PREDICTABLE “START TO FINISH” BIOMIMETIC DENTISTRY IN THE ANTERIOR DENTITION: From chemical treatments, to fragment reattachment, direct, semi-(in)direct and indirect restorations.

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Course Description

Introduction

A healthy, clean and fresh smile is a powerful attribute in our society. Being able to providing your patients with the most appropriate, effective and conservative treatment to restore the anterior dentition is therefore a fundamental element in a contemporary dental practice. This clinically-oriented course will cover the wide spectrum of treatment strategies and their indications from the simplest and effective vital bleaching therapy, micro- and mega-abrasion techniques, nonvital bleaching, tooth fragment reattachment, direct composite resin restorations and finally the more complex application of veneers (detailed steps from diagnosis and treatment planning to luting).  Through this overview, you should be able to enhance your treatment decisions and skills in adhesive dentistry, in order for your restorations “to bond and stay bonded”. Those who will participate also in the two additional days of veneer hands-on course will have an opportunity to practice their skills in a simulated case of smile redesign, with an emphasis on tooth morphology, wax up and mock-up techniques and minimally-invasive veneer preparations.

DAY 1 LECTURE

ANTERIOR RESTORATIONS: FROM BLEACHING, DIRECT, SEMI-DIRECT AND DIRECT

Morning session: 

  • Introduction
  • Vital Bleaching
- Indications and contraindications
- Concentration of bleach and chemical composition
- Which stains vital bleaching works effectively for
- When to combine with other techniques
  • Abrasion Techniques
- When to use Micro/macroabrasion
- When not to use Micro/macroabrasion
- The technique for Micro/macrobrasion
  • Fragment Reattachment
- Technique for fragment reattachment
- How to achieve long term success with fragment reattachment
  • Nonvital Bleaching
- Indications and contraindications for non-vital bleaching
- Concentrations of bleaching agent risks and uses
- Technique for non-vital bleaching and subsequent tooth restoration.
- Long term results and risks of non-vital bleaching

Afternoon session:

  • Direct Composite Layering
- Indications and limitations of composite veneers
- Three increment layering technique
  • Semi-direct Composite Veneers

DAY 2 LECTURE

ANTERIOR INDIRECT BONDED VENEERS
 
Morning session:
 
  • Biomimetic Approach
- Understanding of Biology, mechanics, function and aesthetics to effectively plan anterior bonded restorations
 
  • Extended Spectrum of Indications
- Indications and limitations of composite veneers
- Indications and limitations of porcelain veneers
 
  • Diagnostic Approach – Wax up
- General considerations for tooth shape and proportions
- Technique to achieve reliable and reproducible results
- Technique and indications for the additive wax-up

Afternoon session       

  • Diagnostic Approach – Mock
             - Step by step technique to recreate the diagnostic wax-up
             - Materials and techniques required for long term provisional
             - Cerec scanning and milling and training
 
  • Tooth Preparation

            - Principles of tooth preparation for bonded porcelain restorations including:
            - Chamfer size
            - Axial and incisal reduction

  • Luting Procedures, finishing and maintenance protocol?

            - How to adequately prepare eMax and feldspathic porcelain veneers for optimal bonding
            - How to use composite resin to lute Bonded porcelain restorations
            - Use of different products and techniques to ease luting procedures with optimal results

 

 

 

DAY 3 HANDS-ON SESSION

ANTERIOR SMILE DESIGN: FROM MORPHOLOGY TO MOCKUP TO PREPARATIONS
  • Maxillary additive wax up canine to canine
- Using an electric waxer to wax-up maxillary centrals
- Drop by drop technique to create gross anatomical dental features
- How to create harmonious incisal edges and appropriate tooth contour and shape
- How to establish correct interdental spacing and surface texture for optimal aesthetic and functional integration
- How to use an articulator to adequately evaluate incisal and canine guidance.
 
  • Direct Classic Mock-up technique Silicon index fabrication
-Mock-up-driven tooth preparation
- Model modification to create ideal mock-ups
- Silicone index fabrication techniques
- Testing of silicone indexes to ensure adequate replication of wax-up
- Preparation of acrylic resin in order to achieve shade matching
- Tips and tricks on clean-up and application of stain and glaze to achieve optimal aesthetics
 

DAY 4 HANDS ON SESSION

VENEER PREPARATION TO ADHESIVE LUTING
 
  • Veneer Preparation
- Basic principles of Veneer preparation
- Veneer preparation criteria
- How to achieve optimal veneer criteria
- Tips and tricks on how to create and incisal edge seat and avoid sharp angles.
 
  • Veneer Adhesive Luting
- Use of composite resin to lute veneers
- Isolation and try in procedures to ensure accurate seating and cementation
- How to appropriately condition ceramic for optimal bonding
- How to condition tooth for optimal bonding
- Insertion and excess removal procedures
- Occlusal adjustment and flash removal

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