Mamaly Reshad

Diagnostic mock-ups as an objective tool for predictable outcomes with porcelain laminate veneers in esthetically demanding patients: A clinical report

This clinical report demonstrates how a clinician can objectively overcome some of the barriers associated with providing patients with predictable esthetics, in a mutually satisfactory manner. Two such barriers are identified and discussed. The first is related to psychology and patient attitude to treatment. The second is related to the actual clinical procedure. A direct mock-up technique is described which serves as an effective communication tool between the dentist, patient, and dental laboratory technician.

Fabrication of the mandibular implant-supported fixed restoration using CAD/CAM technology: A clinical report

The mandibular implant-supported fixed restoration is an appropriate treatment choice for patients with inadequate bone volume in the posterior mandible. Computer-aided design/computer-aided manufacturing (CAD/CAM) technology has broadened the scope and application for this treatment option. A milled titanium bar retaining individual all-ceramic zirconium oxide crowns, with composite resin replicating gingival tissues, is recommended as an acceptable variation for this type of prosthesis. An alternative method for fabricating a mandibular implant-supported fixed restoration using CAD/CAM technology is described.

Anterior Provisional Restorations Used to Determine Form, Function, and Esthetics for Complex Restorative Situations, Using All-Ceramic Restorative Systems

A technique is proposed for the restoration of a large and visible maxillary anterior defect. The importance of proper diagnosis, treatment planning, and communication is emphasized. Irreversible treatment should only be rendered once patient approval has been obtained through objective evaluation with provisional restorations. The techniques presented in this article use a combination of ceramic systems currently available to satisfy functional demands while achieving acceptable esthetics. A controlled series of steps, where the provisional restorative components are being replaced by the definitive ones is planned. The only difference between the provisional and definitive restorative components is the material used. The definitive restorations consisted of an implant-supported zirconium oxide framework. Individual pressed porcelain restorations were luted to the framework and a natural tooth. CLINICAL SIGNIFICANCE Provisional restorations allow an objective form of communication. Vertical and horizontal transitional lines can be effectively masked with appropriate treatment planning and a skilled ceramist. Many traditional dental laboratory steps may be eliminated or simplified without compromising the definitive restorations.

Effects of N-vinylcaprolactam containing polyelectrolytes on hardness, fluoride release and water sorption of conventional glass ionomers

STATEMENT OF PROBLEM N-vinylcaprolactam (NVC) containing glass ionomers are promising dental restorative materials with improved mechanical properties; however, little information is available on other physical properties of this type of modified glass ionomer, especially their water sorption, fluoride releasing properties and microhardness. PURPOSE The purpose of this study was to investigate the effects of NVC-containing polyelectrolytes on microhardness, fluoride release and water sorption of conventional glass ionomer cements (GIC). MATERIAL AND METHODS The terpolymer of acrylic acid (AA), itaconic acid (IA) and N-vinylcaprolactam (NVC) with 8:1:1 and 7:1:2 (AA: IA: NVC) molar ratios was synthesized by free radical polymerization and characterized using 1H-NMR and FTIR. Experimental GIC specimens were made from a 50% solution of the synthesized terpolymer with Fuji IX powder in a 3.6:1 P/L ratio. Specimens were mixed and fabricated at room temperature. Vickers hardness was determined using a microhardness tester. Water sorption and fluoride releasing properties were also investigated. Commercial Fuji IX was used as the control group. All specimens were first conditioned in distilled water at 37°C for 1 day up to 1 month. Results for the experimental GIC were compared with the control group, using 1-way and 2-way ANOVA and the Tukey multiple range test (α=.05). RESULTS The NVC-modified GIC exhibited higher mean values of Vickers hardness numbers (VHN). However, the data exhibited no statistically significant differences between the experimental and control groups. The experimental cement (TP2) absorbed significantly more water than the control group (P<.034). Additionally, NVC-containing specimens showed comparable fluoride releasing properties with almost the same fluoride burst and continued fluoride release from the bulk of the material. CONCLUSIONS It was concluded that a hydrophilic monomer such as NVC might be able to increase the water sorption and decrease the amount of initial fluoride release of the glass ionomers. Hydrophilic monomer such as NVC might be able to increase the water sorption and decrease the amount of initial fluoride release of the glass ionomers.

COMMENTARY. The Effect of Ultrasonic Instruments on the Quality of Preparation Margins and Bonding to Dentin1

The authors have shown that ultrasonic instruments can produce finer margins than those prepared with diamond burs. However, it would have been interesting to compare marginal finish with a white stone as the last in the series for group 2. Extremely smooth margins can be achieved with both techniques. However, a diligent clinician may consider using both ultrasonic instruments as well as diamond burs for clinical use. However, it should be noted that each method has relative contraindications and limitations.

COMMENTARY. Ultrasonic Margin Preparation for Fixed Prosthodontics: A Pilot Study1

Adhesive technology does require meticulous attention to detail in order to achieve durability.The article by Drs. Horne, Bennani, Chandler, and Purton is an excellent addition to the literature in this arena. It explores an important parameter with regards to tooth preparation.The ultrasonic instruments are an excellent addition to the armamentarium of any restorative dentist today.This pilot study nicely demonstrates how these instruments can create extremely smooth margins, while being conservative at the same time. Lower temperatures during preparation have been shown to maintain tooth vitality. In addition, smear layer removal may be beneficial to bonding to tooth structure. The ultrasonic instruments also have the added advantage that they are simple to use. In other words, clinicians with varying skill levels and experience can easily and efficiently produce smooth margins and clear finish lines with these instruments.This was a personal observation in a dental school setting.