Aids for esthetic restorations /orthodontic continuing education

GOOD MORNING
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.co
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AIDS FOR ESTHETIC RESTORATIONS
Dr. A . Sudheer
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Introduction
Need for esthetics
Types of aids
Instrumental aids
Material aids
Operator bias
Conclusion
References www.indiandentalacademy.co
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Introduction
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Need for esthetics:
Dentist point of view
Patient point of view
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Types of aids
Instrumental Material
CLINOMETER CERAMICS
TRUBYTE TOOTH INDICATOR RESINS
DIGITAL AIDS LUTING CEMENTS
SHADE GUIDES BLEACHING
OPTICAL MAGNIFIERS PROPHYJET
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INSTRUMENTAL AIDS
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BEHREND CLINOMETER
Donald Albert Behrend is a Prosthodontist, living
and practicing in Melbourne, Australia.
Dr. Behrend has worked for many years perfecting
a system for controlling certain esthetics during
prosthodontic treatment.
He invented the measuring device presented
herewith known as CLINOMETER. It helps determine
the correct tooth and incisal plane angulations for the
patient and permit the dentist to communicate this
information to the dental laboratory. A similar laboratory
clinometer which is attached to the articulator is used
during case fabrication to precisely capture the desired
angles
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clinometer
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BEHREND CLINOMETER AND PARTS OF IT :
An instrument for controlling the esthetics and
angulation of anterior teeth and communicating this to
the dental laboratory.
The two principal component of the system are the
operators clinometer (Large screen) and laboratory
clinometer (small screen).
Using the operatory clinometer, the dentist choose the
ideal angle for the teeth is viewed from the front. This
angle – esthetic angle for the face- is recorded and
transmitted to the dental technician with the work
authorization.
Using a laboratory clinometer fitted to the articulator,
the technician is then able to control the alignment of
the artificial teeth or restoration to conform with the
dentist’s prescription.www.indiandentalacademy.co
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INDICATIONS OF CLINOMETER
It is of great value in the construction of anterior
veneer, crowns, fixed and removable partial
dentures, complete dentures and implant
prostheses.
It may also be used in the planning and control of
orthodontic treatment and orthognathic surgery.
CONTRAINDICATIONS OF CLINOMEER
Gross asymmetry of the face.
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Use of Operating Clinometer :
The esthetic angle of the patient’s face can be
measured at the treatment planning stage or
at any subsequent stage of the treatment
procedure.
When anterior teeth are to be restored with
crowns or a fixed partial denture, it is
advantageous to measure the esthetic angle of
the face prior to tooth preparation.
The operatory clinometer can then be used to
check the alignment of the incisal edges of the
preparations and to check the provisional
restorations. www.indiandentalacademy.co
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The operatory clinometer is used on the Hanau
Spring Bow.
While the esthetic angel is being measured, it
is best for the patient and dentist to stand face
to face.
Fit the spring bow carrying the clinometer to
the patient meatus. (Ask patient to help locate
the ear plugs).
Hold clinometer so that the upper horizontal
line on the screen appears level with the pupils
of the eye. The lower horizontal line will then
be approximately level with the occlusal plane.www.indiandentalacademy.co
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Rotate the Knurled knob to adjust the
angle of the screen, setting the horizontal
and vertical lines to harmonize with the
patients face. While choosing the best
angle, consider all the facial features.
The interpupillary line is particularly
important, but the long axis of the nose,
the line of the lips and general outline of
the face should also be taken into account.
Remove the clinometer from the patient and
note the esthetic angle in degrees clockwise
(C) or Anticlockwise (A). Record this angle
on work authorization form which is sent to
dental laboratory
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Use of the Laboratory Clinometer :
Careful mounting of the casts on the articulator
using the spring bow registration is essential.
Raise the incisal pin so that the casts can be
viewed clearly from the front.
Set the laboratory clinometer to the prescribed
esthetic angle and secure it by turning the
locking nut anti-clockwise.
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It should be noted that the clinometer does
not have a particular center line. However,
the viewing angle can be chosen so that one of
the vertical lines lie over the midline of the
dentition. When this is done, the adjacent
vertical lines will generally lie over the central
incisor, lateral incisor and canine teeth.
The outer lines are useful in controlling the
angle of the posterior teeth.
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TRUBYTE TOOTH INDICATOR
The selection of the six maxillary anterior teeth
for edentulous patients is made primarily for
esthetics and they must be in harmony with the
surrounding oral environment in terms of size,
form and colour.
Manufacturers of artificial teeth have
developed many devices for selecting anterior
teeth. One of these is the Trubyte tooth
indicator instrument, based on the work of
J.Leon William and Milus House.
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TRUBYTE TOOTH INDICATOR AND PARTS
OF IT :
Trubyte tooth indicator instrument
(Dentsply / York Div York Pa) is a valuable guide
in selecting the proper tooth form and correct
size of anterior teeth.
It is designed for easy reading of the 16 to
1 ratio between facial dimensions and teeth
because research has shown this ratio to be the
average relationship between the size of the face
and the maxillary central in natural dentition.
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The tooth indicator is a clear plastic sheet
with cut- cuts for positioning over the eyes
and nose and a centre line for positioning
over the midline of the face. The indicator
has caliberated markings for measuring the
width of the face at the zygoma, and the
length of the face from hairline to gnathion
when the lips are in light contact.
www.indiandentalacademy.comwww.indiandentalacademy.com

FUNCTION OF TRUBYTE TOOTH INDICATOR
Trubyte tooth indicator instrument is a
valuable guide in selecting the proper tooth
form and correct size of anterior teeth.
It is used to clinically determine the face
form thus acting as guide in selection of
anterior teeth.
It is used to clinically determine the facial
profile.
Caliberated markings on tooth indicator helps
to determine width and length of maxillary
central incisor.
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www.indiandentalacademy.comwww.indiandentalacademy.com

INDICATIONS :
Primarily used in selecting proper tooth
form and correct size of anterior teeth in
completely edentulous patient.
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HOW TO USE TRUBYTE TOOTH INDICATOR :
Place the tooth indicator on the patients face allowing
the nose to come through the center triangle.
Center the pupils of the eye in the eye slot and hold
the indicator with its center line coinciding with its
median line of the face.
The long red indicator bar in the horizontal slot on
the right side of the face plate is positioned, pinch
the two ends together and advance the bar into the
slot until it is fully sealed against the face plate.
The shorter indicator bar is inserted in the same
manner in the vertical slot at the bottom center of
the face plate.
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Determination of Facial Form
The form of the face will be best observed by
noting the particular characteristic of each
form as it appears in comparison with the
vertical lines of the indicator.
In square form, side of the face will
approximately follow the vertical lines of the
indicator.
In square tapering from, the upper third of the
face will be vertical and lower two thirds will
taper inwards.
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In tapering faces, the sides of the face
form the forehead to the angle of the
jaw will taper at an inward diagonal.
Ovoid faces will be best determined by
examination of the curved out line of the
face against the straight vertical of the
tooth indicator.
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Determination of facial Profile :
While the indicator is on the face, observe the
relative straightness or curvature of the
profile.
Check the three points namely Glabella,
Subnasale and Pogonion.
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Determination of Width and length of
Central Incisor :
The trubyte tooth indicator has caliberated
markings for measuring the width of face at the
zygomas, and the length of the face from
hairline to gnathion when the lip, are in light
contact. When these markings are adjusted to
contact the face, the width and length of the
maxillary central incisor may be read directly
from the scale.
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OTHER INSTRUMENTS
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VisoDent™ aims to help dentists with the proper
color selection of dental restorative materials. With
Visodent™, the dentist observes a part of the tooth
and sees at the same time a part of the standard
shade guide. A field of view consists of the images of
these two parts that are contiguous to each other.
This split image allows detection of any small color
differences that are invisible to the naked eye
between the tooth and a standard shade.www.indiandentalacademy.co
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Here you can compare
Conventional color matching VisoDent™
Time consuming, (~10 min) Fast, (< 1 min)
Depends on ambient illumination Uses own white light source (color
temperature 5500 K)
Depends on dentist’s color vision
and condition
Dentist compares only two
adjoined fields of view
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Allows the dentist to have a parallax view
of the tooth preparation .
Helpful for anterior restorations.www.indiandentalacademy.co
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colorimeter
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SPECTROPHOTOMETER
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The spectrophotometer is an instrument which
measures the amount of light of a specificed
wavelength which passes through a medium.
According to Beer's law, the amount of light
absorbed by a medium is proportional to the
concentration of the absorbing material or
solute present. Wavelength (often
abbreviated as lambda) is measured in nm.
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VITA EASY SHADE®
…THE NEW DIGITAL SHADE
TAKING DEVICE
The patended SpectroShade System uses a
digital camera connected to a LED
spectrophotometer. With the
SpectroShade™ MICRO, the measured
spectral data is not influenced by the
lighting or any other environmental
conditions affecting vision.
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Composite bur heads
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DR. LEVIN'S PHI DENTAL GRID
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PrepCheck promotes adequate reduction
allowing ideal thickness of the final
restoration and ensures superior strength
and aesthetics. PrepCheck's special coating
marks the tooth in areas that need to be
reduced.
Prep-checkwww.indiandentalacademy.co
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MAGFIT
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OptraFine
OptraFine is a new, high-performance diamond polishing system for
ceramic materials which affords a unique combination of highly
efficient application and perfect polishing results. OptraFine leaves
nothing to be desired in terms of low surface roughness and
aesthetic, high-gloss finish. In contrast to other ceramic polishing
systems, OptraFine can be reused up to 10 times. OptraFine is
available in “flame”, “cup” and “disc” shapes.
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Yaltara Software
VP - Visual Planner
PIB TTR- Patient Information Brochures Total Tooth Replacement
PIB PD - Patient Information Brochures Preventative Dentistry
CI TTR - Case Illustrator Total Tooth Replacement
CI PD - Case Illustrator Preventative Dentistry
ESP - Esthetic Smile Planner
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FireFly Infinity Light System
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DEXcam™ USB-2
The DEXcam™ USB-2 is a high-speed
USB intraoral camera. The DEXcam
features an ultra-light hand piece
with eight highly durable LED lights
for superb brightness, together with
high-quality auto-focus optics from
Sony Corp.
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PowerLase® AT Spa Laser
The Lares PowerLase® AT Spa Laser combines
two wavelengths (Er:YAG and Nd:YAG) into a
single system, making it suitable for both hard
and soft tissue dental procedures as well as
certain dermatological procedures. The laser is
easily upgraded to perform aesthetic
procedures through the addition of the
Aesthetic Handpiece Kit, which includes
handpieces for dermatological use.www.indiandentalacademy.co
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Mock-Up Kit
. BISCO’s Mock-Up Kit is used to create a
template for placing a perfect direct anterior
restoration. During this process, the final
aesthetic restoration will be mimicked and
allows dental professionals the opportunity to
build-up and adjust the restoration to ensure
patient satisfaction. It is now convenient to
provide patients with a life-like presentation of
their restoration(s).
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Interactive Smile Style Guide
The digital Interactive Smile Style Guide makes
choosing the best smiles better than ever!
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XCPT
XCPT software is a highly visual, on-the-spot
consultation and treatment planning method
that recognizes the physical, as well as
psychological aspect of visualization involved
in treatment planning and case.
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MATERIAL AIDS
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LumaWhite™ Plus Single Patient Kit
LumaWhite Plus Single Patient Kit comes with everything needed to perform
in-office whitening in one short visit. The kit includes: 3 unit dose ampoules
of 35% hydrogen peroxide, catalyst and mixing brushes, a LumaBlock
syringe with 2 tips, cheek retractor, Vitamin E Swab lip moisturizer, Flour of
Pumice, and a protocol/instruction sheet. The kit also contains the patented
StayBright take-home whitening enhancer for maintenance and touch-up
with no trays to fabricate.
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IPS e.max®
IPS e.max® delivers the ultimate in metal free esthetics
and strength utilizing both Pressable and CAD/CAM
technologies.
Designed with versatility and simplicity in mind, IPS
e.max lets you select from multiple framework materials
giving you the versatility you want while always veneering
with the same ceramic giving you the simplicity you need.
IPS e.max provides outstanding esthetics, high strength,
and predictable shade matching even with difficult
combination cases.
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Synergy® D6 Self-Blending Duo Shades
Synergy® D6 Dentin Duo shade A2/B2 self-blends
with teeth whose shading properties fall within the
A2 and B2 color spectrum. In most cases, one
Synergy® D6 shade will produce undetectable
restorations.
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BLOCK-OUT by Ultra Bond Plus
A unique formulation for bonding
porcelain over dark stained teeth such as
tetracycline—Great for thin veneers!
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VITA CAD-Waxx Millable
Casting Blocks
Instead of using modeling wax to manually create wax-
ups by hand, the technician designs the fully-contoured
crown, bridge, coping or framework using the inLab 3D
software. Once satisfied with the design, the data is sent
to the inLab milling machine, where it is precision-milled
out of the CAD-Waxx block in a matter of minutes.www.indiandentalacademy.co
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Atlantis Abutment in Zirconia
By combining esthetics, strength, precision,
reliability and simplicity in one product, the Atlantis
Abutment in Zirconia delivers the ultimate esthetic
solution to clinicians, labs and patients .
Independent testing confirms this all-zirconia
abutment, manufactured from yttria-stabilized
tetragonal zirconia polycrystals (Y-TZP), is the
strongest and most reliable patient-specific ceramic
abutment currently available.www.indiandentalacademy.co
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It costs less than the majority of the other
treatments.
It reduces chair time through a single application of a
specially formulated gel.
It's less expensive to operate.
The CoolBlue Wand, with exclusive whitening tip,
uses LEDs which eliminate the heat and discomfort
typically found in more expensive systems.
CoolBlue Tooth Whitening System
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DuraFinish™
Once you’ve completed curing and
shaping the restoration, simply
brush on a thin coat of
DuraFinish™. Smooth it with the
supplied brush - then zap it with a
halogen light.
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Lumineers By Cerinate
Lumineers By Cerinate is a terrific cosmetic
solution for permanently stained, chipped,
discolored, misaligned teeth, or even to
revitalize old crown and bridgework. Lumineers
By Cerinate is a porcelain veneer that can be
made as thin as a contact lens and is placed
over existing teeth without requiring painful
removal of sensitive tooth structure (unlike
traditional veneers.)www.indiandentalacademy.co
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Acrytemp Fluorescent Temporary
Crown and Bridge Material
Acrytemp is a dual compound, self-curing,
self-mixing composite resin for the fabrication
of naturally esthetic temporary crowns and
bridges.
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Embrace Esthetic Opaquer Kit
The Embrace Esthetic Opaquer Kit provides
the five most popular opaquing shades for
esthetic dentistry: bleach white, off-white,
yellow, pink, and brown. The opaquers are
used to mask out metals and discolored
tooth surfaces for improved esthetics.
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OPERATOR BIAS
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Influence of illuminants on the color
distribution of shade guides.
Park JH,
Lee YK,
Lim BS
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The effect of colour defective vision
on shade matching accuracy.
Ethell J,
Jarad FD,
Youngson CC.
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The use of digital imaging for colour
matching
and communication in restorative
dentistry.
Jarad FD,
Russell MD,
Moss BW.
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Comparison of digital and spectrophotometric
measurements of colour shade guides.
Cal E,
Guneri P,
Kose T.
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Shade selection performed by novice
dental professionals and colorimeter.
Klemetti E,
Matela AM,
Haag P,
Kononen M.
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Thank you
For more details please visit
www.indiandentalacademy.com
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Aids for esthetic restorations /orthodontic continuing education

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