Esthetic and Cosmetic Dentistry for Modern Dental Practice: Update 2011

Contents
Preface John R. Calamia, Richard D. Trushkowsky, and Mark S. Wolff xiii

Smile Design and Treatment Planning With the Help of a Comprehensive Esthetic Evaluation Form John R. Calamia, Jonathan B. Levine, Mitchell Lipp, George Cisneros, and Mark S. Wolff Even if a clinician possesses basic knowledge in esthetic dentistry and clinical skills, many cases presenting in modern dental practices simply cannot be restored to both the clinicians and the patients expectations without incorporating the perspectives and assistance of several dental disciplines. Besides listening carefully to chief complaints, clinicians must also be able to evaluate the patients physical, biologic, and esthetic needs. This article demonstrates the use of a smile evaluation form designed at New York University that assists in developing esthetic treatment plans that might incorporate any and all dental specialties in a simple and organized fashion.

187

Photographic-Assisted Diagnosis and Treatment Planning Ron Goodlin The advent of digital photography allows the practitioner to show the patient the photographs immediately, to co-diagnose, and to work with the patient chairside or in a consult room while showing the patient some simple imaging techniques, such as whitening the teeth, making the teeth look longer, and showing the effects of orthodontics or veneers to get better alignment and other factors of smile design and esthetic dentistry. This article describes recommended digital dental photographic equipment, how to produce the standard series of diagnostic dental photographs, photographic assisted diagnosis and treatment planning including a discussion of anthropometrics and cephalometrics, and digital imaging techniques.

211

Whitening the Single Discolored Tooth So Ran Kwon This article discusses the possible methods available for whitening of a single discolored tooth. Treatment options can vary from restorative procedures such as crowns, veneers, or bonding to more conservative bleaching treatments. The long-term success of the treatment is dictated by proper diagnosis and treatment planning. The cause and severity of the discoloration has to be carefully evaluated when planning for bleaching options. The vitality of the pulp, presence and absence of symptoms, and periapical pathoses usually determine whether an external or internal bleaching approach will be considered.

229

viii

Contents

In-office Vital Bleaching with Adjunct Light Joe C. Ontiveros The use of light as an adjunct to in-office bleaching is a controversial topic in dentistry because of the equivocal outcomes of the research conducted in studies using light compared with no light treatment. The proper diagnosis and treatment planning of discolored teeth is of primary importance when managing the outcomes and setting expectations for patients undergoing in-office bleaching with supplemental light. Although no study is conclusive on all bleaching lights, research evidence provides guidelines for the responsible use of in-office bleaching lights in dentistry. Safety Controversies in Tooth Bleaching Yiming Li Tooth bleaching using peroxide-based materials is an effective procedure in dentistry. Studies provide evidence on the safety of bleaching by dental professionals. However, concerns and controversy remain regarding the safety of bleaching systems that do not involve dental professionals, especially those available at mall kiosks, salons, spas, and cruise ships. Bleaching causes tooth sensitivity and/or gingival irritation in a significant portion of patients. Bleaching requires proper examination, diagnosis, and treatment plan, which can be performed appropriately only by dental professionals; therefore, involvement of dental professionals in bleaching is necessary to maximize the efficacy and minimize potential risks. Diastema: Correction of Excessive Spaces in the Esthetic Zone Anabella Oquendo, Luis Brea, and Steven David The presence of a diastema or diastemata between teeth is a common feature found in the anterior dentition. Many forms of therapy can be used for diastema closure. A carefully developed diagnosis and advanced planning allows the most appropriate treatment to be determined for each individual case to address the patients needs. Clinical considerations, advantages, disadvantages, and alternative treatment modalities for diastema closure are discussed in this article and a clinical case is presented to illustrate the application of these techniques. Congenitally Missing Lateral IncisorsA Comparison Between Restorative, Implant, and Orthodontic Approaches Matthias Krassnig and Stefan Fickl Tooth agenesis is one of the most common developmental dental anomalies. Successful and satisfying dental treatment is always the goal for patients and dental practitioners, meaning that a patients needs are solved in a functional and esthetic way. Patients and dentists have to find the best way to reach their common goal of satisfaction. The authors introduce and provide examples of different approaches to solve the problem of congenitally missing lateral incisors. This article discusses the restorative approach, the approach using implants, and the orthodontic approach. In most cases, an interdisciplinary treatment plan has to be worked out and executed.

241

255

265

283

Contents

ix

Dental Crowding: The Restorative Approach Luis Brea, Anabella Oquendo, and Steven David Crowded dentition is commonly found in the esthetic zone. Many forms of therapy can be used to treat the overlap of teeth caused by insufficient space within the dental arch. A careful analysis of patients with dental crowding is necessary to determine the most appropriate treatment of each individual case. Clinical considerations, advantages, disadvantages, and alternative treatment modalities for crowding dentition are discussed in this article and a clinical case is presented to illustrate the application of these techniques. Cements and Adhesives for All-Ceramic Restorations Adriana P. Manso, Nelson R.F.A. Silva, Estevam A. Bonfante, Thiago A. Pegoraro, Renata A. Dias, and Ricardo M. Carvalho Dental cements are designed to retain restorations, prefabricated or cast posts and cores, and appliances in a stable, and long-lasting position in the oral environment. Resin-based cements were developed to overcome drawbacks of nonresinous materials, including low strength, high solubility, and opacity. Successful cementation of esthetic restorations depends on appropriate treatment to the tooth substrate and intaglio surface of the restoration, which in turn, depends on the ceramic characteristics. A reliable resin cementation procedure can only be achieved if the operator is aware of the mechanisms involved to perform the cementation and material properties. This article addresses current knowledge of resin cementation concepts, exploring the bonding mechanisms that influence long-term clinical success of all-ceramic systems. All-Ceramic Systems: Laboratory and Clinical Performance Petra C. Guess, Stefan Schultheis, Estevam A. Bonfante, Paulo G. Coelho, Jonathan L. Ferencz, and Nelson R.F.A. Silva Several all-ceramic systems have been developed in dentistry to meet the increased expectations of patients and dentists for highly aesthetic, biocompatible, and long-lasting restorations. However, early bulk fractures or chippings have led the research community to investigate the mechanical performance of the all-ceramic systems. This overview explores the current knowledge of monolithic and bilayer dental all-ceramic systems, addressing composition and processing mechanisms, laboratory and clinical performance, and possible future trends for all-ceramic materials. Minimum Thickness Anterior Porcelain Restorations Gary M. Radz Porcelain laminate veneers (PLVs) provide the dentist and the patient with an opportunity to enhance the patients smile in a minimally to virtually noninvasive manner. Todays PLV demonstrates excellent clinical performance and as materials and techniques have evolved, the PLV has become one of the most predictable, most esthetic, and least invasive modalities of treatment. This article explores the latest porcelain materials and their use in minimum thickness restoration.

301

311

333

353

Contents

Creating Aesthetic Success Through Proper Clinician and Laboratory Technical Communication John F. Weston and Erik Haupt High-quality aesthetic restorations that look great, function ideally, and last can only be predictably produced through implementation of excellent communication techniques and systems between the doctor and ceramist. With the availability of technology and the Internet, it is now easy to involve the laboratory via digital photographs. This article challenges one to begin including the laboratory early in the process and routinely use reliable techniques to transfer clinically significant information to the laboratory bench. Soft and Hard Tissue Management Using Lasers in Esthetic Restoration Hugh D. Flax Laser technology has become preeminent in the evolution of appearance enhancements. Dentistry has seen a huge breakthrough with the introduction of a combination hard-soft tissue erbium wavelength. The conservative nature of this technique has created a firm footing in the antiaging trend that is spanning the globe. Among the many benefits of this technique are less invasive care and quicker healing responses. In this article, conservative laser and cosmetic modalities are discussed that allows a clinician to be more comfortable in buying a soft/hard tissue laser and also to more quickly become adept with implementing these techniques. Esthetic and Functional Consideration in Restoring Endodontically Treated Teeth Richard D. Trushkowsky The selection of the best restoration for an endodontically treated tooth in the aesthetic zone depends on strength and the ability to recreate the form, function, and aesthetics of the natural tooth. The increased use of all-ceramic materials is a result of improved ceramic materials and adhesive systems. However, the advent of the current variety of translucent ceramic systems makes the shade of the abutment important in achieving the desired aesthetic outcome. This article discusses the different types of posts used in the restoration. Index

371

383

403

411