OBJECTIVES:This survey evaluated dentists' use of adhesive bonding methods of all-ceramic restorations over a period of twelve years. This is a follow-up survey which had been undertaken in 2007, 2011, and in 2015 [1].METHODS:A multiple choice questionnaire regarding adhesive bonding methods for all-ceramic restoration was developed and handed out in 2007 and 2019 to dentist participating in a local annual dental meeting in Northern Germany. The questionnaires were evaluated on the basis of evidence-based techniques from the scientific literature.RESULTS:Data from 93 questionnaires (2019) were compared with 90 evaluated questionnaires from 2007. Bonding of oxide ceramic had improved over the years of observation (7% to 62%) whereas evidence-based bonding of silicate ceramic restorations decreased from 66% to 38%; common mistakes were using air abrasion on silicate surface. Females showed better values for correct adhesive cementation than males (f: 39-50%, m: 22%-41%). A correlation between correct cementation and years of professional experience could not be revealed.CONCLUSION:Incorrect bonding of oxide ceramic restorations decreased within the 12 years investigated whereas there was no improvement of evidence-based bonding procedures of silicate ceramics. Still a high number of survey participants need additional training in bonding techniques.

AIM:The aim of this case report is to present the minimally invasive replacement of a missing molar in the presence of considerable proximal undercuts of the adjacent abutment teeth. The use of two single-retainer resin-bonded fixed dental prostheses (RBFDPs) made this therapy possible.MATERIALS AND METHODS:A missing mandibular right first molar required replacement. Two single-retainer RBFDPs were digitally designed in the shape of half a molar each and were milled using CAD/CAM from monolithic 3Y-TZP zirconia ceramic. The posterior RBFDP portion retained by the second molar was designed in the pontic contact area to create a common path of insertion for the anterior RBFDP portion with the distal surface of the second premolar. A slight interlocking between the proximal contact surfaces of the two pontics was designed to prevent future migration between the split restorations. Precise placement of the two RBFDPs during adhesive luting was ensured with the aid of a positioning splint.RESULTS:The patient was recalled after 10 months and was very satisfied with the minimally invasive molar replacement.CONCLUSION:Using two single-retainer RBFDPs to replace a molar in a split design enables a minimally invasive posterior tooth replacement despite considerable proximal undercuts of the adjacent abutment teeth.

Objectives: For extracted teeth in periodontitis patients, adhesively attaching their crown to the adjacent teeth temporarily closes the otherwise resulting gap, allowing to postpone more comprehensive prosthetic treatment to a more appropriate time if required. This study assessed the survival and maintenance efforts of adhesively attached extracted tooth crowns ('immediate pontics'; IPs). Methods: Patients receiving active and supportive periodontal treatment involving IPs in a university setting were retrospectively assessed. Survival and repairs of IPs were recorded. Multilevel Cox and linear regression analyses were performed to assess factors associated with survival and maintenance efforts. Results: Twenty-seven patients (male/female: 12/15) with 34 IPs (maxilla/mandible: 13/21) were followed over mean +/- SD 8.0 +/- 5.0 [range: 2.0-19.3] years. At baseline 85.2% suffered from periodontitis stage II or III and 59.3% showed rapid progression (grade C). The mean (95% CI) survival time of splinting was 5.3 +/- 3.8 [range: 0.1-18.0] years. Three IPs had been removed without any significant association with patient- or tooth-level factors. 35.3% of the IPs (n = 12) required a repair, with a mean of 0.5 +/- 0.9 [0-3] repairs per IP (annual: 0.1 +/- 0.2 [0-0.5]). The risk of repairs significantly increased with patients' age (p = 0.018). Conclusion: IPs showed moderate survival. However, to maintain IPs, frequent repairs were needed. Clinical significance: Immediately and adhesively attached crowns of extracted teeth in periodontitis patients seems like a valid, albeit temporary strategy which may allow to postpone more comprehensive prosthetic treatment if required, for example during active periodontal therapy. However, to maintain immediate pontics, frequent repairs were needed.

OBJECTIVES:This study assessed the survival and maintenance needs of splinted teeth in periodontitis patients. METHODS:Patients receiving active and supportive periodontal treatment involving teeth splinting in a university setting were retrospectively assessed. Tooth and splint survival and number of splint-repairs were recorded. Multilevel Cox and generalized-mixed linear regression analyses were performed. RESULTS:Fifty-seven patients with 227 splinted teeth (maxilla/mandible: 148/79) were followed over mean ± SD 11.0 ± 7.2 [range: 2.0-32.4]) years. Twenty-six splinted teeth were extracted during this period, the mean (95% CI) time of splint retention was 7.3 ± 5.7 (0.1-22.7). Splinted teeth did not show significantly increased risk of tooth loss compared with non-splinted teeth (HR; 95% CI: 1.30; 0.87-1.93); while age (1.07; 1.05-1.09), PPD >6 mm (4.24; 1.26-14.31), bone loss (mean HR was 5.07-15.36 depending on severity), tooth location (posterior versus anterior teeth: HR 2.08; 1.24-3.49) and the number of occlusal contact areas (mean HR was 4.38-17.34 depending on the number of antagonistic contact areas) were associated with tooth loss. 75.3% splints required repair, with a mean of 2.6 ± 1.9 [1.0-8.0] repairs per splint during the mean observation time (0.4 ± 0.6 [0.0-3.5] repairs per splint/year). CONCLUSION:Splinting did not significantly increase the risk of tooth loss; splinted teeth showed long-term survival. To maintain splints, frequent repairs were needed. CLINICAL SIGNIFICANCE:Splinted teeth were not at significantly higher risk of tooth loss than non-splinted teeth. While splinting does not improve the prognosis of periodontally affected teeth, it can assist their retention by reducing their mobility.