Direct Anterior Composite Restorations

Duration: 39 min

This first video lesson aims to introduce participants to the topics that will be covered during the course.

In particular, Dr. Autràn will focus on the definition and composition of composites, explaining how they are simple materials capable of totally changing patients' smiles while maintaining a 100% reversibility degree and guaranteeing aesthetically optimal results. Restorative treatment using composites is indeed a minimally invasive treatment option and participants will appreciate how the key objective of this treatment is mimicry and camouflage between composite veneers and adjacent natural teeth. The different types of particles that can make up composites will be discussed, as well as their characteristics, advantages and disadvantages.

In particlar, this lecture covers the following topics:

• The importance of smile analysis to achieve restorative success
• How to execute restorative treatments with little or no preparation at all
• Composites: how are they useful? What’s the rationale behind their use? Which are their characteristics?
• Composite blending effect
• Types of particles: definitions, degree of resistance and ease of cleanliness
• Micro-particles, hybrids, nano-hybrids and supra-nano spherical particles

Duration: 27 min

Dr. Autràn presents an overview of today's philosophy regarding stratification techniques.

He begins this discussion by talking about the preliminary phase of aesthetic planning, emphasizing the aspects that need to be assessed by the clinician in order to understand the objectives of each case. All planning phases are examined: from smile analysis to 3D design, via digital wax-up and the creation of a digital model through 3D printing. Finally, Dr. Autràn emphasizes the importance of performing a mock-up, both direct and indirect, as well as the advantages of using silicone guides for composite restorations.

In particlar, this lecture covers the following topics:

• Introduction to aesthetic planning
• Understand and know the natural look of a smile
• The necessity to have a good additive wax-up to not have to prepare the tooth before veneers placement
• Teeth measurement and dental exposure assessment
• How to execute direct and indirect mock-up
• How to create the silicon guide for composite restorations in a very precise way

Duration: 39 min

Dr. Autràn explains how important it is to know the anatomy of teeth in depth by discussing primary, secondary and tertiary anatomical parameters. The lecturer introduces concepts such as mesial and distal edges, the differences between triangular and square teeth, contact points, incisal edges and transition lines, and even discusses tooth texture. The second part of this presentation focuses on the site-specific anatomical characteristics of different types of dental elements: from incisors to laterals, canines and premolars.

In particlar, this lecture covers the following topics:

• Translucency, layers, opacity, color and thickness assessment
• Primary, secondary and tertiary dental anatomy
• Central superior incisors, lateral superior incisors, superior canines and superior premolars anatomical traits
• When to include and when to not include premolars in the smile reconstruction
• The proper incisors positioning
• The need to execute phonetic texts

Duration: 38 min

Dr. Autràn explains to participants how essential it is to have a complete and thorough understanding of colors in order to perform successful restorative treatments with composites. Parameters such as hue, chroma and value are discussed and VITA Classical, a dental guide for veneer coloring, are presented. At the end of the lecture, participants will be able to independently manage the choice of the right color for their veneers in relation to enamel and dentine colors.

In particlar, this lecture covers the following topics:

• Color perception
• Additive and subtractive color system
• VITA Classical features
• Translucency and opacity assessment
• Fluorescence and opalescence assessment

Duration: 34 min

In this lecture, Dr. Autràn guides participants through a full procedure for a total adhesive technique protocol that allows to achieve the best and safest bonding. The lecturer focuses on the adhesive workflow, which represents a minimally invasive and long-term stable operational practice. Participants will appreciate Dr. Autràn’s complete adhesive workflow gold standard; starting with the use of acid, primer (a hydrophilic resin), and bonding agent (a hydrophobic resin). In the second part of this lesson, the speaker shows some small variations to the treatment that can be performed in specific cases and discusses the differences between bonding to dentin and bonding to enamel.

In particlar, this lecture covers the following topics:

• The gold standard for adhesive workflow
• Adhesion on dentine or enamel
• Structure differences between dentine and enamel
• The protocol to achieve the best and safest bonding
• Total-edge bonding and self-edge techniques
• Different types of primers according to different materials
• Photopolymerization: DUAL technique

Duration: 19 min

In this and the next two video lectures, Dr. Autràn shows a complete stratification case, starting from the planning phase and going all the way to polishing and finalization of the case. The patient in question has a unilateral agenesis of the upper lateral incisor, which has caused a shift in the midline and the movement of the canine in position 2.2.

In particlar, this lecture covers the following topics:

• Spaces and volumes design during treatment planning phase
• Isolation techniques
• Digital wax-up and 3D printing
• Gingivectomy with an electric scalpel

Duration: 34 min

In this lesson, the treatment of the patient from the previous lesson continues. Specifically, this module focuses on the placement of the composite and its removal after the isolation phase, then moving on to the preparation of the first layer and polymerization.

In particlar, this lecture covers the following topics:

• Flattening of the surface of the 2.2 element
• How to perform a minimal invasive tooth preparation
• Consideration about the bonding between the enamel and the tooth
• Dentine placement to restore the right volume thickness
• Interproximal contact checking
• Positioning of the chromatic enamel

Duration: 26 min

This final video lecture on the treatment of the patient with unilateral agenesis shows the polishing and finalization phases. Particular attention is given to the final adjustments in the palatal area, achieving a similar emergence profile across all teeth, and checking the transition lines and interproximal surfaces.

In particlar, this lecture covers the following topics:

• Polishing, finalization and final adjustment phases
• Follow-up and immediate fixing of little defects
• Occlusion and canine guide checking

Duration: 28 min

Participants will appreciate the restoration of Class IV cases using composites. Dr. Autràn highlights the importance of hiding fracture lines and shows the innovative technique called the Infinite Bevel Technique.

In particlar, this lecture covers the following topics:

• Specific techniques to manage class IV restorations
• How to hide fracture lines?
• Dentine positioning in relation to the bevel
• Infinite Bevel Technique rationale and execution
• Sandblasting a good proportion of the tooth surface
• When and how to use interproximal strips?

Duration: 15 min

In this video lesson, Dr. Autràn returns to the key topic of color management in restorative cases. In particular, the complete protocol for treating stained teeth is shown and discussed, and some clinical cases are reviewed step-by-step, starting from simpler ones and progressing to very complex cases.

In particlar, this lecture covers the following topics:

• Color management
• Treatment of stained teeth with composites
• The use of a bur to remove the stains
• When to place the chromatic enamel and when to place the achromatic one?

Duration: 45 min

In this video lesson, Dr. Autràn discusses how to manage highly challenging cases from the perspective of tooth color in patients being treated with composite veneers. The lecturer also discusses the treatment of very unfavorable colors, where achieving blending and camouflage with the adjacent teeth is particularly difficult.

In particlar, this lecture covers the following topics:

• Preparation and color analysis
• The necessity to mimicry the color of the neighboring teeth
• Translucent enamel positioning
• Color value assessment

Duration: 20 min

The management of complex cases from a color perspective continues in this video lesson, where Dr. Autràn shows the treatment of tetracycline teeth discoloration using composites.

In particlar, this lecture covers the following topics:

• Very unfavorable color situations
• Minimally additive wax-up
• Camouflage of the color

Duration: 35 min

This presentation is dedicated to the treatment of diastemas and the closure of embrasures. Dr. Autràn illustrates tooth preparation through sandblasting and the creation of new transition lines, showing how proportions and aesthetics are truly key factors in the treatment of diastemas and embrasures.

In particlar, this lecture covers the following topics:

• Treatment of diastemas on the midline
• Tooth preparation through sandblasting
• Creation of new transition lines and correct palatal emergence profiles
• When to do and when not to do full veneers to treat a diastema

Duration: 19 min

In this video lesson, Dr. Autràn focuses on the complete restoration with direct composites, discussing the methods to increase the vertical dimension and to create a new occlusal plane, as well as the reconstruction of cuspids.

In particlar, this lecture covers the following topics:

• Anatomical wax-up
• Creation of a new occlusal plane
• Restoration of the posterior area with direct composites
• Cuspids reconstruction

Duration: 11 min

This lecture is dedicated to the presentation and discussion of various clinical cases that exemplify all the possibilities available to the clinician when working with composites. Topics include treatment planning, minimally invasive tooth preparation, and the possibility of performing combined treatments (for example, with preliminary orthodontic treatment), as well as multidisciplinary treatments finished with composite veneers to achieve the best possible aesthetic outcome.

In particlar, this lecture covers the following topics:

• Tooth preparation before whitening
• Orthodontic treatments before composite veneers
• When is it necessary to perform an orthodontic treatment before restorative dentistry?
• Combined and multidisciplinary treatments

Duration: 32 min

This lecture is dedicated to the presentation of Omnichroma, an innovative composite that ensures the best blending effect among all composites available on the market. The lecturer gives a complete overview of this product, discussing its advantages and indications for use.

In particlar, this lecture covers the following topics:

• Omnichroma blending effect to camouflage the restoration
• Composition of Omnichroma resin
• Filler particles of Omnichroma
• Omnichroma use indications
• When to use the Omnichroma blocker
• Omnichroma polishing degree

Duration: 50 min

This learning experience concludes with the presentation of a hands-on exercise on a model, through which Dr. Autràn illustrates and discusses the restoration of Class IV cavities, posterior teeth, and non-carious cervical lesions using Omnichroma composite. Participants will be guided through a step-by-step procedure on a model and learn how to use Omnichroma composite.