Dental Tribune International
Clinical
Torsional resistance of two nickel-titanium rotary instruments: A comparative study

August 19, 2019

This study explores how heat treatment less significantly influences (increasing or decreasing) torsional resistance when compared to the high increase in flexibility and fatigue resistance reported in many published articles. Moreover, torsional fracture occurs extremely rapidly when an instrument’s tip becomes blocked.

Straumann Pro Arch concept with fully guided implant and abutment placement

August 14, 2019

In cases of severe posterior bone atrophy, Straumann Pro Arch is a solution that helps achieve fixed restoration for the patient. Straumann Guided Surgery and the coDiagnostiX planning software (Dental Wings) can produce predictable results in cases of complex bone anatomy or when implants are placed such to obtain planned multi-unit angulation. With CARES Visual (Straumann), we can obtain a precise framework fit on the original components, which is fundamental for the final restoration.

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Use of 3D technology in the diagnosis and treatment of endodontic disease

August 14, 2019

In recent years, the technology associated with endodontic therapy has undergone a veritable revolution. For years, intraoral radiographs were used as the basis for diagnosis and for planning root canal therapy, despite the fact that these images did not provide a faithful reproduction of the endodontic anatomy. This created a series of technical problems, which, although they could be partly overcome by the operator’s personal experience, to some extent remained unresolved, especially in the field of diagnosis.

Predictable guided implant placement for full-mouth reconstruction

August 2, 2019

When a patient presents to your dental practice with questionable and/or non-restorable teeth requiring full-mouth extractions, the greatest concern is whether implants can be placed at the same surgical visit, and, if so, whether the patient will be able to walk out with fixed teeth. Having an implant system in your practice that allows you to load or progressively load, so that these patient demands are met, allows you to position your practice at a whole new level. Of course, certain parameters must be met in order to facilitate this type of treatment. This includes the quality and quantity of bone, the presence of infection, the patient’s health and the skills of the dental provider. Additionally, the selection of the most appropriate materials for the most ideal situation must be met.

Scan perfectly with CEREC Primescan and gain time for what is really important: your patients

July 24, 2019

At a practice in which digital technologies have been prioritised right from the start, new devices are a real pleasure rather than a duty. That’s why Dr Bernhild-Elke Stamnitz, from Langen in Germany, was delighted to be one of the first dentists to be able to use CEREC Prime scan, the new intraoral scanner from Dentsply Sirona, for her daily work. As a CEREC coach, she is very familiar with digital impressioning, but she is convinced from her first experiences with the device that CEREC Primescan represents a great advance in quality.

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Comparison of guided and non-guided implant placement accuracy (Part 2)

July 23, 2019

Proper 3D implant positioning is a crucial factor for predictable implant and prosthodontic treatment. Guided osteotomy preparation and placing implants through a guide may contribute to more precise implant placement in accordance with the prosthodontic plan. In the first part of the article (published in CAD/CAM 1/2019), we described the use of 3D imaging in implant treatment planning. This study aims at the comparison of two methods in terms of repeatability and compliance with the treatment plan.

Comparison of guided and non-guided implant placement accuracy (Part 1)

June 26, 2019

The procedure of implantation is becoming an increasingly popular method for replacing teeth. The critical factor in the achievement of a therapeutic and aesthetic long-term effect is the accuracy and precision of implant placement, being the support for the future prosthetic work.

Peri-implantitis therapy – Using resorbable bone replacement material

June 26, 2019

Peri-implantitis is one of the medical challenges of the 21st century. Implantologists and periodontists around the world are consistently searching for reliable and implementable therapy solutions. The authors presented their preferred protocol of peri-implantitis treatment in this clinical case using a biomimetic bone replacement material and a resorbable collagen membrane.

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Prevention 0: The best way to prevent peri-implant disease?

June 19, 2019

The philosophy of prevention in all medical professions is increasing from a global perspective. In fact, prevention of chronic non-communicable diseases, the major burden of illness and disability in almost all countries in the world, has been strengthened in recent years. The motivation is to ensure a better quality of life for people and to reduce public health expenditures. In dentistry, periodontitis is one of the major chronic non-communicable diseases. World experts in periodontics and science have published several principles regarding the prevention of periodontal diseases.

Edelweiss PEDIATRIC CROWNs: A new and innovative approach to restoring primary teeth

May 27, 2019

The management of dental caries in children is necessary because caries is a progressive disease which can eventually damage the tooth and can be detrimental to the permanent teeth and the child’s general well-being. As outlined in this clinical case, edelweiss PEDIATRIC CROWNs are a simple solution which is aesthetic but also functional in providing an effective treatment option for the restoration of decayed primary teeth.

Anti-ageing medicine and orthodontic appliance therapy treatment: An interdisciplinary approach

May 15, 2019

Anti-ageing is a branch of medicine focused on how to prevent, slow or reverse the effects of ageing, thus helping people to live longer and healthier lives. Recently, however, more evidence-based medicine has led to antiageing becoming a multi-billion-dollar industry. In the past few decades, the market for anti-ageing products and services has grown into a global industry valued at an estimated US$261.9 billion in 2013, up from US$162 billion just five years before, according to BCC Research, a publisher of technology market research reports based in Wellesley in the US.

The complete digital implant workflow

May 15, 2019

Planmeca is known for high-tech innovations and continuous product development. The company’s powerful Planmeca Romexis software platform allows all stages of the dental implant and aesthetic prosthodontic treatment to be completed using one piece of software, from the computer-assisted design of patients’ smiles to the fabrication of surgical guides. The following clinical case, which I performed together with my colleagues Dr Ponomarev, Dr Kozhevin and Dr Yarokhin, illustrates how digital solutions can be used in prosthodontic treatment, implant placement and restoration design. According to our experiences, digital CAD/CAM technologies enable maximal functional and aesthetic results compared to traditional methods.

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Optical impression and provisional prosthesis: Proposal for a new approach

April 21, 2019

The widespread use of intraoral optical impressions and constant improvements in dental computer-aided design (CAD) software today allow the practitioner to manage various kinds of clinical situations, from the simplest to the most complicated, by using different types of dedicated equipment (camera software, processors and, more recently, 3D printers) as part of a completely digital workflow. Arch scanning methods using intraoral scanners yield impressions that are comparable to those obtained with traditional equipment in terms of clinical precision because they eliminate the variations caused by the user, reduce the readjustment processing time and costs, and improve patient satisfaction and comfort.

The fully digital Pro Arch protocol

April 8, 2019

The Straumann Pro Arch concept involves different treatment solutions for the fully edentulous patient. The objective is to provide a predictable, reproducible and simple treatment that restores patients’ oral health and consequently improves their quality of life dramatically. The possibility of immediate, same-day rehabilitation by means of temporary fixed prostheses offers maximum treatment quality and satisfaction for both the dental team and patient. The objective of the treatment with an immediately loaded fixed prosthesis on implants is to improve the patient’s quality of life by providing function, aesthetics and health until osseointegration is established.

Biomechanical considerations in solving demanding cases

March 28, 2019

The predictability of dental implant osseointegration has enabled clinicians and researchers to focus on additional success criteria in the overall treatment. Initial assessments of implant therapy considered survival rates, restoration stability, detectable bone loss and presence of soft-tissue infection. As implant dentistry advanced, it was necessary to introduce new assessment points in order to broaden the understanding of favourable outcomes and pending failures. These included aesthetics, evaluated by both patients subjectively and clinicians objectively. A more patient-centred approach has led to a better insight into patient satisfaction, which was often overlooked in the past.

Guided bone regeneration in smokers – Use of synthetic bone blocks

March 25, 2019

Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing if necessary. Bone grafting is possible because bone tissue has the ability to regenerate completely if the space into which it has to grow is provided.

Implant retreatment

February 20, 2019

When working with dental implants, a number of specific rules must be followed regarding both the implant surgery and the prosthesis itself (fixed protheses tending to have a more favourable prognosis than overdentures). If these rules are not adhered to, the results are often unsatisfactory, requiring retreatment. In such cases, and despite the patient’s desire to quickly forget the previous treatment, a very strict protocol must be followed, specifically concerning the length of healing periods. Despite an increase in the overall treatment duration, this will ensure success of each stage of treatment. The implant retreatment case outlined in this article will emphasise these different stages in this type of clinical situation.

How to give a second life to third molars: A case series with follow-up

February 1, 2019

Dental autotransplantation entails extracting and repositioning a tooth into a different site in the mouth of the same patient. A successfully transplanted tooth offers several advantages, given the preservation of the periodontal ligament: the proprioceptive function is maintained, the alveolar bone volume is preserved, orthodontics can be included in the treatment plan, and the dentofacial development and growth of the jaws are not impaired. Moreover, pulp regeneration and continued root development can be expected when a donor tooth with incomplete root formation is chosen and infection of the pulp tissue is prevented. [1, 2]

Successful communication in your daily practice

January 30, 2019

My dear readers, be cordially welcomed again to the series “Successful communication in your daily practice”. I am Dr Anna Maria Yiannikos, and I am in the happy position to present you the 4th part of this series filled with helpful communication protocols. This series includes the most popular and challenging scenarios that might occur at your dental practice, and how you can deal with them so that your patients always leave your practice feeling: “My dentist is THE BEST!”

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Apical lesions: To treat or not to treat?

January 25, 2019

What do endodontic experts base their decisions on: intuition, experience or CBCT imaging? The following case report on a 10-year-old patient shows that an apical lesion does not necessarily mean the affected tooth has to go. Using flexible nickel-titanium (NiTi) files, even root canals with curves or special features can be cleaned safely and with long term success.

Maxillary sinus and root canal therapy complications

January 25, 2019

The maxillary sinus is the largest paranasal sinus and overlies the maxillary alveolar process. The topographic anatomical relationship between the maxillary posterior teeth and the maxillary sinus necessitates great care in performing endodontic treatment. It has been suggested that the incidence of sinusitis of dental aetiology is increasing. One reason for this apparent increase may be the availability of improved imaging, specifically in-office cone beam computed tomography (CBCT) scanning.

Minimally invasive root canal shaping—A new protocol

January 23, 2019

Minimally invasive—the most well-known oxymoron in dentistry—is probably nowadays considered the new standard of care in almost every field of dental medicine, but more so in endodontics. Despite improved oral and dental health, the demand for endodontic treatment and restorations remains high among individuals with relatively complete dentition and dental awareness. The need for adequate endodontic treatment is most likely one of the driving forces behind all the improvements that have reached practitioners in recent years. The use of nickel-titanium (NiTi) rotary files in root canal preparation is one of those improvements and has provided a reduction in the frequency of procedural errors and the time required for chemomechanical preparation in relation to manual files.

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Incorporating CAD/CAM solutions for full-mouth dental implant reconstructions

January 16, 2019

Patients facing the loss of their natural dentition have more treatment options than ever before. The traditional complete denture, once the standard of care for the fully edentulous patient, is slowly but surely giving way to fixed full-arch implant restorations as their superior stability, function and aesthetics become more well known. Further, prosthetic materials have advanced in leaps and bounds, and monolithic zirconia can now be milled for fixed full-arch indications. By moving beyond acrylic and its vulnerability to wear, chipping, stains and fracture, this adds long-term durability to the qualities that make the fixed implant prosthesis the ultimate restorative option for fully edentulous cases.

Immediate implantation with CAD/CAM and functional restoration in the aesthetic zone

January 12, 2019

The aesthetics are always a significant challenge during implant restoration, especially in the aesthetic zone, in addition to the full consideration required regarding function. In this article, we present a case of multiple tooth fractures due to trauma. After tooth extraction, immediate implantation and guided bone regeneration (GBR) were performed. During the prosthetic procedure, the design and transfer of the emergence profile of the soft tissue, functional design and occlusal adjustment, as well as the CAD/CAM process, were satisfactorily realised to achieve the aesthetic and functional goals.

Fast, functional aesthetic solution for anterior tooth trauma

January 9, 2019

CEREC and oral surgery? In times when patients go to a practice to receive complete, aesthetic, state-of-the-art treatment as quickly as possible, I think they go together very well. I did not always think so. Certainly, CEREC was always interesting; I have used it since 2003, but I did not always find the results convincing. In 2014, I had a closer look at an event in Salzburg, Austria, and learnt two things: the system had been further developed, and in particular, the precision had been improved considerably. It fits well in my practice; I use it almost every day because I have many patients who have busy jobs and do not have much time. I experience a great workflow in the practice that gives me maximum flexibility. Depending on the indication and the patient’s wishes, I can decide whether to make the restoration myself or outsource it to a laboratory, which I often do for more elaborate bridges. Then, I send the scan directly to my partner laboratory via Sirona Connect—that is very reliable.

Immediate placement and restoration of a Straumann BLX implant replacing maxillary incisors

December 28, 2018

Placing an implant immediately after tooth extraction offers several advantages, including a reduced treatment time, fewer surgical sessions, possibility of fixed implant temporisation, and preservation of the soft-tissue contour and of the interdental papillae. Immediate implant placement into fresh extraction sites has been described as a predictable and successful procedure when proper protocols and case selection are followed. The success of immediate implant placement and the temporisation procedure relies greatly on sufficient primary stability of the implant. The latter depends on the volume of available bone beyond the root apex as classified by Kan et al. [1] and on the choice of the implant, its macro design and the drilling protocol. BLX implants (Straumann) were designed to achieve high primary stability when placed immediately after extraction.

Digital workflow and application of PRF and ozone therapy in oral rehabilitation

November 19, 2018

The digital revolution has changed the world and dental medicine is no exception. We live in the digital era: we have the materials and techniques that allow us to develop a totally digital workflow, allowing dental medicine to grow to a new level, becoming faster and more efficient, when combined with scientific and clinical knowledge. There are numerous technologies that simplify the daily work, such as intraoral, extraoral and face scanners, CBCT (cone beam computed tomography) with a low radiation dose, and software processing and production, better known as CAD/CAM (computer-aided design and manufacturing), which together with new aesthetic materials and prototyping tools (milling machines and 3-D printers) are radically transforming dental medicine. This case report has the aim of presenting an example of prosthetic digital workflow, with the integration of several technologies that help us achieve treatment success.

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Digital vs. analogue workflow on ten ceramic veneers in the maxilla

November 14, 2018

Different materials and treatment options are available in aesthetic and restorative dentistry for the anterior region. The conventional protocol, including an analogue impression with polyether or polyvinylsiloxane, a master cast and die fabrication, waxing and pressing of ceramic materials, requires exceptional skills and is technique-sensitive. Intraoral scanning and digital impression taking provide an accurate alternative method for transferring information from the mouth to the dental laboratory. The digital file is always on the computer and can be immediately processed or at any time, unlike with the conventional procedure.

Aesthetic Digital Smile Design: 2-D-/3-D-assisted communication and software design

November 12, 2018

The communication between dentist and patient is important, especially in cases of partial or complete aesthetic restoration in the anterior (smile makeover). Nowadays, it is important not only to treat oral pathology, but also to request an aesthetic evaluation of the patient’s smile to obtain results that respect the patient’s aesthetic expectation. The smile is our business card and represents the first thing that distinguishes us in human relationships, in work and in social life. It is necessary to know that a smile can appear unpleasant even if there are no evident issues or pathology, influencing people/patients’ psychologically. The clinician should understand the psychological needs of desire, perception and personality to explain in a better way the necessary therapeutics and/or aesthetic choices. When a smile is being designed, these parameters are fundamental and dependent on the communication with the patient and they should be considered in the evaluation of a 360° clinical approach. It often happens that patients are not able to identify their expectations, so dentists must be able to consider whether their exigencies can be satisfied.

Implants should only be inserted when periodontal conditions are stable

November 8, 2018

Biofilm is the most significant cause of inflammatory bone loss around teeth and implants. Diagnostics, biofilm management and, where necessary, treatment help in patients with this problem. The W&H No Implantology without Periodontology workflow should provide stable tissue prior to implantation through prevention, and implant success in the long term through aftercare—something that is advantageous to both the patient and the treatment team.

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