Michel Magne

An esthetic solution for single-implant restorations – type III porcelain veneer bonded to a screw-retained custom abutment: A clinical report

A new esthetic solution to restore dental implants in combination with limited interdental, facial or labial, or interocclusal space is presented. This article describes the translational application of novel-design porcelain veneers and adhesive restorative principles in the implant realm. A patient is presented who was treated with a single implant-supported restoration replacing a missing mandibular lateral incisor and partially collapsed interdental space. A screw-retained custom metal ceramic abutment was combined with a bonded porcelain restoration. This unique design was motivated by the limited restorative space and subgingival implant shoulder. It was also developed as a solution to the interference of the screw-access channel with the incisal edge, therefore providing the surgeon with more options during implant axis selection. The porcelain-to-porcelain adhesive approach was used instead of traditional principles of retention and resistance form of the abutment.

An approach to biomimetics: the natural CAD/CAM restoration: a clinical report.

Those in the dental field have always pursued the perfect dental material for the treatment of compromised teeth. Gold, amalgam, composite resin, glass ionomer, and porcelain have been used. Tooth-like restorative materials (composite resin and porcelain) combined with an effective hard tissue bond have met the growing demand for esthetic or metal-free restorations in the past 15 to 20 years. However, none of those materials can fully mimic the unique properties of dentin (compliance and crack-stopping behavior) and enamel (wear resistance, function). The aim of this article is to report the restoration of an extensively damaged tooth with a natural restoration obtained by milling an extracted third molar tooth with a computer-aided design and computer-aided manufacturing (CAD/CAM) system. The main benefit of this novel technique is the replacement of lost tissues by actual enamel and dentin, with the potential to recover mechanical, esthetic, and biologic properties. The indication for extracting third molars and premolars because of impaction or for orthodontic reasons makes these posterior teeth readily available. The innovation of the method presented here is the optimal use of the extracted tooth substrate thanks to its positioning technique in the CAD/CAM milling chamber.

Influence of symmetry and balance on visual perception of a white female smile

Statement of problem. Clinicians and dental technicians may underestimate what is deemed esthetic by laypersons and dental professionals. Purpose. The purpose of this study was to define the relative importance of symmetry, visual tension, and balance in the smile. Material and methods. Images of a white woman were altered to reproduce symmetry, various visual tensions, distinct tooth shapes, and color changes. A 12‐question survey was presented to 128 individuals, including 81 dental professionals and 47 laypersons. The survey asked individuals to choose the most desirable and beautiful image in a choice of images. Results. Raters were most influenced by the maxillary central incisors and then the canines and were more forgiving on visual tensions of the maxillary lateral incisors. Square‐shaped teeth were preferred over ovoid and triangular ones. The more upright the canines, the more the smile was perceived as masculine. Teeth whiter than the sclera of the eyes were preferred, with lay individuals choosing the lightest shade available and dental professionals choosing the shade slightly lighter than the sclera. Although participants mostly preferred a symmetrical smile, they opted for the natural face as opposed to symmetrical ones. Conclusions. Location of visual tension plays a role in perceiving beauty. Symmetrical smiles were considered more pleasant but not symmetrical faces. Imperfections play an essential role in perceiving beauty because they express life, individuality, charisma, and charm.

Diagnostic waxing transfer from diagnostic casts to soft tissue definitive casts

aAssociate Professor, Division of Primary Oral Health Care; Director, University of Southern California Center for Dental Technology. bSenior Dental Technologist, University of Southern California Center for Dental Technology; Division of Primary Oral Health Care. cAssociate Professor, Division of Primary Oral Health Care; Don and Sybil Harrington Foundation Chair of Esthetic Dentistry. (J Prosthet Dent 2008;99:•••-••) Fabricating quality anterior esthetic restorations, such as porcelain veneers and crowns, requires the fabrication of a soft tissue definitive cast with removable dies and a hard stone gingiva.1,2 This cast is essential to the integration of the definitive restoration with the architecture of the gingiva. It is obtained by repositioning a set of dies (trimmed as a root form with antirotation grooves) into the definitive impression, and subsequently pouring a solid base.1,2 This so-called “alveolar cast” (cast base with alveolar sockets) is not a substitute for another important cast, the solid cast, which is obtained from a single pour of the definitive impression, trimmed and mounted in an articulator. The solid cast represents the most accurate reference for intertooth relationships, and is used only during the final stage of laboratory procedures, for evaluation of the occlusion of the restoration. During the initial stage of restoration fabrication, the soft tissue cast (alveolar cast) will be primarily used. The ceramist is guided by the diagnostic waxing from the diagnostic cast. To facilitate this task, a method to accurately transfer the diagnostic waxing onto a set of removable dies for the soft tissue definitive cast is described. Because all sets of dies result from precise duplication of the original single dies, they all feature identical root portions that fit the alveolar stone base. The dies with transferred waxing can therefore be used alternatively or in combination with the original stone dies or refractory dies, using the same alveolar base (Fig. 1).