Oral Health Group
Continuing Education

Anterior Esthetics – Patients Expectation and Clinical Realities

May 28, 2020

Dr Roberto Turrini

Today’s clinicians are frequently faced with the difficult challenge of covering tooth discoloration that can be quite severe. Currently, we can use the extremely predictable technique of dental bleaching, allowing us to avoid having to cover discoloured elements and to achieve excellent results in terms of esthetics and durability. The choice of extremely versatile products, together with the use of appropriate techniques, facilitates the work of the clinician in cases involving discoloration of medium severity. Dental bleaching procedures can be combined with restorative and prosthetic treatment in order to achieve the best possible results. In more complex situations, it is possible to use high-performance ceramic materials and minimally invasive procedures in order to perform highly esthetic rehabilitations. Choosing the ideal ceramic ingot and communicating the actual abutment shade to the lab are the new challenges. Shade matching using innovative systems is not only crucial for the choice of the ingot, but also for the cementation process, especially if thin restorations are involved. Last but not least, in any prosthetic treatment it is very important to use a precise workflow and to identify the risks in advance in order to obtain esthetic and functional results.

Assoc. Prof. Dr. Gil Tirlet

Single missing anterior teeth frequently represent a great challenge: It is very difficult to replace them prosthetically and achieve great biological and esthetic results. The use of bonded bridges is not new and many authors have documented this subject. Conventional bonded bridges (with two retainers) are clearly a recognized prosthetic treatment and therefore deserve their place in the clinician’s therapeutic arsenal. The cantilever bridge (with a retainer on only one side) is a particularly attractive biological and biomechanical alternative. Studies scientifically support the use of cantilever bridges made of ceramic. Regarding the use of lithium disilicate, recent clinical studies report very positive survival rates. This solution is a smart alternative to the anterior implant, particularly in situations of lateral agenesis or trauma involving the loss of an anterior tooth, primarily in young patients, but also in adults and seniors. This is also confirmed by the personal experiences we have made since 2008. Thus, ceramic cantilever bridges are an attractive alternative to implants. However, practitioners need to select the clinical cases carefully and apply the procedure rigorously. During this lecture, we will analyse the fundamental and clinical aspects of the realization of bonded cantilever bridges made of glass-ceramic (lithium disilicate) based on 10 “recipes”.


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