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

Unlabelled: Today, physical appearance plays a major role in self-esteem and, as a result, also in the overall satisfaction of the person. Facial esthetics plays a crucial role, with the smile being the protagonist. A multidisciplinary approach, including several specialties of dentistry, is usually needed in order to create a pleasing end result. With the Smile's Aesthetic Evaluation Form (SAEF), the authors propose a new evaluation of the esthetics of the smile. It uses both static (photographs) and dynamic (videos) analysis, followed by several objective and subjective items, thus improving the communication between the different dental specialists and laboratory technicians. The SAEF also provides the patient knowledge of the disharmonies of the smile and increases the patient's comprehension and acceptance of treatment. It is organized in such a way as to provide an understanding of the esthetic parameters of the smile individually, and, simultaneously, evaluate the quality of the smile for the specific case. This form is designed to detect small dental anomalies when the patient is not content with his/her smile, but is unable to pinpoint the parameters that cause this dissatisfaction. This esthetic evaluation form can be a useful additional tool to the clinical diagnostic procedure. In order for the analysis to be fully understood, an example of its use will be presented in a clinical case.

Case report: A 28-year-old female patient, dissatisfied with her smile, presented to the Orthodontic Department of Tel Aviv University. She had undergone orthodontic treatment in the past. She presented a relapse in the mandible. The relapse in the mandibular arch was to be corrected with Invisalign. For the maxillary arch, the SAEF was completed in order to improve the communication between the orthodontist, patient, and cosmetic dentist to correct the incorrect parameters highlighted in the analysis.

This study examined the distances between the facial and palatal papillae (DFPP) in the maxillary anterior dentition. A total of 360 filled interdental papillae in 72 study models were examined (Group A: 36 young patients, Group B: 36 adult patients). The DFPP was measured directly on alginate impressions. In Group A, the average DFPP was 1.27 ± 0.6, 1.53 ± 0.42, and 1.83 ± 0.56 mm between the central incisors (CI-CI), central and lateral incisors (CI-LI), and lateral incisor and canine (LI-CA), respectively. In Group B, the respective average DFPPs were 1.3 ± 0.83, 1.38 ± 0.68, and 1.62 ± 0.58 mm. Within the limits of the present study, the average distances between the facial and palatal papillae seem to be useful for setting the proximal contact position.

A thorough understanding of the histoanatomic structures and dynamic light interaction of the natural dentition provides dental practitioners with the ultimate strategic advantage with regard to optical integration of the final restoration. The first part of this article will attempt to provide insight on the threedimensional coronal configuration of natural teeth and on the utilization of this knowledge in the clinical and technical restorative approach. The main goals for this article are to identify and reveal previously unreported histo-anatomic interrelationships and to explain existing ones: the sigmoid curve distribution (convex enamel/concave dentin), the distinction between dentinoenamel "junction" (DEJ, visual interface) and dentinoenamel "complex" (DEC, functional interphase), and the structural significance of DEC preservation.

Statement of problem: Studies have measured the effectiveness of tooth bleaching, however there are very few studies that have measured the persistence in color change after a 6-month follow-up.

Purpose: This study assessed the efficacy of the laser bleaching process using different regimens, and the persistence of color change over a 6-month period.

Method and materials: Sixty patients divided into three equal groups were subjected to bleaching using a diode laser with 34% hydrogen peroxide. Group 1: patients subjected to one session of laser bleaching. Group 2: patients subjected to two sessions of laser bleaching with a 1-week interval. Group 3: the same as Group 2 but followed by home bleaching once a month for 3 months. The color was assessed four times: before bleaching, directly after bleaching, 3 months after bleaching, and 6 months after bleaching.

Results: All teeth had a significant color change at 6 months, but all teeth had regressed from the maximum value. There was significantly less regression in color for Group 3, followed by Groups 2 and 1, respectively.

Conclusion: The combined technique of in-office laser bleaching for two sessions with a 1-week interval, followed by home bleaching once a month for 3 months gave more persistence in color change.

Clinical significance: In-office power bleaching using a laser assisted hydrogen peroxide system repeated after a week, combined with home bleaching once a month for 3 months, is an effective bleaching regimen with less color regression after 6 months compared to a regimen of in-office bleaching alone.

This article proposes a comprehensive and conservative approach to the treatment of tooth wear, based on the application of minimally invasive composite restorations to treat both anterior and posterior decay. Three treatment options were considered, in relation to the severity of tissue loss and size of existing posterior restorations. Posterior tooth status actually will guide the clinician toward the most appropriate restorative option. In the presence of limited tissue loss and small fillings, only direct restorations are considered. With moderate tissue loss and medium size existing restorations, a mix of direct and indirect composite restorations is preferred, and with extensive tissue loss and large restorations, mainly indirect restorations will be chosen. The restoration of anterior guidance and a proper smile line are reestablished using adhesive restorations, including primarily direct composite buildups; in the presence of more severe tissue destruction, loss of facial morphology or discoloration, veneers and possibly crowns can be considered. The driving force behind the concept presented in this article is to intercept tissue destruction and restore proper tooth biomechanics, function, and esthetics using adhesive restorations which do not further invade hard tissues.

Purpose: To determine the color space and the coverage error of two manual shade guide systems in four age groups of a selected population.

Material and methods: A total of 174 patients were divided into four age groups and the shade of their natural teeth was measured (2067 teeth) with a spectrophotometer (Vita Easyshade). Color parameters in terms of L*, a*, b* values, chroma, and hue were recorded for each tooth. Color difference (ΔE*min) between each natural tooth and the closest match using two manual shade guide systems were calculated (3D Master shade guide standard and 3D Master shade guide with intermediate values). A Wilcoxon test was used to assess statistical differences between mean ΔE*min values for each system (α = 0.05).

Results: The recoded ΔE of the two tested manual systems was 6.19 for 3D Master shade guide (standard) and 6.02 for 3D Master shade guide (intermediate values). A statistically significant difference (P < 0.001) was found between the mean ΔE*min of the two systems. 47% of natural teeth presented a best match with intermediate value and chroma shade tabs. The mean ΔE*min was influenced by the age group of the patients (5.15, 5.23, 6.58, and 6.69, respectively).

Conclusion: Using intermediate value and chroma did not improve shade match, nor the coverage error of the tested population. Nevertheless, better coverage error was observed in younger age groups compared to older anterior teeth.

Endodontic and restorative considerations are of primary significance in the treatment of tooth fractures. Since exposed dentinal tubules permit invasion of bacteria into the endodontic system, a protective dressing must be applied as part of the emergency treatment. Provided the dentin wound has been sealed, restorative treatment can also be carried out at a later stage. The fractured tooth fragment can be reattached using adhesive protocols in order to restore function and esthetic appearance. If reattachment is difficult or impossible, eg, in cases of multiple or missing fragments, current composite materials enable excellent esthetic results. Minimally-invasive direct composite restorations are preferred over the more invasive indirect restorations, at least in immature teeth with an extensive coronal pulp dimension. Restorative treatment of crown-root fractures is frequently demanding due to inaccessible subgingival fracture margins. Extrusion of the remaining root is an alternative method to surgical crown lengthening for re-establishing the biological width. This can be carried out either orthodontically (forced eruption), or surgically (intra-alveolar transplantation). Although the treatment of crown-root fractures is one of the most technically sensitive procedures in dental traumatology and is frequently considered as a long-term temporary restoration, tooth conservation up to the age at which implants can be placed may be regarded as a success.

Bonded porcelain restorations are a predictable and durable treatment option with which not only esthetic appearance but also the strength and function of teeth can be re-established. One of the most important issues of today's dentistry is the preservation of sound enamel. Following biomimetic principles, employing minimally invasive applications and adhesive technologies are of paramount importance for successful restorations. The mock-up technique is advised for delicate removal of the required space for thin porcelain veneers minimally. Besides minimally invasive preparation, long-term success is determined by the adhesive quality of the laminate veneers. This case presentation demonstrates restoration of anterior dentition where the wear of incisal edges posed a negative effect on the smile of the patient. Before bonded porcelain veneers were adhesively cemented, incisal lengthening with direct resin composite and gingival contouring was performed. By using the mock-up technique, minimal preparations were made with the outline ending in enamel only. For cementation of these restorations, step-by-step adhesive procedures are presented.