- Definitive Obturator Fabrication for Partial Maxillectomy Patient. [Case Reports]Case Rep Dent. 2020; 2020:6513210.CR
- Maxillectomy defects can result in oroantral communication that causes difficulty in mastication and deglutition, impaired speech, and facial disfigurement. The prosthodontist plays an important role in the rehabilitation of such defects with obturators. This paper describes a clinical report of fabricating a definitive obturator with a cast metal framework using a single flask and one-time proce…
Maxillectomy defects can result in oroantral communication that causes difficulty in mastication and deglutition, impaired speech, and facial disfigurement. The prosthodontist plays an important role in the rehabilitation of such defects with obturators. This paper describes a clinical report of fabricating a definitive obturator with a cast metal framework using a single flask and one-time processing method for an acquired maxillary defect. A tripodal design was selected for this case. Rest was placed on the premolars and molars of both quadrants of the maxilla. Complete palate as the major connector was designed to ensure maximum distribution of the functional load to the tissue. Indirect retainer was planned on the right first premolar. Direct retention was provided by the I-bar clasp placed on the left first premolar, circumferential clasp on the right first premolar, and embrasure clasp between the right first and second molars. Thus, this definitive prosthesis rehabilitated the patient by providing better masticatory efficiency, improving the clarity of speech and quality of life of the patient.
- Influence of Implant-Tooth Proximity on Incidence of Caries in Teeth Adjacent to Implants in Molar Sites: A Retrospective Radiographic Analysis of 300 Consecutive Implants. [Journal Article]Compend Contin Educ Dent. 2020 Jan; 41(1):e1-e5.CC
- Implants used to replace molar teeth present issues of space distribution and crown contours that are unique to these sites. Because the diameter of the implant typically is smaller than that of the tooth being replaced, and the circular shape of the implant does not replicate the anatomy of the tooth, a large gingival embrasure area between the implant platform and adjacent tooth often results. …
Implants used to replace molar teeth present issues of space distribution and crown contours that are unique to these sites. Because the diameter of the implant typically is smaller than that of the tooth being replaced, and the circular shape of the implant does not replicate the anatomy of the tooth, a large gingival embrasure area between the implant platform and adjacent tooth often results. Upon the review of radiographs of molar implants placed over an 11-year period in one private practice, the authors identified an unusually high incidence of approximal, cervical, and root caries on teeth adjacent to these implants. This retrospective radiographic study investigated the incidence of decay as related to: (1) the horizontal distance from the implant to the adjacent tooth (ie, the implant-tooth distance, or ITD) as measured at the alveolar crest, (2) the vertical distance from the apical portion of the prosthetic contact area to the implant platform, and (3) the presence of an existing restoration on the adjacent tooth. Of the three variables examined, both the horizontal distance of the implant to a natural tooth (ITD) and the presence of an existing restoration on an adjacent tooth proved to be significantly correlated with the incidence of decay. Results showed that incidence of decay ranges from 7.4% when the ITD is <2 mm to 40% when the ITD is ≥6 mm. The mean ITD in cases in which decay was found was 4.1 mm, and it was 3.5 mm in cases that showed no decay (P = .005). It is therefore suggested that the horizontal threshold of 4 mm be considered as the "critical ITD." The results also indicated that the presence of a previous restoration on an adjacent tooth increases the incidence of decay to a statistically significant degree with an odds ratio of 2.25 at a 95% confidence level. This information may prove useful in diagnosis and treatment planning for molar implant replacement.
- Internal porosities, retentive force, and survival of cobalt-chromium alloy clasps fabricated by selective laser-sintering. [Journal Article]J Prosthodont Res. 2020 Apr; 64(2):210-216.JP
- CONCLUSIONS: Clasps made by laser-sintering could be an alternative to conventional cast clasps for the fabrication of removable partial denture frameworks.
- Assessing the accuracy of two posterior tooth-size discrepancy prediction methods based on virtual occlusal setups. [Journal Article]Angle Orthod. 2020 03; 90(2):239-246.AO
- CONCLUSIONS: The JB analysis correctly characterized, but overestimated, the degree of posterior ITSDs corresponding to a clinically significant discrepancy in the virtual setups. Algebraically calculated posterior ITSDs based on the Overall and Anterior Bolton ratios were not accurate predictors of discrepancies observed in the virtual setups. Both Bolton and JB demonstrated weaknesses that limit precise identification of clinically significant ITSDs.
- Influence of Radius of Curvature at Gingival Embrasure in Connector Area on Stress Distribution of Three-Unit Posterior Full-Contour Monolithic Zirconia Fixed Partial Denture on Various Amounts of Load Application: A Finite Element Study. [Journal Article]J Int Soc Prev Community Dent. 2019 Jul-Aug; 9(4):338-348.JI
- CONCLUSIONS: The fracture resistance of the zirconia posterior FPD was significantly affected by the gingival embrasure radii and the mode of load application. When there is a clinical situation of heavier occlusal forces, the fracture resistance can be increased by designing greater gingival embrasure radii in the connector region.
- [Relationship of orthodontic treatment and periodontal hard tissue health]. [Journal Article]Hua Xi Kou Qiang Yi Xue Za Zhi. 2019 Aug 01; 37(4):343-349.HX
- Periodontal tissue, especially the alveolar bone, are closely associated with the progress and efficacy of orthodontic treatment. Prior to and during orthodontic treatment, dentists should fully evaluate the status of periodontal hard tissues to prevent clinical problems. This article aims to discuss bone issues associated with orthodontic treatment, including gingival papilla absence, alveolar b…
Periodontal tissue, especially the alveolar bone, are closely associated with the progress and efficacy of orthodontic treatment. Prior to and during orthodontic treatment, dentists should fully evaluate the status of periodontal hard tissues to prevent clinical problems. This article aims to discuss bone issues associated with orthodontic treatment, including gingival papilla absence, alveolar bone insufficiency, excessive cortical resistance, and altered passive eruption, etc. The mechanism and prevention methods of these problems are also described.
- Zirconia single crowns and multiple-unit FDPs-An up to 8 -year retrospective clinical study. [Journal Article]J Dent. 2018 12; 79:96-101.JD
- CONCLUSIONS: Zirconia crowns and FDPs survived well in this retrospective follow-up study. Chipping of veneering ceramic and bleeding on probing were the most common complications. Thick connector areas made according to material demands resulted in insufficient embrasure spaces and inflammation of marginal gingiva.
- Efficacy, Safety and Patient Preference of Knotted Floss Technique in Type I Gingival Embrasures. [Randomized Controlled Trial]J Dent Hyg. 2019 Feb; 93(1):52-62.JD
- CONCLUSIONS: KF is as effective and safe as an inter-dental oral hygiene technique for reducing plaque biofilm and gingival inflammation and bleeding, as compared to CF in Type I gingival embrasures, when both were used in conjunction with regular tooth-brushing. KF was shown to be better than CF in in terms of improved plaque biofilm scores.
- Load-Bearing Capacity of Monolithic Zirconia Fixed Dental Prostheses Fabricated with Different Connector Designs and Embrasure Shaping Methods. [Journal Article]J Prosthodont. 2019 Jan; 28(1):64-70.JP
- CONCLUSIONS: Sharp embrasures and interproximal separations made with diamond discs significantly decrease the load-bearing capacity of monolithic zirconia FDPs compared to FDPs made with blunt embrasures. Blunt embrasures in combination with localized porcelain build-up produce FDPs with high load-bearing capacity in relation to loads that might be expected under clinical use.
- Comparison of Erich arch bar versus embrasure wires for intraoperative intermaxillary fixation in mandibular fractures. [Journal Article]Oral Maxillofac Surg. 2018 Dec; 22(4):419-428.OM
- CONCLUSIONS: Embrasure wire technique is a quick, easy, and reliable technique for minimally or moderately displaced fractured mandible and had better clinical outcomes than did patients that underwent the Erich arch bar technique.
- Details of pleasing smiles. [Journal Article]Int J Esthet Dent. 2018; 13(4):494-514.IJ
- CONCLUSIONS: The following characteristics were observed from the selected most attractive smiles: parallel smile arc, oval-shaped incisors with square-rounded edges, increase of the incisal embrasure and reduction of connector space in distal progression, display of maxillary incisors and minimum display of mandibular teeth, gingival margin of central incisors 0.5 mm coronal to the canines and 0.8 mm apical to the lateral incisors, posterior gingival display of 1.5 mm, less than 20% of buccal corridor and display of 12 teeth, and canines with -2 degrees of inclination. The most attractive smiles also had an absence of asymmetries, diastemas, black spaces, incisal plane inclination, and anterior gingival display.
- Papilla reconstruction: Interdisciplinary consideration for clinical success. [Case Reports]J Esthet Restor Dent. 2018 11; 30(6):484-491.JE
- One of the most difficult achievements in the periodontal therapy is the reconstruction of interdental papilla that has been lost by periodontal disease. The poor esthetic appearance caused by the "black triangle," especially in the maxillary anterior region has been a concern for both patients and professionals. However, when the papilla destruction is followed by loss of contact point, the use …
One of the most difficult achievements in the periodontal therapy is the reconstruction of interdental papilla that has been lost by periodontal disease. The poor esthetic appearance caused by the "black triangle," especially in the maxillary anterior region has been a concern for both patients and professionals. However, when the papilla destruction is followed by loss of contact point, the use of different specialties is usually necessary to restore the interproximal embrasure. This clinical case report describes an interdisciplinary (periodontic-orthodontic-restorative) approach for the treatment of a patient with severe case of papilla destruction in an esthetic zone. The patient's esthetic expectations for the anterior maxilla were met through phase I treatment, including the surgical reconstruction of the papillary complex and the orthodontic movement to restore the contact point. However, after the initial treatment was successfully concluded, the long-term stability of the result was compromised as the intercommunication among the specialists was not coordinated. CLINICAL SIGNIFICANCE: The treatment plan that involves interdisciplinary teamwork should be followed by an understanding about the principles of the specialties as well the intercommunication among specialists.
- Comparative Evaluation of the Embrasure Wire versus Arch Bar Maxillomandibular Fixation in the Management of Mandibular Fractures: Are Arch Bars Replaceable? [Journal Article]Craniomaxillofac Trauma Reconstr. 2018 Jun; 11(2):118-123.CT
- The aim of this prospective study was to appraise the role of embrasure wiring in the treatment of mandibular fractures over the arch bar as adjunctive techniques of maxillomandibular fixation (MMF). This study was conducted on 40 patients who were surgically treated for mandibular fractures with accessory use of MMF (embrasure: group A vs. arch bars: group B). All patients were evaluated for dem…
The aim of this prospective study was to appraise the role of embrasure wiring in the treatment of mandibular fractures over the arch bar as adjunctive techniques of maxillomandibular fixation (MMF). This study was conducted on 40 patients who were surgically treated for mandibular fractures with accessory use of MMF (embrasure: group A vs. arch bars: group B). All patients were evaluated for demographic data, etiology, and location of fracture. Characteristically, the complications, including wire injury, infection, and malocclusion, were recorded. The data were analyzed using Student's t -test and chi-square test as appropriate. Statistical significance was set at p < 0.05). In this study, data from 40 patients were included. In group A (embrasure wiring), time required for placement of MMF was significantly less than (7.85 ± 0.81 minutes) that in group B, and also there was less incidence of wire prick to the operator in group A than in group B (p < 0.05). However, in terms of wire prick and malocclusion, no statistically significant difference was noted in groups A and B (p > 0.05). Patient treated with embrasure wiring intermaxillary fixation had better outcomes especially in terms of time of placement and less incidence of wire prick injury when compared with arch bar.
- Correlation between Dentofacial Esthetics and Mental Temperament: A Clinical Photographic Analysis Using Visagism. [Journal Article]Contemp Clin Dent. 2018 Jan-Mar; 9(1):83-87.CC
- CONCLUSIONS: Although the concept of combining the principles of smile design and mental temperaments through visagism is an appreciable idea, it lacks a practical approach to create a personalized smile for each patient by including mental temperaments at present stage.
- Papilla height in relation to the distance between bone crest and interproximal contact point at single-tooth implants: A systematic review. [Review]Clin Oral Implants Res. 2018 Mar; 29 Suppl 15:50-61.CO
- CONCLUSIONS: There is limited evidence that the vertical distance from the base of the interproximal contact point to the crestal bone level seems to affect the interproximal papilla height; that is, the lower is the distance the higher is the percentage of papilla fill. Complete embrasure fill between an implant restoration and the adjacent tooth seems to be correlated with the integrity of the periodontal ligament of the tooth. To reduce the risk of aesthetic failures, interproximal probing on the adjacent teeth should be encouraged before implant placement.
- Risk factors associated with open gingival embrasures after orthodontic treatment. [Journal Article]Angle Orthod. 2018 May; 88(3):267-274.AO
- CONCLUSIONS: The incidence of open gingival embrasures following orthodontic tooth movement is high. Therefore, attention should be paid to the contributing factors to prevent or reduce the occurrence of open gingival embrasures.
- Dental occlusion ties: A rapid, safe, and non-invasive maxillo-mandibular fixation technology. [Journal Article]Laryngoscope Investig Otolaryngol. 2017 08; 2(4):178-183.LI
- CONCLUSIONS: Dental occlusion ties offer a non-invasive solution featuring operating room efficiency, minimized sharps risk, and less bony and soft tissue trauma than current commercialized solutions.
- Size discrepancies in molars and first key to optimal occlusion. [Journal Article]Eur J Dent. 2017 Apr-Jun; 11(2):250-252.EJ
- CONCLUSIONS: Clinicians have to understand that tooth size discrepancies do exist in patients and that these discrepancies make the completion of a perfect case challenging.
- Local Injection of Hyaluronic Acid Filler Improves Open Gingival Embrasure: Validation Through a Rat Model. [Journal Article]J Periodontol. 2017 11; 88(11):1221-1230.JP
- CONCLUSIONS: Open gingival embrasure was reproduced reliably in vivo. Local injection of HA filler was validated as a meaningful minimally invasive procedure to improve open gingival embrasure.
- Esthetic Reconstruction of Diastema with Adhesive Tooth-Colored Restorations and Hyaluronic Acid Fillers. [Case Reports]Case Rep Dent. 2017; 2017:5670582.CR
- CONCLUSIONS: Esthetic reconstruction of diastema and open gingival embrasure in this case can be accomplished without orthodontic retreatment. Tooth-colored restorations and HA filler injection appear as a promising modality to address this patient's esthetic concern.
- Morphological Simulation of Different Incisal Embrasures: Perception of Laypersons, Orthodontic Patients, General Dentists and Orthodontists. [Journal Article]J Esthet Restor Dent. 2017 Feb; 29(1):68-78.JE
- CONCLUSIONS: The form of the incisal embrasures associated with gingival display influenced the evaluators' esthetic perception. There was a statistically significant difference between the groups of patients and orthodontists.Incisal embrasures play an important role in smile esthetics and influence the attractiveness perception. In general, the semi-rounded embrasure form is the most preferred. Different groups' perceptions on tooth morphology reinforce the importance of patient participation in treatment planning. (J Esthet Restor Dent 29:68-78, 2017).
- [Relationship between crown form of upper central incisors and papilla filling in Chinese Han-nationality youth]. [Journal Article]Beijing Da Xue Xue Bao Yi Xue Ban. 2016 10 18; 48(5):866-870.BD
- CONCLUSIONS: The proportion of clinical crown form of upper central incisor in Chinese Han-nationality youth is obtained. Compared with triangle form, square form is found to favor a gingival papilla that fills the interproximal embrasure space. The consistency of the present classification method for upper central incisor is not satisfying, which indicates that a new classification method, more scientific and objective than the present one, is to be found.
- Association between the central papilla and embrasure crown morphology in different gingival biotypes - a cross-sectional study. [Journal Article]Int J Esthet Dent. 2016; 11(4):550-563.IJ
- CONCLUSIONS: In relation to the maxillary central incisors, the crown and embrasure morphologies have a strong influence over the presence of a central papilla. (Int J Esthet Dent 2016;11:550-563).
- The association between radiographic embrasure morphology and interdental papilla reconstruction using injectable hyaluronic acid gel. [Journal Article]J Periodontal Implant Sci. 2016 Aug; 46(4):277-87.JP
- CONCLUSIONS: These results suggest that the CP-BC is closely related to the efficacy of hyaluronic acid gel injection for interdental papilla reconstruction.
- Fracture behavior of inlay and onlay fixed partial dentures - An in-vitro experimental and XFEM modeling study. [Journal Article]J Mech Behav Biomed Mater. 2016 06; 59:279-290.JM
- CONCLUSIONS: The fracture load and cracking path were found to be very sensitive to loading position in the all-ceramic inlay and onlay FPDs. The study provides a basis for improved understanding on the role of localized contact loading of the cusp surface in all-ceramic FPDs.
- Mandibular and dental characteristics of Late Triassic mammaliaform Haramiyavia and their ramifications for basal mammal evolution. [Historical Article]Proc Natl Acad Sci U S A. 2015 Dec 22; 112(51):E7101-9.PN
- As one of the earliest-known mammaliaforms, Haramiyavia clemmenseni from the Rhaetic (Late Triassic) of East Greenland has held an important place in understanding the timing of the earliest radiation of the group. Reanalysis of the type specimen using high-resolution computed tomography (CT) has revealed new details, such as the presence of the dentary condyle of the mammalian jaw hinge and the …
As one of the earliest-known mammaliaforms, Haramiyavia clemmenseni from the Rhaetic (Late Triassic) of East Greenland has held an important place in understanding the timing of the earliest radiation of the group. Reanalysis of the type specimen using high-resolution computed tomography (CT) has revealed new details, such as the presence of the dentary condyle of the mammalian jaw hinge and the postdentary trough for mandibular attachment of the middle ear-a transitional condition of the predecessors to crown Mammalia. Our tests of competing phylogenetic hypotheses with these new data show that Late Triassic haramiyids are a separate clade from multituberculate mammals and are excluded from the Mammalia. Consequently, hypotheses of a Late Triassic diversification of the Mammalia that depend on multituberculate affinities of haramiyidans are rejected. Scanning electron microscopy study of tooth-wear facets and kinematic functional simulation of occlusion with virtual 3D models from CT scans confirm that Haramiyavia had a major orthal occlusion with the tallest lingual cusp of the lower molars occluding into the lingual embrasure of the upper molars, followed by a short palinal movement along the cusp rows alternating between upper and lower molars. This movement differs from the minimal orthal but extensive palinal occlusal movement of multituberculate mammals, which previously were regarded as relatives of haramiyidans. The disparity of tooth morphology and the diversity of dental functions of haramiyids and their contemporary mammaliaforms suggest that dietary diversification is a major factor in the earliest mammaliaform evolution.
- Food Impaction and Periodontal/Peri-Implant Tissue Conditions in Relation to the Embrasure Dimensions Between Implant-Supported Fixed Dental Prostheses and Adjacent Teeth: A Cross-Sectional Study. [Journal Article]J Periodontol. 2015 Dec; 86(12):1314-20.JP
- CONCLUSIONS: Food impaction between implant-supported FDPs and adjacent teeth occurred more frequently when proximal contact was lost and ESA increased. Food impaction negatively affected overall patient satisfaction. Embrasure dimensions influenced the periodontal/peri-implant mucosal conditions and bone level at the implant.
- Numerical simulation of the fracture process in ceramic FPD frameworks caused by oblique loading. [Journal Article]J Mech Behav Biomed Mater. 2015 Oct; 50:206-14.JM
- Using a newly developed three-dimensional (3D) numerical modeling code, an analysis was performed of the fracture behavior in a three-unit ceramic-based fixed partial denture (FPD) framework subjected to oblique loading. All the materials in the study were treated heterogeneously; Weibull׳s distribution law was applied to the description of the heterogeneity. The Mohr-Coulomb failure criterion wi…
Using a newly developed three-dimensional (3D) numerical modeling code, an analysis was performed of the fracture behavior in a three-unit ceramic-based fixed partial denture (FPD) framework subjected to oblique loading. All the materials in the study were treated heterogeneously; Weibull׳s distribution law was applied to the description of the heterogeneity. The Mohr-Coulomb failure criterion with tensile strength cut-off was utilized in judging whether the material was in an elastic or failed state. The simulated loading area was placed either on the buccal or the lingual cusp of a premolar-shaped pontic with the loading direction at 30°, 45°, 60°, 75° or 90° angles to the occlusal surface. The stress distribution, fracture initiation and propagation in the framework during the loading and fracture process were analyzed. This numerical simulation allowed the cause of the framework fracture to be identified as tensile stress failure. The decisive fracture was initiated in the gingival embrasure of the pontic, regardless of whether the buccal or lingual cusp of the pontic was loaded. The stress distribution and fracture propagation process of the framework could be followed step by step from beginning to end. The bearing capacity and the rigidity of the framework vary with the loading position and direction. The framework loaded with 90° towards the occlusal surface has the highest bearing capacity and the greatest rigidity. The framework loaded with 30° towards the occlusal surface has the least rigidity indicating that oblique loading has a major impact on the fracture of ceramic frameworks.
- Missing upper incisors: a retrospective study of orthodontic space closure versus implant. [Journal Article]Prog Orthod. 2015 Feb 25; 16:2.PO
- CONCLUSIONS: Orthodontic space closure and implant of missing maxillary incisors produced similar, well-accepted esthetic results. None of the treatments impaired temporomandibular joint function. Nevertheless, infraocclusion was evident in implant patients. Space closure patients also showed better periodontal health in comparison with implant patients.
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- Gingival Embrasure Fill In Fixed Implant-Supported Prosthetics: A Review. [Review]J Oral Implantol. 2015 Dec; 41(6):e297-300.JO
- After provisional or definitive cementation of fixed implant-supported prostheses, spontaneous gingival proliferation may occur to fill the cervical embrasure areas of the prosthesis. Adequate oral hygiene, osseous spacing between the supporting implants and attached or immovable soft tissue may be the conditions that allow this phenomenon. This proliferation embrasure fill eliminates interproxim…
After provisional or definitive cementation of fixed implant-supported prostheses, spontaneous gingival proliferation may occur to fill the cervical embrasure areas of the prosthesis. Adequate oral hygiene, osseous spacing between the supporting implants and attached or immovable soft tissue may be the conditions that allow this phenomenon. This proliferation embrasure fill eliminates interproximal gingival voids, that is, black triangles, and makes the outcome more esthetically acceptable. Since interproximal prosthetic deign and implant positioning may be the primary factors for the fill, the gingival fill may be, in fact, an epulis.