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When presented with little coronal tooth structure remaining, four options exist: (1) extraction only, (2) extraction and restoration, (3) root canal therapy and a cast restoration (which may involve crown lengthening and/or orthodontic extrusion), or (4) root canal therapy and a composite/amalgam crown. A technique for the composite crown option is described with case presentations.
BACKGROUND: Reconstructions with aesthetical materials neither finished nor polished can be extremely irregular and wrinkled. For this reason they represent an ideal basis for the growing of pigmentation which come from food remainings and the nestle of bacteria on the plaque. The finishing of aesthetical materials is a fundamental step in conservative dentistry. The finishing session regarding the aesthetical restorations should be considered and planned at the moment of their insertion in the prepared hollows. The finishing should not be considered an option, but the conclusion of all the conservative treatment. Purpose of the search is to examine and assess, through a technical equipment measuring the superficial wrinkledness of the materials, the action of 4 systems of finishing and polishing on two aesthetical materials widely used in the daily practice by dental surgeons: a compomer (Compoglass, Vivadent) and a composite (Spectrum, Dentsply). METHODS: For each of these two materials some little slabs model have been prepared, choosing the universal colour in the colorimetric scale. The two types of filling materials have been compared with 4 systems of finishing and polishing: Sof-Lex Pop-on (3M), Enhance system (Dentsply), Hawe Micro Disc (Howe Neos), Heawe Gommini Polisher (Heawe Neos). The total working time did not overcome 1 minute. The little slabs have been obtained, pressing the resin between two slides used in microscopy. In the hope to guarantee in the different samples, a uniform thickness, we have used a technical device. On each covering slide we have put a weight of 0.5 kg for 5 minutes. The thickness of the little slabs obtained was 2 mm. Thus, pressed between the two slides, the aesthetical material has been photopolymerized according to the time suggested by Manufacturing Industries. The sizes concerning the wrinkledness of samples subjected to different treatments have been carried out using a pointed profilometer with high sensitivity. (Tencor-P10). This instrument used in the National Laboratory of Catania, called INFN, is able to graphitize the wrinkledness of a surface "survbeying" it with a diamond ultramicrometric point. RESULTS: All tested systems gradually produce the upper layers of the materials less suitable to resist the assault of plaque bacteria as time passed. The 3M coarse and medium grain Disks are very abrasive and for this reason the surface of the materials is ill-shaped. Those disks with fine and extra fine grain, smooth the tracks left by previous disks. As they have been always used according to their decreasing granulometry, the disks are used only for removing small composite pieces in excess and to improve micromorphology of the restauration. The "Gommini" are less abrasive than Disks. In a few minutes and often with only one step they produce a much regular and polished fillings surface. CONCLUSIONS: The "Gommini" have a preference when the last photopolymerization has left a regular layer, with a very good micromorphology. Actually, "Gommini" do not remove much material, but they continue to smooth the outline of the reconstruction. Disks are not classified as being of first quality in the finishing of composites and compomers.
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With proper planning, execution, and follow-up care, the maxilla can be surgically repositioned into a stable relationship with the mandible. Complete mobility, preservation of viability by proper design of the bony and soft tissue incisions, and adequate fixation during the healing phase are essential to obtain this objective. Variable maxillary deformities in 15 adults were corrected by Le Forte I osteotomy techniques. The technical problems in planning and design for the necessary bony and soft tissue incisions are discussed and illustrated by three case reports.
Glass ionomer cements are tooth-coloured materials that bond chemically to dental hard tissues and release fluoride for a relatively long period. They have therefore been suggested as the materials of choice for the restoration of carious primary teeth. However, the clinical performance of conventional and metal-reinforced glass ionomer restorations in primary molars is disappointing. And although the handling and physical properties of the resin-modified materials are better than their predecessors, more clinical studies are required to confirm their efficacy in the restoration of primary molars.
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Baby Boomers want to stay younger longer. As they age, a healthy attractive smile becomes much more important to their appearance. Nothing conveys good health and maintenance like aesthetically pleasing teeth. Because the timing is perfect for cosmetic dentistry, there is no reason for people to not have a great smile. Smile-Vision and the latest cosmetic dentistry techniques and materials helped the case patient first see and then become the person he wanted to be. His teeth look and feel better, resulting in a more confident appearance. (Figures 14 through 16).
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Often, the aesthetic dentist will place veneers to nonorthodontically reposition teeth. While this is a valid and beneficial treatment for many patients, the outcome is still compromised by improper tooth alignment. It is a pleasure to complete an interdisciplinary case where the tooth and arch alignment are ideally positioned. Restorative dentists have the responsibility to let orthodontists know what can and cannot be done restoratively.
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While single-tooth replacement can be accomplished with predictability using implant therapy, this procedure is challenging in the anterior region where numerous criteria must be evaluated by the restorative team. The available height of bone, soft tissue volume, and three-dimensional position of the anticipated implant restoration are among the numerous concerns that must be addressed prior to the initiation of treatment. This article provides a comprehensive review for the selection and placement of implants in the aesthetic region and illustrates these principles with a case presentation.
Orthodontists and maxillofacial surgeons frequently plan orthognathic treatment to produce an "ideal" Class I occlusion and skeletal relationship. The aim of this study was to investigate whether the preferred facial profile chosen by orthodontists, maxillofacial surgeons, dental students, and members of the general public conformed to a Class I profile. Photographs were taken of 2 male and 2 female adult subjects with Class I profiles, and by means of a computer program the images were manipulated to produce Class II, Class III, and long face profiles. The orthodontists, surgeons, dental students, and members of the general public ranked each group of 4 photos in order of their attractiveness. Orthodontists and maxillofacial surgeons were found to be significantly more likely to choose a Class I skeletal relationship as the most attractive profile. A significant difference was found between orthodontists and dental students (P < 0.01) and between orthodontists and the general public (P < 0.001) with regard to the assessment of the Class I profile as the most attractive, when all 4 subjects were considered. Similar results were noted for maxillofacial surgeons. Whether the assessor was an orthodontist, maxillofacial surgeon, or a member of the general public was found to be significant when examining subjects 1 (female) and 3 (male). The sex of the assessor was also a significant factor for subject 3 (male), where female assessors were more likely to rank the Class I profile as most attractive (P < 0.05).
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