A multidisciplinary approach to the treatment of a complex case: analog and digital procedures

A multidisciplinary approach to the treatment of a complex case: analog and digital procedures

 

ITALIAN VERSION

 

The clinical case we present here regards a 25-year old girl who underwent an extremely severe car accident in which she was the only one survivor out of 4 passengers of the same age. 

A multidisciplinary approach to the treatment of a complex case: analog and digital procedures ultima modifica: 2017-03-31T07:09:54+00:00 da Matteo Chiapasco

Tooth Isolation. The Rubber Dam, suggested or obligatory?

Tooth Isolation. The Rubber Dam, suggested or obligatory?

 

ITALIAN VERSION

The need to work under dry conditions, free of saliva, has been recognized for centuries, and the idea of using a sheet of rubber to isolate the tooth dates exactly 153 years! The introduction of this notion is attributed to a young American dentist from New York, Sanford Christie Barnum, who in 1864 demonstrated for the first time the advantages of isolating the tooth with a rubber sheet.

Tooth Isolation. The Rubber Dam, suggested or obligatory? ultima modifica: 2017-03-06T09:30:31+00:00 da Arnaldo Castellucci

Compound preparation design on 3.3: Vestibular 100° shoulder; Lingual conservative micro-chamfer.

Compound preparation design on 3.3:  Vestibular 100° shoulder; Lingual conservative micro-chamfer.

Dear friends,

I’m doctor Loris Prosper a dentist and a dental technician. I love our beautiful work since I started doing it, more than 45 years ago. My area of expertise is fixed prosthodontic in aesthetic area that, in my opinion, should respect biology, preserve teeth and soft tissue health and respond to minimal invasive criteria since we make irreversible procedure when we prepare the abutment. It is only a short while I’ve published the book :”Bioestetics  in the Oral Reabilitation “ Quintessence Publishing , that collects my expertise and my researches. Since the beginning of my practice my mission was to teach all the technical expertise and the tricks I’ve been acquiring through experience and mistakes.

Much contemporary literature mainly focuses on abstractions not linked to daily practice of either general either specialist dental practitioner.

Compound preparation design on 3.3: Vestibular 100° shoulder; Lingual conservative micro-chamfer. ultima modifica: 2016-10-11T10:35:27+00:00 da Loris Prosper

Anterior partial edentulism: the Fence Technique

Anterior partial edentulism: the Fence Technique

ITALIAN VERSION

 

 

 

A serious car accident caused severe damage, both systemically as well as to the oral cavity of a young 17 year old female (Fig. 1).
The loss of teeth, hard tissue and soft tissue in the fifth sextant resulted in a critical esthetic-functional deficit.

The patient’s request was to restore the compromised zone with a prosthetic rehabilitation that would be as similar as possible to the area prior to the trauma, avoiding solutions that foresee the presence of artificial gingiva .

The required vertical bone regeneration exemplifies one of the most complex procedures, mainly with regards to the correct management of the soft tissue compromised by the injury.

Following an accurate clinical-radiographic assessment of the skeletal maturity, a complex therapeutic strategy was undertaken (Figs. 2, 3).

Anterior partial edentulism: the Fence Technique ultima modifica: 2016-09-07T10:35:16+00:00 da Mauro Merli

The Classic 3-STEP Technique, a simplified protocol for ADDITIVE adhesive rehabilitations

The Classic 3-STEP Technique, a simplified protocol for ADDITIVE adhesive rehabilitations

VERSIONE ITALIANA

 

Introduction

Patients affected by dental wear often are treated only when their dentation becomes extremely compromised.

However, when pathologies such as dental erosion, and/or parafunctional habits are not intercepted at an early stage, full mouth rehabilitations, mostly implementing crowns, are often considered. Thanks to improved adhesive techniques, the indications for crowns have decreased and a more conservative approach can be nowadays proposed to protect the remaining tooth structure.

The Classic 3-STEP Technique, a simplified protocol for ADDITIVE adhesive rehabilitations ultima modifica: 2016-07-20T12:42:07+00:00 da Francesca Vailati

A new challenge in dentistry – Complex Oral Surgery in the Office

A new challenge in dentistry – Complex Oral Surgery in the Office

ITALIAN VERSION

Root canal therapy of a molar tooth was a sophisticated treatment 50 years ago: the extraction was the rule.

Endodontics of a molar tooth is still a sophisticated treatment today, but it has become a normal dental procedure in any dental office.

What has changed? Tools, techniques, mentality of the dentist and patient needs.

Dentists today are used to working in very narrow spaces.

Progress in some surgical disciplines, such as periodontology and implantology, has been extraordinary.

Oral surgery, however, was excluded: the tools and techniques for the extraction of wisdom teeth are the same as 50 years ago, even in the video clips we see today on the Internet.

The contrast is even more striking when we consider that dentists safely perform sinus lift procedures in their offices, while referring cases of cysts to hospitals. Yet, the elevation of the sinus membrane requires greater skill than the detachment of a cyst wall.

A new challenge in dentistry – Complex Oral Surgery in the Office ultima modifica: 2016-04-08T15:40:30+00:00 da Roberto Barone

Maxillary sinus surgery: lateral approach. The state of the Art

Maxillary sinus surgery: lateral approach. The state of the Art

 

ITALIAN VERSION

 

Introduction

The physiological resorption of alveolar process in the corono-apical and vestibular-palatal direction following tooth loss often does not allow the positioning of implants in the posterior part of the upper jaw without an adequate bone reconstruction. The functional load exerted on the residual crest which transforms into compression force favors centripetal and cranio-caudal bone resorption (Cawood et al. 1988) with consequent reduction in size of the alveolar process associated with a progressive pneumatization of the maxillary sinus.

Among the pre-implant surgical procedures for bone reconstruction, the maxillary sinus surgery has been shown to have a high clinical predictability (Wallace et al. 2003,Del Fabbro et al. 2004-2008-2012-2013 a-b, Pjetursson et al. 2008, Testori et al. 2012). Historically in cases of bone atrophy where the residual bone is less than 4 mm, the lateral approach was utilized.

Maxillary sinus surgery: lateral approach. The state of the Art ultima modifica: 2016-01-11T11:19:14+00:00 da Tiziano Testori

Digital Smile Design interdisciplinary approach

Digital Smile Design interdisciplinary approach

The “Excellence in Prosthodontics” award winning case

 

ITALIAN VERSION

 

Summary:

Limitations in treatment planning are unpredictable due to poor communication between operator – patient, interdisciplinary team, lab technician and clinical factors overlooked by the lack of information .

Tools such as photographys , videos and computer are essential for communication with the patient to create expectations through prototypes that can result in a temporary restoration that will help us see the functional , biological, mechanical and aesthetic performance of the same and future the final restoration.

Digital Smile Design interdisciplinary approach ultima modifica: 2015-12-03T11:04:19+00:00 da Ernesto Guzman

Rehabilitation of maxillary edentulism by means of computer-guided implant surgery and provisional prosthesis with immediate loading

Rehabilitation of maxillary edentulism by means of computer-guided implant surgery and provisional prosthesis with immediate loading

ITALIAN VERSION

 

Computer-guided implantology and immediate loading with CAD-CAM screw-retained full-arch temporary prosthesis

 

A 41 year-old female patient presented with multiple missing teeth at both dental arches and a few remaining elements, among which fractured and non vital teeth. Moreover, the patient, in good general health but with poor oral hygiene, presented with reduced vertical dimension of occlusion (VDO), insufficient labial support and prosthetic space limited by macroglossia. The patient lamented severe functional problems, related both to mastication and speech, as well as serious esthetic concerns, since the maxillary teeth were not visible at all both at rest and during function.

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Rehabilitation of maxillary edentulism by means of computer-guided implant surgery and provisional prosthesis with immediate loading ultima modifica: 2015-10-12T15:26:04+00:00 da Fabio Cozzolino

“Fence Technique”: an innovative reconstruction procedure

“Fence Technique”: an innovative reconstruction procedure

 

ITALIAN VERSION

 

Edentulism was defined as a pathological condition by the World Health Organization in 1990. The discomfort and inconvenience that this condition can generate in terms of aesthetics, function, as well as psychologically, can be so debilitating as to consider edentulism a social handicap.

Due to the gradual increase in the average age of the population, today there are more and more people in their seventies who are enjoying overall good health and intrapersonal relationships. Their expectations have significantly increased as well, and as patients are no longer satisfied with traditional removable dentures; explicit requests are now frequently made for fixed prosthetic solutions with a high level of aesthetics and correct function.

One such example is this patient who came to our observation in 2009 complaining of severe discomfort from a functional and aesthetic perspective (Fig. 1). His dentures were worn and unstable, causing frequent lacerations and sores on the gingival tissues and oral mucosa. The patient reported that this condition was causing psychological problems and lowering his self-esteem, therefore his desire was to solve this complex situation , if possible, with a fixed prosthesis. The assessment of the patient’s systemic risk profile pointed out that his general health conditions were good and that he would classify as ASA class I (Owens et al. 1978).

The evaluation of local risk factors showed the presence of few dental elements (that were in fact compromised) and a particularly marked atrophy of both the upper and lower jaw. The severe bone deficit could have been related also to infrequent readjustment of the prosthesis.

 

“Fence Technique”: an innovative reconstruction procedure ultima modifica: 2015-07-02T16:55:53+00:00 da Mauro Merli