Esthetic rehabilitation of labial tooth defects caused by caries of the anterior teeth using a composite resin injection technique with veneer-shaped 3D printing indices.

PATIENTS: An 18-year-old woman sought treatment for caries of the anterior teeth after completing orthodontic treatment. Direct composite resin restoration was chosen because the patient preferred a minimally invasive and cost-effective treatment whenever possible. Based on diagnostic wax-up, veneer-shaped indices for composite resin injection were designed to replicate and restore tooth defects rapidly and accurately. The overall esthetic result was excellent after a 1-year of follow-up. DISCUSSION: Direct freehand composite resin restorations are clinically challenging. The recently proposed 3D printing index for the composite resin injection technique is helpful for direct restoration but is challenging to remove. The veneer-shaped indices avoid the formation of an undercut in the direction of removing the index, making them easy to remove after finishing the restorations. CONCLUSIONS: Using veneer-shaped indices for composite resin injection enables rapid esthetic rehabilitation of labial tooth defects caused by caries. This approach reduces chairside time and operational difficulty while allowing for easy index removal after completing the restorations.

Esthetic Rehabilitation of Congenitally Peg-Shaped Lateral Incisors Using the Injectable Composite Resin Technique: A Clinical Report.

This report details the esthetic dental rehabilitation of a patient with peg-shaped and malformed lateral incisors, conditions that stem from congenital anomalies in tooth formation, using the injectable composite resin technique (ICRT). The ICRT clinical workflow initiates with a smile analysis and precise shade matching, followed by the construction of a diagnostic wax-up crafted according to esthetic and functional guidelines. Subsequently, a mock-up is developed to ensure that the planned restorations fulfill the patient's functional requirements and esthetic expectations. A transparent silicone index is employed to accurately transfer the patient-approved wax-up into the mouth, utilizing injectable flowable composite resin. This method enhances treatment predictability and ensures that the final direct restoration precisely reflects the approved design within a reasonable chairside timeframe.

Enhancing Aesthetics and Functionality of the Teeth Using Injectable Composite Resin Technique.

In order to prepare composite restorations without the requirement for tooth preparation, the injectable composite resin technique uses a clear silicone index in a minimally invasive direct approach to imitate a diagnostic wax-up. This case report features a 34-year-old female patient having aesthetic and functional concerns, notably spacing between the teeth, insufficient tooth visibility, and diastema in the upper anterior region. Upon clinical examination, spacing and midline diastema were observed. The maxillary incisors and canines were to have composite veneers made as part of the treatment plan. A wax-up and transparent silicone index was prepared following the assessment of a try-in of the prepared mock-up. Subsequenty, for restoring the teeth, a clear silicone index was used to inject and polymerize the flowable composite. The desired outcomes included elongated teeth to enhance visibility, closure of diastemas, and reshaping of the canines. Over a 12-month follow-up period, the patient exhibited no signs of soft tissue inflammation or significant wear. The described technique is characterized by its minimal invasiveness, cost-effectiveness, and suitability for definitive and provisional restorations. Desirable results can be achieved by appropriate planning and adhering to a meticulous planning while minimizing tooth structure loss.

Partial Ceramic Veneer Technique for Challenging Esthetic Frontal Restorative Procedures.

Frontal darkened teeth have shown to be one of the most challenging treatments for esthetic dentistry in recent years. This case report, along with a 30-month follow-up, describes the application of a partial ceramic veneer, restricted to the mid-cervical third region, made in the upper left central incisor darkened by trauma. The procedure consisted of maintenance of the entire incisal face, as well as esthetic and morphological rehabilitation of the smile line with veneers and ultra-thin partial ceramic veneers. The planning process was thoroughly elaborated by photographs, study models, a virtual smile designed, diagnostic waxing, and reproduction in the patient's mouth through mock-up. Following, dental home bleaching, esthetic gingival contouring, and minimally invasive tooth preparation were performed. Two types of glass ceramics (lithium disilicate and feldspathic) were used in different regions due to the peculiar characteristics of resistance, finishing, and polishing. According to the present case report, preparing a cervical partial ceramic veneer is an innovative, viable, and safe approach to maintaining the incisal portion of the tooth preserved and setting a detailed tooth morphology/color. The application of partial ceramic veneer provides incisal edge preservation and simplifies the reproduction of the adjacent tooth characteristics, avoiding multiple esthetic appointments.

Technique to restore the midline space of central incisors using a two-in-one template: A clinical report.

Using composite resin restoration of full-coverage crowns to obtain a completely symmetrical esthetic restoration of individual central incisors remains difficult. Freehand direct composite resin restoration is challenging even for highly skilled dentists. This clinical report describes a digital protocol for achieving symmetrical restoration of two central incisors using a custom-designed, two-in-one template.

Interdisciplinary 3D digital treatment simulation before complex esthetic rehabilitation of orthodontic, orthognathic and prosthetic treatment: workflow establishment and primary evaluation.

BACKGROUND: An interdisciplinary treatment simulation and smile design before a complex esthetic rehabilitation is important for clinicians' decision-making and patient motivation. Meanwhile, intervention and interaction are necessary for dental specialists in these complex rehabilitations. However, it is difficult to visualize an interdisciplinary treatment plan by using the conventional method, especially when orthognathic surgery is involved, thus hindering communication between dental specialists. This research aims to establish a 3D digital workflow of interdisciplinary treatment simulation to solve this problem. METHODS: An interdisciplinary 3D digital workflow of simulated treatment plan for complex esthetic rehabilitation was established. Eleven patients were enrolled and illustrated with their treatment plans using 3D treatment simulation, as well as 2D digital smile design (DSD) plus wax-up. Visual analogue scales (VAS) were used to rate the intuitiveness, understanding, and satisfaction or help between the two methods by patients and dental specialists. RESULTS: According to the ratings from the patients, 3D treatment simulation showed obvious advantages in the aspects of intuitiveness (9.7 ± 0.5 vs 6.4 ± 1.4) and treatment understanding (9.1 ± 0.8 vs 6.6 ± 1.5), and the satisfaction rates were also higher (9.0 ± 0.6 vs 7.1 ± 1.8). Dental specialists regarded the 3D digital plans as more intuitive (8.9 ± 0.8 vs 5.9 ± 1.0) and useful to understand the plans from the other specialists (8.9 ± 0.7 vs 6.1 ± 1.0) and helpful to their own treatment plans (8.7 ± 0.9 vs 5.9 ± 1.4). CONCLUSIONS: The interdisciplinary 3D digital treatment simulation helps both patients and dental specialists to improve treatment understanding, and facilitates dental specialists for decision-making before complex esthetic rehabilitation. TRIAL REGISTRATION: This study was registered in the National Clinical Trials Registry under the identification number MR-11-20-002862. This is an observational study in which we did not assign the intervention.

Orbital rehabilitation of a COVID-19-induced mucormycotic defect - A case report.

The surgical removal of the maxilla and the orbit and its content, which leads to degraded esthetics, weakened functioning, and arrested psyche, has caused widespread fury among coronavirus disease (COVID-19)-produced mucormycosis patients. It has been stated that a patient with an ocular deformity due to surgical excision of a mucormycosis infection can be rehabilitated. Obtaining a healthy location for prosthesis acceptance is critical for the success of many resected patients. The advantages of anatomical and mechanical retention were fully exploited. The report includes an appropriate treatment plan for the rehabilitation of such faults, as well as a follow-up period and maintenance. Such rehabilitation not only improves the cosmetic outcome but also helps to elevate the patients' spirits mentally. The following case report defines the treatment guidelines for rehabilitation of a patient with orbital and intra-oral defect owing to COVID-19-induced mucormycosis. It also establishes the steps required for the fabrication along with materials required and suitable pertaining to the above-mentioned scenario. The text is duly supported by images wherever necessary.

Digital smile planning technique applied to prosthetic rehabilitation of dental esthetic area: a case report.

Nowadays, the objective of esthetic rehabilitation is not only to guarantee the results to the patients in terms of esthetic parameters but also the possibility to show the pre-visualization of possible results and therapy planning. OBJECTIVE: The aim of this study is to apply the 3D-DPS digital planning technique, in the prosthetic treatment of a patient, to produces digitally the mockup for the digital previewing and esthetic crown and veneer for the final prosthetic treatment. MATERIALS AND METHODS: A case report participant is a young patient, a female, 26 years old, with no oral, periodontal, or systemic diseases. After a sign of an informed consent and an explication of a plan of treatment, technical intraoral and extraoral pictures and intraoral digital impressions were taken. The digital images improved from the 2D Smile Lynx Software and the scanner stereolithographic (STL) file was matched into the CAD Lynx to obtain a virtual previsualization of teeth and smile design. Then, the mockup was milled using a CAM system. Minimally invasive preparation was carried out on the enamel surface with the mockup as position guides. Finally, the esthetic CAD-CAM veneer and crown were produced digitally using the CAD Wax as a guide. RESULTS: The use of the digital project and the pre-operative mockup allowed a perfect initial evaluation and a better understanding of the patient's treatment plan. CONCLUSIONS: The 3D digital planning technique is a new, predictably and minimally invasive technique. It allows diagnosis and a better communication with the patient. It helps to reduce the working time and the possible errors usually associated with the classical prosthodontic manual step.

Immediate implant placement and loading in the esthetic area when the buccal socket wall is significantly damaged.

OBJECTIVES: Recent clinical recommendations contraindicate immediate implant placement when the socket buccal bone plate is significantly damaged. The connective tissue graft (CTG) is increasingly being used in implant therapy and can replace periodontal defects lacking bone wall in periodontal regenerative surgery. Therefore, CTG could be used to allow immediate implant placement and loading even when the buccal socket wall is damaged, facilitating graft material stability. CLINICAL CONSIDERATIONS: In the first case, deep bone dehiscence was caused by a vertical root fracture. In the second case, a big bone fenestration was caused by a chronic endodontic periapical lesion. Both cases were treated with immediate implant placement and loading. A buccal CTG was used to compensate for the lack of bone and allow stabilization of the particulate xenograft in the gap between the implant and the damaged buccal socket wall. In both cases, a provisional screw-retained crown was immediately delivered, and the definitive layered zirconia crown was delivered after 3 months. Esthetic results and patient satisfaction monitored for 1 year after loading proved to be encouraging. CONCLUSIONS: Although further investigations with longer follow-up are required, the approach is likely to yield good results after 1 year of loading. CLINICAL SIGNIFICANCE: The purpose of this report is to show a surgical approach that seems to be able to overcome the contraindication of the quoted consensus report, which allows for good esthetic results and patient satisfaction even when the buccal bone wall of the extraction socket has been more than 50% compromised, allowing treatment time and cost reduction.

A Digital Esthetic Rehabilitation of a Patient with Dentinogenesis Imperfecta Type II: A Clinical Report.

A 19-year-old female affected by dentinogenesis imperfecta type II (DI-II), a genetic disease that affects the structural integrity of the dentin, presented with a chief complaint of discolored teeth. For this patient, digital techniques, including digital smile design (DSD), the ARCUSdigma axiograph and computer-aided design/computer-aided manufacturing (CAD/CAM), were extensively used in all phases of the rehabilitation process. Compared to traditional analog methods, these digital techniques could reduce the constant confirmation of occlusion, promote communication between clinicians and dental technicians, achieve accurate occlusion with relatively high efficiency, and improve the efficacy of esthetic rehabilitation in the treatment of this patient with DI-II.

The injectable composite resin technique: minimally invasive reconstruction of esthetics and function. Clinical case report with 2-year follow-up.

The injectable composite resin technique is an indirect/direct method that uses a transparent silicone index for accurate and predictable translation of a diagnostic wax-up into composite restorations without the need for tooth preparation. This case report involves a 22-year-old man who presented with esthetic and functional problems associated with diastemas and insufficient tooth visibility. Clinical examination revealed inadequate canine guidance in lateral excursion. The treatment plan included the fabrication of composite veneers for the maxillary incisors and canines. A wax-up was prepared by simulation of functional movements on an articulator, and a transparent silicone index was prepared after checking a mock-up in the oral cavity. The teeth were restored with flowable composite injected and polymerized through the transparent silicone index. The conventional technique was modified by cutting the silicone index at the gingival margin, using individual mock-ups as space holders, and the use of gingival retraction cords. The final outcomes were elongated teeth for increased visibility, closed diastemas, and reshaped canines for adequate guidance in lateral excursion. A protective splint for night-time wear was fabricated and delivered to ensure long-term stability. The patient did not exhibit any soft tissue inflammation or significant wear during a 24-month follow-up period. The technique described is minimally invasive and inexpensive, and it can be used for definitive as well as translational restorations. The treatment goals are to establish adequate function and esthetics, with advantages including minimal tooth structure loss and cost-effectiveness. Stable and predictable results can be achieved with proper planning and a careful workflow.

Comprehensive and esthetic rehabilitation for phobic patient "case report".

BACKGROUND: One of the main reasons for a patient to be referred for sedation in order to receive dental treatment is dental fear. Minimal Invasive Dentistry is caused by the ceramic material improvement along with luting composites ceramic and well secured to teeth. Modern society considers a lovely smile being the perfect image for beauty and great health. CASE DETAILS: A 24-year old phobic patient Male presented to the clinic, with a chief complaint of an unaesthetic smile. We end up by excellent management of phobic patient and complete comprehensive and esthetic treatment and the patient was highly satisfied with the results. CONCLUSION: Successful management of a fearful patient during the first visit build good patient dentist relationship thus completing comprehensive dental treatment.

Esthetic Rehabilitation of Maxillary Anterior Teeth, Including an Immediate Provisionalization with an Implant-Supported Fixed Dental Prosthesis.

This report describes the case of a patient who required rehabilitation of their maxillary anterior teeth following a traumatic injury through a physical altercation. The decision was made to extract the maxillary central incisors and maxillary right lateral incisor, perform immediate implantation on the maxillary right lateral incisor and left central incisor areas, and place a three-unit immediate provisional restoration. Predesigned virtual teeth enabled efficient fabrication of the immediate provisional restoration following the implant placement. After a sufficient healing period with periodic check-ups, final impressions were made using a digital approach, with meticulous care taken to preserve the gingival architecture around the sites of rehabilitation. Thus, the custom abutments and definitive restoration were placed without eliciting an uncomfortable feeling in the patient. Both esthetic and functional outcomes were satisfactory. Reduced soft tissue volume around the implant restoration was observed, primarily within the two months post-extraction/implantation, based on superimposition of the serial scan data. Soft tissue volume changes in the present case suggest the need for controlled clinical studies of three-dimensional changes of gingival contours after extraction and/or implantation.

[Application of 3D printing in aesthetic oral rehabilitation].

3D printing technology can be used in prosthodontics to obtain detailed structures. The technique offers a possible supersession for the most conventional restorations technologies. Contemporary aesthetic restorations encounter difficulties in the consistency between the analysis and design stages and the clinical implementation stage. 3D printing transfers aesthetic designs to customize the finial restoration fabrication, which could be an appropriate optimization to the aformentioned problem. Meanwhile, 3D printing technology can be employed to manufacture target restoration space guide (TRS guide), which is a blueprint for the aesthetic ceramic restorations and presents a general functional and aesthetic situation of patients. The guidance provided by TRS guide ensures precision and minimal invasive operation in aesthetic restorations. These new digital technologies have revolutionized aesthetic rehabilitation. This paper introduces the application of 3D printing in aesthetic oral rehabilitation.

Application of 3D printing in aesthetic oral rehabilitation / 华西口腔医学杂志

3D printing technology can be used in prosthodontics to obtain detailed structures. The technique offers a possible supersession for the most conventional restorations technologies. Contemporary aesthetic restorations encounter difficulties in the consistency between the analysis and design stages and the clinical implementation stage. 3D printing transfers aesthetic designs to customize the finial restoration fabrication, which could be an appropriate optimization to the aformentioned problem. Meanwhile, 3D printing technology can be employed to manufacture target restoration space guide (TRS guide), which is a blueprint for the aesthetic ceramic restorations and presents a general functional and aesthetic situation of patients. The guidance provided by TRS guide ensures precision and minimal invasive operation in aesthetic restorations. These new digital technologies have revolutionized aesthetic rehabilitation. This paper introduces the application of 3D printing in aesthetic oral rehabilitation.

[Surgical treatment of patients with arteriovenous head and neck angiodisplasia]. / Khirurgicheskoe lechenie bol'nykh s arteriovenoznymi angiodisplaziiami v oblasti golovy i shei.

The aim of the study was to assess the results of surgical treatment in 74 patients with extensive arteriovenous angiodisplasia in the head and neck area. All patients underwent complex examination including ultrasound, CT and MRI with contrast and selective carotid angiography. The lesions excision was performed after endovascular embolization and soft tissue defects were restored by various methods selected according to prevalent vascular lesion type (arterial, arteriovenous, venous, capillary) and blood flow values (high flow, low flow, mixed). Good and satisfactory esthetic results were seen in 95.2% of cases, lesion relapse was detected in 4.8% of cases by 12-18 months follow-up. Endovascular embolization proved to decrease the intraoperative bleeding risk, prevent lesion relapse and minimize the size of the lesion improving the results of radical treatment. Local flap reconstruction usually results in good esthetic results. By local soft tissue deficiency distant free flaps or microsurgical complex flaps may be used.

Esthetic Rehabilitation of Primary Anterior Teeth using Temporization Material: A Novel Approach.

Pediatric dentists should always aim for esthetic and functional rehabilitation of decayed/traumatized primary teeth. The most common method for restoring such teeth involves the use of "strip crowns" with composites, while the recent trend is toward using other extracoronal restorations including preve-neered stainless steel crowns and zirconia crowns. All these restorative options have shown good success rates, but also have some limitations. This case series depicts novel clinical technique of using a temporization material for full-coronal restoration(s) in primary anterior teeth. This included the chair-side custom fabrication of full-coronal restoration using temporization material, which has resulted in good immediate esthetics and might be a cost-effective alternative for restoring primary anterior teeth in future. HOW TO CITE THIS ARTICLE: Gugnani N, Pandit IK, Gupta M, Nagpal J. Esthetic Rehabilitation of Primary Anterior Teeth using Temporization Material: A Novel Approach. Int J Clin Pediatr Dent 2017;10(1):111-114.

Interdisciplinary approach to complete-mouth rehabilitation: a clinical report.

Dental fluorosis results from excess fluoride ingestion during tooth formation and is commonly seen in certain endemic areas. Its clinical manifestations may range from white opaque patches of enamel in mild cases to pitting and loss of enamel in severe cases. The treatment of fluorosis is important not only because of esthetic and functional concerns but also to help improve a patient's self-esteem; therefore, a multidisciplinary approach is often necessary. This article describes a multidisciplinary approach to complete-mouth rehabilitation of a patient affected with fluorosis. A confluence of the endodontic, periodontal, orthodontic, and prosthodontic disciplines resulted in improved esthetics and enhanced masticatory efficiency.

Immediate dental implant placement with immediate loading following extraction of natural teeth.

The loss of tooth in the esthetic area is often a traumatic experience for the patient. Patients may suffer real or perceived detrimental effects following the loss of one or more teeth. Dental implant offers the most cost-effective and long-term solution for replacement of missing teeth with high average life expectancy, providing the patient with the best sense of security and well-being. Recently, immediate implant placement after extraction of tooth with early loading has become more common. The advantages of this procedure include fewer surgical interventions, reduction in overall treatment time, reduced soft and hard tissue loss, and psychological satisfaction to the patient. This case report describes the procedure for immediate implant placement with immediate loading of implants by provisional restorations.

Puente adhesivo en paciente con labio leporino y fisura velopalatina: una solución temporal con compromiso estético / Adhesive bridge in a patient with cleft lip and palate: a temporary solution with esthetic commitment

En la actualidad el aumento de la demanda estética y la necesidad de procedimientos mínimamente invasivos ha llevado a un aumento de la técnica adhesiva. Ribbond® es una marca de fibra de polietileno que permite un eficiente traspaso de fuerzas, es virtualmente plegable y se adapta fácilmente a la morfología dentaria y al contorno del arco dentario. Dentro de sus principales características podemos encontrar: Biocompatibilidad, inerte, translúcido y durable. Dentro de la odontología se le han dado distintos usos para esta fibra, ya sea como mantenedor de espacio, puente adhesivo, poste y núcleo endodóntico, ferulización, restauraciones tipo inlay y estabilización postortodóncica. En el caso de los pacientes fisurados se ha hecho relevante el uso de Ribbond® como puente adhesivo ya que permite mejorar la estética y rehabilitar temporalmente los espacios desdentados causados por la ausencia de un incisivo, principalmente una vez terminado el tratamiento de ortodoncia y en espera de una rehabilitación definitiva, aún más cuando el paciente no ha terminado su crecimiento y desarrollo. En este artículo se presenta un caso clínico de un paciente con labio leporino y fisura velopalatina operado demostrativo de la técnica de rehabilitación con Ribbond®.

Today the increasing demand of aesthetic and minimally invasive procedures has led to a boom of the adhesive technique. Ribbond® is a polyethylene fiber that allows an efficient transfer of forces, is virtually foldable and is easily adapted to tooth morphology and dental arch contour. Among its main features we can find: Biocompatibility, inert, translucent and durable. In dentistry, different uses have been given to this fiber, whether as space maintainer, adhesive bridge, endodontic post and core, splinting, inlay type restorations and postorthodontic stabilization. In the case of cleft lip and palate patients the use of Ribbond® as an adhesive bridge has become relevant, as it improves aesthetics and temporarily rehabilitates the edentulous spaces caused by the absence of an incisor. It is used especially after completion of the orthodontic treatment and waiting for a final rehabilitation, even when the patient has not completed their growth and development. This article presents a clinical case of a patient with lip and cleft palate operated with the rehabilitation technique using Ribbond®.