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Abstract 24

1 Internalized discoloration of dentin under porcelain crowns 2 Ceramic Pressed to Metal Versus Feldspathic Porcelain 3 Effect of two connector designs on the fracture resistance 4 Relationship between Post endodontic Pain,Tooth Diagnostic Factors, and Apical Patency Internalized discoloration of dentin under porcelain crowns: A clinical report Heather J. Conrad DMD, MSa, , and James R. Holtan DDSb aAssistant Professor, Division of Prosthodontics, Department of Restorative Sciences. School of Dentistry, University of Minnesota, Minneapolis, Minn bAssociate Professor, Director of Graduate Program in Prosthodontics,, Department of Restorative Sciences. School of Dentistry, University of Minnesota, Minneapolis, Minn Available online 20 February 2009. This clinical report describes the situation of a patient who was concerned about the appearance of porcelain crowns that were placed on the maxillary incisors 4 years prior. The mechanicochemical gingival retraction technique combining the use of ferric sulfate and knitted retraction cord is described as a possible etiology of internalized discoloration of the dentin in this situation. The hypothesis is explained by the high acidity of gingival retraction fluids (GRFs) and the high affinity of iron for hard tooth tissues, resulting in an interaction with bacterial byproducts and precipitation of insoluble ferric sulfide in the porous demineralized dentin. A prospective clinical trial is warranted to track the effects of GRFs on tooth structure. This article describes the treatment of internalized discoloration of dentin under porcelain crowns. (J Prosthet Dent 2009;101:153-157) Ceramic Pressed to Metal Versus Feldspathic Porcelain Fused to Metal: A Comparative Study of Bond Strength International Journal of Prosthodontics January/February 2009 Volume 22 , Issue 1 Bhavani Venkatachalam, DMD, MS/Gary R. Goldstein, DDS/ Mitchell S. Pines, DDS/Eugene L. Hittelman, MA, EdD Purpose: The aim of this study was to compare the debond/crack initiation strength (D/CIS) of a leucite-based low-fusing ceramic pressed (PC) to metal and feldspathic porcelain (FP) fused to metal. Materials and Methods: Forty rectangular metal specimens, 20 noble alloy (NA; gold-palladium) and 20 base metal alloy (BA; cobalt-chromium) were fabricated per ISO 9693:1999 standards (25.0 mm 3 0.5 mm 3 3.0 mm). Ten samples in each group received FP and the remaining 10 received PC. The samples in the PC group underwent wax pattern build-ups and subsequent investing and casting. The ceramic dimensions in all four groups were 8.0 mm 3 1.0 mm 3 3.0 mm. The final metal-ceramic specimen thickness was 1.5 mm. All specimens were subject to the Schwickerath crack-initiation three-point bending test at a crosshead speed of 1.5 mm/min. Metal-ceramic fracture loads were recorded in Newtons and D/CIS was calculated using the formula: tb = k × Ffail. Results: Mean D/CIS were as follows: BA-FP: 36.11 ± 2.31 MPa, NA-FP: 42.64 ± 1.94 MPa, BA-PC: 37.47 ± 6.02 MPa, and NA-PC: 47.94 ± 3.92 MPa. A 2-way ANOVA revealed no significant difference in D/CIS values between the four groups. A statistically significant difference was noted when comparing the mean D/CIS values obtained between the two metal alloys used (NA: 45.29 MPa and BA: 36.79 MPa). Conclusion: No differences (P > .05) in mean D/CIS were found between the low-fusing ceramic pressed to metal and the FP fused to metal. A higher mean D/CIS (P > .05) was found for the NA compared to the BA, with both ceramics tested. Int J Prosthodont 2009;22:94 100. Effect of two connector designs on the fracture resistance of all-ceramic core materials for fixed dental prostheses Kwansiri Plengsombut DDS, MSa, , , Jane D. Brewer DDS, MSb, Edward A. Monaco Jr DDSc and Elaine L. Davis PhDd aFormer Resident, Department of Prosthodontics; private practice, Bangkok, Thailand, School of Dental Medicine, State University of New York at Buffalo, Buffalo, New York bClinical Associate Professor, Department of Restorative Dentistry, School of Dental Medicine, State University of New York at Buffalo, Buffalo, New York cProgram Director, Advanced Education in Prosthodontics, Department of Restorative Dentistry, School of Dental Medicine, State University of New York at Buffalo, Buffalo, New York dAssociate Professor, Department of Oral Diagnostic Sciences; Associate Dean for Student Affairs, School of Dental Medicine, State University of New York at Buffalo, Buffalo, New York Available online 20 February 2009. Statement of problem Most all-ceramic fixed dental prostheses (FDPs) fail at the connectors. Purpose The purpose of this study was to determine the effect of 2 connector designs on the fracture resistance of core materials used for all-ceramic FDPs. Material and methods Three materials were tested: (1) heat-pressed lithium disilicate glass ceramic (IPS e.max Press (Press)), (2) milled lithium disilicate glass ceramic (IPS e.max CAD (CAD)), and (3) milled yttrium-stabilized tetragonal zirconia polycrystals (Y-TZP) (IPS e.max ZirCAD (ZirCAD)). Specimens were made into 30 × 4 × 4-mm bars to represent 3-unit FDPs. Two connector designs, round (0.60 ±0.01-mm radius of curvature) and sharp (0.06 ±0.001-mm radius of curvature), with a 3.00 ±0.05-mm cross-section for each connector, were studied (n=5). Each specimen was loaded to fracture in a universal testing machine with a crosshead speed of 0.1 mm/min. Data were analyzed with a 2-way univariate ANOVA and Tukey HSD test (a=.05). Results Mean (SD) failure loads for round connector designs were 684.2 (70.1) N for ZirCAD, 260 (7.8) N for CAD, and 172.9 (35.5) N for Press. Mean (SD) failure loads for sharp connector designs were 386.3 (51.5) N for ZirCAD, 87.9 (7.0) N for CAD, and 125.1 (15.1) N for Press. The 2-way univariate ANOVA indicated statistically significant differences (P<.005) for material and connector design, and, also, a significant interaction between material and connector design. Higher maximum failure loads were found for the round connector design when compared to the sharp connector design, for ZirCAD and CAD. However, this difference was not statistically significant for the Press groups. SEM subjective assessment of the fractured specimens revealed that the fracture initiated from the gingival surface (tensile) of the connector toward the pontic (central loading point). Conclusions Fracture resistance of ceramic core materials is affected by fabrication technique and connector design. Connector design affected fracture resistance of the milled ceramic, but not the pressed ceramic. (J Prosthet Dent 2009;101:166-173) Relationship between Post endodontic Pain, Tooth Diagnostic Factors, and Apical Patency Ana Arias DDS, Dr. Odont, Magdalena Azabal MD, DDS, Dr. Med†, Juan J. Hidalgo MD, DDS, Dr. Odont and José C. de la Macorra MD, DDS, Dr. Med, , Private practice, Madrid, Spain Department of Conservative Dentistry, Faculty (Estomatologia II) of Odontology, Complutense University of Madrid, Madrid, Spain Available online 21 January 2009. Abstract This study compares the incidence, degree, and length of postoperative pain in 300 endodontically treated teeth, with and without apical patency, in relation to some diagnostic factors (vitality, presence of preoperative pain, group, and mandible of treated tooth). Of the questionnaires received back, apical patency was maintained during shaping procedures with a #10 K-file in one group (n = 115) and not in the other (n = 121). There was significantly less postendodontic pain when apical patency was maintained in nonvital teeth. If pain appeared, its duration was longer when apical patency was maintained in teeth with previous pain or located in the mandible. Maintenance of apical patency does not increase the incidence, degree, or duration of postoperative pain when considering all variables together. Key Words: Apical patency; postendodontic pain; postoperative pain

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