The Aesthetic Smile: Diagnosis and Treatment
Maurice Salama, DMD;David Garber, DMD
Until recently, dentists' and the public's concept of dental aesthetics was necessarily limited to alterations of the teeth themselves. Dentists concerned themselves with changing the position, the shape and the color of the teeth -basically restoring missing units or enhancing those already present. For the most part the dentist was forced to accept the pre-existing relationship between the three components of the smile; the teeth, the gingival scaffold and the lips.
Interestingly, the restorative dentist's concept of aesthetics varied considerably from that practiced by removable prosthodontists where, in the full denture set-up, they could not only select the most desirable shape and color of denture tooth concomitant with the patient's facial features but could position them in the optimal relationship with regards to the upper lip, the lower lip and the commissures of the mouth -thereby creating the desired ideal smile.
The three basic tenets germaine to optimal aesthetics in removable prosthetics were not really a part of the restorative dentist's rules, as any changes in the pre-existing lip-tooth-gingival relationships were thought to necessitate long-term orthodontic therapy, often in combination with orthognathic surgery or aggressive periodontal procedures. Today much of this has changed; with the advent of soft tissue periodontal plastic procedures designed to enhance dentofacial harmony following the same basic tenets as those of the removable prosthodontist. The domain of periodontics has changed from being strictly a health service to one where smile enhancement has been brought to the forefront of treatment planning.
The essentials of a smile involve the relationships between the three primary components:
Alveolar Ridge Preservation and Reconstruction
Periodontal plastic surgery procedures designed to reconstruct deformed, partially edentulous residual ridges were introduced to the dental profession between 1971 and 1986. They have been revised and refined to their current state of development, where they now occupy a major place in the reconstructive armamentarium. Before these concepts were developed, it was generally believed that it was impossible to surgically reconstruct deformities in the partially edentulous ridge. Deformities were filled…
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Unique Implant Technology for Immediate Provisional Restorations at Implant Placement
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Surgical and Prosthetic Reconstruction of a Periodontally Compromised Case in the Esthetic Zone
Management of severe compromised cases in the esthetic zone entitles proper planning and the use of all tools and technologies and biomaterials to achieve an acceptable result.
In this video it is demonstrated the surgical steps utilizing conebeam and microscope in the use of allogenic bone blocks and acellular dermal matrix.
Clinical Case Review
Dr. Rosenberg reviews a severe clinical case.
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Dr. Daniel Melker describes, in great detail, the management of molar furcation involvement in preparation for crown and bridge therapy.
Tissue Engineering and Platelet Derived Growth Factors: Evidence Based Therapy
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What to do when Good Teeth and Implants go Bad? The Standard of Care for Laser Periodontitis Treatment
In this course, you will understand the laser energy and how the LANAP® protocol creates the specific environment to turn periodontal “degeneration” into “regeneration” around failing teeth and implants.
Managing the Extraction Site - Optimal Preservation and Enhancement Techniques
There is rarely a day that clinicians do not have to deal with an extraction site. If implant therapy is a consideration, then bone and soft tissue quantity and quality must be factored into treatment options. The ideal opportunity for bone preservation exists at the time of tooth extraction. All too often this opportunity is lost. Extraction techniques will be demonstrated that not only preserve but augment the amount of alveolar bone. The importance of piezosurgery, atraumatic surgical technique, the use of bone grafts, resorbable membranes and growth factors will be elucidated along with soft tissue enhancement.
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