In der restaurativen Zahnmedizin kann fehlender okklusaler Freiraum dazu führen, dass gesundes Gewebe geopfert werden muss, um Platz für das Restaurationsmaterial zu schaffen. Eine Versorgung ohne Präparation (No-Prep) lässt sich realisieren, indem Restaurationen in Supraokklusion eingesetzt werden und der dadurch hervorgerufene offene Biss durch einfache kieferorthopädische Extrusion (Simple Orthodontic Extrusion, SOE) der übrigen Zähne wieder geschlossen wird. Diese schnelle, partielle kieferorthopädische Maßnahme wird von den Patienten gut angenommen. Sie verwendet einfache Knöpfchen und benötigt nur wenige Wochen, um die Okklusionskontakte wiederherzustellen. Die SOE stellt eine Weiterentwicklung des Dahl-Prinzips dar und behält dessen Vorteile ohne die inhärenten Nachteile bei. In diesem Beitrag werden zwei mögliche Anwendungen der SOE-Technik gezeigt: die Restauration stark abgenutzter Frontzähne durch palatinale NoPrep-Veneers aus einer Hybridkeramik (duales Feldspatkeramik-Polymer-Netzwerk) und der Ersatz fehlender seitlicher Schneidezähne durch No-Prep-Adhäsivbrücken aus Zirkonoxid. Außerdem wird eine neuartige 3-D-gedruckte Kunststoffschiene zur korrekten Positionierung von Adhäsivbrücken und Erleichterung der Entfernung von überschüssigem Befestigungskomposit vorgestellt. Der Beitrag unterstreicht die Vorteile einer multidisziplinären Zusammenarbeit im Bereich der minimalinvasiven Zahnmedizin. Keywords: Adhäsivbrücken, Hybridkeramik, Kieferorthopädie, minimalinvasive Zahnmedizin, No-Prep, Okklusion, Zahnverschleiß, Zirkonoxid

In restorative dentistry, the lack of occlusal space may lead to the mutilation of healthy tissue in order to provide sufficient space for the restorative material. Noprep dentistry can be achieved by placing high-bite restorations, followed by Simple Orthodontic Extrusion (SOE) of other teeth to close the created open bite. This rapid, partial orthodontic treatment is well accepted by patients as it can be easily performed using simple buttons, and it takes only a few weeks to reestablish occlusal contacts. The SOE technique is a further development of the Dahl concept. It has the advantages without the disadvantages. Two applications of this technique are presented in this article: the treatment of the severe wear of anterior teeth with no-prep palatal veneers made of Polymer-infiltrated Ceramic Network (PICN, “hybrid ceramic”) material and the realization of no-prep zirconia resin-bonded bridges (RBBs) to replace missing lateral incisors. An original 3D-printed resin guide for correctly positioning RBBs and facilitating the removal of excess composite cement is also presented. This work highlights the considerable advantages of multidisciplinary collaboration in the field of minimally invasive dentistry. Keywords: hybrid ceramic, minimally invasive dentistry, occlusion, orthodontics, PICN, resin-bonded bridges, tooth wear, zirconia

Purpose: To assess the influence of operator, tool, dental loupes, and tooth position on enamel loss and composite remnants after removal of composite attachments (CA) for orthodontic clear aligners. Procedure duration was also analyzed. Materials and Methods: Eight maxillary resin dental arches with four natural teeth were placed in the right posterior sector in dental simulators, and CA was realized. The dental arches were randomly distributed according to three experimental factors: operator (junior, senior), tool (tungsten carbide bur and silicone polisher, only silicone polishers), and use of dental loupes. Dental arches were scanned with 3D profilometry before and after CA removal to measure enamel surface height variation (ESHV), particularly enamel loss in the CA area. Digital microscopy was used to detect composite remnants. Results: The mean enamel loss was –22.7 ± 29.4 µm (range –132 to 0 µm). It was not significantly influenced by experimental factors or tooth position. Composite remnants were found in 34.4% of teeth, significantly more in senior than in junior operators (p = 0.038). They were more frequent with silicone polishers than with tungsten carbide burs (p = 0.0005) and were reduced using dental loupes (p = 0.0090). Junior operators worked faster than senior operators (p = 0.031), but the latter were quicker when using the dental loupes (p = 0.012). Conclusion: Aligner CA removal induces enamel damage or leaves composite remnants on its surface. The presence of composite remnants is influenced by the type of tool and can be reduced by using dental loupes, which also lowers working time. Keywords: auxiliaries, Easycomp, magnification, orthodontics, Smoozies

Aim: The objective of the present case series was to evaluate the 4-year outcomes of implants placed in the esthetic area using static computer-assisted implant surgery (s-CAIS) and restored with a one-abutment one-time (OAOT) protocol using custom-made zirconia abutments and cemented provisional crowns manufactured prior to surgery. Materials and methods: Ten consecutive implants were placed in the esthetic area. Based on a digital implant and prosthodontic planning, surgical guides were ordered and used for the preparation of definitive custom-made zirconia abutments and polymethylmethacrylate provisional crowns. Implants were placed using the s-CAIS guide, and prosthetic components were placed immediately. Implant outcomes were evaluated at the time of surgery, after 4 months, and after 4 years. Results: All implants were successfully placed with s-CAIS and restored with final abutments and provisional crowns. No major prosthetic adverse events were observed. After 4 years, the implant survival rate was 100%, minor peri-implant bleeding on probing was reported, and very stable peri-implant bone levels were observed. The pink esthetic score showed that the prosthetic components were well integrated, and the peri-implant soft tissue was stable. Conclusions: Within the limitations of the present case series, these results suggest that emerging digital workflows allow the manufacture of final custom-made abutments and provisional crowns prior to surgery. This individualized OAOT procedure may reduce cement-related complications and improve esthetic outcomes by optimizing soft tissue healing with prosthetic components. However, such protocols have evolved toward fully digital workflows, and comparative clinical trials are needed. Keywords: s-CAIS surgery, digital workflow, one-abutment one-time (OAOT), custom-made abutment, bone remodeling, distance between the implant shoulder and first bone-to-implant contact (DBI), pink esthetic score (PES)

Purpose: The purpose of this study was to evaluate the 2-year outcomes of the one-tooth onetime complete digital workflow, allowing the immediate loading of a single implant in the posterior region with a final CAD/CAM crown made of a polymer-infiltrated ceramic network. Materials and methods: A series of 10 implants were placed, and an intraoral scan was taken after surgery. A final screw-retained polymer-infiltrated ceramic network crown was manufactured chairside and placed the same day in full occlusion. Marginal peri-implant bone changes and soft tissue health were evaluated, and restoration performance was assessed using FDI World Dental Federation criteria and pink and white aesthetic scores. Patient-reported outcome measures and data on the time required to perform the procedures were collected. Results: After 2 years, the implant survival rate was 100%. The debonding of one crown from its titanium base led to prosthodontic survival rate of 90% and the remaining crowns were all considered successful. The mean marginal peri-implant bone changes yielded 0.87 mm (standard deviation 0.96 mm) and 0.55 mm (standard deviation 0.53 mm) after 1 and 2 years, respectively. Mild or no inflammation of peri-implant soft tissue was observed in most implants. The total treatment time was 175 minutes and patient-reported outcome measures displayed high patient satisfaction. Conclusions: This study constitutes the first report examining immediate loading of a single implant in the posterior region with a final crown in occlusion. In this case series, the 2-year outcomes of the one-tooth one-time protocol seem rather promising and fulfilled patient expectations. However, these preliminary results need to be confirmed by randomised controlled trials, and patient selection is likely to be a key factor in the success of this procedure. Keywords: CAD/CAM, dental implant, digital workflow, immediate loading, intraoral scan (IOS), polymerinfiltrated ceramic network (PICN) Amélie Mainjot cohabits with the founder of the company MaJEB, which contributes to the development of polymer-infiltrated ceramic network materials. Prof Lambert has collaboration agreement

Functional and esthetic oral rehabilitation of young patients affected by ectodermal dysplasia is traditionally performed with direct composite restorations, which encounter various limitations. However, recent advances in computer-aided design/computer-assisted manufacturing (CAD/CAM) composites have led to the introduction of high-performance materials. In the present case report, a 9-year-old patient was treated with 20 CAD/CAM partial and peripheral restorations in polymer-infiltrated-ceramic-network material to restore deciduous and permanent teeth. The restorations were minimally invasive, since they did not require any tooth tissue preparation. Appropriate occlusal relationships with increased vertical dimension of occlusion were obtained. Tooth anatomy and esthetics were significantly improved, and chairtime was reduced.