Metal-free materials for making crowns and bridges

Teeth in the foreground

Fixed prosthodontic treatment is a routine dental procedure in which one or more missing or severely damaged teeth are replaced by artificial substitutes. The material used to make the prosthesis may be made of a metal framework with a veneering of an aesthetic material (ceramic) or entirely in metal or it can be made with different non-metal structures (metal-free materials). There is still uncertainty regarding metal-free long-term performance compared to metal-based crowns and bridges. Continue reading

Preformed crowns for managing decayed primary molar teeth

Close-up of fused ceramic corona, three elementsTo stop further damage and restore function of primary molar teeth that are decayed or malformed, a dentist will usually use a filling (a soft material that is placed in the cavity and hardened) to restore the tooth to its original shape. Alternatively the dentist may place a crown over the tooth to cover it. This usually requires an injection in the gum to numb the tooth before trimming it down (conventional technique). These crowns are pre-made (i.e. preformed) in a variety of sizes and can be metal or white, with the correct size being chosen to fit the trimmed down tooth. The Hall Technique is an alternative method for fitting metal crowns, where there is no need for an injection or tooth trimming as the crown is simply pushed over the tooth. Preformed crowns are recommended by specialists in children’s dentistry for the management of baby back teeth (molars) when they are affected by moderate to advanced tooth decay, or where the enamel has malformed during development or the tooth has had to have root canal treatment. Continue reading

Comparing dental implants – does material, surface coating or shape make a difference?

Dental implants

Missing teeth can sometimes be replaced with crowns, bridges or dentures, which may be attached to dental implants. Many different types of implant exist; more than 1,300 are available in different materials, shapes, sizes and with different surface characteristics or coatings. This newly updated review on the Cochrane Library compares the different types of implant, in terms of how often they fail and have to be removed. Failure could be biological and caused by bone loss or infection; or mechanical, where the implant itself fractures. Continue reading

New titles registered at the Cochrane Oral Health Group

The Cochrane Oral Health Group Editorial Team met on Monday afternoon and agreed to register two new titles:

Orthodontic treatment for bimaxillary proclination

This topic has been registered by a team based in London, Greece and at the Bahrain Branch of the UK Cochrane Centre. It will compare headgear, transpalatal arches and temporary anchorage devices and look at the evidence of the effectiveness of each.

Assisted design / Computer assisted manufacture (CAD/CAM) in anterior and posterior teeth

This clinically important topic has been registered by a team based at the College of Dentistry, New York University. It will consider whether restorations manufactured using computer-assisted images are more successful than those made conventionally.

The Oral Health Group looks forward to publishing both protocols and working with these teams.

New Cochrane Oral Health Group Reviews and Protocols for May 2012

Issue 5, 2012 of the Cochrane Library has just been published! The Cochrane Oral Health Group has published 2 new reviews and 2 new protocols:

New review: Single crowns versus conventional fillings for the restoration of root filled teeth
Zbys Fedorowicz, Ben Carter, Raphael Freitas de Souza, Carolina de Andrade Lima Chaves, Mona Nasser, Patrick Sequeira-Byron

This new review features one trial with 117 participants, and concludes that there is currently insufficient reliable evidence on the effectiveness of these two treatments.

ImageNew review: Treatments for adults with prominent lower front teeth
Hideko Minami-Sugaya, Débora A Lentini-Oliveira, Fernando R Carvalho, Marco Antonio C Machado, Clóvis Marzola, Humberto Saconato, Gilmar F Prado

Several treatments have been proposed for this condition, including orthopedics, functional appliances, interceptive and corrective orthodontics and surgery. However, only two small trials matched the inclusion criteria for this review, and more evidence is needed to judge effectiveness.


ImageNew protocol: Interdental brushing for the management of periodontal diseases and dental caries in adults
Tina Poklepovic, Dario Sambunjak, Trevor M Johnson, Pauline Imai, Peter Tugwell, Jason W Nickerson, Jan E Clarkson, Helen V Worthington

This is a protocol for a new systematic review, which will consider the effectiveness of interdental brushing to prevent dental caries and periodontal disease, when compared to regular brushing alone.

New protocol: Rubber dam isolation for restorative treatment in dental patients
Yan Wang, Chunjie Li, He Yuan, May CM Wong, Zongdao Shi, Xuedong Zhou

This new review wil consider the effectiveness of rubber dams in isolating the dental treatment area and controlling moisture. It will compare rubber dams with other methods of isolation (for example, cotton rolls).

Other highlights of the Cochrane Library, Issue 5, 2012 include: