This document summarizes research on esthetic restorations for anterior primary (baby) teeth. It discusses various restoration options like stainless steel, composite strip crowns, and preformed metal crowns. It also describes restoring teeth with severe decay using posts and composites. Alternative fixed and removable esthetic options are evaluated. Biological restorations using natural tooth fragments as crowns and posts are described as providing excellent esthetics, function and preserving tooth structure, though obtaining matching fragments can be difficult. Overall, the document evaluates different esthetic restoration techniques for restoring decayed primary anterior teeth.
In the last decade or so dentistry has undergone a complete image makeover with dentists no longer being associated only with pain relief or disease management only. Today more and more patients seek dental treatment for restoring or even enhancing the smile. Pediatric dentistry with its unique challenge of managing little children has had overcome the traditional mindset of parents that deciduous teeth are temporary and they do not warrant treatment.
Greater awareness towards oral health as well as an understanding by the parents that decay in their child’s front teeth may rob the child of his/her smile has ensured that pediatric dentistry has jumped onto the “aesthetic bandwagon.”
Due to the complex morphology of the root canal system in primary teeth, the clinician must rely primarily on chemical cleansing and sterilization and secondarily on mechanical instrumentation during pulpectomy procedure.
And in order to increase the chance of success of the endodontic treatment, substances with antimicrobial properties are frequently used as root canal filling materials in deciduous teeth
In the last decade or so dentistry has undergone a complete image makeover with dentists no longer being associated only with pain relief or disease management only. Today more and more patients seek dental treatment for restoring or even enhancing the smile. Pediatric dentistry with its unique challenge of managing little children has had overcome the traditional mindset of parents that deciduous teeth are temporary and they do not warrant treatment.
Greater awareness towards oral health as well as an understanding by the parents that decay in their child’s front teeth may rob the child of his/her smile has ensured that pediatric dentistry has jumped onto the “aesthetic bandwagon.”
Due to the complex morphology of the root canal system in primary teeth, the clinician must rely primarily on chemical cleansing and sterilization and secondarily on mechanical instrumentation during pulpectomy procedure.
And in order to increase the chance of success of the endodontic treatment, substances with antimicrobial properties are frequently used as root canal filling materials in deciduous teeth
PIT AND FISSURE SEALANTS- PUBLIC HEALTH DENTISTRYANKUSHA ARORA
Introduction
Definition
Morphology of Pits and fissures
Types of Pit and fissure sealants
Materials used as sealants
Requirements of sealants
Diagnosis of Pit and Fissure caries
Procedure of application of sealants
Indications
Contra-indications
Factors affecting sealant retention in mouth
Summary
We in Chinthamani Laser Dental Clinic & Implant Centre ,cover every speciality and subspeciality in dentistry so that all kind of your dental problems can be treated efficiently and effectively.
Contact us:
Chinthamani Laser Dental Clinic & Implant Centre
1/464,Mount Poonamallee High Road,
Iyyapanthangal,
Chennai-56
Phone no.044-43800059 , 92 83 786776
Email:
chinthamanidental@gmail.com,
dr_mrgvl@gmail.com
Website:
www.chinthamanilaserdentalclinic.com
The concept of a dental home, however, is too new to have been studied as a predictor of oral health.In 1999,Nowak described the term in relation to the desired recurrence of preventive oral health supervisory services as propagated by the American Academy of Pediatric Dentistry.
The human body contains elements that can be classified as
abundant elements trace elements
What are the trace elements
Essential trace element
Biological Significance of Trace Elements
Early childhood caries (ECC) as the presences of one or more decayed (noncavitated or cavitated), missing (as a result of caries), or filled tooth surface in any primary tooth in a child 71 months of age or younger.
There have been several changes since inception in the field of dental ceramics. Need for newer materials with improved aesthetics, flexural strength and optical properties made it necessary for introduction of advanced technology in fabrication of dental ceramics.
PIT AND FISSURE SEALANTS- PUBLIC HEALTH DENTISTRYANKUSHA ARORA
Introduction
Definition
Morphology of Pits and fissures
Types of Pit and fissure sealants
Materials used as sealants
Requirements of sealants
Diagnosis of Pit and Fissure caries
Procedure of application of sealants
Indications
Contra-indications
Factors affecting sealant retention in mouth
Summary
We in Chinthamani Laser Dental Clinic & Implant Centre ,cover every speciality and subspeciality in dentistry so that all kind of your dental problems can be treated efficiently and effectively.
Contact us:
Chinthamani Laser Dental Clinic & Implant Centre
1/464,Mount Poonamallee High Road,
Iyyapanthangal,
Chennai-56
Phone no.044-43800059 , 92 83 786776
Email:
chinthamanidental@gmail.com,
dr_mrgvl@gmail.com
Website:
www.chinthamanilaserdentalclinic.com
The concept of a dental home, however, is too new to have been studied as a predictor of oral health.In 1999,Nowak described the term in relation to the desired recurrence of preventive oral health supervisory services as propagated by the American Academy of Pediatric Dentistry.
The human body contains elements that can be classified as
abundant elements trace elements
What are the trace elements
Essential trace element
Biological Significance of Trace Elements
Early childhood caries (ECC) as the presences of one or more decayed (noncavitated or cavitated), missing (as a result of caries), or filled tooth surface in any primary tooth in a child 71 months of age or younger.
There have been several changes since inception in the field of dental ceramics. Need for newer materials with improved aesthetics, flexural strength and optical properties made it necessary for introduction of advanced technology in fabrication of dental ceramics.
Stainless steel crowns in Pediatric DentistryRajesh Bariker
A crown is a tooth shaped covering which is cemented to the tooth structure & its main function is to protect the tooth structure & retain the function
This was a presentation that was carried out in our research method class by our group. It will be useful for PHD and master students quantitative and qualitative method. It consist sample definition, purpose of sampling, stages in the selection of a sample, types of sampling in quantitative researches, types of sampling in qualitative researches, and ethical Considerations in Data Collection.
Pre prosthetic orthodontic implant for management of congenitally unerupted l...Abu-Hussein Muhamad
The maxillary lateral incisor is one of the most common congenitally missing teeth of the permanent dentition. With the advent of implants in the field of restorative dentistry, a stable and predictable fixed prosthetic replacement has become a reality, especially for young adult patients who suffer from congenital absence of teeth. The dual goals of establishment of functional stability as well as enhancement of esthetic outcomes are made achievable by the placement of implants. A multidisciplinary team approach involving the triad of orthodontist, periodontist and restorative dentist will ensure the successful completion of the integrated treatment approach in these patients. The present case report achieved successful implant based oral rehabilitation in a patient diagnosed with congenital absence of bilateral maxillary lateral incisors utilizing a preprosthetic orthodontic implant site preparation for the purpose of space gain.
Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...Abu-Hussein Muhamad
The maxillary lateral incisor is one of the most common congenitally missing teeth of the permanent
dentition. With the advent of implants in the field of restorative dentistry, a stable and predictable fixed
prosthetic replacement has become a reality, especially for young adult patients who suffer from congenital
absence of teeth. The dual goals of establishment of functional stability as well as enhancement of esthetic
outcomes are made achievable by the placement of implants. A multidisciplinary team approach involving the
triad of orthodontist, periodontist and restorative dentist will ensure the successful completion of the integrated
treatment approach in these patients. The present case report achieved successful implant based oral
rehabilitation in a patient diagnosed with congenital absence of bilateral maxillary lateral incisors utilizing a
preprosthetic orthodontic implant site preparation for the purpose of space gain.
Keywords: Preprosthetic, interdisciplinary treatment, implant placement
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations
Strip Crowns Technique for Restoration of Primary Anterior Teeth: Case ReportAbu-Hussein Muhamad
Dental caries is the single most common chronic childhood disease affecting worldwide. In early childhood caries, there is early pulp involvement and gross destruction of maxillary anterior teeth as well as posterior teeth. Treatment of such caries represents a challenge to pediatric dentists especially, when teeth are badly destroyed. By the time the dentist sees the child, most of the coronal structure is lost. This case report describes challenging task of a Case of early childhood caries patients with mutilated maxillary incisors restored with a strip form composite restorations.
Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an
esthetic and functional restorative treatment. . Fixed prosthodontic and removable prostheses, resin bonded retainers, orthodontic movement of maxillary
canine to the lateral incisor site and single tooth implants represent the available treatment modalities to replace congenitally missing teeth. This case report
demonstrates the team approach in prosthetic and surgical considerations and techniques for managing the lack of lateral incisors. The aims of this case
report of replacement of bilaterally congenitally missing maxillary lateral incisors with dental implants.
Interdisciplinary Management Of Maxillary Lateral IncisorsAbu-Hussein Muhamad
Abstract: Orthodontic management for patients with single or bilateral congenitally missing permanent lateral incisors is a challenge to effective treatment planning. Over the last several decades, dentistry has focused on several treatment modalities for replacement of missing teeth. The two major alternative treatment options are orthodontic space closure or space opening for prosthetic replacements. For patients with high aesthetic expectations implants are one of the treatment of choices, especially when it comes to replacement of missing maxillary lateral incisors and mandibular incisors. Edentulous areas where the available bone is compromised to use conventional implants with 2,5 mm or more in diameter, narrow diameter implants with less than 2,5 mm diameter can be successfully used. This case report deals with managing a compromised situation in the region of maxillary lateral incisor using a narrow diameter implant. Key words: Orthodontics, Correction of unilateral missing maxillary lateral incisors. Minimal invasive technique, narrow diameter implant
Prosthodontic-Orthodontic Treatment Plan with Two-Unit Cantilevered Resin-Bon...Abu-Hussein Muhamad
Abstract: Congenitally missing lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. Selecting the appropriate treatment option depends on many factors, such us the malocclusion, the anterior relationship, specific space requirements, bone volume, root proximity, the condition of the adjacent teeth, and esthetic prediction mainly when the canine must be reshaped.Resin bonded bridges were considered to be doomed owing to their very high decementation rate, have come alive once again because of newer resin based cements. This article will discuss the variety of treatment managements in case of space opening and treated with two 2-unit cantilevered resin-bonded fixed partial dentures supported by the cuspids. This conservative treatment plan was cost-effective without having any significant biological cost. Keywords: Agenesis, Resin- bonded fixed partial denture, interim prosthesis.
Prosthodontic-Orthodontic Treatment Plan with Two-Unit Cantilevered Resin-Bon...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Interdisciplinary Management of Congenitally Agenesis Maxillary Lateral Incis...Abu-Hussein Muhamad
Abstract: The present paper reports the treatment of a young adult woman with congenitally missing maxillary lateral incisors who underwent orthodontic treatment for improvement of teeth alignment and occlusal balance previous to dental implant surgery. This treatment also allowed appropriate space for the future lateral incisors crowns. Then, Implants were positioned and prosthetic abutments installed. Ceramic laminates were planned on central incisors in order to improve anterior aesthetics. All-ceramic crowns and laminates were made using lithium dissilicate-based ceramic The multidisciplinary association of orthodontic, implant and prosthetic techniques resulted in successful functional and aesthetic rehabilitation of the case, which was maintained after 1 year follow up. Keywords: Dental agenesis. Dental implants. Ceramic laminates. Esthetic.
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Implants are a viable option for replacement of congenitally missing lateral incisors and should be considered before the commencement of definitive treatment plan. Early diagnosis, and proper planning can achieve excellent aesthetics. Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic result for a most predictable outcome. This article aims to present a case report of replacement of bilaterally ,congenitally missing maxillary lateral incisors with dental implants .
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Implants are a viable option for replacement of congenitally missing lateral incisors and should be considered before the commencement of definitive treatment plan. Early diagnosis, and proper planning can achieve excellent aesthetics.
Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic result for a most predictable outcome. This article aims to present a case report of replacement of bilaterally ,congenitally missing maxillary lateral incisors with dental implants .
Copy of dentin bonding agents1/ rotary endodontic courses by indian dental ac...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Unilateral Maxillary Lateral Incisor Agenesis with Mini Implant Prostheses: A...Abu-Hussein Muhamad
Orthodontic management for patients with single or bilateral congenitally missing permanent lateral incisors is a
challenge to effective treatment planning. Over the last several decades, dentistry has focused on several treatment
modalities for replacement of missing teeth. The two major alternative treatment options are orthodontic space
closure or space opening for prosthetic replacements. For patients with high aesthetic expectations implants are one
of the treatment of choices, especially when it comes to replacement of missing maxillary lateral incisors and
mandibular incisors. Edentulous areas where the available bone is compromised to use conventional implants with
2.5 mm or more in diameter, narrow diameter implants with less than 2.5 mm diameter can be successfully used.
This case report deals with managing a compromised situation in the region of maxillary lateral incisor using a
narrow diameter implant.
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations.
Impacted Maxillary Central Incisors: Surgical Exposure and Orthodontic Treat...Abu-Hussein Muhamad
The maxillary permanent central incisor develops early in life and forms part of an aesthetic smile. Disruption of the formation or eruption of the permanent
central incisor has multiple etiological factors. Treatment options depend to some extent on the cause of failure of eruption of the central incisor. Generally,
the earlier treatment is provided, the higher the likelihood of success and the less the complexity. Our results suggest that close monitoring and interdisciplinary
cooperation during the treatment phases led to a successful esthetic result, with good periodontal health and functional occlusion.
Excess of space in the dental arch is diagnosed as a
generalised spacing or a local divergence, often
observed in the maxillary anterior region, as a median
diastema, traumatic loss of central incisors, or
congenital absence of lateral incisors. Furthermore,
spacing is observed in aging individuals, due to
pathological migration of teeth caused by
periodontitis. Finally, adult individuals with partial
edentulous jaws demand pre-prosthetic orthodontic
treatment from functional aspects. Thus, indication for
orthodontic treatment in subjects with spacing of teeth
exists for aesthetic reasons, but also for facilitating
prosthetic restorations with optimal occlusalstability.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting
cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically
induced failures, since low primary implant stability, low bone density, short implants and overload have been
identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a
successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field.
Orthodontic tooth movement is basically a biologic response towards a mechanical force. Osteoclast and osteoblast cells mediate bone resorption and apposition, which eventually produces tooth movement. Researches showed that the rate of orthodontic tooth movement can be altered by certain drugs locally or systemically. The Objective of this article is to discuss the current data concerning the effect of drugs on orthodontic tooth movement.
Multidisciplinary Approach in the Rehabilitation of Congenitally Maxillary C...Abu-Hussein Muhamad
Objective: This case report describes the multidisciplinary
approach to treat a congenitally missed maxillary canine, how to
improve patient’s smile using orthodontic fixed appliance, endosseous
dental implant, and porcelain veneer to achieve the treatment results of
function and esthetic.
Materials and procedures: Unilateral agenesis of the permanent
maxillary canines in healthy individuals is extremely rare. This
paper presents the case of a female patient diagnosed with congenital
unilateral agenesis of the permanent maxillary canines as well as
occlusal abnormalities in the form of left-side crossbite. To restore the
proper aesthetics and function, interdisciplinary therapeutic treatment
was implemented. In the case presented in this paper, the aim of
oral rehabilitation was to restore a functional balance by obtaining
proper skeletal relationships, creating optimal occlusal conditions and
obtaining arch continuity.
Conclusion: Interdisciplinary treatment combined of orthodontics,
implant surgery, and prosthodontics was useful to treat a nonsyndromic
oligodontia patient. Especially, with the new strategy, implantanchored
orthodontics, which can facilitate the treatmentand make it
more simply with greater predictability.
The multifactorial factors influenc cleft Lip-literature review Abu-Hussein Muhamad
Congenital cleft-Lip and cleft palate have been the subject of many genetic
studies, but until recently there has been no consensus as to their modes of
inheritance. In fact, claims have been made for just about every genetic
mechanism one can think of. Recently, however, evidence has been
accumulating that favors a multifactorial basis for these malformations. The
purpose of the present paper is to present the etiology of cleft lip and cleft palate
both the genetic and the environmental factors. It is suggested that the genetic
basis for diverse kinds of common or uncommon congenital malformations may
very well be homogeneous, whilst, at the same, the environmental basis is
heterogeneous.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically induced failures, since low primary implant stability, low bone density, short implants and overload have been identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field
Over time, progressively shorter implants have been placed such that short implants are now available that are less than 6 mm in length. The viability and high success rates seen with short implants can be explained by osseointegration, the macro geometric design of the implant, as well as physics and the distribution of forces. This paper was aimed to review the stability and survival rate of short implants under functional loads. Numerical and clinical studies were reviewed. Keywords: Short dental implants, sinus augmentation, factors affecting bone regeneration in dental implantology
Porcelain laminate veneers are among the most esthetic means of creating a more pleasing and beautiful smile. Porcelain veneers within reason allow for the alteration of tooth position, shape, size and color. They require a minimal amount of tooth preparation, approximately 0.5 mm to 0.7mm of surface enamel reduction. This study describes the use of ceramic veneers without tooth wear, reinforcing the concept that minimally invasive porcelain laminate veneers could become versatile and conservative allies in the fi eld of esthetic dentistry. Keywords: Ceramics, dentin-bonding agents, esthetics
Immediate Restoration of Single Implants Replacing Lateral Incisor Compromis...Abu-Hussein Muhamad
Today, the diagnosis of internal root resorption is significantly improved by the three-dimensional imaging. Furthermore, the CBCT’s superior diagnosis accuracy resulted in an improved management of the resorptive defects and a better outcome of Implant therapy of teeth with internal resorption.Implant has become a wide option to maintain periodontal architecture. Diagnosis and treatment planning is the key factors in achieving the successful outcomes after placing and restoring implants placed immediately after tooth extraction. The purpose of this clinical update is to report on the success and survival of Immediate restoration of single implants replacing right lateral incisor compromised by internal resorption.
Immediate Implant Placement And Restoration With Natural Tooth In The Maxilla...Abu-Hussein Muhamad
Anterior tooth loss and restoration in the esthetic zone is a common challenge in dentistry today. The prominent visibility of the area can be especially distressing to the patient and requires a timely and esthetically pleasing solution. Immediate single-tooth implantation followed by immediate provisionalization is becoming an increasingly desirable treatment that offers numerous benefits over conventional delayed loading. Provisionalization for immediately-placed implants using the patient’s existing tooth can enhance the final aesthetic outcome if certain steps are
followed. If the natural tooth is intact and can be used as a provisional, the emergence profile can be very similar to the preoperative condition. This article outlines a technique to use the patient’s natural tooth after extraction to provisionalize an implant.
Clinical Management of Bilateral Impacted Maxillary CaninesAbu-Hussein Muhamad
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive
approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the
dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines
treated with surgical exposure and orthodontic treatment.
Material and Methods: A 15year-old female with various degrees of bilateral palatal impaction of maxillary canines were managed
by the described technique.
Results and Discussion: Autonomous eruption of the impacted canines after surgical uncovering was witnessed in all patients
without the need for application of a vertical orthodontic force for their extrusion.
Conclusion: The described method of surgical uncovering and autonomous eruption created conditions for biological eruption of the
palatally impacted canines into the oral cavity and facilitated considerably the subsequent orthodontic treatment for their proper alignment
in the dental arch.
Keywords: Impacted canines; Surgical; Tooth exposure; Orthodontic treatment
“One-Piece” Immediate-Load Post-Extraction Implant In Maxillary Central IncisorAbu-Hussein Muhamad
Abstract: This case report describes extraction of a fractured left maxillary central incisor tooth, followed by immediate placement of an one-piece implant in the prepared socket and temporization by a bonded restoration.
Materials And Methods: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. The socket was prepared to the required depth and a Implant was inserted.
Results: The atraumatic operating technique and the immediate insertion of the one-piece Implant resulted in the preservation of the hard and soft tissues at the extraction site.
Conclusion: The “One-piece” dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort and most importantly preservation of tissues. The one-piece implant design resulted in a high cumulative implant survival rate and beneficial marginal bone levels.
Single Visit Replacement of Central Maxillary Using Fiber-Reinforced Composi...Abu-Hussein Muhamad
Fiber reinforced composites are high strength filling materials composed of conventional composites and glass fibres. They exhibit extensive applications in different fields of dentistry. This clinical report present a case where FRC technology was successfully used to restore central maxillary incisor edentulous area in terms of esthetic-cosmetic values and functionality.
Zirconium Dental Implants And Crown for Congenitally Missing Maxillary Latera...Abu-Hussein Muhamad
Zirconia implants were familiarized into dental implantology. Zirconia appears
to be an appropriate implant material due to its low plaque affinity, tooth like color, biocompatibility and mechanical properties. The following a case presentations will show how the acid-etched zirconia Implant can be used to functionally and aesthetically replace congenitally missing left lateral incisor tooth germ in the maxilla, and achieve optimal soft tissues and health.
Surgery of Labially Impacted Canine & Orthodontic Management – A Case ReportAbu-Hussein Muhamad
Maxillary canines are one of the most common teeth that are impacted among patients seeking orthodontic treatment. Depending on the position of these impacted teeth, various surgical techniques have been employed for their exposure. His primary goal of surgical phase is to provide the means for correct position of orthodontic anchorage. Additionally, the technique used must ensure favorable tissue anatomy that will permit long-term maintenance of periodontal health. In the present case, a labially impacted maxillary left canine was surgically exposed using an apically positioned flap. Orthodontic extrusion was carried out further.
Taurodontism is a rare dental anomaly in which the involved tooth has an enlarged and elongated body and pulp chamber
with apical displacement of the pulpal floor. Endodontic treatment of a taurodont tooth is challenge to a clinician and
requires special handling because of the proximity and apical displacement of the roots. The present article describes the
diagnosis and management of hypertaurodontism by endodontic treatment in a left mandibular second molar.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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1. International Journal of Public Health Research
2014; X(X): XX-XX
Published online MM DD 2015 (http://www.openscienceonline.com/journal/ijphr)
Anterior dental esthetics in primary teeth
Abu-Hussein Muhamad1, *
, Watted Nezar2
, Abdulgani Azzaldeen3
, Abu-Shilabayeh Hanali4
1
University of Naples Federic II, Naples, Italy, Department of Pediatric Dentistry, University of Athens, Athens, Greece
2
Department of Orthodontics, Arab American University, Jenin, Palestine
3
Department of Conservative Dentistry, Al-Quds University, Jerusalem, Palestine
4
Department of Orthodontics and Pediatric Dentistry, Al-Quds University, Jerusalem, Palestine
Email address
abuhusseinmuhamad@gmail.com (Abu-Hussein M.)
To cite this article
Abu-Hussein Muhamad, Watted Nezar, Abdulgani Azzaldeen, Abu-Shilabayeh Hanali. Anterior Dental Esthetics in Primary Teeth.
International Journal of Public Health Research. Vol. X, No. X, 2014, pp. XX-XX.
Abstract
Esthetic restorations for the anterior primary dentition are discussed. Varied primary crowns--stainless steel, composite strip
crowns, preformed ceramo-base metal crowns, and stainless steel crowns with composite facings--are evaluated as to their
advantages and disadvantages. The repair of grossly decayed teeth, for example, nursing bottle caries, using complete
endodontic therapy and stress relieved posts is described. Alternative esthetic anterior restorations, fixed and removable, are
evaluated as to their efficacy.
Keywords
Anterior Dental, Esthetics, Smile, Children
1. Introduction
Esthetic restoration of primary anterior teeth can be
especially challenging due to the small size of the teeth, close
proximity of pulp to tooth surface, relatively thin enamel and
surface area for bonding, issues related to child behavior and
finally cost of the treatment.[1,2] Apart from a compromise
in esthetics, dental destruction may also lead to development
of parafunctional habits like tongue thrusting and speech
problems, psychological problems, reduced masticatory
efficiency and loss of vertical dimension of occlusion.
[3 ]Hence it is important to restore crowns destroyed by
caries to preserve the integrity of primary dentition until its
exfoliation and eruption of permanent teeth.[4,5]
In the modern civilized cosmetically conscious world, well
contoured and well aligned white teeth set the standard for
beauty. Such teeth are not only considered attractive, but are
also indicative of nutritional health, self esteem, hygienic
pride and economic status.[1] With the growing awareness of
the esthetic options available, there is a greater demand for
solutions to unsightly problems such as nursing bottle caries,
malformed and discolored
teeth, hypoplastic defects, tooth fractures and bruxism in
children.
Anterior teeth fracture, as a result of traumatic injuries,
frequently occurs in dentistry and presents a special
challenge to paediatric dentist. Premature loss of primary
incisors may affect the speech by interfering with the
pronunciation of consonants and labial sounds, decreased
masticatory efficiency, abnormal tongue habits and potential
subsequent malocclusion. The child may also suffer from
psychological problems if aesthetics is hampered[1]. Because
of reduced coronal tooth structure, direct adhesive restorative
procedures do not always give satisfactory results. In the past,
the most expedient treatment was to remove the involved
teeth. This treatment was justified on the basis that the
permanent teeth would eventually replace the extracted ones.
However, the importance of preserving the integrity of
primary dentition until the appropriate exfoliation time is
well recognized. The consequences of premature loss of
primary teeth are well known namely the loss of vertical
dimension of occlusion, tongue thrusting and mouth
breathing habits, which can be sources of future
malocclusion. In cases of severe loss of tooth structure intra
canal posts became mandatory[6,7]. The various root canal
posts used in paediatric dentistry are orthodontic thread in the
2. 2 Abu-Hussein Muhamad et al.: Anterior Dental Esthetics in Primary Teeth
shape of alpha or gamma2, the metallic posts with macro
retention, composites posts biological restoration1 and the
fibreglass post.[7,8] Recent development in restorative
materials, placement techniques, and adhesive protocols
facilitates these restorations. However these procedures turn
out to be expensive, technique sensitive and also require
expertise of the operator. The expression “biological
restoration” was coined by Santos and Bianchi, in 1991[5]. A
biological restoration meets up to the aesthetic and structural
standards of natural teeth. Proper reconstruction of
extensively damaged teeth can be achieved through the
fragment reattachment procedure known as “Biological
Restoration.” They provide natural posts and crowns which
can fit into the treated root stumps of the individual and
replace the coronal portion aesthetically. The first paper
reporting the use of fragments of extracted teeth as dental
restorative materials was published in 1964 by Chosak and
Eidelman. Thereafter, several other reports have
demonstrated the advantages of this technique, such as
favourable aesthetics, resulting from enamel's natural surface
smoothness, anatomic contouring and colour match,
functional and masticatory effectiveness, preservation of
sound tooth structure, prevention of physiological wear, and
no need of complex material resources.[1,3,6,7,8.9] Figure 1,
2
The principle goal of paediatric restorative dentistry is to
restore the damaged teeth to its normal function as well as to
retain its aesthetic. In the past, the only treatment option for
pulpally involved primary teeth would have been to extract
the teeth and replace them with prosthetic substitutes, until
the permanent teeth erupted. However, the availability of
natural crowns and roots would allow the use of biologic
restorations to preserve the integrity of patient's natural
dentition. Fragment re-attachment using natural teeth is a
technique known as biological restoration. Although the
technique is simple, it requires professional expertise to
prepare and adapt the natural crowns and intra-canal
posts.[10,11] Biological restorations not only mimic the
missing part of the oral structures, but are also bio-
functional . The advantages of using biological restorations
are the length of each appointment is reduced because natural
teeth are prepared previously; the technique eliminates
laboratory processing and is economical.[12] The technique
is simple, allows the preservation of sound tooth structure
and provides excellent aesthetics compared to composite
resins and stainless steel crowns, especially regarding
translucency. Clinical chair time for fragment bonding
procedures is relatively short, which is very advantageous
when treating paediatric patients .Resin composite
restorations do not present these advantages and can allow
staining and plaque formation on their surfaces[13,14].
Disadvantages of the biological restoration technique
include the difficulty in obtaining teeth with the required
coronal dimensions and characteristics, problems inherent to
indirect restorations and matching fragment colour with tooth
remnant colour. Also, having fragments from other people’s
teeth in their mouth is not a pleasant idea for some patients
and many of them refuse to receive this treatment. However,
all these factors are not contraindications of the
technique[1,4,7]. It is important that the parents are informed
that the tooth fragments used for biological restoration are
previously submitted to a rigorous sterilization process that
completely eliminates any risk of contamination or disease
transmission to the child receiving the fragment. Presently,
secure methods of sterilization and storage are available to
ensure the safety of teeth or tooth fragments coming from
tooth banks .Several materials have been used for bonding
dental fragments to cavities, e.g., adhesive systems,
composite resins, glass ionomer cements and dual-cure resin
cements. The association between “Biological Crowns and
Posts” offers excellent aesthetic, functional, and psychosocial
results, which justifies the use of this technique to achieve
the morpho functional recovery of extensively damaged teeth.
In the present case, the use of biologic restoration with the
natural roots and crown resulted in clinical success as well as
recovered function and aesthetics.[15,16,17]
The biologic restoration is a promising alternative to
prosthodontic restoration for primary teeth severely
destroyed due to trauma or caries. Also, the technique
eliminates high costs associated with other restorative
techniques for deciduous anterior teeth, and provides highly
functional and aesthetic outcomes.[1,7,9,18,19]
There are several difficulties in designing clinical studies
to evaluate restorative options of primary incisors. One need
only consider the population of patients that require thesem
restorations to develop a list of obstacles. First, children who
exhibit dental caries in the primary incisors are generally
very young. Early childhood caries or baby bottle tooth decay
is usually seen in the 18- to 36-month-old child, although it
can be seen even younger.[1] These children, due to their
young age and lack of cognitive abilities, are usually very
uncooperative for dental treatment, and their behavior playsa
big factor in restoration. Because these children are usually
candidates for sedation, general anesthesia, or immobilization,
few clinicians want to consider placing these children into an
“experimental” situation where failureof a restoration can
mean a significant problem for replacement.[2] Even if the
clinician were willing to do this, many parents will not be
willing, especially if failure of the “experimental” restoration
might require additional sedation.[20]
The purpose of this article is to review the various esthetic
options available for restoring the primary incisors and
enhance the clinician’s ability to make the best choice of
selection for each individual situation.
A. Restoration of Severely Decayed Tooth
1. Crown build up using resin composite short post
technique
Resin composites used directly or indirectly has been an
excellent choice for severely carious teeth due to their
adhesive bonding and esthetic appearance. The technique
involves placement of light cured resin composite in the root
canal and crown region in several steps where the cervical
third of root is left unobturated. This eventually forms the
superstructure of the post. During next visit, celluloid crowns
3. International Journal of Public Health Research 2014; X(X): XX-XX 3
will be used to build up the teeth.
This procedure reduces operator chairtime and they do not
require a layer of opaque material as used in metal posts. The
celluloid crown is filled with same material used in
fabricating the post, hence it produces a glossy finish thereby
minimizing polishing.[11]
2. Indirect composite resin crowns reinforced with a fibre
glass post
With the introduction of new adhesive systems and
restorative materials, a new approach for treating severely
mutilated anterior teeth is explained and documented by
clinical cases, where fiber core posts are introduced into the
root canals of primary incisors for a distance of 2 to 3 mm. It
is retained in place by flowable composite, then the coronal
part is reconstructed by a strip crown to restore the crown
form. A laboratory testing of the fracture load resistance of
the restored teeth proved that this technique significantly
improved the fracture load resistance of composite celluloid
crowns, making it a valuable procedure to consider when the
coronal tooth structure is not enough to support and retain a
composite celluloid strip crown.[13]
3. Biological posts and crowns
Biological restoration was introduced by Santos & Bianchi
in 1991. Here, used teeth from the Human Tooth Bank are
used as natural posts & crowns.
The selected tooth from the tooth bank is reshaped, roots
strengthened by retro filling with flowable composites and
autoclaved for 30min at 121 degree centigrade and 15 lbs
pressure before cementation .[5]The natural crowns offer
esthetics as well as preserves natural teeth colour. The
enamel also has physiologic wear and offer superficial
smoothness and cervical adaptation is compatible with those
of surrounding teeth. The length of each appointment is
reduced because natural teeth are prepared previously.
Further more, the technique eliminates laboratory processing
and is economical.[5]
Although the technique is simple, it requires professional
expertise to prepare and adapt the natural crowns and
intracanal posts. Studies have shown that it is cost effective,
clinician friendly, less technique sensitive and esthetic
alternative to commercially available restorative
materials[7,8,9].
Other factors of concern while using biologic restoration is
that Universal protocol of consent, storage and sterilization
should be followed in the human tooth bank. Figure 3-14
Collected samples should be scaled, polished and freed of
soft tissues and periodontal remnants. Pulps have to be
removed and complete biological preparation is to be done.
Teeth are then stored at 4degree centigrade in HBSS with
donor identification till the time of its use.[14]
4. Orthodontic wires shaped as Greek alphabets like alpha,
omega, theta used as intracanal retainers
The core build-ups are done directly or indirectly over
these wires. Mortada and King(2004) proposed this technique
involving the placement of an omega shaped stainless steel
wire extension into the entrance of the root canal prior to
restoring the crown with an internal compomer core and an
external composite restoration.[2] The modified omega loop
is an efficient technique for the restoration of the severely
damaged anterior teeth. The ease of manipulation and short
chair-side time are further advantages of the technique.[12]
B. Full coronal restorations
Esthetic-type anterior resin crowns have been used in the
general pediatric population for many years, but
unfortunately, much less so in the special needs population.
This article presents the case of a special needs patient who
received anterior resin crowns, outlining the steps taken to
create beautiful and long-lasting esthetic
restorations.[1,7,8,9]
Full coronal restorations of carious primary incisors are
indicated when caries are present on multiple surfaces; the
incisal edge is involved; there is extensive cervical
decalcification; pulpal therapy is indicated; and caries are
minor but the patient’s oral hygiene is very poor, resulting in
a high caries risk. In selected cases, permanent incisors have
also been beautifully restored and esthetic results achieved
without the need for an impression, laboratory models or
follow-up for insertion of crowns or veneers.[1,3,7,9]
Anterior resin crowns are an attractive first choice for
many clinicians, but they are very technique-sensitive.
Hemorrhage or saliva contamination on the tooth will
interfere with the bond, causing the restoration not to adhere
and to subsequently fail. Thorough and complete rubber dam
isolation of the teeth is necessary to create an ideal bonding
environment for placement of successful long-term
restorations. The following clinical steps and photographs are
intended as a guide to restoring teeth with anterior resin
crowns. Figure 15-37
Indications for this include:
- Caries present on multiple surface.
- Extensive cervical decalcification
- Anteriors that have received pulp therapy
- Anteriors that have fractured and lost most of the tooth
structure
- Anterior teeth with multiple hypoplastic defects or
developmental disturbances
-Discolored teeth that are aesthetically unpleasing
- High risk patients where the oral hygiene is poor but
caries is minimal.
The child’s behavior makes moisture control difficult in
placing class III restorations[ 4]
The full coronal restoration can be discussed under;
a.Bonded crowns
b.Cemented crowns
A. Bonded crowns
Strip crowns :
The bonded resin composite strip crown is perhaps the
most esthetic of all the restorations available to the clinician
for the treatment of severely decayed primary incisors.
However, strip crowns are also the most technique-sensitive
and may be difficult to place.
Composite strip crowns are composite filled celluloid
crowns forms. They have become a popular method of
restoring primary anterior teeth because they provide
4. 4 Abu-Hussein Muhamad et al.: Anterior Dental Esthetics in Primary Teeth
superior aesthetics as compared to other forms of anterior
tooth coverage. Composite strip crowns rely on dentin and
enamel adhesion for retention. Therefore the lack of tooth
structure, the presence of moisture or hemorrhage contributes
to compromised retention. They are less resistant to wear
and fracture more readily than other anterior full coverage
restorations. A 2002 study by Tate, et al. found that
composite strip crowns had a failure rate of 51%, compared
to an 8% failure rate of stainless steel crowns.
These are commonly used Crown forms filled with
composite & bonded on the tooth. The benefits of these
crowns include
-Parent/patient pleasing
- Ideal for ankylosed tooth build –ups
- Simple to fit & trim
- Removal is fast & easy
- Easily matches natural dentition
- Leaves smooth shiny surface
- Easy shade control with composite
-Superior esthetic quality
- Ideal for photo cure
-Crystal clear and thin
-Large selection of size
-Easy to repair
However it is technique sensitive, adequate tooth structure
is required and any lapses in patient selection, moisture and
hemorrhage control, tooth preparation and resin placement
can lead to failure[9].
Polycarbonate Crowns:
These are heat molded acrylic resin used to restore primary
anterior teeth. It is esthetic than SSC, easy to trim and can be
adjusted with pliers. These crowns do not resist strong
abrasive forces thus leading to occasional fracture, hence it is
contraindicated in cases of Severe bruxism and deep bite[8].
Pedo jacket
It is a tooth colored copolyester material which is filled
with resin and left on tooth after polymerization instead of
being removed. It does not split, stain or crack. Crowns can
be easily trimmed with scissors.
Dis-advantage :
-Only one size is available.
-Cannot be trimmed with bur
Glastech
Made of Artglass, which is a polymer glass. It gives a
natural feel, bondability and kindness associated with
composite but the esthetics and longevity of porcelain. It is
Color stable, wear of polymer glass is similar to enamel, kind
to opposing dentition and is plaque resistant. The unique
filler materials of microglass and silica are proposed to
provide greater durability and esthetics than strip crowns.
New millenium
These crowns are made up of Lab enhanced composite
resin material. No long term studies are available regarding
these crowns.
B. Cemented crowns
Stainless Steel Crowns
Stainless steel crowns are considered to be the most
durable, economical and reliable for restoring severely
carious and fractured primary incisors.
They are easy to place, fracture proof, wear resistant and
attached firmly to tooth until exfoliation. However there is a
compromise in esthetics due to the unsightly silver metallic
appearance.5
Modifications of Stainless Steel Crowns
a. Facial cut out Stainless steel crowns
This involves placement of composite material in a labial
fenestration of SSC. Although there is an improvement in the
appearance, the technique is time consuming and metal
margins are still visible. Clinicians even face problems to
control hemorrhage during application of composite facing.[5]
b. Veneered Stainless steel crowns
Here the composite resins and thermoplastics are bonded
to the metal. This type of preveneered crown was developed
to serve as a convenient, durable, reliable, and esthetic
solution to the difficult challenge of restoring severely
carious primary incisors. Various commercially available
veneered SSCs include Cheng crowns, Kinder krowns, Nu-
smile and Whiter biter, pedo compu crowns and Dura
crowns.[5]
Cheng Crowns
Cheng Crowns made their public debut in 1987. These are
Stainless steel pediatric anterior crowns faced with a high
quality composite, mesh-based with a light cured composite.
It presents a unique solution for natural-looking Stain-
resistant Crowns.
It is available for the right and left central and lateral as
well as cuspids.
Most crown procedures can be completed in one patient
visit and with less patient discomfort.[6] It is available in
short and regular lengths and sizes suitable for centrals,
lateral and cuspids. They can undergo heat sterilization
without significant effect on their bond strength and color.
Disadvantages of all preveneered crowns are fracture of
veneers during crimping and they are expensive.[6] It is a
Stainless steel crown faced with high quality composite.
Manufacturer claims it to be Color stable, plaque resistant
and matches pedo-shades. It doesn’t cause wear of opposing
teeth.
However there are no long term clinical trials to assess the
durability of these crownsIt is available in upper and lower –
right & left central and lateral with 6 sizes.[21,22]
Kinder krowns :
Kinder Krowns offer the most natural shades and contour
available for the pediatric patient. The great depth and
vitality from the lifelike composite reveal a natural smile
without the bulky “Chiclet” look of other restorations. They
come in 2 aesthetically pleasing shades, Pedo 1 and Pedo 2.
Pedo 2 shade is the most natural shade While Pedo 1 shade is
for those cases when the bleached white shade is wanted.
Figure 37-49
Kinder Krowns are designed with IncisaLock™ - the
optimal union of state-of the-art bonding procedures and
mechanical retention. By adding mechanical retention and
more composite, Kinder Krowns are strong without
5. International Journal of Public Health Research 2014; X(X): XX-XX 5
sacrificing form or function[6]
Pedo Pearlstm
These are beautiful heavy gauge aluminum crowns coated
with FDA food grade powder coating and epoxy-resin. They
serve as ultimate permanent crown for primary teeth.
Features include:
- Universal anatomy--use on either side
-Easy to cut and crimp, without chipping or
peeling.
- Composite can be added
Disadvantages include less durability and the crowns are
relatively soft.[8]
Dura crowns
Crowns can be crimped labialy and lingually, can be easily
trimmed with crown scissors, easily festooned and has got a
full-knife edge. Study has shown that these crowns with
veneer facings were significantly more retentive than the
nonveneered ones when cement and crimping were
combined.[7].
2. Discussion
Restorative treatment is based upon the results of an
appropriate clinical examination and is ideally part of a
comprehensive treatment plan. The treatment plan shall take
into consideration:
1. developmental status of the dentition;
2. caries-risk assessment2,3;
3. patient’s oral hygiene;
4. anticipated parental compliance and likelihood of time-
ly recall;
5. patient’s ability to cooperate for treatment.
Restoration of primary teeth differs from restoration of
permanent teeth, due in part to the differences in tooth
morphology. The mesiodistal diameter of a primary molar
crown is greater than the cervicoocclusal dimension. The
buccal and lingual surfaces converge toward the occlusal.
The enamel and dentin are thinner. The cervical enamel rods
slope occlusally, ending abruptly at the cervix instead of
being oriented gingivally, gradually becoming thinner as in
permanent teeth.[1,9]
The pulp chambers of primary teeth are proportionately
larger and closer to the surface. Primary teeth contact areas
are broad and flattened rather than being a small distinct
circular contact point, as in permanent teeth. Shorter clinical
crown heights of primary teeth also affect the ability of these
teeth to adequately support and retain intracoronal
restorations.[6,7,11]
Young permanent teeth also exhibit characteristics that
need to be considered in restorative procedures, such as large
pulp chambers and broad contact areas that are proximal to
pri-mary teeth.[8.9]
Tooth preparation should include the removal of caries or
improperly developed tooth structure to establish appropriate
outline, resistance, retention, and convenience form
compatiblewith the restorative material to be utilized.
Rubber-dam iso-lation should be utilized when possible
during the preparation and placement of restorative materials.
Dentin/enamel adhesives allow bonding of resin-based
composites and compomers to primary and permanent teeth.
Adhesives have been developed with reported dentin bond
strengths exceeding that of enamel.10-12 In vitro studies
have shown that enamel and dentin bond strength is similar
for primary and permanent teeth.7-14 The clinical success of
adhesives allows for more conservative preparation when
using composite restorative materials.[12,16,18]
The dental literature supports the use of tooth bonding
adhesives, when used according to the manufacturer’s
instruction unique for each product, as being effective in
primary and permanent teeth in enhancing retention of
restorations, minimizing microleakage, and reducing
sensitivity.[20,21]
Stainless steel crowns are prefabricated crown forms that
are adapted to individual teeth and cemented with a
biocompatible luting agent. “The SSC is extremely durable,
relatively inex-pensive, subject to minimal technique
sensitivity during placement, and offers the advantage of full
coronal coverage.[1,11,12]
A resin or porcelain veneer restoration is a thin layer of
restor-ative material bonded over the facial or buccal surface
of a tooth. Veneer restorations are considered conservative in
that minimal, if any, tooth preparation is required. Porcelain
veneersusually are placed on permanent teeth.
Veneers may be indicated for the restoration of anterior
teeth with fractures, developmental defects, intrinsic
discoloration, and/or other esthetic conditions.[7.14,18]
An extensive review of the dental literature concerning the
full coronal coverage of primary anterior teeth was
performed and articles systematically reviewed by objective
criteria. As a result no clinical studies were identified that
met all or even a majority of the criteria, indicating that there
was little, good scientific support for any of the clinical
techniques which clinicians have utilized for many years to
restore primary anterior teeth. While lack of strong clinical
data does not preclude the use of these techniques it points
out the strong need for well designed, prospective clinical
studies to validate the use of these techniques. Several
difficulties and obstacles have been described which make
these types of clinical studies difficult to carry out. In spite of
the difficulties, it is recommended that efforts be made to
scientifically evaluate clinical longevity and success of
various restorative techniques for primary anterior
teeth[9,10,12,16].
In the past, the only treatment option for pulpally involved
primary teeth would have been to extract the teeth and
replace them with prosthetic substitutes, until the permanent
teeth erupted. However, the availability of natural crowns
and roots would allow the use of biologic restorations to
preserve the integrity of patient’s natural dentition, in the
meantime provide excellent esthetic, functional advantages to
achieve the morphofunctional restoration. This method of
using biological crown and post restoration for primary teeth
affected by ECC has shown promising results.[21,22]
Also, this technique is simple, provides excellent esthetics,
6. 6 Abu-Hussein Muhamad et al.: Anterior Dental Esthetics in Primary Teeth
preserves natural tooth colour, allows the preservation of
sound tooth structure and has low cost. The enamel of the
biologically restored tooth has physiologic wear and offers
superficial smoothness and cervical adaptation compatible
with those of surrounding teeth. Biological restorations not
only mimic the missing part of the oral structures, but are
also biofunctional. Advantages include, the length of each
appointment is reduced because natural teeth are prepared
previously and clinical chair time for fragment bonding
procedures is relatively short, which is a merit especially
while dealing with paediatric patients. However,
disadvantages of the biological restoration technique include
the difficulty in obtaining teeth with the required coronal
dimensions and characteristics, problems inherent to indirect
restorations and matching fragment colour with tooth
remnant colour. Also, having fragments from other people’s
teeth in their mouth is not a pleasant idea for some patients
and many of them refuse to receive this treatment. However,
all these factors are not Ocontraindications of the
technique[1.3.6,9,15,19].
3. Conclusion
Many restorative options exist for treating primary anterior
teeth. Finally the choice of restorative technique depends
upon the operator preferences, esthetic demands by the
parents and child’s behavior that affect the ultimate outcome
of whichever restorative material chosen.
Figure 1. What is baby bottle tooth decay?
Figure 2 .Child tooth trauma
Figure 3. Intraoral photograph of the boy before treatment
Figure 4. Panoramic radiographs of the boy before treatment
Figure 5. Intraoral photograph of the girl before treatment
Figure 6. Panoramic radiographs of the girl before treatment
Figure 7. Teeth after preparation for the boy
7. International Journal of Public Health Research 2014; X(X): XX-XX 7
Figure 8. Teeth after preparation for the girl
Figure 9. Postoperative intraoral photograph of the boy
Figure 10 . Postoperative intraoral photograph of the girl
Figure 11. After 6 months photograph of the boy
Figure 12. After 6 months photograph of the girl
Figure 13. After one and a half year photograph of the boy
Figure 14. After one and a half year photograph of the girl
Figure 15. Neglected nursing-bottle caries in a 2-year-old child
Figure 16. Same patient after pulpotomies and placement of stainless steel
crowns.
Figure 17. Same patient after opening of labial surfaces on crowns and
placement of composite facings
8. 8 Abu-Hussein Muhamad et al.: Anterior Dental Esthetics in Primary Teeth
Figure 18. Another shot of the before teeth
Figure 19. This is with the decay removed
Figure 20. Here is what the crown formers
Figure 21. Here is the finished case. The teeth were pretty crwoded so I
didnt get quite the angulation
Figure 22. Preop decay. This 2 year old only had a couple of small decayed
areas on the lower arch.
Figure 23. Different view, same child.
Figure 24. Other side
Figure 25. Decay removed. Note the caries detector shows some slight stain.
If I had removed any more tooth structure i would have been forced to do
9. International Journal of Public Health Research 2014; X(X): XX-XX 9
pulpotomies.
Figure 26. Other view
Figure 27. Different angle
Figure 28. Strip crowns placed
Figure 29. Another 2 year old child with bottle mouth, or "soft teeth", or
"teeth with no enamel"
Figure 30. Another angle..
Figure 31. Granted the problems are more cosmetic
Figure 32. Preop.of another hospital case.
10. 10 Abu-Hussein Muhamad et al.: Anterior Dental Esthetics in Primary Teeth
Figure 33. Another view
Figure 34. The mojority of the decay has been removed and caries detector
is in place for 10 seconds.
Figure 35. I only remove the dark staining. I leave the light stain as I think it
is affected dentin only.
Figure 36. He two laterals have been cured and still have the formers in
place.
Figure 37. Finished view
Figure 38. Kinder Krowns® - Pediatric Crowns, offer the most natural
shades and contour available for the pediatric patient.
Figure 39. NuSmile Pediatric Crowns
11. International Journal of Public Health Research 2014; X(X): XX-XX 11
Figure 40. 3-1/2 - year - old boy with early childhood caries of incisors.
Figure 41. After caries removal, labial groove to retain resin-modified glass-
ionomer liner
Figure 42. RMGI liner in place, tooth "minaturization with low-speed round
bur
Figure 43. "Minaturization" (tooth preparation) with high-speed water-
cooled diamond bur
Figure 44. Final preparation completed
Figure 45. 9 months postoperatively
Figure 46. Patient with severe caries.
Figure 47. Patient after restoration with NuSmile(r) Crowns.
12. 12 Abu-Hussein Muhamad et al.: Anterior Dental Esthetics in Primary Teeth
Figure 48. After restoration, lingual-palatal view.
Figure 49. After restoration, close-up view.
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