Master the Art of Direct Resin Bonding at The Center for Esthetic Excellence in Downtown Chicago

Join these two masters for an unforgettable experience at the Center for Esthetic Excellence.  Dr. Buddy Mopper and Dr. Dennis Hartlieb will be presenting “Catch the Composite Wave and Surf its Potential” on October 11-12, 2018. Dr. Mopper is one of the pioneers of direct resin bonding who has taught thousands of dentists how to successfully use direct resin bonding in their practices. Named by DPR as one of the top five dentists to watch, Dr. Hartlieb is an exceptional clinician and teacher with an intensity of purpose to deliver a comprehensive learning experience to each of the class participants. Only a few spots remain in this class, so don’t miss an opportunity to learn from both of these masters in an intimate and hands-on environment.  Call now to reserve your spot at 800-837-2321or visit us online at
Dr. Newton Fahl will present his advanced class “Form, Color and Anterior Composites” at the Center for Esthetic Excellence on October 22-23, 2018. World renowned for his composite artistry, Dr Fahl can do with composites what great artists do with paint. Dr. Fahl is eager to share with you his passion and his knowledge of esthetic dentistry. Take this class to give yourself a treat- only a few spots left! Call now to reserve your spot at 800-837-2321 or visit us online at
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Comparison of the Fit of Lithium Disilicate Crowns made from Conventional, Digital, or Conventional/Digital Techniques

Journal of Prosthodontics banner

First published: 08 August 2018



To evaluate the fit of single crowns fabricated using conventional, digital, or cast digitization methods.

Materials and Methods

One subject with a peg‐shaped maxillary lateral incisor was selected in this study. Tooth preparation for an all‐ceramic crown was performed and 10 conventional poly(vinyl siloxane) impressions, and 10 digital impressions using an intraoral scanner were made. Each working cast was scanned using a laboratory scanner and an intraoral scanner. Four groups were tested Group 1: conventional impressions. Group 2: cast laboratory scans. Group 3: cast scans using intraoral scanner. Group 4: direct intraoral scans. For group 1, heat‐pressed glass ceramic crowns (IPS e.max Press) were fabricated using casts produced from the conventional impressions. For groups 2‐4, crowns were milled using ceramic blocks (IPS e.max CAD). Ten crowns were fabricated for each group. Marginal and internal gaps were measured using a replica technique. Replicas were sectioned mesiodistally and buccolingually and were observed under a stereomicroscope. Three measurements were selected for each cut: occlusal, axial, and marginal. Statistical analysis was performed using two‐way ANOVA and Tukey HSD tests.


For each replica, 6 measurements were made for the mesiodistal and the same for the buccolingual cuts, producing 12 measurement points per crown (4 measurements for marginal, 4 for axial, 4 for occlusal), 120 measurements for each group (40 measurements for marginal, 40 for axial, 40 for occlusal), and 480 measurements in total. Two‐way ANOVA revealed location to be a significant factor (p = 0.001). No significant differences among groups (p = 0.456), and no interactions between groups and locations (p = 0.221) were found. Means for the occlusal site were significantly larger than other sites in most group combinations, while the difference between the marginal and axial sites was not significant. No significant differences among groups were found for each measurement. The marginal gaps ranged from 125.46 ± 25.39 μm for group 3 to 135.59 ± 24.07 μm for group 4. The smallest axial mean was in group 1 (98.10 ± 18.77 μm), and the largest was 127.25 ± 19.79 μm in group 4. The smallest occlusal mean was in group 2 (166.53 ± 36.51 μm), and the largest occlusal mean was in group 3 (203.32 ± 80.24 μm).


Ceramic crowns, which were made using all‐digital approach or cast digitization by a laboratory or intraoral scanner had comparable fit to those produced by conventional approach.

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Research and Education Evaluation of the success rate of cone beam computed tomography in determining the location and direction of screw access holes in cement-retained implant-supported prostheses: An in vitro study

The Journal of Prosthetic Dentistry


Statement of problem

Cement-retained implant-supported restorations have advantages over screw-retained restorations but are difficult to retrieve. Identifying the approximate location of the screw access hole (SAH) may reduce damage to the prosthesis.


The purpose of this in vitro study was to evaluate the ability of cone beam computed tomography (CBCT) imaging to determine the location and direction of SAHs in cement-retained implant prostheses.

Material and methods

Five clear acrylic resin casts were made based on a mandibular model. Several implant osteotomies (n=30) were created on the models with surgical burs, and crowns were made using the standard laboratory method with a transfer coping and the closed tray impression technique. CBCT images from the acrylic resin casts were evaluated by a maxillofacial radiologist who was blind to the locations and angles of the osteotomies. The locations of the access holes were determined on multiplanar reconstruction images and transferred to the clinical crown surface as defined points. Based on cross-sectional images, the predicted angle of the access hole was provided to a prosthodontist who was requested to pierce the crown at the proposed location in the specified direction. If the location and/or direction of the access hole were found, the process was considered successful, as the crown could then be removed from the implant abutment through the SAH. The success rate in the detection of the location and direction of the SAH was calculated, and chi-square and Fisher exact tests were applied for data analysis (α=.05).


According to the results of this study, the success rate of CBCT to define the location of SAHs was 83.3% and 80% to determine the direction. No significant differences were found among the different dental groups in determination of the location (P=.79) or the direction (P=.53) of the SAHs. Most of the failures in determining the location and direction of the access hole in the buccolingual and mesiodistal directions were in the buccal and mesial locations of the SAH. The success rate of using CBCT to determine the location of SAHs in straight abutments was 100%. A significant difference was found between angled and straight abutments (P=.042).


Using CBCT could help determine the direction and location of SAHs in clinical situations.
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Poor Oral Health Predicts Higher 10-Year Cardiovascular Risk: A Propensity Score Matching Analysis

Background: Although the association between periodontitis and cardiovascular disease (CVD) has been reported, whether periodontitis and poor oral health behavior influence CVD risk remains unclear.

Objective: The aim of this study was to examine whether periodontal disease and poor oral health behavior predict 10-year general CVD risk using the Framingham Risk Score.
Methods: Patients older than 30 years with no CVD history (n = 8370) were selected using cross-sectional study data from the Korean National Health and Nutrition Examination Survey in 2013 and 2014. To reduce selection bias in this population-based study, propensity score matching analysis was used with SPSS and R programs to compare CVD risk.

Results: Overall, 39.2% of the study population (n = 3277) had a global CVD risk of 10% or greater. In the low- and at-risk groups, 20.7% and 45.3% of patients, respectively, were diagnosed with periodontal disease by a dentist. Moreover, 43.2% and 62.8% of the low- and at-risk group patients, respectively, brushed teeth less than 3 times a day. After 1:1 propensity score matching of the low-risk (n = 1135) and at-risk (n = 1135) groups, bivariate analyses showed that a diagnosis of periodontal disease and less frequent toothbrushing were associated with a higher CVD risk (P < .001). Logistic regression analysis also showed that patients having periodontal disease and who brushed teeth less frequently were 1.38 and 1.33 times, respectively, more likely to be at risk of CVD (P < .001).

Conclusion: Education on periodontitis management and oral hygiene behavior should be included, when strategies for public risk reduction of CVD are developed.

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Evaluation of occlusal caries detection and assessment by visual inspection, digital bitewing radiography and near-infrared light transillumination

Clinical Oral Investigations

, Volume 22, Issue 7, pp 2431–2438 | Cite as



This study compared the diagnostic outcomes of visual inspection (VI), digital bitewing radiography (BWR), and near-infrared light transillumination (NIR-LT, DIAGNOcam, KaVo, Biberach, Germany) for occlusal caries detection and assessment of posterior teeth.

Participants and methods

This study included 203 patients (mean age 23.0 years). All individuals received a meticulous VI. Additionally, BWR and NIR-LT images were collected. All BWR and NIR-LT images were blindly evaluated for the presence of enamel caries lesions (ECLs) and dentin caries lesions (DCLs). The descriptive statistical analyses included calculation of frequencies, cross tabulations, and pairwise comparisons using Pearson chi-square tests.


The majority of ECLs/DCLs were detected by VI in this low-risk adult population. The additional diagnostic outcomes in terms of ECLs/DCLs amounted to 5.0% (BWR) and 6.8% (NIR-LT). The combined usage of VI/NIR-LT or VI/BWR identified 95.7 and 94.4% of all ECLs/DCLs on occlusal surfaces, respectively.


This comparative diagnostic study showed that VI detected the majority of occlusal caries lesions. Both additional methods showed limited benefits. Due to the valuable features of NIR-LT, i.e., X-ray freeness and clinical practicability, this method might be preferred over X-ray-based methods. Nevertheless, BWRs should be prescribed in clinical situations where insufficient fillings or multiple (deep) caries lesions are diagnosed or where there is a need to assess the caries extension in relation to the pulp.

Clinical relevance

VI has to be understood as caries detection method of choice on occlusal surfaces in low-risk adult population which may help to avoid multiple diagnostic testing, overdiagnosis, and overtreatment.
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