International Dentistry - Vol. 12, No. 2 - 26
C H A N D R A PA L
Figure 3: Preoperative records to illustrate tooth surface loss.
Once again, the last 10 years have given the clinician a
gentle push to be educated within the field of photography,
given the availability and importance of clinical
documentation.
Curing lights
Curing lights have moved away from halogen and towards
LED, which is now the mainstay of direct and indirect
adhesive dentistry. This means a more constant wavelength
with no variability of curing ability and loss of power that
can happen with an expiring halogen bulb. This has meant
light curing units are smaller, which equates to easier
placement towards the posterior teeth as well as fewer
components, such as fans for cooling.
Within the last 10 years we have seen a reduction in the
use of plasma curing lights that made the claim to being able
to polymerise composite resin within a matter of a few
seconds. We now know that depth of cure varies dependant
on the opacity and bulk of increment being placed, as well
as reflection of the increment also having a bearing.
Angle, rate and intensity of cure have been shown to
matter (Price et al, 2015). In short, whilst LED lights now offer
this, plasma lights are now all but redundant as it has been
shown that polymerisation rates cannot be guaranteed using
such short curing cycles. The principles of light curing have
thus remained to be the same, as the industry appears to
have gone full circle in an effort to bring the clinician more
efficient methods of curing.
Shade taking
Matching the natural dentition remains at times to be a
demanding and time consuming process, which can be
fraught with error and mis-judgement. The notion that single
layer (monochromatic) composites can be used to mimic the
natural dentition simply cannot be achieved with
predictability.
Consequently, we now have greater understanding of shade
and some aids that have been designed within the last 10
years. Certain photographic filters, such as cross-polarisation,
have enabled the clinician to eliminate spectral reflection, thus
effectively highlighting the internal anatomy of teeth.
This has been influential in terms of dentinal mammelon
distribution and inclusion of intensive features such as white
spots. Such filters are now widely available and can even
be homemade, but allow greater depth of observation to
enable more features to be included within direct
restorations.
Historically the industry has relied upon Vita shade guides to
determine the overall shade of teeth. Vita 3D guides have moved
us one step further on in terms of value and chroma determination.
However, the notion that acrylic can mimic the restorative material
used at that time has remained to be incorrect.
As such, the last 10 years have given us the ability to use
prefabricated or custom shade guides that are made from
the direct restorative material being used at that time. This
gives us the closest reference possible in terms of the
materials being used.
26 INTERNATIONAL DENTISTRY - AUSTRALASIAN EDITION VOL. 12, NO. 2
Table of Contents for the Digital Edition of International Dentistry - Vol. 12, No. 2
Contents
International Dentistry - Vol. 12, No. 2 - Cover1
International Dentistry - Vol. 12, No. 2 - Cover2
International Dentistry - Vol. 12, No. 2 - Contents
International Dentistry - Vol. 12, No. 2 - 2
International Dentistry - Vol. 12, No. 2 - 3
International Dentistry - Vol. 12, No. 2 - 4
International Dentistry - Vol. 12, No. 2 - 5
International Dentistry - Vol. 12, No. 2 - 6
International Dentistry - Vol. 12, No. 2 - 7
International Dentistry - Vol. 12, No. 2 - 8
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International Dentistry - Vol. 12, No. 2 - 22
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International Dentistry - Vol. 12, No. 2 - 25
International Dentistry - Vol. 12, No. 2 - 26
International Dentistry - Vol. 12, No. 2 - 27
International Dentistry - Vol. 12, No. 2 - 28
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International Dentistry - Vol. 12, No. 2 - 35
International Dentistry - Vol. 12, No. 2 - 36
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International Dentistry - Vol. 12, No. 2 - 42
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International Dentistry - Vol. 12, No. 2 - 46
International Dentistry - Vol. 12, No. 2 - 47
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International Dentistry - Vol. 12, No. 2 - 49
International Dentistry - Vol. 12, No. 2 - 50
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International Dentistry - Vol. 12, No. 2 - Cover3
International Dentistry - Vol. 12, No. 2 - Cover4
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