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    Amelogenesis Imperfecta: Rehabilitation and Brainstorming on the Treatment Outcome after the First Year
    (Hindawi Ltd, 2015) Izgi, Ayca Deniz; Kale, Ediz; Nigiz, Remzi
    Amelogenesis imperfecta (AI) affects enamel on primary and permanent dentition. This hereditary disorder is characterized by loss of enamel, poor esthetics, and hypersensitivity. Functional and cosmetic rehabilitation is challenging with variety of treatment options. This report presents the treatment of an AI patient using conventional fixed dentures and discusses issues related to posttreatment complications and prosthetic treatment outcome after 1 year of follow-up. A 19-year-old male AI patient with impaired self-esteem presented with hypersensitive, discolored, and mutilated teeth. Clinical examination revealed compromised occlusion and anterior open-bite. After hygiene maintenance full-coverage porcelain-fused-to-metal fixed restorations were indicated and applied. At the end of the treatment acceptable functional and esthetic results could be achieved. However, nearly a year after treatment a gingival inflammation in the esthetic zone complicated the outcome. Insufficient oral hygiene was to be blamed. Tooth sensitivity present from early childhood in these patients may prevent oral hygiene from becoming a habit. The relaxation due to relieve of hypersensitivity after treatment makes oral hygiene learning difficult. Continuous oral hygiene maintenancemotivationmay be crucial for the success of the treatment of AI patients. Treatment of AI patients should be carefully planned and an acceptable risk-benefit balance should be established.
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    Directly Fabricated Inlay-retained Glass- and Polyethylene Fiber-reinforced Composite Fixed Dental Prostheses in Posterior Single Missing Teeth: A Short-term Clinical Observation
    (Quintessence Publishing Co Inc, 2011) Izgi, Ayca Deniz; Eskimez, Sebnem; Kale, Ediz; Deger, Yalcin
    Purpose: To evaluate the clinical usefulness of directly fabricated glass and polyethylene resin-bonded fiber-reinforced composite (FRC) inlay-retained fixed dental prostheses (FDPs) in posterior single missing teeth over a short period of time. Materials and Methods: Fourteen inlay-retained FRC FDPs with tub-shaped or box-shaped retainers were directly constructed in patients of both genders. A baseline examination was performed and the patients were examined regularly at 6-month intervals. The sulcus bleeding index, Silness-Loe plaque index, and probing depths of the abutments were checked regularly. Modified US Public Health Service (USPHS) parameters were used to compare the restorations at baseline and final examination. The Kaplan-Meier survival estimation method was performed to detect the overall survival rates and mean survival times of the restorations at the end of the follow-up. Results: The length of the clinical observation was between 16 and 40 months for the FDPs still functioning after the end of the follow-up. No partial or total debonding of the prostheses or fracture of the frameworks was detected. Four veneering composite fractures at the veneer layer/fiber framework interface occurred in the pontic elements of 2 glass FRC FDPs and 2 polyethylene FRC FDPs after 6 and 10 months, and 20 and 22 months, respectively. Periodontal evaluation revealed clinically acceptable results, as did the USPHS evaluation. The overall survival curves of Kaplan-Meier at the end of the follow-up illustrated a 71% survival rate for the both glass and polyethylene FRC FDPs with mean survival times of 27 and 35 months, respectively. Conclusion: This study reported a mean period of service of 19 and 31 months for directly fabricated inlay-retained glass and polyethylene FRC FDPs, respectively, with a 71% survival rate for the two framework constructions. Within the limitations of the study, these results can only be considered as preliminary. However, because of the lack of clinical data available for directly fabricated inlay-retained FRC FDPs, the results of this clinical observation may contribute to the still-evolving clinical knowledge of the FRC restorations.
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    Marginal and Internal Fit of Monolithic Zirconia Crowns Fabricated by Using Two Different CAD-CAM Workflows: An In Vitro Study
    (Mdpi, 2023) Cin, Vahap; Izgi, Ayca Deniz; Kale, Ediz; Yilmaz, Burak
    Objectives: Few studies have evaluated the marginal fit of computer-aided design-computer-aided manufacturing (CAD-CAM) monolithic zirconia crowns fabricated through completely digital workflow; however, the internal fit of these restorations is not well known. The purpose of this in vitro study was to evaluate the marginal and internal fit of monolithic zirconia crowns fabricated by using digital workflow, including intraoral scanner (IOS) scans, and compare the results to those of a semi-digital workflow, which combined conventional impressions, poured casts, and extraoral scanner (EOS) scanning. Materials and methods: A typodont right mandibular first molar was prepared for a complete-coverage ceramic crown and scanned using an IOS. The conventional impressions of the preparation were also made, and stone casts were poured and scanned by using an EOS. Virtual models were generated for both workflows, and identical virtual anatomic contour crowns were designed using CAD software. Monolithic zirconia crowns were fabricated for both IOS (ZI; n = 10) and EOS (ZE; n = 10) groups. The silicon replica technique was used to evaluate the marginal and internal fit of the crowns. Measurements were made at 13 points on buccolingual and mesiodistal cross-sections per specimen with a x6.5 to x50 zoom stereo microscope. The results from both groups were statistically compared using the Independent Samples t-tests and the Mann-Whitney U test (alpha = 0.05). Results: Mean gap values at all measurement locations for ZE were significantly higher than those for ZI (p <= 0.002). Overall mean values ranged between 29 and 43 mu m (median: 28-42 mu m) for ZI and 42 and 75 mu m (median: 43-77 mu m) for ZE. Conclusion: Completely digital workflow through intraoral scans provided significantly better marginal and internal fit for CAD-CAM monolithic zirconia crowns compared with the semi-digital workflow, where stone casts obtained from conventional impressions were scanned with an EOS. Yet, both workflows provided an acceptable marginal and internal fit for CAD-CAM monolithic zirconia molar crowns (<120 mu m). Clinical Relevance: Completely digital workflow using IOS scans may be advantageous for the fabrication of CAD-CAM monolithic zirconia crowns as favorable results can be obtained with less material waste and potentially shortened overall treatment time as the impression files can be transferred to the production facility electronically. The results need to be corroborated with clinical studies.
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    A Prospective Cohort Study on Cast-metal Slot-retained Resin-bonded Fixed Dental Prostheses in Single Missing First Molar Cases: Results After up to 7.5 Years
    (Quintessence Publishing Co Inc, 2013) Izgi, Ayca Deniz; Kale, Ediz; Eskimez, Sebnem
    Purpose: To evaluate under controlled clinical conditions the outcomes of cast-metal slot-retained resin-bonded fixed dental prostheses (RBFDPs) in which resin composite interlocked the restoration retainers in place after cementation in cases with single missing first molars, and to collect survival data on this esthetic RBFDP design combined with an economical metal fit-surface treatment method and resin luting system. Materials and Methods: Forty-one tub-shaped inlay-retained RBFDPs were clinically observed for up to 7.7 years in 35 recipients of both genders between 18 and 52 years of age. Clinical examinations were performed at baseline and 6 and 12 months after restoration placement, and thereafter at regular 1-year intervals. Modified US Public Health Service (USPHS) parameters, sulcus bleeding index, Silness-Loe plaque index, pocket depths, tooth mobility, pulp vitality, and periapical radiographs regarding the abutment teeth were assessed at these follow-up appointments. The Kaplan-Meier survival estimation method was performed to detect the overall and functional survival rates and mean survival times of the RBFDPs at the end of the study. The Breslow (Generalized Wilcoxon) test was used to evaluate the influence of restoration location and age and gender of the patient regarding the overall survival probability at the end of the follow-up (alpha = 0.05). Results: At the end of the study, 34 RBFDPs (83%) were still functioning with a mean follow-up of 6.3 years. According to the Kaplan-Meier survival curve, the overall and functional survival probabilities were calculated as 76% and 83%, with mean survival times of 6.8 years and 7.2 years, respectively. All clinical parameters monitored throughout the follow-up period predominantly revealed clinically acceptable results. Breslow test statistics presented nonsignificant differences with better results for the RBFDPs placed in the mandible of female recipients younger than 30 years of age. The most common failure noted with the RBFDPs was fracture of the occlusal veneering composite restoration over the retainer of a single abutment, leading to a predisposition of the restoration to partial debonding. Conclusion: Within the limitations of this prospective cohort study, it can be concluded that cast-metal slot-retained RBFDPs utilizing the interlocking mechanism of a resin composite to obtain additional retention from the abutment cavities show acceptable clinical success rates, and can be considered a minimally invasive, economical, and time-saving treatment alternative for the prosthetic rehabilitation of single missing first molars.