Perception: Esthetics in Metal-Free Prosthesis of Natural Teeth and Implants
This immaculately presented publication demonstrates absolute best practice when placing metal-free prostheses, attempting to ascertain functional restorations that have aesthetics at the epicentre of each stage of fabrication. The Brazilian authors have produced an attractive 766 page text, finished with the highest quality paper and accompanied by embossed photography throughout.
The text gives a detailed account of each stage of the process, from treatment planning, occlusal considerations, choice of materials, preparation and adhesive cementation. It also addresses the latest fabrication techniques, incorporating CAD-CAM systems in dental prosthesis manufacturing, and imaging as a means of communication. An entire chapter is dedicated solely to ceramic abutments in implant dentistry.
Perception places great significance on aesthetics, and thus discusses all of the factors which need to be considered in order to obtain the ideal result. Right from the consultation stage, the authors advocate the use of a diagnostic wax up on correctly articulated models, to ensure that both the occlusal scheme can be replicated correctly and the patient can be given realistic expectations of the treatment outcome. They discuss in detail the enigmatic field of colour and its constituents, including an illustrated discussion of hue (or 'matiz'), value and chroma, advocating the use of shade guides designed upon these core principles, eg VITA 3-D Master scale. Also addressed is treatment planning for osseointegrated implants, with consideration given to the prosthetic space to be filled, the position of the implant, implant selection and mesio-distal position.
Preparations for a multitude of metal-free restorations are included, accompanied throughout by clinical cases demonstrating the aesthetic and functional result that can be conferred by each. Ceramic laminate veneers are considered as a separate entity and the authors suggest methods of overcoming many of the aesthetic hurdles that are unique to this restoration.
This truly is a beautiful publication, where the authors approach the practice of dentistry as an art form as much as a science. Although the full mouth rehabilitation cases which are demonstrated clearly can transform a patient's smile with imperceptible restorations, such cases rarely walk through the front door at the general dental practice. Therefore, despite marvelling at the quality of work that can be achieved with metal-free restorations when adopting best practice, I feel this text is more suited to specialist prosthodontists or hospital consultants than the general practitioner. There is, however, a wealth of information contained herein, and this book would serve as a useful reference for any practitioner wishing to further their knowledge in the field of all ceramic restorations, for both the natural tooth and implants.
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