International Journal of Esthetic Dentistry (EN), 02/2007

This article presents two prosthodontically treated patient cases that were observed over a period of at least 5 years after treatment. The evaluation, diagnosis, treatment planning, and treatment stages were critically reviewed and reassessed from different perspectives. The conclusions drawn from this evaluation were subsequently implemented in a third clinical case. To ensure the long-term success of a restoration, certain biologic and mechanical principles must be observed, and the appropriate prosthodontic treatment must be chosen accordingly.

This article presents the essential aspects for understanding and reproducing the color of natural teeth with the use of direct resin composite. Fluorescence and opalescence are discussed, with special emphasis on counter-opalescence, which is primarily responsible for the appearance of an orange discoloration at the mamelon dentin tips and incisal edges of anteriorteeth. The dynamics of color in natural teeth in relation to age is also discussed, focusing on the age-related changes that occur in enamel, dentin, and pulp. Further, it is demonstrated how to reproduce the esthetic features of natural teeth using latestgeneration direct resin composites.

Scientific progress in adhesive dentistry has led to more conservative techniques, both direct and indirect, to solve esthetic problems in anterior teeth. This article will discuss only indirect techniques, which are clearly superior in complex cases in which it will be difficult to recreate harmonious tooth shape and color. After reviewing the literature and highlighting the properties of this technique, the indications and benefits compared to the direct technique will be assessed. This is followed by a step-bystep description of operative procedures, from treatment planning to relining and polishing of the cemented adhesive restoration. The long-term success of veneers depends mainly on the tooth preparation, which should be confined to enamel, involve proximal contact areas, maintain the cervical enamel margin, and incorporate the incisal edge to increase veneer resistance and enable correct placement. Although no clinical follow-up similar to that of ceramic materials is available, the latestgeneration resin composites offer interesting features. They can withstand mechanical stress, have excellent esthetic properties, and, most importantly, can be repaired intraorally without impairing their physicochemical and mechanical properties.

The increasing knowledge of microhybrid composite materials has offered clinicians multiple restorative options. The use of products that guarantee a high adhesive capacity, isolation via rubber dam, and anatomic shaping with thin layering and adequate cyclic polymerization are the bases for a predictable result. Further, a finishing and polishing system that takes into account the superficial roughness and esthetic characteristics of the restorative material is the final element of a restoration that has been fabricated following correct treatment guidelines. This article aims to provide a protocol for the management of direct resin composite restorations and to discuss the correct operative sequence, particularly for the restoration of Class II cavity preparations.

This two-part treatment series discusses the prosthodontic rehabilitation of a female patient with a severe preexisting periodontal condition. In Part 1, the diagnostic and treatment planning strategies are presented, and the advantages and disadvantages of several treatment options are discussed in terms of function, esthetics, and long-term stability. In Part 2, the selected treatment will be revealed and discussed in detail.

The purpose of this study was to determine the staining potential of glass-ionomer and composite resin restorative materials following immersion in common beverages. Nine tooth-colored restorative materials were used: three glass ionomers (ceramic- reinforced, resin-modified, and conventional) and six composite resins (nanofilled, ormocer-based, flowable ormocer-based, polyacid-modified, microhybrid, and flowable microhybrid). Disk-shaped specimens were prepared and immersed in 37°C distilled water for 24 hours. Over a 2- week period, five specimens of each material were immersed daily in one of three test beverages (coffee, tea, or cola), then stored in distilled water. A control group of five specimens of each material was continuously immersed in distilled water during the test period. Color coefficients (CIELab) were measured by a spectrophotometer before and after staining. All materials were susceptible to staining by all test beverages, while distilled water caused no perceptible color change. As determined by ANOVA and Bonferroni tests, there were highly significant differences in the change in color (ΔE) for tested materials in different beverages (P = .001). The ΔE was significantly higher for coffee and tea than for cola; the ΔE was significantly higher for the polyacid-modified composite resin than for all other materials. The material with the least amount of color change in coffee and tea was the ceramic-reinforced glass ionomer (ΔE = 12.45 and 10.64, respectively) and in cola was the nanofilled composite resin (ΔE = 1.93).