Dentaltown April 2021 - 15

dentin when it comes to ultrathin restorations and preparation techniques. Similarly, some
multilayered restorations are prone to chipping or delamination because they must rely
on the resin bonds that can weaken and fracture over time, so exploring other restorative
options becomes necessary.5

Improved imaging
Near-infrared imaging (NIRI) is a nonionizing radiation method of spectroscopy that
uses the near-infrared region of the electromagnetic spectrum (850nm), so the structure's
translucency translates to the brightness level in the NIRI image. Tooth enamel is translucent
to NIRI, so it appears dark, while dentin or any other interference in the enamel displays
as reflective and will appear brighter and opaque.
The resulting NIRI grayscale image shows structures with varying translucency as
different levels of brightness, allowing us to use it as an adjunct to determine if direct resin
bonding results will be allowable on healthy tooth structure with minimal beveling, or if
more preparation is required with a lab-manufactured restoration. The lower the translucency,
the higher the reflection of the infrared light and the brighter the structure. Because dentin
appears bright and enamel dark, we can have another adjunct to our cosmetic dentistry
toolbox. In cases where the enamel darkness at the incisal edge is minimal, the buildup of
resin bonding can be deemed successful if proper proportions can be established. NIRI
allows us to compare the enamel thickness of the central incisor and the canine in reference
to the lateral. We can then make predictable decisions on preparation styles and perform
minimally invasive cosmetic enhancements.6
By providing 3D images, NIRI can deliver useful operating suggestions, enabling a
targeted cavitation into the dental crown and the ability to reach small caries with precision
and good restorative results in a less invasive manner. Because of their two-dimensional
nature, radiography and photography are valuable but cannot be the sole reliance for
proper diagnosis and treatment planning.7 NIRI has considerable potential for imaging
early approximal enamel lesions.8

" Because of their
two-dimensional
nature, radiography
and photography
are valuable but cannot
be the sole reliance
for proper diagnosis
and treatment planning.
[Near-infrared imaging]
has considerable
potential for imaging
early approximal
enamel lesions. "

Better bonding
An indirect technique with a die silicone and minimal tooth preparation to create an
additive partial veneer is cost-effective and allows for aesthetic control and a strong bond
to the existing tooth enamel for a same-day, chairside result.9 A pure
silicate matrix technology combined with nanohybrid fillers, creates a
Fig. 1
nano-ormocer without classic methacrylate monomers, allowing for large
and precondensed inorganic polymer molecules that photo-polymerize
with reduced shrinkage, minimizing microshrinkage.10
Futurabond U, a bonding agent, allows us to pre-etch the beveled
enamel. It also provides an added level of adhesion strength with its
two-component system that is activated when mixed and applied for a
30 MPa bond to enamel and dentin.11 Dental calipers measure proportions
and make assessments on treatment, with or without orthodontics, to
achieve a close-to-ideal golden proportion ratio for improved aesthetic
outcomes. In this case (Fig. 1), we see that length and width of existing
anterior dentition allow for great restorative outcomes.12
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Dentaltown April 2021

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