Systematic analysis of an anterior wear case to fulfill esthetic and functional objectives

It is beneficial to have a system in place for analysis of clinical data collected from a patient's initial examination. This system has four diagnostic categories that enable the clinician to thoroughly assess the clinical findings and establish a comprehensive diagnosis. An optimal treatment plan can be formulated to positively affect the prognosis of the presenting conditions. With the patient's treatment goals in mind, the clinician can determine the minimum amount of dentistry needed to increase long-term prognosis.

Successful strategies for matching one or two indirect restorations to natural dentition

One of the most difficult and noble undertakings of a dental restorative team is to provide an indirect restoration for a compromised tooth surrounded by otherwise healthy, natural dentition. Matching one or two indirect dental restorations to adjacent healthy teeth is a herculean task for both the dentist and laboratory technician. The team must be knowledgeable of the natural dentition's characteristics to best mimic and recreate those same characteristics in a man-made restoration. Knowledge of principles in smile design, dental anatomy, color, characterization, material selection, doctor-technician communication, and clinical acumen are necessary to achieve a successful outcome when matching one or two indirect restorations to natural dentition.

Interdisciplinary treatment of an end-to-end occlusion due to congenitally missing maxillary lateral incisors

Odontogenic aplasia, or the congenital absence of permanent teeth, is relatively common. When the missing teeth include the maxillary lateral incisors, treatment considerations must reconcile both esthetic and functional objectives. In developing dentition, erupting adjacent teeth can drift from their intended positions into the edentulous space created by the congenitally missing tooth. When this movement happens (e.g., cuspids shifting more mesially than normal), esthetic and functional problems occur. A restorative solution for missing maxillary lateral incisors subsequent to the loss of the maxillary incisor spaces is presented while highlighting the use of a leucite-reinforced material. This approach allowed for a minimal preparation design and conservation of tooth structure, providing an optimal bond.

Enhancing facial appearance with aesthetic dentistry, centric relation, and proper occlusal management

Dramatic alterations that affect a person's appearance can be accomplished by changing the shade, shape, and location of individual teeth in the dental arch. With further application of scientifically documented anatomic principles, dentists can change a person's facial appearance without using unnatural tooth shapes and/or creating nonphysiologic changes in the masticatory system. What is most important is that the clinician does not have to open a patient's vertical dimension of occlusion (VDO) to exact a change in facial aesthetics. A conservative approach that is harmonious with the natural human form can be successfully accomplished.

LEARNING OBJECTIVES

This article presents a conservative methodology towards enhancing a patient's facial appearance in order to fulfill their aesthetic objectives. Upon reading this article, the reader should: Realize how a basic understanding of both the anatomy of the temporomandibular joint (TMJ) and how it interacts with the dentition can help provide a beneficial and stable occlusion for aesthetic dentistry. Understand how the VDO is established and how to decide when and if an increase of VDO is necessary for treatment.