Some notes from the systematic review of Dietschi(2007) on restoring endo treated teeth

1. After endo, 9% loss of moisture→slight influence on Young modulus of elasticity. However, NO DECREASE in compressive and tensile strength.
2. NaOCl, EDTA etc reduce dentin elasticity, flexural strength and microhardness.
3. A conservative access cavity decreases 5% tooth stiffness. Loss of marginal ridges decreases 44 to 63% tooth stiffness.
   
4. Behavior of resin-fiber posts depends on composition, fabrication process and the quality of the resin-fiber interface.
5. In vitro, the ideal post design is cylindrical coronally and conical apically.
6. Amalgam or gold restorations on endo treated teeth, when covering cusps, increase fracture resistance and tooth stiffness. If not covering cusps, then composite restorations behave similarly to an unaltered tooth.
7. A higher incidence of catastrophic root fractures is observed with ceramic posts. With fiber posts, the fractures are mainly on the coronal reconstruction.
8. If a crown with good ferrule is present, then the post material is not that important.
9. Cemented posts create less stress within the root than threaded posts.
10. With metallic post-cores the stress is accumulated mainly inside the foundation and in the apex. Fiber posts cause more stress in the cervical area.
11. Tooth reinforcement resulting from the use of posts is insignificant. Stress distribution within dentin is almost identical with or without posts→ role of the post is to support the restoration .
12. Titanium posts cemented with zinc phosphate present more leakage after fatigue, compared to adhesively luted posts.
13. Penetration of adhesives in radicular dentin is decreased towards the apex.
14. Adhesion to coronal dentin is better than to pulpal floor dentin, which is better than to root canal dentin.
15. Total-etch gives better bonding in the canal than self-etch.
16. Total-etch adhesives combined with a dual-curing cement appear to be the best choice.

Tooth as a pontic

In the past a case has been published, demonstrating the feasibility of this option. In the textbook of periodontology by Wilson and Kornman it has been suggested that in older patients treatment plan should aim at the function and phonetics rather than aesthetics, having in mind that those patients present with a fixed income and impaired ability to maintain complex restorative options. In other words, the replacement of anterior teeth with tooth pontic bridges should not be considered a suboptimal treatment option. This is a case series demonstrating that tooth pontic bridges when used in the anterior mandibular segments may stay for 5 years without major repair events.

files.me.com/manosterezakis/ffk5s9

Hyposalivation

A handy paper to read, when you finally meet with a patient complaining of dry mouth. Enjoy

files.me.com/manosterezakis/xkz7z7

Cracked tooth syndrome

Have you ever come at a point where your patient is constantly concerned for pain on chewing on a side and you just simply can't find any solution to his/her problem? Cracked tooth syndrome may be a possible condition related to a situation like this. This review summarises how you can detect this condition. Enjoy.

files.me.com/manosterezakis/58m3hw

Antibiotic prophylaxis in patients with prosthetic joints

This is the reply of the American Academy of Oral Medicine in the position paper of the American Academy of Orthopaedic Surgeons in regards with the use of antibiotic prophylaxis for dental treatment in patients with prosthetic joints. Some evidence are provided on the debate whether the there is a need for antibiotic prophylaxis during dental treatment of these patients.


files.me.com/manosterezakis/zkc7zg

Anterior tooth position

One of the most famous authors in the field of aesthetic dentistry is Frank Spear. In this article he presents the basic factors that influence the positioning of the maxillary central incisors, based on aesthetics. However, one should not forget that functional issues may influence the final outcome as well. Enjoy.

files.me.com/manosterezakis/92x8j0

Final impressions

This is not a recent paper (published in 2004). It may not appear useful to many of us. The authors present the basic principles of the materials selected for the final impression and basic information for the technique. At the end of the day maybe some of us would like to confirm that we utilise the right means and technique for final impression taking.

http://rapidshare.com/files/352602701/24_2_109-17.pdf