Adaptation of a fiber-reinforced restorative system to the rehabilitation of endodontically treated teeth.
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Biomedical subjects
Publications and source records attributed to N Blitz.
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The rejuvenation of this dentition is initiated with the placement of six anterior crowns. Re-establishing the vertical dimension has allowed the restoration of pleasing proportions to the centrals. This has led to the re-assertion of the dominance of the centrals and thus corrected the reverse smile line. The restoration of these teeth demands harmonious accommodation of the requirements of esthetics, phonetics and function. These considerations are inseparable and are in fact, determinants of each other. Esthetics and phonetics help determine the degree of vertical opening and incisal edge placement. This location influences anterior guidance, lingual and labial contours, the pitch of the anterior teeth and proper lip support. The principles of proportion, so important in esthetics, allow us, to calculate incisor length. Thus, function, phonetics and esthetics are intimately intertwined and enhance one another in the restoration of vertical dimension of occlusion.
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Aesthetic rehabilitation in complex diastema closure cases is guided by the principles of proportion. The width to length ratio of the centrals must be pleasing. Achievement of this proper balance dictates treatment. It determines the following: 1) the amount of distal proximal reduction; 2) the decision to completely veneer the incisors vs. just adding to the interproximal; 3) the number of teeth to be treated; 4) the placement and location of naturally occurring prominences and concavities to create the illusion of a narrower tooth. The proper accommodation of these four topics will permit the maintenance or restoration of acceptable dimensions in the centrals. If they are made to appear harmonious then the principle of "golden proportion" (1.6:1:0.6) can be achieved among the centrals, laterals and cuspids. Direct bonding in diastema closure cases allow the dentist and the patient complete control in the formation of that smile. This treatment modality is challenging and ultimately rewarding for the patient and the dentist. At times it enables us to restore form and function and to make our patients whole again not just figuratively but literally.
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Recent advances in the science and technology of porcelain and the biomaterials associated with adhesive dentistry, are effecting a shift towards a more conservative approach to the restoration of endodontically treated posterior teeth. These new materials and techniques enable the practitioner to approach old problems from a different perspective and thereby achieve unique and innovative solutions. The historical, often anecdotal approach to the restoration of endodontically treated teeth, is being replaced by a scientifically determined rationale that takes into account the biology and biometrics of pulpless teeth.