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Smile architecture: beyond smile design.

Successful cosmetic dental treatment is both functional and aesthetic. It requires evaluation of a patient's expectations, diagnosis of pre-existing problems and careful planning of treatment to eliminate or control the causes of existing conditions. The use of mounted diagnostic casts and a diagnostic wax-up allows visualization of the expected result. Provisional restorations offer a "dress rehearsal" to preview functional and aesthetic results before completion of the final restorations. The term "smile architecture" is used to describe the process that guides a patient and dentist from initial complaint through to final case acceptance.

Adult↗

Technique for realistic anterior crowns using the IPS Empress porcelain system.

In dentistry, the concept of realism can be applied to the creation of an artificial prosthesis that is not perfect, but real. If prosthesis are made to a flawless perfection, they will appear artificial. Ultimately, the clinician and ceramist should strive for realism. The IPS Empress System (Ivoclar Williams, Amherst, NY) is an all-ceramic restorative alternative utilizing a pressable leucite-reinforced glass ceramic for a variety of indications (e.g., crowns, inlays/onlays, veneers). The resulting tooth-colored and metal-free restorations combine strength and aesthetics approaching those of natural teeth. This article describes the technique and procedures required to achieve realistic anterior crowns with this all-ceramic system.

Aged↗

Securing the position of ceramic veneers in dentistry.

Porcelain laminate veneers have exhibited predictability and, as a result, experienced an incredibly rapid public acceptance with widespread utilization. The introduction of a stronger, leucite-reinforced ceramic system which could be accurately pressed (IPS Empress, Ivoclar Williams, Amherst, NY), presented new avenues for this remarkable treatment modality beyond aesthetic enhancement. Porcelain veneer restorations could be utilized to accurately alter and correct occlusal relationships, and the less abrasive surface of the material offered a distinct advantage in occlusal modifications, such as altering cuspal guidance or vertical dimension. This presentation reviews the history of porcelain veneer restoration and outlines the use of a luting cement (Variolink II, Ivoclar Vivadent, Amherst, NY) for its application.

Aluminum Silicates↗

Conventional cementation technique for Targis restorations.

Ivoclar can now recommend a clinical and laboratory procedure for the conventional cementation of Targis single- and multiple-unit full-coverage restorations. The ability to bond restorations utilizing enamel/dentin bonding systems and dual-cure resin cements (Variolink II, Ivoclar Vivadent, Amherst, NY) has minimized microleakage and postoperative sensitivity, provided stronger restorations, and reinforced remaining tooth structure. Unfortunately, the benefits of the adhesive technique can often be compromised by existing or pre-existing clinical conditions. This challenge has limited the broad use of adhesive, metal-free restorations in many clinical situations. Targis restorations can now be successfully cemented utilizing zinc phosphate or conventional glass ionomer cements. This article describes the technique through a case presentation.

Cementation↗

IPS Empress veneers. Color communication, laboratory fabrication, and cementation.

Once considered to be revolutionary, porcelain veneers are now the foundation of most aesthetic dental practices. Requiring only conservative preparations, porcelain veneers can dramatically change a smile. This article discusses the technique necessary to prepare and place porcelain veneers, using a new pressed-ceramic system. Close and thorough cooperation and communication between the clinician and the laboratory are essential throughout the procedure, and this article is coauthored by a dentist and a ceramist.

Adult↗

Provisionalization for ceramic laminate veneer restorations: a clinical update.

At the inception of ceramic veneer restorations in the early 1980s, provisional veneer restorations were not customarily placed over teeth which had undergone tooth reduction. During the last several years, provisional veneer restorations have been utilized with increased frequency for a variety of valid reasons. The learning objective of this article is to examine the reasons for the increased utilization of provisional veneer restorations and to describe a selection of the clinical methods employed for direct and indirect fabrication. The indications and contraindications for provisionalization are presented. Four case reports are utilized to describe and illustrate the various clinical circumstances, the provisionalization procedures, the appropriate instruments, and the materials that facilitate the fabrication of aesthetic, functionally sound, and biocompatible provisional restorations.

Adult↗

The single incisor.

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Adult↗