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Crowns and Bridges Articles
Surgical Veneer Grafting - Compensation for Natural Labial Plate Remodeling After Immediate Implant Placement

Surgical Veneer Grafting - Compensation for Natural Labial Plate Remodeling After Immediate Implant Placement
Contemporary implant therapy aims to provide highly esthetic and predictable treatment outcomes while decreasing treatment duration and complexity. The clinician must therefore be cognizant of circumstances with a predisposition toward esthetic outcomes and treatment plan accordingly. Preservation of the surrounding hard and soft tissues associated with an immediate postextraction socket implant to replace a nonrestorable tooth in the esthetic zone is one of the greatest challenges facing the dental team. A case report of a hopeless maxillary left central incisor in a patient with a thin periodontal phenotype illustrates this new surgical and prosthetic approach. Clinical, radiological, and esthetic parameters were recorded to evaluate primary treatment outcomes.

Author(s): Alessandro Agnini, DMD;Maurice Salama, DMD;Henry Salama, DMD;David Garber, DMD;Andrea Mastrorosa Agnini, DDS
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CAD/CAM Solutions for Minimally Invasive All-Ceramic Rehabilitation of Extended Erosive Lesions

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.

Author(s): Petra C. Guess Gierthmuehlen, DDS; Enrico Steger, MDT
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Retrospective Analysis of 26 Complete-Arch Implant-Supported Monolithic Zirconia Prostheses with Feldspathic Porcelain Veneering Limited to the Facial Surface

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.

Author(s): Pietro Venezia, MD, DDS; Ferruccio Torsello, DDS, PhD; Raffaele Cavalcanti, DDS, PhD; and Salvatore D’Amato, MD, DDS
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The "Hybrid Abutment": A New Design for Implant Cemented Restorations in the Esthetic Zones

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.

Author(s): Roberto Cocchetto, MD, DDS; Luigi Canuello, DDS
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Porcelain Veneers Articles
CAD/CAM Solutions for Minimally Invasive All-Ceramic Rehabilitation of Extended Erosive Lesions

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.

Author(s): Petra C. Guess Gierthmuehlen, DDS; Enrico Steger, MDT
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Updating Classifications of Ceramic Dental Materials

Updating Classifications of Ceramic Dental Materials
The indications for and composition of today’s dental ceramic materials serve as the basis for determining the appropriate class of ceramics to use for a given case. By understanding the classifications, composition, and characteristics of the latest all-ceramic materials, which are presented in this article in order of most to least conservative, dentists and laboratory technicians can best determine the ideal material for a given treatment.

Author(s): Edward A. McLaren, DDS, MDC;Johan Figueira, DDS
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Retrospective Analysis of 26 Complete-Arch Implant-Supported Monolithic Zirconia Prostheses with Feldspathic Porcelain Veneering Limited to the Facial Surface

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.

Author(s): Pietro Venezia, MD, DDS; Ferruccio Torsello, DDS, PhD; Raffaele Cavalcanti, DDS, PhD; and Salvatore D’Amato, MD, DDS
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The "Hybrid Abutment": A New Design for Implant Cemented Restorations in the Esthetic Zones

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.

Author(s): Roberto Cocchetto, MD, DDS; Luigi Canuello, DDS
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Composite Resin Articles
Updating Classifications of Ceramic Dental Materials

Updating Classifications of Ceramic Dental Materials
The indications for and composition of today’s dental ceramic materials serve as the basis for determining the appropriate class of ceramics to use for a given case. By understanding the classifications, composition, and characteristics of the latest all-ceramic materials, which are presented in this article in order of most to least conservative, dentists and laboratory technicians can best determine the ideal material for a given treatment.

Author(s): Edward A. McLaren, DDS, MDC;Johan Figueira, DDS
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Fatigue Resistance and Crack Propensity of Novel "Super-Closed" Sandwich Composite Resin Restorations in Large MOD Defects

Fatigue Resistance and Crack Propensity of Novel "Super-Closed" Sandwich Composite Resin Restorations in Large MOD Defects
To asses the influence of conventional glass ionomer cement (GIC) vs resin-modified GIC (RMGIC) as a base material for novel, super-closed sandwich restorations (SCSR) and its effect on shrinkage-induced crack propensity and in vitro accelerated fatigue resistance. A standard MOD slot-type tooth preparation was applied to 30 extracted maxillary molars. A modified sandwich restoration was used, in which the enamel/dentin bonding agent was applied first, followed by a Ketac Molar or Fuji II LC base, leaving 2mm for composite resin material. Shrinkage induced enamel cracks were tracked with photography and transillumination. Samples were loaded until fracture or to a maximum of 185,000 cycles under isometric chewing, starting with a load of 200 N and gradually up to a maximum of 30,000 each...

Author(s): Pascal Magne, DMD, PhD; Silvana Silva, DMD, PhD; Mauro de Andrada, DMD, PhD; Hamilton Maia, DMD, PhD
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Contemporary Options for Restoration of Anterior Teeth with Composite

Contemporary Options for Restoration of Anterior Teeth with Composite
The present article gives an overview of modern adhesive restoration in the anterior area, in view of the fact that modern dental therapy should be as minimally invasive as possible. Illustrated with multiple cases, the article shows possible prospective fields of indication.

Author(s): Eva Wirsching, Dr med dent
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Visagism: The Art of Dental Composition

Visagism: The Art of Dental Composition
The aim of this article is to present a novel concept: Visagism. The Visagism concept helps dental clinicians provide restorations that account not only for esthetics, but also for the psychosocial features of the created image, which affect patients’ emotions, sense of identity, behavior, and self-esteem. These factors, in turn, affect how observers react to patients following treatment.

Author(s): Marcelo Calamita, DDS, MS, PhD;Christian Coachman, DDS, CDT;Braulio Paolucci, DDS; Galip Gürel, DDS, MS; Adriano Shayder, CDT; Philip Hallawell
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Bleaching Articles
Re-establishing Esthetics of Fluorosis-Stained Teeth Using Enamel Microabrasion and Dental Bleaching Techniques

Re-establishing Esthetics of Fluorosis-Stained Teeth Using Enamel Microabrasion and Dental Bleaching Techniques
The aim of this study was to report the clinical case of a female patient of 18 years with moderate fluorosis, whose smile was re-established by the use of an enamel microabrasion technique, followed by in-office bleaching. A microabrasion technique with 6% hydrochloric acid associated with silica carbide showed to be a safe and efficient method for removing white fluoroses stains, while dental bleaching was useful for obtaining a uniform tooth shade. The association of these techniques presented excellent results and the patient was satisfied. Both techniques are painless, fast and easy to perform, in addition to preserving the dental structure. Treatment showed immediate and permanent results; this technique must be divulged among professionals and their patients.

Author(s): Danielson Guedes Pontes, PhD; Ketlen Michele Leite Correa, DDS; Flavia Cohen-Carneiro, PhD
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Orthodontic Caries Control and Bleaching

Orthodontic Caries Control and Bleaching
Oral hygiene during orthodontic treatment can be facilitated by applying bleaching materials to elevate the pH of the mouth during the course of treatment. Fabrication of thermoplastic bleaching trays directly in the mouth over the braces without impressions affords a reasonable technique for the multiple trays required during the orthodontic changes.

Author(s): Van B. Haywood, DMD
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Efficacy and Persistence of Tooth Bleaching Using a Diode Laser with Three Different Treatment Regimens

Efficacy and Persistence of Tooth Bleaching Using a Diode Laser with Three Different Treatment Regimens
Bleaching is the most conservative esthetic treatment for discolored teeth when compared to resin-bonded composites, porcelain veneers, or crowns. The purpose of this study was to compare the efficacy of power bleaching using a laser assisted hydrogen peroxide system, and to determine the stability of the color change over a 6-month period.

Author(s): Firas AM Al Quran, PhD, MSc Med, BDS; Yasar Mansour, PhD, BDS; Sabaa Al-Hyari, MSc Dent, BDS; Ahed Al Wahadni, PhD, MDSc, BDS; Lawrence Mair, PhD, BDS, FADM, FHEA
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Use of a Reflectance Spectrophotometer in Evaluating Shade Change Resulting from Tooth-Whitening Products

Use of a Reflectance Spectrophotometer in Evaluating Shade Change Resulting from Tooth-Whitening Products
Historically, shade change assessment associated with vital bleaching treatment regimens has been visually evaluated through the use of shade guide tabs. Innovations in the industry of dentistry have brought forth new technologies capable of measuring such changes via the capture and analysis of reflected wavelengths of light.

Author(s): Stephen J. Chu, DMD, MSD, CDT
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Other Restorative Articles
CAD/CAM Solutions for Minimally Invasive All-Ceramic Rehabilitation of Extended Erosive Lesions

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.

Author(s): Petra C. Guess Gierthmuehlen, DDS; Enrico Steger, MDT
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Surface Roughness of Restroation Margin Preparations: A Comparative Analysis of Finishing Techniques

Surface Roughness of Restroation Margin Preparations: A Comparative Analysis of Finishing Techniques
This study compared the margin profile and surface roughness created by the tips of four different finishing instruments: fine diamond, dura white stone, tungsten carbide, and ultrasonic diamond-coated tips (UDTs). The aim was to determine which of these instruments produced the smoothest finish and created the most evenly contoured margin characteristics. It was hypothesized that UDTs would produce a rougher dentin surface than a fine diamond bur, that a tungsten carbide bur would provide a smoother finish than a fine diamond, and that the dura white stone would produce an intermediate finish.

Author(s): Isabelle Clarke, BSc, BDent; Adriana Aquilia, BSc, BDent; Luiz Eduardo Bertassoni, DDS; MAssimiliano Guazzato, DDS, DClinDent, PhD; Iven Klineberg, BSc, MDS, PhD
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Enhancing Esthetics with a Fixed Prosthesis Utilizing an Innovative Pontic Design and Periodontal Plastic Surgery

Enhancing Esthetics with a Fixed Prosthesis Utilizing an Innovative Pontic Design and Periodontal Plastic Surgery
During the past two decades, significant advancements with the integration of periodontal plastic surgery into esthetic restorative dental procedures have received increased attention. While ovate pontics have traditionally been used as a restorative design following augmentation procedures to enhance esthetics, an alternate E-pontic design aims to predictably support and maintain the gingival architecture between a single missing anterior tooth adjacent to a natural tooth or an implant that is in harmony with the lip line and face. In addition, the E-pontic design promotes the gingival facial tissue to coronally migrate over the pontic, creating a gingival sulcus. This article describes an innovative new technique and a pontic design that predictably will develop, support, and maintain the gingival architecture to provide a long-term esthetic and functional outcome.

Author(s): Robert P. Korman, DDS, MAGD
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