Quintessence International, 05/1996

Stainless steel crown forms with bonded resin veneers for primary incisors are commercially available to dentists. This type of preveneered crown was developed to serve as a convenient, durable, reliable, and esthetic solution to the difficult challenge of restoring severely carious primary incisors. This article describes preveneered crowns, reviews their advantages and disadvantages, and details a technique for placement of such restorations.

This study evaluated 30 gallium alloy (Gallium alloy GF) and 31 amalgam (Dispersalloy) restorations over a period of 8 months in both Class I and Class II cavity preparations in 28 human subjects. At baseline, all gallium alloy and amalgam restorations were considered acceptable (Alfa) in terms of caries, anatomic form, marginal adaptation, surface texture, and bulk fracture. Postoperative sensitivity was reported in 67% of the gallium alloy restorations and in 29% of the amalgam restorations. At 8 months, 61% of the gallium alloy restorations were rated Beta for marginal adaptation, and all restorations exhibited tarnish and corrosion. With a few exceptions, the amalgam restorations were rated Alfa for those criteria. Three gallium alloy restorations had to be replaced during the evaluation period because of severe postoperative sensitivity and 39% of gallium restorations still presented some sensitivity at 8 months. Additional problems exhibited by gallim restorations were tooth fractures, tooth cracks, and marginal whitening.

Two alternative methods of restoring primary teeth that had multisurface lesions were examined in a clinical longitudinal study. In a paired comparison, stainless steel crowns proved far superior to multisurface amalgam restorations with respect to both lifespan and replacement rate. Stainless steel crowns are not only more acceptable to the patient and more cost effective, but also more acceptable to the dentist because of the comparatively simple procedures involved in restoring even severely affected primary molars.

Dental electronic anesthesia, although still in its infancy, promises to be an increasingly effective adjunct for the management of dental pain. Electronic anesthesia is noninvasive, safe, and generally well accepted by patients. Electronic anesthesia can be used for a wide variety of operative, prosthodontic, and periodontal procedures and the management of some orofacial pain conditions including temporomandibular dysfunction. While it is unrealistic to expect electronic anesthesia to replace traditional local anesthetic, this method provides a feasible alternative in the dentist's pain control armamentarium in certain situations.

This case report describes the treatment of an adult patient with a combination of fixed and removable prosthodontics. The patient was very conscious of esthetics and asked to have no clasps showing. Therefore, retentive features that produced good esthetics without being overly complex or expensive were provided. This report describes two less commonly used yet very practical and esthetic retentive features that can be used in many situations.

Formation of plaque on the surfaces of dentures is a common problem among denture wearers. A study was conducted to determine the distribution of plaque on dentures. The plaque material was disclosed with a dye solution and measured with a modified Quigley-Hein scale. A photographic method was used to determine the distribution of plaque on the dentures of a group of complete-denture wearers. The effectiveness of a perborate soak-type cleanser was also measured by studying the precleaned and postcleaned states of the denture. Denture plaque was more evident on the fitting surfaces of the dentures than on areas of the flange, teeth, and palate. The use of the soak-type cleanser alone may not be completely effective for the control of heavy plaque.

Three procedures to ensure the correct location of components in the orifice of a hydroxyapatite-coated implant cylinder are presented. These facilitate recording of an accurate impression and the correct location of a customized abutment supporting a single-tooth crown. A technique is offered for obtaining the reproducible, comparable radiography necessary for monitoring horizontal bone levels.

An alternative method of polymerization involves the gradual exposure of resin composite material to the light-activating lamp. This process is intended to facilitate the internal flow of the resin during the hardening phase, resulting in a better adaptation of the restoration to the cavity walls. A regulating device is added to a conventional lamp to allow a gradual increase in intensity of the emitted light until it attains the values emitted in normal use. This study compared the adherence of resin composite to dentin after conventional polymerization or polymerization with the slow and gradual technique. The resin composite-dentin interface in replicas obtained from longitudinal sections of the specimens was examined by scanning electron microscopy. Results revealed that it was possible to improve the adaptation of resin composites to the dentinal surface by reducing the speed of polymerization.