Dr. Andreas Kurbad, Germany
Keynote Speaker
An extensive treatment planning is the key for success in esthetic reconstructions. The planning should start with diagnostics. An evaluation of the esthetics is necessary. It can be based on the direct investigation of the patient, but more important is the work with photos and in the last time also videos are used. A lot of analysis can be done with simple methods, for instance using common PC programs like PowerPoint.
An excellent design and, in the second place, the predictability of results are very important when restoring teeth in the esthetic zone. In most esthetic dentistry cases, a re-design of the shape and contour of the respective teeth is required. In conventional treatment procedures, this is accomplished by means of a wax up. This also can be done digitally today. Once approved by the patient, the wax-up represents the basis for all the working steps that are carried out in the course of the treatment.
Very frequently, the wax-up is used to fabricate splints for so-called mock-ups or provisional restorations. Those temporary restorations play a more and more important role within the treatment concepts. Moreover, silicone matrices are made to ensure control of the amount of tooth structure removed during preparation. These matrices enable the mandatory minimum layer thickness to be observed and the shape and contour of the final restoration previously defined by means of the wax-up to be reproduced. To provide patients with a restoration whose appearance is very close to that originally defined in the treatment plan is crucial to treatment success.
Following tooth preparation, the new situation will be scanned again and matched with the data of the case already stored in the computer. The digital wax-up can then be used for the design of the final restoration. The modern, highly esthetic all-ceramic materials available today even allow full-contour restorations to be milled, which only need to be stained and glazed. In challenging cases, a slight cut-back can be performed to optimize the result.
Cementation is the last and a very important part of this complex. The thinner the ceramic thickness, the more important is to pay attention to the underground color and the type of cement. All in all, this is a completely new way of achieving highly esthetic outcomes in the management of restoration cases. It allows the predictability of results to be increased in a very cost-effective way.
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