The European journal of esthetic dentistry : official journal of the European Academy of Esthetic Dentistry最新文献

Background: Unfavorable conditions at the soft tissues adjacent to a recession defect may preclude performing pedicle flaps (advanced or rotational) both as a root coverage procedure, and as a covering flap for a connective tissue graft. Free gingival grafts may not be recommended because of the low root coverage predictability and the poor esthetic outcome. The goal of the present case report is to suggest modifications of the two-stage surgical technique aimed at improving root coverage and esthetic outcomes, and reducing patient morbidity.

Method: In the first case report, a Miller class II gingival recession, associated with a deep buccal probing depth, affecting a lower central incisor was treated. In the first step of the surgery an epithelized graft with an apical-coronal dimension equal to the keratinized tissue height of the adjacent teeth was sutured apical to the bone dehiscence. Four months later, a coronally advanced flap was performed to cover the root exposure. In the second case report, a Miller class III gingival recession, complicated with a deep buccal probing depth affecting the mesial root of the first lower molar was treated. In the first step of the surgery, a free gingival graft was positioned mesially to the root exposure to create keratinized tissue lateral to the recession defect. This was adequate to perform the laterally moved, coronally advanced flap that was used as a second-step root coverage surgical procedure.

Results: In the first case report complete root coverage, an increase (4 mm) in keratinized tissue height and realignment of the mucogingival line were achieved 1 year after the surgery. The reduced dimension of the graft permitted to minimize patient's discomfort and to obtain good esthetics of mucogingival tissues. These successful outcomes were well maintained for 5 years. In the second case report successful root coverage, increase (3 mm) in keratinized tissue height and good harmony of mucogingival tissues were achieved 1 year after the surgery. These outcomes were well maintained 5 years after the surgery.

Conclusions: The present study suggested that modifications of the two-stage procedure by minimizing the dimension of the graft and by standardizing the surgical techniques allowed successful results to be achieved in the treatment of gingival recessions characterized by local conditions that otherwise preclude the use of one-step root coverage surgical techniques.

Tooth preparations for fixed prosthetic restorations can be done in different ways, basically of two kinds: preparation with a defined margin and the so-called vertical preparation or feather edge. The latter was originally used for prosthetics on teeth treated with resective surgery for periodontal disease. In this article, the author presents a prosthetic technique for periodontally healthy teeth using feather edge preparation in a flapless approach in both esthetic and posterior areas with ceramometal and zirconia restorations, achieving high quality clinical and esthetic results in terms of soft tissue stability at the prosthetic/tissue interface, both in the short and in the long term (clinical follow-up up to fifteen years). Moreover, the BOPT technique, if compared to other preparation techniques (chamfer, shoulder, etc), is simpler and faster when in preparation impression taking, temporary crowns' relining and creating the crowns' profiles up to the final prosthetic restoration.

This study aimed to evaluate the efficacy of chemical agents to increase the bleaching effectiveness of 10% carbamide peroxide. Two hundred and ninety enamel-dentin discs were prepared from bovine incisors. The color measurement was performed by a spectrophotometer using the CIE L*a*b*system. The groups were divided according to the bleaching treatment: negative control group (NC): without bleaching; positive control group (PC): bleached with 10% carbamide peroxide gel without any chemical activator; Manganese gluconate (MG); Manganese chloride (MC); Ferrous gluconate (FG); Ferric chloride (FC); and Ferrous sulphate (FS). Three different concentrations (MG, MC, FG, FC: 0.01, 0.02 and 0.03% w/w; FS: 0.001, 0.002 and 0.003% w/w) for each agent were tested. The bleaching gel was applied on the specimens for 8 h, after which they were immersed in artificial saliva for 16 h, during 14 days. Color assessments were made after 7 and 14 days. The data were analyzed by repeated measures analysis of variance and Tukey's test (5%). Generally, the test groups were unable to increase the bleaching effect (ΔE) significantly compared to the PC group. Only for ΔL, significant higher values compared to the PC group could be seen after 7 days in groups MG (0.02%), and FS (0.002 and 0.003%). The NC group showed significantly lower values than all tested groups. It was concluded that for home bleaching procedures, the addition of chemical activators did not produce a bleaching result significantly higher than the use of 10% carbamide peroxide without activation, and that the concentration of chemical activators used did not significantly influence the effectiveness of treatment.

In restorative dentistry, the non-vital tooth and its restoration have been extensively studied from both its structural and esthetic aspects. The restoration of endodontically treated teeth has much in common with modern implantology: both must include multifaceted biological, biomechanical and esthetic considerations with a profound understanding of materials and techniques; both are technique sensitive and both require a multidisciplinary approach. And for both, two fundamental principles from team sports apply well: firstly, the weakest link determines the limits, and secondly, it is a very long way to the top, but a very short way to failure. Nevertheless, there is one major difference: if the tooth fails, there is the option of the implant, but if the implant fails, there is only another implant or nothing. The aim of this essay is to try to answer some clinically relevant conceptual questions and to give some clinical guidelines regarding the reconstructive aspects, based on scientific evidence and clinical expertise.

Purpose: The purpose of this study was to evaluate the esthetic result of monophasic zirconium dental implants, placed in the highly esthetic areas of the jaws.

Material and methods: In this case series the results of 12 monophasic zirconium dental implants placed in highly esthetic areas of 8 patients (6 male and 2 female). For each implant the Pink Esthetic Score (PES) and the White Esthetic Score (WES) were evaluated. All implants were inserted in fresh postextraction sites.

Results: The esthetic parameters PES/ WES has given a total average value of 15.5 ± 1.5. Analyzing the two indices individually, the PES has given a value equal to 7.5 ± 1 and the WES has given a value equal to 8 ± 1.13. Both values obtained indicate the achievement of an absolutely satisfactory esthetic result.

Conclusion: Within the limits of this study, the zirconium dental implants seems to give excellent results with regard to the esthetic result and for the maintenance of peri-implant soft tissues.

Objectives: To our knowledge, there is no study regarding the effects of facial type (short face or long face) on the esthetic perception of smiles as related to the amount of tooth and gingival display.

Materials and methods: Four photographs from two long- and two shortfaced females with posed smiles were prepared and, with altering the amount of tooth display, 5 photos for each of them were produced. These photos were given to 62 dentists and 69 laypersons to rate the images.

Results: There were significant differences between short and long-face patterns in low and high smile lines; also there were significant differences between dentists and laypersons about some images. Smile lines consistent with gingival margin were the best for both short and long-face patterns; also 1.5 mm incisor coverage in short-face and 1.5 mm gingival display in long-face received as high scores.

Conclusion: In short-face patterns, lower smile lines, and in long-face patterns, higher smile lines are more acceptable by both dentists and laypersons, which can help in designing orthodontic treatment goals.

Coronal rehabilitation of endodontically treated posterior teeth is still a controversial issue. Although the classical crown supported by radicular metal posts remains widely spread in dentistry, its invasiveness has been largely criticized. New materials and therapeutic options based entirely on adhesion are nowadays available. They allow performing a more conservative, faster and less expensive dental treatment. All clinical cases presented in this paper are solved by using these modern techniques, from direct composite restorations to indirect endocrowns.

Specialist literature shows that the repeated disconnection of the transmucosal components can generate tissue recession due to the alteration of the delicate environment created between the abutment and surrounding soft tissue. This article will analyze two different techniques of creating the final abutment in the pre-surgery phase, evaluating 2 failing central incisors considered suitable for the immediate tooth replacement technique.