Physical appearance and attractiveness consciously and subconsciously, affect patients’ quality of life. Traditionally, dentists were tasked with improving a patient’s smile, a central aspect of ...facial aesthetics and physical appearance. More recently, as the scope of practice of the aesthetic dentist has broadened to potentially include other components of facial cosmesis that go hand-in-hand with a patient’s smile, new options have emerged with which modern aesthetic dentists should familiarize themselves. As laws surrounding their use in dental offices continue to evolve, Botox and dermal fillers represent natural next steps in aesthetic dentistry.
Objective: multidisciplinary treatment has become increasingly common in dental offices and this treatment strategy is based on the achievement of a healthy, harmonious, and pleasant smile. In ...addition, the development of new ceramic systems and the possibility of making indirect restorations with a low thickness, such as laminates veneers, allowed combining highly satisfactory aesthetic properties, preserving the dental structure through minimal wear. Case report: this paper describes a multidisciplinary approach involving periodontics and restorative dentistry for the successful, functional, and aesthetic treatment in an adult patient. The digital smile design was performed as a guide to plan the clinical case considering factors such as tooth inclination and position, golden proportion, tooth size and shape. Discussion: based on these concepts, the present work reports, through a clinical case, the restoration of aesthetics and function with ceramic laminates veneers in lithium disilicate, in the case of anatomical correction and diastema closure. Conclusion: overall, the multidisciplinary treatment plan demonstrated to have greater advantages both for the aesthetics and function of the patient, as well as for the work team. During the 24-month follow-up, this case presented great functional and aesthetics results.KEYWORDSCeramic veneers; Aesthetic dentistry; Multidisciplinary treatment.
Aesthetic composite restoration is the most common method for dental hard tissue defects reconstruction. Despite the active development and use of ceramic restorations for dental rehabilitation, the ...introduction of new nanotechnological filling materials has opened up fundamentally new possibilities in restorative dentistry. This article represents a clinical case of direct composite restoration in teeth 25, 26 and 27 using new nanoceramic materials.
In this functional magnetic resonance (fMRI) study, we investigated the activation of cerebral pathways involved in the elaboration of self-retracting photos (SELF) and the same pictures of others ...(OTHER). Each of the photographs showed one of the participants during different stages of the rehabilitation: pre-treatment (PRE), virtual planning using "Smile-Lynx" smile design software (VIR), and post-rehabilitation (POST).
We selected eighteen volunteers, both male and female, between 22 and 67 years of age, who previously underwent prosthetic rehabilitation. Each of them was subjected to an fMRI acquisition. Various stimuli were then shown to the subjects in the form of self-retracting photographs and photographs of other participants, all in pseudo-randomized order. We then carried out a two- stage mixed-effects group data analysis with statistical contrast targeting two main effects: one regarding the main effect of Identity (SELF vs. OTHER) and the other regarding the effect of the prosthetic rehabilitation phase (PRE vs. VIR vs. POS). All the effects mentioned above survived a peak-level of
< 0.05.
For the effect of identity, results reported the involvement of dorsolateral frontoparietal areas bilaterally. For the phase by identity effect, results reported activation in the supplementary motor area (SMA) in the right hemisphere. A stronger activation in observing self-retracting photos (SELF) post-treatment (POST) was reported compared to the other phases considered in the experiment.
All the collected data showed differences regarding the main effect of Identity (SELF vs. OTHER). Most importantly, the present study provides some trend-wise evidence that the pictures portraying the subject in their actual physiognomy (POST) have a somewhat special status in eliciting selectively greater brain activation in the SMA. This effect was interpreted as a plausible correlate of an empathic response for beautiful and neutral faces. The present research suggests a possible way to measure self-perception of the subject after an appearance-altering procedure such an implant-prosthetic rehabilitation. However, future clinical studies are needed to investigate this matter further.
Composite materials are the most common materials in use in modern dentistry. Over the years, the methods of photopolymerization of composite materials have been improved with the use of various ...devices, such as quartz tungsten halogen lamps (QTHs), light-emitting diode units (LEDs), plasma-arc lamps and argon-ion lasers. This study aimed to compare the mechanical properties of a composite material, depending on the time and mode of photopolymerization. One hundred and forty rectangular specimens (25 × 2 × 2 mm) and forty-two disc-shaped samples (5 mm diameter and 2 mm thickness) were prepared from shade A2 Boston composite resin. Samples were cured using the following seven photopolymerization protocols: four fast-cure modes (full power for 3, 5, 10, and 20 s), two pulse-cure modes (5 and 10 shots of 1 s exposures at full power), and one step-cure mode (soft start with a progressive cycle lasting 9 s). Specimens were subjected to a flexural strength test, Vickers microhardness test, and FTIR spectroscopy test. A 2-factor ANOVA and post-hoc tests were carried out to assess the differences in the flexural strength parameter between the tested groups of samples before and after aging. A mixed-model ANOVA was carried out to assess the differences in the Vickers microhardness parameter between the tested groups of samples before and after aging. The lowest values of flexural strength (p < 0.001) and Vickers microhardness (p < 0.001) were obtained for the 3 s mode for the pre- and post-aging groups. The FTIR mapping tests showed a much more homogeneous chemical structure of the composite after 20 s of continuous irradiation, compared to the sample irradiated for 5 s in the continuous mode. The mode and cure time affects the mechanical properties of the composite resin. Appropriate selection of the cure mode and time ensures better mechanical properties of composite resin. This suggests that the survival of dental restorations within the oral cavity could be extended by using longer photopolymerization durations.
Currently, composite resins are used in many restorative procedures. Previous studies showed that drinking beverages may affect the mechanical properties such as microhardness or flexural strength of ...dental composite resins. The aim of the present study was to investigate the influence of common beverages on the mechanical properties of composite resins. Samples of the materials were prepared according to the ISO 4049:2010 standard and producer’s recommendations. The samples were next conditioned in tested fluids: distilled water, sparkling water, Coca-Cola, Red Bull and orange juice for 7 days. Vickers microhardness and flexural strength testing was performed after 7 days. Performed statistic tests confirmed the significance of microhardness changes of the tested materials in terms of both different conditioning of the samples and different composite materials. The mean flexural strength of composites was highest in distilled water and it was reduced after one week in different beverages. We conclude that all tested beverages influenced on Vickers microhardness of tested composite resins. Flexural strength only in one material was statistically significantly influenced by tested beverages. The results of this study should be taken into consideration by a dentist preparing recommendations for the patients after dental treatment with usage of composite material or after cementing composite based fixed dentures.
A scope of results by global dental practice bears testimony to the fact, that there is an urgent necessity to work out and formulate the basic principles, standards and definitions of aesthetic ...Stomatology as a study, which in its turn ensures wide implementation of prospective patterns and methods into the healthcare system. Theoretical knowledge, received form modern literary sources, as well as scientific researches and clinical observations, performed by the author in collaboration with his colleagues, enables us to define the grounding principles for modern aesthetic Stomatology. The most crucial principle or the cornerstone of aesthetic Stomatology consists in achieving treatment results, which are as close to the natural parameters of a dentition as possible. The realization of the primary principle is ensured by means of optimum medication practices relying on methods, which cause the minimal damage or no damage at all to intact structures. Different methods of dental bleaching are to be considered as well as minor dissection (microabrasion) and grinding the prismless layer off the enamel surface. Dissection and especially depulping are to be performed only when no other solutions are deemed viable. Any treatment used must guarantee a high degree of aesthetics, mechanic durability, safe and reliable adhesion between restorations and tooth tissue. In restorational and orthopeadic Stomatology the optimal treatment presupposes the choice of such a construction, which would secure the maximal protection of both the hard tissue and the pulp of a tooth. Performing a safe minimal dissection under the control of a binocular loupe, the usage of high-quality materials and up-todate technologies ensures that the pulp will remain vital and no complications will follow. Implantology effectively combines surgical and orthopeadic treatments, preventing bone structure atrophy and preserving the healthy look of the gingiva and restoring the natural shape and color of teeth. The principle of fully conscious collaboration between patient and dentist presupposes regular and thorough completion of all the procedures prescribed. As far as the quality of personal hygienic requirements goes, a patient’s role in the preparation for the restoration process becomes dramatically emphasized. Working with photo-composites and modern ceramics is based on a scope of strictly formulated requirements, which give scientific grounding to the manipulations applied. The principle of color imitation secures modeling of a restored structure with application of high aesthetic parameters, such as selecting the color of restorative material with utmost precision to match the optical characteristics of dentine and enamel as well as the consecutive color imitation of the lost tissues of a tooth. Layer-by – layer restoration and precise imitation of every single shade of color makes the construction look as natural as ever. The material used to restore dentine, which is marked as O (opaque) or D (dentine), ought to be chosen in accordance with the color of a given tooth. Colors of the enamel are selected according to the same regulations and are applied so that a restoration has a naturally sparkling and transparent surface. The principle of reproduction for natural volume parameters consists in planning the size, shape, relief of the surface usually followed by the reproduction of microand macrostructures on a restoration or alveolar sockets. The visual assessment and measurement results make it possible to examine the geometric parameters of a crown based on the interrelations of the side surfaces, to evaluate the expression of characteristics towards the side depending on the correlation between angles, convexity of the crown and inclination of the gingival dome. At this point of research scaled monoculars are normally used to measure linear and angle sizes. The principle of adhesive preparing stands for the expansion of the contact area between the tooth and the filling with the purpose of sufficient increase in the amount of surface energy, which, in its turn, ensures proper adhesion of the composite to the teeth. The objective can be achieved by means of hard tissue excision down to the intact structures, by creating enamel slant or cavity of a particular shape as well as via etching enamel by acid and the use of the adhesive system. In case of front teeth the contact area between the enamel and the photo-polymer may be increased by slanting down the cavity combined with the excision of the prismless layer. For molars it is advisable to shape a cavity in a specific way, namely: make a sharp angle between the bottom and the gingival wall, create an additional plateau on the chewing surface and smooth over inner angles. The minimization principle for the consequences of Polymer shrinkage is based on the characteristic of the material to shrink down when hardening. If the defect is considerable a filling across the bottom or the side area may “split off” as a result of which a “gap” may appear, followed by many complications. The risks of a filling splitting off or cracking in a composite-enamel contact zone as well as the risks of hypertension decrease on conditions that chemically hardened filling materials are used. As they get harder, they get “attracted” toward the pulp as a source of heat. Before the initial level of hardening process the shrinkage of the material is partly compensated for its flowability. The risk of the composite splitting off the enamel is growing as the contact area is increasing and the structural design is becoming more complicated. In case of cavity with a distinctly complex configuration, with a bottom and several sides included, minimization of the negative consequences of polymer shrinkage is achieved through the simultaneous application of one layer of the composite on to no more than two surfaces. One of the methods employed suggests the use of herringbone pattern, another one is the lateral layering.
Dental composites are gaining great popularity in restorative dentistry because of their aesthetic appeal and capacity to replicate the natural color of teeth. Nevertheless, their lifespan and ...durability rely on various factors, such as the polishing technique and the environmental conditions they are exposed to. The study aimed to assess the influence of the method of final polishing of dental composite on the surface roughness and microhardness of materials also considering the environment of different pHs. Disc-shaped samples (5 mm diameter and 2 mm thickness) have been prepared for microhardness and roughness tests from two dental composites: A2 Clearfil Majesty ES 2 Classic and A2D Clearfil Majesty Premium. One-third of samples were polished with polishing discs, OptiDisc, another one-third of samples were polished with Eve Diacomp Twist rubbers and polishing brush with diamond particles, and rest of the samples were stored without any polishing (the control group). Tested materials were incubated in distilled water or acidic buffer (pH = 2) for 3 weeks at a temperature of 37 °C. No statistically significant differences were found for roughness for the two materials tested after incubation in liquids. A decrease in Vicker microhardness was found for Clearfil Majesty ES 2 Classic after soaking in a low pH liquid, and no such relationship was found for Clearfil Majesty Premium. The improved resistance of these materials to the negative oral environment may result in the longer survival of composite restorations in patients with poor diet or diseases, causing a decrease in oral pH.
Background and Objectives: The report describes a technique using a diagnostic mock-up as a crown-lengthening surgical guide to improve the gingival architecture. Materials and Methods: The patient’s ...primary concern was improving her smile due to her “gummy smile” and short clinical crowns. After clinical evaluation, surgical crown lengthening accompanied by maxillary central full-coverage single-unit prostheses and lateral incisor veneers was recommended. The diagnostic mock-up was placed in the patient’s maxillary anterior region and used as a soft tissue reduction guide for the gingivectomy. Once the planned gingival architecture was achieved, a flap was reflected to proceed with ostectomy in order to obtain an appropriate alveolar bone crest level using the overlay. After six months, all-ceramic crowns and porcelain veneers were provided as permanent restorations. Results: A diagnostic mock-up fabricated with a putty guide directly from the diagnostic wax-up can be an adequate surgical guide for crown-lengthening procedures. The diagnostic wax-up was used to fabricate the diagnostic mock-up. These results suggested that it can be used as a crown-lengthening surgical guide to modify the gingival architecture. Several advantages of the overlay used in the aesthetic complex case include: (1) providing a preview of potential restorative outcomes, (2) allowing for the appropriate positioning of gingival margins and the desired alveolar bone crest level for the crown-lengthening procedure, and (3) serving as a provisional restoration after surgery. Conclusions: The use of a diagnostic mock-up, which was based on a diagnostic wax-up, as the surgical guide resulted in successful crown lengthening and provisional restorations. Thus, a diagnostic overlay can be a viable option as a surgical guide for crown lengthening.
The wide range of materials and methods for restoration the shape and function of the frontal group of teeth appeared due to modern technology in the daily practice of a dentist. The defeat of the ...aesthetic region of the tooth (especially the vestibular surface) leads to suffering, self-doubt and a decrease in the patients quality of life. In this regard, the doctor bears a high degree of responsibility, and must decide on a method of recovery and choice of material. In modern aesthetic dentistry, polymerizable composite materials are the method of choice when filling the lost volume of hard tissues of vital teeth. Russian materials deserve special attention in the current political and economic situation in our country. A review of the literature showed the need for a detailed study of the properties of composites in the oral cavity for a qualitative selection of the optimal variant both for physical characteristics and for financial accessibility.
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