Quintessence International, 07/1995

This article provides a comprehensive and detailed description of the technique for making a custom tray for the delivery of bleaching gel in dentist-supervised home bleaching systems. Specific recommendations about certain steps and materials are made and the advantages offered by these variations are explained. This information should facilitate the preparation of the tray by the dental staff in office or provide some guidelines to the dental laboratory to improve its service. The resulting appliance may offer some advantages for patient comfort during specific treatment regimens.

A four year old boy with severely discolored primary maxillary incisors was treated with bonded porcelain veneer restorations. Two years previously, the child had been treated with topical application of sodium fluoride-silver nitrate solution to arrest dental caries associated with a nursing bottle habit. With minimal chair time, the incisors were restored with laboratory-processed porcelain veneer restorations that were bonded with resin cement. This is perhaps the only report to date of the use of porcelain veneer restorations for primary anterior teeth.

Radical surgery was performed to remove the left side of the mandible in a patient diagnosed with mandibular carcinoma. For 36 years, the patient functioned with a hinged, removable partial denture anchored to the remaining natural dentition on the mandibular right side. Because of deterioration of the remaining natural dentition, the patient could no longer function with the partial denture. In lieu of reconstruction with a bond graft, the patient chose to undergo treatment with osseointegrated implants to permit insertion of a stable prosthesis with a cantilevered extension into the area of the surgical resection. The rigid attachment of the prosthesis to the remaining mandible provided function as well as soft tissue support in the area of the surgical defect.

A technique is described whereby a diagnostic appliance simulating an implant-supported fixed prosthesis for the edentulous patient can be made quickly and relatively inexpensively. Such an appliance gives the patient an understanding of the physical limitations of various modalities of prosthodontic restoration. It is a tool that permits both the patient and the dentist to assess functional, esthetic, and phonetic criteria in the realistic setting of everyday usage. Important decisions regarding future treatment can thus be finalized before a huge financial commitment is made. It is a highly cost-effective technique, both financially and emotionally.

A 60-year-old man sought treatment for extensive tooth wear resulting from bruxism. He had no signs of temporomandibular joint dysfunction. The kinesiographic study revealed that he had a dual bite, with two intercuspal positions, separated by 3mm anteroposteriorly and by 7mm laterally. The dentition was restored with metal-ceramic crowns to restore a normal occlusion. The kinesiographic follow-up studies revealed that, initially, it was difficult for the patient to adapt to a new occlusal design, but 6 years later, the dual bite had disappeared. However the disoccluding angle had flattened where the second intercuspal position had previously existed, corresponding, clinically, to a change from canine guidance to anterior-canine guidance.

This is a report of the treatment and prognosis of a maxillary second milar exhibiting a complete vertical crown-root fracture. The buccal and palatal segments were widely separated by as much as 2 mm and were immobile. To restore this tooth, it was essential to bring the segments into close apposition. This was accomplished by application of orthodontic elastics to the tooth crown in combination with a wire splint. After approximately 1 month of continuous use of the orthodontic elastics, the dislodged segments were suitably repositioned close to their original positions. The tooth was then endodontically treated and restored with a case complete crown. The restored tooth has become functioning well, with periodic periodontal maintenance, for more than 3.5 years, indicating a promising prognosis.

The treatment rationale for, and successful management of, teeth with cracks in the form of imcomplete vertical fractures are reported. Further crack propagation was prevented by placement of either stainless steel orthodontic bands or aluminum or acrylic resin provisional crowns, and endodontic treatment was subsequently carried out. The teeth were restored with intraradicular amalgam cores and complete veneer crowns. The teeth were reexamined periodically for up to 3.5 years after treatment. During the period of review, all teeth remained asymptomatic.

The allure of multiple porcelain veneers resides in the conservative preparation and the potential for excellent esthetics. to uphold the pennant of adhesive technology on which the procedure is founded, the fastidious guidelines of direct adhesive techniques should be carried over to porcelain veneers. Delivery of procelain veneers is compromised in the absence of rubber dam isolation. Traditional rubber dam application is cumbersome and impractical, however, during placement of multiple veneers, with their priority of gingival margin access. This article introduces a rubber dam-retaining appliance that improves access and isolation during the restoration of anterior teeth with multiple porcelain veneers.

For more than 130 years, several systems for designating and encoding teeth have been in use. Starting with the oldest one, which was proposed by Zsigmondy and Palmer, the most important methods are briefly described. Because none of these early systems complies with the requirements set by the Federation Dentaire Internationale, the organization introduced its own two-digit system in 1970. Although this system has not gained worldwide recognition yet, it has many advantages over the other methods and should be universally adopted.

the objective of this study was to evaluate the in vitro microleakage of a new adhesive system, Syntac. Class V preparations were cut at the cementoenamel junction in 20 extracted bovine incisors and 20 extracted human incisors. One group of 10 human and 10 bovine teeth was restored with Syntac and a microfilled posterior resin composite; the other group was restored with Syntac and a hybrid resin composite, Microleakage was evaluated a 1 week with a 45 Ca radioisotope method. No statistically significant differences between human and bovine substrates were found with either resin composite. The Syntac/hybrid resin restorations leaked less than did the Syntac/microfilled resin restorations at the gingival (dentin) margin in the bovine teeth; however, this difference was not statistically significant.