The Alleman-Deliperi Centers for Biomimetic Dentistry
Advanced Course on Biomimetic Dentistry 2020
“Biomimetic Dentistry: the additive direct composite”
This program is designed for dentists wishing to achieve excellence with direct anterior composite restorations.
The final aesthetic outcome of an anterior restorations depends on the combination of the final form of the restoration with the color selection, tooth anatomy and the thickness of each composite shade.
Clinicians should have a precise idea of the form of the final restoration in their mind before starting color selection and composite layering (Deliperi, 2011).
Three mandatory steps are recommended when placing direct anterior composite restorations:
1-pre-op mock and/or wax-up to determine the final form of the restoration
2-shade selection and optical characteristic reproduction based on tooth age
3-evaluation of tooth thickness to manage the three-dimensional layering of dentin and enamel shades
Current evidence-based research supporting this technique will be presented.
The course will cover a minimally invasive approach for the restoration of both vital and devital teeth in the anterior area. Tooth whitening procedures will be presented as a mean to preserve as much tooth structure as possible (Deliperi, 2008); a step-by-step protocol will guide clinicians to “go additive” in most direct anterior applications! Participants will learn how to mimic both the mamelon expression, the incisal characterization and the incisal halo.
Particular attention will be given to the ultra-conservative restoration of discolored and structurally compromised teeth as well as teeth resistant to bleaching procedure. A fiber lay down protocol will be presented to increase the fracture toughness of these teeth.
Attendees will also learn how to integrate direct composite and indirect porcelain restorations in a patient smile.
Completion of the course should provide attendees with many tips and tricks they may apply the next Monday in their practice.
Topics covered through demonstration and hands-on experience:
Silicone Matrix Fabrication
Criteria for composite choice: single mass vs dual vs polychromatic technique
– Shade selection for the cervical, middle and incisal third
Composite layering protocols for Class IV, diastema closure, composite veneers and the biomimetic SRDC crown
Additive composite layering procedure for both vital and devital teeth
Finishing and polishing: how to reproduce the macro and micro-texture of the natural teeth
Understand plus and minus of different composite systems
Learning specific layering protocols for each composite brand to restore vital and devital anterior teeth
Compare a direct technique with traditional techniques available for the restoration of anterior teeth (porcelain laminate veneers, zirconia crowns)
Understand how to replicate the esthetic appearance of porcelain restorations with a step-by step protocol for direct restorations
Become familiar with a new technique for the restoration of discolored teeth resistant to bleaching
Learn a fiber lay down protocol to mimic the functional characteristics of the natural dentition when teeth are structurally compromised
Day 1 : Class IV restorations and Additive Direct Composite Veneers
Guidelines to mimic the optical characteristics of the young, adult and mature dentition in the cervical, middle and incisal third of the tooth
The 3D meticulous management of the body, dentin, trans and enamel shades to achieve both color integration and vitality (color depth) of the restoration in the incisal third
How to avoid aesthetic failures
Day 2: Fiber lay down protocols for structurally compromised teeth
Stress-reduced direct composite restorations (SRDC) for structurally compromised teeth
How to preserve ultra thin remaining cavity walls via fiber lay down protocols
Day 3: Additive protocols for the worn and discolored dentition
Direct composite veneers for the worn dentition
How to mask the tooth discoloration through a prepless approach: contraindication for tooth preparation in shade matching
Introducing a stress-reduced semi-direct (SRSD) protocol for challenging cases in the anterior area
Day 4: The Biomimetic SRDC crown and the full mouth rehabilitation
How to stress reduce teeth which were prepped for a crown: from artificial dental crowns to biomimetic SRDC restorations
The Dahl principle
TMJ, TMD and Full mouth rehabilitation via SRDC and SRSD restorations: 5-y results