Maximizing esthetic results in posterior restorations using composite opaquers

Masking Ability of the Combined Application of Opaquers and Resin Composite on Discolored Backgrounds

The aim of this study was to evaluate the masking ability of a combined application of opaquers and resin composite over discolored backgrounds: A3, A3.5, C2, C3, and C4. The groups were divided according to the opaquer brand, the number of opaquer coats (one or two), and the thickness of the resin composite layer (0.5 or 1.0 mm). The color measurements were made by a reflectance spectrophotometer (SP60, EX-Rite). The color difference between the opaquer + resin composite + background and a reference background was calculated using the CIEDE2000 formula. ANOVA and Tukey's post hoc test (α=0.05) were used to analyze the ΔE00 mean values. A bivariate analysis was used to determine the association between dependent and independent variables. The masking ability was rated by the ΔE00 visual thresholds of acceptability and perceptibility (Excellent Match: ΔE00 ≤ 0.8; Acceptable Match: 0.8 < ΔE00 ≤1.8; Moderately Unacceptable Mismatch: 1.8 < ΔE00 ≤ 3.6; Clearly Unacceptable Mismatch: 3.6 < ΔE00 ≤ 5.4; Extremely Unacceptable Mismatch: ΔE00 > 5.4). The mean ΔE00 values ranged from 0.5 to 5.52. Masking ability was affected by the opaquer brand, thickness of the resin composite layer, and background shades. Most of the combinations that achieved either excellent or acceptable masking ability were obtained with combinations composed of one or two coats of opaquer and a 1.0-mm-thick resin composite layer for all backgrounds except C4. Acceptable results were also obtained for combinations with 0.5-mm-thick resin composite over C2, A3, and A3.5 backgrounds.

The outlook for implants and endodontics: a review of the tissue engineering strategies to create replacement teeth for patients

Ideally, root canal therapy involves the removal of diseased pulp tissues and permanent replacement with healthy pulp to revitalize teeth. Rather than placing implants, the ideal solution is to grow new replacement teeth. Success rates of implants and endodontic treatments can exceed 90%, which presents a formidable challenge to tissue engineering researchers to ensure that future dental treatments are even more successful. The purpose of this article is to explain how tissue engineering can be used to create replacement teeth. The science of tissue engineering has evolved from growing simple tissues in cell culture incubators to a multistep process. Although the problems of introducing tissue engineering therapies as part of routine dental treatments are substantial, the potential benefits are equally ground breaking.

Clinical Strategies for Success in Proximoincisal Composite Restorations. Part I: Understanding Color and Composite Selection

The restoration of proximoincisal (Class IV) defects with direct resin-based composites requires attention to many technical and artistic details. This article is the first of a series of two articles that aim at presenting clinical strategies for optimal success when direct resin-based composites are used for the restoration of moderate or large proximoincisal defects. Concepts of natural anatomy, color as it relates to dental structures, and composite selection are discussed in this article and are illustrated with a preclinical exercise and two clinical cases in which these concepts are applied.

Stem Cell Responses in Tooth Regeneration

Scientific advances in the creation of restorative biomaterials, in vitro cell culture technology, tissue grafting, tissue engineering, molecular biology, and the human genome project provide the basis for the introduction of new technologies into dentistry. This review is intended to facilitate the development of stem cell therapy for use with established therapeutic modalities to restore and regenerate oral tissues. Teeth have been shown to mineralize in response to injury for many decades, but only in recent years has the position of the stem cells been localized around blood vessels. The cells have been identified as myofibroblastoid pericytes. The ability to control the differentiation and proliferation of these cells is being examined to create stem cell therapies that can solve dental problems more effectively than current treatment regimes. Although the problems of introducing these technologies are substantial, the potential benefits to patients and the profession are equally promising - a cure for caries and diseases, a cure for oral cancer, correction of congenital defects, and the regeneration of teeth and tissues to restore oral functions. The purpose of this review is to describe how these new technologies can most usefully be employed in dentistry to enable clinicians to satisfy patient demand for a nondefective dentition.

Using opaquers under direct composite resin veneers: an illustrated review of the technique

In restorative dentistry direct composite resin materials can be used to conservatively resolve many esthetic problems. Opaque resins are often necessary to mask discolorations and/or dark backgrounds when restoring anterior teeth. This article presents a direct composite resin veneer technique using opaquers. Potential problems with the tone of restorations after the use of opaquers are discussed. Advantages, limitations, and the clinical technique are presented. Training, as well as attention to the technique, contributes to an acceptable result.

CLINICAL SIGNIFICANCE

Resinous opaquers can be used as a valid adjunct to the direct composite resin veneer technique when conservatively restoring dark teeth.