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Clinical Photos

Illustrations / Diagrams

Frenectomy via Soft Tissue Laser

Adolescent Patient Requiring Frenectomy - Laser technology has allowed clinicians to improve the level of dental care they provide to their patie...

Adolescent Patient Requiring Frenectomy - Laser technology has allowed clinicians to improve the level of dental care they provide to their patients. The soft tissue laser can be used in daily practice for precise soft tissue applications, providing rapid healing of the patient and increasing revenu...

Adolescent Patient Requiring Frenectomy<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative view of adolescent patient who requires frenectomy.</span>

Figure 1 - Preoperative view of adolescent patient who requires frenectomy.

Adolescent Patient Requiring Frenectomy<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Use of the soft tissue laser improves hemostasis and enhances healing postoperatively.</span>

Figure 2 - Use of the soft tissue laser improves hemostasis and enhances healing postoperatively.

Adolescent Patient Requiring Frenectomy<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Performing a frenectomy with an 810 nm diode laser is less invasive to the tissue as well as the patient.</span>

Figure 3 - Performing a frenectomy with an 810 nm diode laser is less invasive to the tissue as well as the patient.

Adolescent Patient Requiring Frenectomy<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Note the enhanced tissue response at 1 week postoperatively achieved through the frenectomy performed with the 810 nm diode laser.</span>

Figure 4 - Note the enhanced tissue response at 1 week postoperatively achieved through the frenectomy performed with the 810 nm diode...

Figure 4 - Note the enhanced tissue response at 1 week postoperatively achieved through the frenectomy performed with the 810 nm diode laser.

Soft Tissue Contouring

Recontouring of Gingival Height via the Soft Tissue Laser - Critical to a natural, esthetic smile is a harmonious soft tissue architecture. The e...

Recontouring of Gingival Height via the Soft Tissue Laser - Critical to a natural, esthetic smile is a harmonious soft tissue architecture. The evolution of advanced technology offers every clinician the opportunity to significantly improve the health, design, and overall appearance of the soft tiss...

Recontouring of Gingival Height via the Soft Tissue Laser<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative view of lateral incisor with unesthetic gingival height that compromises the patient’s smile.</span>

Figure 1 - Preoperative view of lateral incisor with unesthetic gingival height that compromises the patient’s smile.

Recontouring of Gingival Height via the Soft Tissue Laser<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Bone sounding is performed to assess the biologic width and evaluate the potential of soft tissue recontouring.</span>

Figure 2 - Bone sounding is performed to assess the biologic width and evaluate the potential of soft tissue recontouring.

Recontouring of Gingival Height via the Soft Tissue Laser<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Based on evaluation of the biological criteria, an 810 nm diode laser will be used to reestablish the position of the gingiva on the incisor.</span>

Figure 3 - Based on evaluation of the biological criteria, an 810 nm diode laser will be used to reestablish the position of the gingiv...

Figure 3 - Based on evaluation of the biological criteria, an 810 nm diode laser will be used to reestablish the position of the gingiva on the incisor.

Recontouring of Gingival Height via the Soft Tissue Laser<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Image of lateral incisor following contouring with the soft tissue laser.</span>

Figure 4 - Image of lateral incisor following contouring with the soft tissue laser.

Laser assisted gingival tissue procedures in aesthetic dentistry - Laser assisted gingival tissue procedures in aesthetic dentistry

Laser assisted gingival tissue procedures in aesthetic dentistry - Laser assisted gingival tissue procedures in aesthetic dentistry Contributed by Ernesto A. Lee, DMD on 7/13/2012

Laser assisted gingival tissue procedures in aesthetic dentistry<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Diode lasers provide unsurpassed operator control, allowing for precise tracing of a pre-established incision design.</span>

Figure 1 - Diode lasers provide unsurpassed operator control, allowing for precise tracing of a pre-established incision design.

Laser assisted gingival tissue procedures in aesthetic dentistry<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Gingival excision is achieved in layers with excellent hemostasis and a clean surgical field.</span>

Figure 2 - Gingival excision is achieved in layers with excellent hemostasis and a clean surgical field.

Laser assisted gingival tissue procedures in aesthetic dentistry<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The diode laser may be utilized to perform a bloodless external bevel gingivectomy, facilitating the immediate placement of provisional restorations.</span>

Figure 3 - The diode laser may be utilized to perform a bloodless external bevel gingivectomy, facilitating the immediate placement of...

Figure 3 - The diode laser may be utilized to perform a bloodless external bevel gingivectomy, facilitating the immediate placement of provisional restorations.

Laser assisted gingival tissue procedures in aesthetic dentistry<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Postoperative appearance two weeks following laser assisted aesthetic crown lengthening with immediate provisionalization.</span>

Figure 4 - Postoperative appearance two weeks following laser assisted aesthetic crown lengthening with immediate provisionalization.

Laser assisted gingival tissue procedures in aesthetic dentistry<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Preoperative view of abutments prior to definitive impressions. Please not inflamed tissues and presence of bleeding.</span>

Figure 5 - Preoperative view of abutments prior to definitive impressions. Please not inflamed tissues and presence of bleeding.

Laser assisted gingival tissue procedures in aesthetic dentistry<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Gingival troughing with the diode laser exposes finish lines while providing excellent hemostasis. Heat transfer to the alveolar crest must be carefully monitored.</span>

Figure 6 - Gingival troughing with the diode laser exposes finish lines while providing excellent hemostasis. Heat transfer to the alve...

Figure 6 - Gingival troughing with the diode laser exposes finish lines while providing excellent hemostasis. Heat transfer to the alveolar crest must be carefully monitored.

Laser assisted gingival tissue procedures in aesthetic dentistry<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> Access to preparation margins coupled with adequate moisture control results in consistently successful impression taking.</span>

Figure 7 - Access to preparation margins coupled with adequate moisture control results in consistently successful impression taking.

CAD/CAM Restorations with Aluminum Oxide Copings

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations - Extensive Aesthetic Rehabilitation with CAD/CAM Restorations

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations - Extensive Aesthetic Rehabilitation with CAD/CAM Restorations Contributed by Bernard Touati, DDS, DSO on 3/27/2012

$Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative facial view of severely discolored maxillary dentition. The form and aesthetics of the teeth have been compromised by excessive wear and fracture of existing laminate veneers, as well as poor hygiene measures.</span>$ Figure 1 - Preoperative facial view of severely discolored maxillary dentition. The form and aesthetics of the teeth have been compromi...

Figure 1 - Preoperative facial view of severely discolored maxillary dentition. The form and aesthetics of the teeth have been compromised by excessive wear and fracture of existing laminate veneers, as well as poor hygiene measures.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Chamfer preparations were rendered with chamfer and football burs under water irrigation, and were characterized by smooth, rounded internal angles (depth of 1mm to 1.3mm) that allowed unimpeded access to the scanner tip in the laboratory phase.</span>

Figure 2 - Chamfer preparations were rendered with chamfer and football burs under water irrigation, and were characterized by smooth,...

Figure 2 - Chamfer preparations were rendered with chamfer and football burs under water irrigation, and were characterized by smooth, rounded internal angles (depth of 1mm to 1.3mm) that allowed unimpeded access to the scanner tip in the laboratory phase.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> In the anterior region, faciolingual and proximal reduction of approximately 1.3mm and 1mm, respectively, were necessary for maxillary and mandibular dentition. This design permitted the development of a uniform thickness (~0.5mm) of stratified porcelain, maintenance of appropriate occlusal clearance, and adequate incisal reduction (~2mm).</span>

Figure 3 - In the anterior region, faciolingual and proximal reduction of approximately 1.3mm and 1mm, respectively, were necessary for...

Figure 3 - In the anterior region, faciolingual and proximal reduction of approximately 1.3mm and 1mm, respectively, were necessary for maxillary and mandibular dentition. This design permitted the development of a uniform thickness (~0.5mm) of stratified porcelain, maintenance of appropriate occlusal clearance, and adequate incisal reduction (~2mm).

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Anterior preparation required a taper of 5 to 10 degrees as well. This taper was also utilized in the posterior regions, although occlusal reduction of approximately 2mm was necessary for these restorations. As the anterior region, posterior tooth preparation was performed approximately 1.5mm buccally and lingually.</span>

Figure 4 - Anterior preparation required a taper of 5 to 10 degrees as well. This taper was also utilized in the posterior regions, alt...

Figure 4 - Anterior preparation required a taper of 5 to 10 degrees as well. This taper was also utilized in the posterior regions, although occlusal reduction of approximately 2mm was necessary for these restorations. As the anterior region, posterior tooth preparation was performed approximately 1.5mm buccally and lingually.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> The preparations were captured in polyvinylsiloxane impressions that were forwarded to the laboratory technician with collateral data (eg, detailed color prescriptions, face-bow, occlusal registrations, models) for the fabrication of the definitive restorations.</span>

Figure 5 - The preparations were captured in polyvinylsiloxane impressions that were forwarded to the laboratory technician with collat...

Figure 5 - The preparations were captured in polyvinylsiloxane impressions that were forwarded to the laboratory technician with collateral data (eg, detailed color prescriptions, face-bow, occlusal registrations, models) for the fabrication of the definitive restorations.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Digital photographs were also transmitted via the internet to the laboratory.</span>

Figure 6 - Digital photographs were also transmitted via the internet to the laboratory.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> Once the color of the underlying tooth substrate and adjacent teeth had been recorded, acrylic provisional restorations were delivered to maintain the patients intraoral condition, as well as to improve the health and scallop of the soft tissue.</span>

Figure 7 - Once the color of the underlying tooth substrate and adjacent teeth had been recorded, acrylic provisional restorations we...

Figure 7 - Once the color of the underlying tooth substrate and adjacent teeth had been recorded, acrylic provisional restorations were delivered to maintain the patient's intraoral condition, as well as to improve the health and scallop of the soft tissue.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 8. <span style='font-size: 16px; font-weight: normal'> In the laboratory, stone models were created and separated into die segments, which were ditched under a microscope to permit scanning of the cervical margins with the scanner.</span>

Figure 8 - In the laboratory, stone models were created and separated into die segments, which were ditched under a microscope to permi...

Figure 8 - In the laboratory, stone models were created and separated into die segments, which were ditched under a microscope to permit scanning of the cervical margins with the scanner.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 9. <span style='font-size: 16px; font-weight: normal'> Once the 15 individual dies were scanned with the CAD/CAM technology, the finish line was plotted on each.</span>

Figure 9 - Once the 15 individual dies were scanned with the CAD/CAM technology, the finish line was plotted on each.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 10. <span style='font-size: 16px; font-weight: normal'> The emergence profiles of the restorations were subsequently established on the system software, and these data were forwarded via modem to the production facility to permit the fabrication of the 15 aluminum oxide copings.</span>

Figure 10 - The emergence profiles of the restorations were subsequently established on the system software, and these data were forwar...

Figure 10 - The emergence profiles of the restorations were subsequently established on the system software, and these data were forwarded via modem to the production facility to permit the fabrication of the 15 aluminum oxide copings.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 11. <span style='font-size: 16px; font-weight: normal'> Enlarged dies were fabricated and pressed with sluminum oxide; the external surfaces of the copings were milled, and each coping was placed in an oven (~1600 degrees Celsius) to facilitate the sintering process.</span>

Figure 11 - Enlarged dies were fabricated and pressed with sluminum oxide; the external surfaces of the copings were milled, and each c...

Figure 11 - Enlarged dies were fabricated and pressed with sluminum oxide; the external surfaces of the copings were milled, and each coping was placed in an oven (~1600 degrees Celsius) to facilitate the sintering process.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 12. <span style='font-size: 16px; font-weight: normal'> This reduced the porosities in the copings, which were returned to the laboratory and covered with porcelain in the conventional manner. The dentin buildup and translucent regions were formed with shaded ceramic powders.</span>

Figure 12 - This reduced the porosities in the copings, which were returned to the laboratory and covered with porcelain in the convent...

Figure 12 - This reduced the porosities in the copings, which were returned to the laboratory and covered with porcelain in the conventional manner. The dentin buildup and translucent regions were formed with shaded ceramic powders.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 13. <span style='font-size: 16px; font-weight: normal'> The enamel layer was created with ceramic and fired in a furnace at 930 degrees Celsius during the first bake. No liner was used prior to the dentin buildup; the external surfaces of the copings were lightly sandblasted with aluminum oxide particles (50 micrometers).</span>

Figure 13 - The enamel layer was created with ceramic and fired in a furnace at 930 degrees Celsius during the first bake. No liner was...

Figure 13 - The enamel layer was created with ceramic and fired in a furnace at 930 degrees Celsius during the first bake. No liner was used prior to the dentin buildup; the external surfaces of the copings were lightly sandblasted with aluminum oxide particles (50 micrometers).

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 14. <span style='font-size: 16px; font-weight: normal'> In effect, the industrial fabrication process eliminated human error from the aspect of marginal fit while permitting artistic creativity in the veneering phase.</span>

Figure 14 - In effect, the industrial fabrication process eliminated human error from the aspect of marginal fit while permitting artis...

Figure 14 - In effect, the industrial fabrication process eliminated human error from the aspect of marginal fit while permitting artistic creativity in the veneering phase.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 15. <span style='font-size: 16px; font-weight: normal'> For the restoration of the mandibular incisors, the dentin buildup was completed to final contour and then cut back to permit the vertical stratification of the enamel layers and transparent effects.</span>

Figure 15 - For the restoration of the mandibular incisors, the dentin buildup was completed to final contour and then cut back to perm...

Figure 15 - For the restoration of the mandibular incisors, the dentin buildup was completed to final contour and then cut back to permit the vertical stratification of the enamel layers and transparent effects.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 16. <span style='font-size: 16px; font-weight: normal'> Internal effects were subsequently rendered, and the buccal stratification was completed by the alternating application of opalescent and transparent coats. Lingual stratification consisted of thin opacious dentin, dentin, enamel, and opalescent effects. Once the porcelain layers had been built up over the aluminum oxide copings, all 15 full-coverage crowns were remounted along with the 2 PFM crowns on the master model and prepolished.</span>

Figure 16 - Internal effects were subsequently rendered, and the buccal stratification was completed by the alternating application of...

Figure 16 - Internal effects were subsequently rendered, and the buccal stratification was completed by the alternating application of opalescent and transparent coats. Lingual stratification consisted of thin opacious dentin, dentin, enamel, and opalescent effects. Once the porcelain layers had been built up over the aluminum oxide copings, all 15 full-coverage crowns were remounted along with the 2 PFM crowns on the master model and prepolished.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 17. <span style='font-size: 16px; font-weight: normal'> The bisque-bake try-in was performed to allow analysis and refinement of fit, proximal contacts, occlusion, phonetics, lip support, and aesthetics.</span>

Figure 17 - The bisque-bake try-in was performed to allow analysis and refinement of fit, proximal contacts, occlusion, phonetics, lip...

Figure 17 - The bisque-bake try-in was performed to allow analysis and refinement of fit, proximal contacts, occlusion, phonetics, lip support, and aesthetics.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 18. <span style='font-size: 16px; font-weight: normal'> As the emergence profile (is, soft tissie support) had yet to be achieved, a pickup impression was obtained; this allowed the laboratory technician to finely tune the emergence contours in the final porcelain bakes.</span>

Figure 18 - As the emergence profile (is, soft tissie support) had yet to be achieved, a pickup impression was obtained; this allowed t...

Figure 18 - As the emergence profile (is, soft tissie support) had yet to be achieved, a pickup impression was obtained; this allowed the laboratory technician to finely tune the emergence contours in the final porcelain bakes.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 19. <span style='font-size: 16px; font-weight: normal'> Since the CAD/CAM process provided space for the cement layer, the crowns exhibited a passive fit.</span>

Figure 19 - Since the CAD/CAM process provided space for the cement layer, the crowns exhibited a passive fit.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 20. <span style='font-size: 16px; font-weight: normal'> To facilitate the final laboratory sequence, impressions were obtained in polyvinylsiloxane utilizing a double-mix technique.</span>

Figure 20 - To facilitate the final laboratory sequence, impressions were obtained in polyvinylsiloxane utilizing a double-mix techniqu...

Figure 20 - To facilitate the final laboratory sequence, impressions were obtained in polyvinylsiloxane utilizing a double-mix technique.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 21. <span style='font-size: 16px; font-weight: normal'> This allowed the registration of the soft tissues following complete healing. At this stage, occlusal registration was similarly performed in polyvinylsiloxane.</span>

Figure 21 - This allowed the registration of the soft tissues following complete healing. At this stage, occlusal registration was simi...

Figure 21 - This allowed the registration of the soft tissues following complete healing. At this stage, occlusal registration was similarly performed in polyvinylsiloxane.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 22. <span style='font-size: 16px; font-weight: normal'> A new model was created from this final impression, and the emergence profile and cervical embrasures were optimized in accordance with the gingival architecture using dentin masses and cervical transparent effects.</span>

Figure 22 - A new model was created from this final impression, and the emergence profile and cervical embrasures were optimized in acc...

Figure 22 - A new model was created from this final impression, and the emergence profile and cervical embrasures were optimized in accordance with the gingival architecture using dentin masses and cervical transparent effects.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 23. <span style='font-size: 16px; font-weight: normal'> In order to ensure proper retention, the high-strength all-ceramic restorations were thoroughly cleansed prior to final seating. Each restoration was filled with a resin-modified glass ionomer cement of the appropriate color and seated accordingly.</span>

Figure 23 - In order to ensure proper retention, the high-strength all-ceramic restorations were thoroughly cleansed prior to final sea...

Figure 23 - In order to ensure proper retention, the high-strength all-ceramic restorations were thoroughly cleansed prior to final seating. Each restoration was filled with a resin-modified glass ionomer cement of the appropriate color and seated accordingly.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 24. <span style='font-size: 16px; font-weight: normal'> The gingival margins were protected by glycerin gel during seating. Once the definitive restorations had been seated, and explorer, scalpels, and dental floss were utilized to remove excess resin cement from the margins. The relative radiopacity of the all-ceramic copings allowed the fit of the cemented restoration to be verified with radiographs postoperatively.</span>

Figure 24 - The gingival margins were protected by glycerin gel during seating. Once the definitive restorations had been seated, and e...

Figure 24 - The gingival margins were protected by glycerin gel during seating. Once the definitive restorations had been seated, and explorer, scalpels, and dental floss were utilized to remove excess resin cement from the margins. The relative radiopacity of the all-ceramic copings allowed the fit of the cemented restoration to be verified with radiographs postoperatively.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 25. <span style='font-size: 16px; font-weight: normal'> The enhanced translucency, vitality, and color stability of the restorations were ensured by the densely sintered all-ceramic coping, which permitted maximum control of light, substrate, strength, and aesthetics.</span>

Figure 25 - The enhanced translucency, vitality, and color stability of the restorations were ensured by the densely sintered all-ceram...

Figure 25 - The enhanced translucency, vitality, and color stability of the restorations were ensured by the densely sintered all-ceramic coping, which permitted maximum control of light, substrate, strength, and aesthetics.

Extensive Aesthetic Rehabilitation with CAD/CAM Restorations<br/> Figure 26. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view of definitive full-coverage all-ceramic crown restorations. Note the natural vitality and aesthetics, as well as the harmony with the gingival architecture.</span>

Figure 26 - Postoperative facial view of definitive full-coverage all-ceramic crown restorations. Note the natural vitality and aesthet...

Figure 26 - Postoperative facial view of definitive full-coverage all-ceramic crown restorations. Note the natural vitality and aesthetics, as well as the harmony with the gingival architecture.

Aesthetic Crowns Adhesively Cemented with Resin-Modified Glass-Ionomer - Aesthetic Crowns Adhesively Cemented with Resin-Modified Glass-Ionomer

Aesthetic Crowns Adhesively Cemented with Resin-Modified Glass-Ionomer - Aesthetic Crowns Adhesively Cemented with Resin-Modified Glass-Ionomer Contributed by Bernard Touati, DDS on 4/27/2012

Aesthetic Crowns Adhesively Cemented with Resin-Modified Glass-Ionomer<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative view of a 66 year old female patient demonstrates severe discoloration of the maxillary anterior region.</span>

Figure 1 - Preoperative view of a 66 year old female patient demonstrates severe discoloration of the maxillary anterior region.

Aesthetic Crowns Adhesively Cemented with Resin-Modified Glass-Ionomer<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Vital teeth #7 through #10 were prepared for full-coverage ceramic restorations and a silicone impression was taken and forwarded to the laboratory.</span>

Figure 2 - Vital teeth #7 through #10 were prepared for full-coverage ceramic restorations and a silicone impression was taken and forw...

Figure 2 - Vital teeth #7 through #10 were prepared for full-coverage ceramic restorations and a silicone impression was taken and forwarded to the laboratory.

Aesthetic Crowns Adhesively Cemented with Resin-Modified Glass-Ionomer<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The definitive restorations were fabricated with 0.6mm aluminum oxide copings.</span>

Figure 3 - The definitive restorations were fabricated with 0.6mm aluminum oxide copings.

Aesthetic Crowns Adhesively Cemented with Resin-Modified Glass-Ionomer<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Lingual view following adhesive cementation using a resin-modified glass-ionomer.</span>

Figure 4 - Lingual view following adhesive cementation using a resin-modified glass-ionomer.

Aesthetic Crowns Adhesively Cemented with Resin-Modified Glass-Ionomer<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Postoperative radiograph demonstrates the similarity in radiolucency between the CAD/CAM ceramic crowns and natural dentition. Note the precision of the margins and thinness of the cement film.</span>

Figure 5 - Postoperative radiograph demonstrates the similarity in radiolucency between the CAD/CAM ceramic crowns and natural dentitio...

Figure 5 - Postoperative radiograph demonstrates the similarity in radiolucency between the CAD/CAM ceramic crowns and natural dentition. Note the precision of the margins and thinness of the cement film.

Aesthetic Crowns Adhesively Cemented with Resin-Modified Glass-Ionomer<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Postoperative buccal view demonstrates the aesthetic integration of the CAD/CAM ceramic crown restorations.</span>

Figure 6 - Postoperative buccal view demonstrates the aesthetic integration of the CAD/CAM ceramic crown restorations.

Use of the 810 nm Diode Laser for Soft Tissue Management

Soft tissue management post orthodontic therapy - Soft tissue management post orthodontic therapy

Soft tissue management post orthodontic therapy - Soft tissue management post orthodontic therapy Contributed by David M. Sarver, DMD, MS on 7/16/2012

Soft tissue management post orthodontic therapy<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Once orthodontic treatment was finished and appliances removed, the aesthetic finish was less than optimal.</span>

Figure 1 - Once orthodontic treatment was finished and appliances removed, the aesthetic finish was less than optimal.

Soft tissue management post orthodontic therapy<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Tooth #8(11) had a narrow gingival apex and asymmetric gingival shape, while tooth #9(21) had a flat gingival shape an was disproportionately short.</span>

Figure 2 - Tooth #8(11) had a narrow gingival apex and asymmetric gingival shape, while tooth #9(21) had a flat gingival shape an was d...

Figure 2 - Tooth #8(11) had a narrow gingival apex and asymmetric gingival shape, while tooth #9(21) had a flat gingival shape an was disproportionately short.

Soft tissue management post orthodontic therapy<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The diode laser was used to reshape tooth #9 (i.e., its marginal shape and length); tooth #8 was made more symmetric.</span>

Figure 3 - The diode laser was used to reshape tooth #9 (i.e., its marginal shape and length); tooth #8 was made more symmetric.

Soft tissue management post orthodontic therapy<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> At four weeks postoperatively, the patient had fully healed. The final smile was significantly enhanced by the finishing contouring provided.</span>

Figure 4 - At four weeks postoperatively, the patient had fully healed. The final smile was significantly enhanced by the finishing con...

Figure 4 - At four weeks postoperatively, the patient had fully healed. The final smile was significantly enhanced by the finishing contouring provided.

Management of hypertrophic gingiva and papillae - Management of hypertrophic gingiva and papillae

Management of hypertrophic gingiva and papillae - Management of hypertrophic gingiva and papillae Contributed by David M. Sarver, DMD, MS on 7/16/2012

Management of hypertrophic gingiva and papillae<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Poor oral hygiene, despite repeated reinforcement instructions from the orthodontist, resulted in hypertrophic gingva and papillae, creating pseudopockets, which were even more difficult to keep clean.</span>

Figure 1 - Poor oral hygiene, despite repeated reinforcement instructions from the orthodontist, resulted in hypertrophic gingva and pa...

Figure 1 - Poor oral hygiene, despite repeated reinforcement instructions from the orthodontist, resulted in hypertrophic gingva and papillae, creating pseudopockets, which were even more difficult to keep clean.

Management of hypertrophic gingiva and papillae<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The hypertrophic papillae were ablated and the gingiva recontoured to provide a better cleaning environment.</span>

Figure 2 - The hypertrophic papillae were ablated and the gingiva recontoured to provide a better cleaning environment.

Management of hypertrophic gingiva and papillae<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> At 4 weeks, there is a much more attractive and healthy intraoral picture.</span>

Figure 3 - At 4 weeks, there is a much more attractive and healthy intraoral picture.

The Role of Diode Lasers in Orthodontic Therapy

Soft Tissue Management Prior to Bracket Placement - Soft Tissue Management Prior to Bracket Placement

Soft Tissue Management Prior to Bracket Placement - Soft Tissue Management Prior to Bracket Placement Contributed by David M. Sarver, DMD, MS on 7/16/2012

Soft Tissue Management Prior to Bracket Placement<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> This 12-year-old patient illustrates how soft tissue management prior to bracket placement can facilitate the goals of the orthodontist in smile design.</span>

Figure 1 - This 12-year-old patient illustrates how soft tissue management prior to bracket placement can facilitate the goals of the o...

Figure 1 - This 12-year-old patient illustrates how soft tissue management prior to bracket placement can facilitate the goals of the orthodontist in smile design.

Soft Tissue Management Prior to Bracket Placement<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Due to the gingival encroachment, the orthodontic bracket must be placed well below the center of the tooth, resulting in incisor intrusion and further decreasing incisor display.</span>

Figure 2 - Due to the gingival encroachment, the orthodontic bracket must be placed well below the center of the tooth, resulting in in...

Figure 2 - Due to the gingival encroachment, the orthodontic bracket must be placed well below the center of the tooth, resulting in incisor intrusion and further decreasing incisor display.

Soft Tissue Management Prior to Bracket Placement<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> After periodontal probing, it was determined that sufficient tooth height could be gained to place the bracket more superiorly, resulting in a favorable outcome.</span>

Figure 3 - After periodontal probing, it was determined that sufficient tooth height could be gained to place the bracket more superior...

Figure 3 - After periodontal probing, it was determined that sufficient tooth height could be gained to place the bracket more superiorly, resulting in a favorable outcome.

Soft Tissue Management Prior to Bracket Placement<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> At the appointment for orthodontic appliance placement, anterior crown height of the central incisors was increased to more than 10 mm.</span>

Figure 4 - At the appointment for orthodontic appliance placement, anterior crown height of the central incisors was increased to more...

Figure 4 - At the appointment for orthodontic appliance placement, anterior crown height of the central incisors was increased to more than 10 mm.

Soft Tissue Management Prior to Bracket Placement<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Because of the clear field provided by the biodressing, brackets could be placed in the desired position in a single visit.</span>

Figure 5 - Because of the clear field provided by the biodressing, brackets could be placed in the desired position in a single visit.

Maintaining Appropriate Crown Width and Height After Orthodontic Treatment - Maintaining Appropriate Crown Width and Height After Orthodontic Tre...

Maintaining Appropriate Crown Width and Height After Orthodontic Treatment - Maintaining Appropriate Crown Width and Height After Orthodontic Treatment Contributed by David M. Sarver, DMD, MS on 7/16/2012

Maintaining Appropriate Crown Width and Height After Orthodontic Treatment<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> This patients maxillary lateral incisors were disproportionate in terms of width and height; the gingival margins also required management with the laser.</span>

Figure 1 - This patient's maxillary lateral incisors were disproportionate in terms of width and height; the gingival margins also requ...

Figure 1 - This patient's maxillary lateral incisors were disproportionate in terms of width and height; the gingival margins also required management with the laser.

Maintaining Appropriate Crown Width and Height After Orthodontic Treatment<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The diode laser was used to lengthen the lateral incisors. The brackets were then removed and re-bonded, extruding the anterior teeth to more closely match the smile arc.</span>

Figure 2 - The diode laser was used to lengthen the lateral incisors. The brackets were then removed and re-bonded, extruding the anter...

Figure 2 - The diode laser was used to lengthen the lateral incisors. The brackets were then removed and re-bonded, extruding the anterior teeth to more closely match the smile arc.

Maintaining Appropriate Crown Width and Height After Orthodontic Treatment<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The lateral incisors were lengthened to meet the proportionality requirements of the anterior teeth; brackets were placed to finish the anterior tooth position.</span>

Figure 3 - The lateral incisors were lengthened to meet the proportionality requirements of the anterior teeth; brackets were placed to...

Figure 3 - The lateral incisors were lengthened to meet the proportionality requirements of the anterior teeth; brackets were placed to finish the anterior tooth position.

Maintaining Appropriate Crown Width and Height After Orthodontic Treatment<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> The final smile was greatly improved, the smile arc was idealized, and tooth proportion was now aesthetic.</span>

Figure 4 - The final smile was greatly improved, the smile arc was idealized, and tooth proportion was now aesthetic.

Management of Altered Tooth Eruption During Orthodontic Therapy - Management of Altered Tooth Eruption During Orthodontic Therapy

Management of Altered Tooth Eruption During Orthodontic Therapy - Management of Altered Tooth Eruption During Orthodontic Therapy Contributed by David M. Sarver, DMD, MS on 7/16/2012

Management of Altered Tooth Eruption During Orthodontic Therapy<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Orthodontic treatment can be impeded by altered tooth eruption. Management of treatment can be facilitated by tissue modification with the diode laser.</span>

Figure 1 - Orthodontic treatment can be impeded by altered tooth eruption. Management of treatment can be facilitated by tissue modific...

Figure 1 - Orthodontic treatment can be impeded by altered tooth eruption. Management of treatment can be facilitated by tissue modification with the diode laser.

Management of Altered Tooth Eruption During Orthodontic Therapy<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> A small window was opened in attached gingival tissue. Note the clean margins and the availability of the tooth surface for preparation and bonding of a bracket.</span>

Figure 2 - A small window was opened in attached gingival tissue. Note the clean margins and the availability of the tooth surface for...

Figure 2 - A small window was opened in attached gingival tissue. Note the clean margins and the availability of the tooth surface for preparation and bonding of a bracket.

Management of Altered Tooth Eruption During Orthodontic Therapy<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> A bracket was bonded to the canine surface and the archwire was engaged.</span>

Figure 3 - A bracket was bonded to the canine surface and the archwire was engaged.

Management of Altered Tooth Eruption During Orthodontic Therapy<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> At 6 weeks, the canine had moved enough to reset the bracket more ideally.</span>

Figure 4 - At 6 weeks, the canine had moved enough to reset the bracket more ideally.

Management of Altered Tooth Eruption During Orthodontic Therapy<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> After an additional 6 weeks, the canine tooth had been moved into its final position for the case to be finished.</span>

Figure 5 - After an additional 6 weeks, the canine tooth had been moved into its final position for the case to be finished.

Chairside Fabrication of Single-Unit CAD/CAM Restorations

Single-Tooth Restoration of Tooth #9 With Metal-Free Crown - Single-Tooth Restoration of Tooth #9 With Metal-Free Crown

Single-Tooth Restoration of Tooth #9 With Metal-Free Crown - Single-Tooth Restoration of Tooth #9 With Metal-Free Crown Contributed by Walter Renne, DMD on 7/24/2012

Single-Tooth Restoration of Tooth #9 With Metal-Free Crown<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Digital scan of the tooth requiring restoration as viewed via CAD/CAM software.</span>

Figure 1 - Digital scan of the tooth requiring restoration as viewed via CAD/CAM software.

Single-Tooth Restoration of Tooth #9 With Metal-Free Crown<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Immediate postoperative view of all-ceramic restoration on tooth #9. Note seamless integration of the CAD/CAM crown.</span>

Figure 2 - Immediate postoperative view of all-ceramic restoration on tooth #9. Note seamless integration of the CAD/CAM crown.

Single-Tooth Restoration of Mandibular Premolar With A Metal-Free Restoration - Single-Tooth Restoration of Mandibular Premolar With A Metal-Free...

Single-Tooth Restoration of Mandibular Premolar With A Metal-Free Restoration - Single-Tooth Restoration of Mandibular Premolar With A Metal-Free Restoration Contributed by Walter Renne, DMD on 7/24/2012

Single-Tooth Restoration of Mandibular Premolar With A Metal-Free Restoration<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative occlusal view of the mandibular premolar tooth that will be treated with CAD/CAM restoration.</span>

Figure 1 - Preoperative occlusal view of the mandibular premolar tooth that will be treated with CAD/CAM restoration.

Single-Tooth Restoration of Mandibular Premolar With A Metal-Free Restoration<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Morphology for the full-coverage crown restoration is adjusted chairside in the CAD/CAM system to replicate natural contours.</span>

Figure 2 - Morphology for the full-coverage crown restoration is adjusted chairside in the CAD/CAM system to replicate natural contours...

Figure 2 - Morphology for the full-coverage crown restoration is adjusted chairside in the CAD/CAM system to replicate natural contours.

Single-Tooth Restoration of Mandibular Premolar With A Metal-Free Restoration<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Buccal view of the seated restoration demonstrates proper shade match and integration with the adjacent dentition. </span>

Figure 3 - Buccal view of the seated restoration demonstrates proper shade match and integration with the adjacent dentition.

Single-Tooth Restoration of Mandibular Premolar With A Metal-Free Restoration<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Magnified view of the restoration postoperatively demonstrates natural aesthetics and tissue response.</span>

Figure 4 - Magnified view of the restoration postoperatively demonstrates natural aesthetics and tissue response.

Single-Tooth Restoration of Mandibular Premolar With A Metal-Free Restoration<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Occlusal view of the definitive CAD/CAM restoration following seating.</span>

Figure 5 - Occlusal view of the definitive CAD/CAM restoration following seating.

Single-Tooth Restoration of Mandibular Molar With A Metal-Free Onlay - Single-Tooth Restoration of Mandibular Molar With A Metal-Free Onlay

Single-Tooth Restoration of Mandibular Molar With A Metal-Free Onlay - Single-Tooth Restoration of Mandibular Molar With A Metal-Free Onlay Contributed by Walter Renne, DMD on 7/24/2012

Single-Tooth Restoration of Mandibular Molar With A Metal-Free Onlay<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative view of failing posterior restoration that requires replacement with a single-visit CAD/CAM onlay.</span>

Figure 1 - Preoperative view of failing posterior restoration that requires replacement with a single-visit CAD/CAM onlay.

Single-Tooth Restoration of Mandibular Molar With A Metal-Free Onlay<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> View of the preparation and finish lines as viewed in the chairside CAD/CAM system.</span>

Figure 2 - View of the preparation and finish lines as viewed in the chairside CAD/CAM system.

Single-Tooth Restoration of Mandibular Molar With A Metal-Free Onlay<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Buccolingual view of the planned nanoceramic resin hybrid onlay restoration in the CAD/CAM software.</span>

Figure 3 - Buccolingual view of the planned nanoceramic resin hybrid onlay restoration in the CAD/CAM software.

Single-Tooth Restoration of Mandibular Molar With A Metal-Free Onlay<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Postoperative buccal view of the nanoceramic resin hybrid onlay restoration following seating and cementation.</span>

Figure 4 - Postoperative buccal view of the nanoceramic resin hybrid onlay restoration following seating and cementation.

Digital Radiography: Partially Edentulous Patient

Bitewing Radiograph of the Partially Edentulous Mandible - Digital radiograph of the partially edentulous patient

Bitewing Radiograph of the Partially Edentulous Mandible - Digital radiograph of the partially edentulous patient Contributed by Shawneen Gonzalez, DDS on 9/20/2012

Bitewing Radiograph of the Partially Edentulous Mandible<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Mandibular molar exposure produces bitewing radiograph of the partially edentulous patient.</span>

Figure 1 - Mandibular molar exposure produces bitewing radiograph of the partially edentulous patient.

Bitewing Radiograph of the Partially Edentulous Mandible<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Mandibular premolar exposure yields this bitewing radiograph of the partially edentulous patient.</span>

Figure 2 - Mandibular premolar exposure yields this bitewing radiograph of the partially edentulous patient.

Bitewing Radiograph of the Partially Edentulous Mandible<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Left mandibular premolar exposure in partially edentulous patient.</span>

Figure 3 - Left mandibular premolar exposure in partially edentulous patient.

Bitewing Radiograph of the Partially Edentulous Mandible<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Bitewing radiograph demonstrates bone resorption in mandibular arch. Left mandibular exposure in partially edentulous patient.</span>

Figure 4 - Bitewing radiograph demonstrates bone resorption in mandibular arch. Left mandibular exposure in partially edentulous patien...

Figure 4 - Bitewing radiograph demonstrates bone resorption in mandibular arch. Left mandibular exposure in partially edentulous patient.

Panoramic Radiographs of Interrradicular Bone Loss in the Partially Edentulous Patient - Digital pantomographs of the partially edentulous patien...

Panoramic Radiographs of Interrradicular Bone Loss in the Partially Edentulous Patient - Digital pantomographs of the partially edentulous patient Contributed by Shawneen Gonzalez, DDS on 9/20/2012

Panoramic Radiographs of Interrradicular Bone Loss in the Partially Edentulous Patient<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Panoramic radiograph demonstrates presence of interradicular bone loss in partially edentulous patient.</span>

Figure 1 - Panoramic radiograph demonstrates presence of interradicular bone loss in partially edentulous patient.

Panoramic Radiographs of Interrradicular Bone Loss in the Partially Edentulous Patient<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Panoramic radiograph of interradicular bone loss in mandibular arch of partially edentulous patient.</span>

Figure 2 - Panoramic radiograph of interradicular bone loss in mandibular arch of partially edentulous patient.

Panoramic Radiographs of Interrradicular Bone Loss in the Partially Edentulous Patient<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Pantomograph demonstrates interradicular bone loss in the maxillary and mandibular arches of this partially edentulous patient.</span>

Figure 3 - Pantomograph demonstrates interradicular bone loss in the maxillary and mandibular arches of this partially edentulous patie...

Figure 3 - Pantomograph demonstrates interradicular bone loss in the maxillary and mandibular arches of this partially edentulous patient.

Panoramic Radiographs of Interrradicular Bone Loss in the Partially Edentulous Patient<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Panoramic radiograph of interradicular bone loss in the partially edentulous patient.</span>

Figure 4 - Panoramic radiograph of interradicular bone loss in the partially edentulous patient.

Panoramic Radiographs of Impacted Teeth - Panoramic radiograph if impacted third molar in partially edentulous patient

Panoramic Radiographs of Impacted Teeth - Panoramic radiograph if impacted third molar in partially edentulous patient Contributed by Shawnee Gonzalez, DDS on 9/20/2012

Panoramic Radiographs of Impacted Teeth<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Panoramic radiograph of impacted tooth #17 in the partially edentulous patient.</span>

Figure 1 - Panoramic radiograph of impacted tooth #17 in the partially edentulous patient.

Digital Radiography: Fully Edentulous Patient

Panoramic Radiograph of the Fully Edentulous Patient - Digital pantomographs of fully edentulous patients

Panoramic Radiograph of the Fully Edentulous Patient - Digital pantomographs of fully edentulous patients Contributed by Shawnee Gonzalez, DDS on 9/20/2012

Panoramic Radiograph of the Fully Edentulous Patient<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Digital panoramic radiograph of fully edentulous patient--vital for determining alveolar bone present.</span>

Figure 1 - Digital panoramic radiograph of fully edentulous patient--vital for determining alveolar bone present.

Panoramic Radiograph of the Fully Edentulous Patient<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Panotmograph of the edentulous patient, used often to detect retained roots, impacted teeth, cysts, and foreign bodies. Panoramic radiographs yield important information on the quantity and quality of bone present.</span>

Figure 2 - Panotmograph of the edentulous patient, used often to detect retained roots, impacted teeth, cysts, and foreign bodies. Pano...

Figure 2 - Panotmograph of the edentulous patient, used often to detect retained roots, impacted teeth, cysts, and foreign bodies. Panoramic radiographs yield important information on the quantity and quality of bone present.

Digital Impression Making in Prosthetic Rehabilitations

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment - Aesthetic enhancement following completion of orthodontic therapy for c...

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment - Aesthetic enhancement following completion of orthodontic therapy for crowding, overbite, overjet, and edge-to-edge bite. Contributed by Steven Glassman, DDS on 11/14/2012

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative facial view demonstrating a lack of occlusal harmony and aesthetics.</span>

Figure 1 - Preoperative facial view demonstrating a lack of occlusal harmony and aesthetics.

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Preoperative view of the patient, who had his premolars removed years prior during adolescent orthodontics.</span>

Figure 2 - Preoperative view of the patient, who had his premolars removed years prior during adolescent orthodontics.

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> View of the patients dentition following the completion of orthodontic treatment to relieve crowding of the mandibular incisors.</span>

Figure 3 - View of the patient's dentition following the completion of orthodontic treatment to relieve crowding of the mandibular inci...

Figure 3 - View of the patient's dentition following the completion of orthodontic treatment to relieve crowding of the mandibular incisors.

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> A diagnostic waxup was created from mounted casts and would enable the fabrication of a putty matrix for chairside tooth reduction.</span>

Figure 4 - A diagnostic waxup was created from mounted casts and would enable the fabrication of a putty matrix for chairside tooth red...

Figure 4 - A diagnostic waxup was created from mounted casts and would enable the fabrication of a putty matrix for chairside tooth reduction.

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Prepared model in the dental laboratory indicating the amount of tooth reduction that would be necessary for the pending maxillary restorations.</span>

Figure 5 - Prepared model in the dental laboratory indicating the amount of tooth reduction that would be necessary for the pending max...

Figure 5 - Prepared model in the dental laboratory indicating the amount of tooth reduction that would be necessary for the pending maxillary restorations.

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> A reduction matrix was created from the diagnostic waxup and would be used chairside to guide tooth preparation.</span>

Figure 6 - A reduction matrix was created from the diagnostic waxup and would be used chairside to guide tooth preparation.

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> Clinical application of the tooth reduction guide to ensure sufficient space would exist for the zirconia full-coverage crown restorations.</span>

Figure 7 - Clinical application of the tooth reduction guide to ensure sufficient space would exist for the zirconia full-coverage crow...

Figure 7 - Clinical application of the tooth reduction guide to ensure sufficient space would exist for the zirconia full-coverage crown restorations.

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment<br/> Figure 8. <span style='font-size: 16px; font-weight: normal'> Facial view of the prepared dentition following the insertion of the gingival retraction cord.</span>

Figure 8 - Facial view of the prepared dentition following the insertion of the gingival retraction cord.

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment<br/> Figure 9. <span style='font-size: 16px; font-weight: normal'> View of the digital impression chairside enabled immediate verification of the preparation design.</span>

Figure 9 - View of the digital impression chairside enabled immediate verification of the preparation design.

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment<br/> Figure 10. <span style='font-size: 16px; font-weight: normal'> The digital impression would be used to create polyurethane models on which the ceramic restorations would be fabricated.</span>

Figure 10 - The digital impression would be used to create polyurethane models on which the ceramic restorations would be fabricated.

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment<br/> Figure 11. <span style='font-size: 16px; font-weight: normal'> The provisionalization phase enabled the patient to evaluate aesthetics, function, and phonetics while the definitive restorations were fabricated.</span>

Figure 11 - The provisionalization phase enabled the patient to evaluate aesthetics, function, and phonetics while the definitive resto...

Figure 11 - The provisionalization phase enabled the patient to evaluate aesthetics, function, and phonetics while the definitive restorations were fabricated.

All-Zirconia Crowns and Feldspathic Veneers After Orthodontic Treatment<br/> Figure 12. <span style='font-size: 16px; font-weight: normal'> Immediate postoperative facial view of the bonded restorations, demonstrating enhanced aesthetics and symmetry.</span>

Figure 12 - Immediate postoperative facial view of the bonded restorations, demonstrating enhanced aesthetics and symmetry.

Restoration of the Fully Edentulous Patient

Computer-Guided Implant Placement for Rehabilitation of the Edentulous Patient - A 50-year-old female patient presented with removable dentures a...

Computer-Guided Implant Placement for Rehabilitation of the Edentulous Patient - A 50-year-old female patient presented with removable dentures and moderate bone resorption, requesting a fixed, implant-supported rehabilitation Contributed by Dr. Paulo Malo on 2/1/2013

Computer-Guided Implant Placement for Rehabilitation of the Edentulous Patient<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Since the patients existing denture did not meet functional and aesthetic requirements, a new removable maxillary denture was fabricated. Special consideration was given to her low smile line and mouth-opening capability of over 50 mm.</span>

Figure 1 - Since the patient's existing denture did not meet functional and aesthetic requirements, a new removable maxillary denture w...

Figure 1 - Since the patient's existing denture did not meet functional and aesthetic requirements, a new removable maxillary denture was fabricated. Special consideration was given to her low smile line and mouth-opening capability of over 50 mm.

Computer-Guided Implant Placement for Rehabilitation of the Edentulous Patient<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The preoperative radiograph and the 3D radiographic analysis showed moderate bone resorption in the maxilla and severe bone resorption in the mandible. Note the lack of available bone for implant placement in the posterior maxilla and mandible.</span>

Figure 2 - The preoperative radiograph and the 3D radiographic analysis showed moderate bone resorption in the maxilla and severe bone...

Figure 2 - The preoperative radiograph and the 3D radiographic analysis showed moderate bone resorption in the maxilla and severe bone resorption in the mandible. Note the lack of available bone for implant placement in the posterior maxilla and mandible.

Computer-Guided Implant Placement for Rehabilitation of the Edentulous Patient<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Computer-guided treatment planning yielded a detailed diagnostic process in both jaws. Prosthetic-driven planning based on the patients anatomy and prosthetic needs was chosen to ensure implant support for an optimal restorative solution.</span>

Figure 3 - Computer-guided treatment planning yielded a detailed diagnostic process in both jaws. Prosthetic-driven planning based on t...

Figure 3 - Computer-guided treatment planning yielded a detailed diagnostic process in both jaws. Prosthetic-driven planning based on the patient's anatomy and prosthetic needs was chosen to ensure implant support for an optimal restorative solution.

Computer-Guided Implant Placement for Rehabilitation of the Edentulous Patient<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> In the maxilla, a flapless procedure was selected. A surgical template was used to optimally position the four implant and ensure minimally invasive treatment.</span>

Figure 4 - In the maxilla, a flapless procedure was selected. A surgical template was used to optimally position the four implant and e...

Figure 4 - In the maxilla, a flapless procedure was selected. A surgical template was used to optimally position the four implant and ensure minimally invasive treatment.

Computer-Guided Implant Placement for Rehabilitation of the Edentulous Patient<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Occlusal view immediately after implant placement. Straight multi-unit abutments were placed on the axial anterior implants. The 30 degree multi-unit abutments (non-engaging) were placed using a custom jig for the correct positioning.</span>

Figure 5 - Occlusal view immediately after implant placement. Straight multi-unit abutments were placed on the axial anterior implants....

Figure 5 - Occlusal view immediately after implant placement. Straight multi-unit abutments were placed on the axial anterior implants. The 30 degree multi-unit abutments (non-engaging) were placed using a custom jig for the correct positioning.

Computer-Guided Implant Placement for Rehabilitation of the Edentulous Patient<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> After traditional treatment planning for the mandible, a conventional flap procedure was done. The surgical guide was positioned for optimal implant placement, assisting in the correct angulations (between 30 and 45 degrees) for the posterior implants.</span>

Figure 6 - After traditional treatment planning for the mandible, a conventional flap procedure was done. The surgical guide was positi...

Figure 6 - After traditional treatment planning for the mandible, a conventional flap procedure was done. The surgical guide was positioned for optimal implant placement, assisting in the correct angulations (between 30 and 45 degrees) for the posterior implants.

Computer-Guided Implant Placement for Rehabilitation of the Edentulous Patient<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> After 6 months, the immediately loaded temporary bridges were replaced with a ceramic bridge in the maxilla and--following the same protocol--an acrylic arch built upon a titanium framework on the mandibular implants.</span>

Figure 7 - After 6 months, the immediately loaded temporary bridges were replaced with a ceramic bridge in the maxilla and--following t...

Figure 7 - After 6 months, the immediately loaded temporary bridges were replaced with a ceramic bridge in the maxilla and--following the same protocol--an acrylic arch built upon a titanium framework on the mandibular implants.

Computer-Guided Implant Placement for Rehabilitation of the Edentulous Patient<br/> Figure 8. <span style='font-size: 16px; font-weight: normal'> Radiograph at 6 months shows successful treatment with four grooved implants in combination with precision-manufactured titanium frameworks in each jaw, milled for fit, longevity, and the patients expectations.</span>

Figure 8 - Radiograph at 6 months shows successful treatment with four grooved implants in combination with precision-manufactured tita...

Figure 8 - Radiograph at 6 months shows successful treatment with four grooved implants in combination with precision-manufactured titanium frameworks in each jaw, milled for fit, longevity, and the patient's expectations.

Computer-Guided Implant Placement for Rehabilitation of the Edentulous Patient<br/> Figure 9. <span style='font-size: 16px; font-weight: normal'> Extraoral view of the patient postoperatively, showing the definitive rehabilitation with fixed bridges to fulfill the phonetic, masticatory, and aesthetic needs of the patients.</span>

Figure 9 - Extraoral view of the patient postoperatively, showing the definitive rehabilitation with fixed bridges to fulfill the phone...

Figure 9 - Extraoral view of the patient postoperatively, showing the definitive rehabilitation with fixed bridges to fulfill the phonetic, masticatory, and aesthetic needs of the patients.

Caries Detection Using Intraoral Cameras

Interproximal Caries of Stage III - A 30-year-old male patient presented with interproximal caries of stage III. His condition was diagnosed usin...

Interproximal Caries of Stage III - A 30-year-old male patient presented with interproximal caries of stage III. His condition was diagnosed using an intraoral camera. Contributed by THE NEXTDDS on 3/14/2014

Interproximal Caries of Stage III<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> The carious lesion is not visible under white light.</span>

Figure 1 - The carious lesion is not visible under white light.

Interproximal Caries of Stage III<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The fluorescence image shows a demineralization on the marginal mesial ridge compared to the opposite ridge.</span>

Figure 2 - The fluorescence image shows a demineralization on the marginal mesial ridge compared to the opposite ridge.

Interproximal Caries of Stage III<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Radiography confirms the presence of the carious lesion of stage 3.</span>

Figure 3 - Radiography confirms the presence of the carious lesion of stage 3.

Interproximal Caries of Stage III<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Under white light, the entry point of the caries and the cavity can be seen.</span>

Figure 4 - Under white light, the entry point of the caries and the cavity can be seen.

Interproximal Caries of Stage III<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> The fluorescence image shows the demineralized enamel, the destructured, and the infected dentin.</span>

Figure 5 - The fluorescence image shows the demineralized enamel, the destructured, and the infected dentin.

Interproximal Caries of Stage III<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> At the end of the preparation, the fluorescence image shows all the infected dentin was removed.</span>

Figure 6 - At the end of the preparation, the fluorescence image shows all the infected dentin was removed.

Interproximal Caries of Stage III<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> The finished restoration, filled with glass ionomer cement.</span>

Figure 7 - The finished restoration, filled with glass ionomer cement.

Occlusal Caries of Stage II - A 13-year-old female patient presented with occlusal caries of stage II. The condition was diagnosed using an intra...

Occlusal Caries of Stage II - A 13-year-old female patient presented with occlusal caries of stage II. The condition was diagnosed using an intraoral camera. Contributed by THE NEXTDDS on 3/14/2014

Occlusal Caries of Stage II<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> The white light clearly shows an occlusal carious lesion.</span>

Figure 1 - The white light clearly shows an occlusal carious lesion.

Occlusal Caries of Stage II<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The image of fluorescence shows a demineralization around the lesion.</span>

Figure 2 - The image of fluorescence shows a demineralization around the lesion.

Occlusal Caries of Stage II<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The cavity is clearly evident when viewed under white light.</span>

Figure 3 - The cavity is clearly evident when viewed under white light.

Occlusal Caries of Stage II<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Fluorescent imaging shows destructured and infected dentin.</span>

Figure 4 - Fluorescent imaging shows destructured and infected dentin.

Occlusal Caries of Stage II<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> At the bottom of the preparation, the image of fluorescence shows that all the infected dentin was removed. The orange zone on the side corresponds to the tertiary dentin.</span>

Figure 5 - At the bottom of the preparation, the image of fluorescence shows that all the infected dentin was removed. The orange zone...

Figure 5 - At the bottom of the preparation, the image of fluorescence shows that all the infected dentin was removed. The orange zone on the side corresponds to the tertiary dentin.

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