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Contemporary aesthetic restorative procedure
 

Contemporary aesthetic restorative procedure

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Restorative Dentistry II

Restorative Dentistry II
Fifth Year

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    Contemporary aesthetic restorative procedure Contemporary aesthetic restorative procedure Presentation Transcript

    • Contemporary Esthetic Restorative Procedure Restorative Procedure II 5th Year College Of Dentistry University Of Dammam
    • Color • Three Color Dimensions Hue Chroma Value • Color Mixing Primary Hues Secondary Hues Complementary Hues
    • Color And Teeth • Human Teeth are NEVER a single color • Cervical Third: the Perceived color close to pure dentin. • Middle Third: (Body color) mainly the Dentin Hue, influenced by the thick layer of overlying Enamel. • Incisal Third: minimal influence of dentin, mainly the influence of Enamel.
    • Color Perception & Shade Selection • Optical Properties • Spectral Reflection • Metamerism www.logodesignworks.com/blog/ images/eye-perce
    • Sensitivity of the Observer Eye www.logodesignworks.com/blog/images/eye-perce • Perception threshold & light sensitivity • Color Fatigue • Color Blindness
    • Viewing Conditions • Lightning: Standard day light, Artificial light (color corrected CRI > 90) • Surroundings: walls, floors, sealing ..etc • Time: Initial diagnosis appointment and again at the beginning of preparation appointment • Patient Position • Tooth condition
    • Esthetic/Cosmetic Dentistry • Esthetic: relating to sense perception, judgement and taste concerning beauty .. a pleasing appearance or effect” Webster 3rd International Dictionary • Cosmetics: The ART of beatifying or altering the appearance. Webster 3rd International Dictionary
    • Factors Altering Esthetics • Exogenous • Endogenous • Defects of Enamel and Dentin • • http://www.sciencephoto.com/images/showEnlarged.html/ P486115-Tooth_enamel,_SEM-SPL.jpg?id=804860115 Environmental Hereditary • Other factors http://www.sciencephoto.com/images/showFullWatermarked.html/ P486153-Tooth_dentine,_SEM-SPL.jpg?id=804860153
    • Esthetic Modification HEALTH FUNCTION ESTHETICS
    • Smile Design
    • Visible Incisal Length Incisal edge position with lips at rest. Incisal edge position framed between upper and lower lip. Maxillary and mandibular incisal edge relationship. http://c1-preview.prosites.com/10426/wy/images/Embrasures.gifweb.gif
    • Tooth Position & Relationships
    • Tooth Access Zenith Point http://c1-preview.prosites.com/10426/wy/images/Tooth%20proportionweb.gif
    • Interdental Contact Area Interdental Contact Point Incisal Embrasure
    • Tooth Dimension & Proportions Tooth Shape
    • Central Incisor • The length to width proportion • • (10:8) The rule of 1/16” (tooth & face) Size, gender and shape http://www.confidentsmile.com/smile-design/
    • Symmetry & Proportionality • • • The Golden Proportion Visual Width Repeated Ratio (more more practical) http://c1-preview.prosites.com/10426/wy/images/Embrasures.gifweb.gif http://c1-preview.prosites.com/10426/wy/images/Tooth%20proportionweb.gif
    • Tooth Character • • • • • • Surface Texture Surface Contour Surface Luster Line Angle Position Embrasure Form Incisal Edge Form http://www.confidentsmile.com/smile-design/
    • Gingiva & Supporting Tissue http://www.scielo.br/img/revistas/dpjo/v15n1/en_14f04.jpg • • • • • Lip Line Lip Profile Upper & Lower lip interrelationship Commissure Width & Location Size of Buccal Corridor
    • Age Characteristics of Teeth • Chroma & Value • Surface Texture
    • Causes of Esthetic Defects • Caries. • Occlusal Disharmony. • Loss of tooth substance. • Discoloration. • Minor abnormality in size and shape of teeth. • Missing teeth.
    • Teeth Defects http://3.bp.blogspot.com/_r2K1IjhvZV0/TB_NX0Y6K-I/ AAAAAAAAADI/8YUuvcQ312g/s1600/erosion.jpg http://t1.gstatic.com/images? q=tbn:ANd9GcSoIFfH6j4RLrYKO_QtZDC_7qMc7yeGrD6hPrGm-8d _b4EjS3H75g
    • Objectives of Restoring Esthetics • Restore Affected teeth into normal form, size, position, alignment, color, surface and optical characteristics and occlusion. • Restore normal periodontium
    • Limitation in Restoring Esthetic • Color matching. • Gingival and periodontal health. • Occlusion • Available restorative materials
    • Correctable Defects • • • • • • Incisal Irregularities Length/ Width discrepancies Shape discrepancies Enamel Defects Diastema Slight Malposition http://boca-raton-cosmetic-dentist.co.cc/wp-content/uploads/2009/01/porcelain_veneers.jpg
    • http://www.knoxsmiles.com/Images/LumineersBA1.gif
    • Treatment Modalities • • • • • • • Visual Mock-ups Bleaching Micro-abrasion Reshaping Direct Resin Bonding Indirect Veneers Crowns
    • Esthetic Treatment Modalities
    • Mock-up
    • Teeth Re-shaping
    • http://www.drglasband.com/blog/wp-content/uploads/2010/11/after-reshaping1-300x160.png
    • http://dentalclinicintoronto.ca/wp-content/uploads/2010/07/contouring_before_after.jpg
    • http://www.dentalcomposites.com/Recontabc29.gif
    • Diastema http://www.dentalcomposites.com/Didddaste44.gif
    • http://www.renicholsdds.com/images/gap_smile.jpg http://www.zimbio.com/go/vGZHexiokZ6/http://www.brooksidedental.com/blog/wp-content/uploads/2008/12/diastema-after-cosmetic-dentistry.jpg
    • Cosmetic Bonding
    • http://www.charlesortiz.net/wp-content/uploads/2009/07/Patients-588x391.jpg http://bansaldentalcare.com/images/contour.jpg
    • http://www.yourdentistingoa.com/images/Cosmetic-Bonding-3.jpg
    • http://www.dentalcomposites.com/rotate2.jpg http://www.dentalcomposites.com/rotate5055.gif
    • http://cosmetic-dentistry-and-porcelain-veneers.com/smile-design/gum-shape/gums9drhuefner/ http://eshomdds.com/services/gumcont.jpg
    • http://www.blakesmiles.com/img/before-after/veneer-b-a.jpg http://2.imimg.com/data2/LL/NO/MY-2113805/bleahingtooth-veeners-250x250.jpg
    • http://sherwooddental.ca/images/smilegallery/6.png
    • Direct Composite Veneers
    • Black Triangle
    • Esthetic Cavity Design • Should reflect the concept of esthetics. • Modified Designs.
    • Restorative Materials & Techniques
    • Natural Tooth Bleaching
    • Tooth Bleaching • • As early as 1890’s (Pyrozone) • • • • 1940’s (Hydrogen Peroxide + ether) 1910 in-office bleach (Hydrogen Peroxide) 1950’s (Pyrozone + Na-perborate) 1960’s (10% Carbamide Peroxide) 1989 (Profession Acceptance)
    • Types & Nature of Staining • Poor oral hygiene, chromatogenic food & drinks. • • • • Aging. Tetracyclic Staining. Fluorosis. Some systemic conditions.
    • Factors Altering Esthetics • Exogenous • Endogenous • Defects of Enamel and Dentin • • http://www.sciencephoto.com/images/showEnlarged.html/ P486115-Tooth_enamel,_SEM-SPL.jpg?id=804860115 Environmental Hereditary • Other factors http://www.sciencephoto.com/images/showFullWatermarked.html/ P486153-Tooth_dentine,_SEM-SPL.jpg?id=804860153
    • Bleaching Agent Mode of Action
    • Indication for Bleaching • • • Pt discomfort Further Treatment Presence of other restorations
    • Contraindication for Bleaching • Superficial or extrinsic Staining • Discolored carious lesion or restoration • In-home & pregnant women or lactating • Root of teeth • In-office & teeth with large pulp, exposed dentin, cracks, caries ... • Broxers needs to alter the wearing time of inhome trays • Bonding has to be delayed for 7 to 10 days
    • • Treatment Planning • Shade Selection and Record Collection • Patient Education
    • Current Bleaching Modalities
    • Non-Vital Bleaching • • Sodium Perborate 10% Carbamide Peroxide http://www.scritube.com/files/limba/engleza/health/170_poze/image059.jpg • Hydrogen Peroxide • • Thermocatalytic Walking bleach
    • • • • • • • Hydrogen Peroxide Heat Trauma Cementum Infection Seal http://cro.sagepub.com/content/14/4/292/F3.medium.gif
    • Vital Bleaching • In-office • At home http://img.diytrade.com/cdimg/556049/8452357/0/1271005827.jpg
    • Factors Affecting Bleaching Process • • • • • • • Surface Cleanliness Concentration of Peroxide Temperature (in-office) pH Time Sealed environment Additives
    • In-Office Technique
    • Dentist-Supervised AtHome Technique • Over Night • Day Time
    • http://veneerstooth.net/wp-content/uploads/2011/02/laser-whitening.jpg
    • Safety Factors • Tooth & Pulpal Problems
    • •Soft Tissue Respond
    • •Soft Tissue Respond
    • Effect on Restorations
    • Enamel Micro-abrasion • Indications: • • Extrinsic stains • White, hypo-calcified spots Cream, yellow & brown flourosis
    • Mechanism of Action • • • Physical Removal Etching Oxidation
    • Pasts • • • 30% H2O2 36% HCL 18% H2O2
    • Risks • Excessive Removal of Enamel • • • • Compounds (36-62 Micron) Normal Prophylaxis (4-8 Micron) Chemical Burns Post-operative Sensitivity
    • http://www.drdanmckay.com/images/results_laser_gum_contouring.jpg
    • http://cosmetic-dentistry-and-porcelain-veneers.com/wp-content/uploads/2010/10/gums6drhuefner.jpg