Creating natural vitality with direct-bonded composite veneers.
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The purpose of this retrospective study was to determine the longevity and quality of Class II resin composite restorations with Sonicsys approx inserts placed in private practice. In 79 patients 213 composite restorations with margins in enamel and in dentin were evaluated clinically using a modified version of established USPHS-Criteria. The mean time in clinical service was 18+-8 months. The majority of the restorations investigated were rated as "good" (Alpha) or "clinically acceptable" (Bravo). In more than 90% sufficient proximal contact points were evaluated. Seven restorations had no contact to their adjacent tooth. Only one failed after an average period of 18 months in clinical service because of loss of the ceramic insert and was replaced. It is concluded that the composite restoration in combination with Sonicsys insert is an appropriate system for the restoration of Class II lesions in premolar and permanent molar teeth.
All-ceramic restorations in the posterior region are an increasingly important area of dental care. However, no real suitable ceramics or economic processing procedures have been available so far. With the new LAVA system, it will be possible to satisfy these demands in the future. The system is based on the machining of presintered zirconia, which, due to its outstanding mechanical properties, its biocompatibility, and its excellent esthetics in combination with a specially designed veneer ceramic, is the ideal candidate for these applications. In combination with a corresponding CAD/CAM unit, the use of an easy-to-machine presintered ceramic material (which is sintered to full density after shaping, thus eliminating the need for extensive use of diamond tools) allows for the first time reliable, fully-automated and thus fast manufacturing of such restorations.
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Gingival replacement is often a component of comprehensive prosthodontics. Gingival prostheses may be fixed or removable and may be made from acrylics, composite resins, silicones or porcelain-based materials. Undercuts or dental attachments are used to secure removable prostheses, which are esthetically pleasing and easy to maintain. This paper describes several clinical situations in which gingival prostheses were used effectively.
Communication is a critical element to obtaining satisfying results with esthetically driven treatment. Communication must first be established with the patient then among all the clinicians and technicians involved with the treatment to achieve the esthetic goals of the patient. This article will review methods to communicate esthetic parameters to allied specialists and the dental technician.
Clinical indications for direct composite restorations have expanded in the last decade, primarily due to improved physical, aesthetic, and handling properties. As a consequence, their increased predictability has encouraged clinicians to progressively abandon amalgam. This article presents a clinical protocol to reconstruct severely damaged endodontically treated and bleached anterior teeth with particular emphasis on placement and curing techniques. Common complications encountered during the bonding of teeth that have undergone endodontic and bleaching treatments are also analyzed.
Treatment for a single discolored anterior tooth may involve placement of a direct composite veneer to enhance a patient's smile and mask underlying discoloration. Among the challenges clinicians may face in this endeavor are the selection of suitable composite materials, application of an adhesive bonding system, and re-creation of the natural shade variations inherent in natural teeth. This article discusses the characteristics and placement protocol for a recently introduced self-etching adhesive system and a reinforced microfill composite when they are used to restore a single discolored central incisor.
Indirect composites are becoming more popular as technology yields materials with increased mechanical properties while reducing occlusal wear with opposing teeth. Several of the indirect systems currently on the market use both light and heat catalysts in the same resin, which results in higher polymerization rates than light-curing alone. However, the order in which the indirect restoration is exposed to pressure and light may make a difference in the final properties of the prosthesis.
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Contemporary direct restorations have significantly evolved since their initial development, allowing clinicians to develop natural-looking restorations. Composite resins can be applied for restoration of cavities, anterior tooth reconstruction, core preparation for crowns, splinting, provisionalization, placement of orthodontic brackets, and cementation. The development of hybrid and microfilled composite materials has further improved the clinician's ability to deliver minimally invasive treatment options. This article demonstrates a stratification process in the interproximal and incisal edge reconstruction of maxillary right and left central incisors using a small-particle hybrid composite resin to develop an optimal aesthetic result.