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Editor-in-chief: Dr. Martina Stefanini PhD, ZTM Vincent Fehmer BDT, MDT, Dr. Alfonso Gil DDS, PhD Coordinating editor: Dr. Kristin Ladetzki QP Deutschland
Previously published as the European Journal of Esthetic Dentistry.
Boasting an editorial board that unites the world's most talented master clinicians, The International Journal of Esthetic Dentistry seeks to advance the state of the art in the practices of esthetic dentistry. Each issue features articles on the latest techniques, materials, and technology, allowing readers to obtain the knowledge and skills required to achieve the outstanding esthetic results that more and more patients are demanding. Photos of breathtaking quality grace the pages of this quarterly journal.
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Dr. Stefanini is a researcher in the Department of Biomedical and Neuromotor Sciences at Bologna University, Italy and also a dental surgeon in private practice. She graduated from the University of Bologna with a degree in dentistry in 2005. She was awarded a PhD in Medical Sciences in 2016 from the same institution. Dr. Stefanini is an ITI Fellow, has sat on of the Editorial and the Scientific Committees of the Italian Society of Periodontology and continues to be an active member. She was a Visiting Professor at San Raffaele University Milan in 2015-2016 and taught a postgraduate program at the Dental School San Raffaele, University Milan and for the II level International Master at Bologna University in 2017. Dr. Stefanini is an expert in periodontology and has authored several publications in Pubmed, as well as speaking at national and international conferences on periodontology.
Vincent Fehmer, MDT, received his dental technical education and degree in Stuttgart, Germany, before completing fellowships in Great Britain and the United States in Oral Design–certified dental technical laboratories. After working several years in such a laboratory in Berlin, he received his MDT degree and became the chief dental technician at the Clinic for Fixed and Removable Prosthodontics in Zurich, Switzerland. Since 2015, he has been a dental technician at the Clinic for Fixed Prosthodontics and Biomaterials in Geneva, Switzerland. He also runs his own laboratory in Lausanne. Mr Fehmer is a Fellow of the International Team for Implantology, an active member of the European Academy of Esthetic Dentistry (EAED), and a member of the Oral Design group as well as the European Association of Dental Technology (EADT) and the German Society of Esthetic Dentistry (DGÄZ). He is a sought-after international speaker and has received many honors for his work, including the Kenneth Rudd Award from the American Prosthodontic Society. He has published more than 50 articles in peer-reviewed journals within the field of fixed prosthodontics and digital dental technology, contributed to many books, and recently coauthored the book Fixed Restorations: A Clinical Guide to the Selection of Materials and Fabrication Technology with Irena Sailer and Bjarni Pjetursson. Mr Fehmer also serves as Editor-in-Chief for the International Journal of Esthetic Dentistry, Section Editor for the International Journal of Prosthodontics, and co-chair for the 26thInternational Symposium on Ceramics (June 2023).
Alfonso Gil is receiving a 5-year post-graduate education in Fixed and Removable Prosthodontics and Dental Material Sciences from the University of Zurich. He obtained his DDS Degree from the University of the Basque Country (2013). His Master of Science and Advanced Periodontology Implantology Certificate from the University of Southern California (USC) (2013-2016) were followed by a Certificate in Advanced Surgical Implant Dentistry from the University of California Los Angeles (UCLA) (2016-2017). He is a Diplomate of the American Board of Periodontology. He obtained his PhD with highest honors from the University International of Catalunya in November 2019. His research focuses on the treatment of peri-implant disease, soft tissue augmentation of teeth and implants and fixed prosthodontics.
In the case of discolored devitalized anterior teeth, several treatments are available to enhance the esthetic outcome, from noninvasive external/internal bleaching to freehand resin composites and more complex prosthetic solutions such as veneers or full crowns. Innovative computer-aided design/computer-aided manufacturing (CAD/CAM) chairside technologies and the introduction of new industrially polymerized composite resin blocks coupled with modern adhesive strategies have reduced both biological and financial costs compared to the classic post-core-crown approach. The aim of this article is to show how these new materials can be used in association with noninvasive internal and external tooth bleaching to restore a discolored, fractured, non-vital central incisor.
Purpose: To evaluate in vitro the vertical seating of computer-assisted design/computer-assisted manufacturing (CAD/CAM) composite resin inlays, onlays, and overlays luted with two different composite resins.
Materials and methods: Sixty plastic typodont molars were prepared for medium-sized MOD inlays, anatomic onlays, and flat overlays (n = 20); 3-mm thick at the central groove with similar morphology (Cerec biogeneric copy). Restorations were milled using Lava Ultimate blocks, and included standardized hemispherical occlusal concavity for seating measurements with an electromechanic system (force = 30 N). Restorations were luted either with preheated composite resin (Filtek Z100) or dual-cure resin cement (RelyX Ultimate). Seating of restorations was first evaluated at try-in (baseline). Seating was reevaluated after airborne-particle abrasion (Step 1), after seating with luting agent (Step 2), and after light polymerization (Step 3). The Friedman test followed by the Wilcoxon post hoc test were used to compare the seating among steps, and the Kruskal-Wallis test followed by the Mann-Whitney post hoc test were used to compare the seating between luting agents at P < 0.05.
Results: Seating differences varied significantly from baseline (P < 0.0125). All restorations seated 3.85 µm (inlays) to 5.45 µm (onlays) deeper after airborne-particle abrasion (Step 1) (P < 0.007). Except for cement-luted inlays, the try-in position (±1 µm) was recovered following unpolymerized luting (Step 2). After polymerization (Step 3), onlays and overlays seated 2.9 to 3.9 µm deeper than during try-in (baseline) using Z100 (P < 0.005), and 7.0 to 7.3 µm deeper using RelyX (P = 0.005). Inlays luted with RelyX seated higher than during try-in (baseline), exactly 7.9 µm after Step 2 (P = 0.005), and 7.7 µm after Step 3 (P = 0.008). Luting with Z100 sustained the seating of inlays with no statistical difference when compared to baseline (P = 0.157).
Conclusion: Airborne-particle abrasion significantly deepens the seating of CAD/CAM composite resin restorations, but the presence of unpolymerized restorative composite resin luting agent perfectly compensates for this discrepancy. Following polymerization, onlays and overlays seat deeper compared to inlays, especially when using RelyX. The latter, however, resulted in a slightly higher seating of inlays.
Clinical significance: With the least variation compared to baseline seating (try-in), restorative composite resin used as luting agent resulted in the seating of CAD/CAM inlays, onlays, and overlays closer to baseline when compared to dual-cure resin cement.
This article revisits the concept of biologic width, in particular its clinical consequences for treatment options and decisions in light of modern dentistry approaches such as biomimetics and minimally invasive procedures. In the past, due to the need to respect biologic width, clinicians were used to removing periodontal tissue around deep cavities, bone, and gum so that the limits of restorations were placed far away from the epithelium and connective attachments, in order to prevent tissue loss, root exposure, opening of the proximal area (leading to black holes), and poor esthetics. Furthermore, no material was placed subgingivally in case it led to periodontal inflammation and attachment loss. Today, with the more conservative approach to restorative dentistry, former subtractive procedures are being replaced with additive ones. In view of this, one could propose deep margin elevation (DME) instead of crown lengthening as a change of paradigm for deep cavities. The intention of this study was to overview the literature in search of scientific evidence regarding the consequences of DME with different materials, particularly on the surrounding periodontium, from a clinical and histologic point of view. A novel approach is to extrapolate results obtained during root coverage procedures on restored roots to hypothesize the nature of the healing of proximal attachment tissue on a proper bonded material during a DME. Three clinical cases presented here illustrate these procedures. The hypothesis of this study was that even though crown lengthening is a valuable procedure, its indications should decrease in time, given that DME, despite being a very demanding procedure, seems to be well tolerated by the surrounding periodontium, clinically and histologically.
Digital extra printPubMed ID (PMID): 30073218Pages 358-376, Language: EnglishGonzález, David / Cabello, Gustavo / Olmos, Gema / López Hernández, Emilia / Niñoles, Carlos L.
The buccal bone wall is the part of the socket of an anterior tooth that is most susceptible to resorption. Immediate implants offer advantages in terms of time, comfort, and esthetics, especially regarding the maintenance of the papillae architecture. However, the loss of the buccal bone wall is often a limitation for such a therapy. This case report describes a clinical procedure designed to reconstruct the buccal bone wall to restore an anterior tooth where this wall was absent. The approach involved a flapless immediate implant based on the principles of guided bone regeneration (GBR), and consisted of the preparation of a large, flapless recipient bed ad modum envelope, immediate implant placement, deposition of xenograft surrounding the implant surface, and coverage with a collagen membrane. Finally, a palatal connective tissue graft (CTG) was placed, and the natural tooth crown acting as a temporary restoration was delivered. One year later, a zirconia-ceramic crown was delivered. Two years after implant placement, the soft tissue level was stable. No signs of inflammation or bleeding were observed, and periapical radiographic examination revealed bone stability.
Purpose: To investigate periimplant soft tissue response following flapless extraction and immediate implant placement and provisionalization (IIPP) associated with bovine hydroxyapatite bone and connective tissue grafting in the anterior maxilla. The study evaluated the effectiveness of this technique in terms of soft tissue contours in esthetic areas with the use of the pink esthetic score (PES).
Materials and methods: In this retrospective study, 39 consecutive patients were treated and followed by two experienced clinicians for single-tooth implant treatment in the esthetic zone. Treatment consisted of flapless extraction, immediate implant placement, inorganic bovine bone filling of the periimplant gap, and connective tissue grafting. A provisional crown was placed at the time of implant placement. The final crown was positioned 5 to 8 months after surgery. To assess the esthetic outcome of the technique, the soft tissue around the tooth to be extracted was scored according to the PES by seven evaluators before the surgery at visit 1 (v1), and at least 1 year after the final prosthesis placement at visit 2 (v2).
Results: After a mean follow-up of 4 years, the mean total PES score on a scale from 1 to 10 was 5.64 and 7.07 at v1 and v2, respectively. Statistical analysis revealed a significant difference between the PES scores before surgery and at the follow-up examination of the anterior single implants (P = 0.0008).
Conclusion: Within the limitations of this study, postextraction with immediate implant loading associated with bovine hydroxyapatite and connective tissue grafting is a predictable technique. The esthetic outcome is that soft tissue seems to be maintained or improved significantly according to PES assessment compared with baseline.
This study evaluated the effectiveness of resin infiltration or enamel microabrasion for restoring color changes caused by incipient carious lesions as well as the color stability achieved by these treatments. Enamel specimens were subjected to cariogenic challenge to produce white spot lesions (WSLs) using a microcosm biofilm model. These lesions were treated with resin infiltration or enamel microabrasion (n = 8), and color changes were measured with a spectrophotometer at baseline and after the treatments. Untreated specimens were used as a control. The treated specimens were then immersed in coffee for 1 week, and tooth color was measured again. Data for ΔL*, Δa*, Δb*, and ΔE were analyzed by two-way repeated measures ANOVA and Tukey's test (α = 0.05). Caries induction resulted in significant color changes, mainly decreased lightness. Neither resin infiltration nor enamel microabrasion were able to restore tooth color. The specimens subjected to resin infiltration and the control specimens were more susceptible to color changes following immersion in coffee. In conclusion, enamel microabrasion and resin infiltration were unable to restore the initial tooth color observed prior to WSL induction. Moreover, resin-infiltrated enamel seems more susceptible to staining solutions than enamel subjected to microabrasion.
1st Edition 2022 Book Hardcover; Two-volume book with slipcase; 21 x 28 cm, 1100 pages, 6557 illus Language: English Categories: Oral Surgery, Implantology
2nd Edition 2022 Book Hardcover; Two-volumes book with slipcase; 21 x 28 cm, 888 pages, 2500 illus Language: English Categories: Restorative Dentistry, Esthetic Dentistry