DTUK1810

July 12-18, 201018 Cosmetic Tribune United Kingdom Edition T his article will outline how the combined and simul- taneous use of the Inman Aligner, tooth whitening followed by edge bonding can redefine the ap- proach taken to smile design. It also highlights how it will help dentists respect a patient’s decision as their treatment progresses rather than shortcutting to an end result using ceramics setup with classic smile design principles. Discussion. “Changing cosmetic dentistry“ might seem like a pretty big goal, but It’s become very clear from lecturing and writing about this particular dis- cipline that it creates a huge amount of excitement and positive reaction. Dentists see the logic in it very quick- ly and can also see how, with some education, they can employ a safe, low risk technique that they know their patients will want and will massively change their approach to cosmetic and aesthetic dentistry. They also understand that there is a massive market of patients who will accept this kind of non-invasive treatment happily. Treatment with the Inman Align- er has been further developed in the UK where techniques are used to make it dramatically effective as a solution for certain mild and moder- ate anterior orthodontic issues. Cas- es, which traditionally would take six-10 months with clear aligner sys- tems can, with education, be treated in six-16 weeks. We have all seen how bleach- ing can affect a smile. We know how much bonding can improve aesthetics and tooth anatomy. Now that alignment is potentially so simple, these three disciplines have been brought together to cre- ate results that easily challenge tra- ditional veneer based smile make- overs. And, if the three treatments are combined with some thought, it is possible to massively improve a patient’s smile in around three months. All of a sudden the six-10 unit ve- neer case used for a smile makeover can look ridiculous and be seriously in danger of becoming over treat- ment. There are always situations where ceramics are highly appropri- ate, such as in wear cases or in major reconstructions, but for anyone with good quality intact enamel, I believe this kind of treatment represents a far more ethical, patient centric ap- proach. This is because I believe the way smile design is approached, and perhaps even taught, is wrong. The final outcome, for what is aesthetic is important. Golden proportion ide- als, tooth width length ratio, gingival zeniths etc all together create some- thing we know to me almost math- ematically correct. The problem is that most dentists’ experience their smile design education attached to a lecture or course based on veneer dentistry. As a result dentists will naturally think this to be the only and perhaps fastest way to achieve a “perfect smile”. If we assess a patient’s smile and try to preview an end result at the first consult, using imaging soft- ware, a wax up or even a preview try in, we are not really letting the patient see their teeth improve at different stages to see if their expec- tations are being met along the way. The smile design rules are there, but how many patients if they see their teeth improving with align- ment then bleaching and then bond- ing, would actually then take an- other step with porcelain and some tooth destruction to achieve total perfection? In my experience, very few. Some still do go further, but at least by then their teeth are straight and we can use truly minimal and almost no prep veneers to improve the aesthetics further. Most of the time, once we are ¾ through alignment and start to bleach it becomes very clear that simple bonding is all that will be needed to create a very aesthetic smile that previously would only have been achieved with aggressive veneer preps. The case outlined below is a typi- cal case of a patient who once want- ed and considered having porcelain veneers. Instead she opted to align her teeth then bleach and bond. Case and Diagnosis This 32-year-old patient complained about the “crooked look” of her smile. The patient was aware of what a smile makeover could achieve, but wanted to achieve something with- out damaging her teeth. On examination several prob- lems existed. Firstly her teeth were moderately misaligned. This creates aesthetic issues immediately. Large unsightly embrasures were made worse around the canines. The in- standing laterals appeared darker and in the shadow of the lips, the left one being in slight cross-bite. With the centrals splayed out and rotated the line angles of the four incisors were all different. It was clear at the start by ex- amining the incisal edges that there had been differential degrees of wear meaning that even if the teeth were aligned, the incisal outline would ABB (Alignment, Bleaching, Bonding) The Treatment Sequence that should change Cosmetic Dentistry says Tif Qureshi The UK’s leading supplier of dental anaesthetic, Septodont, already bring you the high quality Septoject and Septoject XL needles and would now like to introduce a new development to Ultra Safety Plus. Ultra Safety Plus syringe is a sterile, disposable and self aspirating syringe system with a pre-mounted needle. Its use means needle stick injuries can be virtually eliminated. With the option of a NEW single use handle (non sterile), Ultra Safety Plus is now 100% disposable. For more information please contact your dental retailer www.septodont.co.uk Anaesthetics • Endodontics Restorative Dentistry • Dental Surgery Prosthetic Dentistry • Disinfection & Hygiene ‘If the three treatments are combined with some thought, it is possible to massively improve a pa- tient’s smile in around three months.’

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