Jovito Adiel Skupien

The role of resin cement on bond strength of glass-fiber posts luted into root canals: a systematic review and meta-analysis of in vitro studies.

Because there are several ways to cement glass-fiber posts (GFPs) into root canals, there is no consensus on the best strategy to achieve high bond strengths. A systematic review was conducted to determine if there is difference in bond strength to dentin between regular and self-adhesive resin cements and to verify the influence of several variables on the retention of GFPs. This report followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. In vitro studies that investigated the bond strength of GFPs luted with self-adhesive and regular resin cements were selected. Searches were carried out in the PubMed and Scopus databases. No publication year or language limit was used, and the last search was done in October 2012. A global comparison was performed between self-adhesive and regular resin cements. Two subgroup analyses were performed: 1) Self-adhesive × Regular resin cement + Etch-and-rinse adhesive and 2) Self-adhesive × Regular resin cement + Self-etch adhesive. The analyses were carried out using fixed-effect and random-effects models. The results showed heterogeneity in all comparisons, and higher bond strength to dentin was identified for self-adhesive cements. Although the articles included in this meta-analysis showed high heterogeneity and high risk of bias, the in vitro literature seems to suggest that use of self-adhesive resin cement could improve the retention of GFPs into root canals.

Crown vs. composite for post-retained restorations: A randomized clinical trial

OBJECTIVES This randomized clinical trial compared the survival of composite resin restorations and metal-ceramic crowns on endodontically treated teeth that received a glass fiber post using 2 different cementation methods. METHODS Forty-seven patients (age 42.5 ± 11.5) with fifty-seven endodontically treated teeth with extensive coronal damage but always with one intact surface were randomly allocated according to the type of coronal restoration: metal-ceramic crown or composite resin. In case of crown restoration, a core buildup was performed with microhybrid composite resin. The dentin bonding agent and composite resin used were the same for both direct and indirect restorations. Descriptive analysis was performed using FDI clinical criteria and survival of restorations/teeth analyzed using Kaplan-Meier statistics and log-rank tests. RESULTS 57 restorations (30 composite resin and 27 crowns) were made in 47 patients. The recall rate was 100% and follow up time ranged between 1 and 5 years. One tooth was extracted 11 months post-restoration due to root fracture (composite group). Eight composite restorations and one crown had reparable failures, all due to secondary caries or restoration fracture. The overall annual failure rate (AFR) was 0.92% after 50 months for success of the restorations, with 1.83% for the composite group and 0.26% for the metal-ceramic crown group. The log-rank test showed no difference for survival according to the type of restoration (p=0.344). However, for success rates, metal-ceramic crowns demonstrated better performance (p=0.022). CONCLUSIONS Indirect restorations provided higher acceptable clinical performance and lower need for re-intervention, but both types of restorations presented good survival rates. (NCT01461239). CLINICAL SIGNIFICANCE When endodontically treated teeth with at least one intact surface must be restored, composite resin restorations and metal-ceramic crows are acceptable alternatives to achieve good survival and success rates.

Case Report: A Predictable Technique to Establish Occlusal Contact in Extensive Direct Composite Resin Restorations: The DSO-Technique

This paper describes the application technique of direct shaping by occlusion (DSO) for large composite restorations including the entire occlusal surface. For this technique, matrix bands and wedges are inserted without interference with antagonists in the desired occlusion. The final increment of soft-composite resin is shaped by letting the patient occlude on the uncured composite. Due to the nature of the technique, special care has to be taken for moisture control and handling of contamination. The procedure, advantages, and limitations of the technique are discussed.

Although Cast Post and Cores Present Acceptable Survival, Patient-related Factors May Influence Survival

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Survival of teeth treated with cast post and cores: A retrospective analysis over an observation period of up to 19.5 years. Raedel M, Fiedler C, Jacoby S, Boening KW. J Prosthet Dent 2015;114(1):40-5. SOURCE OF FUNDING Information not available TYPE OF STUDY/DESIGN Retrospective cohort study.

Effect of Remaining Cavity Wall, Cervical Dentin, and Post on Fracture Resistance of Endodontically Treated, Composite Restored Premolars.

PURPOSE The aim of this study was to examine the effect of remaining buccal cavity wall, remaining cervical tissue, and post on the fracture strength of endodontically treated restored premolars. MATERIALS AND METHODS Teeth were randomly allocated to 10 experimental groups (n=10) according to cavity design and presence or absence of post or to a control group. After thermal and mechanical aging, ramped loading until fracture was performed. RESULTS A high cervical outline (417 N) and the presence of a post (189 N) increased fracture strength, but both factors together had an antagonistic effect of -218 N, resulting in a higher strength of not 606 N (417+189) but 388 N. The risk of catastrophic failure increased (OR=3.17) when a post was present.

Resilient Attachments as an Alternative to Conventional Cast Clasp Removable Partial Denture: 3-Year Follow-up

The present clinical report describes the prosthodontic management for a patient with uncontrolled bleeding and diabetes mellitus treated with a maxillary complete denture and a mandibular partial fixed dental prosthesis designed to interface with a removable cast framework partial denture retained by 2 ERA attachments. This approach was undertaken to improve both retention and stability of the distal extension Kennedy Class I removable partial denture. The rehabilitation provided better anterior esthetics than if treated with a conventional clasp retained removable partial denture, by employing a simple, practical design and offering a significant biomechanical advantages, restoring both oral health and function. Thus, this treatment modality, involving an ERA system and transfixation in fixed crowns, is an effective treatment and can be indicated as a clinical alternative for edentulous and partially edentulous patients with systemic disorders or for patients in economic situations that might preclude implant-based rehabilitation.

Five-year of tooth-supported overdenture as prosthetic solution for elderly patients: A case series

Purpose: This is a case series report with up to five-year follow-up of preservation of remaining teeth used as retentive attachments to support an overdenture. Case Description: A valuable treatment to achieve immediate retention and stability was performed by using the patient’s remaining teeth with root-retained attachments combined with an overdenture. All overdentures were considered successful at the 5-year follow-up. Conclusion: Within the limitations of this case series, the use of short-coping and ball attachments to improve the retention and stability of overdentures is recommended. This treatment option is usually related to limited financial resources or to any health restraint.

Acid Foods and Soft Drinks Dental Erosive Potential: Warning Messages or Not?

El objetivo del presente estudio es abordar el tema de la erosion dental desde otro punto de vista. Al tener en cuenta la creciente tasa de incidencia de esta lesion dental en ninos y adultos, el trabajo plantea la pregunta sobre el peligro de la ingesta indiscriminada de ciertos alimentos acidos y bebidas que han sido identificados cientificamente como una de las causas de la erosion dental, como asimismo, una completa falta de informacion por parte la industria alimentaria sobre estos productos. Se presentan algunos puntos que aun quedan en duda referente a este tema y algunos enfoques que se deben tomar para alertar a lapoblacion acerca de la relacion entre la acidez de los alimentos y la erosion dental.