Publications

Our frequently updated publication list offers interesting and new insights into technologies and treatments surrounding innovative dentistry. Check it out!

poly carbonate schiene

CAD/CAM-Schienen zur funktionellen und ästhetischen Evaluierung einer neu definierter Vertikaldimensionen der Okklusion

Eine Schienentherapie wird in der Regel als Initialbehandlung im Rahmen einer Funktionstherapie durchgeführt, da sie zeitnah eine Tonusminderung in der Kaumuskulatur und eine reversible Korrektur einer von der Norm abweichenden Okklusion erreichen kann.

Grundsätzlich werden in Anlehnung an die verschiedenen Indikationsbereiche Okklusionsschienen von anderen Aufbissbehelfen unterschieden. Okklusionsschienen dienen vornehmlich dazu, eine neu definierte Bisslage in statischer und dynamischer Okklusion klinisch zu erproben. Dieser funktionellen Evaluierung wird in den meisten Fällen eine vom Wax-up abgeleitete ästhetische Evaluierung vorgeschaltet. Zusammenfassung

Zahnfarbene Okklusionsschienen aus Polycarbonat können aufgrund ihrer Flexibilität ohne erhöhte Frakturgefahr auch in sehr geringen Schichtstärken hergestellt werden. Durch die Teilung in eine Ober- und eine Unterkieferschiene bei größeren Veränderungen der Vertikaldimension können die im Wax-up festgelegten ästhetischen und funktionellen Aspekte komplett in die Okklusionsschienen übertragen und realitätsnah wie auch reversibel von den Patienten erprobt werden. Dieses „Zwei-Schienen- Konzept“ erleichtert zudem eine segmentale Umsetzung in die spätere definitive Restauration.

Sehen Sie die Keynote zur Publikation!

Indizes

Wax-up, zahnfarbene Schienen, CAD/CAM-Schienen, Polycarbonat, Vorbehandlungs- phase, Vertikaldimension der Okklusion (VDO)

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root analogue implants

Historical development of root analogue implants: a review of published papers

R. Saeidi Pour a, C. Freitas Rafael b, M.L.P.D. Engler b, D. Edelhoff c, G. Klaus d, O. Prandtner e, M. Berthold c, A. Liebermann c,
DOI: https://doi.org/10.1016/j.bjoms.2019.01.021

The purpose of this paper is to provide an overview of the historical development of root analogue implants from their beginning to the present day.

Dental implants are an optimal way of replacing missing teeth.

After a tooth has been extracted there is an inevitable remodelling of the socket. As a result, it can limit the placing of an implant. The continuous resorption can reach up to 63% on horizontal and 11%-22% on vertical alveolar bone within six months. Alterations of the dimensions of the alveolar socket on the buccal wall are related to the resorption of the bundle bone a tooth-dependent structure that is left after the extraction with few or no vessels for its blood supply.

Immediate use of implants might control these alterations to the ridge by reducing the speed of resorption of the socket.

Usually the operator has to face some surgical challenges in this approach, including: difficulty in achieving primary stability and controlling the 3-dimensional position of the implant; discrepancies between the sizes of the implant and the socket; poor quality of bone that is often present in the extraction socket; and the need to prepare the socket with drilling burrs that can overheat the bone.

These challenges are related to the characteristics of conventional implants, mainly the standardised sizes and shapes.

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implant prosthetics

Overview of the possibilities and limitations of metal-free implant-supported single-tooth restorations. Part I

Edelhoff D, Schweiger J, Prandtner O, Stimmelmayr M, Güth JF. 2019;50(3):176-184. doi: 10.3290/j.qi.a41906.

Metal-free materials offer an alternative to metal-based restorations while ensuring high levels of biocompatibility and esthetics. Rapidly evolving CAD/CAM technology has significantly expanded the range of materials available. In addition, digital methods offer previously unavailable options in diagnostics and greater planning reliability. There is also a better material quality through standardization of the manufacturing process, and reproducibility available. This significant benefits can be used to advantage, especially in oral implantology.

Even though technological progress in the field of metal-free materials has given rise to considerable improvements in their mechanical properties over the decades, their clinical longterm success is still very much dependent on an appropriate indication and proper material selection. For instance, on the knowledge and skills of the dental practitioner and dental technician, and on an adequate occlusion concept. The high rate of innovation – both with regard to the materials themselves and to CAD/CAM technology.

Therefore, it requires an adequate level of prior knowledge to sensibly and successfully implement the wide range of possibilities now open. This review article provides an up-to-date overview of the possibilities and limitations of metal-free implant-supported single-tooth restorations. The first part discusses abutments and cemented crowns.

page1image26499072

Key words: abutments, CAD/CAM, hybrid abutments, implant prosthetics, implant-supported crowns, lithium disilicate, lithium silicate, monolithic restorations, polymers, titanium adhesive bases, zirconia, zirconium oxide.

Watch a relating metal-free implant story.

 

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Dental restoration

Amelogenesis Imperfecta

Saeidi Pour R, Edelhoff D, Prandtner O, Liebermann A.
2015 Nov-Dec;46(10):843-52. doi: 10.3290/j.qi.a34721.

Full-mouth rehabilitation of a patient diagnosed with amelogenesis imperfecta using porcelain veneers and CAD/CAM polymer restorations.

Keywords: Minimally invasive occlusal onlays, veneers, adhesive technique, smile and functional analysis, amelogenesis imperfecta

The complete dental rehabilitation of patients with a vertical dimension loss caused by structural enamel deficits associated with amelogenesis imperfecta represents a difficult challenge for restorative teams. Therefore, an accurate analysis and treatment planning is important prerequisites for successful results. That includes esthetic and functional evaluations and adequate material selection.

Longterm provisional restorations play an important role in exploring and elucidating the patient’s esthetic demands and functional needs.

Restorative treatment options can vary from requiring only oralhygiene instructions to extensive dental restorations that include composite fillings, ceramic veneers, metal-ceramic, or all-ceramic crowns.

Watch the patient feedback 5 years post treatment

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Veneers

Veneers & Onlays bei Zahnhartsubstanzverlust mit beeinträchtigter Ästhetik und Funktion

Der Verschleiß von Zahnhartsubstanz ist grundsätzlich ein physiologischer Prozess, der durch die normale Kaufunktion verursacht wird. Überschreiten die Einflüsse von Attrition, Abrasion und/oder Erosion ein bestimmtes Ausmaß und sind für das Patientenalter in diesem Beitrag untypisch hoch.

Der starke Zahnhartsubstanzverlust hat eine pathologische Forms angenommen wodurch eine Präventivmaßnahmen unerlässlich geworden ist.

Einleitung zum Artikel:

Abradierte Zähne und die daraus resultierenden Folgen stellen für das zahnärztliche Behandlungsteam eine große Herausforderung dar. Grundsätzlich ist der Verschleiß der Zähne ein physiologischer Vorgang mit einem normalerweise geringen Verlust an Zahnhartsubstanz, der im Bereich von 0,02 bis 0,04 mm pro Jahr liegt.

Aus epidemiologischen Studien geht hervor, dass die Prävalenz eines moderaten Zahnhartsubstanzverlustes mit zunehmendem Alter tendenziell steigt. Der Zahnhartsubstanzverlust kann aber auch ein pathologisches Ausmaß annehmen („pathologische Abrasion“), bei der die Menge des Zahnhartsubstanzverlusts für das Patientenalter atypisch ist. Die Folgen sind Beschwerden und/oder Schmerzen, funktionelle Probleme sowie ästhetische und funktionelle Beeinträchtigungen.  

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Veneer

Frontzahnrestaurationen: Was leisten Keramikveneers?

Die Einführung der Adhäsivtechnik in Kombination mit zahnfarbenen Restaurations- materialien zählt zu den größten Errungenschaften der restaurativen Zahnheilkunde.

Dazu haben adhäsiv befestigte Veneers auf der Basis verschiedener silikatkeramischer Materialien ganz wesentlich beigetragen. Keramische Veneers, denen über lange Zeit der Nimbus einer rein ästhetischen Versorgung anhaftete, erfahren noch heute eine stetige Indikationserweiterung. Sie haben sich zu einer ernsthaften Behandlungs- alternative zu klassischen, weitaus invasiveren Restaurationsformen entwickelt. Heute werden sie neben zahlreichen anderen Anwendungsbereichen zur Rekonstruktion der Biomechanik von Zähnen eingesetzt. Ebenso zur Einstellung einer angemessenen Funktion bis hin zur Maskierung stark verfärbter endodontisch behandelter Zähne.

Der Beitrag beschreibt anhand klinischer Beispiele die Prinzipien der modernen Veneertechnik unter besonderer Berücksichtigung der Zusammenarbeit mit dem Zahntechniker bei der Analyse, der Definition des Behandlungsziels, der Farbbestimmung, der Entscheidung zugunsten einer passenden Keramik, der Präparationsgestaltung und der Festlegung des Befestigungsmaterials für die adhäsive Eingliederung. Außerdem wird auf der Basis der vorhandenen wissenschaftlichen Literatur das Langzeitverhalten keramischer Veneers bewertet.

Analyse und Festlegung des Restaurationsziels

Die Analyse der Funktion, der Ästhetik und der Bio­mechanik sowie die Festlegung des Restaurationsziels setzen eine sehr enge Kommunikation mit dem Zahn­techniker voraus. Folgende Unterlagen sollten für die labortechnische Analyse zur Herstellung des diagnosti­schen Wax­ups zur Verfügung stehen:

  • Porträtaufnah­men frontal und lateral mit und ohne Gesichtsbogen
  • Aufnahmen mit leicht geöffnetem Mund und entspann­ter Oberlippe sowie Videoaufnahmen (Smartphone reicht aus)
  • Aufnahmen bei denen der Patient frei erzählt und ein­ mal beispielsweise von „50“ bis „55“ zählt
  • intraorale Fotos beider Kiefer (Fotostatus),

Diese Aufnahmen unterstützen die Bestimmung der Länge und der Inklination der Scheidekanten der mittleren Oberkieferinzisivi. Dies ist der zentrale Ausgangspunkt jeder Frontzahn­ oder komplexeren Rehabilitation. Weiter­ werden Abformungen beider Kiefer mit der Darstellung des Vestibulums einschließlich der Jugae alveolaria und eine Kieferrelationsbestimmung benötigt.

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Soft Tissue Regeneration

Soft Tissue Regeneration in the Esthetic Zone

Liebermann A1, Frei S2, Pinheiro Dias Engler ML1, Zuhr O3, Prandtner O2, Edelhoff D1, Saeidi Pour R1.
2018 Jan;30(1):22-29. doi: 10.1111/jerd.12336. Epub 2017 Sep 19.

Multidisciplinary full-mouth rehabilitation with soft tissue regeneration in the esthetic zone.

Oral rehabilitation often requires a multidisciplinary approach in restorative dentistry, prosthodontics, and periodontology to fulfill high esthetic and functional demands, frequently combined with changes in the vertical dimension.

The presence of gingival recessions can be associated with numerous factors

  • such as brushing
  • preparation trauma
  • persistent inflammation of the gingiva
  • inadequate marginal fit of restorations
  • functional problems

Because gingival recessions can cause major esthetic and functional problems, obtaining stability of the gingival tissue around prosthetic restorations is of essential concern. Modifications of the occlusal vertical dimension require sufficient experience of the whole dental team. Patients with functional problems and craniomandibular dysfunction, a newly defined occlusal position should be adequately tested and possibly adjusted.

Clinical considerations: This case report presents a complete prosthetic rehabilitation combined with a periodontal surgical approach for a patient with gingival recessions and functional/esthetic related problems. The vertical dimension was carefully defined through long-term polymethyl methacrylate provisionals as a communication tool between all parts involved. All-ceramic crowns were inserted after periodontal healing as definitive rehabilitation.

Conclusions: Complex rehabilitation in patients with high esthetic demands including soft tissue corrections requires a multidisciplinary team approach that consists of periodontal surgeon, dentist and dental technician.

Watch the related story.

KEYWORDS

ceramic, connective tissue graft, minimally invasive restorations

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immediate Implantat

Replicate Tooth Hybrid Implant

2017 May/Jun;32(3):e153-e160. doi: 10.11607/jomi.5562.

Innovative Single-Tooth Replacement with an Individual Root-Analog Hybrid Implant in the Esthetic Zone: Case Report.

An innovative approach to single tooth replacement using an individually custom fabricated root analog, hybrid dental implant.  It avoids the micro gap and micro movements between the implant and abutment.  The process requires capturing accurate root geometry through combined CAD/CAM and a three-dimensional 3D visualization digital volume tomography of the tooth in situation.

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Okklusionsonlays

Neue Präparation mit Prof. Edelhoff und Dr. Ahlers

  • Bei der Präparation geht man typischerweise davon aus, zunächst zu entscheiden, ob ein zusätzlicher Substanzabtrag im Kauflächenbereich erforderlich ist. In dem Fall sollte dieser mittels entsprechender Tiefmarkierer erfolgen.
  • Im weiteren Verlauf ist häufig in entsprechenden Fällen zunächst eine Vorpräparation erforderlich, um bei den teilweise recht zerstörten Okklusionsflächen die Grundform eines Okklusionsinlays vorzubereiten.
  • Danach sollte die eigentliche Formgebung erfolgen. Dafür eignen sich Instrumente besonders gut, die von der Geometrie her in einem Zug die Form der späteren Restauration vorgeben.

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Ceramic Chipping

Option to Prevent Ceramic Chipping

Combining Esthetic Layering and Lithium Disilicate Sintering Technique on Zirconia Frameworks: A Veneering Option to Prevent Ceramic Chipping.
Saeidi Pour R, Edelhoff D, Rafael CF, Prandtner O, Frei S, Maziero Volpato CA, Liebermann A.
2017 Jul/Aug;37(4):561-569. doi: 10.11607/prd.3043.

Chipping of veneering porcelain is the most frequent complication in all ceramic restorations with zirconia frameworks.

In cases of major chipping, replacement of the affected restoration may be necessary.

Complications after the placement of implant supported fixed dental prostheses occur over time as a result of fatigue and stress.

High strength ceramics offers new options to serve as veneering material in a sintering technique with zirconia frameworks.

In conclusion the purpose of three case presentations here was to describe the use of lithium disilicate ceramic on zirconia frameworks.

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Dental Restoration Step by Step

Patient Oriented Treatment Concept

2018;13(4):476-492.
A patient-calibrated individual wax-up as an essential tool for planning and creating a patient-oriented treatment concept for pathological tooth wear.
Saeidi Pour R, Engler MLPD, Edelhoff D, Prandtner O, Frei S, Liebermann A.

Tooth wear is generally a physiological process. However, it can also be a pathological condition associated with attrition, abrasion, and erosion processes. Quantity of tooth loss is atypical and often causes functional problems, symptoms of discomfort/pain. This condition frequently needs restorative treatment, combined with an increase in the vertical dimension of occlusion. The mock-up to determine the new occlusal plane and vertical dimension of occlusion is a fundamental tool considering the backward planning involved in the execution of a complex rehabilitation.

We strive to make our articles alive! How are we going to do that? The patient creates the inspiration for the restoration. As a result we started to make videos about patient story’s aligned with tutorials.

Please watch the relating story!

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Amelogenesis imperfecta

Rehabilitation bei Amelogenesis imperfecta

Unter Berücksichtigung der klinischen Phänotypen und des Vererbungsmechanismus werden 15 Subtypen der Amelogenesis imperfecta unterschieden. Die generellen Auswirkungen der AI variieren je nach Subtyp und Schweregrad erheblich. Am häufigsten klagen Patienten über ästhetische Probleme, Sensibilitäten gegenüber mechanischen und chemischen Reizen und eine beeinträchtigte Phonetik durch den Verlust der vertikalen Dimension der Okklusion.

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dental printing

3D Printing of Dental Structures

BDJ volume 221, pages 555–560 (04 November 2016)

Histo-anatomic 3D printing of dental structures

J. Schweiger, F. Beuer, M. Stimmelmayr, D. Edelhoff, P. Magne & J. F. Güth

A general description of the workflow by creating dental restorations with natural appearance and biomechanics.
Using additive manufacturing technologies by 3D capturing of outer and inner tooth-structures…

The creation of dental restorations with natural appearance and biomechanics represents a major challenge for the restorative team. The manufacturing-process of high-aesthetic restorations from tooth coloured restorative materials is currently dominated by manual manufacturing procedures and the outcome is highly dependent on the knowledge and skills of the performing dental technician. This article describes the possibilities and technologies available for so-called ‘4D-printing’. It introduces the digital manufacturing process of multilayered anterior teeth using 3D multipart printing, taking the example of manufacturing replicas of extracted intact natural teeth.

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Socket Shield

Socket Shield Technique

2017 Apr;29(2):93-101. doi: 10.1111/jerd.12291. Epub 2017 Feb 12.

Clinical Benefits of the Immediate Implant Socket Shield Technique.

Extraction-socket resorption is considered a major problem that can limit implantological rehabilitation options and compromise the esthetic outcome. Surgical techniques to reduce remodeling are of restricted predictability and commonly require several surgical interventions and grafting.This increases the treatment cost and places a physical and psychological strain on the patient.This clinical case report presents a replacement of an upper canine using the socket- shield technique with a CAD/CAM surgical guide, resulting in a predictable, high esthetic, and functional result.

 

 

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Dentin

Digitally Produced Dentin Cores

Quintessence of dental technology 38(2015):207-220 · January 2015

Automated Production of Multilayer Anterior Restorations with Digitally Produced Dentin Cores

Josef Schweiger, Daniel Edelhoff, Michael Stimmelmayr, Jan-Frederik Güth, Florian Beuer

When producing digital dental restorations, it is now possible to mirror the geometry of teeth, to output the result as a data record, and to mill the resulting shape monolithically from a tooth- colored blank…

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veneer

The Performance of Veneers

2018;49(2):89-101. doi: 10.3290/j.qi.a39509.

Anterior restorations: The performance of ceramic veneers.

Bonding techniques in combination with tooth colored restorative materials are one of the greatest achievements in restorative dentistry.

Keywords:
Adhesive bonding, all-ceramics, analysis, material selection, tooth preparation , wax-up, preparation template, shade taking, veneer

Ceramic veneers had long been considered to be only esthetic implements. However, their range of indications have been steadily increasing, making ceramic veneers a highly viable alternative to the classic and far more invasive forms of restorative treatment. Today these veneers are used to restore the biomechanics of the dentition. This establishes adequate function to mask highly discolored treated teeth, and for many other purposes. The present article explains the principles of modern veneer technology based on clinical examples.

 The article will also explore the longterm prognosis of ceramic veneers as reported by a number of scientific studies.

Watch a relating onlay & veneer story

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Partial Anodontia

Partial Anodontia

Published in spectrum dialogue and EDI Dental Magazin

Otto Prandtner, Jacinthe M. Paquette, Cherilyn G. Sheets

Agenesis of permanent teeth, also known as partial anodontia, is a common problem. Recent studies have shown that the incidence of anodontia is increasing. When lateral incisors are missing, parents, dentists and orthodontists are tasked to make the right decisions at an early stage – i.e. during the early years of the young patient’s life. This early decision will determine the dental health and physical appearance of the patient for a whole lifetime. This article presents three different implant treatment cases.

Watch a relating partial anodontia story.

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dental aplasia

Dental Aplasia – Dental Agenesis

2017 Jul 8;29(4):247-255. doi: 10.1111/jerd.12315. Epub 2017 Jul 6.
Systematic development of esthetics and function in a young patient with maxillary dental aplasia.
Full arch rehabilitations in young patients suffering from dental agenesis should compensate for the reduced vertical dimension of occlusion and restore both esthetics and function at minimal biological cost. This requires precise planning and maximum patient compliance during the preprosthetic phase. The present clinical case documents a minimally/non-invasive maxillary full arch rehabilitation of an agenesis patient with multiple dental aplasia, primary tooth persistence, and deficits in bone growth.
Keywords
aplasia, ceramics, lithium disilicate, primary tooth persistence

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