Smile Design Integrating Esthetics and Function: Essentials in Esthetic Dentistry, 1e

298 Pages·2015·148.18 MB·English

by  Jonathan B Levine DMD

Essentials of
Esthetic
Dentistry
Smile Design Integrating Esthetics and Function
Volume Two
Essentials of
Esthetic
Dentistry
Smile Design Integrating Esthetics and Function
Volume Two
Edited by
Jonathan B. Levine DMD
Founder; Program Director and Clinical Assistant Professor
Jonathan B. Levine & Associates; New York University College of Dentistry CE
New York, USA
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto
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ISBN 9780723435556
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical
treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described herein. In
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Contributors
Paulo Battistella MDT CDT Nicholas Hodson BDS BSc PhD FDS RSCEng(Rest)
Founder and CEO Senior Lecturer and Honorary Consultant in
Studio Paulo Battistella Restorative Dentistry
São Paulo University of Central Lancashire
Brasil Preston
UK
Newton P. B. Cardoso DDS MS PC
Adjunct Assistant Professor, Adrian S. Jurim MDT
Department of Cariology and Comprehensive Care Owner of Jurim Dental Studio, Inc
Newclinic; New York University College of New York University College of Dentistry CE
Dentistry CE New York
São Paulo USA
Brazil
Jeffrey L. McClendon BS Chemistry DMD Dentistry
Frank Celenza DDS PC Clinical Instructor Department of Cariology and
Specialist in Periodontics and Orthodontics, Comprehensive Care
Private Practice New York University School of Dentistry
New York New York City
USA USA
Steven B. David DMD Anabella Oquendo DDS
Clinical Professor; Former Director Advanced Clinical Assistant Professor and Program Director of
Program in Esthetic Dentistry for International the Advanced Program for International Dentists in
Dentists; Private Practice Esthetic Dentistry
New York University College of Dentistry, New York University
David, Hirsch, & David New York
New York USA
USA
Kia Rezavandi BDS MSc MRD RSC(Eng)
Sivan Finkel DMD Specialist in Periodontics
Co-owner; Clinical Instructor and Education Private Practice
Co-Director London
The Dental Parlour NYC; New York University College UK
of Dentistry CE
New York Sylvia S. Welsh PhD
USA Clinical Associate Professor of Psychiatry
New York University Langone School of Medicine
New York
USA
vii
Foreword
In the past decade, technology and innovations in the dental field have given
dental professionals the opportunity to create esthetic restorations by mimick-
ing nature. The esthetic demands and expectations of patients have risen with
the impact of social media, which has made it easy to access information about
new technologies and a lot of different esthetic cases. Today, patients are more
willing to have restorations that copy the form, colour, surface texture and func-
tion of healthy and esthetic-looking natural teeth. This leads us to observe
and imitate natural teeth and smile design not only from functional and mor-
phological perspectives, but also structurally, optically and, more importantly,
in harmony with the face.
In any dental treatment, diagnosis has prime importance, since many steps will
be planned and constructed on the basic cause of the problem. Then it will be
time for treatment planning. It is very obvious that, whether you work in a solo
office or in a group practice, team work is absolutely essential. The importance
of working as a team is that you will be able to achieve the most efficient treat-
ment planning. There are different factors that may influence the treatment
planning, including formal education, clinical experience, continuing educa-
tion, books and journals followed, exchange of information, working within a
good team and, finally, the common sense of the dentist. On the other side, there
is the patient, who has to be satisfied with the results of the treatment. In addi-
tion to all of the above, the patient’s expectations, mentality, commitment, time
and financial conditions will also be taken into consideration while planning
the treatment.
As we can clearly see, the way to ‘excellence’ is not easy, especially when the
esthetic treatment should be executed using a minimally invasive approach. This
definitely requires an understanding of the patient’s expectations and a great
team effort between the general dentist, the specialists and the laboratory
involved. Only then can we can truly talk about a successfully completed esthetic
case.
viii
This select group of master clinicians and ceramists exemplifies many years of
practical knowledge and presents invaluable and diverse perspectives. This book
covers all of the necessary details mentioned above. And what makes this text-
book special is that the authors base their discussions on being minimally inva-
sive, hence the importance of the treatment planning, as well as sharing many
different treatment planning modalities.
With the guidance of this book, dentists, specialists and ceramists will find it
easier to take crucial decisions about the improved esthetics that will influence
directly on their patients’ lives. Readers will be most impressed with the overall
organization of the text, the clarity of each chapter and the outstanding
photography.
Nonetheless, my rationale for this foreword is not only my appreciation of the
book but also my respect for Dr Levine (as the editor) and for all of the authors
he has gathered for this book and their accomplishments.
Dr Galip Gurel DDS MSc
iixx
Series Preface
Esthetic dentistry is a complex subject and in many ways it requires different
skills from those required for disease-focussed clinical care. The team that have
created this series have shared a vision that a broad range of additional skills
are needed.
The first volume provided useful, readily applicable information and sets the
scene for those wishing to go further into ethetic techniques. It included
techniques for smile makeovers using readily available procedures in general
practice.
This volume covers the techniques applicable to more detailed patient assess-
ment, advanced smile design and illustrates some of the more complex methods
available to experienced clinicians where intervention is accepted.
Volume 3 which follows will provide in some ways an alternative approach to
this present volume. While attitudes vary one increasing concern to many clini-
cians is the amount of tooth reduction and destruction carried out for esthetic
change alone while the world moves towards MI, Minimal Intervention, in rela-
tion to oral and many other diseases. This series should be seen as a whole,
challenging your thinking and approach to this growing subject area, particu-
larly by showing different approaches to clinical situations. We no longer need
to rely on a single formula to provide a smile make-over, selling only one treat-
ment modality where both the dentist and their patients are losing out; the
patient losing valuable irreplaceable enamel as well as their future options.
As the series progresses you can discover in greater depth the many clinical
techniques to practice a range of effective procedures in esthetic dentistry.
Professor Brian J. Millar BDS FDSRCS PhD FHEA
xi
Preface
When we set out to write another book on dental esthetics, I asked myself, is
this what the dental education community really needs, another book on
esthetics?
And then, I got to thinking. I thought about what is truly missing today for the
practicing dentist, the ones who are in the trenches, with patients looking for
new ways to improve their smile and maintain the health of their mouth. I took
a step back and thought deeply about our challenges.
On one hand, we need to duplicate nature and use materials that are completely
invisible when working in the esthetic zone. My team and I call this supernatural
esthetics. On the other hand, we need to restore teeth conservatively, paying
special attention to structure, function, and biology.
There are numerous challenges the clinicians face today and obstacles that
prevent them from achieving great success for their patients and for their dental
team. With the myriad of responsibilities that dentists have today – from running
a business, to caring for his or her patients, to continually improving their
talents and skills with additional education – I realized that we need to create
an everyday guide for esthetic dentistry. Something that is easy to assimilate,
with a goal of creating smile experts.
With the help of the Elsevier team, we have set the vision for this book. A practi-
cal guide for the clinician that looks at esthetics from both sides of the proverbial
coin: beauty and function. We seek to create an integrated approach across the
disciplines of dentistry, from communication and psychology, to periodontics
and orthodontics, to esthetic techniques, all synthesized together for the restora-
tive dentist. This approach will yield smile architects, with the right capabilities
for successful esthetic outcomes every time.
We believe that it all starts with three C’s: Communication, Collaboration, and
Consistency. The clinician will know exactly where to begin and how to finish
with great success. From simple to the most complex esthetic cases many esthetic
xii
failures occur because of lack of communication. Whether it is between the
esthetic dentist and the patient, or with the technician or other specialists, we
need to create a culture where open communication thrives between everyone
involved. Once this happens, the patient feels heard, the esthetic dentist has
direction, and the technician isn’t guessing about color or incisal edge position.
With this collaboration set into motion, success will follow success, and the
necessary skills, check lists, protocols, and procedures will need to be developed
and set into motion.
This volume focuses on the clinician’s personal development. Our goal is to
teach methods to develop consistency through checklists, protocols, and proce-
dures in the practice. Clinical ‘takeaway boxes’ incorporated throughout the
chapter highlight key data points, along with answers to potential FAQs that
your patient might be asking.
As the old saying goes, “it all starts at the top”. As a clinician, your role is to be
a leader in the practice. Think about setting a vision for your practice: whom you
want to practice with, and what you want to do day in, and day out. After you set
this vision, map out a plan that will allow you to get there. Keep in mind, the
quality of the people on your team, how well you communicate with one another,
and how well you engage the patients of the practice, will ultimately determine
everyone’s collective happiness. The goal of this text is to help you achieve your
vision, bringing you great personal satisfaction on the road to success.
Jonathan B. Levine DMD
xiii
C h a p t e r 1
Esthetic Diagnosis: A Three-Step Analysis
JONATHAN B. LEVINE, SIVAN FINKEL
Introduction to the three-step analysis 2
The Esthetic Evaluation Form 3
Records 27
The diagnostic wax-up 33
The esthetic mock-up 36
Summary 40
1