Practical Procedures in Aesthetic Dentistry Practical Procedures in Aesthetic Dentistry Edited by Subir Banerji BDS MClinDent(Prostho) PhD MFGDP(UK) FICOI FICD Private Dental Practitioner; Senior Clinical Teacher, Programme Director, Aesthetic Dentistry MSc King’s College London Dental Institute, UK; Board Member of the Academy of Dental Excellence and Shamir B. Mehta BDS BSc MClinDent(Prostho)(Lond) MFGDP(UK) Dental Practitioner; Senior Clinical Teacher, Deputy Programme Director, Aesthetic Dentistry MSc King’s College London Dental Institute, UK; Faculty Member of the Academy of Dental Excellence and Christopher C.K. Ho BDS Hons(SYD) GradDipClinDent(Oral Implants) MClinDent(Prostho)(LON), FPFA Prosthodontist, Sydney, Australia; Visiting Clinical Teacher, King’s College London Dental Institute, UK; Faculty Member of the Global Institute for Dental Education; Board Member of the Academy of Dental Excellence This edition first published 2017 © 2017 by John Wiley & Sons Ltd. 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Set in 10/12pt Warnock Pro by Aptara Inc., New Delhi, India 1 2017 v Contents List of Contributors ix Foreword xi Preface xiii Acknowledgements xv About the Companion Website xvii 1 Ethics 1.1 Ethics in Aesthetic Dentistry 3 Russ Ladwa 2 Patient Assessment 2.1 Patient History and Examination 9 Subir Banerji and Shamir B. Mehta 2.2 Clinical Photography (Video) 13 Christopher C.K. Ho 2.3 Evaluation of the Aesthetic Zone (Video) 18 Subir Banerji and Shamir B. Mehta 2.4 Clinical Smile Evaluation (Video) 22 Subir Banerji and Shamir B. Mehta 2.5 Digital Smile Evaluation (Video) 27 Andrea Shepperson 2.6 Principles of Shade Selection (Video) 34 Christopher C.K. Ho 2.7 Treatment Planning for Aesthetic Dentistry (Video) 39 Subir Banerji and Shamir B. Mehta 3 Clinical Occlusion 3.1 Clinical Occlusion: Assessment 47 Subir Banerji and Shamir B. Mehta 3.2 Facebows: The Facebow Recording (Video) 51 Subir Banerji and Shamir B. Mehta 3.3 Intra-occlusal Records (Video) 55 Subir Banerji and Shamir B. Mehta vi Contents 3.4 Semi-adjustable Articulators (Video) 60 Bill Sharpling 3.5 Functional Diagnostic Waxing Up 67 Il Ki Ricky Lee 3.6 Occlusal Stabilisation Splints (Video) 71 Subir Banerji and Shamir B. Mehta 4 Periodontology in Relation to Aesthetic Practice 4.1 Clinical Assessment of Periodontal Tissues 79 Jorge André Cardoso 4.2 Crown Lengthening without Osseous Reduction: Gingivectomy and Lasers (Video) 86 Jorge André Cardoso 4.3 Crown Lengthening with Osseous Reduction (Video) 93 Jorge André Cardoso 4.4 Management of Gingival Recession and Graft Harvesting (Video) 100 Jorge André Cardoso 5 Direct Aesthetic Restorations 5.1 Adhesive Dentistry 109 Subir Banerji and Shamir B. Mehta 5.2 Teeth Isolation (Video) 113 Subir Banerji and Shamir B. Mehta 5.3 Cavity Preparation 117 Subir Banerji and Shamir B. Mehta 5.4 Anterior Restorations (Video) 122 Subir Banerji and Shamir B. Mehta 5.5 Posterior Restorations (Video) 128 Subir Banerji and Shamir B. Mehta 5.6 The Finishing and Polishing of Resin Composite Restorations (Video) 134 Subir Banerji and Shamir B. Mehta 5.7 Direct Resin Veneers (Video) 137 Subir Banerji and Shamir B. Mehta 5.8 Repair and Refurbishment of Resin Composite Restorations (Video) 141 Subir Banerji and Shamir B. Mehta 6 Indirect Aesthetic Restorations 6.1 Tooth Preparation for Full Coverage Restorations (Video) 147 Christopher C.K. Ho 6.2 Tooth Preparation for Partial Coverage Restorations 153 Christopher C.K. Ho 6.3 Provisionalisation 156 Christopher C.K. Ho Contents vii 6.4 Impressions and Soft Tissue Management 161 Tom Giblin 6.5 Aesthetic Post and Cores 167 Subir Banerji and Shamir B. Mehta 6.6 Appraisal and Cementation 172 Christopher C.K. Ho 6.7 Adhesive Bridges 178 Subir Banerji and Shamir B. Mehta 6.8 Fixed Partial Dentures 184 Tom Giblin 6.9 The Role of CAD/CAM in Modern Dentistry (Video) 188 Charles A.E. Slade 6.10 Ceramic Repair 194 Christopher C.K. Ho 7 Indirect Ceramic Veneer Restorations 7.1 Planning for Porcelain Laminate Veneers 201 Christopher C.K. Ho 7.2 Tooth Preparation for Porcelain Laminate Veneers (Video) 209 Christopher C.K. Ho 7.3 Provisionalisation for Porcelain Laminate Veneers (Video) 216 Christopher C.K. Ho 7.4 Appraisal and Cementation of Porcelain Laminate Veneers (Video) 220 Christopher C.K. Ho 8 Partial Removable Prosthodontics 8.1 Aesthetic Removable Dental Prosthetics (Video) 229 Subir Banerji and Shamir B. Mehta 9 Aesthetic Management of Tooth Wear 9.1 Aesthetic Management of Tooth Wear: Current Concepts 237 Subir Banerji and Shamir B. Mehta 9.2 The Direct Canine Rise Restoration (Video) 241 Subir Banerji and Shamir B. Mehta 9.3 Anterior Freehand Direct Restoration (Video) 246 Subir Banerji and Shamir B. Mehta 9.4 Maxillary Anterior Direct Build-up with Indices (Video) 253 Subir Banerji and Shamir B. Mehta 9.5 M andibular Anterior Direct Build-up: Injection Moulding Technique (Video) 260 Subir Banerji and Shamir B. Mehta 9.6 Management of the Posterior Worn Dentition 268 Subir Banerji and Shamir B. Mehta viii Contents 9.7 Evaluation and Management of the Occlusal Vertical Dimension: Generalised Tooth Wear (Video) 274 Subir Banerji and Shamir B. Mehta 10 Tooth Whitening 10.1 Assessment of the Discoloured Tooth (Video) 283 Kyle D. Hogg 10.2 Vital Bleaching (Video) 289 Kyle D. Hogg 10.3 Non-vital Bleaching (Video) 294 Kyle D. Hogg 11 Implants in the Aesthetic Zone 11.1 Pre-operative Evaluation (Video) 301 Kyle D. Hogg 11.2 Abutment Selection 308 Christopher C.K. Ho 11.3 Impression Taking in Implant Dentistry (Video) 314 Christopher C.K. Ho 11.4 Screw versus Cemented Implant-Supported Restorations 320 Christopher C.K. Ho 11.5 Implant Provisionalisation (Video) 327 Kyle D. Hogg 11.6 Pink Aesthetics 333 Brian Chee 11.7 Implant Maintenance and Review (Video) 341 Kyle D. Hogg Index 347 ix List of Contributors Subir Banerji BDS MClinDent(Prostho) Kyle D. Hogg DDS, MClinDent PhD MFGDP(UK) FICOI FICD. (Prostho). Visiting Clinical Teacher Programme Director, MSc Aesthetic and Postgraduate Tutor, MSc Aesthetic Dentistry and Senior Clinical Teacher, Dentistry, King’s College London. King’s College London Dental Institute. Previous Honorary Clinical Teacher, In private practice in London and Faculty University of Florida College of Dentistry and Board member, Academy of Dental – Jacksonville. Faculty and Editorial Excellence. Board member, Academy of Dental Excellence and in private practice, Dental Jorge André Cardoso DMD(Portugal) Health Professionals, Cadillac, MI, USA. MClinDent(Prostho)(UK). Tutor, MSc Aesthetic Dentistry and Secretary, Russ Ladwa BDS LDS FDSRCS MGDS Portuguese Society of Esthetic Dentistry, DGDP FFGDP. Past Dean, Faculty of In private practice in Espinho, Portugal General Dental Practice (UK), at the and Faculty member Academy of Dental Royal College of Surgeons of England and Excellence. Past President, Odontology Section of the Royal Society of Medicine, London. Brian Chee BDS MSc DClinDent(Perio) MFDSRCS(Eng). Greenhill Periodontics Il Ki Ricky Lee RDT. Sydney dental & Implants, Wayville, South Australia. specialist. Tom Giblin BSc BDent(Hons) CertPros. Shamir B. Mehta BDS BSc In private practice in Sydney, Australia MClinDent(Prostho)(LON) and Diplomate, ICOI. MFGDP(UK). Deputy Programme Director, MSc Aesthetic Dentistry; Christopher C.K. Ho BDSHons(SYD) Senior Clinical Teacher, Department of GradDipClinDent(Oral Implants), Conservative and MI Dentistry, King’s MClinDent(Prostho)(LON), FPFA. College London Dental Institute; in Visiting Clinical Lecturer, King’s College private practice in London and Faculty London, Faculty member, Global Institute member Academy of Dental Excellence. for Dental Education and Faculty and Board member, Academy of Dental Excellence. x List of Contributors Bill Sharpling MBA, DipCDT (AAOSH), Member of the New Zealand RCS(Eng). Director of the London Dental Association. Digital Smile Design Dental Education Centre (LonDec) and Instructor and Kois Center Mentor. Senior Clinical Teacher and Associate Dean (CPD) at King’s College London Charles A.E. Slade BDS LDS RCS Dental Institute. MFGDP(UK) MClinDent(Prostho). Clinical Lecturer, London Deanery, Andrea Shepperson BDS(Otago). Clinical Teacher, King’s College London Member of the American Academy of Dental Institute and Faculty member, Cosmetic Dentistry (AACD), Honorary Academy of Dental Excellence. Key Life Member of the New Zealand opinion leader Biomet 3i. In private Academy of Cosmetic Dentistry practice, Lister House, Wimpole Street, (NZACD), Member of the American London and No45 Dental, Chichester, UK. Academy of Oral and Systemic Health xi Foreword Dr Banerji is to be congratulated for assembling such an impressive, international array of co-authors, all of whom I know to be highly talented clinicians and teachers. Collec- tively, they bring together a wealth of clinical experience and knowledge. This very practical work is clearly aimed at the senior dental undergraduate/newly qualified dental practitioner, but will also prove of value to more experienced clinicians. The ambition of the authors, set out in the Preface, is to supplement established stan- dard textbooks and the many hands-on courses available to us. The combination in each chapter of concise text, practical clinical tips, high-quality illustrations, and particularly the many hours of ‘live’ video that accompany a majority of the chapters, ensures that this ambition will be achieved. A companion website is also available to complement this work. The inclusion of high-quality ‘live’ video is a major strength and a huge advance on the static illustrations in most standard textbooks. Several of the videos show actual clinical procedures from start to finish and, along with narrated presentations from the authors, allow a level of understanding that cannot be achieved using static images alone. Their extensive clinical experience has also enabled the authors to compile a whole series of extremely helpful clinical tips. Every reader will find something to adopt here to enhance their own clinical practice. Even today, there probably remains, in the minds of some people, a stigma associated with the terms ‘aesthetic’ or ‘cosmetic’ when applied to healthcare. The inclusion of a chapter on ‘Ethics’ is, therefore, entirely appropriate. It should also be noted that many of the procedures described are additive or minimally invasive, and fully accord with the principles of best practice. This work covers a comprehensive range of aesthetic clinical procedures and will be a very useful addition to every library. For many clinicians, it will be a ‘must have’ book! Stephen M. Dunne BDS LDS FDS PhD Professor of Primary Dental Care and Advanced General Dental Practice, King’s College London Clinical Director, Genix Healthcare Ltd Specialist in Restorative Dentistry President of the European Federation of Conservative Dentistry