Objectives: The objective of this systematic review was to assess the 5-year survival rates and incidences of complications of all-ceramic fixed dental prostheses (FDPs) and to compare them with those of metal‐ceramic FDPs. Methods: An electronic MEDLINE and Dental Global Publication Research System search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on all-ceramic and metal‐ceramic reconstructions with a mean follow-up time of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by three reviewers. Failure rates were analyzed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year survival proportions. Results: The search provided 3473 titles for single crowns and FDPs and resulted in 100

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A systematic review of the survival and complication rates of all‐ceramic and metal–ceramic reconstructions after an observation period of at least 3 years. Part II: fixed dental prostheses.

Porcelain veneers: a review of the literature.

The purpose of this article is to identify the incidence of complications and the most common complications associated with single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores. A Medline and an extensive hand search were performed on English-language publications covering the last 50 years. The searches focused on publications that contained clinical data regarding success/failure/complications. Within each type of prosthesis, raw data were combined from multiple studies and mean values calculated to determine what trends were noted in the studies. The lowest incidence of clinical complications was associated with all-ceramic crowns (8%). Posts and cores (10%) and conventional single crowns (11%) had comparable clinical complications incidences. Resin-bonded prostheses (26%) and conventional fixed partial dentures (27%) were found to have comparable clinical complications incidences. The 3 most common complications encountered with all-ceramic crowns were crown fracture (7%), loss of retention (2%), and need for endodontic treatment (1%). The 3 most common complications associated with posts and cores were post loosening (5%), root fracture (3%), and caries (2%). With single crowns, the 3 most common complications were need for endodontic treatment (3%), porcelain veneer fracture (3%), and loss of retention (2%). When fixed partial denture studies were reviewed, the 3 most commonly reported complications were caries (18% of abutments), need for endodontic treatment (11% of abutments), and loss of retention (7% of prostheses). The 3 most common complications associated with resin-bonded prostheses were prosthesis debonding (21%), tooth discoloration (18%), and caries (7%). (J Prosthet Dent 2003;90:31-41.) A complication has been defined 1 as “a secondary disease or condition developing in the course of a primary disease or condition.” Although complications may be an indication that clinical failure has occurred, this is not typically the case. It is also possible that complications may reflect substandard care. But once again, this is usually not true. Most of the time, complications are conditions that occur during or after appropriately performed fixed prosthodontic treatment procedures. Knowledge regarding the clinical complications that can occur in fixed prosthodontics enhances the clinician’s ability to complete a thorough diagnosis, develop the most appropriate treatment plan, communicate realistic expectations to patients, and plan the time intervalsneededforpost-treatmentcare.Althoughaplethora of articles present clinical complications data, none provide a comprehensive comparison of the complications associated with the most commonly used restorations/

Clinical complications in fixed prosthodontics

Since the development of the ruby laser by Maiman in 1960, there has been great interest among dental practitioners, scientists, and patients to use this tool to make dental treatment more pleasant. Oral soft tissue uses are becoming more common in dental offices. The possible multiple uses of lasers in dentistry, beyond soft tissue surgery and dental composite curing, unfortunately, have not yet been realized clinically. These include replacement of the dental drill with a laser, laser dental decay prevention, and laser decay detection. The essential question is whether a laser can provide equal or improved treatment over conventional care. Safe use of lasers also must be the underlying goal of proposed or future laser therapy. With the availability and future development of different laser wavelengths and methods of pulsing, much interest is developing in this growing field. This article reviews the role of lasers in dentistry since the early 1960s, summarizes some research reports from the last few years, and proposes what the authors feel the future may hold for lasers in dentistry.

Lasers in dentistry.

This article reviews the current and potential applications of laser technology in nonsurgical therapy for the treatment of periodontal diseases. Based on its various characteristics, such as ablation or vaporization, hemostasis, and sterilization effect, laser treatment may serve as an adjunct or alternative to conventional, mechanical periodontal therapy. The Carbon dioxide (CO2) and the Neodymiumdoped:Yttrium-Aluminum-Garnet (Nd:YAG) lasers were previously approved for soft tissue treatment in periodontics (1, 2, 4), because of their superior ability of soft tissue ablation, accompanied by strong hemostatic and bactericidal effects (6, 37, 143, 170, 218). However, when these lasers are applied to dental hard tissues the result is major thermal damage, especially at a high-energy output, rendering them unsuitable for hard tissue treatment (56, 214). Recently, the Erbium-doped:Yttrium-AluminumGarnet (Er:YAG) laser was developed in dentistry (71, 85, 87). As it is capable of ablation in both soft and hard tissues, the Er:YAG laser can be used for periodontal hard tissue treatment such as root surface debridement, as well as soft tissue management (78). The use of lasers within the periodontal pocket has become a topic of much interest and is a promising field in periodontal therapy. This article deals with recent advances in nonsurgical laser therapy for periodontal disease, and will briefly describe the advantages and disadvantages of various laser types.

Lasers in nonsurgical periodontal therapy.

An in vivo study of cuspal fracture.

A study was conducted to compare the degree of resin polymerization achievable using conventional visible light techniques and argon lasing. High performance liquid chromatography was used to extract unpolymerized resin from microfilled and small particle composite resin samples following photoactivation with visible light and the argon laser. It was determined that a significantly greater degree of microfilled resin polymerization was achievable following argon lasing compared to exposure to conventional visible light techniques. Although the small particle composite resin samples were polymerized as well as, or slightly better, with the argon laser, the differences were found to be insignificant. As a result, the argon laser should be considered a potentially advantageous method of initiating the polymerization of dental composite resin restorations.

Degree of composite resin polymerization with visible light and argon laser.

A study was conducted to compare the compressive strength, diametral tensile strength, transverse flexural strength, and flexural modulus of a microfilled and a small particle composite resin restorative material following argon laser and conventional visible light polymerization techniques. All physical properties examined in this study were enhanced by laser polymerization. The diametral tensile strength of both types of restorative materials was significantly greater following laser polymerization, as were the transverse flexural strength and the flexural modulus of the microfilled resin restorative material. Additionally, these results were obtained with a laser polymerization time that was one-fourth that used for visible light activation. It was concluded that the argon laser is a potentially advantageous means of initiating the polymerization of dental composite resin restorations.

Enhancement of physical properties of resin restorative materials by laser polymerization

The aim of this study was to evaluate the effect of low fluence argon laser (AL) and acidulated phosphate fluoride (APF) treatment on caries initiation (CI) and progression (CP) in human enamel. Twenty caries-free molars were divided into tooth quarters. Tooth quarters from each specimen were assigned to one of four groups: 1) Control; 2) AL Only; 3) AL before APF; 4) APF before AL. AL was at 0.25 watts for 10 seconds (12.0 +/- 0.5 J/cm2). APF treatment was with a 1.23% gel for 4 minutes. Lesions were created in two treated, sound enamel windows per tooth quarter with an acidified gel. After CI and CP, sections were obtained and imbibed with water for polarized light study. Mean body of the lesion (BL) depths were determined and compared among groups (ANOVA & DMR). After CI, BL depths were: 189 +/- 29 micrometers for Control, 133 +/- 23 micrometers for AL only; 91 +/- 17 micrometers for AL before APF; and 83 +/- 14 micrometers for APF before AL. After CP, BL depths were: 321 +/- 43 micrometers for Control, 206 +/- 35 micrometers for AL only; 118 +/- 21 micrometers for AL before APF; and 114 +/- 19 micrometers for APF before AL. After CI and CP, argon laser irradiation alone resulted in significant reductions in lesion depth when compared with controls (p<0.05). APF treatment before or after argon laser exposure resulted in a significant reduction in lesion depth when compared with AL alone or control groups (p<0.05). Caries initiation and progression in vitro are affected to a significant extent when low fluence (energy) argon laser irradiation of sound enamel alone or in conjunction with APF treatment is done. This caries-protective effect occurs at an argon laser fluence (energy) that is capable of polymerizing visible light-cured resins.

Enamel caries initiation and progression following low fluence (energy) argon laser and fluoride treatment.

Argon laser shows promise in retarding caries progression. Recent research shows that laser irradiation can improve enamel’s resistance to caries. This in vitro study examines the effects of argon laser irradiation on root surface caries. Treated surfaces seemed more resistant to an artificial caries medium than control surfaces.

https://jada.ada.org/article/S0002-8177(94)54012-1/pdf

Richard J. Blankenau

Papers

An in vivo study of cuspal fracture.

Degree of composite resin polymerization with visible light and argon laser.

Enhancement of physical properties of resin restorative materials by laser polymerization

Enamel caries initiation and progression following low fluence (energy) argon laser and fluoride treatment.

Argon Laser Irradiation in Root Surface Caries: in Vitro Study Examines Laser’S Effects