Nowadays the maintenance of “a nice smiling” represents the main desire of our patients and the request for tooth coloured restorations is very high in both anterior and posterior areas too. Predictable and repeatable results can be achieved through materials and clinical practices that, on one hand, preserve the original structure of the compromised tooth and, on the other hand, involve a very low biologic price. New technologies for the enamel-dentin adhesion and the continuous evolution of more sophisticated esthetic materials (composite resins and porcelains) allow the effective reaching of verifiable and predictable results.
Technologies and materials have to follow an operative approach that strictly involves operative steps which have been carefully codified referring to the materials typology used form time to time.
In this lecture the speakers,building on 40 years of experience, will point out the relevant guidelines in order to reach correct and standardized clinical results in a modern restorative dentistry.
The evolution of adhesive aesthetic materials has profoundly changed the modern restorative approach.
Modern adhesive restorative materials are now able to guarantee excellent long-term results from a morphological, functional and aesthetic point of view. However, this need a deep knowledge of the materials themselves, of the techniques and of the fundamental objective and subjective aesthetic parameters.
The digital aesthetic preview (Digital Smile Design) is an important communication tool with the patient and is a key element that guides the diagnostic wax-up.
This will be followed by a clinical preview using a mock-up. As part of direct restorative solutions, composite materials are usually used with rigorous layering methods with the aid of a palatine matrix template. In some clinical situations, direct veneering of the V surfaces is performed with possible modification of the emergence profiles.
In all these cases, however, it is evident that the modeling of the vestisbular surface and the definition of the macro and microgeography of superficies are necessarily carried out “free-hand”.
Ultra-conservative techniques (eg microabrasion, erosion-infiltration, re-gluing of the fragment ..) and mucogingival surgery are further options for a complete approach to the aesthetic sectors. A recently acquired technique which is attracting great interest among professionals is the Injection Molding Technique.
The author has carefully developed the technique with the aid of a new template dedicated to the injection procedure and called Triple Layer Silicon Index.
The technique assumes the use of flowable composites or thermo-viscose composites and allows the restoration of the shape, surface and surface texture of the elements by replicating shapes defined in the laboratory by accurate waxing and tested with mock-ups before being injected. the pure restorative one especially in additive cases (eg diastemas, erosion / abrasion etc.) from the single restoration or of some frontal elements up to the full mouth adhesive rehabilitaion. However, the technique also becomes strategic in orthodontic cases in order to define the final volumes before the orthodontic movements: this is a huge advantage for the orthodontist. A very important last option developed by the author is the application of the injection technique in even severe periodontal cases with significant loss of periodontal support; in these cases, after an adequate surgical or non-surgical periodontal therapy, it is possible to re-establish adequate shapes by closing black triangles and possibly splinting together the elements with significant mobility. , constitutes an extraordinary therapeutic opportunity in an increasingly conservative and minimally invasive perspective, which also allows lower times and costs than a traditional prosthetic or implant approach.
The achievement of Aesthetics can not but go through the patient’s expectations. Disappointing results are not only due to technical or clinical problems, rather, frequently, the result of poor communication with the patient. A correct Aesthetic Preview it is the only system that allows us to control the function and, above all, the final aesthetic result before starting work.
Through this technique, dental preparations will be minimally invasive and in any case less destructive than traditional preparations.
Digital technique and classical technique are compared in order to be able to trace the guidelines to be followed for a correct clinical execution.
The expectations of patients, the suffering and fear of the dentist are emotions we face every day in our profession.
On the other hand, joy, happiness and relief are emotions we can deal with.
With directly layered composite veneers, we can completely change the smile and the attitude to life associated with it in just one session. Dentistry is not just a medical discipline, but a type of art and architecture capable of creating highly aesthetic results for the patient. Let us take you to a wonderful world of minimally invasive dentistry.
Implants with a significant EMBL (Early Marginal Bone Loss) during the first year of function showed a higher probability of future peri-implantitis. Therefore, preventing and minimizing EMBL during implant therapy may significantly reduce the risk of peri-implantitis. Surgical and prosthetic factors limiting EMBL will be exposed.