The purpose of this study was to evaluate the clinical application of the BeautiCem Veneer, which consists of three different shades of color lineup, and the BeautiCem Try-in paste, which is a try-in paste for the BeautiCem Veneer system, in determining the shade of resin cement for esthetic restorations with laminate veneers. A silicone impression was taken of the female patient's central incisor, and abutment tooth models were made using dental filling composite resin (shades: A1, A2, A3, A4) from this impression. Laminate veneers (IPS e.max Press, shade: HT BLS) were made for the abutment tooth models, and trial fitting was conducted using try-in paste (BeautiCem Try-in, Shofu) of three different shades (L-Value, M-Value, H-Value) with different brightness levels, and measurements (L*a*b*) were taken with the non-contact colorimeter DCCM-1 (Shofu) (L*a*b*). When the colorimetric results for the L* value, which indicates brightness, were statistically analyzed, there was no significant difference between the try-in paste of each color tone when applied to the abutment tooth model of the shade A1. When applied to the abutment tooth models in the other shades A2, A3, or A4, there was no significant difference between the L-Value and M-Value, but the H-Value, which had the highest brightness, showed a significantly higher L* value. In addition, in all the models, there was a tendency for the L* value to increase in the order of L-Value, M-Value, and H-Value, where the brightness of the try-in paste was higher. When the try-in of the laminate veneers was performed using the three types of try-in paste, it was confirmed that the M-Value was confirmed to have the best color harmony with the adjacent teeth. When the tooth surfaces of the restored teeth and adjacent teeth that were measured with SpectroShade (SpectroShade USA), it was confirmed that they showed equivalent L*a*b* values. Based on these results, the laminate veneers were bonded using the M-Value of the resin cement, and an esthetic restoration was achieved. The results of this study show that esthetic restorations are not only possible but feasible using a system of resin cement and try-in paste that consists of three different levels of brightness.

View full abstract

The aim of this study was to compare the brightness of a prosthesis when tested with water, which is often used as a simple test material, with that of a cementation system, and to clarify relative differential of the brightness. A female patient presented with a chief complaint of esthetic dissatisfaction of the maxillary left lateral incisor, for which a laminate veneer restoration was selected. Before laminate veneers (IPS e.max press MT BL3: Ivoclar Vivadent) were applied, they were tested with three different types (L-Value, M-Value and H-Value) of BeautiCem Try-in paste (Shofu) along with water. The brightness was measured visually and calorimetrically (using SpectroShade, SpectroShade USA). When the prosthetic device was tested with water, the L* value was 70.9 and with BeautiCem Try-in, the L-Value, M-Value and H-Value were 72.3, 73.7 and 74.0 respectively. The color distance Δ E*ab between water and other materials was L-Value: 1.6, M-Value: 3.0 and H-Value: 3.2. The perceptive threshold, which is the color distance that 50% of observers can recognize, corresponds to Δ E*ab=1.80, and the tolerance threshold, which is the color distance that 50% of observers can tolerate, is E*ab=3.46. Compared to these threshold values, the color distance between water and L-Value is within the perceptual threshold and the color difference cannot be recognized. On the other hand, the color distance between water, M-Value and H-Value is within the tolerable threshold but above the perceptual threshold, so the color difference can be recognized. In comparison with adjacent teeth, the b* values of both the central incisor and canine were higher and different, but the L* value of tooth restored with BeautiCem Try-in L-Value was similar. The patient was satisfied with the result of esthetic restoration with application of BeautiCem Veneer L-Value, which harmonized with the color tone of the adjacent teeth. It was concluded that L-Value should be selected for this cementation system if the balance with the adjacent teeth was satisfactory in the water test as the brightness of the L-Value was similar to that of the water test.

View full abstract

The satisfaction of patients wearing complete dentures is greatly affected by the maxillomandibular relationship, and it is said that the anatomical conditions of the mandible and the stability of the denture are important for this maxillomandibular relationship. It has been reported that application of functional impression technique to make mandibular dentures suctioneffective can achieve retention and stability even in cases where the condition of alveolar ridge is poor, and that the oral-related quality of life of patients wearing complete dentures is good, but the effect on occlusion is unknown. Therefore, in this study, we investigated the relationship between the stability of complete dentures fabricated using the impression technique aiming for suction-effective mandibular complete dentures. This study was conducted at 11 general dental clinics. The subjects were 66 completely edentulous patients (average age 77.2 ± 10.9), and those wearing overdentures or single dentures were excluded. The evaluation criteria included the occlusal score and the retention and stability score by the Kapur method. The average occlusal score was 4.89 ± 4.54. There was a tendency for the occlusal score to be higher in cases where the condition of the mandibular alveolar ridge is poor. The average value for the retention and stability score was 4.77 ± 0.63 for the maxilla and 3.94 ± 1.38 for the mandible. The results of the dentist-assessed retention and stability score and the patient-reported occlusal score suggest that fabrication of new mandibular dentures with application of suction-effective impression taking not only improves the stability of the denture, but also leads to good occlusal results, and may contribute to improving the patient's quality of life.

View full abstract

Objective: The stability is the most important factor in complete dentures. In particular, we present our considerations for the arrangement of artificial teeth for the mandible with residual ridge in bad shape. Treatment method: There is a textbook rule of the interalveolar ridge line, but this does not help attaining the stability of a denture. In this case, the anterior teeth of the mandible were arranged on the interalveolar ridge line, with reference to the lip support (partial flange technique), and the molar teeth were arranged on the alveolar crest, while also taking the Pound’s Line into consideration. After that, the denture was made after confirming stability with a wax mock-up. Results: After fitting, adjustments were required several times in all cases, but using this method, denture stability was achieved relatively easily, and good results were obtained. Discussion: It is thought that this method makes it possible to easily set appropriate denture space for each patient which in effect leads to denture stability.

View full abstract

Case summary: A 72-year-old woman presented with 5-year-old pain and clicking in the temporomandibular joints of both jaws when opening and closing her mouth after losing her lower right molar and upper left molar. She also had esthetic problems due to severe attrition. Since attrition had caused a decrease in the vertical dimension, a fixed prosthetic device was fitted after occlusal reconstruction. Discussion: After centric relation was obtained, vertical and horizontal maxillo-mandibular relations were determined using a therapeutic denture and overlay provisional restoration. By using a provisional restoration to check function and esthetics, a high level of oral-related quality of life was achieved. Conclusion: By using an overlay provisional restoration and a therapeutic denture to appropriately determine the vertical dimension in response to its decrease, a high level of patient satisfaction was achieved.

View full abstract

Edentulous patients with mandibular fractures often experience concurrently or subsequently fractures in the condyle and often show abnormalities in occlusion and masticatory movement after surgery for the mandibular fracture. Furthermore, there are many conditions̶i.e., their systemic conditions, etc.̶to take into considerations in cases with the elderly, and it is not uncommon for the dentists to struggle with the choice of treatment method. In Case 1, a mandibular fracture was found 42 years ago, and since then the patient has complained of abnormal occlusion even after becoming edentulous. The patient subsequently developed dementia, but the use of the clinical remounting technique led to a recovery of masticatory function, and there was also a corresponding improvement in cognitive function. In Case 2, a non-surgical reduction and fixation technique was used to treat a patient with a fractured mandible and occlusal deviation after he had suffered a fall due to an abdominal aortic aneurysm rupture, but masticatory function was restored early using the clinical remounting technique three months after surgery. The clinical remounting technique can be used to easily restore masticatory function even in cases where there is an occlusal deviation, such as after a mandibular fracture, and since it does not require any invasive procedures, it can be used to help determine the treatment plan in broader terms for patients with mandibular fractures who are edentulous.

View full abstract

[in Japanese]

View full abstract