When Esthetic Becomes Challenging
This case report shows the successful change of a young lady smile, by following standard dental esthetic guide lines. With careful, detailed examination and diagnosis, we could reach our goal toward providing a high esthetic smile change.

Treating Two Adjacent Missing Teeth in the Esthetic Zone - Part 1: The Pink Hybrid Restoration & the Unilateral Versus Bilateral Defect Concept
This article, the first of a planned three-part series, outlines a new surgical & prosthetic approach for treating cases involving two missing adjacent teeth in the esthetic zone. These type of cases, particularly when combined with a three-dimensional ridge deficiency, represent one of esthetic dentistry's most challenging dilemmas. A Clear understanding of the unilateral and bilateral defect concept is necessary to properly evaluate each particular case, understand surgical limitations, perform a better risk assessment, establish an esthetic prognosis, develop the best clinical-laboratory strategy, and adjust patients' expectations. While not recommended for every case, represents a useful, economical, and predictable alternative that decreases the umber and complexity of interventions.

The “Scalloped Guide”: A Proof-of-Concept Technique for a Digitally Streamlined, Pink-Free Full-Arch Implant Protocol
Inadequate restorative space can result in mechanical, biologic, and esthetic complications with full-arch fixed implant-supported prosthetics. As such, clinicians often reduce bone to create clearance. The aim of this paper was to present a protocol using stacking computer-aided design/computerassisted manufacturing (CAD/CAM) guides to minimize and accurately obtain the desired bone reduction, immediately place prosthetically guided implants, and load a provisional that replicates predetermined tissue contour. This protocol can help clinicians minimize bone reduction and place the implants in an ideal position that allows them to emerge from the soft tissue interface with a natural, pink-free zirconia fixed dental prostheses.

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.

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.

When Esthetic Becomes Challenging
This case report shows the successful change of a young lady smile, by following standard dental esthetic guide lines. With careful, detailed examination and diagnosis, we could reach our goal toward providing a high esthetic smile change.

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.

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.

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...

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.

Planning & Finishing Techniques
Longevity and optimal aesthetics are critical aspects to consider when planning for direct composite resin restorations. While strength, wear resistance, and superior micromechanical retention are typically associated with functional durability, during the planning stage clinicians must equally consider aesthetic longevity, which includes retension of the original morphology, color stability, stain resistance, and marginal adaptation. To ensure optimum results for direct composite resin restorations,…

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.

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.

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.

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.

Three-Dimensional (3D) Facially Driven Workflow for Anterior Ridge Defect Evaluation: A Treatment Concept
The esthetic rehabilitation of anterior ridge defects and achieving patient satisfaction have become major clinical challenges for dentists and technicians. Poor diagnosis and treatment planning are frequently associated with multiple surgical procedures that fail to meet patient expectations. The loss of hard and soft tissues in anterior ridges results in an esthetically compromised zone that affects the rehabilitation prognosis. The presence of interdental papilla and papillary configuration play a decisive role in patient satisfaction.

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.

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.

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.