bluuebunny/crossref_metadata_2025 huggingface dataset:
Permeability Effects of Two Dentin Adhesive Systems
Authors: Hansen Scott E. , Swift Edward J. , Krell Keith V.
Published: July 2007

This in vitro study evaluated the effects of two dentin adhesive systems on dentin permeability. The XR‐Bonding System modifies the smear layer but does not open dentinal tubules. The Kanca or “total‐etch” technique (phosphoric acid, Tenure A and B, Scotchbond 2 Adhesive) removes the smear layer and opens dentinal tubules. Despite these differences, both systems reduced dentin permeability in a similar manner. XR‐Bond decreased permeability to 52% of the smear layer value, while total etching reduced permeability to 66% of that value.
Three‐Year Clinical Evaluation of CAD/CAM Restorations
Authors: Isenberg Barry P. , Essig Milton E. , Leinfelder Karl F.
Published: July 2007

This study dealt with the clinical evaluation of 121 inlays and onlays generated from both Dicor ceramics and Vita porcelains. These two different types of ceramic materials were cemented using three different duo‐cured composite resin luting agents, which differed in particle size. At the end of 3 years, no difference could be detected between the clinical performance of the Dicor and Vita restorations. Both exhibited the same degree of color matching characteristics, marginal integrity, and general clinical performance; however, seven of the restorations exhibited fracture through the isthmus, which was shown to be due to insufficient cavity depth. The balance of the restorations exhibited excellent clinical performance when evaluated against the United States Public Health Service System.
Three Composite Finishing Systems: A Multisite In Vitro Evaluation
Authors: Jefferies Steven R. , Barkmeier Wayne W. , Gwinnett A. John
Published: July 2007

Selection of appropriate finishing and polishing devices is critical to the optimal appearance and longevity of composite resin restoratives. This report compares the effectiveness of three specific finishing and polishing systems when used to prepare the surfaces of composite restorative materials provided by the respective manufacturers. Profilometer surface roughness analyses were conducted at two separate laboratories to cross‐correlate numerical smoothness data in this study. Statistically significant differences in mean surface roughness were found between various finishing system/composite resin pairings. Surprisingly, a hybrid composite resin finished and polished with its respective finishing/polishing system gave a significantly smoother surface than a microfill composite surface prepared with its corresponding sequentially coated abrasive disc system. This finding was corroborated at a second site using a separate methodology for profilometer analysis.
Indirect Porcelain Veneer Technique for Restoring Intrinsically Stained Teeth
Authors: Cutbirth Steven T.
Published: July 2007

Indirect porcelain veneers are often the ideal restoration for intrinsically stained teeth. This article details a step‐by‐step procedure for esthetically restoring discolored teeth. Porcelain laminate veneers are often indicated when teeth bleaching or direct composite bonding procedures cannot provide the desired esthetic result. Veneers are more appealing to many patients than full coverage crowns because of the more conservative tooth preparation required. If technique details are followed meticulously and cases are appropriately selected, porcelain veneers are not only durable but also promote marvelous gingival health and may be the most esthetic anterior dental restoration.
Effect of Thermocycling Times on Dentin Bond Strength bond
Authors: Burger Karen M. , Cooley Robert L. , Garcia‐Godoy Franklin
Published: July 2007

Thermocycling is widely used in the evaluation of dentin bonding agents. The purpose of this study was to determine the effect of increasing thermocycling times on the shear bond strength of composite resin to dentin using a NTG‐GMA/BPDM‐type bonding agent. Fifty human molar teeth were ground fiat on the buccal surface into dentin (600 grit). Ten specimens were prepared for each thermocycling group of 100,500,1000,2000, and 4000 cycles. The adhesive agent was applied to the dentin according to the manufacturer's instructions. A cyclindrical‐shaped matrix was used to form the composite resin that was light cured to the treated dentin surface for 60 seconds. Thermocycling was started after 24 hours of storage in deionized water at 37°C. Shear bond strengths were determined with an Instron universal testing machine at a cross‐head speed of 0.5 mm per minute. The bond strengths in megapascals (MPa) were: 100 cycles 18.1 (± 5.2) MPa, 500 cycles 19.4 (± 4.0) MPa, 1000 cycles 16.5 (± 2.9), 2000 cycles 14.6 (± 5.1), and 4000 cycles 19.9 (± 3.2) MPa. When this data was subjected to an ANOVA, no significant difference was found between the groups.
Bonding Amalgam to Tooth Structure: A Scanning Electron Microscope Study
Authors: Scherer Warren , Penugonda Bapanaiah , Allen Kenneth , Ruiz Michelle , Poveda Carol
Published: July 2007

The purpose of this scanning electron microscope study was to observe the interface between dentin and amalgam utilizing various adhesive resin cements. The adhesive resin materials used in this study were Imperva Dual, Geristore, and Panavia. The scanning electron micrographs revealed that bonds were established between amalgam, adhesive resins, and dentin.
Two‐Step Provisional Technique for Onlay Preparations
Authors: Nicholson Jerry W. , Chan Daniel C. N.
Published: July 2007

Compared to full crown temporization, direct autocured resin provisional technique for intracoronal onlay preparations is more complicated and less predictable. Clinical concerns include possible pulpal irritation, extra chair time for contouring proximal and marginal excess, and a critically short time constraint to remove the curing resin in the “rubbery stage” to avoid distortion or “locking” into the preparation. A two‐step direct technique using two new light‐cured provisional resins addresses these problems. First, a light‐cured, elastic resin is condensed against the internal preparation walls and confined within a wedged metal matrix band. Then, using a clear template matrix, the elastic foundation is overlaid with a strong and esthetic light‐cured provisional resin.
Effectiveness of Reciprocal‐Action Instrumentation for Polishing Composite Resin: An In Vitro Study
Authors: Small Keith L. , Goldfogel Marvin H. , Newman Sheldon M.
Published: July 2007

This in vitro study investigates the use of reciprocal‐action instrumentation for polishing composite resin restorative materials. Electron photomicrographs were made of surfaces of a microfilled and a hybrid composite resin restorative material polished by various reciprocal‐action polishing procedures, including several types of polishing pastes used with nonabrasive plastic tips. The best polish on the microfilled composite resin restorative material tested was produced by ending with 3‐μ diamond polishing paste. The best polish on the hybrid composite resin restorative material tested was produced by ending with 0.5‐μ diamond polishing paste. The surfaces produced were comparable to those produced by polishing discs.
Diastema Closure: A Case Report
Authors: Putter Harvey , Huberman Al , Scherer Warren
Published: July 2007

This clinical study describes two combined modalities of treatment, orthodontic and porcelain laminate placement, to facilitate diastema closure. Geristore, a dual‐cure fluoride‐releasing composite was mixed to bond orthodontic brackets in place. H6 elastic bands were used with the orthodontic brackets to close the diastemas sufficiently and to allow the placement of Cerlnate porcelain laminates to produce a beneficial cosmetic effect.
Bonding Ni‐Cr Alloy to Tooth Structure with Adhesive Resin Cements
Authors: Penugonda Bapanaiah , Scherer Warren , Cooper Harmon , Kokoletsos Noelle , Koifman Vladik
Published: July 2007

This study was to determine the shear bond strengths of Ni‐Cr alloy to Ni‐Cr alloy (Group I), Ni‐Cr alloy to enamel (Group II), and Ni‐Cr alloy to dentin (Group III) using Imperva Dual, DC Metabond, All‐Bond, Geristore, and Panavla. All bonded specimens were thermocycled 2000 X (5CC‐55°C) after 24 hours and subjected to shear bond testing on a Universal Instron Testing Machine. In all groups of the study, Imperva Dual and CB Metabond had significantly (p < .05) higher bond values than Panavia.
Quantitative Analysis of Six Composite Polishing Techniques on a Hybrid Composite Material
Authors: Tate William H. , DeSchepper Edward J. , Cody Teresa
Published: July 2007

Determining the best technique for finishing and polishing composite resins is important to ensure longevity of the restoration and prevention of recurrent decay and periodontal disease. This study quantitatively compared the surface roughness of a small particle hybrid composite material finished and polished using six different techniques. Five composite samples were randomly assigned to one of six polishing techniques. Uniform composite surfaces were prepared by finishing samples with a 600‐grit carborundum disk prior to polishing. The unpolished surfaces were analyzed with the Taylor‐Hobson Talysurf 10 surface texture measuring instrument. The surfaces were then polished and analyzed again. There were no statistical differences among treatment groups prior to polishing. There was a statistical difference between treatment groups after polishing. The smoothest surfaces were obtained using Centrix System rubber points alone, Centrix System rubber points plus Caulk's Prisma Gloss fine and super‐fine pastes, and Caulk's Enhance disks plus Caulk's Prisma Gloss fine and super‐fine pastes. There was no statistical difference between these methods and 3M Sof‐flex disks alone. The roughest surface was produced by the Enhance disks only without using the Prisma Gloss pastes. There was no statistical difference between this method, however, and the use of Sof‐flex disks plus Kerr's Lustre Paste. Lustre Paste, included with Herculite kits, did not improve a surface polished with Sof‐flex disks.
Esthetic Arch Bar for Maxillomandibular Fixation in Orthognathic Surgery
Authors: Loh Fun‐Chee , Lew Kenneth K.K. , Sim Chee‐Hwee
Published: July 2007

Arch bars are well‐known dental appliances for the management of fractures and orthognathic surgery. Traditionally both the commercially available, prefabricated arch bars as well as the custom‐made arch bars are made of metal so as to provide good rigidity. Each of these types of arch bars has its own advantages as well as drawbacks. This article looks at a type of custom‐made arch bar that is easy to construct and use. At the same time, it provides good rigidity, fit, and esthetics.
Comparative In Vitro Evaluation of Recent Enamel and Dentin Adhesive Materials
Authors: Kubo Shisei , Finger Werner J. , Muller Michael , Podszun Wolfgang
Published: July 2007

In tills in vitro study, two experimental and four commercially available enamel‐dentin bonding agents are characterized by shear bond strengths to human teeth following storage of the specimens for 2 minutes, 15 minutes, and 24 hours, respectively, or after stressing of the bonds by 5000 thermal cycles between 5° and 55CC. It is assumed that the experimental compounds are clinically adequate materials to mediate long‐term retention of resin restorations placed without reliance on mechanical undercuts. The limitations of such in vitro strength data regarding clinical performance are discussed and emphasized.
Noncarious Cervical Lesions: The Decision To Ignore or Restore
Authors: Grippo John O.
Published: July 2007

A variety of unusual noncarious cervical lesions (NCL) are depicted that appear to negate W.D. Miller's toothbrush/dentifrice abrasion theory and demonstrate that other factors may be involved in their etiology. Confusion exists in the designation of NCL ever since G.V. Black stated in 1908 that toothbrush/dentifrice abrasion is an erosive effect. Since abrasion and erosion are two distinct activities, it is suggested that dentistry adopt the same terminology as chemical engineering in order to foster improved communication between the sciences. The term “abfraction” has been used to supplant erosion because it seems more appropriate when describing the loss of tooth substance attributable to effects of occlusal loading forces as well as the physiochemical breaking that occurs during stress corrosion. Numerous reasons, based on accepted engineering principles, indicate that NCL should be restored. It is incumbent on dentists to become cognizant of these reasons, since this would help them inform patients of the benefits to be gained by restoring such deficient areas.
Primarily Research
Authors: PAUL STEFAN J. , SCHARER PETER
Published: July 2007

Dentin bonding has been the object of intensive research for many years. If a substance is expected to bond to a natural tooth surface, the morphologic and physiologic characteristics of the substrate determine both the bonding applications and testing methods used.

This two‐part article is a literature review. Part I is a detailed description of the structure of dentin. In Part II the importance of intrapulpal pressure on understanding bonding and testing will be discussed.
Practice Made Perfect
Authors: Goldstein Ronald E.
Published: July 2007

You can manage difficult patients even if you can't manage to like them. In Part I1 of this topic we'll continue to explore the Difficult Patient Stress Syndrome. Send us your thoughts.
Esthetic Dentistry Development Program
Authors: Abrams Leonard
Published: July 2007

The ESTHETIC DENTISTRY DEVELOPMENT PROGRAM is an interactive continuing education series, with education credits from Temple University School of Dentistry. Each issue of the Journal offers homework assignments for you to complete. The first year's program has six lessons, the first of which follows.
Primarily Research
Authors: TOROSIAN JAMES , ROSENBERG EDWIN S.
Published: July 2007

The goal of implant therapy is to restore a physiologic state of health to a compromised dentition. A successfully osseointegrated fixture is surrounded by healthy alveolar bone and gingival tissues.
Natural and Restorative Oral Esthetics Part II: Esthetic Treatment Modalities
Authors: MAGNE PASCAL , MAGNE MICHEL , BELSER URS
Published: July 2007

A previous article, Journal of Esthetic Dentistry, Volume 5, Number 4, 161‐173 (Part I) described the basic strategies for successful esthetic rehabilitation, including the knowledge about natural oral esthetics and the interactive relationship between patient‐clinician‐technician. This article presents the actual choice of current esthetic treatment modalities. Constantly evolving due to continuous improvement of materials and techniques, the treatment alternatives include a “crescendo” of methods that stretch from the very conservative (chemical treatments, direct composite resins) to the more invasive and sophisticated (laminate veneers, full ceramic FPDs). Using selected clinical cases, a rationale is described for the choice of the appropriate technique related to a specific clinical situation.
Altering Gingival Levels: The Restorative Connection Part I: Biologic Variables
Authors: KOIS JOHN C.
Published: July 2007

Achieving periodontal harmony commensurate with the requirements of restorative dentistry and esthetics at times seems diametrically opposed. Blending in the gingival esthetic components of symmetrical levels, form/a degree of scallop, and the amount of gingival display (see Part II) with the restorative mechanical prerequisites of incisaVocclusa1 reduction, preparation length, and adequate sound tooth structure (see Part III) provides key guidelines for therapy. However, in order to provide predictable esthetic results, two essential biologic issues must be fully understood.
Bleaching Teeth: Report of a Survey, 1997*
Authors: CHRISTENSEN GORDON J.
Published: July 2007

Vital tooth bleaching is here –it is a viable, predictable concept providing great patient acceptance and satisfaction. Practitioners are advised to educate patients routinely about bleaching and to upgrade themselves and their auxiliary staff to be able to accomplish all aspects of bleaching.
Resistance to Fracture of Three All‐Ceramic Systems
Authors: NEIVA GISELE , YAMAN PETER , DENNISON JOSEPH B. , RAZZOOG MICHAEL E. , LANG BRIEN R.
Published: July 2007

Abstract: All‐ceramic restorations have become an attractive alternative to porcelain‐fused‐to‐metal crowns, but their strength is still an important issue. The purpose of this study was to compare the in vitro fracture resistance of three all‐ceramic systems: IPS Empress, In‐Ceram, and Procera AllCeram. Thirty dies were replicated from a master die using high filler resin with a modulus of elasticity similar to dentin. Ten cores each of In‐Ceram and Procera were fabricated to a thickness of 0.5 mm. The remaining porcelain was applied using a sculpting device to produce a crown with a final thickness of 1.0 mm axially and 2.5 mm occlusally. Ten IPS Empress crowns were waxed to the same dimensions and were pressed by the manufacturer. The internal surfaces of all the crowns were etched and silanated prior to cementation with a resin cement (Panavia 21). The cemented samples were loaded in an Instron machine until fracture. The mean fracture loads were: IPS Empress, 222.45 (±49) kg; In‐Ceram, 218.8 (±36) kg; Procera AllCeram, 194.20 (±37) kg. Tukey's test showed no statistically significant differences among the three all‐ceramic systems at p < .05.
Primarily Research
Authors: Moritz A. , Schoop U. , Goharkhay K. , Szakacs S. , Sperr W. , Schweidler E. , Wernisch J. , Gutknecht N.
Published: July 2007

Abstract: Composite materials have become an integral part of the wide range of filling materials currently available. Conditioning is necessary to achieve adequate bonding of the composite material to enamel and dentin. Normally, this is done by applying acid preparations to the dental surfaces. These acids have an etching effect that causes surface roughening. The increasing application of lasers in dentistry has introduced another possibility. Laser irradiation can cause roughening of enamel and dentin surfaces. Another interesting alternative is the so‐called kinetic cavity preparation technique. This method also results in distinct surface roughening. The purpose of the present study, was to compare the described methods. Tensile bond strength tests and shear bond tests were carried out to examine the adhesion of a composite material to surfaces treated with these methods. Laser irradiation with certain devices and the air‐abrasive technique yielded results similar to those with acid etching.
Morton Amsterdam, DDS, ScD
Authors: Walter Cohen D.
Published: July 2007

If one were to examine the rolls of the dental profession during the past 120 years, several individuals who were associated with the University of Pennsylvania would qualify for a seat in the “Dental Medicine Hall of Fame.” Certain individuals have had a monumental impact on the dental profession, including W.D. Miller, Edwin Darby, Robert Ivy, Matthew Cryer, Edward Kirk, Louis Grossman, Lester W. Burket, L.A. Cohn, and Milton Leof. One superstar of the modern era who has distinguished himself as a master clinician, teacher, mentor, and author is Morton Amsterdam, to whom this issue is respectfully dedicated.
Biologic Width and its Relation to Periodontal Biotypes
Authors: SANAVI FARSHID , WEISGOLD ARNOLD S. , ROSE LOUIS F.
Published: July 2007

Abstract: Although average measurements of the biologic zone do not necessarily reflect any one clinical situation, they do establish a basis upon which clinical decisions can be made. Clinical impressions, human autopsy material, and animal studies support the concept of a biologic width. Impingement on the attachment in a susceptible host has shown adverse reactions, including gingival inflammation and alveolar bone loss. The concept is clinically important in determining the extent of osseous surgery necessary in the exposure of sound tooth structure. If the implant‐abutment interface is considered to be similar to a subgingival crown margin, its importance in relation to peri‐implant inflammatory disease is readily apparent. In the presence of inflammation, it is likely that epithelial migration would occur to a level apical to that source. Clinical observations indicate that, once the biologic attachment is invaded around the implant, the gingival reactions are similar to those found around natural teeth, whether the tissue is of the thick flat or thin scalloped type.
Sinus Floor Elevation with Osteotomes
Authors: SUMMERS ROBERT B.
Published: July 2007

Abstract: This article describes a new methodology for augmentation of the bone at the sinus floor that is less invasive than previous techniques. This procedure is called the osteotome technique. Two different applications of the osteotome technique are described. First an implant site is created in a location that previously had inadequate bone for immediate fixation of an implant. In a second surgical step additional augmentation of the bone is carried out when the implant is inserted. This case report provides details, from the original ridge defect with 1 to 2 mm of bone under the low sinus to the final esthetic crown restoration on a 5‐ × 13‐mm external‐hex screw implant that is supported by newly generated bone.
Esthetic Proportions versus Biologic Width Considerations: A Clinical Dilemma
Authors: SADAN AVISHAI , ADAR PINHAS
Published: July 2007

Abstract: Combining harmonious proportions of final restorations with periodontal health and stability surrounding these restorations is a basic fundamental in esthetic dentistry. However, when one can adversely affect the other, a clinical dilemma arises. This article describes a case with unfavorable proportions that may be worsened due to an existing unfavorable preparation design. A simple approach for diagnosis and treatment of such a situation is presented.
Protection against Minocycline Pigment Formation by Ascorbic Acid (Vitamin C)
Authors: BOWLES WILLIAM H.
Published: July 2007

Abstract: Minocycline, a member of the tetracycline family of antibiotics, is widely used in the treatment of acne. Its use has been associated with intrinsic staining of adult human teeth, bones, and soft tissues. It causes blackening of the thyroid glands in both animals and humans. It has been determined that the pigment is the product of an oxidation reaction. Laboratory studies have shown that the pigment formation can be induced by exposure to ultraviolet light in the presence of air, and that an antioxidant, such as ascorbic acid (vitamin C), can block its formation. The present study was undertaken to determine whether the antioxidant vitamin C could prevent the pigmentation of tissues of laboratory rats given minocycline. Based on other studies, one group of rats was given minocycline by stomach tube at a dose of 75 mg/kg/day, 5 days per week, for 6 weeks. A second experimental group was given the same regimen of minocycline plus a supplement of ascorbic acid at a level of 0.1% of the diet. A control group received no treatment at all; all rats were maintained on laboratory rat chow and water ad libitum. The rats were euthanized by carbon dioxide inhalation. Nasomaxillary bones, including central incisors, and thyroid glands were removed and fixed with 10% buffered formalin. Bones and teeth showed no gross signs of staining and, therefore, were not processed further. Thyroid glands were visibly darker in the minocycline group; specimens from all three groups were processed histologically. Microscopic examination revealed extensive deposits of black pigment throughout the follicles of the minocycline group, whereas the group receiving both minocycline and vitamin C showed no sign of pigmentation and were indistinguishable from controls. It is suggested that patients on long‐term minocycline medication be monitored for thyroid function.
Evidence‐Based Esthetic Dentistry
Authors: NIEDERMAN RICHARD , ERGUSON MICHAEL , RDANETA RAINIER , ADOVINAC RACHEL , CHRISTIE DIANA , TANTRAPHOL MAGGIE , RASOOL FAHEEM
Published: July 2007

Abstract: :Evidence‐based clinical practice integrates the best available evidence with clinical expertise. This article presents a clinical case scenario and, using a four‐step, evidence‐based approach, demonstrates how to (1) ask an evidence‐based question; (2) search MEDLINE for the best evidence; (3) critically appraise the evidence; and (4) apply the evidence to the patient. The procedure is demonstrated with the sample question, Does bleaching of bonded porcelain veneers increase marginal leakage? A MEDLINE search strategy was developed for synonyms of the key words that best identify the problem, the intervention, and the outcome. The synonyms were combined using the Boolean operator “or” to identify a “sensitive” (i.e., inclusive) universe of 140,000 journal articles. These categories were then combined using the Boolean operator “and” to identify the most “specific” (i.e., exclusive) four articles from among the 140,000. Finally, to find the best evidence, the articles were limited to “humans” and “randomized controlled trials.” This identified one article. Critical appraisal of the limited data in this one article indicates that the methods are valid and statistically significant, but because of the methods employed, may not be clinically important. Evidence‐based methods take one to the edge of the available information universe in about 15 minutes. The results can be both exhilarating and sobering. They can indicate the depth or limits of available information and suggest gaps in the knowledge‐base that require further study. Most importantly, however, the results allow practitioners to communicate incisively and truthfully with patients and to make more informed clinical choices.
Issues in Esthetic Dentistry for Older Adults
Authors: GOLDSTEIN RONALD E. , NIESSEN LINDA C.
Published: July 2007

Abstract: Esthetic dentistry offers a myriad of opportunities for older adults wishing to improve their smile, oral function, and self‐esteem. The challenge for dental professionals is to maintain oral health throughout the patient's lifetime, even through periods of dependence that may include residence in a nursing home. Dental professionals will have increasing opportunities to share their knowledge and expertise about the relation between oral health and overall health, with a variety of health professionals who care for the aging population.
Issues in the Treatment of Root Caries in Older Adults
Authors: FEDELE DENISE J. , SHEETS CHERILYN G.
Published: July 2007

Abstract: Increased life expectancy, improvements in tooth retention, and higher expectations about oral health will continue to result in an increased demand for esthetic restorative dental care. Using demographics as a predictor of future dental treatment needs, root caries may be one of the most significant patient management issues of the next decade. Root caries also can present the clinician with challenging restorative problems. The best treatment option is determined by the lesion, the caries rate, the condition of the patient, and the esthetic requirement or desire. Material selection is critical for successful restoration of root caries. The treatment of root caries also should include methods for the prevention of future lesions. Although caries risk assessment is not a perfected science, models can assist in estimating caries risk and then guide the clinician toward the most suitable preventive approach.
Identifying and Treating Xerostomia in Restorative Patients
Authors: GIBSON GRETCHEN
Published: July 2007

Abstract: Inadequate saliva can have devastating consequences for a patient, including oral discomfort, rampant caries, increased candida infections, and desiccation of restorative and esthetic dental treatment. Diagnosis of the cause of xerostomia is imperative to treating the condition, and multiple causes should be considered. Treatment options for xerostomia consists of treatment for hyposalivation, palliative and preventive care to combat the results of long‐term dry mouth. Treatment of xerostomia should be based on the etiologic factors of the disease, with prevention of further oral destruction and comfort being the primary goals of treatment.
Periodontal Diseases and Dental Implants in Older Adults
Authors: WILSON THOMAS G. , HIGGINBOTTOM FRANK L.
Published: July 2007

Abstract: Older adults present special problems for the dentist trying to establish or reestablish esthetics. Periodontal diseases are of concern for this population since tooth loss from these widespread problems increases with age. In general, this loss occurs because of increased exposure time to pathogenic bacteria, not some change inherent in the body brought on by the aging process. The profession has begun to place more emphasis on systemic risk factors and their role in modifying periodontal inflammation. The current thinking is that bacteria are necessary to initiate and sustain periodontal diseases, but the clinical manifestation is dictated to a significant extent by systemic factors. Smoking, diabetes, and being positive for the interleukin‐1 genotype predispose the patient to developing more severe disease. For those older adults who lose teeth, dental implants have emerged as reliable replacements, and concerns about placing these devices in patients who have lost teeth as a result of periodontitis appear to be largely unfounded.
A Prospective Multicenter Study Evaluating Loading of Osseotite Implants Two Months After Placement: One‐Year Results
Authors: LAZZARA RICHARD J. , PORTER STEPHAX S. , TESTORI TIZIANO , GALANTE JORGE , ZETTERQVIST LARS
Published: July 2007

Abstract: Historically, the recommended time between placement and functional loading of machined‐surface dental implants has been 3 months for the mandible and 6 months for the maxilla. However, such recommendations are a result of evaluating randomly chosen healing times during the initial phase of implant development and are based on the subsequent clinical outcome of either implant integration or mobility. In recent years, histologic and experimental studies have shown that specifically designed micro‐topographic implant surfaces can result in increased bone‐to‐implant contact at earlier healing times than obtained with machined‐surface implants. Histologic and clinical studies investigating early and immediate implant loading support the premise that implants can be placed into function earlier than previously recommended. With the development of specifically designed implant surfaces and the utilization of time‐saving surgical (one‐stage surgical protocol) and prosthetic (implant position indexing) techniques, patients are now being restored and returning to function sooner than previously thought possible. The purpose of this multicenter clinical investigation is to evaluate the efficacy of loading Osseotite dental implants (3i‐Implant Innovations Inc., Palm Beach Gardens, Florida) at 2 months and to determine the effect of early loading on implant performance and survival. A total of 429 Osseotite implants were placed in 155 patients (87 females and 68 males; mean age 54.0 ± 13.7 yr), at 10 study centers, and subsequently loaded 2.1 ± 0.7 months following placement. A single‐stage surgical protocol was followed, with implants indexed immediately or impressed 4 to 6 weeks following placement. Patient restorative treatments included placement of 83 single‐implant provisional restorations and 129 splinted, two‐, three‐, and four‐implant supported maxillary and mandibular provisional restorations. The mean time from prosthetic loading to the most recent follow‐up evaluation was 10 ± 1.3 months. Seven of the 429 implants did not integrate; of these, six were identified prior to loading and one was identified 1 month after loading. The cumulative implant survival rate was 98.5% at 12.6 months. The cumulative post‐loading implant survival rate was 99.8% at 10.5 months. The preliminary results of this clinical investigation suggest that successful functional loading of the Osseotite dental implant is possible at 2 months following noncomplicated implant placement.
Current Use of Tooth‐Colored Inlays, Onlays, and Direct‐Placement Resins
Authors: CHRISTENSEN GORDON J.
Published: July 2007

ABSTRACT: An extensive survey was conducted to determine the current prevalence of intra‐coronal tooth‐colored restorations. Members and guests attending the American Academy of Esthetic Dentistry meeting in Cancun, Mexico, August 1997, were the participants in this survey. The participants were asked 21 basic questions related to all aspects of tooth‐colored restorations. Definite responses were reported in percentages designating every subtitle of each question. Findings indicated that 84% of these restorations were direct placement resins, 4% were indirect placement resins, and only 2% were indirect ceramic. Survey outcomes also revealed that tooth‐colored restorations are rapidly gaining popularity in the field of restorative dentistry.
Microleakage of Composite Restorations Bonded with Three New Dentin Bonding Agents
Authors: SANTINI ARIO , MITCHELL STEPHEN
Published: July 2007

ABSTRACT: This report evaluates the impact of two dentin bonding techniques on microleakage of Class V restorations bonded with three new dentin bonding systems. Forty‐eight extracted human premolar and molar teeth were randomly assigned to four groups for bonding with EBS Bonding System (ESPE, Seefeld, Germany); Syntac Single‐Component (Ivoclar‐Vivadent, Schaan, Liechtenstein); Scotchbond 1 (3M Dental Products, St. Paul, Minnesota); and a control, Prime and Bond 2.1 (Dentsply, DeTrey, Konstanz, Germany). Cavities were cut in both the buccal and lingual surfaces. The coronal half of each preparation was in enamel, and the gingival half was in cementum or dentin. The cavities were restored with composite after the application of dentin bonding agents, using two different drying techniques for each material. The teeth were stored in distilled water for 6 days at 37°C and then thermocycled. The restorations were examined microscopically for leakage, using Procion brilliant red as a marker. All groups showed microleakage at both the enamel and dentin margins. At the gingival margin, there was no significant difference between any of the experimental materials and the control for either wet bonding (Kruskal‐Wallis: p .8920) or dry bonding (Kruskal‐Wallis: p .9973); or between the two techniques for each material (Mann‐Whitney U in all cases p > .05). Scanning electron microscopic examination confirmed that the zones of microleakage, as indicated by dye penetration, were principally resin‐cohesive failures within the collagen‐rich hybrid layer. Three water‐based bonding agents were unable to prevent microleakage at either the enamel or dentin margins of Class V cavities regardless of which bonding technique was employed. All systems behaved equally.
Esthetic Orthodontic Considerations for the Adult Patient: A General Dentist's Perspective
Authors: BROOKS SIDNEY A. , POLK MELVIN
Published: July 2007

ABSTRACT: Esthetic orthodontics is a viable treatment option for patients seeking cosmetic enhancement. Today, the use of preadjusted orthodontic brackets and straight wire allow general dentists to create optimum esthetic results in a short period of time. Two cases are presented to I demonstrate a clinical technique to enhance a patient's smile through adjunctive orthodontic therapy.
Aspects of the Use of Endosseous Palatal Implants in Orthodontic Therapy
Authors: WEHRBE H. , MERZ BEAT R.
Published: July 2007

ABSTRACT: Control of anchorage is one of the fundamental aspects in orthodontics and dento‐facial orthopedics. Osseointegrated implants provide such an anchorage in a reliable fashion, as has been demonstrated in orthodontic use of dental implants inserted for prosthetic reasons. More recently, special implants have been introduced that serve as temporary anchorage in orthodontics. One example is the Straumann Orthosystem (Institut Straumann AG, Waldenburg, Switzerland), which is inserted in the midsagittal area of the palate. Owing to the reduced bone height available in the palate, only short implants should be considered; surface enlargement by texturing and the achievement of good primary stability are prerequisite for success. The use of a palatal implant provides a continuous stable anchorage for patients with compromised periodontal anchorage potential, as well as in cases in which compliance is not dependable or cases with esthetic considerations in which the use of extraoral anchorage aids or Class II elastics may be problematic. Minimal stress on the patient, combined with maximal anchorage, distinguishes this promising new treatment modality for the orthodontist cooperating with an oral surgeon. The treatment concept is well aligned with the emphasized need for integral treatment in dentistry, especially of the adult patient.
Rationalization of Esthetic Restorative Dentistry Based on Biomimetics
Authors: MAGNE PASCAL , DOUGLAS WILLIAM H.
Published: July 2007

Abstract: The exponential progressivism that characterizes the current decade often comes with substantial financial implications. Dental care is not spared by this phenomenon. However, new generations of concepts emerging from biomimetics provide the operator with the ability to restore the biomechanical, structural, and esthetic integrity of teeth. The development of adhesion and the evolution of porcelain veneers constitute striking examples of this nascent process. Indications for bonding porcelain are extending to more perilous situations (crown‐fractured incisors, nonvital teeth), resulting in considerable improvements, comprising both the medical‐biologic aspect (economy of sound tissues and maintenance of tooth vitality) and the socioeconomical context (decrease of costs compared to traditional and more invasive prosthetic treatments).

CLINICAL SIGNIFICANCE: In the bonded porcelain veneer and its extensions, restorative dentistry has found new solutions for the anterior segment that balance the need for functional and esthetic reconstruction. The optimal stiffness of porcelain in thin section, the ideal surface characteristics, and the biomechanical continuum achieved through high performance bonding mean the crown of the tooth as a whole can support incisal or masticatory function. By the same token, the conduction of optical effects from within the tooth combined with the ideal surface features of the porcelain veneer make this restorative approach the ultimate in esthetic satisfaction, for both the practitioner and the patient.
Use of a Customized Rigid Clear Matrix for Fabricating Provisional Veneers
Authors: RAIGRODSKI ARIEL J. , SADAN AVISHAI , MENDEZ ARTURO J.
Published: July 2007

Abstract: The fabrication of provisional veneers is time consuming, and may be unpredictable, especially in cases of multiple veneer preparations; however, functional and esthetic provisional veneers, may be used as diagnostic adjuncts for the fabrication of the definitive restoration. This article presents, in a step‐by‐step procedure, the use of a customized rigid clear matrix with light‐cured composite resin as a fast alternative for the fabrication of functional and esthetic provisional composite resin veneers.
Laboratory Evaluation and Clinical Application of a New One‐Bottle Adhesive
Authors: PERDIGÃO JORGE , BARATIERI LUIZ N. , LOPES MANUELA
Published: July 2007

Abstract: Purpose: The purposes of this project were to compare the enamel and dentin bond strengths of a new nanofilled one‐coat adhesive system with its predecessor, an unfilled two‐coat adhesive system; to analyze the dentin interfacial ultramorphology, using scanning and transmission electron microscopy (SEM and TEM); and to illustrate the clinical technique associated with the use of the new nanofilled one‐coat adhesive system.

Material and Methods: Twenty flat dentin surfaces and 20 flat enamel surfaces were polished on the labial surface of bovine incisors mounted in acrylic resin. The specimens were equally and randomly assigned to four bonding groups: (1) dentin with Prime & Bond 2.1; (2) dentin with Prime & Bond NT; (3) enamel with Prime & Bond 2.1; and (4) enamel with Prime & Bond NT. A composite post was then adapted to the treated area and light‐cured. After thermocycling, shear bond strengths were determined by testing the shear strength of the specimens. The data were analyzed using one‐way analysis of variance (ANOVA) and Student's t‐test. For SEM and TEM, six dentin disks were obtained from middle dentin of human third molars and assigned equally to each adhesive. The adhesives were applied to dentin according to manufacturer's directions. The hybrid layer and resin penetration into dentin tubules were analyzed at an ultramorphologic level, and the observations were compared.

Results: Shear bond strengths were as follows: group 1: 17.8 + 4.1 MPa; group 2: 20.5 + 3.5 MPa; group 3: 24.7 + 6.7 MPa; and group 4: 27.0 + 5.4 MPa. Electron microscopy showed that both adhesives penetrated the dentin tubules and formed a fully infiltrated hybrid layer. The nanofiller included in the new one‐application adhesive penetrated the dentin tubules and infiltrated the microspaces between the collagen fibers within the hybrid layer.
Two‐Year Clinical Evaluation of Tooth Whitening Using an At‐Home Bleaching System
Authors: SWIFT EDWARD J. , MAY KENNETH N. , WILDER ALDRIDGE D. , HEYMANN HARALD O. , BAYNE STEPHEN C.
Published: July 2007

Abstract: Purpose: The purpose of this study was to evaluate the 2‐year effectiveness of a carbamide peroxide at‐home bleaching gel used to provide tooth lightening treatment.

Material and Methods: Twenty‐nine patients participated in the original study, during which they treated their maxillary teeth with a 10% carbamide peroxide gel nightly for 2 weeks. Shades were determined before and after treatment by comparison with a Vita shade guide. Twenty‐four patients (a recall rate of 83%) were recalled for evaluation 2 years after the initial bleaching treatment. The shade of the maxillary incisors was evaluated and compared with shades before, immediately after, and at 6 months and 2 years after initial treatment. Data were analyzed using a repeated‐measures analysis of variance.

Results: At 2 years after bleaching with a 10% carbamide peroxide gel, the median shade was D2, a six‐increment difference from the baseline median of D3. Twenty of 24 patients (83.3%) had a shade change of two or more units, which is the threshold value for bleaching efficacy using American Dental Association guidelines. The lightening result remained statistically significant (p <.0001) at 2 years.
Dental and Oral Discolorations Associated with Minocycline and Other Tetracycline Analogs
Authors: CHEEK CAROLINE CARVER , HEYMANN HARALD O.
Published: July 2007

Abstract: It has been well acknowledged in recent literature that minocycline, a semisynthetic tetracycline derivative, causes discolorations in adult teeth and various other collagenous tissues. This article presents the most common patterns of minocycline staining in addition to comparing the staining patterns of other tetracycline analogs in the permanent dentition. It also reviews the literature's most prominent theories describing the process of minocycline discoloration, and evaluates their plausibility. It is a goal of this article to make dental practitioners aware of the possible effects of minocycline therapy and to highlight useful ways to treat or prevent these discolorations. Currently, conventional treatments include vital and nonvital bleaching, veneers, or crowns, depending on the severity of the discoloration. The literature shows that possible preventive efforts revolve around cessation of the drug or the use of large doses of vitamin C or other antioxidants in conjunction with minocycline therapy to prevent the formation of the pigment responsible for the staining.
P‐ASA Block Injection: A New Palatal Technique to Anesthetize Maxillary Anterior Teeth
Authors: FRIEDMAN MARK J. , HOCHMAN MARK N.
Published: July 2007

Abstract: This technique article presents a new local anesthetic injection that is reported to produce anesthesia of the six maxillary anterior teeth, the anterior third of the palate, and the facial gingiva from a single‐site injection. The injection is referred to as the palatal approach anterior superior alveolar (P‐ASA) nerve block. The 0.9 to 1.4 mL dosage recommendation for this block injection is significantly less than for a traditional supraperiosteal approach. The primary advantage of this injection is that it allows the dentist to anesthetize the teeth and gingiva without collateral anesthesia to the lips, face, or muscles of facial expression. Therefore, the smile line is not distorted during the operative phase of an appointment, and the patient is more comfortable postoperatively.
Ceramic Restorations for Posterior Teeth: Guidelines for the Clinician
Authors: RITTER ANDRÉ V. , BARATIERI LUIZ N.
Published: July 2007

Abstract: Metal‐free ceramic restorations are increasingly popular for restoring posterior teeth. These restorations are generated through a variety of techniques (e.g., CAD‐CAM, copy‐milling, heat‐pressing, and firing). When appropriately indicated and made, ceramic inlays or onlays can be reliable and provide a highly serviceable restoration. The aim of this article is to review and present updated information regarding indications, restorative technique, and maintenance for this class of restorations, with emphasis to fired ceramic inlays or onlays. The information presented is based on 15 years of controlled clinical experience with this category of restorations. Clinical cases that represent some applications also are presented.
Effects of Air Abrasion and Acid Etching on the Microleakage of Preventive Class I Resin Restorations: An In Vitro Study
Authors: FU BAIPING , HANNIG MATTHIAS
Published: July 2007

Abstract: Purpose: To evaluate the effects of air abrasion, acid etching, and the combination of both procedures on the microleakage of preventive Class I resin restorations.

Materials and Methods: Eighty‐four extracted human molar teeth were randomly assigned to seven groups with 12 teeth each. Occlusal fissures were opened with a diamond bur and etched with phosphoric acid (groups I and VI); prepared with a diamond bur without etching (group VII); air abraded with the KCP 1000, using SO‐pm aluminum oxide particles without etching (group 11), and with phosphoric acid etching (group 111); or air abraded with 27‐pm aluminum oxide particles without etching (group IV), and with phosphoric acid etching (group V). Preparations were filled with a low‐viscosity resin composite (Liquicoat, groups I to V) or with a low‐viscosity poly acid‐modified resin composite (PrimaFlow, groups VI and VII). Six teeth in each group were thermo‐cycled (5°‐55°C, 2500 cycles). Dye penetration (methylene blue) was evaluated in ordinal scale.

Results: The number of non‐thermocycled and thermocycled specimens revealing no microleakage was as follows: group I, 6 and 1; group II, 2 and 2; group III, 4 and 3; group IVY 0 and 0; group V, 1 and 0; group VI, 3 and 2; and group VII, 0 and 0, respectively. No significant differences existed between the thermocycled specimens and non‐thermocycled specimens, except within group I.
Bilateral Dental Fusion of the Upper Central Incisors: A Multidisciplinary Approach
Authors: GARATTINI GIOVANNA , CROZZOLI PAOLO , BRENNA FRANCO
Published: July 2007

Abstract: The multidisciplinary treatment of a case of bilateral dental fusion of the upper central incisors with maxillary constriction, crowding, and palatal inversion of one of the lateral incisors is reported. The rarity with which this anomaly appears, along with its complex characteristics, often make it extremely difficult to treat. It requires the involvement of different specialists to find the most suitable treatment for each individual patient.