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Anterior fixed prosthetic restorations and the bleached dentition: laboratory techniques.

The process of matching fixed prosthetic restorations to bleached dentition has often created a dilemma, as clinicians are not able to accurately communicate shade selection to the dental laboratory. By understanding the effect of vital bleaching on the dentition, it is possible to fabricate porcelain restorations that match the bleached natural teeth. This article presents a laboratory technique for utilizing a sequence of porcelain powders and stains to develop the internal anatomy (e.g., halos, mamelons, luminosity) of restorations that appear indistinguishable from the bleached dentition.

Adult↗

Laser tooth whitening.

Cosmetic and adhesive dentistry has not only increased patients' self-esteem and confidence, it has increased their awareness of the value of healthy teeth and gums. White teeth have always been a high priority with patients. Creating and maintaining white teeth, however, has not always been easily achieved. The recent development of laser-assisted tooth whitening procedures makes it easier, faster, non-invasive, and affordable for patients to have whiter teeth.

Attitude to Health↗

The "sandwich" technique as a base for reattachment of dental fragments.

Esthetics and function were restored to a fractured maxillary central incisor by reattaching the tooth fragment with the "sandwich" technique (glass-ionomer cement and composite resin). After 3 years, the tooth showed optimal fragment rehydration, presence of pulpal vitality, absence of sensitivity, and a discrete color alteration in the line between the fragment and the dental remnant.

Acid Etching, Dental↗

Esthetic modification of cast dental-ceramic restorations.

The advantages and disadvantages of conventional opaque substructures (eg, metal ceramic restorations) used for creating esthetic complete crown restorations are reviewed, and the esthetic advantages of veneering a translucent crown (Dicor) are considered. An appropriate aluminous veneering porcelain was identified (Vitadur Veneer). This veneer porcelain was chosen to match the thermal coefficient of expansion of the cast glass-ceramic substructure. A flexural strength study was then completed and it showed no difference in the strength of the veneered and nonveneered translucent cast glass-ceramic specimens. Scanning electron microscopy revealed that the interface between the porcelain veneer and cast glass-ceramic substructure had no visible porosity and resulted in a continuous-appearing structure. Potential coping designs, as well as the clinical applications and ramifications of this modified crown, are discussed.

Aluminum Oxide↗

Predicting esthetics of laminate veneers without tooth preparation.

High expectations may contribute to stress in the patient and dentist during dental treatment. Esthetic and restorative results can be predicted for laminate veneers by using a powder blower and a liquid dispenser preoperatively to form self-cured resin veneers. Trial veneers are formed in a precision "salt and pepper" technique that conserves materials and time. The trial veneers are placed, without tooth preparation, on the treatment site so that the patient can preview the planned treatment and so that the dentist can explain proposed treatment in a reversible procedure. This may circumvent misunderstandings between dentist and patient and allow the consideration of alternate treatment plans.

Acrylic Resins↗