Chapter 18 Visualising the end result – techniques to improve the predictability of aesthetic dentistry Dr Elaine Halley Principal of Cherrybank Dental Spa, Perth , elaine@jmiuk.com
When restoring teeth for anterior aesthetics, there are a variety of techniques available which increase the predictability of the treatment outcome. In many cases the treatment indicated to improve the aesthetics of a smile is elective in nature and so it is essential that informed consent is gained, and that the patient’s expectations are fully understood. Paying proper attention to the planning phase using specific techniques will in turn:
• Improve the predictability of the final result
• Enhance communication thereby reducing errors in communication between
dentist and patient and dentist and laboratory
• Ensure only specific removal of tooth structure as indicated by the treatment
plan, thus minimising unnecessary loss of healthy tooth tissue.
Failures in aesthetic dentistry may be classified in the following way:
• Psychological failures
• Technique failures
• Communication failures.
Psychological failures In other words, no matter how good the dentistry and the aesthetics, the patient will not be happy with the result. Sometimes this may be due to unrealistic expectations but occasionally there are other underlying psychological issues e.g. body dysmorphia, which manifest in a dissatisfaction with the dentistry. Careful time spent in the pre-planning stage, asking questions, listening to the patient and clarifying their expectations may help identify these potential patients. Technique failures These failures can be due to errors in the clinical situation or the laboratory procedures. There are obviously many possibilities for technique failures including failure to prepare the teeth adequately either for the clinical situation or for the material selected or a lack of understanding of the occlusal scheme. As clinicians,
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