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      Restorative management using hybrid ceramic of a patient with severe tooth erosion from swimming: a clinical report

      case-report

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          Abstract

          This clinical report presents the clinical appearance and treatment approach in a case of excessive anterior teeth erosion resulted from swimming in a poorly-chlorinated swimming pool. Clinical findings revealed tooth sensitivity, severe enamel erosion resembling veneer preparations, and the presence of anterior open bite. A novel hybrid ceramic (Vita Enamic) was chosen for fabricating full-coverage crowns for this patient. After 6-months follow-up, the tooth sensitivity disappeared and the patient was satisfied with esthetic outcome. The hybrid ceramic restorations can be recommended with no complications.

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          Most cited references12

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          Mechanical properties of polymer-infiltrated-ceramic-network materials.

          To determine and identify correlations between flexural strength, strain at failure, elastic modulus and hardness versus ceramic network densities of a range of novel polymer-infiltrated-ceramic-network (PICN) materials. Four ceramic network densities ranging from 59% to 72% of theoretical density, resin infiltrated PICN as well as pure polymer and dense ceramic cross-sections were subjected to Vickers Indentations (HV 5) for hardness evaluation. The flexural strength and elastic modulus were measured using three-point-bending. The fracture response of PICNs was determined for cracks induced by Vickers-indentation. Optical and scanning electron microscopy (SEM) was employed to observe the indented areas. Depending on the density of the porous ceramic the flexural strength of PICNs ranged from 131 to 160MPa, the hardness values ranged between 1.05 and 2.10GPa and the elastic modulus between 16.4 and 28.1GPa. SEM observations of the indentation induced cracks indicate that the polymer network causes greater crack deflection than the dense ceramic material. The results were compared with simple analytical expressions for property variation of two phase composite materials. This study points out the correlation between ceramic network density, elastic modulus and hardness of PICNs. These materials are considered to more closely imitate natural tooth properties compared with existing dental restorative materials. Copyright © 2013 Academy of Dental Materials. All rights reserved.
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            Strength and fracture pattern of monolithic CAD/CAM-generated posterior crowns.

            This study evaluated the strength and fracture pattern of monolithic posterior CAD/CAM crowns hypothesizing that zinc-phosphate cemented lithium disilicate crowns might show the same fracture strength as adhesively cemented crowns. Two sets of monolithic posterior crowns each with uniform occlusal and lateral wall thickness of 1.5mm were fabricated from three types of block ceramic (1) lithium disilicate glass, (2) leucite glass and (3) feldspathic ceramic using CEREC 3 CAD/CAM. Crowns (n = 15) of ceramics (1), (2) and (3) each were (A) zinc-phosphate cemented, (B) adhesively cemented on resin-based composite dies and loaded until fracture. Load data was analyzed using ANOVA and Scheffé tests. Crack pattern was evaluated on an additional three sample cross-sections for each group at start of fracture. Radial cracks originated early at the cementation interfaces and cone cracks were observed finally at the loading sites. Mean load values (SD) of A-crowns at fracture start/end (1) 807 (91) N/2082 (192) N; (2) 915 (193) N/1130 (166) N; (3) 985 (199) N/1270 (301) N were all significantly (P < 0.001) lower when compared to their B-crown analogs (1) 1456 (205) N/2389 (84) N; (2) 1684 (395) N/2469 (171) N; (3) 1548 (304) N/2392 (75) N, rejecting the authors hypothesis. A-1 crowns had significantly (P < 0.001) higher fracture load than A-2 and A-3 crowns. The A-1 crown fracture load data, even if significantly (P < 0.001) lower, came close to the B-1 values. Adhesive cementation balanced the strength of weak ceramics with that of strong ceramic and recommended itself for leucite glass ceramic and feldspathic ceramic crowns. Zinc-phosphate cementation appeared feasible for lithium disilicate crowns.
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              Etiology of dental erosion--intrinsic factors.

              Dental erosion due to intrinsic factors is caused by gastric acid reaching the oral cavity and the teeth as a result of vomiting or gastroesophageal reflux. Since clinical manifestation of dental erosion does not occur until gastric acid has acted on the dental hard tissues regularly over a period of several years, dental erosion caused by intrinsic factors has been observed only in those diseases which are associated with chronic vomiting or persistent gastroesophageal reflux over a long period. Examples of such conditions include disorders of the upper alimentary tract, specific metabolic and endocrine disorders, cases of medication side-effects and drug abuse, and certain psychosomatic disorders, e.g. stress-induced psychosomatic vomiting, anorexia and bulimia nervosa or rumination. Based on a review of the medical and dental literature, the main symptoms of all disorders which must be taken into account as possible intrinsic etiological factors of dental erosion are thoroughly discussed with respect to the clinical picture, prevalence and risk of erosion.
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                Author and article information

                Journal
                J Adv Prosthodont
                J Adv Prosthodont
                JAP
                The Journal of Advanced Prosthodontics
                The Korean Academy of Prosthodontics
                2005-7806
                2005-7814
                October 2014
                21 October 2014
                : 6
                : 5
                : 423-426
                Affiliations
                Department of Prosthetic Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand.
                Author notes
                Corresponding author: Chaimongkon Peampring. Department of Prosthetic Dentistry, Faculty of Dentistry, Prince of Songkla University, 15 Kanchanawanit Road, Hat Yai, Thailand. Tel. 6674-429-874: mongkon.5c@ 123456gmail.com
                Article
                10.4047/jap.2014.6.5.423
                4211059
                0e027d5d-ff8b-470e-a6e9-ec09ef7f79bb
                © 2014 The Korean Academy of Prosthodontics

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 February 2014
                : 18 June 2014
                : 05 August 2014
                Funding
                Funded by: Prince of Songkla University
                Categories
                Case Report

                Dentistry
                dental erosion,swimming,hybrid ceramic,vita enamic
                Dentistry
                dental erosion, swimming, hybrid ceramic, vita enamic

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