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Book Review – ‘Aesthetic & Restorative Dentistry: Material Selection & Technique’

April 30, 2010
Author
image
Michael DiTolla, DDS, FAGD
‘Aesthetic & Restorative Dentistry: Material Selection & Technique’

Most of us purchased our last dental textbooks in dental school and probably rarely refer to them. I still pull out my color atlas of human anatomy and local anesthesia book from time to time, but that’s about it. For the most part, the books we studied from were boring but served their purpose: to educate. However, I have found that I’m a visual learner. I learn better through pictures, and the better the photography is, the more drawn in to the subject matter I am.

Toward the end of last year, I received an email about a new book being completed by Dr. Douglas Terry, Dr. Karl Leinfelder and Master Dental Technician Willi Geller. I was only familiar with Dr. Terry at the time and had actively followed his numerous published articles. Many of these articles focused on direct composites, and you could clearly see his skill and artistry. As a dentist who has focused exclusively on indirect restorations for the past 10 years, I told myself I would reprint the next article on indirect restorations that Dr. Terry wrote.

Since the book arrived in mid-January, it has had its own reserved parking spot on my desk. It is 700-plus pages of some of the most accomplished photography in dentistry, and more importantly, it is downright useful. “Aesthetic & Restorative Dentistry: Material Selection & Technique” is an exhaustive work, but an absolute joy to read.

Dr. Terry covers composite resins as expected, but I was surprised and delighted to see him cover such diverse topics as: principles of tooth preparation, ceramic materials, elastomeric impression materials, contemporary adhesive cements, provisionalization and periodontal plastic surgery. It is exactly the table of contents I would have come up with, because it contains all the topics that I love.

A number of dental journals publish articles in which amazing dentistry is accomplished with, for example, multi-layered direct composites. A patient with a fracture of an anterior tooth needs a large Class IV composite with an incisal edge involved. The dentist takes an impression, pours a study model, repairs the defect, makes a putty matrix, and then begins rebuilding the tooth. The result is absolutely gorgeous, but I don’t know a single dentist who routinely practices like this. That is why it is so refreshing to see the practical knowledge Dr. Terry has included in this book.

I wanted to give you a sneak peek of the stunning visuals I am referring to, and Dr. Terry was kind enough to give us permission to reprint one such case from the book. Following is a short photo essay on utilization of the total etch technique for rebonding a fractured porcelain veneer. There have been other articles on the same topic, but none have been done with the same style and simplicity of this case. Like our dental school textbooks, this book will certainly educate you, but with a passion, clarity and detail rarely seen in dental publishing today.

Figure 1

Figure 1: Preoperative facial view of fractured porcelain on a maxillary left central incisor.

Figure 2

Figure 2: The internal surface of the fractured porcelain restoration was micro-etched with silica coated aluminum oxide particles (Rocatec™/CoJet™ System [3M™ ESPE™; St. Paul, Minn.]).

Figure 3

Figure 3: The fractured fragment was etched for two minutes with a 9% buffered hydrofluoric acid gel (Porcelain Etch [Ultradent Products, Inc.; South Jordan, Utah]).

Figure 4

Figure 4: Application of an MDP-containing bonding/silane coupling agent mixture (Porcelain Bond Activator mixed with Clearfil SE™ Bond Primer [Kuraray America, Inc.; New York, N.Y.]).

Figure 5

Figure 5: The fractured ceramic surface of the intact veneer was etched with 9% buffered hydrofluoric acid gel (Porcelain Etch).

Figure 6

Figure 6: The exposed tooth preparation was etched for 15 seconds with a 37.5% phosphoric acid (Gel Etchant [Kerr/Sybron; Orange, Calif.]).

Figure 7

Figure 7: Silane was applied to the etched ceramic surface of the intact veneer and lightly air-dried.

Figure 8a
Figure 8b

Figures 8a, 8b: An adhesive (All-Bond 3™ [Bisco, Inc.; Schaumburg, Ill.]) was applied to the tooth structure and ceramic surface and lightly air-dried.

Figure 9

Figure 9: A dual-cured resin cement (Illusion™; Bisco, Inc.) is placed onto the internal surface of the fragment.

Figure 10

Figure 10: The fragment was seated and the excess resin cement was removed with a #000 sable brush. It was then polymerized from all aspects, facial, lingual, incisal and proximal, for 60 seconds, respectively.

Figure 11

Figure 11: The final post-operative result reflects harmonious integration of form, color and texture that can be achieved from the reattachment of a fractured porcelain veneer restoration.

Purchase “Aesthetic & Restorative Dentistry: Material Selection & Technique” at quintpub.com or amazon.com. For an autographed copy of the book, log on to everestpublishingmedia.net.

Contact the author, Dr. Douglas Terry, at 281-481-3470, dentalinstitute.com or dterry@dentalinsititue.com.

References

Terry DA, Leinfelder KF, Geller W. Aesthetic & restorative dentistry: material selection & technique. Stillwater (MN): Everest Publishing Media; 2009.