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PubMed2004

An esthetic technique to fill screw-retained fixed prostheses.

Currently, many composite materials have been used in the filling of access openings for screw-retained implant prosthesis. The main disadvantage of these materials is the compromise in esthetics that they place on the implant crown. An additional disadvantage is leakage of bacterial contaminants around traditional light-cured composites placed in the screw access hole. This article introduces a technique that uses opaqueing composites and the expansion properties of panacea (Zeza Inc, Chester, NY) resin to help remedy these problems. The fabrication of the silicone obturator is explained in previous literature. By following this technique, the dentist can use resin to decrease microleakage and opaqueing composite to improve esthetics.

Composite Resins↗
PubMed2004

Single-tooth replacements in the esthetic zone with an immediate function implant: a preliminary report.

Patients demand an economic, esthetic, and expedient fashion to replace teeth that are missing in the esthetic zone. The clinical response of a 1-piece spiral immediate-function implant was evaluated for this purpose. The implants were placed into immediate extraction sites as well as healed sites and were provisionalized, and patients were put into immediate function the same day as surgery. Sites that qualified for this technique were based on bone density. Bone density in combination with its aggressive thread design and conservative surgical osteotomy preparation produced a 98.8% success rate over a 3-year period for 86 patients.

Adolescent↗
PubMed2004

Functional and esthetic considerations for single-tooth Ankylos implant-crowns: 8 years of clinical performance.

PROBLEM: Following the loss of an anterior natural tooth, the mucogingival complex begins to collapse. The early placement of endosseous dental implants can prevent or reduce the extent of this collapse. If there is a long interval between the loss of the natural tooth and the placement of the implant prosthetic replacement, this collapse tends to increase significantly. PURPOSE: This paper will report on the clinical success of this implant product in the fabrication of esthetic, functional, and harmonious replacements for missing single, natural teeth for a period of 8 years. METHOD: A total of 275 single Ankylos implant tooth restorations in the anterior and posterior jaw regions were placed and monitored for 8 years. Of these, 264 implants were restored using the titanium Balance abutments, and only 11 were restored using ceramic abutments. The final restorations were either metal-ceramic or full-ceramic crowns and were cemented with glass ionomer cement. RESULTS: The survival rate was 98.2%, with only 5 implants being lost during the healing phase. There were no other implant losses in the postloading period that averaged 3.2 years. To date, there have been no mechanical complications associated with the prosthetic components (ie, screw loosening, screw breaking, or crown breaking) for either the titanium or the ceramic abutments. CONCLUSIONS: Experience with the Ankylos system with single-tooth replacement indications may be considered positive with regard to the esthetic and functional results of the treatment. The lack of mechanical complications and problems with the hard and soft tissue in the loading phase of the implants suggests the functional safety of the tapered connection between implant and abutment.

Crowns↗
PubMed1985

The frenectomy combined with a laterally positioned pedicle graft. Functional and esthetic considerations.

In many cases it is necessary to perform a frenectomy to prevent reopening of a midline diastema following closure by orthodontic therapy. Often the loss of the interdental papilla between the maxillary incisors during the classic frenectomy creates an unacceptable esthetic result. A surgical technique combining a frenectomy with a laterally positioned pedicle graft is presented. The interdental papilla is left surgically undisturbed if it is of physiologic size. If it is enlarged, gingivoplasty is performed to reduce it to an appropriate size. Closure across the midline by laterally positioning gingiva and healing by primary intention results in attached gingiva across the midline. This attached gingiva may have a bracing effect and thus aid in preventing orthodontic relapse (reopening of the diastema). Twenty-seven cases were treated. No relapse was found in 24 cases and in 3 cases only minimal relapse was noted (less than 1 mm). The esthetic result is superior to that obtained with the classic frenectomy technique.

Esthetics, Dental↗
PubMed2006

[A case report of esthetic and functional rehabilitation by a combination of periodontal and orthodontic treatments for advanced periodontal disease].

PATIENT: The patient was a 44-year-old woman who presented with masticatory and esthetic problems. She had discoloration of CR filling of a maxillary anterior tooth, marginal discoloration, anterior protrusion, median diastema, and closed bite where the mandibular anterior tooth region occluded with the maxillary alveolar region, tooth 8 elongation and tooth 4 defect. Periodontal and orthodontic treatments were therefore performed for esthetic and functional recovery. DISCUSSION: After prosthodontic therapy, postoperative management techniques are crucial, including thorough plaque control, use of a retainer to prevent teeth from moving back towards the original positions (Begg technique), muscle function therapy (improving tongue movement patterns and strengthening the lingual and oral sphincter muscles) and occlusal adjustment. CONCLUSION: In the present patient, the effectiveness of orthodontic therapy before prosthodontic therapy was reaffirmed: dentine can be preserved, prosthodontic therapy is easier to perform, and therapeutic outcomes are highly predictable.

Adult↗
PubMed2006

[A case report: treatment of an esthetically highly motivated patient with Konus telescope denture].

PATIENT: A 49-year-old male was referred to our hospital in February 1999, complaining of esthetic problems of a mandibular partial denture and poor retention of a maxillary denture. This case was treated with a Konus mandibular denture for obtaining the patient's esthetic satisfaction. DISCUSSION: The abutment teeth and dentures have been kept in good condition since the dentures were delivered six years ago. According to panorama x-ray, however, the maxillary alveolar ridge appears to have already started to gradually resorp. Therefore, it is very important to carefully check the symptoms of what is wrong with his teeth, dentures, and alveolar ridge during every visit. CONCLUSION: The Konus denture has given the patient a great satisfaction, although the potential symptom of maxillary alveolar ridge resorption exists.

Bone Resorption↗
PubMedDate not supplied

Use of two surface analyzers to evaluate the surface roughness of four esthetic restorative materials after polishing.

This study had two aims: determine how well four esthetic restorative materials lent themselves to polishing and compare the results obtained using two different techniques for evaluating surface roughness. The four materials used were two composites modified by the addition of resin, Dyract AP (Dentsply) and Dyract Flow (Dentsply); one composite designed for posterior restorations, SureFil (Dentsply) and one universal micromatrix composite, Esthet-X (Dentsply). Five test pieces were made with each product by inserting the material into cylindrical molds and polymerizing it layer by layer. A single operator polished the specimens on the same day using the Enhance system (Dentsply) and two aluminum oxide pastes. The surfaces were studied successively by means of two surface analyzers: a high-resolution optical profilometer (Nanosurf 488, SAS Technology) and a mechanical profilometer (Mitutoyo Surftest-SV 402). These measurements gave the mean roughness of the surface (Ra). Ten zones were examined for each specimen, and the specimens were observed under an optical microscope (PMG3 inverted metallographic microscope) at 50x magnification. The qualitative and quantitative analyses of the results showed good surface states for all materials. However, the composites based on nano- and micro-filler technology gave the smoothest surfaces after polishing. A comparison of the values obtained with each method of observation showed that mechanical profilometry tended to show roughness caused by polishing, while optical profilometry brought out roughness due to the structure of the material itself.

Aluminum Oxide↗
PubMedDate not supplied

Optimal esthetics in single-tooth replacement with the Re-Implant system: a case report.

PURPOSE: This report demonstrates the use of root-analogue titanium implants for single-tooth replacement. MATERIALS AND METHODS: A maxillary lateral incisor was removed and a custom-made one-stage, root-analogue titanium implant (Re-Implant) with an apical extension and a healing cap was fabricated and placed immediately after tooth extraction. Six months later the healing cap was removed, an impression was taken, and a porcelain-fused-to-metal crown was fabricated and cemented. RESULTS: No complications occurred during the healing period. A good esthetic result was achieved with the final ceramometal crown. Bony resorption and buccal soft tissue recession led to a slight discoloration of the marginal periimplant mucosa. CONCLUSION: Further research into the modalities of the immediate placement of root-analogue implants is needed to obtain predictable esthetic results concerning the soft tissue environment.

Dental Implantation, Endosseous↗
PubMedDate not supplied

Tissue preservation and maintenance of optimum esthetics: a clinical report.

Today, most tooth replacement in the esthetic zone is done using implants placed in a delayed surgical protocol. Unfortunately, this delay can result in loss of both hard and soft tissue during the healing period, necessitating guided tissue regeneration techniques at the time of implant placement. Recent developments with tapered implants have facilitated predictable immediate implant placement, preserving the osseous structure surrounding the socket. Further developments with custom healing abutments can preserve the crestal soft tissues, including the papillae. This article reviews techniques that provide for the preservation of both bone and soft tissue while enhancing the esthetic results around implants.

Bicuspid↗
PubMed1999

Esthetic replacement of a maxillary central incisor with an ITI 15-degree angled implant: a case report.

Single-stage implants are frequently used, but their use in the anterior dentition has not been widely published. The purpose of this case report is to present the esthetic result of a single-stage implant to replace a maxillary central incisor, and to demonstrate the unconventional use of a 15-degree angled ITI implant. A 15-degree 12-mm hollow cylinder was placed with the angle reversed facially. The emergence profile of the adjacent roots was matched with the transmucosal portion, turning at the osseous crest. The implant was restored after 6 months with an ITI gold coping and transverse screw-retained crown. The gingival margin and the papillae were shaped by the transmucosal portion and the restoration. To date, the implant has been loaded for 24 months with an ideal soft tissue esthetic and radiographic appearance.

Adult↗
PubMed2000

Creating esthetic composite restorations.

The purpose of this article is to describe a fabrication technique to assist dental technicians creating esthetic indirect composite restorations. After the teeth have been prepared and the models completed, the technician can begin the fabrication process. Translucent dentin is selected to reduce opacity and enhance the blend with the remaining dentition. High chroma modifiers can then be placed into the fossa area to replicate dentin seen in natural dentition. Different incisal materials can then be layered into the build-up to regulate the value of the restoration. Special effects such as hypocalcification are placed internally to mimic naturally occurring esthetics. Realistic anatomy is created using a small-tipped instrument directly into the final layer of uncured enamel material. Fissure characterization is placed in the restoration to match existing dentition. Fit and margins are verified on separate dies to minimize discrepancies. Path of insertion and proximal contacts are established on a solid model to minimize chairside adjustments.

Color↗
PubMedDate not supplied

Creating esthetic composite restorations: Part II, Crown fabrication.

The purpose of the article is to describe a fabrication technique to assist dental technicians to create an esthetic, indirect, high strength composite crown with fiber reinforcement. After the teeth have been prepared and the models completed the technician can begin the fabrication process. A fiber coping is fabricated on a separate transfer die. Translucent dentin is selected to reduce opacity and enhance the blend with the remaining dentition. High chroma dentin modifiers can then be place into the fossa, cervical, and interproximal areas to replicate dentin seen in natural dentition. Different incisal materials can then be layered into the build-up to regulate the value of the restoration. Special effects such as hypocalcification are placed internally to mimic naturally occurring esthetics. Realistic anatomy is created using a small tipped instrument directly into the final layer of uncured translucent blue enamel material. Fissure characterization is placed in the restoration to match existing dentition. Fit and margins are verified on separate dies to minimize discrepancies. Path of insertion and proximal contacts are established on a solid model to minimize chairside adjustments.

Color↗
PubMed1975

Advances in surgery of the tip: intact rim cartilage techniques and the tip-columella-lip esthetic complex.

There is no one technique best for all noses. The sensitive, versatile, and experienced cosmetic surgeon should select from his choices the combination of modalities best tailored to the needs of each patient. Among these modalities should be cartilaginous septal transfixion combined with the three techniques for changing the quantity and shape of the tip cartilages. The most important factor in choosing from the three tip techniques is the decision as to where the rotation points and major thrusts should be. Then come the choices as to tip width and infratip lobule length and the fine points of cartilage incision levels and directions and cartilage excisions or morselization. The decision to detach or not detach the septal strut below the cartilaginous septal transfixion incision is predicated mainly on tip-columella-lip esthetic complex requirements. Proper selection of these methods and attention to the tip-columella-lip esthetic complex should allow the surgeon to construct pleasing, relatively natural looking profiles with fewer radical hump removals and nostril base resections and with rare complications from nostril notching or collapse. No magic is involved in rhinoplasty; the surgeon's incision, removals, and additions, plus scar formation and contraction, produce the results.

Cartilage↗
PubMed2001

The finishing touches for more predictable esthetic dentistry.

The popularity of esthetic dentistry has transformed the traditional dental practice. Anterior tooth restorations impact the beauty of a smile as well as the function of the entire dentition. The long-term success of esthetic restorations can be improved by controlling the occlusal forces to which they are subjected. During sleep and periods of intense concentration, dental patients move their mandibles far beyond the accustomed positions and are able to place significant forces on anterior teeth. The dentist must test and balance new restorations to ensure that they allow for the full range of mandibular movement. Three basic types of movements are discussed.

Dental Prosthesis↗
PubMed2001

Achieving high-level esthetics with CEREC.

This article describes the evolution of the CEREC CAD/CAM restorative system and its ability to create esthetic, durable ceramic- and resin-based restorations chairside. Included is discussion about specific techniques for color enhancement and modification to increase the esthetic result. The three machinable materials currently available for use with the CEREC system also are discussed.

Ceramics↗
PubMed2001

The management of gingival and esthetic problems: a clinical case.

The coordinated management of gingival and esthetic problems is important in dentistry. In addition, the most difficult variable to control in the treatment of anterior esthetics is the soft tissue. This article discusses the relationship between the surrounding soft tissue and the emerging crown form. The authors introduce a soft-tissue index model technique that will help the technician in fabricating the final crown with a form similar to the provisional. In this case report, provisional crowns are fabricated with enough tissue support to provide for an optimal crown-gingival interface. The present case demonstrates how to manage the gingival margin in the provisional stage and how to transfer the provisional and soft tissue to the laboratory model.

Adult↗
PubMed2001

Perspectives on esthetics in implant dentistry.

Esthetic outcomes are related more to soft tissue volume and adaptation than to implant components. A preoperative understanding of the influence and inter-relationship of bone volume, soft tissue volume and contours, attainable augmentation goals, and the achievable realistic restorative results is important. This article shows the application of routine components in methods to solve routine commonly encountered clinical problems, including matching a missing central incisor to the adjacent dentition and soft tissue, esthetic provisionalization for the hopeless anterior tooth after extraction, and elective replacement of an upper denture with a fixed implant restoration without the use of bone grafting.

Alveolar Ridge Augmentation↗