Eugene Hittelman

Comparison of the Marginal Fit of Pressable Ceramic to Metal Ceramic Restorations

PURPOSE The aim of this in vitro study was to compare the marginal adaptation of a pressed ceramic material, when used with and without a metal substructure, to a traditional feldspathic porcelain-fused-to-metal restoration with a porcelain butt margin. MATERIALS AND METHODS A maxillary central incisor typodont tooth was prepared with a 1.5 mm 360 degrees shoulder with rounded internal line angle, and 30 polyether impressions were made. Dies were poured in type IV dental stone, and 30 restorations were fabricated: 10 metal ceramic restorations (MCR) with porcelain butt joints, 10 pressed to metal restorations (PTM), and 10 all-ceramic restorations (PCR). All restorations were evaluated on their respective dies at 45x magnification using an Olympus SZX-12, measurements of the marginal openings were made, and ANOVA and Scheffé post hoc tests were used to evaluate the data. RESULTS The mean marginal opening was 72.2 +/- 5.9 microm for MCR, 49.0 +/- 5.9 microm for PTM, and 55.8 +/- 5.9 microm for PCR. The post hoc tests showed that there was a statistical difference between the marginal adaptation of the PTM and MCR groups (p < 0.05). There was no significant difference in marginal adaptation between the PTM and the PCR groups, or the PCR and the MCR groups. CONCLUSIONS The PTM group demonstrated a smaller mean marginal opening than the MCR group. The mean marginal openings of all three groups were within a clinically acceptable range.

Psychologic aspects of prosthodontic treatment for geriatric patients

Abstract In summary, the orofacial region is essential to the quality of life and must be reemphasized for the geriatric patient. The extent to which the face and mouth have provided satisfaction of basic biologic and social needs in the past will determine their significance to the quality of life. Such oral contributions to self-fulfillment include the continuation of musical abilities such as singing or playing an instrument, and, of course, the expression of love. The extent to which the face and mouth have provided satisfaction of basic biologic and social needs in the past will also determine the significance of the changes in the orofacial areas to the aging person. Although it is not absolutely necessary for digestion of food, a properly functioning dentition will provide greater opportunity for variation in diet and appreciation of food. Equally important is the influence of appearance and function of the orofacial areas on socialization, communication skills, and interpersonal relations. 24 Sometimes, for example, the dentist may decide that the preservation of esthetics and improvement of self-image are more important than preserving the natural dentition. Finally, dentists must apply their humanity, training, experience, and clinical judgment in evaluating the biosocial history of each individual patient; this treatment must include consideration of the patients needs and expectations of treatment outcome. Dentists, with their extensive training and experience in the biosocial and technical aspects of clinical practice, can provide this essential service to the geriatric patient requiring prosthodontic care.