International Journal of Esthetic Dentistry (EN), 03/2020

The proliferation of digital technology is progressively changing dentistry. Thanks to continual improvements in CAD/CAM devices and dental materials, it is possible nowadays to carry out a treatment plan for oral rehabilitations with fully digital approaches and noninvasive concepts. The availability of digital resources allows clinicians to increase the predictability of enhanced esthetics and good functional results. There is an increasing number of patients today who are affected by excessive tooth wear and may benefit from these kinds of treatments. This article provides a step-by-step documentation of a full-mouth rehabilitation performed with a digital approach and additive CAD/CAM composite resin restorations. An innovative functional evaluation is also documented and discussed. The initial situation was assessed and compared with the rehabilitation project through a snap-on device. After the intraoral adjustment and validation, the final rehabilitation was performed according to the information obtained in the provisional phase and digitally transmitted to the laboratory.

A modern approach to treating tooth wear aims to stop its progression at an early stage and, ideally, to install effective preventive measures or, in cases when it is already late, to intervene using an interceptive treatment approach. It is important to avoid the need for a full prosthetic treatment that implies additional tooth substance removal, with potential biologic complications. As signs of tooth wear often appear in young individuals, an interceptive treatment has the great potential of stabilizing tooth wear progression early using a no-prep approach and composite resins. The additional benefit of this treatment approach is its affordability and maintainability in the light of tooth wear being, usually, a lifelong pathology. Among the various options for restoring tooth wear lesions with composite resins, interest has lately been increasing for molding techniques (single or full) due to their efficiency and simplicity. This article describes modifications of the basic full molding technique to alleviate most of the known shortcomings of this method; namely, the index deformation, the time-consuming removal of excesses in the proximal and contact areas, and the possible insufficient precision in the molding of the occlusal anatomy. The 1- and 3-year follow-ups of both cases presented here confirmed the functional and esthetic quality of the results obtained with this technique. A kinesiographic and 3D superimposition of the posttreatment and 1-year results of one case provided additional perspectives on this treatment method.

The socket-shield technique, first published in 2010, has gained worldwide scientific and clinical acceptance. To address possible complications with this innovative approach in esthetic implant dentistry, we provide a comprehensive step-by-step protocol incorporating what we have learnt in the past decade. After initial decoronation of the tooth, the implant bed is prepared through the root of the tooth to be extracted. Following extraction of the palatal root fragments, the shield is prepared according to either a mechanical or biologic 'locking' principle. The mechanical 'locking' comprises a direct contact between the implant and the shield, whereas the biologic approach facilitates ankylosis of the shield, preventing its coronal displacement. The coronal part of the shield is brought into a concave shape, ending up 0.5 mm coronal to the buccal bone. The implant is consequently inserted, and an individualized healing cap fabricated. When performed according to the underlying biologic and mechanical principles, the socket-shield technique can provide highly esthetic and predictable outcomes.

The aim of this study was to evaluate, in vivo, the immediate masking effect of white spot lesions (WSLs) treated with an infiltrant resin (IR). The investigation was conducted on 40 young adolescent and adult patients (11 to 23 years old) who presented with at least one permanent maxillary or mandibular anterior tooth with active WSLs on the enamel (ICDAS score 2). Before resin infiltration, the color of both the WSLs and the sound adjacent enamel (SAE) was evaluated by a digital spectrophotometer (CIELab). Subsequently, a resin infiltration technique (Icon) was performed on the WSLs according to the manufacturer's instruction. At the end of the clinical session, the color of the IR was evaluated. The color difference (ΔE) was calculated between WSL × SAE, WSL × IR, and IR × SAE, and then analyzed using one-way analysis of variance (ANOVA), followed by the Tukey's test. The L*, a*, and b* values of WSL, SAE, and IR were compared using the Student's t test for related samples (α = 5%). The ΔE observed was 5.93 ± 0.41 on the WSL × IR comparison, and 5.77 ± 0.41 on the IR × S AE one, indicating that the color of the WSL changed after treatment, but that the infiltration did not fully camouflage the WSLs when compared with the SAE. The lightness was higher for the SAE than for the IR. It was concluded that the IR treatment was not able to camouflage the color of the WSLs when compared with the SAE. However, the treatment was able to attenuate the discoloration of the demineralized dental enamel.

Objective: The fluorescence properties of tooth-colored restorative materials can vary according to the shade of the material. The objective of this study was to investigate the fluorescence behavior of different shades of selected contemporary tooth-colored restorative materials when illuminated with violet light (405 nm wavelength). Methods: Fifteen different tooth-colored restorative materials, in total 111 shades, were analyzed. Samples of 10-mm diameter and 5-mm thickness were fabricated for each shade. The levels of red, blue, green, and luminosity were analyzed for each sample under 405 nm illumination and an orange long pass filter, using data from the histogram tool in Adobe Photoshop software. Results: There were significant variations in fluorescence luminosity according to both shade and manufacturer. Within any one brand of material, fluorescence emissions differed according to shade, with the lightest shades giving the strongest emissions. Variations in fluorescence were most prominent for composite resins, followed by ormocers, and then glass-ionomer materials. There were also significant variations in fluorescence luminosity between materials of the same shade made by different manufacturers. Conclusion: Fluorescence emissions vary considerably among different shades of the same material, and between different materials that are labelled as having the same shade. In the present study, the lightest shades had the greatest emissions under UV light.

Aim: This study was conducted to assess the masking effects of some experimental resin infiltrants containing bioactive glass (BAG) and nano-fluorohydroxyapatite (n-FHAP) on enamel white spot lesions (WSLs). Materials and methods: Fifty enamel specimens were embedded in an acrylic resin and divided into five groups (n = 10). After creating artificial enamel lesions, the specimens were infiltrated by the following resins: 1) Group 1 (T/control group): TEG-DMA; 2) Group 2 (T2H): TEG-DMA + 2 wt% n-FHAP; 3) Group 3 (T5H): TEG-DMA + 5 wt% n-FHAP; Group 4 (T2B): TEG-DMA + 2 wt% BAG; Group 5 (T5B): TEG-DMA + 5 wt% BAG. Next, the specimens were subjected to demineralization–remineralization cycles for 2 weeks. Color assessments were performed by a spectrophotometer in four distinct stages: baseline, after the production of artificial caries, after resin infiltration, and 2 weeks after resin infiltration. L*, a*, b*, and ΔE values were calculated at each stage. Color parameters were analyzed statistically using the Kruskal-Wallis and Mann-Whitney U tests. The significance level was set at 5%. Results: All treatments led to a decrease in the L3* compared with the L2* value. The resin infiltrant containing 5% fluorohydroxyapatite (FHAP) exerted the highest L* reduction effect among all the groups. The T group was the only resin infiltrant group with a lower mean of a4* than those compared at baseline. Regarding the ΔE13* and ΔE14* values, only the resin infiltrants of groups 1 (T), 2 (T2H), and 3 (T5H) were able to mask artificial caries. Conclusion: Experimental resin infiltrants containing n-FHAP were able to mask WSLs after 14 days.

Aim: Die silicone materials are used to build chairside composite restorations. The purpose of this study was to compare the flowability, dimension accuracy, and tear strength of four elastomeric die materials. Material and methods: Materials were divided into four groups: Mach-2 (M2), Scan Die (SD), GrandioSO Inlay System (GIS), and Impregum-F (IM). Flowability analysis was carried out using the shark fin test (SFT). For dimension accuracy, impressions were taken from a premolar Class I preparation and an elastomeric model was cast. Composite resin restorations were built and positioned into the premolar for gap measurement. The mean gap length was divided into three levels: acceptable (A), not acceptable (NA), and misfit (M). For tear strength, strip specimens were made with a V-shaped notch (n = 6). The specimens were tested in a universal machine until tear. All data were analyzed statistically with a confidence interval of 95%. Results: GIS showed the lowest flowability values, with no differences between IM, M2, and SD. For dimension accuracy, IM showed 100% 'A' gap values, followed by M2 (80%), SD (60%), and GIS (60%). For tear strength, IM showed the highest values, followed by M2, GIS, and SD. Conclusions: M2, SD, and IM had similar flowability, while GIS had the lowest. IM presented higher tear strength than M2, followed by GIS and SD. IM showed the highest degrees of acceptable gap filling, followed by M2.

This erratum serves to correct the misplacement of the images on this page in the IJED Supplement of the Proceedings of the 2019 Autumn Meeting of the EAED entitled 'Anterior Missing Teeth and Growth' published in the summer, 2020. Please find the correct PDF using the QR code or link provided on the page. We apologize for any inconvenience this may have caused our readers.