
Published: July 2007

Abstract: Restoring splinted mandibular incisors and canines with full crown restorations has always presented a challenge in creating an esthetic illusion of reality of normal individual teeth. This treatise is designed to present the rules for mandibular anterior esthetics that have been distilled from almost 4 decades of clinical practice of restoring dentitions that have been severely, compromised by the deformities of disease or accident. The resultant formula systematically creates the desired results with a high degree of predictability.
Soft Tissue Modeling for the Esthetic Single‐Tooth Implant Restoration
Authors: POTASHNICK STEVEN R.
Published: July 2007

Abstract: The ability of the restorative dentist to understand and control the relation of the implant to its associated gingival tissues is extremely important in achieving the maximum esthetic result in the final restoration. The position of the gingival margin following stage‐two surgery represents collapse of the gingival tissues until it finds support by the component against which it comes to rest. This component may be a healing abutment, final abutment, or provisional restoration, if placed at the same time of implant exposure. Generally, it will be a healing abutment. There is a complex relation between implant position, gingival management at stage‐one and stage‐two surgery, the position of the gingival margin over the buccal surface of the implant compared to the adjacent natural teeth, component selection, and lip line esthetics. The therapist who understands these relations will know how to mold the gingival tissue around implants to maximize the esthetic result. This article focuses on these relations and the technique of tissue modeling with subgingival contours to create a restoration with the illusion of reality.
Fifty Years of Interdisciplinary Site Development: Lessons and Guidelines from Periodontal Prosthesis
Authors: SALAMA HENRY , GARBER DAVID A. , SALAMA MAURICE A. , ADAR PINHAS , ROSENBERG EDWIN S.
Published: July 2007

Abstract: Just as “osseointegration” became synonymous with successful restoration of function in the fully edentulous patient during the 1980s, the term “implant site development” has become intricately associated in the 1990s with the techniques used to achieve esthetic results with implants in the partially edentulous patient. This article explores the roots of the concept of site development within the philosophy and principles of periodontal prosthesis. In addition, the myriad of techniques that are presently collectively referred to as site development are systematically classified into a sequential four‐tiered approach that optimizes their efficient application as well as overall success.
Accumulation of Streptococcus mutans on Light‐Cured Composites and Amalgam: An In Vitro Study
Authors: ZALKIND MAYA M. , KEISAR OSNAT , EVER‐HADANI PNINA , GRINBERG RODIKA , SELA MICHAEL N.
Published: July 2007

Abstract: The aim of the in vitro study was to examine the accumulation of Streptococcus mutans on light‐cured composite materials and amalgam. Bacteria cultures were grown in a brain heart infusion medium, and their growth rate was determined through turbidity measurements. The data, so obtained, were evaluated statistically by analysis of variance (ANOVA) followed by Scheffe test. Experiments on amalgam showed better results compared to those on composite materials. There were no statistically significant differences in plaque accumulation on different composite materials after finishing and polishing procedures, compared to plaque accumulation on composite materials against a Mylar strip.
Porcelain for Veneers
Authors: BARGHI NASSER , MALISTER ELIZABETH
Published: July 2007

Abstract: An ideal porcelain veneer placed on a non‐discolored tooth requires the least amount of tooth preparation and the use of a translucent porcelain that interferes minimally with the transmission of light. In contrast, veneering a discolored tooth requires additional tooth preparation and the use of a chromatic or opacious porcelain. This article discusses several criteria for the selection of porcelain for porcelain veneers, including some steps to enhance the esthetic properties of these restorations.
Gingival Recessions and Noncarious Cervical Lesions: A Soft and Hard Tissue Challenge
Authors: TOFFENETTI FABIO , VANINI LORENZO , TAMMARO STEFANO
Published: July 2007

Abstract: Gingival recessions and noncarious cervical lesions are frequent and closely related defects which can be successfully treated by mucogingival surgery and restorative therapy techniques either used alone or in combination depending on the defect characteristics. Proper treatment planning is guided by careful clinical diagnosis. A selection of treatment modalities are presented and useful hints proposed: the long term success is always strictly bound to the identification and elimination of the ethiologic factors, to a correct treatment and a meticulous maintenance program.
Comparison of Wear‐Resistance of Class V Restorative Materials
Authors: FRAZIER KEVIN B. , RUEGGEBERG FREDERICK A. , METTENBURG DONALD J.
Published: July 2007

ABSTRACT: Compomers and resin‐modified glass ionomers have been developed to improve the physical properties of traditional glass ionomer cements. This project compared the toothbrush wear‐resistance of three compomers (Compoglass, Dyract, Hytac) and three resin‐modified glass ionomer restorative materials (Fuji II LC, Photac‐Fil, Vitremer) to that of two resin‐based composites (Herculite XRV, Silux Plus). Specimens (n = 7) were prepared according to manufacturers' instructions and stored in a humidor for 48 hours prior to testing. The specimens were subjected to 120,000 strokes at 1.5 Hz, using a brush‐head force of 200 g on a Manly V‐8 cross‐brushing machine. The slurry contained a 50:50 (w/w) mixture of toothpaste and deionized water. Abrasion‐resistance was calculated by measuring specimen mass‐loss prior to and subsequent to brushing. The data were analyzed using a one‐way analysis of variance (ANOVA) and the Tukey‐Kramer post‐hoc test. Significant differences (p±.0001) in mass‐loss were found, and loss ranged from 0.013 ± 0.003 g (Hytac) to 0.061 ± 0.009 g (Compoglass). No correlation (p= .959) between wear‐resistance and experimentally determined filler content existed. This study showed that all but one hybrid resin‐ionomer type material exhibited a resistance to toothbrush wear that was as good as or better than that of the two traditional resin‐based composite materials.
Etched‐Porcelain Resin‐Bonded Onlay Technique for Posterior Teeth
Authors: YATANI HIROFUMI , WATANABE ELISETE KAZUMI , KANESHIMA TAKUSHI , YAMASHITA ATSUSHI , SUZUKI KAZUOMI
Published: July 2007

ABSTRACT: porcelain to enamel and dentin. This evolution has dramatically changed restorative dentistry and has produced a new, highly esthetic, and strong restoration‐etched‐porcelain resin‐bonded restorations. These restorations can be placed with confidence on posterior teeth. They are virtually indistinguishable from natural tooth structure and, thus provide additional treatment alternatives for patients who desire natural‐appearing posterior teeth. Etched‐porcelain resin‐bonded onlays on posterior teeth not only are an excellent restorative modality for moderately broken‐down teeth but also may be used to bring caries‐free teeth into occlusion. The latter can be an option for stabilizing occlusion for some patients with posterior open bite due to various causes. This article presents clinical and laboratory techniques for etched‐porcelain resin‐bonded onlays on posterior teeth. Remarkable advances in adhesive dentistry have made it possible to strongly bond
Colorimetric Assessment of Laser and Home Bleaching Techniques
Authors: JONES AARON H. , DIAZ‐ARNOLD ANA M. , VARGAS MARCOS A. , COBB DEBORAH S.
Published: July 2007

Abstract:Purpose:This study recorded in vitro color change of three tooth bleaching techniques that included laser‐activated hydrogen peroxide and two concentrations of carbamide peroxide.

Materials and Methods:Forty extracted human central incisors were exposed to argon laser‐activated 35% H2O2, 10% carbamide peroxide, or 20% carbamide peroxide. A fourth group (control) did not receive any bleach treatment (n = 10/group). Commission International de ľEclariage (CIE) L*a*b* coordinates were recorded prior to bleaching (baseline), at 1 week, and at 2 weeks. The color difference (ΔE*ab) between baseline and subsequent measurents was calculated.

Results:The control group did not demonstrate significant color difference over time (p> .05). The laser group was not statistically different from the control group (p> .01). The color difference of the 10% and 20% carbamide peroxide groups was statistically different from the control group (p< .01).
Efficacy of Nightguard Vital Bleaching Technique Beyond the Borders of a Shortened Tray
Authors: OLIVER TRUDY L. , HAYWOOD VAN B.
Published: July 2007

Abstract: Purpose: The purpose of this study was to determine if bleaching extends beyond the borders of a shortened tray or if a demarcation line is found.

Materials and Methods: Fifteen extracted teeth were selected darker than B2 on a Vita Lumin Shade guide (Vita Lumin, Bad Sackingen, Germany). The teeth were mounted in arch‐like fashion in dental stone. Alginate impressions were made, and a stone replica of the four arches of teeth was generated. Vacuum‐formed bleaching trays were fabricated for each arch, without and with reservoirs, as per the product to be tested. The nonreservoir trays were trimmed to one half the clinical crown length, and the reservoir trays were trimmed 1 mm beyond the border of the half‐length reservoir. Measurements were taken from the cementoenamel junction (CEJ) to the tray border for each tooth. The trays averaged 5.1 mm short of the CEJ. The reservoir group was treated with viscous glycerin‐based 10% carbamide peroxide (Opalescence, Ultradent Products Inc., South Jordan, Utah); the nonreservoir group with creamy dentifrice‐based 10% carbamide peroxide (Platinum, Colgate Oral Pharmaceuticals, Canton, Massachusetts). The trays were loaded and fully seated on the teeth. Excess bleaching material was removed with a toothbrush and water rinse. Each assembly was placed in a humidor with incisal edges down to simulate oral conditions. The process was repeated for fourteen 6‐ to 8‐hour bleaching sessions. Blinded and nonblinded operators determined post‐bleaching shades, with consensus reached on differing shades.

Results: All teeth demonstrated lightening of 1 to 10 (mean 5.2) increments on the value‐oriented shade guide. The bleaching effect extended beyond the tray and no demarcation lines were noted on any of the teeth.

CLINICAL SIGNIFICANCE: This in vitro study suggests that successful bleaching occurs beyond the borders of inadvertently shortened trays. The clinician does not necessarily need to remake the tray if the tray does not cover all portions of the tooth.
Shear Bond Strengths of One‐Bottle Adhesives to Moist Enamel
Authors: SWIFT EDWARD J. , PERDIGÃO JORGE , HEYMANN HARALD O. , RITTER ANDRÉ V.
Published: July 2007

Abstract: Purpose: This study evaluated bond strengths of six one‐bottle bonding agents and a control (primer plus unfilled resin) to moist enamel.

Materials and Methods: One‐hundred and five bovine teeth were randomly assigned to seven groups of 15. Enamel was etched for 15 seconds with 35% phosphoric acid. Etched enamel was rinsed, and excess water was blotted with tissue paper. Following application of the adhesive, composite resin was bonded using a gelatin capsule technique. Shear bond strengths to enamel were determined using a universal testing machine (Instron Corp., Canton, Massachusetts).

Results: Mean bond strengths ranged from 21.9 MPa for OptiBond Solo (Kerr Corp., Orange, California) to 29.6 MPa for Prime & Bond 2.1 (Dentsply/Caulk, Milford, Delaware). Prime & Bond 2.1 had a significantly higher mean bond strength than the other adhesives.

CLINICAL SIGNIFICANCE: The results of this study suggest that all of the one‐bottle systems tested should provide clinically acceptable bonding to moist enamel.
Potential for Load‐Induced Cervical Stress Concentration as a Function of Periodontal Support
Authors: KUROE TOSHIFUMI , ITOH HIDEMI , CAPUTO ANGELO A. , NAKAHARA HIROKO
Published: July 2007

Abstract: Purpose: The purpose was to determine, photoelastically, the locations of occlusal load‐induced stress concentrations within a maxillary premolar as a function of degree of periodontal support.

Materials and Methods: Composite three‐dimensional models of a maxillary first premolar were fabricated for quasi‐three‐dimensional photoelastic stress analysis. Individual materials were used to model enamel, dentin, periodontal ligament, and alveolar bone. Three levels of periodontal support reduction (0%, 20%, 25%) were simulated by varying the socket depth. Vertical loads of 10 lb were applied to: (1) tip of buccal cusp, (2) tip of lingual cusp, and (3) center of occlusal surface. The resulting stresses were monitored and recorded photographically in the field of a circular polariscope arrangement.

Results: Cuspal loading concentrated stress around the cervical region below the loaded cusp, being highest under buccal cusp loading. The location of the stress concentration shifted apically as periodontal support diminished.
Packable Composites: Overview and Technical Considerations
Authors: LEINFELDER KARL F. , BAYNE STEPHEN C. , SWIFT EDWARD J.
Published: July 2007

Abstract: Objective: New composites, called packable or condensable composites, are being promoted as amalgam alternatives. The purposes of this review article are to identify these products, define new terminology associated with them, summarize the advertised properties for the materials, discuss the ideal properties for packable composites, review the properties of the major products, and critically evaluate the proposed handling procedures for these materials.

Review: The term packable is preferable to condensable for describing this new class of materials. All materials should be considered amalgam alternatives, not amalgam substitutes. The compositions and physical properties reported by manufacturers reveal that none of the materials represents a remarkable improvement over the properties of more traditional universal composites. The designs of Solitaire (Heraeus Kulzer), ALERT (Jeneric‐Pentron), and SureFil (Dentsply/Caulk) are discussed in detail. The distinguishing characteristics of all packable compositions are less stickiness or stiffer viscosity than conventional composites, which allow them to be placed in a manner that somewhat resembles amalgam placement.

Conclusions: Packable composites may allow more convenient placement in posterior sites and may offer some technique advantages over conventional composites. However, there is no evidence that their clinical properties are consistently better than those of conventional universal composites.
Nightguard Vital Bleaching of Tetracycline‐Stained Teeth: 54 Months Post Treatment
Authors: LEONARD RALPH H. , HAYWOOD VAN B. , EAGLE JAMES C. , GARLAND GLENN E. , CAPLAN DANIEL J. , MATTHEWS KEVIN P. , TART NATILE D.
Published: July 2007

Abstract: Purpose: The purpose of this longitudinal whitening study was to determine the stability, post‐treatment side effects, and patient satisfaction after 6 months of active treatment of tetracycline‐stained teeth with 10% carbamide peroxide at 0 and 54 months post treatment.

Materials and Methods: Twelve patients who completed the study (80%) were contacted and asked to participate in a survey concerning their whitening experience. Subjects were asked whether there had been any change in the shade of their teeth after treatment, and if they had experienced any side effects that they believed were treatment‐related. Eight of the twelve patients underwent clinical examination.

Results: Ten patients (83%) reported no obvious shade change or only a slight darkening not noticed by others. Two (17%) reported a slight darkening that is probably noticeable by other people, but no one reported moderate darkening or significant darkening back to original shade. All respondents (n = 12) denied having to have a crown or root canal that they believed was treatment‐related. Examiners who compared preoperative and post‐treatment photographs and Vita shade values were in agreement with the patients' perceptions of shade change. The degree of improvement was significant for both the immediate (0 mo) and the 54‐month post‐treatment comparison with the pretreatment shade (p < .005 and p < .01 respectively).
Development of Noncarious Cervical Notch Lesions in Vitro
Authors: WHITEHEAD SHAUN A. , WILSON NAIRN H. F. , WATTS DAVID C.
Published: July 2007

Abstract: Purpose: The initiation and progression of noncarious cervical notch lesions (NCCL) continues to perplex clinicians worldwide and poses a considerable restorative challenge. The purpose of this brief communication is to report what is believed to be the first in vitro production of notch‐shaped lesions in the cervical third of premolar teeth.

Materials and Methods: The lesions, were produced by axial loading of selected permanent premolar teeth in a 10% aqueous solution of sulfuric acid over a period of 5 days, followed by immersion in water for 7 days.

Results: Results revealed macroscopic and microscopic features similar to those observed in noncarious cervical lesions in vivo. The lesions were incidental findings while the authors were studying stress corrosion of enamel at low pH. Although much remains to be investigated regarding the etiology and pathogenesis of NCCL, axial loading and a corrosive environment may be implicated in these processes. The artificial lesions arose in clinically sound teeth, suggesting that there is no simple clinical examination to identify teeth at risk from NCCL.