Ceramic veneers on central incisors without finish line using bopt in a case with gingival asymmetry

Abstract

Objectives This clinical case report describes the rehabilitation of central incisors with veneers in a patient with gingival asymmetry. The teeth were prepared without finish line, applying BOPT concepts to correct asymmetry, and obtained a harmoniously integrated restoration with optimal periodontal health. Clinical implications Biologically oriented preparation technique (vertical or “feather edge” preparation) was used to obtain gingival symmetry. Teeth were prepared without horizontal finish line to achieve correct emergence, soft tissue adaptation and stabilization, while maintaining biological space, both at the provisional restoration stage and later when definitive restorations were placed. To perform the technique correctly, it is essential to perform adequate periodontal diagnosis to verify the space available between the bone crest and the future margin of the restoration. Conclusions It is possible to correct gingival asymmetry by performing dental preparation without finish line providing a correct periodontal analysis is first performed, which will contribute to successful soft tissue stabilization. Clinical Significance Beyond of all the prosthodontic preparation techniques, knowledge of B.O.P.T. (Biological Oriented Preparation Technique) allows us to achieve predictable and consistent results in terms of periodontal health and gingiva architecture surrounding ceramic veneers. Nevertheless long term studies are necessary to ensure the benefits of this techniques. Key words: Gingival margin, emergence profile, biologically oriented preparation technique.

Three-year clinical evaluation of zirconia and zirconia-reinforced lithium silicate crowns with minimally invasive vertical preparation technique

“…According to the technique used in this study, the biological width violation is practically not possible as the nonworking tip of the special bur is calibrated so that not touching the first millimeter of the root where the connective tissue enters the cementum. Furthermore, the usage of a smaller tip permits a rotary curettage of the sulcus epithelium with little or no bleeding and a quicker healing [43,44]. The interim crowns were used to direct the remodeling of gingiva through over-contouring or under-contouring to increase the gingival thickness [45].…”

Técnica de Preparación Biológicamente Orientada: Una alternativa para rehabilitar dientes e implantes

“…En rehabilitación oral se encontraron 479 casos clínicos empleando esta técnica en coronas, carillas y puentes fijos con un periodo de seguimiento de 6 años; llama la atención la denominada "ortodoncia protésica o POA" que permite movimientos dentales; por ejemplo, si se requiere un movimiento mesial del pilar, se desgasta más su lado opuesto distal para que el diente pueda moverse mesialmente. La evidencia científica de este enfoque protésico fue escasa, tan solo 3 casos clínicos ocuparon POA con un seguimiento mínimo de un año (4)(5)8,(12)(13)(14)(15)(16)18,19,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) .…”

“…Pasado este tiempo, se realiza una impresión definitiva con técnica de dos pasos y doble hilo retractor; en este momento, el técnico dental entra en acción cuando obtiene los modelos de trabajo; se establecen tres líneas: la primera marca el margen gingival, luego se desgasta toda la parte cervical dejando expuesto el final del surco gingival en donde se trazará la segunda línea, la tercera línea se coloca en la mitad de las dos trazadas anteriormente. Esta última es el límite de finalización para las coronas definitivas, así no se invade el ancho biológico (4,8,(10)(11)(12)(13)15,16,18,19,22,24,25,27,(29)(30)33,34,43,44) . En comparación con un protocolo digital, un escáner intraoral se encarga de todo el trabajo; desde la confección de los provisionales hasta la confección de las coronas definitivas.…”

“…Es menester mencionar que las investigaciones realizadas muestran al disilicato de litio y el zirconio como principales porcelanas para rehabilitar estructuras dentales preparadas con BOPT. Tanto en los métodos convencionales como digitales, si se trabaja con zirconio, es necesario realizar un revestimiento triboquímico con sílice 30 um Al 2 O 3 (4,(8)(9)(10)(11)(12)(13)(15)(16)(17)(18)(19)22,24,25,(27)(28)(29)(30)33,34,(43)(44)(45)(46)(47) .…”

The Influence of the Thickness of the Materials for the Provisionalization in Minimally Invasive Restorations

“…For example, Loi and Di Felice described a new technique for tooth preparation and management of the provisional restoration by creating a new crown with a new emergence profile that simulates the shape of the natural tooth: the BOPT protocol. Healing over this restoration is a critical step to guide the gingival tissues to a new profile [ 1 , 2 , 3 ].…”