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PubMed2001

Using platelet-rich plasma to accelerate soft tissue maturation in esthetic periodontal surgery.

The transposition of connective tissue to increase the zone of keratinized tissue and/or for root coverage has become an integral part of the surgical dental practice. In an effort to reduce the incidence of postoperative complications occasionally observed with these procedures, the incorporation of platelet-rich plasma and its growth factors has been introduced into the surgical protocol. Documentation of several cases requiring esthetic soft tissue grafting procedures and the use of regenerative barriers to obtain root coverage with the incorporation of platelet-rich plasma is presented.

Adult↗
PubMed2001

Use of a serially layered, double connective tissue graft approach to enhance maxillary anterior esthetics.

The demands of current periodontal practice require that clinicians use varied approaches to resolve poor esthetic appearances. In particular, patients are becoming less and less accepting of exposed roots and lost interdental papillae, especially in the maxillary anterior sextant. This report describes a surgical technique that combines the advantages of a root-coverage procedure using subepithelial connective tissue grafts and an incision design that preserves interdental papillae, coupled with the use of enamel matrix derivative (Emdogain) to maximize the regenerative potential.

Adult↗
PubMed1999

Additive contour of porcelain veneers: a key element in enamel preservation, adhesion, and esthetics for aging dentition.

Esthetics and function are equal concerns when restoring the anterior dentition. Modern concepts in restorative dentistry have brought new solutions through bonded porcelain veneers that are stress distributors and involve the crown of the tooth as a whole in supporting occlusal force and masticatory function. This recovery of the original biomechanics of the intact tooth, the biomimetic principle, is particularly valuable when considering the restoration of an aging dentition. Both function and appearance are affected by the senescent changes of the aging teeth. Erosion and surface wear lead to a progressive thinning of enamel, ultimately leading to increased crown flexibility and higher surface strains. It appears therefore that the restoration of tooth volume will not only re-establish the original and youthful appearance of the smile but will also allow the biomimetic recovery of the crown. The final treatment outcome strongly depends on the therapeutic approach chosen, the driving force of which should be the preservation of the thin remaining enamel. While a number of preparation techniques will expose dentin to a great extent, the principle of enamel preservation can still be fulfilled by the use of a specific approach. This article describes a treatment method which includes the use of a diagnostic template. This type of work strategy, documented with clinical cases, integrates additive wax-ups and acrylic mock-ups. The latter will provide a significant amount of diagnostic information and economy of tooth substrate, the importance of which cannot be overestimated in the completion, functionality, and longevity of the final restoration.

Acrylic Resins↗
PubMed2000

Effect of mouthwash and accelerated aging on the color stability of esthetic restorative materials.

PURPOSE: To evaluate the color stability of esthetic restorative materials after immersion in mouthwashes and accelerated aging. MATERIALS AND METHODS: Compomers and resin-based composites (RBC) were measured at baseline and repeatedly after immersion in three kinds of mouthwash (Listerine, Peridex, Rembrandt Age Defying) for 24 hrs and 7 days, and after aging for 150 kJ/m2. Color was measured according to CIE L*a*b* color scale on a reflection spectrophotometer. RESULTS: After immersion for 7 days, the mouthwash groups did not produce significantly higher color changes than the distilled water group, except with some mouthwashes used with Tetric-Ceram. After immersion for 7 days and aging for 150 kJ/m2, the mouthwash groups did not produce significantly higher color changes than the distilled water group. Aging in weathering chamber produced color change (deltaE*) of 1.1-3.9, which was mainly influenced by the material. With some exceptions, the color changes from immersion of the RBCs and compomers in mouthwashes were not perceptible (deltaE*<3.3).

Analysis of Variance↗
PubMed1999

Crown lengthening in the esthetic zone.

Crown lengthening in the esthetic zone is a prosthodontically designed and surgically executed procedure that must only be considered after careful restorative and surgical treatment planning, including a detailed smile analysis, clinical and radiographic evaluation of the quality of soft and hard tissues, and selection of the appropriate approach for each individual case. The presented techniques are modifications of the original conventional surgical approach, where longer healing periods may have been required and loss of papilla height or fullness is of concern. Recognition of the advantages and disadvantages of each technique should increase predictability and success in interdisciplinary smile enhancement therapy.

Crown Lengthening↗
PubMed2001

Esthetic restorations designed with confidence and predictability.

When the ProCAD product line is used in combination with the CEREC system, clinicians have at their disposal an armamentarium of materials with which to achieve greater predictability, precision, and control in fabricating chairside all-ceramic restorations. At a time when time is the dentist's and patient's most precious commodity, the ProCAD line enables clinicians to definitively restore form, function, and esthetics in a single visit, regardless of the specific individual indirect treatment indication (Figures 13A through 13C, and 14A through 14C).

Cementation↗
PubMed2002

Illustrating predictable anterior and posterior esthetic results: two case studies.

More natural-looking restorations are possible today because of advances in the quality of impression materials and the techniques used for tooth preparation and cementation. This article presents two cases that illustrate the use of a new generation of impression materials, bonded resin cement, and pressable porcelain to obtain the desired esthetic result.

Adult↗
PubMed2001

Tissue preservation for single-tooth anterior esthetics.

Placing implants in the esthetic zone can be difficult because of the expectations of the patient. Inevitably, the hard and soft tissue architecture is lost after extraction in the traditional two-stage procedure, and additional surgical procedures are required to restore the tissue that has been lost. The authors describe techniques that can be applied to retain ideal soft tissue if it is present and predictably restore tissue that is less than ideal.

Adolescent↗
PubMed2001

The esthetic effects of implant platform selection.

Implant dentistry has undergone considerable evolution over the history of modern endosseous implant therapy. With the advent of enhanced bone and soft tissue manipulation procedures, improved implant hardware components, and enough experience for the procedures to evolve, an implant restoration today may be indistinguishable from a natural tooth. Guidelines are discussed for implant selection and implant placement dictated by the desired functional and esthetic result. The implant platform should be selected only after the tooth and soft tissue dimensions are decided. In addition, the largest platform diameter that fits within the normal root contours should be selected. Surgically, that platform should be placed 3 mm apically and 1 mm lingually to the buccal emergence point. The buccal cementoenamel junction or free gingival margin thus becomes the key determinant for implant position. Specific implant dimensions are discussed for each tooth to provide appropriate guidelines for the practitioner.

Dental Implantation, Endosseous↗
PubMed2002

Artificial formed caries-like lesions around esthetic restorative materials.

Dental restorations fail for a variety of reasons. Secondary caries is one of the primary causes of failure of dental restorations. One method for reducing frequency and severity of this problem is the use of fluoride containing restorative materials. The ability of a material to inhibit secondary caries formation is an important clinical therapeutic property. This investigation assessed the capacity of esthetic restorative materials to resist caries in vitro. Class V cavities were prepared in buccal and lingual surfaces of 50 extracted sound third molars. The occlusal and gingival cavosurface margin of each preparation was on enamel surface. The five materials were used: Conventional glass ionomer cement Ceramfil beta (PSP), two polyacid modified resin composites Compoglass (Vivadent) and Dyract (Dentsply/DeTrey), non fluoride releasing composite resin Valux Plus (3M) and fluoride releasing composite resin Tetric (Vivadent). After 10 weeks in an acid gel for caries-like lesion formation, the teeth were sectioned occluso-gingivally through the middle of the restorations and examined by polarized light microscopy, while immersed in water. The statistical analysis of the results showed that secondary caries initiation and progression might be reduced significantly when fluoride-containing materials were placed. The conventional glass ionomer cement (Ceramfil beta) provided the highest protection against caries attack and the non-fluoride releasing composite resin (Valux Plus) restoration provided the least (p<0.05).

Acids↗
PubMedDate not supplied

Surgical templates for function and esthetics in dental implants.

The functional and esthetic importance of surgical templates associated with dental implants has been discussed. The design of the stent and proposed location of the fixtures basically determine the dentist's "wish list." Although ideal placement of an implant fixture often is achieved, it can be aided through use of a surgical template. Particularly useful in larger partially edentulous cases as described above, the ideal template is made of hard acrylic with holes slightly larger than the 3.0 mm drill often used during surgery. Construction of a template requires the dentist and surgeon to think about the case, create a wax-up, and decide on location before constructing the appliance. This process will benefit all, particularly the patient, and provide a foundation for a long-lasting prosthetic result.

Acrylic Resins↗
PubMedDate not supplied

Preparation of teeth for esthetic restorations.

Preparation details have been described for a porcelain veneer restoration on the most commonly used teeth. With operator knowledge of the preparation, sharp instrumentation, and, most of all, patience, it is possible to place a restoration that may last as long as any others outside of those made of cast or direct gold. It is imperative to remember that this type of conservative "esthetic" dentistry should be performed only on canine-guided occlusions after equilibration (if necessary) (Fig. 13). Even then, it still is possible to fracture a veneer accidentally (Fig. 14). Prior to beginning treatment, it is prudent to inform the patient of the pros and cons of using porcelain veneers, including a warning of possible failure.

Bicuspid↗
PubMedDate not supplied

Interdisciplinary treatment for esthetic restorative dentistry.

Many of our patients have dental needs that general dentists cannot satisfy and may not even know about. Using an interdisciplinary team will expand the knowledge of all of the team members and can only enhance the restorative result, including function, long-term prognosis, and esthetics. Suggestions have been offered to help develop these teams, which may include general dentists, periodontists, orthodontists, oral surgeons, and endodontists. Team members are chosen based on individual skills needed for a particular case but all must be able to motivate and educate patients while providing excellent dentistry.

Adolescent↗
PubMedDate not supplied

Colorimetric values of esthetic stainless steel crowns.

OBJECTIVES: The colorimetric values of two different kinds of esthetic stainless steel crowns were measured and compared with the colorimetric values of primary anterior teeth in Japanese children. METHOD AND MATERIALS: The colorimetric values of resin composite-faced stainless steel crowns (Kinder Krown) and epoxy-coated stainless steel crowns (White Steel Crown) were measured with a color difference meter. The Commission Internationale de Eclairage L*, a*, b*, and delta E*ab values and Munsell value, chroma, and hue were calculated. The data were compared with previously reported colorimetric values of Japanese primary anterior teeth measured with the same color difference meter used in this study. RESULTS: Compared to Japanese primary anterior teeth, Kinder Krown Pedo I and Pedo II showed much higher L* values and lower hue; on the other hand, White Steel Crown showed much higher L*, a*, b* values, much higher value and chroma, and much lower hue. CONCLUSION: Color analysis revealed that the colors of the White Steel Crown and Kinder Krown Pedo I were substantially different from the color of Japanese primary anterior teeth. The color difference between Pedo II crowns and Japanese primary anterior teeth was relatively high, but the color of Pedo II might be acceptable for clinical use.

Algorithms↗
PubMed2002

Enhancing implant esthetics with ideal provisionalization.

BACKGROUND: Recent literature has increased our understanding of how the osseous crest responds to implant placement. Proper pre-prosthetic conditioning of these tissues is required to achieve predictable esthetic results in the anterior region. CASE DESCRIPTION: The author presents a case of a 38-year-old male with traumatic loss of a central incisor replaced with an ITI implant. The case demonstrates the fabrication of a provisional temporary crown designed to optimize the development of ideal soft tissue form. CLINICAL IMPLICATIONS: The difference between implants and teeth in terms of sulcular makeup (osseointegration vs. periodontal ligaments and circumferential fibers vs. transverse ligamental fibers) requires modification of procedures for temporary crown fabrication.

Adult↗