Planning and predictability of clinical outcomes in esthetic rehabilitation.

In esthetic rehabilitation, it is a challenge to meet the needs of patients with growing expectations. Creating predictable results is the key to success. This can be accomplished by performing a comprehensive esthetic diagnosis, elaborating treatment proposals that satisfy today's esthetic standards, and using modern computer-assisted methods. The diagnostic wax-up and mock-up are effective tools that allow patients to visualize treatment proposals without invasive procedures. Once the patient has approved the proposals, they provide the basis for the fabrication of the final restoration. The use of modern ceramic materials makes it possible to achieve a good esthetic outcome, even in restorations with extremely thin layer thicknesses. Esthetic cementation is the final step of restorative treatment.

Provisional polymer-based CAD/CAM implant superstructures.

The prosthetic restoration of implants to obtain an esthetically balanced outcome is an extremely complex process--especially in terms of effective soft-tissue management. So-called hybrid abutment crowns, which can be made from polymer milling blocks in an uncomplicated process and used for immediate provisional restoration, represent an advance in the efficient production of superstructures.

CAD/CAM-based implant abutments.

This article presents two novel options for lithium-disilicate restorations supported by single-tooth implants. By using a Ti-Base connector, hybrid abutments and hybrid abutment crowns can be fabricated for different implant systems. The latter option in particular is an interesting new process that yields economical and esthetic restorations supported by single-tooth implants. Further studies are urgently needed to validate the usefulness of this system.

A new, hybrid material for minimally invasive restorations in clinical use.

A new type of material consisting of a ceramic substructure infiltrated with a composite material--referred to as a hybrid ceramic--is currently being introduced for dental CAD/CAM use. The characteristic brittleness of ceramic is thus replaced by an elasticity resembling that of natural human dentin. The material features a high fracture load value of 2980 N, and is straightforward to process in CAD/CAM milling machines. This article presents a case example describing the manufacture of a veneer restoration.

CAD/CAM generated all-ceramic primary telescopic prostheses.

Computer-aided design and manufacturing (CAD/CAM) systems have proven effective not only for the manufacture of crown and bridge frameworks, inlays, onlays and veneers, but also for the generation of all-ceramic primary telescopic prostheses in more than 10 years of use in dental technology. The new InLab 4.0 software generation makes it possible to design and mill primary telescopic prostheses with CAD/CAM technology. The computer-generated raw crowns for these restorations require very little manual adaptation. The secondary crowns are manufactured by electroforming and bonded onto the tertiary structure or framework.

New implant software abutments for inLab 3.65.

The "Implants for inLab" implant software is based on a polyvalent bonding base which can be used on different types of implant. The modifiable part is a zirconium dioxide block with a prefabricated connection configuration for accurate coupling to the bonding base. The software offers different design possibilities which are especially suitable for implant restorations with high esthetic requirements.

A method for the easy fabrication of all-ceramic bridges with the Cerec system.

Both pressing technology and CAD/CAM methods have proven themselves clinically for the fabrication of all-ceramic restorations. The advantages of the Cerec technology for the economic fabrication of all-ceramic bridges can be exploited by the use of burn-out blanks of polymer material. The milling process of very hard ceramics in the milling unit, which has some disadvantages, is replaced by the pressing process and makes the IPS e.max press material accessible to CAD/CAM users, primarily for extending the range of indications to splinted crowns and small all-ceramic bridges.

InEOS--new system component in Cerec 3D.

A new device for digitizing model surfaces for dental CAD/CAM applications is available with the inEOS scanner. It works according to the principle of stripe light projection. Both rotational scan mode of single prepared teeth and overview scan mode in which a complete model of the jaw can be acquired are possible. Detailed scans can be token in addition to improve the data quality. The software basis is the proven Cerec inLab 3D program. The virtually produced restorations can be milled either with the inLab milling unit or transferred to the Infinident milling center for central production. A clinical case which was treated by using the inEOS scanner is presented.

The prefabricated anatomical polychrome CAD/CAM crown for the inLab system.

An innovative extension of performance in the area of single crown production is presented. Prefabricated crown blanks with color layering are inserted in the row of teeth with specially developed software and adapted apically to the stump with a CAM milling program.

Assessment of periodontal disease and dental caries in a population survey using the CPITN, GPM/T and DMF/T indices.

2263 randomly selected subjects, aged 15-19, 20-24, 25-29, 30-34, 35-44, 45-54, 55-64, and greater than 64 yr, were assessed for periodontal status, caries status and treatment needs using the Community Periodontal Index of Treatment Needs (CPITN), the ratio of Gingivitis: Periodontitis: Missing teeth (GPM/T index) and the DMF/T index. The advantages of full mouth examination were compared to partial recordings. The CPITN underestimated deep pocketing especially in older age groups and in younger groups overestimated the need for scaling. Although the mean GPM/T number of periodontally affected teeth is in the range of 9-13 teeth and stable throughout the age groups there were age-dependent high risk groups for developing shallow pocketing (20-24 yr) and deep pocketing (45-54 yr), whereas adolescents were at high caries risk. The increase in the number of missing teeth was dramatic after the age of 54 yr only one decade after the high risk age for deep pathologic pockets.

The optical conditioning of Cerec preparations with scan spray.

Coating the surfaces with an anti-reflection substance before taking the optical impression is indispensable for exposures with the Cerec camera. Up to now, this has been done mainly by powdering with titanium dioxide. Errors which have a negative influence on the result can, of course, arise during the coating process. Although powdering is a proven method which has led to outstanding results in many thousands of restorations, it represents a weak spot in the clinical procedure. In the present study, the handling and data quality of an innovative spray for applying an anti-reflection coat to restoration surfaces were examined. The values obtained were chiefly displayed in the Section window of the Cerec 3 software. Despite a few small problems, handling can be considered good and safe. The primary advantage consists in the display of the preparation boundaries, since the coated surface can be dried with an air stream. With regard to detail reproduction, data quality, and coat thickness, the quality of the optical impression has reached a new level. The present study shows that considerable errors can arise in the restoration from powdering, due partly to material buildup. The Scan Spray tested can be recommended for clinical use.

The integration of Cerec Scan into the treatment process.

An efficient CAD/CAM machine for single-tooth restorations and possibly small bridges is available with Cerec Scan. Despite the higher workload needed for scanning and indirect work, restorations can be produced in one appointment by using fast-curing impression and modelling materials.

Cerec goes inLab--the metamorphosis of the system.

In spite of its underlying conception as being a chairside procedure, the Cerec procedure is now establishing itself in the dental laboratory as well. Based on hard core infiltration ceramic technology, it allows the production of crown caps and bridge frames held with a single attachment. The scan machine of the existing Cerec product family forms the technical basis of the new Cerec inLab instrument. Numerous modifications have been carried out. In addition, not only the magnification of the implementable work piece size, but also the changes in the scan process have been modified, which allows a higher resolution and the introduction of a new, very delicate milling bur. The software has been designed to be very user-friendly; the design of caps and frames has been greatly simplified. Without basic changes to the clinical process used for metal-ceramic, the smooth transition to full-ceramic restorations is possible for the dentist. The distinct separation of Cerec units for the dentist and Cerec inLab as a laboratory machine makes sense simply because of the high proportion of dental-technical steps. The new instrument can be seen as a further step toward the integration of CAD/CAM technology in the field of dentistry, of equal benefit to dentists, dental technicians, and patients.

Clinical aspects of all-ceramic CAD/CAM restorations.

All-ceramic restorations were restricted in the past to a relatively small group of users. Among other things, this is explained by the high clinical expense for such work. The latter can be reduced decisively by using high-strength hard core ceramics and CAD/CAM production. The preparation corresponds largely to the preparation in metal-ceramic work. There are also scarcely any differences in elastic impression taking. Thanks to the high strength of modern all-ceramic systems, they can be inserted conventionally; using adhesive systems is naturally also possible and recommended.

All-ceramic primary telescopic crowns with Cerec inLab.

On the one hand, all-ceramic primary telescopic dentures serve to satisfy the growing esthetic needs of older patients, and on the other hand guarantee good adhesive stability. With the aid of the Cerec inLab system, primary telescopic crowns made of Vita In-Ceram infiltration ceramic can be designed and milled after previous conventional determination of the over all insertion direction. The raw crowns gained in this way then require only minor improvement. The secondary parts are produced with the aid of electroforming. These are adhesively bonded to the tertiary structure. The special feature of adhesive bonding of the primary telescopic crowns requires uncompromisingly good cooperation between dentist and laboratory.

3D software extension for Cerec inLab.

Three new software components for the Cerec inLab system, already proven in the dental laboratory area, are presented. They are all based on three-dimensional display. On the one hand, the design can be simplified, and on the other hand, the range of indications can be extended to inlays, onlays, veneers, and multiunit bridges with the aid of these new components.

[An assessment of the variations in periodontal pathology in adolescents]. / Otsenka variatsii patologii parodonta u podrostkov.

Forty-seven adolescents with periodontal abnormalities were examined using clinical, immunologic, and functional tests (altogether 12 signs). Factor analysis helped cut down the number of signs just to 4 major factors. Interpretation of these factors and consideration of the individuals in factor space permitted singling out at least 2 types of periodontitis course, requiring, possibly, different approaches to therapy.