Essay II: Space closure vs space preservation as it relates to craniofacial classification.

Bilateral or unilateral congenitally missing maxillary lateral incisors is a common clinical situation that requires an interdisciplinary approach. It is often complicated by the presence of narrower teeth. Occlusal, periodontal, and esthetic considerations will influence the decision to close the space for a canine-lateral substitution or to open the space for a prosthodontic replacement of the missing lateral incisor. The team should define the proper dental position to provide a stable occlusion and dental esthetics obtained with a minimally invasive preparation. The restorative approach should provide a long-term functional and esthetic solution in the transitional period from adolescence to adulthood, reversible for future possible interventions.

The decision-making process in interdisciplinary treatment: digital versus conventional approach. A case presentation.

The digital technology can be a GPS in designing a multidisciplinary treatment that involves orthodontics and restorative dentistry. A proper hierarchy of decisions and responsibilities need to be defined. Form is everything but position and size. For this reason the orthodontist first needs to set up the proper occlusion deciding the position and the available size that will be necessary for the restorative dentist to obtain the proper form with a minimally invasive preparation. This case report illustrates with a step-by-step approach all the clinical issues of the treatment, from diagnosis to orthodontic guided position of Tads, materials of choice and laminate veneers realization passing through all the interactions between the dental team members explaining who does what and when and proposing a clear hierarchy of decision. A review of digital and classical possibilities for the realization of laminate veneers is proposed with its pros and cons.

From orthodontic treatment plan to ultrathin no-prep CAD/CAM temporary veneers.

Several treatment options are described in the literature to solve the microdontia-related problems of maxillary anterior teeth. These options are often focused on an orthodontic rather than a restorative approach. The case presented here started with an orthodontic phase followed by a restorative one. The aim of the orthodontic phase was to achieve the correct spacing, respecting ideal average tooth proportions. This was done using a digital setup to restore the six anterior teeth, so that an optimal esthetic and functional result was achieved by the end of the orthodontic treatment. The purpose of the restorative phase was to contribute to the esthetic outcome and occlusal stability. The 12-year-old patient was treated utilizing a CAD/CAM procedure, which took advantage of the mechanical properties and reasonable cost of the chosen resin matrix ceramic material (Vita Enamic). Once stability has been attained and proper periodontal tissue maturation has been reached at the end of the patient's growth, there will then be the option of improving the esthetics by replacing these restorations with ceramic veneers.

Central incisor loss after delayed replantation following avulsion: a contemporary restorative and adjunctive orthodontic management approach.

Delayed replantation of an avulsed tooth may result in rapid root resorption or, more frequently, dental ankylosis with subsequent bone substitution. If this process develop slowly, it is possible to observe that tooth loss is characterized by a well conserved alveolus with regard to bone preservation, particularly in vertical dimension. This clinical case reports a dental trauma of a central incisor in a young boy characterized by tooth avulsion and its delayed replantation. After 10 years, dental ankylosis of the incisor was recorded and the patient underwent a prosthetic-orthodontic rehabilitation using CAD-CAM technology and no-prep veneers.