Quintessence International, 11/1996

A method of placing a reinforced resin-bonded sealant is described. When the beneficial properties of resin-bonded sealants are combined with those of preventive resin restorations, the outcome is perhaps the quintessential sealant.

A new technique for the performance of resin composite direct restorations on posterior teeth is presented. A clear acrylic resin matrix, fabricated prior to the preparation of the occlusal and proximal surfaces, is employed. The matrix allows the fast and accurate reproduction of the anatomic details from the original occlusal surface of the tooth, as well as the marginal ridges in the case of Class II (occlusoproximal) restorations. Advantages and limitations of the procedure are discussed.

The objective of restorative treatment of teeth with incomplete fractures is to minimize flexure of the compromised cusps to prevent propagation of the crack. These goals can be addressed with resin-bonded posterior ceramic restorations, but long-term integrity rests on the efficiency of the restoration'sbond to the dental hard tissues. Success is dependent on diligent operative performance throughout the entire procedure. Some tips for achieving successful preparation, provisionalization, and partial-coverage restoration of the incompletely fractured posterior tooth are discussed.

After 7 years of clinical experience, the alumina ceramic, In-Ceram, can be regarded as a well-proven material for all-ce ramic crowns. Because of its high strength, this material can also be used for small all-ceramic fixed partial dentures. First attempts at using this material for resin-bonded prostheses revealed a high failure rate. The aim of this article is to present a new preparation design for all-ceramic resin-bonded fixed partial dentures that allows fabrication of highly esthetic and also tooth-saving adhesive prostheses. Clinicial results over a per iod of 4 years revealed that they are strong enough to replace anterior teeth. Nevertheless, positive long-term clinical results are necessary before a general recommendation can be given for this kind of prosthesis.

The prosthetic replacement of a missing central incisor is described. The left anterior teeth were transformed, through the placement of laminate veneers, to simulate a complete dentition: the lateral incisor was made to look like a central incisor, the canine like a lateral incisor, and the first premolar like a canine. The right central and la teral incisors were also restored for esthetic purposes. The most important factors associated with this type of case are discussed in detail.

Desquamative gingivitis is believed to be a clinical sign of certain mucocutaneous diseases rather than a distinct pathologic entity. The prevalence of desquamative gingivitis was studied in a group of patients with the most common mucocutaneous diseases. Of 414 patients with pemphigus vulgaris, mucous membrane pemphigoid, or oral lichen planus, 49 (11.8%) exhibited gingival lesions in the form of desquamative gingivitis. Desquamative gingivitis was most rpevalent in the patients with mucous membrane pemphigoid (41.6%) followed by those with pemphigus vulgaris (9.1%). Other clinical characteristics, as well as histopathologic and immunohistochemical findings, that aid in early diagnosis are presented.

Producing radiographs of good diagnostic quality while keeping the dose as low as possible is the goal of the dental radiographer. Rare earth compound filters reduce the do se, but few clinical studies have evaluated the diagnostic yield. The diagnostic quality of a samarium compound filter used with E-speed film was compared with that of a conventional aluminum filter used with E-speed film. Bitewing projections with the test and standard filters were exposed for 39 patients. Agreement was evaluated with kappa statistics. The results indicated a substantial level of agreement between the two filter types. The combination of samarium compound filter and E-speed film appears to be a good mechanism for achieving dose reduction without compromising the diagnostic yield of the film.

A 3-year follow-up clinical trial of two experimental Bayer total-etch adhesive systems and two commerical total-etch systems. Clearfil Liner Bond System and Scotchbond Multi-Purpose, was conducted to evaluate their clin ical effectiveness in Class V cervical lesions. Four hundred twenty abrasion-erosion lesions were restored randomly using the four adhesive systems. There were two experimental cavity designs, in which the adjacent enamel margins either were or were not beveled and acid etched. Clearfil Liner Bond System and Scotchbond Multi-Purpose demonstrated high retention rates in both types of cavity design at 3 years. The two experimental Bayer systems scored much lower retention rates in both cavity designs at 3 years. None of the systems guaranteed margins free of microleakage for a long time. At 3 years, superficial, localized marginal discolorations were observed, the least for Clearfil Liner Bond System, followed by Scotchbond Multi-Purpose and the two experimental systems. Small marginal defects were recorded at the cervical dentin and the incisal enamel margin. Retention of Clearfil Liner Bond an d Scotchbond Multi-Purpose appears to be clearly improved over earlier systems, but marginal sealing remains problematic. The two Bayer systems were found to be clinically unreliable.