001.Evidence-based direct Esthetic Dentistry

DR. GARY L. UNTERBRINK
Private Practitioner in Triesen, Liechtenstein , University of Zagreb, Croatia

Composites have been used for the restoration of anterior teeth for more than 30 years, and materials designed specifically for optimal aesthetics have been introduced by nearly every company in recent years. Despite significant improvements in composite technology, anterior restorations remain challenging.

Preparation Technique

The preparation is the first critical step. Restorations with discolored margins are not aesthetic! Naturally we want to be as conservative as possible, but the correct angles are required at the margins to achieve a stable bond. Different types of bevels are used to maximize strength or aesthetics.

Material Selection

Some composites are designated as "universal" and suitable for every indication. Other materials are divided into anterior and posterior. One or both of these recommendations must be wrong. Which materials or material combinations are best for the different indications? The correlation of physical properties with clinical results provides guidelines for our decisions.

Application Technique

Shade selection and layering techniques are other determinants of our final result. In particular with the newer materials with enamel transparency, layer thickness dramatically changes the appearance. Achieving proper emergence angles and tooth form is a question of matrix technique and experience. Adequate polymerization and suitable finishing techniques are required to provide wear resistance and shade stability.

Although some compromises remain, modern composite materials permit achievement of aesthetic results rivaling ceramics.
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DR. NICOLAS JEDYNAKIEWICZ
 The University of Liverpool Pembroke Place  Liverpool, United Kingdom

Dentistry for aesthetic reasons is rarely minimally-invasive. The preparation of teeth to receive crowns or veneers causes tooth substance to be lost and there is always a biological impact of some type on the pulp or periodontal tissues. When such restorations are placed properly and skillfully the collateral damage may be minimal. In other cases the results may be catastrophic. This presentation examines aesthetic dentistry from the viewpoint of causing minimal damage to the teeth, the pulps and to the periodontal tissues. The emphasis of the lecture is on achieving a good aesthetic result with the least possibility of clinical complications and failures.

It is essential that aesthetic problems are identified correctly and that treatment is planned appropriately. Aesthetic analysis is discussed in detail during the presentation with an emphasis on avoiding over-prescription. The practitioner will be shown how to balance the appearance of the smile against the appearance of the whole face.

Mechanisms of mechanical damage to the architecture of the tooth are identified and contemporary tooth preparation designs and methods are illustrated.

With a range of step-by-step clinical photographs, the management of several aesthetic cases is explained in detail. Hints, tips and tricks for achieving a good result are given at every stage.

The range and application of current adhesive dental materials is highlighted against the advantages of laboratory-produced ceramic restorations. New adhesive materials are beginning to replace old-fashioned dental composites. The latest concepts in nano-technology adhesive restoratives will be presented and illustrated with case studies. Along the way, the presentation reviews some of the newer technologies in dental instruments such as laser systems, diode curing lights, etc., giving an appraisal of the applications of such devices in everyday practice.
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DR. CLAUS PETER ERNST
Department of Operative Dentistry,Johannes Gutenberg - University Mainz , Mainz, Germany

High end aesthetic restorations are mainly made of all ceramic (veneers, inlays, crowns, and bridgework) or of directly placed resin composite materials. Over the last decade, a significant shift towards directly placed resin composite restorations was evident. Resin restoratives improved significantly over the last years, resulting in today's state of the art superfine hybrids or nano-filled resin composites, which offer a wide variety of esthetic treatment alternatives without further need of indirect lab-made inlays and crowns. Improved polishability, long lasting aesthetics, reliability and longevity are the keywords of these new materials.

The adhesive philosophy today strictly follows a minimal invasive approach: Only caries or existing restorations will be removed, the margins finished and the entire cavity adhesively restored - mainly with directly placed resin composites that results in smaller, more aesthetic restorations which can last a decade or longer. Even bigger restorations or entire built ups of teeth - permanently, not semi-permanent - can be achieved with this technology today.

The lecture will introduce the state of the art in modem resin composite technology and will demonstrate the achievable high end aesthetic results utilizing this minimal invasive, direct approach.
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DR. MASAAKIIWAKU 
 Niigata University (National),Nippon Dental University, Tokyo, Japan

It already passed about 30 years since the first product of the composite resin bonding system (Cliafil Bonding System) was developed by Kuraray Company and a new technique of caries treatment was introduced by Fusayama and Iwaku et al. Recently, many commercial products of the composite resin bonding system are in the market and due to the improvement of various physical properties such as adhesion to tooth structure, mechanical strength, natural tooth colour, colour stability et al., this system has been widely used not only as anterior restoration but also as posterior restoration, especially as various esthetic restorations. Various clinical cases, the evaluation by a longitudinal observation and the limitation for clinical use of esthetic restoration by composite resin bonding system will be introduced in this presentation.
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005.Evidence-based practice Cookbook or new look

DR. DEREK RICHARDS
 Center for Evidence-based Dentistry, Consultant in Dental Public Health. Oxford, United Kingdom

The lecture will outline the reasons underlying the development of the evidence-based approach to practice. The lecture will also cover common criticisms of the approach while  explaining the principles of their application to dental practice.
Saudi Dental Journal 2006;18(SI)-Abstr.005