Friday, July 21, 2017

Will Bioceramics be the Future Root Canal Filling Materials?


DOI: 10.1007/s40496-017-0147-x
Cite this article as:
Camilleri, J. Curr Oral Health Rep (2017). doi:10.1007/s40496-017-0147-x



Abstract

Purpose of Review

Filling the root canal is necessary when the dental pulp is lost as the dead space will be colonised by bacteria, leading to reinfection of the root canal and treatment failure. Treatment methodology depends on the extent of root formation and the choice of materials available. This review looks at the classical clinical methods and also queries if the newer materials change the treatment rationale.

Recent Findings

There is considerable confusion with nomenclature for some classes of dental materials. The newer materials have specific features that may not address the treatment needs. Nonetheless, the use of bioceramics and related materials definitely modifies and improves treatment outcome.

Summary

The classical treatment methods for filling the root canals of both immature and mature teeth are quite well-established in clinical practice. Open apices are treated with calcium hydroxide paste for an extended period of time to stimulate barrier formation at the apex, and the roots are then obturated in a similar way to adult teeth using a solid cone and root canal sealer. With the introduction of bioceramics and related materials, treatment of the immature apex has been shortened to one to two visits. Bioceramic root canal sealers have changed the concept of root canal obturation from the concept of hermetic seal and inert materials to biological bonding and activity. The introduction of these materials has certainly changed the clinical outcomes of filling the root canals. Treatment time has been reduced, which is beneficial for the treatment of paediatric patients. The chemical bond and antimicrobial properties of the sealers in conjunction with hydraulic properties are promising and can potentially improve the clinical success of treatment. Further research is necessary to be able to define clinical protocols for the use of these materials in order to optimise their properties.

Thursday, July 20, 2017

A technique for immediately restoring single dental implants with a CAD-CAM implant-supported crown milled from a poly(methyl methacrylate) block



Abstract

This technique is used when a single dental implant is placed. A stent made of autopolymerized acrylic resin was used to transfer the implant position to the laboratory. Once the implant position was transferred, the stone cast was scanned, and a computer-aided design and computer-aided manufacturing (CAD-CAM) interim implant-supported crown was milled from a poly(methyl methacrylate) (PMMA) block. A titanium insert, in contact with the implant platform and not the PMMA material, was used to support the crown. The interim prosthesis was then placed intraorally. The soft tissues were sutured, and the interim prosthesis was left for a period of at least 3 months to confirm osseointegration and allow the soft tissue to heal. A CAD-CAM titanium impression coping was made and used for the definitive impression. The contours of the impression coping were identical to the contours of the interim restoration. The data of the digital design of the interim prosthesis were saved, and the definitive prosthesis was fabricated with contours identical to those of the interim prosthesis.