Multidisciplinary approach to the establishment and maintenance of an esthetic smile: a 9-year follow-up case report

In addition to providing functionality to patients, contemporary dentistry strives for esthetic excellence. Patients with anterior impairments, such as shape, size, and position alterations, have compromised smile harmony. A multidisciplinary orthodontic-operative dentistry approach has improved the treatment of these patients, since the use of orthodontic appliances in association with direct composite restorations can solve many esthetic problems. Although this treatment strategy is rather widespread, professional skills are necessary for the correct reproduction of the main features of teeth. Moreover, treatment success is directly related to its longevity. With the aid of a 9-year follow-up case report, a simple direct technique associated with an orthodontic treatment for restoring the esthetic appearance of an impaired smile, with good short- and long-term outcomes, based on minimal but essential esthetic repair interventions is discussed. Such coordinated treatment proved to be effective for the establishment and maintenance of an esthetic and pleasant smile.

The force-distance properties of attracting magnetic attachments for tooth movement in combination with clear sequential aligners

BACKGROUND

The demand for clear sequential aligner therapy has increased dramatically in recent years. An improved system utilising small neodymium-iron-boron (NdFeB) magnetic attachments has been proposed to enhance appliance capabilities.

AIM

The aim of the investigation was to analyse the force system diagrams produced by small attracting NdFeB magnets to determine, 1) whether the force levels were sufficient to induce tooth movement, 2) the effect of magnet morphology on force characteristics and, 3) the most appropriate magnet dimensions that could be utilised for this application.

METHODS

Twenty-nine NdFeB rectangular magnets of varying dimensions were tested. A Mach-1 universal testing machine (Biosyntech Inc, Quebec, Canada) was used to measure the attractive force of pairs of magnets. Measurements commenced with a magnetic pair in contact and subsequently vertically separated a distance of 10 mm at a speed of 12 mm/minute. For all magnetic configurations four repeat measurements were performed on five magnetic pairs of the same size.

RESULTS

The force-distance diagrams for all magnet configurations demonstrated a dramatic decrease in force with increasing magnet separation. Rather than a suggested inverse square law, the experimental data followed an inverse fourth law when an offset determined by a regression analysis was applied to the distance. For the majority of magnets, insignificant forces were attained beyond 2 mm of separation. Magnets with large pole face areas and longer magnetic axes provided the greatest force.

CONCLUSIONS

A select range of magnet configurations exhibited suitable and reliable attractive forces and therefore could be advocated for prescribed clinical application.

Esthetic and functional rehabilitation for oligodontia in the mixed dentition: case report

Tooth agenesis can be considered the most common anomaly of craniofacial development in humans, with an estimated prevalence reaching up to 20% worldwide. Treatments for tooth agenesis include orthodontic space closure, use of fixed or removable dentures, and placement of dental implants. Some of these options may not be applicable to children in mixed dentition because they can prevent the normal development of facial bones. A multidisciplinary, staged approach considering the number, size, and development of the remaining teeth in the long term would be the most suitable treatment. The purpose of this paper is to describe a 5-year clinical follow-up of a case of oligodontia in a young female patient in mixed dentition.

Ultimate ceramic veneer: a laboratory-guided preparation technique for minimally invasive laminate veneers

Clinical success of ceramic laminate veneers depends on material selection, bonding procedures, controlled laboratory steps, and enamel preservation. Enamel preservation is the most critical because excessive tooth preparation can expose dentin reducing bond strength, which is a factor that can cause a decrease in long-term clinical success. The proposed technique based on carefully treatment planning developed between clinician and dental technician helps to maximize enamel preservation, which is an important element for clinical success.

The use of fragments of thin veneers as a restorative therapy for anterior teeth disharmony: a case report with 3 years of follow-up

AIM

The present case report described the use of contact lens of thin porcelain veneers as a restorative therapy to solve anterior teeth disharmony.

BACKGROUND

Fragments of thin veneers are minimally invasive restorations with little or no dental preparation and present thickness ranging from 0.2 to 0.5 mm. They are used in case of diastema closure, small changes of teeth, color and restoration of teeth with small fractures.

CASE REPORT

A 25-year-old man was admitted at a dental clinic complaining about the diastema presence on the upper anterior teeth. Patient was referred to an orthodontic treatment in order to provide better distribution of the diastemas and harmonious proportion of the teeth. Afterwards, contact lens of thin porcelain veneers were fabricated on the six upper anterior teeth.

CONCLUSION

Based on the outcomes of this clinical report, we considered the use of fragments of thin veneers as a successful treatment option after 3 years of follow-up.

CLINICAL SIGNIFICANCE

The fragments of thin veneers have been established to be an interesting alternative to esthetically restore the anterior teeth with minimal invasiveness. However, since it is a new treatment modality, longitudinal studies are necessary to understand the material's behavior.

Direct resin composite approach to orthodontic relapse. Case report

The treatment of malaligned teeth represents a challenge, especially in the presence of root resorption. Options to improve aesthetics are limited and often involve high costs. Direct composite restorations offer an alternative for the realignment of orthodontic-relapsed teeth where orthodontic retreatment is not indicated. Their reasonable cost, conservativeness and excellent aesthetics have allowed resin composites to gain popularity in recent years. This report describes a direct composite approach to the realignment of teeth with anterior root resorption. Furthermore, the article describes the use of a "silicon lingual matrix" to facilitate the polychromatic layering of composite and the manipulation of illusions to improve perception of tooth alignment.

Multidisciplinary treatment plans in the adult patient - step by step and rationale

Interdisciplinary, multidisciplinary and comprehensive treatment plans are now part of everyday practice. The interaction between different specialists can provide patients with better, more conservative and more pleasing results. This case report shows the step by step of a multidisciplinary treatment plan and the rationale for each part of a process where conservative dentistry, periodontics, orthodontics, implant dentistry and prosthetics are involved.

Anterior open bite correction using bite block: a case report

Several etiological factors that result in dental and/or skeletal alterations make the open bite a type of malocclusion with several treatment alternatives. Corrective fixed orthodontics in conjunction with mechanical or functional orthopedics is a routine approach in correcting this problem. However, orthosurgical treatment must never be discarded for cases with skeletal involvement. This article describes a clinical case which, despite involving skeletal aspects, was treated satisfactorily using a passive bite-block appliance in conjunction with corrective fixed orthodontics.

[Tongue retraining and occlusal stability in a young adult. Case report]

The clinical observation describes the case of a 20-year-old woman who has consulted for aesthetic and functional reasons. She presents a skeletal class III normodivergent, an occlusal class III with a lower proalveoli quite marked. In addition, a lingual dysfunction which manifests itself by important anterior diastema and dento-dental disharmony at the upper jaw complicates the case. The undertaken therapeutic project starts with a first step of a lingual praxis rehabilitation, followed by an orthodontic step and upper lateral incisors-plasty. The purpose of those results is the evaluation of the stability two years later, which was reported positive.

Sequelae of iatrogenic periodontal destruction associated with elastics and permanent incisors: literature review and report of 3 cases

The purpose of this paper was to report 3 cases of localized aggressive periodontal bone destruction related to improper use of orthodontic elastic bands to close diastemas in permanent anterior teeth and to compare the results to previous studies. Some common signs and symptoms of this particular destruction were observed with these patients that had been previously reported when the comparisons of these cases were made. The patients usually experienced a painful sensation, and an isolated pyogenic-like granuloma appeared at the interdental area. Radiographs revealed localized periodontal destruction, with tooth extrusion and clinical crown divergence and radiographic root convergence; the two involved teeth moved simultaneously during mobility testing. Surgical intervention and treatment of the cases was described. The prognosis is usually decided by the severity of the condition, and many factors may influence the healing of treated cases.

Finishing and polishing criteria for minimally invasive composite restorations

To achieve the benefits that composite restorations can provide, it is incumbent on dentists to understand the importance of proper finishing and polishing techniques and how to incorporate them appropriately into everyday practice. A smooth surface finish is clinically necessary because the presence of surface irregularities from poor finishing and polishing can lead to staining, plaque retention, gingival irritation, recurrent caries, abrasiveness, wear kinetics, and tactile perception by the patient. However, finishing and polishing procedures for direct composite restorations are technique- and material-sensitive. This article describes the proper composite material placement considerations, as well as finishing and polishing techniques and materials, for providing highly esthetic, long-lasting restorations. By incorporating such protocol into their everyday practices, dentists can increase the long-term esthetic and plaque-resistant predictability of direct composite restorations.