cosmetic dentistry - beauty & science

10 I I special topic _ minimally invasive cosmetic dentistry occlusion have been recognised and advocated: balancedocclusion,17, 18 canine-protectedocclu- sion,19–26 group-function occlusion,27–31 mixed canine-protected and group function,32 flat- plane (attrition) occlusion,33, 34 biological (multi- varied, physiological) occlusion.35 However, no single type of functional occlusion has been found to predominate in nature and there ap- pears to be no scientific evidence to support one occlusal scheme over other.36 Therefore, the literature and research find- ings, along with individual clinical experiences and accepted parameters of care, should always be considered in selecting the occlusal scheme during cosmetic dental treatment. Case-finish- ing procedures should not be based on a one- size-fits-all concept, and must be customised and designed according to the patient’s aes- thetic desires, functional requirements and physiological limits. MCCF integrates the concept of force finish- ing into the conventional case-finishing pro- tocol in the hope that it will help practitioners to achieve long-term optimum results in terms of health, function, aesthetics and patient sa- tisfaction with minimal biological cost. MCCF consists of three clinical components: _force finishing; _aesthetic finishing; and _finishing evaluation. _Force finishing The concept of force finishing is new in cos- metic dentistry and should not be confused with the conventional occlusal equilibration or oc- clusal adjustment process. The concept of force finishing is based on the universal principles of force balance and force loading timing during dynamic occlusion. In order to achieve precise force finishing in restorative dentistry, clinicians need to plan the occlusal goals. This is required because the force-finishing steps alone cannot refine the major occlusal discrepancies of the patient. Hence, proper jaw positioning, angulation and establishment of tooth form (natural ana- tomy) must be completed before proceeding to Fig. 15_Aesthetic-finishing clinical facts. Fig. 16a–d_A dental loupe, T-Scan III, BioJVA (jaw vibration analysis), BioEMG (electromyography) and digital SLR camera are used as the guiding tools to evaluate the force-finishing quality. cosmeticdentistry 3_2012 1.A rough restoration surface allows dental plaque to adhere, which can promote secondary caries and periodontal diseases.54Asthefreesurfaceenergyofunevensurfacesislowerthanthatofsmoothsurfaces,micro-organismscaneasily adhere and colonise.55,56 As a result,susceptibility to soft-tissue infection and caries can increase.57,58 2.Theroughsurfaceofthefinalrestorationpromotesmarginalrestorationdiscoloration,59–61 whichcandecreasetheaesthetic quality of the restorations.62 3.Surface gloss plays an important role in the appearance of tooth-coloured restorative resins63 and is a desirable characteristic that allows restorative materials to better mimic the appearance of the enamel.64,65 4.A smooth and well-polished surface improves the flexural strength of the restorations and decreases abrasion of the opposing teeth.66,67 5.The quality of intra-oral aesthetic finishing depends on the restorative materials used,finishing techniques,finishing tools and materials selected,and skill of the operator. 6.The quality of polishing of the restoration surfaces is vital for long-term health,function and aesthetics of the oral tissue. Fig. 15 Fig. 16c Fig. 16d Fig. 16a Fig. 16b