Management of Withe and Pink Esthetics - an interdisciplinary approach
The restoration of a tooth or the replacement of a missing tooth in the esthetic area is very delicate, specifically in patient cases with high lip line. At demanding patients high efforts have to be made to reduce the risk for not ideally shaped or colored restorations and/or for soft tissue discolorations in order to avoid esthetic failure. From a restorative point of view the type of reconstruction and the material it is made out of have a significant influence on the result. The current restorative material options offer many esthetic features to best copy the optical properties of teeth. The color, chroma and lightness of the esthetic materials (e.g. ceramics) are hereby important parameters. Furthermore, the translucency is a important both for the mimicking of teeth as also for the masking of discolorations. A structured approach for the evaluation and the establishment of the white esthetics helps reducing the risk for unpleasant surprises with the result.
Discolored non-vital abutment teeth are a specific challenge with this respect since they may not only be difficult to be masked, but they also may be associated with soft tissue discoloration. Recent studies have evaluated the threshold for the visibility of dental and of mucosal/gingival discoloration. These studies have shown that the human eye detects soft tissue discoloration at similar threshold values as it would detect tooth discoloration. Hence, the pink esthetics is at least as important as the white esthetics. Besides the non-vital teeth implant reconstructions may be challenging with this respect. It has been shown that greyish metallic abutments and metal- ceramic reconstructions lead to dark discoloration of the soft tissue. In conclusion, the selection of the material and the restorative components is of great importance for all types of restorations. Clinicians and technicians need to be aware of the possibilities and also of the limitations of the current restorative options.
- Understand the criteria that influence the esthetics of teeth and of soft tissues
- Learn about the visibility of discolorations
- Learn about the restorative options, their possibilities and limitations
- Learn to select restorative options for predictable white and pink esthetic
Irena Sailer Prof. Dr. med. dent., Head Division of Fixed Prosthodontics and Biomaterials at the University of Geneva. Adjunct Associate Professor Department of Preventive and Restorative Sciences, Robert Schattner Center, School of Dental Medicine, University of Pennsylvania, Philadelphia, USA (Head: Prof. Dr. M.B. Blatz). She received her dental education and Dr. med. dent. Degree from the Faculty of Medicine, University of Tubingen, Germany in 1997/ 1998. In 2003 Dr. Sailer received an Assistant Professorship at the Clinic of Fixed and Removable Prosthodontics and Dental Material Sciences in Zurich. Since 2010 she is an Associate Professor at the same clinic. In 2007 Dr. Sailer was a Visiting Scholar at the Department of Biomaterials and Biomimetics, Dental College, New York University, USA. Additionally, since 2009 she holds an Adjunct Associate Professorship at the Department of Preventive and Restorative Sciences, Robert Schattner Center, School of Dental Medicine, University of Pennsylvania. Philadelphia, USA and is part of The EAO Board of Directors. Irena Sailer is a Specialist for Prosthodontics (Swiss Society for Reconstructive Dentistry), and holds a specialization degree for Dental Implantology (WBA) of the Swiss Society for Dentistry. Since September 2013 she is the Head of the Division of Fixed Prosthodontics and Biomaterials at the University of Geneva.
Vincent Fehmer, Master Dental Technician (MDT), at the Clinic for Fixed Prosthodontics and Biomaterials, Center for Dental and Medicine, University of Geneva, Switzerland (Head: Prof. Dr. I. Sailer) He received his dental technical education and degree in Stuttgart, Germany in 2002. From 2002 to 2003 he performed fellowships in Great Britain and the US in Oral Design certified dental technical laboratories. From 2003 to 2009 he worked at an Oral Design certified laboratory in Berlin, Germany - The Dental Manufaktur Mehrhof. In 2009 he received the degree as a MDT in Germany. From 2009 to 2014 he was the chief dental technician at the Clinic for Fixed and Removable Prosthodontics in Zurich, Switzerland. Since 2015 he is dental Technician at the Clinic for Fixed Prothodontics and Biomaterials in Geneva, Switzerland and runs his own laboratory in Lausanne Switzerland. MDT Fehmer is a Fellow of the International Team for Implantology, and a member of the Oral Design group, the European Association of Dental Technology (EADT) and German Society of Esthetic Dentistry (Deutsche Gesellschaft für Ästhetische Zahnheilkunde, DGÄZ). He is active as speaker on a national and international Level. Mr. Fehmer has received honours like the prize for the Best Master Program of the Year (Berlin, Germany). He has published numerous articles within the field of fixed prothodontics and dental technology.
