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Dental Tribune Middle East & Africa Edition | January-February 2016 21 aesthetics < Page 20 Figure 18: Final restorations Figure 17: Pick up implants with duralay bonnets The article on Dahl appliances will cover its history and usage in today’s modern restorative dentistry, focusing on the use of traditional chrome cobalt ‘Maryland wings’ style of Dahl appliances and also the use of splinted temporary or proto- type restorations used to gain space during crown proce- dures (Figures 13-15). Duralay bonnets Impression techniques de- mand a high degree of accu- racy for the completion of the advanced restorative case. Often this is a difficult proce- dure for the restorative dentist when taking impressions both sides of the mouth at the same time (as a full arch impression where there are multiple teeth present) or undertaking an im- pression of mobile teeth as in the Lindhe/Nyman bridge. Both of these applications will be reviewed and clinical ex- amples shown of how the du- ralay bonnets and coat hanger wire technique can be used not only for impressions but also for jaw registrations (Fig- ures 16-18). Periodontal prosthesis The article on the periodontal prosthesis, commonly known as the Lindhe/Nyman bridge, reviews all the literature from the 1970s on this exciting tech- nique, which allows multiple pontic replacement in fixed bridgework on often severely mobile and reduced number of abutment teeth. The science is overwhelmingly in favour of this type of bridge in certain situations where conventional dentures or implants are not possible (Figures 19-21). Peter Wohrle bridgework The duralay bonnet technique also crops up in this article on individual crowns cemented onto a pink porcelain fused to metal bridgework cemented onto gold copings and then onto abutments screwed into dental implants – hence the abbreviated name ‘Peter Wohrle bridgework’ for ease of use after the dentist who first described the technique. Several cases will be described using slightly different tech- niques to illustrate the tech- nical difficulties in producing this bridgework but demon- strating the overall superior aesthetic result, optimal fit and maintenance potential (Fig- ures 22-24). Prof. Paul A. Tipton BDS, MSc, DGDP UK, gained his MSc from the Eastman Dental Hospital in 1989. In 1999 he was certified as a specialist in prosthodontics. During the last 20 years he has es- tablished his private practice and established for Tipton Training Ltd on restorative, aesthetic and implant dentistry. Over 2,000 den- tists have been through one of his one-year dental programmes of which there are four levels (for more details visit www.tiptontrain- ing.co.uk). Prof. Tipton is currently president of the British Academy of Im- plant Dentistry and in clinical practice at the Yorkshire Centre for Advanced Dentistry outside Leeds where he takes referrals for restorative, aesthetic and implant dentistry (www.centreforad- vanceddentistry.com). About the Author Aesthetic periodontics The last article in the series reviews the latest techniques in periodontology used to enhance optimal aesthetic restorative techniques. The periodontist is an essential team member of the aesthetic restorative practice and an increasing amount of patients are requiring pink as well as white aesthetics. Connective tissue grafting, pontic site de- velopment, crown lengthening etc will be reviewed and dis- cussed with step-by-step pro- tocols (Figures 25-27). Conclusions Restorative dentistry has gone full circle with old techniques revisited and amended for today’s dentistry. These tech- niques do not, however, get enough ‘air time’ in many journals as the importance of aesthetics takes over. It is my aim to help the reader under- stand these advanced restor- ative techniques and encour- age them to put them into their everyday practice in order to help their patients and gain more clinical satisfaction For the writing of this article on advanced clinical tech- niques, I would like to thank certain members of my team, including Dr Ibrahim Hussain, BDS, M.Med.Sci.Implantology – implant surgeon, Mr Brad- ley Moore – dental technician, ADS Laboratory, Harrogate and Dr Andrew Watson, BDS, MSc, specialist in endodontics. Article was published in Pri- vate Dentistry. Why choose The P hantom Head Course Dr N Gokul. www.tiptontraining.co.uk T: 0161 348 7848 E:enquiries@tiptontraining.co.uk Discover more at Fast track your MclinDent in association with British Academy of Restorative Dentistry Improve your tooth preparation skills Offer more complex treatments Increase your private income Keep more work in-house Secure a better, more varied job Enrol Now Courses starting February 2015 Manchester & London From £499+VAT per day 12 days approx 1 day per month 6hrs CPD per day Why choose The P hantom Head Course 12 days approx 1 day per month 6hrs CPD per day Courses starting February 2015 Manchester & London From £499+VAT per day 12 days approx 1 day per “Professor Paul Tipton is an inspiring teacher with his knowledge I take up more complex work of a better standard and charging more.” Topics Covered Bonded Crowns • Gold Preparations • Porcelain Veneers • Posterior Anatomy Amalgams/Nayyar • Cores Semi-direct Composites Minimal Invasive Posterior Composites • Composite Veneers • Post-gold, Carbon fibre • Marylands, Ceramic Crowns • Bridge Design & Preps 549 NOW IN DUBAI! Dental Tribune Middle East & Africa Edition | January-February 201621 T: 01613487848