Contemporary management of generalized erosive tooth surface loss.

UNLABELLED: Management of generalized erosive tooth surface loss can be challenging. Careful pre-operative assessment of the patient and treatment planning is essential. The aim of any treatment provided is to prevent further tooth surface loss, restore aesthetics and function, and provide a stable occlusal relationship. Whilst attempting to fulfil these goals, it is important to protect the remaining tooth structure by using restorations which are conservative and do not cause further damage to teeth which are already compromised. This paper aims to describe a conservative approach to restoring patients with generalized tooth surface loss. CLINICAL RELEVANCE: To highlight conservative treatment options available for the management of generalized erosive tooth surface loss and show how they contrast with other destructive irreversible conventional techniques.

Dentinogenesis imperfecta: full-mouth rehabilitation using implants and sinus grafts--a case report.

UNLABELLED: This case report outlines one possible treatment modality to manage the developmental abnormality dentinogenesis imperfecta (DI). In this case, the patient's dentition is restored using a combination of full-coverage crowns for the remaining teeth and implant-supported crowns to replace missing teeth in a re-organized occlusal scheme. The case also demonstrates the effective use of the sinus graft procedure with simultaneous placement of dental implants. This paper also aims to make the reader aware of the current thinking behind treatment delivered to this group of patients, focusing on full-mouth rehabilitation using a combination of implant-supported and conventional metal ceramic crowns. CLINICAL RELEVANCE: For the general dental practitioner this case outlines the prevalence and cause of DI. It demonstrates how early diagnosis and appropriate referral has an impact on future treatment.

Aesthetic preview: a novel approach.

UNLABELLED: Planning the final aesthetic result of restorative treatment is a key skill needed by the clinician to ensure predictable success. This paper aims to review current techniques that may be used by clinicians for an aesthetic preview, whilst also highlighting a simple technique that may be readily utilized in practice. CLINICAL RELEVANCE: It is considered good practice to give patients an aesthetic preview of the end result prior to commencing active treatment. This article demonstrates the different techniques available and those that are easily utilized in general practice. The aesthetic preview is of benefit to both the clinician and technician in defining treatment goals and improving communication.

The ovate pontic for fixed bridgework.

UNLABELLED: The provision of fixed prosthodontic restorations that meets the patient's functional and aesthetic demands can be challenging, especially in the anterior maxilla. It requires close communication with the technician and knowledge of the available options. This article will outline the options for pontic design and focus on the ovate pontic, which has the potential to provide the most aesthetic outcome. This should equip the practitioner with the knowledge as to which pontic to prescribe if such a challenge arises. CLINICAL RELEVANCE: Fixed bridgework is a commonly prescribed prosthesis for the replacement of missing teeth. In order for this to be provided successfully, the practitioner should have a working knowledge of the available options for pontic design.This is especially important in cases where aesthetic demands are high.

Techniques for restoring worn anterior teeth with direct composite resin.

UNLABELLED: Toothwear is increasing in prevalence. Traditional treatment methods for moderate or advanced toothwear, such as indirect restorations and crown lengthening surgery, are invasive and destructive of remaining tissues. The 'Dahl technique' has been used to obtain space for anterior restorations and has been modified such that direct composite restorations are placed at increased occlusal vertical dimension. These restorations have proved durable and aesthetic, protect tooth structure and posterior occlusal contact is predictably re-established. The authors describe and compare two techniques using composite resin to treat localized anterior toothwear in a general practice setting. CLINICAL RELEVANCE: Toothwear is a significant clinical problem and general dental practitioners and specialists alike must be familiar with the available conservative treatment options.

Conservative aesthetic techniques for discoloured teeth: 2. Microabrasion and composite.

UNLABELLED: The first article in this series discussed the minimal intervention approach to discoloured teeth, starting with dental bleaching. This second article goes on to explain the technique of microabrasion and the use of direct composite techniques. CLINICAL RELEVANCE: Microabrasion and composite can provide minimally invasive treatments for discoloured teeth.

Cosmetic rehabilitation following successful treatment of aggressive periodontitis.

UNLABELLED: With advances in periodontal therapy, many sufferers from aggressive periodontitis are retaining their teeth after successful treatment. This presents the practitioner with aesthetic and restorative challenges in these relatively young patients. Lifelong motivation is essential to the supportive therapy for these patients, and the maintenance of good aesthetics, combined with biologically acceptable corrective therapy, may help maintain a high level of motivation. Any treatment provided must naturally be conducive to maintaining long-term dental and periodontal health. This paper aims to demonstrate options for dealing with the aesthetic challenges posed by a number of patients who have undergone initial cause-related therapy for aggressive periodontitis. CLINICAL RELEVANCE: Loss of gingival tissue, tooth positional changes and tooth loss present practitioners with challenges in relation to patient satisfaction with aesthetics following advanced periodontal breakdown. A range of techniques will be required, tailored to the consequences of periodontal attachment loss, in order to satisfy patient demands.

Conservative aesthetic techniques for discoloured teeth: 1. The use of bleaching.

UNLABELLED: There is an increasing move towards more minimally invasive techniques in restorative dentistry. This series of two articles discusses conservative techniques for the treatment of discoloured teeth. A step-wise approach to treatment is promoted to encourage the most conservative solution to achieve satisfactory aesthetics. The first of these two articles will describe the use of bleaching, whilst part two will go on to describe microabrasion and the use of direct composite resin. CLINICAL RELEVANCE: Discoloured teeth are a common dental problem. Bleaching provides a simple conservative solution in many cases.