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issue 2016 — 53 Esthetic and Restorative Dentistry Article Fig. 1 Culp classification of anterior tooth shapes. Fig. 2 All-ceramic restorations, showing natural shape nuances that create a more natural tooth arrangement. that has been identified, primaryanatomy canbeestablished,followedbysecondary anatomy.8–10 It is important to note that characteristics of secondary anatomy, such as texture and luster, can change the perception of the tooth shape and value. Restorations that are smooth appear translucent and lower in value. Rougher restorations, because of the manner in which light reflects off the front, appear morebrilliantbutlesstranslucent,despite possessing the same translucency. The various kinds oftextures—broad, horizon- talstriations;narrow,horizontalstriations; vertical striations; and a dimpled texture overthefrontofthetooth—createvarious visual characteristics.8–10 Digital dentistry Although basic dentistry has not changed agreatdealinthepast20years,innovative materials and equipment are continually enhancing the dental field. Owing to its state-of-the-art applications, allowing creation of strong and esthetic ceramic restorations in a single appointment uti- lizing computer software, CAD/CAM technologyhasbecomesynonymouswith digital dentistry. CAD/CAM is an innova- tive tool for creating a restoration de- signed on computer. Digital dentistry, however, encompasses communication, high- and low-resolution data, 3-D pho- tography, and computer programs that provide dentists with the ability to create digital restorations and virtual patients throughthecollectionofdataandtheuti- lization of various software programs.The compilationofconventionaldataforplan- ning and treating patients, including de- mographic data, clinical measurements, observation,clinicalanalysis,thermaldata, and color data, has been expanded to in- clude digital data, intra-oral photographs, scan data, cone beam computed tomog- raphydata,anddigitalradiographsfordigi- tal planning and restorative treatment.11, 12 Conventionally,adigitalrestorationwas a zirconia coping built up with modifiers, dentins, and enamels, sculpted by hand, ground down where necessary, baked, then stained and glazed. Today, a dentinal structure can be milled from a lithium dis- ilicate block and enamel added, or from a block of ceramic prelayered with gingival dentin and incisal materials and milled Fig.1 Fig.2 using CAD/CAM technology, with no dis- cernible differences evident among the three restorations (Fig. 3). The only dif- ferenceistime.Thefirstislabor-intensive, the second less so and, as expected, the machine-milledrestorationisthequickest and easiest of all to produce. CAD/CAM The attainment of perfection in the dupli- cation of natural dentition is the ultimate goal of contemporary esthetic dentistry. Understanding the complex relationship between tooth form and function, and how these relate and combine to create theestheticsofnaturaldentitionistheba- sis of study for achieving predictable suc- cessinoralreconstruction.Aspatientsbe- come more educated about the advances of modern dentistry (as a result of televi- sionmakeovershowsandprofessionaland over-the-counter whitening systems), their motivation and desire for natural- looking, esthetic restorative dentistry is increasingatadramaticrate.Dentistsand techniciansarenowfulfillingthesepatient demands, but still use dental laboratories Article_McLaren_00-00.qxp_Layout 1 02.03.16 20:49 Seite 2 Article_McLaren_00-00.qxp_Layout 102.03.1620:49 Seite 2