Discussions on Cosmetic Dentistry

My understanding is that the rule of thumb is that if the cavity preparation at the isthmus is greater than one third the distance between the buccal and lingual cusps then I should plan for an indirect ceramic restorations.

I do a lot of Class II composites in my amalgam free practice. One problem I have had is with cases where the proximal box is very deep and I am concerned about getting the composite to cure completely in the deeper part of the proximal box

My sales rep told me that I should not use a dual cure resin cement to cement veneers because over time, they will stain.

Is it true that the laser will create absolute hemostasis and then once you use it to create a trough around the finish line, there will be no bleeding and no need to apply hemostatic agents?

I am a bit concerned about the use of the diode laser for soft tissue troughing for final impressions for crowns, bridges and veneers. Every lecturer assures the audience that this will not cause permanent soft tissue damage, gingival recession and that all the tissue lased away will simply grow back.

In the past, when I did veneers I just sent the impressions to the lab and they sent back porcelain veneers. I never knew there were choices of materials to use.

I have to restore a full maxillary arch of single unit crowns on implants and natural teeth – 14 single units. I want to use the same material for all the crowns. What should I use?

I only charge for an onlay if I shoe at least one entire cusp. She told me that all I have to do is cover part of one cusp and then the inlay restoration is considered an onlay.

What is a pressed ceramic restoration? How is this different from feldspathic porcelain?

What is the best way to establish tight proximal contact with composite resins?

What do you do when a patient comes back two weeks after you have cemented ceramic crowns on her lateral incisors and tells you that she does not like the aesthetics and wants the crowns redone.

In the real world, with all ceramic restorations my margins generally end up subgingivally and I have to contend with tissue retraction, saliva and blood. How do you achieve adequate isolation so you will not get contamination of the resin cement at the gingival margins?

Many of my patients want posterior composites. I can’t blame them. Composite makes the filling look like it is part of the tooth.

When should you remove the cement from the margins of an all-ceramic restoration? What worries me is that I routinely use a shoulder finish line. When I remove partially set resin cement when it is in its gel state, I am wondering if I am also pulling out the cement from the marginal seal?

I would like to go amalgam-free. How do I accomplish this? In my area, all the GP’s still do amalgam restorations. Is it legal for me to advertise that I am an amalgam-free dental practice?

What composite systems are you using and are you satisfied with the results? Have any of you moved on from the Estelite composite system to something you think produces better aesthetics?

I recently had a difficult time making ceramic crowns for the maxillary central incisors in one of my patients. I know the party line is to only accept these cases if the patient agrees to multiple veneers or ceramic crowns, but with the economy on the way down, it is getting more difficult to get patients to accept the more costly treatment plans.

How accurate is the new Cerec 3? I tried the Cerec 1 and 2 and found that margins were not sealed at the proximal box floor level. These gaps concerned me.

I took a course in cosmetic dentistry where the instructor used a stiff sable haired paint brush to contour the composite on the facial surfaces of the maxillary incisors.

I just took a course sponsored by my dental lab on CAD/CAM restorations. The course was very instructive and being an older practitioner I was surprised at how advanced we are now in some areas of dentistry.

The problem is that on all of these veneers, the gingival margin is stained dark. It actually looks like someone took a dark pencil and drew a dark line across the cervical. How do I prevent this from happening when I remake these veneers?

Do you use a different bonding agent for repairing or adding to an old composite restoration?

I am looking for an all-around good and dependable cement that will work for all contingencies. I just want to have one cement in the operatory.

I had a very irate patient call me yesterday to complain that I charged her $700 for an in-office tooth bleaching when she could just have easily gone to the local drugstore and bought a bleaching kit for $40 and done the bleaching herself.

I am a general practitioner and when I was in school we learned the ENAP, but now we have the LANAP procedure which is better and faster and with enhanced healing.