Tooth Preparation Guidelines in Fixed Prosthodontics-I

Webinar Coordinator:
Dr. Suresh Nayar,
Honorary Web Editor of EPA

WEBINAR ANALYSIS
Lecture:
Overview on Reconstruction Types: Single Tooth to Multiple Unit Reconstructions
Speaker: Prof. Marco Ferrari
Clinical diagnosis during the evaluation of the possibility to save an endodontically involved tooth has to be based on the capability to keep the tooth in function for a reasonable time.
For that, there is a need for new baseline parameters that will have to establish once the treatment goals to restore endodontically treated teeth (ETT) in different clinical conditions.
Under optical circumstances, the Restorative Difficulty Evaluation System (RDES) would be able to maintain ETT in function for many years and also to give an idea of the difficulty that the operator will have to treat the single case.
From a clinical point of view, the maintenance of an ETT for a long time reflects proper treatment planning for the tooth itself and the mouth of the patient. It is clear that the diagnostic process must be based on a multifactorial approach, with a proper evaluation of each patient.
Parameters such as endodontic anatomy, complexity and outcome of the endodontic treatment, amount of coronal residual structure, margins quality of restoration, local interdisciplinary conditions, in particular periodontal status, type and complexity of the treatment planning, functional need, dental wear, and esthetic needs must be evaluated.
The RDES may be evaluated based on several clinical factors, local and more generally related to the entire mouth, whereby no single parameter displays a more paramount role.
The entire spectrum of local and mouth parameters ought to be evaluated simultaneously.
For this purpose, a functional diagram has been created including the following aspects:
1. Endodontic complexity and outcome, 2. Vertical amount of coronal residual structure and dimension of the pulp chamber, 3. Horizontal amount of coronal residual structure,4. Restoration marginal seal, 5. Local interdisciplinary conditions,6. The complexity of the treatment planning, 7. Functional need, 8. Dental wear and esthetic need.
Clinical examples of each RDES parameters will be shown and ano overview of materials and techniques to restore ETT will be presented.

Tooth Preparation Design in Contemporary Prosthodontics – From Minimal to Full-Coverage
Speaker: Prof. Daniel Edelhoff
Digital technologies, new restorative materials associated with reliable adhesive techniques have significantly changed the preparation design in Prosthodontics. Mechanical anchorage of restorations via conventional cementation as a predominantly subtractive treatment method is gradually being superseded by a primarily defect-oriented additive approach. Modifications of conventional treatment procedures have led to the development of an economical approach with regard to the removal of healthy tooth structure, as the planned treatment outcome is defined in a wax-up before the treatment is commenced. This wax-up is subsequently used as a reference during tooth preparation.
The lecture will give an update and overview over contemporary options of tooth preparation: from low prep veneers, occlusal onlays over resin bonded FDPs to partial coverage and full coverage preparations.
Disclosure Statement: Dr. Edelhoff receives financial support for research projects with 3M, Amann Girrbach, Camlog, Dentsply Sirona, Heraeus Kulzer, Ivoclar Vivadent, Komet Dental, Straumann, Dentsply VDW, zirkonzahn.