Digital Guided Micro Prosthodontics 数字引导的显微修复(英文版)

1 Overview /1 1.1 Development and Requirements of Micro Dentistry /2 1.1.1 Different Levels of Visual Basis Bring Different Levels of Recognition /2 1.1.2 Development of Micro Dentistry /3 1.2 Application of Dental Microscope in Dental Specialties /3 1.2.1 Accuracy of Measurement Required by Each Dental Specialty Is Not the Same, and that of Endodontics and Prosthodontics Is Relatively Small /3 1.2.2 The Application of Microscope in Endodontics /4 1.2.3 The Application of Microscope in Periodonticsand Dental Implantology /4 1.2.4 The Application of Microscope in Prosthodontics /4 1.2.5 The Application of Microscope in Dental Technology /4 1.2.6 The Application of Microscope in Teaching,Scientific Research, and Clinical Skill Training /5 1.3 Development and Advantages of Micro Prosthodontics /5 1.3.1 In the Naked-Eye Age, the Complications of RestorationAre Mostly Related to Unclear Vision /5 1.3.2 Reasons Why We Need Micro Prosthodontics /5 1.3.3 The Relationship Between Digital Micro Prosthodonticsand Minimally Invasive Dentistry /6 Suggested Readings /7 Part I Analysis, Design and Preclinical Preparation of Micro Prosthodontics 2 Theory and Practice of Target Restorative Space (TRS) /11 2.1 Definition and Classification of Target Restorative Space (TRS) /11 2.1.1 Definition /11 2.1.2 Classification /11 2.2 The Significance of Target Restorative Space (TRS) in Prosthodontics /15 2.2.1 The Significance of TRS in Aesthetic Restoration /15 2.2.2 The Significance of TRS in Implant Surgery /18 2.3 Classification and Manufacturing of TRS Guide /18 2.3.1 Classification of TRS Guides /19 2.3.2 Transparent Dental Membrane TRS Guide /20 2.3.3 3D Printing TRS Guide /20 2.3.4 Two-in-One TRS Guide for Tooth Preparation and Implantation /21 2.4 Application of Target Restorative Space (TRS) Guide in Preoperative Analysis and Design /21 2.4.1 Application of TRS Guide in Aesthetic Restorationof Anterior Teeth /21 2.4.2 Application of TRS Guide in Functional Reconstructionof Oral and Maxillofacial System /22 2.4.3 Application of TRS Guide in Secondary Restoration/ 24 2.4.4 Application of TRS Guide in Dental Implant /24 2.5 Summary and Prospect /24 Suggested Readings /26 3 Microscope and Auxiliary Devices for Micro Prosthodontics /27 3.1 The Basic Structure and Working Principle of Dental Microscope /27 3.1.1 Definition of Dental Microscopes /27 3.1.2 Classification of Dental Microscopes /28 3.1.3 Basic Structures of Dental Operating Microscope /29 3.2 Auxiliary Devices for Micro Prosthodontics /35 3.2.1 Ring Flash/Twin Flash Device Around the Objective Lens /37 3.2.2 Lingual/Palatal Reflector and Its Holder /37 3.2.3 Variable Diaphragm /38 3.2.4 Enamel Chisel /38 3.3 The Basic Set-Up and Instructions of Dental Operating Microscope /39 3.3.1 Set-Up and Precautions of Dental Operating Microscope /39 3.3.2 Basic Adjustment of Dental Operating Microscope /40 3.4 Summary and Prospect /42 Suggested Readings /42 4 Posture and Microscopic View of Prosthodontic Microsurgery /43 4.1 Dental Microsurgery Technique and Ergonomics /43 4.1.1 Definition of Ergonomics /43 4.1.2 The Connection Between Dental Microsurgery Technique and Ergonomics /43 4.1.3 Ergonomic Recommendations /43 4.2 Postures of Dental Microsurgery /44 4.2.1 Ergonomic Posture of Dental Microsurgery /44 4.3 Microscopic View of Each Tooth /46 4.3.1 Microscopic View of Maxillary Anterior Teeth /46 4.3.2 Microscopic View of Maxillary Posterior Teeth /47 4.3.3 Microscopic View of the Mandibular Anterior Teeth /49 4.3.4 Microscopic View of the Mandibular Posterior Teeth /50 4.4 Thoughts and Comments Regarding the Practice of Micro Prosthodontics /51 4.4.1 Using a Microscope Can Prolong the Career Longevity of Dentists and Improve Clinical Results /51 4.4.2 Microscopy Does Not Mean Minimal Invasiveness /52 4.4.3 Application of Dental Microscope in Prosthodontics Teaching /53 4.4.4 “Five Difficulties” in the Practice and Teaching of Microscopic Prosthodontics /53 4.4.5 Consensus Should Be Achieved on MicroscopicProsthodontic Teaching /56 4.5 Summary and Prospect /57 Suggested Readings /57 Part II Sequential and Key Clinical Techniques for Digital Micro Prosthodontics 5 Pain Management and Comfortable Treatment in Micro Prosthodontics /61 5.1 Local Anesthetics and Local Anesthesia Methods /61 5.1.1 How to Choose Local Anesthetics /61 5.1.2 How to Choose Local Anesthesia Method /62 5.1.3 How to Calculate Drug Dosage /64 5.1.4 Sedation /66 5.2 Clinical Operation Procedure /67 5.2.1 Evaluation and Preparation Before Anesthesia /67 5.2.2 Implementation of Anesthesia /68 5.2.3 Complications /69 5.3 Pain Control of Tooth Preparation /70 5.3.1 Principles and Mechanisms /70 5.3.2 Pain Control During and After Tooth Preparation /72 5.4 Pain Control of Dental Implantation /72 5.4.1 Principles and Mechanisms /72 5.4.2 Reasons for Pain after Dental Implantation /73 5.4.3 Pain Control After Dental Implantation /73 5.5 Summary and Prospect /74 Suggested Readings /74 6 Isolation of the Operative Field in Micro Prosthodontics: Practical Rubber Dam Technology /75 6.1 Rubber Dam and Accessories /75 6.1.1 Composition of Rubber Dam Kit /75 6.2 Basic Technology of Rubber Dam /77 6.2.1 Placement of Rubber Dam /77 6.2.2 Reminder for Rubber Dam Placement /79 6.3 Use of Rubber Dam in Special Situations /81 6.3.1 Gingival Sulcus Fluid or Saliva Microleakage /81 6.3.2 Large Defect of the Tooth or Poor Retention of the Crown /81 6.3.3 Isolation of PFM and Ceramic Crown /81 6.3.4 Isolation of Fixed Bridge Restoration /81 6.3.5 Tooth Neck Defect /81 6.3.6 Patients in Poor General Condition and Elderly Patients /81 6.4 Summary and Prospect /81 Suggested Readings /81 7 Introduction to Digital Micro Tooth Preparation Technology /83 7.1 Control of Tooth Preparation Amount /83 7.1.1 Biological Factor /84 7.1.2 Biochemical Factor /85 7.1.3 Esthetic and Functional Factor of Prosthesis /86 7.2 Control of the Preparation Shape /86 7.2.1 Requirements for the Shape of the Axial Surface of the Preparation /86 7.2.2 The Control of the Position and Shape of the Preparation's Margin /87 7.3 Instrument Selection for Tooth Preparation /89 7.3.1 Types and Selection of Cutting Bur for Tooth Preparation /89 7.3.2 Types and Selection of Dental Handpiece and Motors /92 7.4 Application of TRS Guide in Tooth Preparation /94 7.4.1 Classification According to the Purpose of Use /94 7.4.2 Classification According to Manufacturing Technology /95 7.5 Classification and Characteristics of the Existing Micro Tooth Preparation Techniques /96 7.5.1 Micro Groove Reference Tooth Preparation Technique /96 7.5.2 Micro Hole Reference Tooth Preparation Technique /99 7.6 Clinical Workflow and Preparation Method of High-Precision Margin /99 7.6.1 Three Determinations /100 7.6.2 Three Choices /101 7.6.3 Three Steps /102 7.7 Summary and Prospect /102 Suggested Readings /102 8 Digital Impression Technology /105 8.1 Classification and Characteristics of Digital Impression /105 8.1.1 Classification of Digital Impression /105 8.1.2 Characteristics of Digital Impression /108 8.2 Operation Procedure of Digital Intraoral Scanning System /109 8.2.1 Installation of Digital Intraoral Scanning System /109 8.2.2 Introduction to Home Page of Intraoral Scanning Software /109 8.2.3 Case Management in Intraoral Scanning Software /109 8.2.4 Scanning Scheme and Scan and Image in Intraoral Scanning Software /111 8.2.5 Processing of Digital Intraoral Scanning Model /117 8.2.6 Storage and Export of Digital Intraoral Scanning Data /120 8.3 Common Problems and Solutions of Digital Impression /120 8.3.1 Common Problems and Solutions About Hardware /120 8.3.2 Common Problems and Solutions About Software /122 8.4 Summary and Prospect /123 Suggested Readings /123 9 Digital Depth-Hole-Guiding Micro Tooth Preparation for Porcelain Veneer /125 9.1 Overview and Indications of Porcelain Veneer /125 9.1.1 The Indications of Porcelain Veneer /125 9.1.2 The Characteristics of Porcelain Veneer /125 9.1.3 Materials of Porcelain Veneer /126 9.1.4 Types of Porcelain Veneer /126 9.2 Design of Targeted Restorative Space (TRS) and Porcelain Veneer Preparation /128 9.2.1 TRS Design of Porcelain Veneer /128 9.2.2 Preparation Design of Porcelain Veneer /128 9.3 The Clinical Protocol of Micro Tooth Preparation with Digital Guide for Porcelain Veneer /130 9.3.1 Veneer Preparation Using the Silicone Rubber Guide /130 9.3.2 Veneer Preparation Using the Transparent Vacuum-Formed TRS Guide /136 9.3.3 Veneer Preparation Using 3D Printing TRS Guide /140 9.3.4 Finishing and Polishing /143 9.4 Gingival Retraction Technique Under a Microscope /143 9.4.1 Microscope Field of View for Gingival Retraction /145 9.4.2 The Procedure of Gingival Retraction Under a Microscope /145 9.5 Impression Making and Provisional Restoration /146 9.5.1 Impression Making /146 9.5.2 Provisional Restoration /146 9.6 Overview and Indications of Partial Porcelain Veneers /147 9.6.1 Indications and Contraindications of Partial Porcelain Veneer /147 9.6.2 Materials for Partial Porcelain Veneer /147 9.6.3 TRS Design for Partial Porcelain Veneer /148 9.6.4 Preparation Requirements for Partial Porcelain Veneer /148 9.6.5 Preparations for Tooth Preparation of Partial Porcelain Veneer /148 9.6.6 Preparation of Various Types of Dental Veneers /149 9.7 Summary and Prospect /151 Suggested Readings /151 Contents xv 10 Digital Micro Tooth Preparation for Posterior Indirect Adhesive Restorations /153 10.1 Overview of Posterior Indirect Adhesive Restorations /153 10.1.1 The Advantages and Disadvantages of PIAR /153 10.1.2 Material Selection for PIAR /154 10.1.3 Types of PIAR /155 10.2 Preparation Design of Posterior Indirect Adhesive Restoration /155 10.2.1 The Amount of Preparation /155 10.2.2 The Principle of Posterior Indirect Adhesive Restoration Preparation /156 10.3 Micro Preparation Protocol for Posterior Indirect Adhesive Restorations /159 10.3.1 Basic Principles of PIAR Preparation /159 10.3.2 Preparation Before Tooth Preparation /159 10.3.3 Preparation Process of Micro Preparation Guided by TRS Guide /159 10.3.4 Preparation for Single-Surface PIAR /161 10.3.5 Preparation for MO/DO PIAR /162 10.4 Summary and Prospect /163 Suggested Readings /164 11 Digital Depth-Hole-Guiding Micro Preparation for All-Ceramic Crown /165 11.1 Overview and Indications of All-CeramicCrown /165 11.1.1 Indications of All-Ceramic Crown /165 11.1.2 Contraindications of All-Ceramic Crown /166 11.2 Classification of All-Ceramic Material /166 11.2.1 Slip-Casting Ceramic /166 11.2.2 Castable Glass Ceramic /166 11.2.3 Pressed Castable Ceramic /167 11.2.4 Infiltrated Ceramic /167 11.2.5 Machinable Ceramic /167 11.2.6 Zirconia Ceramic or Zirconia-Toughened Ceramic /167 11.2.7 Nanocomposite Ceramic /168 11.2.8 Ceramic-Resin Composite /168 11.3 The Clinical Protocol of Digital Depth-Hole-GuidingMicro Tooth Preparation for All-Ceramic Crown /168 11.3.1 Analysis and Design Phase /168 11.3.2 Micro Tooth Preparation of Anterior Teeth Under the Guidance of the Transparent Vacuum-Formed TRS Guide /170 11.3.3 Micro Tooth Preparation of Anterior Teeth Under the Guidance of the 3D Printing TRS Guideof Non-uniform Thicknesses /173 11.3.4 Impression and Temporary Restoration /175 11.4 Summary and Prospect /177 Suggested Readings /178 12 Immediate Dentin Sealing and Micro Bonding /179 12.1 Overview and Mechanism of Adhesion /179 12.1.1 Concept of Adhesive /179 12.1.2 Mechanism of Adhesion /179 12.1.3 Type of Adhesives /180 12.1.4 Bonding of Enamel /181 12.1.5 Bonding of Dentin /182 12.1.6 Immediate Dentin Sealing (IDS) /184 12.1.7 The Treatments of the Ceramic Prosthesis /185 12.1.8 Cementing of Temporary Restorations /187 12.2 Micro Bonding Process of Zirconia- and Glass-Based Ceramics /188 12.2.1 Characteristics of Bonding of Different Restorative Materials /188 12.2.2 Surface Conditioning of Different Restorative Materials /189 12.2.3 Surface Conditioning of the Preparation (Abutment Tooth) Which Is to Be Repairedwith Different Restorative Materials /190 12.3 Micro Bonding Process of Porcelain Veneer /192 12.3.1 Selection of Adhesive Resin /192 12.3.2 Try-In and Preparation /192 12.3.3 Surface Conditioning of the Tooth /193 12.3.4 Surface Conditioning of the Porcelain Veneer /195 12.3.5 Placement /196 12.3.6 Occlusal Check and Adjustment /198 12.4 Micro Bonding Process of All-Ceramic Crown /199 12.4.1 Selection of Adhesive /199 12.4.2 Try-In and Preparation /199 12.4.3 Occlusal Check and Adjustment /199 12.4.4 Surface Conditioning of the Tooth Surface /199 12.4.5 Surface Conditioning of the All-Ceramic Crown /201 12.4.6 Placement /203 12.5 Summary and Prospect /204 Suggested Readings /206 Part III Complications and Treatment After Micro-prosthodontics 13 Complications and Treatment After Micro Prosthodontics /209 13.1 Routine Maintenance /209 13.1.1 Brush Teeth and Use Dental Floss Correctly /209 13.1.2 Receive Regular Scaling and Treatment in Time If There Is Any Problem /209 13.1.3 Apply Fluoride and Prevent Secondary Caries /209 13.2 Complications and Treatment /209 13.2.1 Chipping Fracture of Porcelain /209 13.2.2 Porcelain Cracking /210 13.2.3 Debonding of Prosthesis /211 13.2.4 Dental Allergy /211 13.2.5 Abutment Fracture /211 13.2.6 Discoloration at the Margin of the Prosthesis /211 13.2.7 Dental Pulp Devitalization and Secondary Caries /212 13.3 Summary and Prospect /212 Suggested Readings /212 Part IV Clinical Rehabilitation of Secondary AestheticPorcelain Restoration 14 Decisions on Clinical Rehabilitation of Secondary Aesthetic Porcelain Restoration /215 14.1 Possible Complications of Secondary Aesthetic Porcelain Restoration /215 14.1.1 Hypersensitivity of Abutment Teeth /215 14.1.2 Spontaneous Pain of Abutment Teeth /215 14.1.3 Loosening, Cracking and Discolouration of Abutment Teeth /216 14.1.4 Occurrence of Exacerbation of Periodontal Disease /216 14.1.5 Discolouration of Restoration /216 14.1.6 Loosening and Falling Off of Restoration /216 14.1.7 Cracking, Breaking and Perforation of Restoration /216 14.1.8 Dysfunction and Psychological Problems /217 14.2 Clinical Decision Tree of Secondary Aesthetic Porcelain Restoration Guided by TRS Guide /217 14.2.1 Psychological Evaluation /217 14.2.2 Previous Treatment Evaluation /218 14.2.3 Prosthodontic Decision After Removing the Old Restoration /219 14.3 Typical Cases of Secondary Porcelain Aesthetic Repair and Retreatment /220 14.3.1 Secondary Aesthetic Porcelain Restorations in the Anterior Area /220 14.4 Summary and Prospect /272 Suggested Readings /274 15 Occlusal Reconstruction Under the Guidance of Target Restorative Space /275 15.1 Comprehensive Assessment Before Occlusal Reconstruction /275 15.1.1 Clinical Consultation and Risk Assessment /275 15.1.2 Examination of the Oral and Maxillofacial System /275 15.1.3 Radiographic Examination /277 15.1.4 Mounting of Diagnosis Casts onto the Articulator /277 15.2 Typical Cases of Occlusion Reconstruction Aided by the TRS Guide /277 15.2.1 A Case of Secondary Aesthetic and Functional Porcelain Restoration of Maxillae and Mandible Aided by TRS Guide /278 15.2.2 A Case of Secondary Aesthetic Porcelain Restoration of Maxillae and Mandible Aided by TRS Guide /285 15.2.3 A Case of Occlusal Reconstruction Restored by Implant-Supported Fixed Prosthesis with the Aid of Whole-ProcessDigital Guidance /300 15.3 Clinical Application of Occlusion Adjusting Guidein Occlusal Reconstruction /317 15.3.1 Digital Clinical Workflow of Occlusion Reconstructionfor Cases with Insufficient Occlusal Space /318 15.3.2 A Clinical Case of Designing Occlusion Adjusting Guide /322 15.4 Summary and Prospect /334 Suggested Readings /334 16 Cases of Digital Micro Prosthodontics Guided by Target Restorative Space /337 16.1 Typical Cases of Digital Micro Restoration Guided by Wax-Up Surface /337 16.1.1 A Case of Crown Lengthening Combining with Porcelain Veneer Restoration of Maxillary Anterior Tooth Guided by Mock-Up Surface /337 16.2 Typical Cases of Digital Micro Restoration Guided by Silicone Index /344 16.2.1 A Case of All-Ceramic Crown of Maxillary AnteriorTooth with ETRS Guided by Silicone Index /344 16.3 Typical Cases of Digital Micro Restoration Aided by Transparent Dental Membrane TRS Guide /347 16.3.1 A Case of Digital Micro Restoration of Traumatic Maxillary Anterior Tooth with Ceramic Veneer Aided by Transparent Dental Membrane TRS Guide /347 16.3.2 A Case of Porcelain Inlay Restoration of Elongated and Rotated Maxillary Anterior Teeth Aidedby Transparent Dental Membrane TRS Guide /359 16.3.3 A Case of Porcelain Inlay Restoration of Defected Upper Anterior Teeth Aided by Transparent Dental Membrane TRS Guide /369 16.3.4 A Case of Porcelain Veneer Restoration of Maxillary and Mandibular Tetracycline Teeth Aided by Transparent Dental Membrane TRS Guide /381 16.4 Typical Cases of Digital Micro Restoration Aided by 3D Printing TRS Guide with Uniform Thickness /393 16.4.1 A Case of Digital All-Ceramic Restorations of Maxillary and Mandibular Anterior Tooth with Exogenous Severe Erosion and Extensive Caries Aided by 3D Printing TRS Guide with Uniform Thickness /393 16.5 Typical Cases of Digital Micro Restoration Aided by 3D Printing TRS Guide with Non-uniform Thickness /410 16.5.1 A Case of Digital All-Ceramic Crown of Maxillary Rotated Anterior Tooth Aided by 3D Printing TRS Guide with Non-uniform Thickness /410 16.5.2 A Case of Digital All-Ceramic Veneer of Maxillary Anterior Dental Fluorosis Aided by 3D Printing TRS Guide with Non-uniform Thickness /417 16.5.3 A Case of Immediate Restoration of Prefabricated Crown Aided by 3D Printing TRS Guide with Non-uniform Thickness /427 16.6 Typical Cases of Digital Micro Restoration Aided by Two-in-One TRS Guide for Implant Surgery and Tooth Preparation /436 16.6.1 A Case of Digital Micro Restoration Aided by Two-in-One TRS Guide for Implant Surgery and Tooth Preparation /436 16.7 Summary and Prospect /452 Suggested Readings /452