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Our latest technique in digital dentistry are getting faster and better. We have so many option avialble to us that we did not in years past and our aesthetics and overall case design have been greatly improved as well because of these stremlined processes.
The female patient, who was 45 years old at the time, came into our practice with a deficient restoration, which
was mainly metal ceramic crowns and bridges in the maxilla. Following examination, we determined that the extraction of several teeth was unavoidable and this in turn also meant that the bridges had to be redone.
Our case report involves a 55 year old female patient requesting four crowns on her anterior teeth in a bright white color. The patient was very particular about her desires regarding her restorations. She wanted a certain shape, color and design but was not completely sure how to describe what was missing. Patients are not taught to
understand teeth width, incisal edges, embrasures or any other of the characteristics dental professionals discuss. Therefore, we have to listen and learn what they are concerned about if we are to truly make them happy.
A male patient in his mid-fifties was presented to Dr. Christopher Igiel from the Department of Dental, Oral and Maxillofacial Surgery at the Mainz University Medical Center. The palatine and occlusal surfaces in particular of the maxillary dentition showed significant abrasion, which had resulted in a deeper bite (Figure 1).
The patient was suffering from hypersensitivity in the tooth neck area, where the dentin was already partially exposed. The dentition generally showed a considerable amount of discoloration in the form of stains. Slight raising of the bite in order to restore the previous occlusion was planned. Improved aesthetics as well inexpensive implementation of the prosthetic restoration were important to the patient.
Tissue Biotype” has become a popular word in dentistry. If tissues are thin and friable around crowns, we worry that tissues may recede away from crown margins. Great care with regard to tissue management during tooth
preparation, tissue retraction during final impressions, maintenance of biologic width and marginal integrity are essential to maintain tissue health but often, despite great care, thin tissue will still recede around crowns or veneers.
Hybrid Denture bridges have a well documented history greater than 40 years as a successful treatment modality.1 In recent years I have seen a dramatic increase in their usage.
Only if the treatment goals have been well defined before the treatment is started may the range of materials and the required treatment steps be synchronized with each other and streamlined towards a successful outcome. In this two-part article Prof. Dr. Daniel Edelhoff and Oliver Brix present a systematic way to the full-mouth rehabilitation of complex cases. The first part deals with the efficient planning and targeted selection of appropriate ceramic materials.
Only if the treatment goals have been well defined before the treatment is started may the range of materials and the required treatment steps be synchronized with each other and streamlined towards a successful outcome. In this two-part article Prof. Dr. Daniel Edelhoff and Oliver Brix present a systematic way to the full-mouth rehabilitation of complex cases. The first part deals with the efficient planning and targeted selection of appropriate ceramic materials.
The first materials that very quickly come to mind are light-curing materials, the majority of which, however, do not burn out without residue and are therefore unsuitable for modeling a pattern for subsequent casting.
New materials, the increasing needs of patients, the economic crisis, and dental tourism are putting odontotechnical laboratories, their owners, and their partners under pressure. How can this challenge be met? A winning tactic in this battle is surely the product’s quality and Italian dental technicians and the “Made in Italy” have nothing to fear in this field. Client services and “teamwork” are another two factors needed in facing future challenges. In the second part of his article, the author shows how to obtain excellent results by illustrating the second clinical case.
The use of a provisional is not just a temporary bridge placed in the patient’s mouth while a final restoration is being fabricated in the laboratory.
Provisionals are an integral part of the exacting task for predictable comprehensive dental treatment. They become our template for the definitive restoration of our patient.
The provisionals are developed and designed from a rigorous ritual of esthetic evaluation using a series of 18 photographs with acetate overlays, to compare the presenting condition to an ideal one, in order to design new tooth positions, gingival levels, occlusal and incisal planes, arrangements, contours and shapes of teeth as well as color/shade changes as desired. These changes are then transferred to properly mounted models of the patient.
There have been tons of articles and opinions on techniques and materials for impressions over the years, yet speak to any lab technician and #1 on the list of complaints about dentists is the one about “sloppy” impressions. After inspecting a bunch of these in any given lab, you can easily understand why. The final impression is probably the most important starting point of any given case in the eyes of the lab technician, because many times it is the first contact they have with that particular patient.
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