International Journal of Esthetic Dentistry (EN), 02/2006

Reconstruction and long-term maintenance of esthetically satisfactory papillalike soft tissue between two adjacent implants in the esthetic zone is generally regarded as very difficult. There are few reports on papilla reconstruction for immediate implants in fresh extraction sockets; however, postsurgical soft tissue management plays a crucial role in treatment outcomes. This article describes two case reports in which two immediate implants were placed after tooth extraction, with concurrent soft tissue management aimed to preserve the original soft tissue contour. Both cases showed low probability for long-term success at posttreatment evaluations. Further efforts should be made to better understand the behavior of the periimplant hard and soft tissue specific to the esthetic zone.

The transition from conventional to digital photography presents many advantages for authors and photographers in the field of dentistry, but also many complexities and potential problems. No uniform procedures for authors and publishers exist at present for producing high-quality dental photographs. This two-part article aims to provide guidelines for preparing images for publication and improving communication between these two parties. Part 1 provided information about basic color principles, factors that can affect color perception, and digital color management. Part 2 describes the camera setup, discusses how to take a photograph suitable for publication, and outlines steps for the image editing process.

The esthetic outcome of dental implants in the esthetic zone is a major treatment concern in modern dentistry, especially in singlestep procedures, which unite extraction, implantation, and augmentation into one surgical intervention, and are gaining popularity. Although these procedures offer advantages concerning early soft tissue preservation, they also show a high risk of complications when careful patient selection is neglected. Thus, the aim of this article is to illustrate the complexity and limitations of immediate implant procedures using two case reports. The clinical cases and scientific data show that immediate implant placement must be divided into two different groups: single-tooth implants and multiple adjacent implants. While immediate placement of single-tooth implants often shows predictable and superior esthetic results, the immediate placement of multiple adjacent implants is far less predictable. It is important to establish whether the advantages observed in single-tooth applications are also feasible for multiple adjacent implants.

The purpose of this spectrophotometric study was to evaluate the influence of different color backgrounds on Vita In-Ceram (Vident) glass-infiltrated ceramic veneers. A total of 50 color background disks were fabricated from Vitadur Alpha 2M2 (n = 30) and 5M1 (n = 20) dentin porcelain (Vident). Ceramic veneer disks were fabricated from In-Ceram Spinell (n = 20) or In- Ceram Alumina (n = 20) glass-infiltrated core veneered using Vitadur Alpha 2M2 dentin porcelain. In addition, 10 ceramic veneer disks were fabricated from feldspathic dentin porcelain Vitadur Alpha 2M2. The ceramic veneer specimens were bonded onto the color background specimens using dual-curing luting composite cement, creating the following groups (each n = 10): S2M2 (Spinell/2M2), S5M1 (Spinell/5M1), A2M2 (Alumina/2M2), A5M1 (Alumina/5M1), and control (Vitadur Alpha/ 2M2). L*a*b* color coordinates were measured five times for each specimen using a Vita Easyshade (Vident) spectrophotometer. Mean color differences (ΔE) between each study group and the control group were: 3.79 for S2M2; 7.24 for S5M1; 5.86 for A2M2, and 7.32 for A5M1. Two-way ANOVA showed statistically significant differences in ΔE between all groups. However, a t test revealed that the statistically significant differences only existed between groups S2M2/S5M1, A2M2/A5M1, and S2M2/A2M2. The results suggest that vacuum infiltration with a translucent glass provides the Spinell and Alumina ceramic veneers with increased semi-translucency, which makes them highly influenced by discolored backgrounds. In-Ceram Spinell glass-infiltrated ceramic veneers could be considered as an alternative to conventional feldspathic veneers for the restoration of nondiscolored teeth. Although Spinell and Alumina ceramic veneers could enhance the final color establishment of discolored teeth, the results would not be clinically acceptable.

In this two-part treatment planning series, the case of a 54-year-old woman with a failing four-unit fixed partial denture (FPD) is presented. Part 1 presented pretreatment strategies, occlusal and periodontal status, and the advantages and disadvantages of three treatment options: removable partial denture, tooth-supported FPD, and implant-supported FPD. In this follow-up article, the treatment selected for the case is revealed, and the rationale-including indications and contraindications for the different treatment options-is discussed. The treatment sequence is then outlined, and the final outcome is presented.

In this two-part treatment planning series, the case of a 63-year-old woman with severe attachment loss at the maxillary incisors is presented. In Part 1, pretreatment strategies, eg, use of intra- and extraoral photographs, analysis of periapical radiographs, and examination of occlusal and periodontal status, are discussed. The advantages and disadvantages of six treatment options using both conventional and implant therapy are presented. In Part 2, the treatment selected will be revealed and the rationale governing the decision will be discussed.