Minimal Tooth Reduction Research Articles

Aesthetic Rehabilitation with Veneers Using Digital Precision: A Case Report

Smiling is an essential aspect of daily life, and a confident smile can greatly impact an individual's self-esteem. Aesthetic correction of the anterior teeth poses a challenge in dentistry, particularly in cases where there is spacing between the teeth. This can lead to a lack of confidence and negatively affect a person's self-image. Laminate veneers, a cosmetic dental procedure, involve attaching a thin layer of porcelain or resin composite material to the surface of a tooth. Compared to conventional methods, digital technology offers greater precision and efficiency in placing laminate veneers. Computerised templates guide the teeth preparation process, ensuring minimal tooth structure removal and accurate fitting of the veneers. The present report presents a case (43-year-old female patient) of spacing in the maxillary anterior that was corrected using a minimally invasive technique with laminate veneers and a fully digital workflow using lithium disilicate. The use of this material enhances the aesthetics of the patient's smile, requiring minimal tooth reduction and providing a natural appearance. The paper also includes a nine-month follow-up. Incorporating digital technology in the creation and placement of laminate veneers offers numerous benefits, including improved accuracy, reduced turnaround time, and the ability for patients to preview their enhanced smile.

MINIMALLY INVASIVE TECHNIQUE FOR ANTERIOR TEETH REPLACEMENT- CASE SERIES

Patients are very much concerned nowadays about the replacement of their missing teeth. Missing anterior teeth are a serious concern for patients, be it an aesthetic concern or functional loss. Aesthetics is the harmony between the teeth and the entire stomatognathic system. Aesthetic is the art that the dentist must procure, with a subtle touch of artistry, appreciation, and scientific knowledge, touch to recreate the beauty of a smile that suits the face and the personality of an individual. Beauty is in the eye of the beholder hence beauty is perspective. Science and dental treatment have progressed over the years, bringing us various options from removable partial dentures to fixed partial dentures and implants. Treatment options are delineated based on the patients concern as well as anatomic, functional, and scientific norms. Every treatment being fixed or removable has its own merits and demerits. An appropriate treatment plan should look into not only the aesthetic needs of the patient but also try to restore and maintain the harmony of the entire orofacial complex. Anterior teeth replacement can be done using a short-span cantilever bridge, as it is conservative and has a significant survival rate. Conventional cantilever fixed partial dentures have a survival rate of 82% over 10 years [1]. Maryland bridge is amongst other options which necessitate minimal tooth reduction with optimum bonding using adhesive cement.

The aesthetic management of diastema closure treatment with indirect veneer using lithium disilicate: A case report

Background: Diastema is a space between two or more adjacent teeth that can interfere with the patient's aesthetic appearance. Various aesthetic treatments can be performed for diastema closure on anterior teeth, one of which is through the installation of veneers. The lithium disilicate ceramic material produces the thinnest veneer and has better properties than other materials, and is able to cover the anterior diastema with a fairly large width. Purpose: To describe the aesthetic procedure for closing the diastema of anterior teeth using indirect lithium disilicate ceramic veneer. Case(s): A 29-years-old male patient came with a complaint of dissatisfaction with her smile because of a gap between teeth 12 and 13. The teeth are in vital condition with normal overjet and overbite, and there are no systemic health problems. Case Management: The management of diastema closure on teeth 12 and 13 was carried out with indirect lithium disilicate veneer treatment. Lithium disilicate veneer has promising aesthetic results due to its enamel-like nature, minimally invasive because it requires minimal tooth reduction, good strength, and did not cause gingival irritation. As a result, this treatment could increase self-confidence of the patient. Conclusion: Diastema closure treatment using indirect lithium disilicate veneer is an effective treatment, gives satisfactory results and can increase the patient's confidence.

Three-year clinical performance of posterior monolithic zirconia single crowns

Statement of problemMonolithic zirconia has become widely used for single crowns, with the advantages of minimal tooth reduction and good esthetics. However, clinical studies evaluating the performance of and patient satisfaction with posterior monolithic zirconia crowns are sparse. PurposeThe purpose of this clinical study was to evaluate the clinical performance of and patient satisfaction with posterior monolithic zirconia crowns. Material and methodsWithin a prospective cohort study design, participants were recruited from a university dental clinic if they required 1 posterior monolithic zirconia crown. The clinical performance was evaluated at follow-up appointments 1, 2, and 3 years after insertion. Bleeding on probing and pocket probing depths for the crowned teeth were recorded. Overall patient satisfaction was measured by using a visual analog scale (VAS), and quality of life was measured by using the validated German version of the Oral Health Impact Profile 14 (OHIP-G14). Descriptive statistical methods were applied. Mean values were calculated and compared by using the paired t test (α=.05). ResultsThirty participants received a monolithic zirconia crown (14 premolars, 16 molars). One biologic complication (vertical root fracture) was identified at the 1-year follow-up. Three years after insertion, 22 participants could be examined, and the crowns were still in function. The gingival and the periodontal status of the crowned teeth had not changed significantly over the 3 years. After insertion, a significant improvement in patient satisfaction was measured up to 3 years ConclusionsPosterior monolithic zirconia crowns led to enhanced patient satisfaction up to 3 years after insertion. They provided good middle-term success and offered a promising alternative to conventional metal-ceramic crowns.

Smile Designing Using Laminate Veneers – A Case Report

Aim: To describe a treatment plan that serves as a functional and aesthetic alternative to orthodontic treatment options that may be time-consuming, for mild crowding in anterior teeth wherein only aesthetics is of concern. Background: Laminate veneers are a conservative alternative to full coverage crowns for improving the appearance of the anterior teeth. Adhesive technologies make it possible to bond the prosthesis whilst preserving the tooth structure.[3] Immediate results are achieved since the prosthesis could be delivered within a few days. Ceramics are aesthetic, biocompatible, wear- resistant, exhibit excellent colour stability, and present a thermal coefficient of expansion similar to enamel. Hence prove to be the most desired material for laminate veneers. Case Description: Laser gingivoplasty was done on the maxillary anterior (13 to 23) to align the gingival zenith. Veneer preparation was done on the same teeth with minimal tooth reduction (0.5 mm) on the enamel only. All-ceramic veneers were bonded to the teeth with light cure resin cement to achieve the desired aesthetic results. Conclusion: Smile aesthetics can be achieved only when there is harmony between the teeth and the gingival zenith. With proper diagnosis and treatment planning, a desirable aesthetic result was achieved. Clinical Signification: Smile designing includes scientific and artistic principles, which helps in creating an aesthetic smile. These norms were found through the collection of data from patients, diagnostic casts, mock wax-ups, measurements, concepts of beauty, and golden proportions.

Survival of posterior fixed partial dentures with minimal tooth reduction and improved esthetics: An in vitro study

Statement of problemDifferent designs of posterior minimally invasive fixed partial dentures (MIFPDs) still require additional tooth preparation for guide planes, occlusal rest seats, and grooves and/or slots to increase retention and resistance forms. Whether a design with less tooth reduction can be successful is unclear. PurposeThis in vitro study compared the long-term survival and retention after cyclic loading of a conventional MIFPD and a posterior MIFPD that was designed for less tooth reduction and improved esthetics. Material and methodsPreviously frozen extracted human premolars and molars were embedded in polymethylmethacrylate resin blocks to simulate the loss of a first molar. The block specimens were divided into 3 groups (n=10) according to prosthesis design: control, a conventional posterior MIFPD with partial-coverage retainers; A2S, a 2-part posterior MIFPD with a semiprecision attachment; and A3, a 3-part posterior MIFPD. The prostheses were cemented onto the abutments with 4-methacryloxyethyl trimellitate anhydride/methylmethacrylate-tri-n-butylborane (4-META/MMA-TBB) resin. The specimens were subjected to 2 500 000 cyclic loading cycles with a compressive force of 50 to 800 N in a universal testing machine. After cyclic loading, the intact prosthesis was removed by using tensile force at a crosshead speed of 1 mm/min until failure. The mode of failure and bonding interface were evaluated by using stereomicroscopy and scanning electron microscopy. The retention data were analyzed by using 1-way ANOVA and the Tukey honestly significant difference (HSD) test (α=.05). ResultsNo prosthesis detached during cyclic loading. The mean ±standard deviation retentive forces among the control (396.7 ±73.2 N), A2S (228.3 ±52.5 N), and A3 (529.9 ±86.2 N) groups were significantly different (P<.05). The hybridized enamel layer of the abutments had a consistent thickness after immersion in 6 mol/L hydrochloric acid. ConclusionsThe results suggest that the 2- and 3-part posterior MIFPDs should have a high long-term survival rate in the oral cavity.

Operational specifications for the cementation of porcelain laminate veneers

The minimal tooth reduction, esthetic appeal and biocompatibility of porcelain laminate veneers have made them one of the mainstream technologies for minimal invasive esthetic dental restorations. Cementation is a crucial step in ensuring retention, marginal seal and influencing the clinical longevity of veneer restorations. Experts from Society of Prosthodontics, Chinese Stomatological Association formulated operational specifications for the cementation of porcelain laminate veneers, so as to standardize the clinical operating procedures, achieve the long-term success of veneer restorations, and promote the application of porcelain laminate veneers.

The art of minimal tooth reduction for veneer restorations

AbstractMinimal tooth reduction is crucial for the long-term success of adhesive restorations. It has been proven that bonding to enamel is more predictable in obtaining better long-term success than dentin due to its higher percentage of mineral content. The diagnostic wax-up and subsequent mock-up are the first diagnostic tools available to evaluate discrepancies between current and ideal tooth proportions. The intraoral mock-up provides the patient a tactile and visual evaluation of the size, shape, and shade of the proposed final restorations, and at the same time, the clinician can evaluate the smile line, lip support, phonetics, and occlusion. During the tooth preparation, the mock-up provides a reduction guide to the clinician to achieve the minimal required reduction for the final restoration avoiding the over-reduction and dentin exposure. This clinical report shows feldspathic veneer restorations provided with conservative tooth preparation. The long-term success of the restoration requires following well-defined protocols for restorative material selection, conservative tooth preparation, total isolation with rubber dam, and bonding ceramic protocols.

Multidisciplinary approaches to recreate a beautiful smile of a patient with bulimia nervosa: a case report

본 증례는 26세 여성환자로 폭식증과 이로 인한 구토 및 위산역류로 상악 전치부에 광범위한 치질 손상과 더불어 산부식으로 인해 상아질 노출로 기능뿐만 아니라 심미적인 문제를 주소로 내원했다. 환자는 단시간 내 심미성 회복을 원하는 상태로 교정 등의 치료는 원치 않았다. 이를 감안해 치료계획은 이미 손상된 치질을 최대한 보존하면서 심미성 및 기능 회복을 목표로 하였다. 상악 전치부의 치관 비율 및 치은 형태 개선을 위해 치은절제술 및 치관연장술을 시행했으며, 전부도재관을 이용해 수복하였다. 회전 이동되어있는 우측 상악 측절치는 치질 삭제 없이 veneer 형태로 제작했다. 산 부식 및 마모에 강한 지르코니아에 도재로 순측을 veneering해 기능 회복뿐만 아니라 심미적인 면에서도 만족할만한 결과를 얻을 수 있었다. 추후 미백치료를 고려해 최종보철물의 색상을 결정했으며, 환자는 색상과 형태에 만족했으며 자신감있는 미소를 회복할 수 있었다. The patient was a 26-year old female who was not satisfied with the aesthetic approach of her maxillary incisors. The treatment goal throughout the process was to manage the risk and recreate the original and youthful appearance of the smile. The biomechanical risk was managed by providing coverage of the exposed dentin and rebuilding the eroded structures with minimal tooth reduction throughout the treatment. Functional risk and prognosis for this patient were both improved by achieving acceptable function. The patient was satisfied with the full-ceramic restorations and the symmetry, harmony gingival architecture.

歯質の保存をめざしたブリッジ治療 接着ポンティック・ブリッジの考え方と臨床

歯質の保存をめざしたブリッジ治療 接着ポンティック・ブリッジの考え方と臨床

Use of resin‐bonded extracoronal attachments with removable partial denture: case report

Resin-bonded extracoronal attachments may be indicated for the abutment teeth of removable partial dentures, especially for anterior teeth when a cingulum rest must be provided. This type of treatment has a series of advantages such as minimal tooth reduction, supragingival margins, favourable stress distribution, and improved aesthetic appearance. To report a clinical case of oral rehabilitation using a combination of resin-bonded extracoronal attachments joined by a Dolder bar with a removable partial denture. A 60-year-old male patient with only the canines in the maxillary arch was restored with a combination of resin-bonded extracoronal attachments joined by a Dolder bar and a removable partial denture. Dentures with resin-bonded extracoronal attachments can have a number of advantages over traditional clasp-retained removable partial dentures.

Minimally Retentive Gold Onlays: A Six-Year Case Report

Partial veneer gold restorations, such as gold onlays, have changed little in preparation design over the past 40 years, as evidenced by textbooks that have long been in print. Such designs must have been based on the assumption that restorations would be luted with zinc phosphate cement but have not altered, despite the introduction of stronger luting cement classes, such as resin composite and resin-modified glass ionomer cements. It is well-established that both porcelain and base metal materials, which have been etched on the intaglio surface, can be combined with resin composite luting cements to produce restorations retained largely through adhesion. However, neither of these materials can equal the combination of minimal tooth reduction and margin adaptation that is possible with high noble gold restorative materials. Although high noble gold alloys cannot be etched, air abrasion of the intaglio surface of restorations likely improves micromechanical retention, but it is unknown whether this, along with a strong luting cement, is sufficient to stabilize high noble gold alloys in preparations with considerably less retention and resistance form than traditional designs.

Fiber-reinforced Onlay Composite Resin Restoration: A Case Report

The purpose of this case report is to describe the clinical procedure for fabricating fiber-reinforced composite (FRC) onlay composite resin restorations using a FRC as the substructure. A variety of therapeutic modalities are available to restore teeth with moderate coronal defects in the posterior region of the mouth. For patients who refuse complete crown restorations or when minimal tooth reduction is preferred, a FRC restoration can be a good alternative to conventional restorative techniques. A 42-year-old female patient presented with an endodontically treated mandibular right first molar with extensive destruction of the coronal tooth structure. To conserve the remaining tooth structure a FRC resin core substructure was fabricated and veneered with Ceramage dentin and enamel hybrid composite to create the final restoration. FRC restorations using adhesive technology appears to be a promising restorative option. However, further clinical investigation will be required to provide additional information on this technique. Based on the clinical and radiographic findings in the present case, the fabrication of a conventional crown was avoided in order to conserve the remaining tooth structure. The restoration of badly damaged teeth is a challenge for clinicians when cast crown restorations are not an option for the patient. The use of FRC restorations along with adhesive technology may be a rational restorative alternative in the near future.

Fiber-Reinforced Composite for Chairside Replacement of Anterior Teeth: A Case Report

A variety of therapeutic modalities, from implant to conventional Maryland prosthesis, can be used for the replacement of a missing anterior tooth. Whenever a minimal tooth reduction is preferred, a fiber reinforced composite (FRC) prosthesis could be a good alternative to conventional prosthetic techniques, chiefly as temporary restoration before making a final decision on the treatment. The purpose of this case report is to describe the clinical procedure of fabricating anterior chairside FRC prosthesis with pre-impregnated unidirectional E-glass fibers and veneered particulate filler composite. Fiber-reinforced composite in combination with adhesive technology appears to be a promising treatment option for replacing missing teeth. However, further and long-term clinical investigation will be required to provide additional information on the survival of directly-bonded anterior fixed prosthesis made with FRC systems.

A Nine-year Follow-up of a Porcelain Laminate Veneer Restoration Applied to an Adolescent with Traumatized Dentition: A Clinical Report

Patients: A 9-year-old Japanese female patient with an unremarkable medical history was initially examined for the chief complaint of slight pain and discomfort in a traumatized maxillary central incisor. Four years after endodontic treatment, the patient complained of dark discoloration of the tooth. Among the treatments/restorations indicated, the patient and her parent consequently selected and approved of a porcelain laminate veneer restoration because of its advantage of minimal tooth reduction. The maxillary diastema was gradually closed after insertion of a porcelain laminate veneer, and 9 years of follow-up have revealed that the prosthodontic treatment successfully restored the tooth.Discussion: Many methods have been introduced as aesthetic solutions to discoloration. Although the patient was satisfied with the prosthodontic approach from a functional as well as an aesthetic point of view, direct composite restorations might be an alternative for younger patients in mixed dentition.Conclusion: The treatment in a growing individual should be carefully planned and performed, considering the development of permanent dentition.

Materials for chairside CAD/CAM–produced restorations

and Overview. Although the use of computer-aided design/computer-aided manufacturing (CAD/CAM) seems to be a recent addition to the dental restorative armamentarium, this concept was first investigated more than 35 years ago. CEREC (Sirona Dental Systems GmbH, Bensheim, Germany) was the first and is the only available chairside system, and it has more than 20 years of use in the dental office. The initial concept had three tenets: esthetic ceramic reconstruction, a single patient visit and minimal tooth reduction (inlays and onlays instead of crowns). The author reviews the materials used for CAD/CAM-fabricated restorations. The structure, properties and clinical success of the materials for full-contour chairside restorations, as well as laboratory-based high-strength all-ceramic restorations are presented. CAD/CAM restorations have demonstrated clinical success owing to a combination of improvements in materials with advances in CAD/CAM systems. Full-contour ceramic restorations fabricated chair-side may reinforce the tooth, providing good long-term clinical success. High-strength milled restorations allow for the use of all-ceramic restorations for multiple-unit posterior and anterior bridges. Examination of the structure, properties and clinical results of CAD/CAM materials supports their use in routine dental practice.

Fiber-reinforced Composite Fixed Partial Denture to Restore Missing Posterior Teeth: A Case Report

In patients refusing implant surgery for psychological reasons, when minimal tooth reduction is desired, a fiber-reinforced composite inlay fixed partial denture (IFPD) can be used to replace missing teeth. In comparison to other restorative systems this conservative approach carries a lower risk of pulp exposure and/or periodontal inflammation, maintaining the health of supporting tissues. The purpose of this case report is to describe the clinical procedure for fabricating an IFPD with a pre-impregnated glass fiber system and a hybrid composite. Fiber-reinforced composite, in combination with adhesive techniques, appears promising for an IFPD. Further clinical investigation will be required to provide additional information on this technique.

Restoration of anterior teeth with indirect composite partial coverage crowns: A clinical report

When an esthetic restoration with minimal tooth reduction is desired, for example in patients with uncomplicated tooth fractures, composite partial coverage crowns may be a therapeutic option. The indirect composite restoration allows restoration of the original tooth anatomy, function, and esthetics to be reproduced while preserving tooth structure. The use of composite partial coverage crowns to restore fractured anterior teeth is described.

形状記憶合金を用いた少数歯欠損補綴ピンブリッジ法 その１． ピンホール形成器，ピンホールの精度ならびに部位の設定

To diminish the amount of irreversible tooth reduction during preparation for a fixed restoration of missing teeth, supplementary preparation of small pins in addition to conventional tooth reduction techniques has been advocated. Among them, the most epoch-making one might be UDA system reported by S. Sandhaus in 1985, making it possible to support the conventional pontic structure with minimal tooth reduction (pin holes) prepared on the proximal tooth surfaces of the abutment teeth. However, the diameter and length of the pins and the head size of the preparation instrument was eventually too big for Japanese adults who have less thick teeth. On the basis of the concept, we redesigned the whole system (pin size, preparation instrument head) for Japanese adults. Furthermore, to reinforce the reduced mechanical retention ascribed to the reduced adherent area of the newly-designed smaller pin to the smaller pin hole, titanium-nickel shape memory alloy was utilized. In this paper, the detail of the pinhole preparation instrument was described and its redone precision of the holes prepared by the instrument was assessed. The standard deviation range of the diameter of the prepared pin-holes was from 1/100 to 5/100 mm. Based on the X-ray estimation of the enamel and dentin thickness in the proximal tooth surface of an extracted tooth sample, the most suitable pin hole position for each tooth was advocated.

ラミネート・ベニア・クラウンに関する研究 第１報 光重合型合着材の流動特性について

ln recent years a number of porcelain laminate veneer systems have been developed for possible esthetic advantages and minimal tooth reduction as alternatives to metal ceramic restorations. Although these laminate veneers must be bonded to the etched surface of the abutment tooth, luting materials were not discussed sufficiently for the luting operations.This investigation evaluated four light-cured luting materials, CLAPEARL (CP), COSMOTECH (CT), LAMINABOND (LB) and OPTEC (OP), for film thickness, inorganic filler content, filler particle size and viscosity before light curing.The results obtained were as follows.1.The film thickness of four light-cured luting materials under 5 kgf load was comparatively smaller than that of glass-ionomer and resin cement.And the film thickness was within 25 pm, and was not effected by applied load and loading time.2.The inorganic filler contents (wt%) were about 62% for CT, LB, OP, and 69.8% for CP. The filler particle size was within 10 pm, and its shape was irregular.3.The reduction ratios of viscosities of four light-cured luting materials in the range of 20-40°C were-3.7%/°C for CT, -4.6%/°C for KP, -4.0%/°C for LB, and-3.7%/°C for OP.