ABSTRACT
Objective. A patient presented to the dental office expressing dissatisfaction with the appearance of his teeth, and as a result, of his smile. Our objective was to satisfy his initial chief complaint: "I don't like how my teeth look when I smile." Methodology. Upon completing all initial exams and consultations, an esthetic dental treatment plan was formulated and agreed upon by both the practitioners and the patient. Results. The patient received periodontal treatment first to create esthetic gingival margins. Anterior ceramic crowns followed. Conclusion. The results surpassed all patient's expectations.
ABSTRACT
Anterior tooth replacement has always posed an esthetic challenge for dentists. A multidisciplinary approach makes it possible to provide patients with esthetics and function. Treatment planning should involve other specialists when clinicians are faced with the additional esthetic concerns of the patient (such as anterior spatial anomalies and esthetically unpleasant existing restorations). Metal-ceramic fixed partial dentures have been used to allow the replacement of missing teeth for many years, providing both strength and esthetics. Several other options also are available, including implant placement. Dental implants in the esthetic zone are well-documented in the literature; numerous controlled clinical trials have shown overall implant survival and success rates. This article illustrates a step-by-step analysis and treatment option for a single-tooth replacement and maxillary anterior spatial dilemma using Captek crowns.
Subject(s)
Dental Prosthesis Design , Denture, Partial, Fixed , Diastema/therapy , Esthetics, Dental , Jaw, Edentulous, Partially/therapy , Crown Lengthening , Crowns , Dental Bonding/methods , Dental Veneers , Humans , Incisor , Male , Maxilla , Middle Aged , Patient Care Planning , Treatment OutcomeABSTRACT
Creating an esthetic result that is pleasing to both the patient and the dentist requires careful consideration of patient concerns and treatment goals. This article presents a case involving a patient with many esthetic concerns. Following in-depth examination of the patient and consultations, an esthetic treatment plan involving the placement of laminate veneers was developed and executed. After the first set of laminate veneers was placed, some concerns led to an alteration in the proposed treatment plan. Each step of the treatment plan must be assessed before the next step is performed to guarantee a result that is both functional and esthetically pleasing.
Subject(s)
Dental Prosthesis Design , Dental Veneers , Dentist-Patient Relations , Patient Care Planning , Tooth Discoloration/therapy , Adult , Esthetics, Dental , Female , Humans , Treatment OutcomeABSTRACT
This in vitro study used two resin cements to evaluate the microleakage of CEREC 3D restorations. An mesio-occluso-distal-lingual (MODL) onlay preparation was placed on an ivorine premolar tooth. Sixty elastomeric impressions of this preparation were used to fabricate resin dies. Imaging propellant was applied to the resin dies. Optical impressions were taken with the CEREC 3 and the CEREC 3D software and used to design and mill 60 onlays. The reliability coefficient was alpha = 0.76 with an examiner agreement rate of 96.4%. Restorations cemented with posterior composite demonstrated a mean microleakage value of 1.46 mm (SD+/- 1.64); by contrast, those restored with dual-cure cement reported a mean microleakage value of 0.21 mm (SD+/-0.57). The difference in microleakage was very highly significant (alpha = 0.001). Posterior composite CEREC 3D restorations cemented with the dual-cure cement showed significantly less microleakage compared to those cemented with posterior composite.
Subject(s)
Computer-Aided Design , Dental Leakage/prevention & control , Dental Prosthesis Design , Inlays , Resin Cements , Bicuspid , Cementation , Composite Resins , Dental Marginal Adaptation , Dental Porcelain , Dental Stress Analysis , Humans , Materials TestingABSTRACT
A multidisciplinary approach is generally required in the treatment of patients who present with missing and malpositioned teeth to achieve an esthetic and functional outcome. Treatment of a patient with congenitally transposed canines, missing central incisors, and peg-shaped lateral incisors using a multidisciplinary approach is presented.
Subject(s)
Cuspid/abnormalities , Tooth Eruption, Ectopic/congenital , Adolescent , Anodontia/therapy , Dental Prosthesis Design , Dental Veneers , Esthetics, Dental , Follow-Up Studies , Humans , Incisor/abnormalities , Male , Malocclusion, Angle Class II/therapy , Orthodontic Space Closure/instrumentation , Orthodontic Space Closure/methods , Patient Care Planning , Patient Care Team , Tooth Eruption, Ectopic/therapyABSTRACT
This study compared the manufacturing times and the accuracy of proximal and occlusal contacts on restorations produced by two different versions of CEREC 3 software, COS and 3D. Fourteen casts containing pre-existing inlay and onlay preparations of premolars and molars were mounted on articulators. A bite registration was made in maximum intercuspation. Optical impressions of the preparation and the bite registration were made. The Wilcoxon signed rank test was applied for a statistical analysis of time expended in the different design and manufacturing steps of both software versions. The chi-square test was applied for the statistical analysis of proximal and occlusal contacts.
Subject(s)
Ceramics/therapeutic use , Computer-Aided Design , Software , Dental Occlusion , Dental Restoration, Permanent/methods , Humans , Image Processing, Computer-Assisted , Time FactorsABSTRACT
Computer-aided design/computer-aided manufacture (CAD/CAM) technology has made steady inroads into the practice of dentistry. The CEREC CAD/CAM system can be used chairside to fabricate porcelain and composite inlays, onlays, and crowns and porcelain veneers. The latest incarnation of the CEREC system is the CEREC 3D, which provides a versatile, relatively simple, user-friendly method for fabricating esthetic restorations chairside without involving a dental laboratory. CEREC 3D may be the system that allows the average general dentist to provide chairside porcelain restorations during single-visit appointments, eliminating the need for an elastomeric impression or an interim restoration as well as the expense of a laboratory fee.
Subject(s)
Computer-Aided Design , Dental Prosthesis Design , Dental Restoration, Permanent , Technology, Dental , Ceramics/chemistry , Composite Resins/chemistry , Crowns , Dental Porcelain/chemistry , Dental Veneers , Humans , Inlays , User-Computer InterfaceABSTRACT
BACKGROUND: Increased public access to fluoride has decreased the prevalence of caries and increased the prevalence of fluorosis staining. This article provides a case report involving a conservative method of removing fluorosis stain, as well as describes an in vitro test of the method. CASE DESCRIPTION: A healthy man sought treatment at New York University College of Dentistry for removal of severe, dark brown fluorosis staining on his anterior teeth. To remove the stain, the treating clinician used a microabrasive material, which leaves enamel intact, instead of a tooth-whitening agent, which requires removal of all affected enamel. METHODS: To demonstrate that enamel structure is not disturbed by the microabrasive material, the authors performed a study using scanning electron microscopy, or SEM. They viewed enamel structure under SEM at x1,000 magnification. They viewed untreated microabraded enamel and compared it with enamel that had been treated for 20 seconds with 37 percent phosphoric acid. RESULTS: An etch pattern was not discernible on the tooth treated with the microabrasive material. The enamel prisms remained intact and the cores were not exposed. CLINICAL IMPLICATIONS: Microabrasion removes intrinsic fluorosis stain effectively while protecting enamel. In this case, an enamel shade of brown not in the range of any tooth color shade guide was reduced.
Subject(s)
Enamel Microabrasion/methods , Fluorosis, Dental/complications , Tooth Bleaching/methods , Tooth Discoloration/therapy , Adult , Carbon Compounds, Inorganic/therapeutic use , Dental Enamel/ultrastructure , Fluorosis, Dental/therapy , Humans , Hydrochloric Acid/therapeutic use , Male , Microscopy, Electron, Scanning , Silicon Compounds/therapeutic use , Tooth Discoloration/etiologyABSTRACT
In response to an increased public demand for esthetic restorations, dentists are using computer-aided design/computer-aided manufacture (CAD/CAM) technology to fabricate inlay/onlay, crown, and laminate veneers. This study evaluated the fit at the gingival margin of surface inlay restorations milled by the CEREC II as well as the more recently developed CEREC III. The marginal fit of inlays milled by the CEREC III was more accurate than the fit of those milled by the CEREC II, although both were within the ADA specifications of 50 micro.
Subject(s)
Ceramics/chemistry , Computer-Aided Design , Dental Porcelain/chemistry , Inlays , Acetone/chemistry , Acid Etching, Dental , Dental Cavity Preparation/classification , Dental Marginal Adaptation , Humans , Inlays/classification , Microscopy, Electron, Scanning , Polymethacrylic Acids/chemistry , Resin Cements/chemistry , Silanes/chemistry , Surface Properties , Tooth Cervix/ultrastructureABSTRACT
Research indicates that microleakage is the major cause of composite restoration failure. Because the different physical properties of composite resin and tooth structure cause microleakage in composite tooth restorations, it is possible to eliminate microleakage by making composite's physical properties more similar to those of tooth structure. This article reviews the physical properties of composite resin systems last as they relate to tooth structure and microleakage.
