Predictable Implant Aesthetics Utilizing A Custom Fabricated Provisional Abutment & Impression Coping
Mastering the art of predictable implant aesthetics can be challenging. One of the most stressful areas for most dentists is the process of creating a beautiful provisional that will guide tissue and predictably communicate the aesthetic outcome for the final restoration in the aesthetic zone. Combining the use of a custom fabricated provisional abutment, provisional restoration and a custom fabricated impression coping many of the aesthetics challenges can be addressed. This information can then be communicated to the laboratory to ensure the most predictable aesthetic outcome possible. This program is designed to simplify and streamline the entire process of implant provisionalization and impression. This program will provide a systematic, step by step approach to tissue management, provisionalization and impression of implant cases.
Modern Crown Lengthening: Classification and Clinical Application
Crown lengthening procedures are indicated to provide adequate tooth structure in case of subgingival tooth fracture or caries, uneven gingival level, un-esthetic short crowns due to the tooth wear, inadequate axial height, altered passive eruption ,forced eruption of a single or multiple teeth and finally in case of gingival smile.
The treatment modality for esthetic crown lengthening procedure should be based on detail diagnosis in each case because of the multifactorial etiology and because of the type of therapy selected by the clinician, will have a direct implication for the esthetic result.
Achieving Stable Esthetic Results with Implant Supported Restorations
We will discuss basic concept regarding immediate implant placement and guided bone regeneration procedure related to the esthetic zone before focusing on the soft tissue management. We will describe the prosthetic procedures which are performed before, during and after the surgical procedures. Provisional restorations, impression techniques, prosthetic profiles and restorative materials will be presented. The purpose of the presentation is to provide a check list that will guide the clinician developing a proper analysis and diagnosis for the successful esthetic result with implant supported restoration.
Vertical or Shoulderless Preparations in Contemporary Prosthodontics
Tooth preparations without a defined finish line have been termed in several different ways, such as knife edge, feather edge, or shoulderless.
From a biological standpoint, preserving a maximum amount of sound tooth structure, as it is done in vertical preparations, might also offer a more conservative alternative to a horizontal margin design in other clinical conditions such as endodontically treated teeth, vital teeth in young individual, teeth affected by caries at the cervical third. Vertical margins on zirconia crowns have been tested in vitro and clinical reports have been published. A re-evaluation of possible advantages and shortcomings of vertical preparation design in contemporary prosthodontics will be presented in light of recently published literature.
CAD/CAM Solutions for Minimally Invasive All-Ceramic Rehabilitation of Extended Erosive Lesions
Dental erosion is a global health problem that can lead to significant functional and esthetic impairments of the affected patients. Treatment of sever cases with augmented loss of the vertical dimension of occlusion (VDO) represents a challenge for both the dental team and the patient. CAD/CAM technology was used in the presented case to analyze the inter-occlusal space. The case report documents a practical, digital approach and discusses the advantages related to treatment time, ease of treatment, and predictability.
Retrospective Analysis of 26 Complete-Arch Implant-Supported Monolithic Zirconia Prostheses with Feldspathic Porcelain Veneering Limited to the Facial Surface
The purpose of this retrospective study was to evaluate the clinical performances of 26 implant-supported, complete-arch, monolithic zirconia restorations with facial feldspathic porcelain veneers for the rehabilitation of completely edentulous patients.
Eighteen patients were treated with a total of 26 complete-arch fixed prostheses. The mean follow-up time was 20.9 months. In total, 154 implants were placed supporting 309 retainers and pontics.
The results of this retrospective evaluation showed that monolithic zirconia restorations
with facial porcelain veneer provided satisfactory clinical performance and suggest that these
rehabilitations are a viable treatment option for completely edentulous patients.
The "Hybrid Abutment": A New Design for Implant Cemented Restorations in the Esthetic Zones
Cemented implant restorations are widely used by many dentists. The traditional abutment design resembles a natural tooth prepared for a crown with a similar taper and a chamfer finish line. A frequent complication associated with implant restorations in the esthetic zones is the recession of buccal gingiva over time. Abutment morphology, among several other prosthetic factors, may play an important role in the stability of gingival margin in esthetically sensitive areas, but this has never been thoroughly analyzed. With many considerations in mind and recent techniques released, this article proposes the "hybrid abutment: design (HAD), a new design that includes a combination of the two types of features - a feather edge on the buccal side, and a chamfer finish line on the lingual side. This article also presents a rationale for the use of different abutment designs for different situations.
Advanced Esthetic Management of Dental Implants: Surgical and Restorative Considerations to Improve Outcomes
This article demonstrates the importance of proper surgical and prosthetic principles in achieving esthetic implant
results.Successful dental implant therapy in the maxillary anterior dentition requires meticulous attention to surgical
and prosthodontic measures.
Proper diagnosis, extraction technique, implant selection, and placement significantly impact
outcomes. Respect of hard and soft tissue physiology following tooth loss and implant placement requires specific steps
be taken. Management tissue contours properly, via regenerative therapy, results in successful framing of the restoration.
Provisionalization and definitive restorative therapy also impacts the level of esthetic success.The contours of the
temporary abutment and crown develop soft tissue contours for the final restoration. Overcontouring can lead to soft
tissue recession and mucosal asymmetry. Design of the definitive crown(s) is crucial for long-term maintenance of
esthetically acceptable results.
Interdisciplinary Team Dentistry for Total Dentofacial Esthetics
Orthodontics sets up the foundation for future prosthetics in cases with periodontal, surgical and restorative dentistry requirements. Adult orthodontics simplifies complex clinical situations. Making it easier for restorative dentist to achieve better esthetic & functional results. Orthognatic surgery combined with orthodontics corrects skeletal discrepancies in order to have the patient ready for prosthodontic replacement of multiple missing teeth. Cases combined with implants to restore form & function will further illustrate the importance of multidisciplinary dentistry. Today´s practice requires a team approach that will be presented. In order to meet the patient´s demands for better esthetics and to obtain long term occlusal stability of our results.
Crowns and Bridges