I want to give you a quick tip on how to cement a crown in 20 minutes or less every single time. Now, a lot of you may be doing this, but I'm not so sure you are because my first 17 years in practice, I didn't know if it was going to take 15 minutes to cement a crown or 30 to 40 minutes, because of all the unpredictability. So here's a few tips for you to make this happen every single time.
Any time that we're planning to work on multiple teeth on a patient, it's important to start with a complete exam and plan our treatment.
So as we begin to consider design as it relates to nature, it would be nice if there were some rules or formulas that would allow us to harness the power of what esthetics are all about. That would give us some predictability or a roadmap for our final design. I think it's been the Holy Grail, through mankind, to try to understand what those rules would be.
Fibonacci was a 13th-century mathematician, and he began to observe repeated patterns in nature. And what he tried to create were a series of mathematical logarithms that would give us a mathematical understanding of what esthetics was all about. The Fibonacci sequence was one of those formulas that look specifically at golden proportions.
It was a couple of centuries later that a guy by the name of Leonardo da Vinci came along. And he popularized a sketch called the Vitruvian Man. And it was based upon some work by another Italian engineer and architect, and his name was Vitruvius. And he felt as if the divine proportions seen in man ought to be what is replicated in architecture and design.
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So creating beautiful smiles is really about creating beautiful health.
Our vision when we're trying to create a great looking smile is to design something that's going to be a mirror of the relative health of the system. And I think, as we begin to consider enhancements or changes to someone's smile, we need to think of it in a perspective as a smile designer first, before we're beginning the treatment plan, what the results will be.
And when we begin to consider what components we're going to manipulate in order to try to optimize someone's smiles, we need to consider that with the end in mind, but obviously with an omnipresent understanding of the system at large and how the engineering will be.
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In our smile design process, we have learned from Dr. Dawson how to develop incisal embrasures. And also from Dr. Dawson and the American Academy of Cosmetic Dentistry, how to develop the apparent contact zone between teeth.
So between two centrals it should be 50%, a central and lateral, 40%, and a lateral and a canine, 30%.
There are times, though, where, depending on the restorative interfaces, say, for example, two implants, we cannot create an apparent contact zone that falls in those parameters. And if we want to keep the incisal embrasures developed, as Dr. Dawson's taught us, we need to have a long contact zone.
One of the things that can negatively affect the result and success of our cosmetic cases is the appearance of black triangles.
There were two landmark studies and papers that were released in '92 by Tarnow, and Garber and Salama in '98 that talked about where to set the contact points depending on the restorative interfaces relative to the bone to prevent black triangles from forming.
Say, for example:
- Tooth to tooth set at 5 millimeters or less
- Tooth to implant, four and a half millimeters or less
- Implant to implant, three and a half millimeters or less.
- And there are other combinations.
The key is from our end, we have to communicate to the lab and let them know where to set that contact point relative to the margin.
For example, if you're restoring teeth numbers eight and nine and you want to prevent a black triangle from forming between those teeth, you have to let your lab know where to set the contact relative to the margin.
So one of the things that I know that a lot of you are doing as good, complete dentists is actually doing afull contour wax-up, especially when we're doing an anterior case, a full arch reconstruction, or a full mouth reconstruction.
Something that's been very useful to us in helping to communicate with the patient and also be able to preview our results, is when we order the wax-up from the lab, we'll have the ceramist send us a vinyl impression of the wax-up.
Hi. I'm Scott Finley with The Dawson Academy, with a quick tip that will give you something to consider when you're selecting shades for you restorations.
The first thing I'd like you to think about is the management of the light that is in the environment that you're selecting the shade.
The ambient lighting will certainly the wavelength that is then received back to the observers' eyes. So we can determine whether or not the color truly is true, in a full spectrum lighting.
Implant dentistry has become extremely predictable. However, we must pay attention to some very non-forgiving principles if we hope to create stable, long lasting results for our implant patients. I call these the “Seven Deadly Sins”. Each one, on it’s own, can jeopardize even the best implant surgery.