International Journal of Esthetic Dentistry (EN), 03/2013

A full-mouth adhesive rehabilitation in case of severe dental erosion may present a challenge for both the clinician and the laboratory technician, not only for the multiple teeth to be restored, but also for their time schedule, difficult to be included in a busy agenda of a private practice. Thanks to the simplicity of the 3-step technique, full-mouth rehabilitations become easier to handle. In this article the treatment of a very compromised case of dental erosion (ACE class V) is illustrated, implementing only adhesive techniques. The very pleasing clinical outcome was the result of the esthetic, mechanic and most of all biological success achieved, confirming that minimally invasive dentistry should always be the driving motor of any rehabilitation, especially in patients who have already suffered from conspicuous tooth destruction.

In a historical pendulum of porcelain veneer preparation concepts, an oversimplified version of the so-called "no prep" approaches has resurfaced. A case from the USC student clinics is presented, which could be easily considered by many as a "no prep" veneer case. Moderate tooth preparations guided by natural morphology were used instead with a great benefit on the final outcome. While it is widely accepted that minimally invasive restorative approaches should be favored, a certain controversy exists regarding strictly noninvasive approaches. The purpose of this article is to re-emphasize the concept of guided tooth preparations, based of natural tooth morphology (given by a wax-up and a mock-up), a customized and sensible approach to indirect ceramic veneer tooth preparations.

Background: The treatment of gingival recessions is one of the important branches of periodontics related to esthetics. However, no surgical technique has been reported for the treatment of a particular type of gingival recession called Stillman's cleft. Methods: The technique proposed is a laterally moved, coronally advanced flap. After local anesthesia, two parallel incisions, one along the cleft and the second parallel to the first one, have been placed beyond the mucogingival junction, allowing a rotating partial-thickness flap to cover the recession. Results: The procedure, in this case presentation, resulted in successfully covering the previously exposed root surface. Conclusion: Root coverage of a Stillman's cleft can be obtained and maintained for 5 years follow-up with a laterally moved, coronally advanced flap.

Specialist literature shows that the repeated disconnection of the transmucosal components can generate tissue recession due to the alteration of the delicate environment created between the abutment and surrounding soft tissue. This article will analyze two different techniques of creating the final abutment in the pre-surgery phase, evaluating 2 failing central incisors considered suitable for the immediate tooth replacement technique.

The evolution of restorative dental materials has led to the development of more direct or indirect conservative techniques to solve both functional and esthetic problems in anterior and posterior teeth. Several authors have concluded that indirect restorations are the technique of choice in complex cases where shape and colour are difficult to achieve and function has to be restored. Even though there is no clinical evidence of the appropriateness of indirect composites in these treatments, the latest generation of composites used indirectly in the anterior teeth exhibits some interesting characteristics: it supports mechanical stress adequately, has an excellent esthetic result and can be repaired intraorally.

Purpose: The aim of this paper is to describe a protocol for a one-stage technique called Immediate Dentoalveolar Restoration (IDR), which uses autogenous bone grafts to restore peri-implant bone defects, presenting the results of mid-term follow-up. Summary: The patient presented a left central incisor that was compromised and with a total loss of buccal bone wall. The proposed treatment followed a protocol of immediate implantation, with a flapless surgery, using corticocancellous bone graft harvested from the maxillary tuberosity to restore the bone defect in question. The graft was shaped to the defect size and inserted between the implant and the remaining buccal soft tissue. The provisional restoration was made at the same time. The patient was followed for 36 months. The results were analyzed by means of clinical assessment, photography, periapical radiography and cone beam computed tomography. Conclusion: The treatment described appears to afford satisfactory esthetic results, with lower overall costs and treatment time.

This study aimed to evaluate the perception of lip position preferences in a Saudi population and compare it to the perception of other populations. Master pictures of a male and female Saudi model were prepared with the upper lip 3 mm from Ricketts' E-line and the lower lip 1 mm behind. The lip position was then altered using computer imaging to create a range of pictures from the upper lip 15 mm behind the E-line to the upper lip 6 mm beyond the E-line. One hundred and fifty-six individuals (60 male, 96 female) were asked to rate the pictures in terms of acceptability and also which picture they liked best. The preferences were compared based on gender, perception of their own lateral profile and history of previous orthodontic treatment. The study found that regardless of gender, the Saudi population has a distinct preference for lip positions that are further away from the E-line than the current Western standard. The population studied also showed a greater tolerance for deviation in the lip position away from the E-line than deviations towards the E-line.

Aims and objectives: The aim of this study was to assess the efficacy of 18% hydrochloric acid and 37% phosphoric acid by an in vivo comparison. Methods: Sixty fluorotic permanent maxillary central incisors from 30 patients were divided into 3 categories. The teeth received 5 seconds (mild fluorosis), 20 seconds (moderate fluorosis) and 30 seconds (severe fluorosis) application of 18% hydrochloric acid on 11 and 37% phosphoric acid on 21. Standardized intraoral photographies were taken immediately before, after, and one month after treatment. Vinyl polysiloxane impression of the patient were made before and after the treatment. A scanning electron microscopic (SEM) evaluation was carried out on the models to judge the surface alterations. Wilcoxon and Mann-Whitney tests were used to verify the hypothesis. Results: A statistically significant result was obtained in the reduction of white spot opacities, intensity of stains and the total area occupied by the stains in mild and moderate fluorosis teeth. Results of severe fluorosis had an unpredictable outcome. An SEM evaluation revealed good improvement in the surface texture of mild and moderate fluorosis teeth. Teeth with severe fluorosis showed only a slight improvement. Conclusion: A microabrasion procedure is effective for treating mild and moderate fluorosis cases.