Seminar Galip Gurel: The concept of modern restoration: Occlusion, personalized design, minimal invasion, pink aesthetics

Occlusion issues, digital and minimally invasive protocols, working in the concept of pink aesthetics, an personalized design, as well as an interdisciplinary approach - this is what modern orthopedic dentistry cannot be imagined without.

And the seminar of the legend of aesthetic dentistry - Galip Gurel, is dedicated to these important topics!

This event can be called exclusive, because in the CIS doctors seminars are extremely rare ...

Do not miss the opportunity to learn from such a legendary restorer!

1) Creating the most Personalized Smile Design: Analog vs Digital

While some of the final esthetic results are creating the “wow effect, some may fail to meet the patient’s expectations due to disharmony between the smile design and the patient’s personality. The patient may feel that the restored teeth do not really “belong” to him or her. Without the proper knowledge, the origin of this disharmony can be difficult to identify.

Most of all the smiles are being designed intuitively by the dentist or the ceramist.

The aim of this lecture is to present a novel concept which involves the creation of a customized personal image expressing a person`s sense of identity which is based on the “visagism” VIS concept that helps dental clinicians provide restorations that account not only for esthetics, but also for the psychosocial features of the created image, which affect patients’ emotions, sense of identity, behavior, and self-esteem.

Even with this very valuable 2D VIS smile design, for some dentists translating the 2D design into a direct mock up may be difficult. Filling an empty space with properly choosen teeth shape, incisal silhouettes, tooth axis and dominance can be a difficult task. However with the new digital technologies this problem is now solved. The REBEL is the new 3D SMILE DESIGN program, which can immediately convert the 2D VIS program in to 3D REBEL. This way the dentist will be able to immediately receive the STL file of the digital 3D wax up and then 3D print this STL file and be able to place the final wax up in the patients mouth.

2) Interdisciplinary approach for better aesthetic results

A beautiful smile seems to reflect a certain style of living, and the enhancement of facial beauty is one of the primary goals of patients seeking elective dental care. The lower one-third of the face has a major impact on the perception of facial aesthetics, and the role of a beautiful smile design not only changes the smile alone but also the overall facial appearance as well.

Once the ideal relationship between the restoration and the facial soft tissues is achieved, improvements in natural beauty can be expected to follow. With the ever-increasing importance that the media, patients and general society place on appearance, an even greater emphasis has recently been placed on elective aesthetic dentistry. By improving deficient facial proportion and integumental form, surgeons, orthodontists, and restorative dentists have the unique opportunity to weave these aesthetic needs and the creation of a pleasing smile into the fabric of their comprehensive treatment planning.

Creating the precision in terms of the preparation, fit and the aesthetic final outcome needs a serious treatment planning which is different for each case… Designing a new smile consists of many steps which are so very important and if followed right, produce predictable success.

After that stage, in order to achieve a very precise and predictable tooth preparation, wax-up, silicon indexes and related techniques such as APR (Aesthetic Pre Recontouring), APT (Aesthetic Pre-evaluative Temporaries) and preparation through the APTs are extremely crucial. This eliminates all the possible mistakes and destruction of the depth cutters that could have been done if the tooth was to be prepared without realizing the aging affects on the enamel (volumetric enamel loss) or their unappropriate teeth positions on the dental arch....

At this point I would also like to emphasize the importance of minimally-invasive dentistry. This is only possible if we can insure that proper tooth position in the arch is established, eliminating the need for any soft or hard tissue removal. This brings to mind the importance of the interdisciplinary team (in contrast to multidisciplinary). The major difference between an interdisciplinary versus a multidisciplinary approach, is that with an interdisciplinary approach, treatment planning is accomplished in a group setting with all treatment team members present. All treatment planning and treatment challenges can be discussed in a collaborative environment with team members complementing and supporting the efforts of each other. A multidisciplinary approach only represents that each discipline or area of dentistry is involved in one aspect of the treatment without necessarily working together in a unified manner. This also applies to minor or major soft tissue deficiencies. In this lecture pink esthetics will also be emphasized and discussed throughly.

Learning Objectives:

1. Interdisciplinary Aesthetic Treatment Planning.

2. When to use Restorative Tools or Orthodontics or Perio or a combination of these three.

3. Minimal Invasive Tooth Preparation Techniques.

4. Maximum and predictable communication between specialists.

3) Occlusion in daily clinical practice

Occlusal adjustments become an issue in aesthetic cases when there is a vertical dimension lost and needs to be altered.

The aesthetic rehabilitation of a worn dentition is challenging because the clinical crowns have become shorter and the tooth length needs to be increased. Increasing the coronal length is often associated with the increase of the VDO, even though this loss of tooth structure may not automatically indicate a loss of the VDO due to a possible compensatory phenomena. To achieve the restorative, functional and aesthetic objectives, it is perhaps most important to ensure that the proposed increase in VDO will be the minimum amount necessary in either one or both arches.

In those cases the projected relation of the anterior teeth, the amount of increase of the VDO according to the aesthetics and function, the anterior/posterior shifting of the occlusion of the patient are the important details to be handled carefully.

The VDO alteration requires a thorough clinical assessments of phonetics, interocclusal distance at rest and face height, along with facial soft tissue contours. The careful evaluation of the mock up, followed by the provisional restoration at the increased VDO through out each phase of the treatment, will appropriately test the new height for patient adaptation.

In those kind of treatment plannings, determining the new position of the occlusion, wether it is going to be kept at the MIP (maximum intercuspation), CR (centric relation) or ICP ( intercuspal position) are the crucial decisions to be made.

All these details and re-establishing the occlusion according to esthetic & functional needs will be presented in this lecture.

4) Pink Aesthetics

A beautiful smile seems to reflect a certain style of living and the enhancement of facial beauty is one of the primary goals of patient seeking elective dental care. However, aesthetics can not only be achieved by restoring the teeth, but also taking the surrounding tissues into consideration, such as gums and the lips.

Once the ideal relationship between the restoration and the facial soft tissues is achieved, improvements in natural beauty can be expected to follow. With the ever-increasing importance that the media, patients and general society place on appearance, an even greater emphasis has recently been placed on elective aesthetic dentistry. By improving deficient facial proportion and integumental form, surgeons, orthodontists, and restorative dentists have the unique opportunity to weave these aesthetic needs and the creation of a pleasing smile into the fabric of their comprehensive treatment planning. The things get more complicated if the soft tissues are compromised with early tooth extractions, missplaced implants or huge soft tissue and bone loss.

Creating the precission in terms of the preparation, fit and the aesthetic final outcome needs a serious treatment planning which is different for each case… Designing a new smile consists of many steps which are so very important and if followed right, produce predictable success.

With an interdisciplinary approach, treatment planning is accomplished in a group setting with all treatment team members present. All treatment planning and treatment challenges can be discussed in a collaborative environment with team members complementing and supporting the efforts of each other.

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