Contemporary aesthetic restorative procedure

3,151 views

Published on

Restorative Dentistry II
Fifth Year

0 Comments
18 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
3,151
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
0
Comments
0
Likes
18
Embeds 0
No embeds

No notes for slide

Contemporary aesthetic restorative procedure

  1. 1. Contemporary Esthetic Restorative Procedure Restorative Procedure II 5th Year College Of Dentistry University Of Dammam
  2. 2. Color • Three Color Dimensions Hue Chroma Value • Color Mixing Primary Hues Secondary Hues Complementary Hues
  3. 3. 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.
  4. 4. Color Perception & Shade Selection • Optical Properties • Spectral Reflection • Metamerism www.logodesignworks.com/blog/ images/eye-perce
  5. 5. Sensitivity of the Observer Eye www.logodesignworks.com/blog/images/eye-perce • Perception threshold & light sensitivity • Color Fatigue • Color Blindness
  6. 6. 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
  7. 7. 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
  8. 8. 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
  9. 9. Esthetic Modification HEALTH FUNCTION ESTHETICS
  10. 10. Smile Design
  11. 11. 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
  12. 12. Tooth Position & Relationships
  13. 13. Tooth Access Zenith Point http://c1-preview.prosites.com/10426/wy/images/Tooth%20proportionweb.gif
  14. 14. Interdental Contact Area Interdental Contact Point Incisal Embrasure
  15. 15. Tooth Dimension & Proportions Tooth Shape
  16. 16. 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/
  17. 17. 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
  18. 18. Tooth Character • • • • • • Surface Texture Surface Contour Surface Luster Line Angle Position Embrasure Form Incisal Edge Form http://www.confidentsmile.com/smile-design/
  19. 19. 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
  20. 20. Age Characteristics of Teeth • Chroma & Value • Surface Texture
  21. 21. Causes of Esthetic Defects • Caries. • Occlusal Disharmony. • Loss of tooth substance. • Discoloration. • Minor abnormality in size and shape of teeth. • Missing teeth.
  22. 22. 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
  23. 23. Objectives of Restoring Esthetics • Restore Affected teeth into normal form, size, position, alignment, color, surface and optical characteristics and occlusion. • Restore normal periodontium
  24. 24. Limitation in Restoring Esthetic • Color matching. • Gingival and periodontal health. • Occlusion • Available restorative materials
  25. 25. 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
  26. 26. http://www.knoxsmiles.com/Images/LumineersBA1.gif
  27. 27. Treatment Modalities • • • • • • • Visual Mock-ups Bleaching Micro-abrasion Reshaping Direct Resin Bonding Indirect Veneers Crowns
  28. 28. Esthetic Treatment Modalities
  29. 29. Mock-up
  30. 30. Teeth Re-shaping
  31. 31. http://www.drglasband.com/blog/wp-content/uploads/2010/11/after-reshaping1-300x160.png
  32. 32. http://dentalclinicintoronto.ca/wp-content/uploads/2010/07/contouring_before_after.jpg
  33. 33. http://www.dentalcomposites.com/Recontabc29.gif
  34. 34. Diastema http://www.dentalcomposites.com/Didddaste44.gif
  35. 35. 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
  36. 36. Cosmetic Bonding
  37. 37. http://www.charlesortiz.net/wp-content/uploads/2009/07/Patients-588x391.jpg http://bansaldentalcare.com/images/contour.jpg
  38. 38. http://www.yourdentistingoa.com/images/Cosmetic-Bonding-3.jpg
  39. 39. http://www.dentalcomposites.com/rotate2.jpg http://www.dentalcomposites.com/rotate5055.gif
  40. 40. http://cosmetic-dentistry-and-porcelain-veneers.com/smile-design/gum-shape/gums9drhuefner/ http://eshomdds.com/services/gumcont.jpg
  41. 41. http://www.blakesmiles.com/img/before-after/veneer-b-a.jpg http://2.imimg.com/data2/LL/NO/MY-2113805/bleahingtooth-veeners-250x250.jpg
  42. 42. http://sherwooddental.ca/images/smilegallery/6.png
  43. 43. Direct Composite Veneers
  44. 44. Black Triangle
  45. 45. Esthetic Cavity Design • Should reflect the concept of esthetics. • Modified Designs.
  46. 46. Restorative Materials & Techniques
  47. 47. Natural Tooth Bleaching
  48. 48. 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)
  49. 49. Types & Nature of Staining • Poor oral hygiene, chromatogenic food & drinks. • • • • Aging. Tetracyclic Staining. Fluorosis. Some systemic conditions.
  50. 50. 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
  51. 51. Bleaching Agent Mode of Action
  52. 52. Indication for Bleaching • • • Pt discomfort Further Treatment Presence of other restorations
  53. 53. 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
  54. 54. • Treatment Planning • Shade Selection and Record Collection • Patient Education
  55. 55. Current Bleaching Modalities
  56. 56. 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
  57. 57. • • • • • • Hydrogen Peroxide Heat Trauma Cementum Infection Seal http://cro.sagepub.com/content/14/4/292/F3.medium.gif
  58. 58. Vital Bleaching • In-office • At home http://img.diytrade.com/cdimg/556049/8452357/0/1271005827.jpg
  59. 59. Factors Affecting Bleaching Process • • • • • • • Surface Cleanliness Concentration of Peroxide Temperature (in-office) pH Time Sealed environment Additives
  60. 60. In-Office Technique
  61. 61. Dentist-Supervised AtHome Technique • Over Night • Day Time
  62. 62. http://veneerstooth.net/wp-content/uploads/2011/02/laser-whitening.jpg
  63. 63. Safety Factors • Tooth & Pulpal Problems
  64. 64. •Soft Tissue Respond
  65. 65. •Soft Tissue Respond
  66. 66. Effect on Restorations
  67. 67. Enamel Micro-abrasion • Indications: • • Extrinsic stains • White, hypo-calcified spots Cream, yellow & brown flourosis
  68. 68. Mechanism of Action • • • Physical Removal Etching Oxidation
  69. 69. Pasts • • • 30% H2O2 36% HCL 18% H2O2
  70. 70. Risks • Excessive Removal of Enamel • • • • Compounds (36-62 Micron) Normal Prophylaxis (4-8 Micron) Chemical Burns Post-operative Sensitivity
  71. 71. http://www.drdanmckay.com/images/results_laser_gum_contouring.jpg
  72. 72. http://cosmetic-dentistry-and-porcelain-veneers.com/wp-content/uploads/2010/10/gums6drhuefner.jpg

×