Minimally Invasive Laminate Veneer Therapy for Maxillary Central Incisors.

Minimally invasive dentistry is a considered process that requires the clinician to be prepared with the ideal sequence and the tools needed. This report describes a well-planned ultraconservative approach using only two ceramic laminate veneers for the maxillary central incisors to significantly improve the patient's overall smile. A 30-year-old female presented with the chief complaints of having diastemas between the central and lateral incisors as well as incisal wear. Diagnostic wax-up and mock-up were performed, and the patient approved the minimally invasive treatment with veneers only for central incisors. A reduction guide aided the conservative tooth preparations, and hand-crafted feldspathic veneers were bonded under total isolation with a rubber dam. The two final conservative veneers significantly improved the smile and fulfilled the patient's expectations. Following proper planning and sequencing, predictable outcomes were obtained and fulfilled the patient's esthetic demands. Minimally invasive restorative dentistry with only two single veneers can impact the entire smile frame. Overtreatment in the esthetic zone is unnecessary to meet a patient's esthetic expectations

Influence of Light Intensity on Surface Free Energy and Dentin Bond Strength of Core Build-up Resins

Objective: We examined the influence of light intensity on surface free energy characteristics and dentin bond strength of dual-cure direct core build-up resin systems. Methods: Two commercially available dual-cure direct core build-up resin systems, Clearfil DC Core Automix with Clearfil Bond SE One and UniFil Core EM with Self-Etching Bond, were studied. Bovine mandibular incisors were mounted in acrylic resin and the facial dentin surfaces were wet ground on 600-grit silicon carbide paper. Adhesives were applied to dentin surfaces and cured with light intensities of 0 (no irradiation), 200, 400, and 600 mW/cm2. The surface free energy of the adhesives (five samples per group) was determined by measuring the contact angles of three test liquids placed on the cured adhesives. To determine the strength of the dentin bond, the core build-up resin pastes were condensed into the mold on the adhesive-treated dentin surfaces according to the methods described for the surface free energy measurement. The resin pastes were cured with the same light intensities as those used for the adhesives. Ten specimens per group were stored in water maintained at 37°C for 24 hours, after which they were shear tested at a crosshead speed of 1.0 mm/minute in a universal testing machine. Two-way analysis of variance (ANOVA) and a Tukey-Kramer test were performed, with the significance level set at 0.05. Results: The surface free energies of the adhesive-treated dentin surfaces decreased with an increase in the light intensity of the curing unit. Two-way ANOVA revealed that the type of core build-up system and the light intensity significantly influence the bond strength, although there was no significant interaction between the two factors. The highest bond strengths were achieved when the resin pastes were cured with the strongest light intensity for all the core build-up systems. When polymerized with a light intensity of 200 mW/cm2 or less, significantly lower bond strengths were observed. Conclusions: The data suggest that the dentin bond strength of core build-up systems are still affected by the light intensity of the curing unit, which is based on the surface free energy of the adhesives. On the basis of the results and limitations of the test conditions used in this study, it appears that a light intensity of >400 mW/cm2 may be required for achieving the optimal dentin bond strength

Full-Mouth Rehabilitation of a Patient with Sjogren's Syndrome with Maxillary Titanium-Zirconia and Mandibular Monolithic Zirconia Implant Prostheses Fabricated with CAD/CAM Technology: A Clinical Report.

Dental implants have become a well-established treatment modality for the management of complete and partial edentulism. Recent advancements in dental implant systems and CAD/CAM technologies have revolutionized prosthodontic practice by allowing for the predictable, efficient, and faster management of complex dental scenarios. This clinical report describes the interdisciplinary management of a patient with Sjogren's syndrome and terminal dentition. The patient was rehabilitated using dental implants and zirconia-based prostheses in the maxillary and mandibular arches. These prostheses were fabricated using a combination of CAD/CAM and analog techniques. The successful outcomes for the patient demonstrate the importance of appropriate use of biomaterials and the implementation of interdisciplinary collaboration in treating complex dental cases

Diagnostic Mock-Up as a Surgical Reduction Guide for Crown Lengthening: Technique Description and Case Report.

Background and Objectives: The report describes a technique using a diagnostic mock-up as a crown-lengthening surgical guide to improve the gingival architecture. Materials and Methods: The patient's primary concern was improving her smile due to her "gummy smile" and short clinical crowns. After clinical evaluation, surgical crown lengthening accompanied by maxillary central full-coverage single-unit prostheses and lateral incisor veneers was recommended. The diagnostic mock-up was placed in the patient's maxillary anterior region and used as a soft tissue reduction guide for the gingivectomy. Once the planned gingival architecture was achieved, a flap was reflected to proceed with ostectomy in order to obtain an appropriate alveolar bone crest level using the overlay. After six months, all-ceramic crowns and porcelain veneers were provided as permanent restorations. Results: A diagnostic mock-up fabricated with a putty guide directly from the diagnostic wax-up can be an adequate surgical guide for crown-lengthening procedures. The diagnostic wax-up was used to fabricate the diagnostic mock-up. These results suggested that it can be used as a crown-lengthening surgical guide to modify the gingival architecture. Several advantages of the overlay used in the aesthetic complex case include: (1) providing a preview of potential restorative outcomes, (2) allowing for the appropriate positioning of gingival margins and the desired alveolar bone crest level for the crown-lengthening procedure, and (3) serving as a provisional restoration after surgery. Conclusions: The use of a diagnostic mock-up, which was based on a diagnostic wax-up, as the surgical guide resulted in successful crown lengthening and provisional restorations. Thus, a diagnostic overlay can be a viable option as a surgical guide for crown lengthening

Bond Durability of Two-Step HEMA-Free Universal Adhesive

The purpose of this study is to compare bond durability, in terms of fatigue bond strength, of a two-step HEMA-free universal adhesive and representative adhesives in each systematic category. The adhesives used in this study were OptiBond FL, Prime&Bond NT, Clearfil SE Bond 2, G2-Bond Universal, and Scotchbond Universal Plus Adhesive. Fatigue bond strength testing and scanning electron microscopy analysis of adhesively bonded enamel and dentin interfaces were performed. For the adhesives in etch-and-rinse mode, the enamel fatigue bond strength of the G2-Bond Universal adhesive was significantly higher than those of other adhesives, and the dentin fatigue bond strength of Prime&Bond NT was significantly lower than the others. For adhesives in self-etch mode, the enamel fatigue bond strengths of Clearfil SE Bond 2 and G2-Bond Universal were significantly higher than that of the Scotchbond Universal Plus Adhesive, and the dentin fatigue bond strength of G2-Bond Universal was significantly higher than Clearfil SE Bond 2 and the Scotchbond Universal Plus Adhesive. The two-step HEMA-free universal adhesive showed higher enamel and higher or equal dentin fatigue bond strength than other selected representative adhesive systems in etch-and-rinse mode and higher or equal enamel and higher dentin fatigue bond strength than adhesive systems in self-etch mode