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This article describes a technique for treating anterior toothwear. The technique allows the placement of direct composite on the palatal surface of upper anterior teeth in an efficient and accurate manner. The advantages of an indirect wax-up technique and a direct intra-oral approach are combined to give an aesthetic and conservative result.
A mild Class II division 2 incisal relationship is often associated with a pleasing facial profile and aesthetically acceptable arrangement of the teeth. Severe cases, however, have the potential to cause trauma and a number of older patients present with extensive soft and hard tissue damage. Management options may range from simple preventive advice to complicated surgical orthodontics. Detailed assessment of the case is paramount in developing an appropriate treatment plan.
This paper describes the restoration of an endodontically treated upper first molar with a fibre-reinforced onlay indirect composite resin restoration. The clinical and radiographic examination confirmed that the tooth had suffered considerable loss of structure. Therefore, an indirect restoration was indicated. First, a core was built with resin-modified glass ionomer cement, followed by onlay preparation, mechanical/chemical gingival retraction and impression with addition-cured silicone. After the laboratory phase, the onlay was tried in, followed by adhesive bonding and occlusal adjustment. It can be concluded that fibre-reinforced aesthetic indirect composite resin restoration represented, in the present clinical case, an aesthetic and conservative treatment option. However, the use of fibres should be more extensively studied to verify the real improvement in physical and mechanical properties.
PURPOSE OF THE INVESTIGATION: To investigate, by questionnaire, the direct restorative materials used by a sample of practitioners from the United Kingdom. BASIC PROCEDURES: A postal questionnaire was distributed to a group of self-selected practitioners, who volunteered to participate in the study. In all 110 practitioners participated in the study. MAIN FINDINGS: The most used material for the restoration of occlusal (Class I) and approximal (Class II) lesions was amalgam with 61% and 73% of practitioners indicating that they used amalgam in this situation. Adhesive tooth-coloured materials, specifically composites and compomers, were preferred by the majority of practitioners for anterior approximal (Class III) and incisal (Class IV) restorations with compomer preferred for Class V restorations including non-carious cervical lesions and for the restoration of primary teeth. PRINCIPAL CONCLUSIONS: It is concluded that the general practitioners surveyed in this study tend to use amalgam for the restoration of Class I and II lesions as opposed to resin composite. The majority of practitioners in this study used compomers, a relatively new group of restorative materials, with little evidence of traditional glass-ionomer cements being used routinely.
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Explore the source record for details and available documents.
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Explore the source record for details and available documents.
Enamel surface "dysmineralization" can be defined as a disturbance in formation of the inorganic component of enamel during amelogenesis. Enamel microabrasion, a method of removing certain enamel dysmineralization and decalcification coloration defects, is described. In many cases, with insignificant and unrecognizable loss of enamel, superficial enamel discoloration defects can be permanently eliminated, improving the appearance of treated teeth.
Goal-driven treatment plans promote an accurate differential diagnosis resulting in appropriate implant prosthodontic treatment. The identification, understanding, and acceptance of the limitations of therapy assist both the doctor and the patient in achieving their objectives and minimizing disappointments. The implementation of such a regimen helps to achieve a successful result.
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Resin restorations for anterior teeth, properly planned and well placed, should be expected to serve many years. Small resin restorations in anterior teeth may even be lifetime restorations. Class III, IV and V resin restorations with large facial display are best when hybrid resin is placed internally and microfill resin is placed facially. Restorations without significant facial display are best treated with hybrid resin alone. Although new, more refined resin systems will come, the current state of the art for anterior resin restorations is excellent and certainly the best it has ever been.
Cast gold restorations have overall characteristics unavailable in any other restorative procedure for inlays and onlays, including low restoration wear; low wear of opposing teeth; lack of breakage; burnishability-malleability; and proven long-term service. Bonding cast gold restorations with resin cement improves their characteristics even more. However, they are not tooth-colored, which eliminates them from consideration for many patients. Although tooth-colored inlays and onlays, both ceramic and filled polymer, are increasing in use, and their serviceability is acceptable at a moderate level, cast gold restorations remain the standard of care for long-term indirect restorative service.
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Observation of occlusion, providing patient education about occlusion and treatment of occlusal conditions sadly are neglected in the profession. Occlusal equilibration is one of the major treatments for occlusally oriented diseases, and I estimate that this procedure is not accomplished frequently by many practitioners. I have discussed the conditions needing occlusal equilibration and suggested procedures for the conditions. I encourage practitioners needing education in occlusion to seek it.
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