The purpose of the present study was to examine the relationship between the form of the clinical crowns in the maxillary anterior segment and the clinical feature of gingiva such as morphological characteristics and the gingival thickness. Fifty periodontally healthy subjects were clinically examined regarding the probing depth, the thickness of the free gingiva, and the width of the keratinized gingiva. From study models of the maxillary anterior region, the width at cervical third(CW) and the length(CL) of the clinical crown, the papillary height, and the gingival angle of the 6 anterior teeth were measured. Each tooth was classified into 4 groups (longnarrow, NL; narrow, N; wide, W; short-wide, WS) according to CW/CL ratio and all the data were compared between groups NL and WS using independent t-test. Stepwise multiple regression analysis was performed for each tooth region with the gingival thickness at the level of sulcus bottom, the width of keratinized gingiva, and gingival angle as the dependent variables. As the results, the NL group of the upper anterior teeth displayed, higher papilla height, and narrower keratinized gingiva, more acute gingival angle resulting in pronounced "scalloped" contour of the gingival margin, compared to the WS group. There was no significant difference between groups NL and WS with respect to probing depth and the gingival thickness. The regression analyses demonstrated that the gingival thickness in central incisors was significantly associated to the mesio-distal width and bucco-lingual width of the crown, and labial probing depth. The width of keratinized gingiva was significantly associated with labial probing depth in central incisors and with proximal probing depth and gingival angle in lateral incisors, and with labial and proximal probing depth, and gingival angle in canines. The gingival angle was significantly associated with papillary height and CW/CL ratio and additionally with proximal probing depth in central incisors, with the width of keratinized gingiva in lateral incisors, and with labial probing depth and the width of keratinized gingiva in canines. These results indicate that the form of clinical crown in upper anterior region could influence the clinical feature of gingiva and the influencing factors might be different according to the tooth region.
BACKGROUND. In order to restore severely attrited teeth properly, surgical intervention in the form of a crown-lengthening procedure may be required. And also, proper diagnosis and treatment sequencing is critical to obtain a successful results. Adequate diagnostic wax-up ensures good esthetics and healthy periodontal tissue. CASE DESCRIPTION. This clinical case report describes a diagnostically based protocol for restoration on mandibular anterior teeth with crown lengthening procedure and the treatment of partially edentulous mandible combined with an edentulous maxilla. In addition, the effort to prevent the combination syndrome was described. CLINICAL IMPLICATION. An interdisciplinary diagnosis and examination through visualization of the desired results ensure conservative and more predictable outcome.
Statement of problems. There are only a few studies available that deal with the clinical behavior of ceromer systems as potential substitutes for metal-ceramic crowns. Purpose. This prospective study was initiated to evaluate the clinical performance of 35 Sculpture crowns after 2 years in service. Material and methods. Thirty five Sculpture crowns were placed for 20 patients (7 men and 13 women). All patients were treated by the same dentist, and all restorations were fabricated by the same dental laboratory. Crown placement involved both the anterior and posterior regions of the dental arches. Patients were evaluated by two examiner at baseline, 12, and 24 months using the CDA quality assessment system in addition to periodontal criteria. Results. Of 34 crowns remaining in the study after 2 years, only one crown had experienced a marginal fracture. The crown was replaced as a result of recurrent caries. All remaining crowns were ranked as either excellent or acceptable for surface and color, anatomic form, and marginal integrity. Conclusion. The 2-year clinical observations and ranking with the CDA quality assessment criteria supported the conclusion that Sculpture crowns may be used in substitutes for metal-ceramic crowns.
Due to high esthetic demands from patients, we are driven to fabricate natural-looking(form and color) restorations. In the past decade, the glass-ceramic in dentistry has been used as a material with variable crystals that affects the appearance, characteristics, and mechanical properties of metal-free fixed restoration. The conventional IPS Empress glass-ceramic is a heat-pressed, leucite reinforced material using the "lost wax" principle. This glass-ceramic has been successfully used for esthetic restorations such as all-ceramic crowns, inlays/onlays, and veneers for about 15 years. This article presents that the form and surface texture of clinical crown are duplicated by IPS-Empress system using "lost-wax technique".
Kim, Yun-Jeong;Park, Ji-Man;Cho, Hyun-Jae;Ku, Young
Journal of Periodontal and Implant Science
/
제51권2호
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pp.88-99
/
2021
Purpose: Direct intraoral scanning and superimposing methods have recently been applied to measure the dimensions of periodontal tissues. The aim of this study was to analyze various correlations between labial gingival thickness and underlying alveolar bone thickness, as well as clinical parameters among 3 tooth types (central incisors, lateral incisors, and canines) using a digital method. Methods: In 20 periodontally healthy subjects, cone-beam computed tomography images and intraoral scanned files were obtained. Measurements of labial alveolar bone and gingival thickness at the central incisors, lateral incisors, and canines were performed at points 0-5 mm from the alveolar crest on the superimposed images. Clinical parameters including the crown width/crown length ratio, keratinized gingival width, gingival scallop, and transparency of the periodontal probe through the gingival sulcus were examined. Results: Gingival thickness at the alveolar crest level was positively correlated with the thickness of the alveolar bone plate (P<0.05). The central incisors revealed a strong correlation between labial alveolar bone thickness at 1 and 2 mm, respectively, inferior to the alveolar crest and the thickness of the gingiva at the alveolar crest line (G0), whereas G0 and labial bone thickness at every level were positively correlated in the lateral incisors and canines. No significant correlations were found between clinical parameters and hard or soft tissue thickness. Conclusions: Gingival thickness at the alveolar crest level revealed a positive correlation with labial alveolar bone thickness, although this correlation at identical depth levels was not significant. Gingival thickness, at or under the alveolar crest level, was not associated with the clinical parameters of the gingival features, such as the crown form, gingival scallop, or keratinized gingival width.
Paula Pontes Garcia ;Aline Cappoani ;Ricardo Susin Schelbauer ;Gisele Maria Correr ;Carla Castiglia Gonzaga
Restorative Dentistry and Endodontics
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제45권4호
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pp.49.1-49.11
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2020
Objectives: The aim of this study was to perform a clinical and radiographic analysis of endodontically treated teeth (ETT) restored with cast metal posts (CMPs) or prefabricated glass fiber posts (GFPs) and crowns. Materials and Methods: Fifty ETT were restored with 25 CMPs and 25 GFPs at a private dental clinic between 2001 and 2016. The restorations consisted of 12 all-ceramic crowns, 31 metal-ceramic crowns, and 7 composite resin crowns. Demographic data, type of teeth, type of post-and-core system, time of placement, crown restorations, the number of proximal contacts, the type of antagonist, and reports of any complications after post-and-core placement were recorded for each patient. Assessments were performed at baseline (radiographic) and follow-up (radiographic and clinical). Data were analyzed by the McNemar test, the Pearson χ2 test, and Kaplan-Meier survival curves (α = 0.05). The mean follow-up was 67.6 months. Results: No significant difference was observed for any of the radiographic parameters when the baseline and final radiographs were compared. In the clinical evaluation, anatomical form (p = 0.009) and occlusion (p = 0.001) showed significant differences according to the type of crown restoration; specifically, metal-ceramic and all-ceramic crowns outperformed composite resin crowns. Conclusions: CMPs and GFPs showed favorable results for restoring ETT after 6 years of follow-up. All-ceramic and metal-ceramic crowns showed higher survival rates and better clinical outcomes.
It has been suggested that morphologic characteristics of the periodontium are partly related to the shape and form of the teeth. Furthermore, the severity of symptoms of periodontal disease have been proposed to differ among these various morphologic entities or "biotypes". The purpose of the present study was to examine the relationship between the form of the crowns in the maxillary anterior tooth segment and (1) a group of morphological characteristics and (2) the thickness of the gingiva. The thickness of gingiva was measured by ultrasonic device(SDM). 100 subjects devoid of symptoms of destructive periodontal disease were examined regarding, e.g., probing depth, gingival recession, width of keratinized gingiva, thickness of the keratinized gingiva. From maxillary study cast, the width(at the apical third-CW) and the length(CL) of the crowns of the 6 anterior teeth were determined. A CW/CL-ratio was calculated for each tooth and averaged for each tooth region. The individual mean CW/CL-ratio values for the central incisors were ranked. The 10 subjects ranked highest and the 10 ranked lowest were selected as having either a long-narrow(group N) or a short-wide(group W) form of the crown of the tooth. The data for each of the examined parameters were averaged for each tooth region in each subject and mean values for subjects in groups W and N were compared using the Student t-test. Stepwise multiple regression analysis, including data from the whole sample, was performed for each tooth region with the thickness of the free gingiva as the dependent variable. The results from the analyses demonstrated that individuals with a long-narrow form of the central incisors displayed, compared to individuals with a short-wide crown, form (l) a narrow zone of keratinized gingiva, (2) a pronounced "scalloped" contour of the gingival margin. There was no significant difference between groups N and W with respect to the thickness of the keratinized gingiva. The CW/CL-ratio data revealed that a certain form of the crowns in the central incisors was accompanied by a similar form in the lateral incisors and canine tooth region. The regression analyses demonstrated that the thickness of the keratinized gingiva in central, lateral incisors and canines was significantly related to the width of the keratinized gingiva.
Purpose: Variation in the morphology of gingival papilla may be determined by the shape and position of anatomic crown as well as contact area and embrasure form of individual teeth. However, periodontal biotype classification is regarded to be subjective because of the lack of definite criteria. In this study, we defined the objective parameters which constitute the periodontal biotype and measured their relationship. Materials and Methods: 109 of dental casts were prepared using three dimensional scanner and specialized reconstruction software, then acquiredvirtual models were sent to the 20 professional dentists to define the specific periodontal biotypes. Several parameters around periodontal structures were measured from the virtual models; facial surface area of the anterior tooth (AT), anterior papillary area (AP), proportion of the dento-papillary complex, clinical papillary length (PL), and clinical papillary angle (PA). Statistical analysis was performed to confirm the relationship among parameters. Results: Coincidence rate of periodontal biotype within observers was $63.77{\pm}16.05%$. Coincidence rate between observers was $76.15{\pm}16.43%$. Among the parameters measured, PL showed the most positive correlations and PA presented the most negative correlations. The parameter of the AP and PL of six maxillary anterior teeth showed significant correlation coefficient. Conclusion: Anterior papillary area and clinical papillary length would be objective parameters for determining the consistent periodontal biotypes.
Developmental dental morphological anomalies are fusion, gemination, twinning, concrescence and etc. They may cause many problems in conservative, periodontal and esthetic aspects. Fusion is a condition where two separate tooth buds unite at some stage in their development to form a bifid crown. If tooth contact occurs early, at least before the start of calcification, the two teeth may be completely unites to form a single large tooth. If tooth contact occurs after the time when a portion of the tooth crown has completed its formation, there may be union of the roots only. In fusion the dentin is always confluent. Fusion teeth is more common in the deciduous than in the permanent dentition. Fused teeth are relatively rare, and are mostly mandibular anterior teeth. Fusion of normal and supernumerary teeth or between normal teeth may occurs. The exact etiology factor of fusion is unknown, but genetic and environmental factors seems to be related. A variety of complications and subsequent treatments have been suggested on this teeth. Periodontal conditions may arise due to a groove formed at the line of fusion of the two teeth. Crowding or Protrusion with potential for malocclusion or delayed eruption of adjacent teeth. Fusion teeth appear in the anterior region, they usually cause esthetic problems. Treatments vary depending on the problem, the location, and the extent of fusion. Treatment of fused teeth has been reported from endodontic, orthodontic, periodontic, surgical and multidisciplinary. This report presents the esthetic improvements by separation of two clinical crowns. Bone reduction or endodontic treatments are not required.
An aim of this study is to find out influenced factors of satisfaction degree on the clinical practice for the dental technology student and it can be provided the basic necessary data for the educational planning of the curriculum for the clinical practice. The target of study are selected form 7 junior health college students and colleges are located in around seoul form 14 junior health college throughout the nation. The questionnaries were distributed between 24th Feb to 30th July in 1997 to the 100 dental technicians who finished clinical practice and entered profession in 1997. All collected data were analysed by using SPSS/PC, Technical Statistic, One-Way ANOVA, Ttest, Person Correnlation Coefficient, Chrobach Alpha Coefficient and the result of the study is follow. 1) The satisfaction degree were classificated as 7 aspect and overall average score was 3.042. During that period satisfaction of personal relation aspect(M=3.737) shows highest level. Satsfiaction of clinical parctice(M=3.571) shows as second, Satisfiaction of environment(M=3.028), Satisfaction of guidance(M=2.915), satisfaction of subject are ordered of their scores. According to above study satisfaction's degree of subject show lowest level. 2) According to the result of verification of study. general character of student and satisfiaction degree has not much relation with sex, location of college, religion, period for enrolling college, teaching method of clinical practice. But the result show similar relation with following items. Satisfaction if subject and satisfaction of clinical practice(P=0.000), place of clinical practice and satisfaction of clinical practice(P=0.002), Academic record of college and satisfaction of clinical practice(P=0.000). 3) The relation of satisfaction(Subject, method of teaching, environment, period, rating, personal relation) of clinical practice and age of investigation's target Older student show higher satisfaction(P=0.040). Also method of teaching, environments, period, rating, personal relation has similarities with satisfaction. Therefore student who has higher satisfaction of clinical practice they also have higher rate for subject, environment, period, personal relation. 4) The result fo investigation, most interesting subject was crown & bridge and most difficult factor was too many simple-works to the student. One of ideal factor was discussing with counselor before they choose place for clinical practice. Third grade and first semester is most efficient time for clinical practice and 8 week is proper period for clinical practice. Clinical practice is absilutory mecessary and we find out most student rated positively. However we need more specific study about satisfcation of each subject. Because it shows lowest level and we need more pay attention for planning of clinical practice.
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