Immediate bridgework can ease the pain of removing unwanted teeth.
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In dentistry, the concept of realism can be applied to the creation of an artificial prosthesis that is not perfect, but real. If prosthesis are made to a flawless perfection, they will appear artificial. Ultimately, the clinician and ceramist should strive for realism. The IPS Empress System (Ivoclar Williams, Amherst, NY) is an all-ceramic restorative alternative utilizing a pressable leucite-reinforced glass ceramic for a variety of indications (e.g., crowns, inlays/onlays, veneers). The resulting tooth-colored and metal-free restorations combine strength and aesthetics approaching those of natural teeth. This article describes the technique and procedures required to achieve realistic anterior crowns with this all-ceramic system.
The search for tooth-colored and metal-free restorations is one of the major challenges in dental research. For several decades, ceramic has been used as a restorative material because of its aesthetics and stability. Unfortunately, the survival rate of most all-ceramic systems seems unsatisfactory; due to the natural brittleness of ceramic, fractures have been the primary reason for the high failure rate. Since 1988, the University of Zurich Dental School, Switzerland, has been working with the IPS Empress all-ceramic system (Ivoclar/Williams, Amherst, NY). This article reports the clinical and research data from approximately 3,000 all-ceramic restorations.
Although porcelain-fused-to-metal (PFM) restorations are the most widely used full-coverage crown restoration systems, their inherent properties make the achievement of natural aesthetic restorations an elusive task. In contrast, the all-ceramic system (IPS Empress, Ivoclar North America, Amherst, NY) offers excellent translucency and vitality, without the opacity associated with PFM restorations. Its vitality is further enhanced by an adhesive resin cementation method that conducts the color of the underlying tooth structure. This article reports the status of a 5-year investigation, initiated in 1992, of the clinical performance of the IPS Empress all-ceramic system and the resin cementation system used with it.
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Dental literature supports the concept that vertical dimension of occlusion is normally not lost in severely worn dentition, and the bite should generally not be opened to facilitate dental reconstruction. However, restoration of a periodontally sound but severely worn dentition, at existing vertical dimension, frequently presents unique challenges in patient management, diagnosis, treatment planning, and restorative methodology. This report reviews and demonstrates an integrated and planned approach to this complex treatment situation that can lead to a favorable and predictable prognosis. The approach also allows a practitioner free use of various techniques if certain goals of occlusion are followed.
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Occasionally, clinicians are faced with a situation in which a solitary tooth between two bridges requires extraction. When this type of situation occurs, we must ponder the dilemma of how to replace the missing tooth. Options include placing an implant where the tooth was extracted or remaking one large multiunit bridge. Implants are not always possible or practical, and remaking a multiunit bridge that involves the abutments of the two existing bridges can be challenging and becomes much more expensive to the patients. The overcasting technique is a treatment modality that offers a solution in these particular situations.
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