Digital workflow for virtually designing and milling ceramic lithium disilicate veneers: a clinical report.

Laminate veneers have been routinely used to restore and enhance the appearance of natural dentition. The traditional pathway for fabricating veneers consisted of making conventional polyvinyl siloxane impressions, producing stone casts, and fabricating final porcelain prostheses on stone dies. Pressed ceramics have successfully been used for laminate veneer fabrication for several years. Recently, digital computer-aided design/computer-aided manufacturing scanning has become commercially available to make a digital impression that is sent electronically to a dental laboratory or a chairside milling machine. However, technology has been developed to allow digital data acquisition in conjunction with electronically transmitted data that enables virtual design of restorations and milling at a remote production center. Following the aforementioned workflow will provide the opportunity to fabricate a physical cast-free restoration. This new technique has been reported recently for all-ceramic IPS e.max full-coverage pressed-ceramic restorations. However, laminate veneers are very delicate and technique-sensitive restorations when compared with all-ceramic full-coverage ones made from the same material. Complete digital design and fabrication of multiple consecutive laminate veneers seems to be very challenging. This clinical report presents the digital workflow for the virtual design and fabrication of multiple laminate veneers in a patient for enhancing the esthetics of his maxillary anterior teeth. A step-by-step process is presented with a discussion of the advantages and disadvantages of this novel technique. Additionally, the use of lithium disilicate ceramic as the material of choice and the rationale for such a decision is discussed.

Predictable Restorative Work Flow for Computer-Aided Design/Computer-Aided Manufacture-Fabricated Ceramic Veneers Utilizing a Virtual Smile Design Principle.

The purpose of this case report was to present the use of a contemporary digital photograph-assisted virtual smile design principle, an intraoral digital impression, and computer-aided design/computer-aided manufacture-fabricated lithium disilicate ceramic veneers to treat a patient with esthetic needs in the maxillary anterior region. By using the proposed digital restorative work flow, this case report demonstrated an effective communication pathway between the patient, clinician, and dental laboratory technician. Effective communication can help to achieve a more predictable and satisfactory esthetic outcome.

Maxillary and Mandibular Rehabilitation in the Esthetic Zone Using a Digital Impression Technique and CAD/CAM-fabricated Prostheses: A Multidisciplinary Clinical Report.

Interdisciplinary treatment planning is necessary in certain clinical situations to optimize esthetic treatment outcomes. Patients presenting with severe wear of their anterior teeth from iatrogenic influences pose a particularly difficult problem in terms of esthetic treatment planning. Collaboration of practitioners from the disciplines of orthodontics, periodontics, and restorative dentistry is essential for the treatment of patients with complex esthetic dental needs. Careful assessment of clinical situations and corresponding specialty consultations are of utmost importance to achieve more predictable and esthetic treatment outcomes. The purpose of this clinical case is to report to the readership a novel digital fabrication of computer-aided design/computer-aided manufacturing milled acrylic provisional restorations and final lithium disilicate definitive restorations after orthodontic and periodontal therapy with virtual master impressions, casts, and articulation.

Dental student perception and assessment of their clinical knowledge in educating patients about preventive dentistry.

In today's dental school curricula, an increasing amount of time is dedicated to technological advances, and preventive dentistry topics may not be adequately addressed. Freshman (D1) students participated in a new Introduction to Preventive Dentistry course, which consisted of didactic lectures, active learning breakout sessions and case-based studies. The goal of this study was to determine if D1 dental students completing the course had a better knowledge and comfort level with basic preventive dentistry concepts and caries risk assessment than the upcoming graduating senior dental students. Following the completion of the course, D1 students were administered a survey that assessed their comfort level describing preventive dentistry topics to patients. This was immediately followed by an unannounced examination over the same topics. Senior (D4) students, who had not taken a formal course, reported statistically significant higher comfort levels than D1 students. However, the D4s scored significantly lower in all of the examination areas than the D1 students. Higher scores in D1s may have been due to recent exposure to the course material. However, the basic nature of the content-specific questions should be easily answered by novice practitioners educating their patients on oral disease prevention. As the current data shows lower content-specific scores of basic preventive dentistry knowledge amongst graduating D4 students, this may indicate a need for more guidance and education of students during the patient care. This study showed that implementation of a formalised course for D1 students can successfully ameliorate deficiencies in knowledge of preventive dentistry topics.

The effect of ceramic and porous fillers on the mechanical properties of experimental dental composites.

OBJECTIVES: The purpose of this study was to investigate the effect of ceramic fillers (containing leucite crystals) and their porosity on the mechanical properties of a new experimental dental composite in order to compare with the properties of composites containing conventional glass fillers. METHODS: In this study, experimental composites were prepared by mixing the silane-treated fillers with monomers. Experimental composites were divided into four groups according to their filler type, amount and porosity. The monomers were composed of 70% Bis-GMA and 30% TEGDMA by weight for all groups. Glass and leucite-containing-ceramic were prepared as different filler types. In order to make fillers porous, leucite-containing-ceramic fillers were treated with HF acid. Camphorquinone and DMAEMA were used as photo initiator system. Post-curing was done for all groups before mechanical testing. Degree of Conversion of composites was measured using FTIR spectroscopy. The diametral tensile strength (DTS), flexural strength and flexural modulus were measured and compared among the groups. RESULTS: The results showed that the stronger and more porous filler has a positive effect on flexural strength. Porosity of filler increased flexural strength significantly. No significant difference was found in DTS tests among the groups. Flexural modulus was affected and increased by using ceramic fillers. The type of the filler affected the DC of the composite and DC increased by post-curing. SIGNIFICANCE: Flexural strength is one of the most important properties of restorative dental materials. Higher flexural strength can be achieved by stronger and more porous fillers. Investigation into the effect of filler on dental material properties would be beneficial in the development of restorative dental material.