Esthetic Restorations Research Articles

COMPARATIVE ASSESSMENT OF VISUAL COLOR MATCHING FOR ARTIFICIAL AND NATURAL TEETH BY STUDENT OF DENTAL FACULTY AT KHARKIV NATIONAL MEDICAL UNIVERSITY

The purpose of this study was to conduct a comparative assessment of dental students’ ability to match the color of patients’ teeth with aesthetic restorations. Materials and Methods. The study was conducted from 2021 to 2024 with participation of 2nd- and 3rd-year students at the Faculty of Dentistry, Kharkiv National Medical University, Kharkiv, Ukraine. Results. Accurate determination and reproduction of natural tooth color is a challenging task in aesthetic dentistry, as color plays a crucial aesthetic role. This process depends heavily on the experience and perception of dentists and can be approached subjectively (visual analysis) or objectively (special devices). Although shade determination is a routine task for dentists, errors are still common. The study revealed that 2nd-year students struggled significantly with color matching, especially for natural teeth, with error rates of 66.6% for artificial teeth and 80.8% for natural teeth, indicating a need for more training. Students performed better using the VITA Classic shade guide, which is simplified, but matching the color of natural teeth requires additional practice. The results confirm that clinical training improves students’ color-matching skills. After training, 3rd-year students showed a marked decrease in error rates: 35.8% for artificial teeth and 53.3% for natural teeth. The Vita 3D Master scale proved more accurate due to its broader color-matching capabilities. Overall, the accuracy levels improved significantly, highlighting the effectiveness of the training program. Conclusion. The results of the study demonstrate that training significantly improves students' ability to accurately determine tooth color. The 3rd year students who underwent clinical training showed better results in matching the color of both artificial and natural teeth, reducing the number of errors by 35.8% and 53.3%, respectively. The Vita 3D Master scale proved to be more accurate due to a wider selection of colors and more evaluation parameters. The 81.5% increase in the overall score confirms the effectiveness of the training in improving the accuracy of tooth color determination in the educational process.

Retreatment and aesthetic restoration of maxillary incisor with calcified root canal using a dynamic navigation system: a case report

BackgroundPulp canal occlusion (PCO) increases the difficulty of root canal treatment as well as tooth preservation and restoration. This is the first case report of successful localization of a calcified root canal under the guidance of a dynamic navigation system (DNS) for complete root canal retreatment and aesthetic restoration after a failed attempt to locate the calcified root canal with a traditional dental operating microscope (DOM).Case presentationThe patient was scheduled for root canal treatment for a labially inclined maxillary central incisor and post-core crown restoration with resin veneers in another hospital, but the calcified root canal could not be located with a microscope, so the patient was referred to our department. Root canal retreatment was planned for tooth #8, and the calcified root canal of tooth #9 was planned to be located and dredged under the guidance of a DNS. We used a DNS for successful positioning and to complete the root canal retreatment operation in the following 4 steps: preoperative CBCT imaging, preoperative plan design, calibration and registration, and real-time dynamic navigation. Three months later, teeth #8 and #9 presented no clinical symptoms, after which the fiber post-cores and zirconia all-ceramic crown restorations were completed. At the 12-month follow-up visit, the patient continued to be symptom­free, and satisfied with the final aesthetic restoration.ConclusionsThis case report suggests that DNS may be a promising technique with high accuracy and effectiveness to reduce the risk of iatrogenic errors and provide maximal preservation of dentin, when the traditional treatment of calcified root canals approaches failure (lateral perforation).

Prosthetic Soft Tissue Management in Esthetic Implant Restorations, Part I: Presurgical Planning, Implant Placement, and Restoration Timing. A Narrative Review.

This two-part review article delineates various techniques to enhance esthetic outcomes in anterior implant treatments. Part I concentrates on presurgical measures, case selection, implant placement, and restoration timing. Part II discusses post-surgical steps, the temporary restoration phase, the emergence profile contour, abutment types, and impression techniques. A comprehensive search was conducted using Medline/PubMed, Embase, Scopus, and the Cochrane Library. The primary keywords included were "Dental Implants," "Dental Prosthesis, Implant-Supported," "Esthetics, Dental," "Dental Impression Techniques," and "Tissue Management." Initially, 1472 studies were identified, from which 187 were selected based on publication year and title relevance. After removing duplicates, 84 abstracts were reviewed in full text, culminating in 59 studies being thoroughly analyzed. Optimal esthetics in implant restorations are attainable through meticulous treatment planning, precise surgical execution, and systematic restorative steps, ensuring predictable outcomes. Factors such as a thick gingival biotype, an intact facial bone wall, and atraumatic extraction significantly contribute to superior esthetic results. Immediate implant placement combined with immediate provisionalization provides the most predictable outcomes by supporting and maintaining soft tissue architecture. Conversely, delayed implant placement and provisionalization often require extensive manipulation of collapsed soft tissues to achieve desired esthetics.

Shear bond strength evaluation of bioactive restorative materials on pretreated carious dentin-influence on silver diamine fluoride, potassium iodide, and glutathione

Background: Silver diamine fluoride (SDF) has gained popularity for its caries-arresting properties, yet its tendency to cause esthetic concerns due to black-staining limits its widespread acceptance. Aim: The aim of the study was to evaluate and compare the shear bond strength of Activa BioActive and Giomer restorative material with different protocols of SDF pretreatment on carious dentin. Materials and Methods: Ninety-two extracted teeth were decoronated at the cementoenamel junction, sectioned 1 mm into dentin, mounted in acrylic resin and randomly divided into four (n = 8) control and six (n = 10) experimental groups. Seventy-six samples underwent demineralization process for a period of 14 days for artificial carious dentin (ACD) formation. The samples categorized based on the dentin substrate (sound or ACD) were subjected to various SDF pretreatment protocols, i.e., only SDF, SDF with potassium iodide (KI), and SDF with glutathione (GSH). Further, bioactive restorative materials, i.e., Activa BioActive and Giomer (Beautifil II), were placed on it, and the samples were subjected to shear bond strength testing. Statistical Analysis: Independent t-test was run to analyze the values obtained. Results: Giomer exhibited better mean bond strength with SDF, SDF + KI, and SDF + GSH (6.56, 4.67, and 3.34 mega-pascals [MPa], respectively) compared to Activa BioActive (3.42, 3.27, and 2.96 MPa, respectively). Conclusion: This study contributes to understanding the interplay between SDF application protocols, esthetic concerns, and the adhesive properties of bioactive restorative materials. Giomer exhibited enhanced bond strength after SDF application, unlike Activa BioActive. In addition, incorporation of KI or GSH adversely affected the bond strength of both the restorative materials, underscoring the critical need for cautious clinical application. Clinical Relevance: This study highlights the importance of selecting appropriate dentin pretreatment agents to maximize the bond strength of bioactive restorative materials with carious dentin. SDF application significantly enhanced the bond strength of Giomer with carious dentin compared to Activa BioActive, thus, making it a good choice for restoring nonesthetic areas. In addition, the application of KI or GSH to mitigate discoloration of carious dentin negatively affected the bond strength of both, Activa BioActive and Giomer. Thus, the clinicians should weigh the benefits of SDF against potential bond strength reductions when using KI or GSH, especially for esthetic restorations.

VANTAGENS DOS IMPLANTES UNITÁRIOS COM CARGA IMEDIATA EM REGIÃO ANTERIOR DE MAXILA: REVISÃO DE LITERATURA

Among the various teeth that can be lost, the front ones are the most relevant in terms of aesthetics, since they represent an individual’s calling card. In this scenario, implantology is one of the main forms of oral rehabilitation in dentistry. Dental implants can be installed with immediate or delayed loading. Immediate loading implants arose from the need for faster results and in situations where aesthetics are the main objective, such as the front region of maxilla, representing a huge technological advance in implantology. The present study aimed to conduct a literature review on the advantages of single immediate loading implants in the front of maxilla. Through a search in the online databases Google Scholar, Pubmed and Scielo, 25 scientific articles were selected to compose the review, divided into the following topics: mediate loading vs. immediate loading; requirements for the application of immediate loading in single implants; immediate loading in the front of maxilla and its advantages; and the success rates. After explaining and discussing the data, it was concluded that single immediate loading implants in the front of maxilla is considered effective, especially due to advantages such as immediate aesthetic restoration and reduced treatment time, benefits considered extremely important by most patients. However, it is important to emphasize that the professional must evaluate each case individually and decide whether the patient is suitable for the technique.

Fechamento de diastemas com faceta direta de resina composta: relato de caso

The search for an aesthetic standard is increasingly frequent and restoring a harmonious smile represents a real challenge for restorative dentistry. Composite resins are aesthetic and adhesive materials that have received special attention for ensuring predictable and lasting results with minimal tooth sacrifice. The technique of making direct veneers is simple, but requires discretion and attention from its indication to the final stages of its execution. The procedure has high success rates and predictable results with desirable longevity for anterior teeth. The objective of this study was to present a clinical case of diastema closure with direct composite resin veneers on anterior teeth and maxillary first premolars, with the aid of diagnostic wax-up for better accuracy of work on anterior teeth. It is concluded that the application of the direct restorative technique allowed a fast, low, cost and less invasive treatment. Providing a satisfactory result, raising self-esteem and allowing a restoration of the patient's facial aesthetics.

PROBLEMS OF CHOOSING A METHOD OF DENTAL TREATMENT OF TEETH AFTER ENDODONTIC INTERVENTION

The optimal way to restore the anatomical structure of teeth after endodontic intervention is a controversial topic. Teeth after endodontic intervention have different properties compared to intact living teeth. Changes in these properties are associated with volumetric loss of hard tissues, caries, final preparation of the cavity taking into account access to endodontic treatment. Choosing the optimal method of dental treatment of teeth requires compliance with many factors, such as: prevention of infection penetration into root canals, restoration of tooth contacts, restoration of chewing functions, protection against further carious and non-carious destruction, restoration of tooth aesthetics. Dentists are now more than ever aware of the interdependence of the endodontic and restorative aspects of dental treatment and how much this will affect achieving the best long-term outcome. Controversies of the clinical relevance of endodontic and restorative treatment choice issues are mostly unanswered based on clinical data and scientific evidence. The modern approach to tooth restoration after endodontic intervention is an important topic. To improve clinical outcomes, it is important to determine the effectiveness of treatment, the importance of preserving tooth structure, the choice of treatment method with restorative materials, and the integration of digital dentistry to improve diagnosis and treatment principles. Research rationale. The purpose of this study is to find and use literature data on the effectiveness of modern methods of dental treatment after endodontic intervention in Ukraine. Materials and methods. Scientific data from a review and systematic analysis of the literature were used. Materials were searched using the Google Scholar, PubMed, Google Scholar databases and open sources of the World Health Organization, the Ministry of Health of Ukraine and other government web portals of Ukraine. Results, Discussion. After conducting a literature analysis to compare the effectiveness of using cast metal inserts and fiberglass posts, we can come to the conclusions that retrospective studies on the relationship between successful restorations and such factors as the type of tooth, the volume of residual hard tissues, the number of occlusal contacts, the type of the final restoration and the position of the tooth in the dental arch are the main criteria for choosing a treatment method. A controversial choice is that metal abutments are associated with a higher risk of root fracture, their manufacture requires laboratory techniques, while the use of fiberglass posts is associated with a higher risk of decementation, and overloading of fiberglass posts leads to their fractures. Conclusions. Decision-making and the choice of methods of dental treatment after endodontic intervention remain difficult. However, the interdependence of endodontic treatment and restoration of the crown part of the tooth is clearly established. Physicians must consider both aspects of treatment equally to ensure the best possible outcomes for their patients. The use of digital scanning enables an accurate volumetric assessment of the residual hard tissues of the tooth, which can be used to provide tangible qualitative results of the analysis and decision-making with the choice of treatment method. The choice of treatment method is not defined in a single protocol and requires further careful study with new experimental developments, based on the latest technologies of world leaders in dentistry.

Impact of liner treatment on the translucency of CAD/CAM multi-colored lithium disilicate and multi-layered zirconia implant-supported crowns, and evaluation of fracture strength of ceramic crowns.

This study aimed to evaluate the optical properties of liner-treated CAD/CAM Multi-colored lithium disilicate (Amber Mill Direct; AMD) and multi-layered zirconia (Omega multi; OM) implant-supported crowns, as well as their effect on the fracture strength of Ti or Zr abutments to which they were applied. After sintering AMD and OM ceramic blocks, they were classified into three groups: untreated, liner-treated, and liner-treated with added color. Optical properties were evaluated by analyzing color differences using background materials to assess translucency and the masking ability of liner-treated ceramics. Subsequently, the fracture strength of implant-supported crowns applied to Ti or Zr abutments was measured, and statistical analysis was conducted using Weibull statistics. Untreated AMD exhibited the highest translucency. Liner treatment reduced translucency in both ceramics, while color-added liner treatment increased translucency. Liner-treated AMD showed greater color difference compared to OM, whereas color-added liner treatment reduced the color difference. Fracture strength was highest in Ti abutment-OM crowns (548.03 N) and lowest in Zr abutment-AMD crowns (283.58 N). Additionally, the Weibull coefficient was over twice as high in Ti abutment-AMD crowns (m = 17.500). Color liners can adjust the high translucency of lithium disilicate ceramics to block discoloration, providing natural tooth-like color and enabling the creation of esthetic restorations. Furthermore, lithium disilicate ceramic crowns applied to Ti abutments exhibited high Weibull coefficients and fracture strengths.

Dermal Regeneration Template Generated Skin Can Be Raised as A Flap: A New Dimension in Aesthetic Restoration

AbstractChildhood scars can lead to hideous aesthetic and functional deformities in young adults, which can be particularly distressing when involving the face and the breast in a female. Aesthetic restoration requires replacement of the whole or a part of the scarred skin by soft, pliable, and texture-matching skin, which nearly always is in short supply. Dermal regeneration templates (DRTs) can help in skin regeneration that is almost always aesthetically superior to most flaps. Aesthetic demands at the time of final restoration may require the regenerated skin to be moved as a local flap. As regenerated skin from dermal templates is known to match the vascularity of normal native skin, raising it as a flap should follow logically. This, however, has never been attempted to the best of our knowledge after a thorough literature search. We report a case of successfully using DRT-generated skin raised as a flap for aesthetic reconstruction of a postburn scarred breast in a young female. This adds a whole new dimension to the use of DRTs and points to a new field of research in scar management and aesthetic restoration.

Survival Rate Of Composite Veneer - A Review

Composite veneers are a minimally invasive and increasingly popular choice for aesthetic dental restorations. Their clinical durability and success are determined by multiple factors, including material composition, patient habits, and the technical expertise of the dental practitioner. This review evaluates the existing research on the lifespan of composite veneers, with a focus on the key elements that affect their durability, clinical performance, and patient satisfaction. These elements include adhesive bonding methods, patient oral hygiene practices, and mechanical stressors that influence the long-term success of composite veneers.

Влияние ополаскивателей полости рта на стабильность цвета эстетических реставраций

Over the past decades, intensive work has been carried out to expand the possibilities of aesthetic dentistry; the range of demands from patients has also increased. One of the main conditions for the long service life of filling material is careful oral care using the full arsenal of available hygiene products. We analyzed the effect of mouth rinses with various active ingredients (fluorine, chlorhexidine digluconate, medicinal plant extracts) on the level of oral hygiene, as well as on the quality of the filling, in particular on the color of the aesthetic restoration after their use. At the end of the study, all subjects experienced a significant improvement in oral hygiene (decrease in API scores). However, a negative effect of a liquid product containing chlorhexidine digluconate (Waterdent “Chlorhexidine mouthwash with mint flavor”) on the quality of composite restorations has been established. The use of additional oral hygiene products can reduce the risk of caries, but their selection must be personalized so as not to have a negative impact on the aesthetics of composite restorations.

Double Monolithic Protocol: The Solution to FluorescenceLimitations.

The present paper aims to demonstrate the incorporation of the double monolithic protocol (DMP) into a chairside digital workflow to reproduce the fluorescence properties of natural teeth with chairside monolithic restorations when exposed to different light sources. A female patient reporting dissatisfaction with her upper anterior teeth was rehabilitated using seven veneers and a three-element bridge. The DMP was applied to the bridge, which consisted of a primary lithium disilicate framework to which leucite-reinforced glass ceramic veneers were cemented. The fluorescence of the different substrates and ceramic restorations was evaluated throughout the rehabilitation process, under 365 and 405 nm light. The DMP allows chairside procedures to be optimized by achieving predictable, mechanically resistant, and esthetic restorations. The DMP is a new chairside solution for developing ceramic restorations with optimal esthetics and combined mechanical properties, eliminating the need for sintering or glazing procedures.

APLICAÇÕES ESTÉTICAS DE PORCELANA NA ODONTOLOGIA CONTEMPORÂNEA – REVISÃO SISTEMÁTICA

Since the early 1800s, porcelain and ceramic materials have been used in the production of aesthetic dental restorations. Advances in dental ceramic technology and adhesive systems have made porcelain veneers a highly sought after aesthetic option. Thus, this work aims to review the literature, with the aim of discussing the use of porcelain veneers in modern dentistry, emphasizing their advantages, disadvantages, indications and limitations. The databases used were PubMed, SciELO, Google Scholar where a total of 21 articles published in the last 10 years were selected. The findings revealed that this technique has several indications and advantages, among its benefits are the minimal compromise of tooth wear during the tooth preparation phase and the achievement of harmony in the patient's smile, in addition to longevity. Its contraindications and disadvantages include, in some cases, detachments and fractures, among others.

APLICAÇÕES ESTÉTICAS DE PORCELANA NA ODONTOLOGIA CONTEMPORÂNEA – REVISÃO SISTEMÁTICA

Since the early 1800s, porcelain and ceramic materials have been used in the production of aesthetic dental restorations. Advances in dental ceramic technology and adhesive systems have made porcelain veneers a highly sought after aesthetic option. Thus, this work aims to review the literature, with the aim of discussing the use of porcelain veneers in modern dentistry, emphasizing their advantages, disadvantages, indications and limitations. The databases used were PubMed, SciELO, Google Scholar where a total of 21 articles published in the last 10 years were selected. The findings revealed that this technique has several indications and advantages, among its benefits are the minimal compromise of tooth wear during the tooth preparation phase and the achievement of harmony in the patient's smile, in addition to longevity. Its contraindications and disadvantages include, in some cases, detachments and fractures, among others.

Comparison of optical properties and bond strength of new CAD/CAM ceramic materials

Objective. To compare the shear bond strength values of current CAD/CAM materials and to evaluate the color changes resulting from immersion in coloring solutions. Material and Methods. A total of 160 specimens were prepared from 4 CAD/CAM blocks; lithium disilicate glass ceramic (IPS E.max CAD[EC]), zirconia reinforced lithium silicate ceramic (Vita Suprinity[VS]), polymer infiltrated glass ceramic (Vita Enamic[VE]) and hybrid ceramic (GC Cerasmart [GC]). The ceramic specimens were immersed in tea, coffee, cherry juice and distilled water solutions. Color measurements were made. To compare the shear bond strength values, all specimens were bonded to resin cement. Then the specimens were aged with 5000 thermocycling. The failure modes were classified according to stereomicroscope analysis and than scanning electron microscopy images for surface topography were obtained. Results. The color change values were significantly greater in coffee compared to other solutions and the highest color change was seen in GC and VE. The highest bond strength values were seen in VS and VE. The shear bond strength values are listed as follows: VS>VE>EC>CS. Conclusions. EC and VS can be used, especially in aesthetic restorations, due to their high color stability. Additionally, considering the bond strength values of VS, it appears to be a highly satisfactory material.

Management of complicated crown fracture in maxillary incisor using fragment reattachment - 5-year follow-up

Complicated crown-root fractures of maxillary incisors are a relatively common occurrence in cases of trauma to the facial region. Patients with such fractures are in acute pain and usually require emergency care on their first clinical visit. Pain management and restoration of function, esthetics, and phonetics should be the prime objective in handling such patients. The reattachment of fractured tooth fragments is a relatively simple procedure that provides natural esthetics and conservation of tooth structure. This case report describes such a reattachment procedure in a complicated crown-root fracture and its success at 5 years of follow-up.

Esthetic restoration of maxillary anterior teeth considering facial features in digital diagnostic wax-up: a case report

Esthetic restoration of maxillary anterior teeth considering facial features in digital diagnostic wax-up: a case report

Comparison of Mechanical Properties Between Zirconia-reinforced Lithium Silicate Glass-ceramic and Lithium Disilicate Glass-ceramic: A Literature Review

Lithium disilicate glass-ceramic (LDS) is increasingly being adopted for use in therapeutic restorative procedures. Concurrently, zirconia-reinforced silicate glassceramics (ZRS) are becoming broadly utilized in dental applications. The purpose of this study was to evaluate and compare the mechanical properties of zirconia-reinforced lithium silicate glass-ceramics and lithium disilicate-based glass-ceramics, with a focus on their application in CAD/CAM technologies. In this review, the researchers conducted a search of the PubMed (MEDLINE) database to identify studies related to LDS and ZRS. This search was limited to articles published in English over a seven-year period, from January 1, 2015, to December 31, 2022. Additional studies were sourced from Google Scholar and through manual exploration. Key published works were identified and included in the literature review. The findings concluded that ZRS exhibits superior mechanical properties, including higher flexural strength, fracture toughness, and hardness, compared to LDS. Furthermore, ZRS combines desirable esthetic qualities with robust mechanical strength, rendering it an excellent material for single tooth aesthetic restorations such as inlays, onlays, crowns, and veneers, applicable to both tooth and implant supports. Currently, there is a notable scarcity of data concerning the mechanical properties and clinical efficacy of ZRS. Therefore, it is imperative to conduct long-term clinical studies to verify the optical and mechanical properties, clinical applications, limitations, and long-term effectiveness of ZRS.

Effect of finishing and polishing systems on surface roughness and color stability of aesthetic restorations exposed to staining solution.

The color and the surface roughness of aesthetic restorations are related to the clinical sucess and longevity of these treatments. Aim: This study evaluated the influence of finishing and polishing systems, and storage media on the surface roughness and color stability of aesthetic restorative composites. Materials and Method: Cylindrical specimens (n=10) were prepared and treated according to: 1. Type of composite resin (nanofilled- Filtek Z350XT, suprananofilled- Estelite Omega, nanohybrid- Empress Direct); 2. Type of finishing and polishing systems (no polishing, aluminum oxide discs or abrasive rubber polishers); and 3. Type of immersion medium (water or coffee, 3 h/day/30 days). Surface roughness (Ra - μm) and color stability (L, ΔEab, and ΔE00) were evaluated at baseline (after polishing) and final time (after immersion). Data were subjected to Kruskal-Wallis, Mann-Whitney, Wilcoxon, and Student-Newman-Keuls tests (α=0.05). Results: Nanohybrid (p<0.001) and suprananofilled composite resins (p=0.004) showed an increase in Ra after polishing, regardless the finishing and polishing system. After immersion in coffee, the nanofilled composite had the highest roughness values (p=0.032). L values increased for all resins after polishing (p<0.05). Suprananofilled composites had the greatest color stability with the lowest values of ΔEab and ΔE00. Conclusions: Finishing and polishing systems had an impact on the surface roughness and color stability of all aesthetic resins, and their effectiveness depended on the type of composite resin.

The effect of adding pineapple leaf microfibers (Ananas comosus L. Merr) to packable composite resin on flexural strength

Composite resin is a restorative material often used for the aesthetic restoration of anterior and posterior teeth. Packable composite resin is indicated for posterior teeth because its resistance to pressure can reduce the problem of loss of contact. Flexural strength is a combination of compressive stress and tensile stress on the restoration of the teeth in the anterior and posterior areas while functioning in the oral cavity. A restorative material that cannot withstand the flexural force continuously can cause fractures. The addition of microfiber is capable of increasing the strength and mechanical properties, including the flexural strength of packable composite resin. This study aims to determine the influence of the addition of discontinuous microfiber on the flexural strength of packable composite resin. This type of research is a true experimental laboratory study with a post-test only control group design. The study used a total of 16 packable composite samples, divided into two groups: the control group without added discontinuous microfiber from pineapple leaf and the treatment group with the addition of discontinuous microfiber from pineapple leaf.