Dental Sales Flyer - April 2023 - Email - 104

WINTER 2023
WINTER 2023
Smile Enhancement
in the Era of Minimal
Tooth Reduction
WINTER 2023
CLINICAL LIFE
™
CLINICAL LIFE
™
FEATURE
A Conservative
Approach to
Restoring the
Worn Anterior
Dentition
CASE REPORT
Smile Enhancement in the Era
of Minimal Tooth Reduction
A Conservative Approach
to Restoring the Worn
Anterior Dentition
WINTER 2023
FEATURE
A Conservative
Approach to
Restoring the
Worn Anterior
Dentition
CASE REPORT
Smile Enhancement in the Era
of Minimal Tooth Reduction
BEFORE
AFTER
BEFORE
AFTER
Newton Fahl,
DDS, MS
5 on 5: 5 Clinical Must-Haves
From 5 Restorative Educators
4
12
Dimple Desai,
DDS, AAACD
10
Newton Fahl,
DDS, MS
imP.R.E.S. Dental
Education Redefined
with Amanda Seay, DDS,
FAACD, FAGD and Adamo
Notarantonio, DDS, FICOI,
FAACD
16
The Fabrication of
Temporary Restorations
An Interview with
Nate Lawson,
DMD, MA, PhD
18
5 on 5: 5 Clinical Must-Haves
From 5 Restorative Educators
4
12
Dimple Desai,
DDS, AAACD
10
imP.R.E.S. Dental
Education Redefined
with Amanda Seay, DDS,
FAACD, FAGD and Adamo
Notarantonio, DDS, FICOI,
FAACD
16
The Fabrication of
Temporary Restorations
An Interview with
Nate Lawson,
DMD, MA, PhD
18
Dentistry and photography courtesy of Dimple Desai, DDS, AAACD
Dentistry and photography courtesy of Newton Fahl, DDS, MS
Dimple Desai, DDS, AAACD
T
here is a constant stream of social media content depicting a wide
variety of methods of improving one's smile. These vary from
at-home and in-office tooth whitening to actual dental procedures
that alter existing tooth shape and positioning. In many cases,
viewing even moderate tooth reduction on these social media platforms
can produce anxiety in a patient that is actually contemplating such a
dental procedure. Such was the case with a 43-year-old patient whose son
was undergoing Invasalign treatment in the office. Due to the abundance
of information on social media regarding the aggressive removal of tooth
structure in order to improve smile esthetics, she was cautious, even
fearful, of seeking dental treatment to improve hers. As she frequented her
son's appointments, she became comfortable enough to broach the subject
and inquire as to the possibilities of improving her smile.
The patient's desire was to have her smile improved by having her teeth
longer and look more natural, and in fact presented with maxillary anterior
wear. Her teeth were scanned, and models were fabricated and mounted.
This revealed the moderate wear of the maxillary anterior teeth as well as
a constricted bite. The patient subsequently agreed to the treatment plan of
Invisalign therapy of approximately 3 months to improve the constricted
bite; crown lengthening of teeth #8 and #9 to assist in overall esthetics;
and either composite or porcelain veneers on teeth #7 to #10. The patient
accepted the treatment plan and readily chose the composite veneer option
due to the conservative nature of the tooth preparation, however she was
very insistent that as much tooth structure as possible be preserved.
An in-office wax-up was prepared on the mounted models to establish
ideal incisal length and thickness as well as lingual and facio-incisal
contours. A lingual matrix was fabricated using
Template Ultra Quick Matrix Material (Clinician's
Choice) on a model of the wax-up in order to accurately
transfer this information to the final restorations.
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Newton Fahl, DDS, MS
L
ong-term restorative treatment of the worn dentition can be a
complex endeavour and possibly extend beyond the scope and
experience of the general dentist. Additionally, restoration of this
compromised dentition may require other health disciplines'
involvement to address any psycho-social factors that may limit the
long-term success of the restorative treatment. Therefore, before treating
the worn dentition, there is a requirement of due diligence in thoroughly
investigating its etiology and overall effect on occlusal function and
tooth structure through a rigorous clinical examination, medical and
social history, and careful assessment of mounted study models.
Traditionally, the treatment plan is developed using the information from
these articulated models in addition to the clinical findings. However, the
need for a restorative wax-up and a means of transferring that information
to the operatory setting may be replaced by an intraoral mock-up by adding
composite to the worn anterior teeth. Once the desired tooth form and
occlusion are achieved, a lingual matrix is quickly fabricated chairside to
transfer this information into the final restoration. This composite mock-up
will also serve as a shade selection for the various composite layers, providing
the optimal location and thickness of the incisal edges, establishing lingual
contours incisal embrasures, and point angles of the new restorations. This
restorative guide, constructed in real-time using the patient's envelope of
function, will significantly reduce placement and finishing time while
providing a more predictable, long-term restorative result.
A 28-year-old male presented with a worn maxillary anterior dentition
from canine to canine. He freely admitted to a stressful lifestyle and
was diagnosed with bruxism limited to the anterior
teeth only. There was no clinical wear observed on the
posterior teeth. Unfortunately, this young man was a
habitual fingernail biter.
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clinicianschoice.com
|
CLINICAL LIFE
|
SPRING 2023
7
http://www.clinicianschoice.com
Dental Sales Flyer - April 2023 - Email

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