A prospective comparative analysis of the survival rates of conventional vs no-prep/minimally invasive veneers over a mean period of 9 years

Objectives The present study compares the survival rates of 186 conventional and no-prep/minimally invasive porcelain veneers in 35 patients over a mean period of 9 years. Materials and methods The veneers were placed on the incisors, canines, and premolars in 35 patients between January 2009 and December 2010. Fourteen patients received 84 conventional veneers, and 21 patients received 102 no-prep/minimally invasive veneers. The restorations were evaluated at baseline and after every 6 months until June 2019 based on modified United States Public Health Service criteria. The data was analyzed by using Wilcoxon–Breslow–Gehan and Taron–Ware tests. Kaplan–Meier survival and success curves were plotted for two groups of veneers. The results were compared by using the log rank test. A test probability of P < .05 was regarded as significant, while a test probability of P < .01 was considered to be statistically significant. Results The mean survival rate, according to the Kaplan–Meier estimator, was 9.67% for conventional veneers and 100% for the no-prep or minimal prep veneers. A total of ten absolute failures were observed in six patients: eight restoration chipping/fractures, one debonding, and one fracturing of the tooth. Mean success rate time for conventional veneers without absolute or relative failures was 9.32 years, and 10.28 years for no-prep/minimally invasive veneers. Conclusions Over a mean observation period of 9 years, the survival rate of no-prep/minimally invasive veneers exceed that of conventional veneers. Clinical relevance No-prep/minimally invasive veneers appear very effective and should always be considered in certain clinical situations.

At the Intersection of Harm Reduction and COVID-19: The Role of Anthropologists during and Post-Pandemic

Harm reduction is a public health approach that emphasizes reducing the negative effects of drug use rather than eliminating it. It has been practiced for decades; however, the COVID-19 pandemic poses new challenges for people who use drugs (PWUD) and harm reduction providers. In the United States, public health recommendations to curb the pandemic are complicating harm reduction efforts. Harm reduction programs are rethinking how they engage with PWUD to comply with these recommendations while also providing essential services. In this article, we draw on academic literature, news articles, and information distributed by harm reduction programs to discuss issues currently faced by PWUD and harm reduction providers across the country. This discussion focuses on policy changes and programming adaptations related to three harm reduction interventions—syringe services programs, overdose prevention, and medications for opioid use disorder—that have emerged or gained traction during the pandemic. We argue that anthropologists should play a key role in addressing the obstacles and opportunities for harm reduction in the United States during and post-pandemic. Ethnographic research can generate important knowledge of how pandemic-related service and policy changes are localized by providers and experienced by PWUD and uncover how race, class, and gender may shape access to and experiences with modified harm reduction services. Applied anthropologists also have an important role in collaborating with harm reduction programs to ensure that the voices of marginalized individuals are not ignored as policy and programming changes take place during and after the pandemic.

Clinical Evaluation of Reduced-Thickness Monolithic Lithium-Disilicate Crowns: One-Year Follow-Up Results

Purpose: The purpose of this in vivo study was to investigate whether the less invasive approach (reduced thickness of the restoration) will result in a comparable risk of failure and similar aesthetic results, compared to conventional layered full porcelain crowns, and can, therefore, be used as a good alternative. Material and Methods: The tested ceramic was lithium-disilicate ceramic (IPS e.max). Forty-four patients with endodontically treated premolars or molars were randomized into two groups and provided with single crowns. One group received conventional all-ceramic crowns made from a lithium-disilicate core and hand-veneered aesthetic ceramic, while another group received full-contoured lithium-disilicate ceramic crowns with reduced wall thickness than manufactures recommendations. The teeth for conventional crowns were prepared with 1 mm rounded shoulder and 2 mm occlusal reduction, while teeth for monolithic crowns were prepared with 0.6 mm wide rounded shoulder and 1 mm occlusal reduction. All crowns were prepared by the same clinician and manufactured in the same laboratory by the same technician. The survival and aesthetics of the crowns were assessed by the independent clinician. Apart from this, patients’ aesthetic satisfaction was evaluated. The assessment was double blind as both the examiner and the patients did not know which type of crown was provided. The observation period was 36 months. Survival of the crowns was assessed using the modified United States Public Health Service (USPHS) criteria and aesthetics and participants’ aesthetic satisfaction with the crowns was evaluated using a visual analogue scale. Results: The one-year survival rate for layered crowns was 100% and for monolithic crowns 95.5%. The median patients’ aesthetic satisfaction with both crowns was 100%. Conclusions: The results indicate similar one-year survival rate of reduced-thickness monolithic lithium-disilicate crowns and conventional veneered crowns. Differences with patients’ satisfaction with the aesthetics of both crowns were not statistically significant and it can be said that the patients’ aesthetic satisfaction was the same for both crowns.

Survival of Hybrid Laminate Veneers using two different tooth preparation techniques: Randomized Clinical Trial

The aim of this study was to evaluate the survival of laminate veneers constructed using a recent polymer-infiltrated ceramic network material following the aesthetic pre-evaluative temporary (APT) technique of tooth preparation in comparison to traditional technique. Six patients received 54 laminate veneers. They were divided into two equal groups (n=27) according to the technique of tooth preparation: group T: traditional technique and group A: aesthetic pre-evaluative temporary technique. VITA ENAMIC material was used for CAD/CAM construction of laminate veneers. Cementation was performed using a light cured resin cement. The laminate veneers were evaluated at baseline, after 3, 6 and 12 months according to the modified United States Public Health Service (USPHS) criteriea. The data was collected, tabulated and statistically analyzed. Secondary caries, endodontic complications, cracks and loss of retention were not noted in any laminate veneer. Extensive fractures were not detected in both study groups through the study period. There was a statistically significant decrease of color match criteria between the two groups at the 6 and 12 months recalls. Based on this study, both preparation techniques resulted in successful clinical performance. After 12 months, all the veneers in both groups showed no post-operative sensitivity and all patients were highly satisfied regarding their veneers. However, there was a deterioration in color match criteria through the study period in both study groups.

Glass Ionomer Versus Self-adhesive Cement and the Clinical Performance of Zirconia Coping/Press-on Porcelain Crowns

SUMMARY Objective: This split-mouth clinical study investigated the effect of luting cement on the performance of veneered yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) zirconia crowns. Methods and Materials: A total of 60 crowns prepared with Y-TZP coping and press-on porcelain were made with a split-mouth design in 30 participants. The crowns were cemented either with glass ionomer cement (GIC) (Meron, Voco) or with self-adhesive resin cement (Bifix-SE, Voco). The restorations were assessed immediately after treatment and after 6, 12, 24, 36, and 48 months using the modified United States Public Health Service criteria. The parameters analyzed were retention, color stability, marginal discoloration, marginal adaptation, surface roughness, anatomic form, and secondary caries. The differences between the groups were analyzed by the Fisher exact test in each period of evaluation. The survival rate was analyzed with the Kaplan–Meier and log-rank test (α=0.05). Results: After 48 months, 20 participants attended the recall. During the period of evaluation, 1 crown cemented with glass ionomer cement and 1 crown cemented with resin cement lost retention. Color match, marginal discoloration and adaptation, surface roughness, and anatomic form did not change in any of the periods evaluated, and no secondary caries was observed. No significant differences were found between the 2 luting cements for any of the clinical parameters analyzed, nor for the survival rates during the study. Conclusions: The type of cement did not influence the performance of the crowns after 48 months of clinical use. Both cements resulted in adequate retention rates, aesthetic and functional outcomes, and biological response.

Retrospective evaluation of fiber-reinforced periodontal splints and resin bridges in the anterior region

Aim: The aim of this study was to evaluate the clinical performance of fiber-reinforced periodontal splints (FRSs) and adhesive bridges (FRBs) in treating anterior single-tooth defects. Methodology: Sixty-five patients who received FRSs and FRBs from 2001 to 2012 were recalled and evaluated clinically. The FRS and FRB restorations of the patients were clinically evaluated in terms of anatomical form, marginal adaptation, marginal coloration, secondary caries, and retention, according to the modified United States Public Health Service (USPHS) criteria. The current restoration statuses of the patients from 5 to 10 years post-treatment were photographed and recorded. Patient satisfaction level was assessed using a visual analogue scale (VAS), and periodontal pocket depth was measured. Clinical follow-up data were obtained and analyzed with the Chi-squared test (p<0.05). Results: When each of the modified USPHS criteria was compared with the baseline values, statistically significant differences were observed between the groups. There were statistically significant differences when the categories were evaluated according to initial values (p<0.05). When the clinical evaluation criteria were compared with each other, no statistically significant differences were found (p>0.05). While the most successful results were obtained in the FRB group, most of the restoration losses and repairs occurred in the FRS group. According to the data obtained, 38% of restorations were lost and all restorations had been intact for at least 5 years. All lost restorations were in FGS restorations. The recall rate was 49% (n=32). Twenty (62.5%) of 32 patients rated their satisfaction with the restorations as being between 90 and 100, 8 (25%) as being between 80 and 90, and 4 (12.5%) as being between 70 and 80 on the VAS scale. The pocket depths of the patients at 5- and 10-years post-restoration were 2.3–3.8 mm and 2.4–5.2 mm, respectively. Conclusion: Fiber-reinforced restorations performed due to the loss of anterior single teeth and periodontal tissue can serve patients clinically for at least 5 years. FGK and FGS restorations can be considered alternative treatments that can further delay the more expensive implant and prosthetic treatment options for years. How to cite this article: Ünlü N, Altınbilek N, Velioğlu MS. Retrospective evaluation of fiber-reinforced periodontal splints and resin bridges in the anterior region. Int Dent Res 2021;11(Suppl.1):122-7. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.19 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Clinical Performance of Lithium Disilicate Glass-Ceramic Onlays For The Treatment of Tooth Defects

BackgroundThe aim of this study was to assess the clinical performance of lithium disilicate glass-ceramic onlays for the treatment of tooth defects and to evaluate the clinical performance and whether they are worth more extensive use as that of the full crown. MethodsPatients who received treatment by lithium disilicate glass-ceramic onlays at the Western China Hospital of Stomatology were recalled after 1~4 years. The clinical performance and patients’ satisfaction of onlays for various tooth defects, cracked or uncracked teeth and endodontically treated or vital teeth were retrospectively evaluated with a combination of modified United States Public Health Service Criteria and questionnaire survey. Statistical analysis was performed by using the chi-squared test, Kaplan–Meier analysis and Log-rank test (a = 0.05) where appropriate. ResultsA total of 154 patients with 166 onlays were recalled for clinical examination. Of the 166 onlays examined, 65 (39.19%) were occlusal onlays, 92 (55.42%) were proximal-occlusive onlays and 9 (5.42%) were buccal-or lingual-occlusal onlays. The clinical performance of O and PO onlays was not significantly different (P > 0.05), according to USPHS Criteria. Kaplan-Meier analysis showed that the 4-year survival rate of O and PO onlays was 95.4% and 97.8%, respectively while there was no failure happened in buccal-or lingual-occlusal onlays. Log- rank test showed that the kinds of defects/onlays, tooth vitality and tooth crack had no influence on the survival rate (P > 0.05). The overall satisfaction rate was more than 98%.ConclusionsThis medium-term analysis indicated that lithium disilicate glass-ceramic onlays achieved satisfactory clinical performance for the restoration of different tooth defects. The survival rate of onlays was comparable to that of full crown. Different kinds of tooth defects, tooth vitality and tooth crack did not influence performance.Trial registrationThe study was approved by the Medical Ethics Committee of West China Hospital of Stomatology of Sichuan University with the approval number: WCHSIRB-D-2021-300. Consent to participate was not applicable.

Clinical Evaluation of Flowable Composite Materials in Permanent Molars Small Class I Restorations: 3-Year Double Blind Clinical Study

This study evaluated the 3-year clinical performance of four different flowable composite materials used in Small Class I restorations in permanent molars. This double-blinded, clinical study analyzed 229 Small Class I restorations/103 children at baseline, 12, 24, and 36 months with modified United States Public Health Services (USPHS) criteria. The tested flowable materials were Voco Grandio Flow + Voco Solobond M, Vivadent Tetric EvoFlow + Vivadent Excite, Dentsply X-Flow + Dentsply Prime&Bond NT, and 3M ESPE Filtek Supreme XT Flow + 3M ESPE Scotchbond Universal. The retention and marginal adaptation rates were highest for Grandio Flow and X Flow materials after 36 months, resulting in the highest score of clinical acceptability at 95.3% and 97.6%, respectively. The Tetric EvoFlow and Filtek Supreme XT Flow had the same retention rate after 36 months at 88.1%. Statistical significance was found in Grandio flow material in postoperative sensitivity criteria (p = 0.021). Tetric EvoFlow showed statistical differences in retention (p = 0.01), color match (p = 0.004), and marginal adaptation (p = 0.042). Filtek Supreme showed statistical differences in retention (p = 0.01) and marginal adaptation (p < 0.001). The flowable composite materials showed excellent clinical efficacy after 36 months of their clinical usage. There was no difference among the tested flowable composite materials quality in Small Class I restorations over time.

Restoration in primary molars placed by undergraduate dental students: reasons for failures

Dental caries is one of the most common chronic childhood diseases and highly prevalent in the world. The commonest treatment procedure for dental caries is a dental restoration which aims to retain the tooth. The survival of restoration depends on the factors associated with restorative materials, patients or operators. Thus, this study aimed to determine the reasons for the failure of restoration in posterior primary teeth performed by undergraduate dental students. A total number of 32 patients aged from 5 to 12 years old were included in this study. Overall, 115 primary molar restorations were assessed clinically using the modified United States Public Health Service Ryge criteria. The O’Leary plaque score was used to evaluate the oral hygiene status of all patients. Then, the data was analysed using the Kaplan-Meier survival curves with log-rank test and Cox regression analysis. 43 (37.4 %) restorations failed with 62.1 % for glass ionomer cement and 36.4 % for composite restorations. Marginal adaptation (62.8 %) is the commonest cause of failure. 76.7% of failure restoration was in patients with poor oral hygiene, and it showed a significant difference compared to patients with moderate and good oral hygiene (p = 0.014). Thus, it was concluded that the type of restorative material and oral hygiene status contributed to the failure of restoration placed in primary molar restorations with failure restoration may occur 2.6 times more in poor oral hygiene patients.