cosmetic dentistry_ beauty & science

cosity cements. Excess cement is immediately wiped off, and floss is used to clear the interprox- imal areas. If a retraction cord is placed before- hand, this is now removed together with excess cement and the restoration firmly held in place during light-curing from all aspects with an ap- propriate light intensity and duration (20 second for halogen lights and 10 seconds for LED lights of 800 mW/cm2 ). After setting, a #12 blade is used to trim set excess cement. The occlusion is checked and adjusted accordingly. Finally, minor adjustments and margins are polished with silicone tips, inter- proximal diamond strips, and the sulcus irrigated with chlorhexidine solution to wash out rem- nants of set cement and to promote gingival health. To illustrate the above three processes of cementation, two case studies are presented in Figures 19 to 32 (cementation of a ceramic inlay) and Figures 33 to 45 (PLVs). _Conclusion Cementation is the penultimate clinical pro- cedure, besides review and maintenance, for theprovisionofindirectrestorations.Fittingindi- rect restorations requires adherence to stringent clinical procedures for ensuring success and longevity. Achieving these objectives involves understanding the mechanism of adhesion, the benefitsandlimitationsofcontemporarycements, and selecting the most appropriate cement de- pendingonthetypeofrestoration,therestorative material and the prevailing clinical situation. For aesthetic tooth-coloured restorations, the ideal choice is RED bonding with CR cements. It is observed in the dental literature that all-ceramic restoration survival rates are now approaching those of metal-ceramic prostheses. However, providing metal-ceramic units is re- latively technique insensitive, unlike all-ceramic prostheses, which are highly technique sensitive. Forgettingthisbasicdifferenceinclinicalpractice is costly, frustrating and embarrassing, and al- though clinical judgement may be forgiven, the patient may not be so forgiving._ Editorial note: A complete list of references is available from the publisher. Fig. 40_Two silica-based ceramic PLV for the central incisors. Fig. 41_PLV cemented with a resin-based cement, showing harmonious integration with the surrounding dentition and impeccable gingival health. Fig. 42_Post-op incisal view showing the pseudo-realignment of the left central incisor. Fig. 43_Post-op dento-facial view (compare with Fig. 33). Fig. 44_Pre-op facial view. Fig. 45_Post-op facial view. Notice elimination of the left central incisor imbrication over the left lateral incisor. Fig. 41 Fig. 42Fig. 40 Fig. 44 Fig. 45Fig. 43 Dr Irfan Ahmad The Ridgeway Dental Surgery 173The Ridgeway,North Harrow Middlesex,HA2 7DF UK iahmadbds@aol.com www.irfanahmadtrds.co.uk cosmeticdentistry _contact I clinical technique _ bonding 32 I cosmeticdentistry 1_2012