Anna Salat

Born in Barcelona, Dr Anna Salat graduated with a degree in dentistry from the International University of Catalonia (UIC) in Barcelona. She continued her postgraduate studies in implantology and esthetic dentistry, earning a master’s degree from UIC. Dr Salat is particularly interested in conservative dentistry and esthetic restorations and lectures internationally on these topics. She has contributed articles to a number of international journals. Author of the book Layers (Quintessence 2012).
Born in Barcelona, Dr Anna Salat graduated with a degree in dentistry from the International University of Catalonia (UIC) in Barcelona. She continued her postgraduate studies in implantology and esthetic dentistry, earning a master’s degree from UIC. Dr Salat is particularly interested in conservative dentistry and esthetic restorations and lectures internationally on these topics. She has contributed articles to a number of international journals. Author of the book Layers (Quintessence 2012).

EVENTS BY THIS MEMBER

ARTICLES PUBLISHED BY THIS AUTHOR

The most important tip I have learnt for posterior direct restorations is an extreamly easy thing of an amazing simplicity and advanced performance. Talking about shape, one of the goals for second class composite is to achieve strong contact point while another goal is to obtain a precise proximal contour. The custom ring technique offers both advantages while being an extremely economic solution, easy to do and at the reach of everyone. Thanks to the Styleitaliano team for describing and making available to everyone this technique 3 years ago with their more than 12 articles in www.styleitaliano.org Material needed: - metal ring (Garrison, Palodent) - liquid dam (Opaldam, Gingival barrier) - convex matrices (Garrison, slick matrix) - wooden wedges
For perfection in aesthetic restorations we need a precise modeling, right color selection and good shapes. In order to model the composite precisely it is suggested to have the right instruments. In the market we can find plenty of suitable instruments for composite stratification. In some of the modelling instruments for composite kits we can find a very thin spatulas. Thin spatula is convenient for modelling precisely the composite. Not all the kits have thin spatula maybe because it is a delicate instrument, but the disadvantages outweigh the advantages in the opinion of most of the experts in composite. Inside the LM arte kit (LM instruments, Finland) it is possible to find a thin spatula, thinner than many others in the market. In this article we wanted to point out the advantages of modeling with a thin spatula like Applica (the thin spatula from the LM arte kit) whilst presenting anterior free hand restorations for a change of smile of a patient after orthodontics. The instrument has an Italian name (Applica), but the name is internationally understood because it is similar to the english word apply, which is related to its function which is applying composite. The Styleitaliano group pushes the high quality dentistry with feasible, repeatable protocols, moderate costs for the patient, avoiding over-treatments and controlling the chair time. The free hand single visit smile rehabilitation with a single mass is a good example of that philosophy. In this particular case we demonstrate how choosing the right material, specially choosing the right opacity of the material, with a precise modelling of composite and giving the right shapes, in a single visit and a unique color, the aesthetic results can be more than acceptable for the patient and for us. THE IMAGES FROM THIS ARTICLE WERE EXTRACTED FROM A 4K VIDEO DONE DURING THE COURSE LAYERS OVER THE SHOULDER WITH LIVE PATIENT IN DENTCOF, TIMISOARA. THANKS TO DR.FLORIN COFAR AND MIHAI SIMONIA FOR THE FILMATION DURING THE CASE PERFORMANCE. I WOULD ALSO LIKE TO THANK WALTER DEVOTO AND ANGELO PUTIGNIANO FOR PUSHING ME USING THE SINGLE APPOINTMENT AND SINGLE SHADE APPROACH AS IT IS IN THE MAJORITY OF SITUATIONS THE PREFERED APPROACH FOR MY PATIENTS. AND THANKS TO LM FROM FINLAND FOR CREATING THE THIN SPATULA BECAUSE I UNDERSTOOD THAT IT WAS A CHALLENGE TO PRODUCE IT BECAUSE IT IS SO THIN THAT IT REQUIRED SPECIAL TECHNOLOGY AND ATTENTION.

In the enamel proximal lesions, before cavitation, the initiation of the caries process, is characterized by a subsurface white spot formation, with a overlying pseudointact surface.

Once a tooth is cavitated because of a caries, the lesion tends to progress. (5)(6) So ideally before having a cavitated lesion some kind of intervention should be done: to invert the process of demineralization to a remineralization, or, at least,to arrest the demineralization process.

REMINERALIZATION of white spot lesions with an intact surface is possible. The arrest of the lesion may be achieved and it can rely on calcium and phosphate ions. The use of topical fluorides to enchance remineralization of demineralized proximal enamel has been advocated (7). For example one of the protocols  that demonstrated some benefits is  the application of fluoride varnish every third months. It significantly reduces the progression of proximal caries lesions in premolars and molars. The most obvious reduction of caries progression is observed among children with moderate caries risk, while children with high caries activity (more than 9 new proximal lesions) do not benefit from proximal caries reduction. (8)

CAVITY PREPARATION is nowadays considered destructive and outmoded in incipient proximal lesions because another less invasive techniques are possible.

A considerable number of professionals still tend to practice invasive techniques  with lesions confined to enamel ranged from 19% to Norway (Tveit et al) to nearly 50% in Mexico and Brazil (Traebert et al).

The RESIN INFILTRATION TECHNIQUE in interproximal caries lesions is a less invasive technique compared to a cavity preparation and fits in the concept of minimal intervention dentistry.

THE INFILTRATION TECHNIQUE:

The infiltration technique should be an alternative to cavity preparation, thus at least postponing (if not avoiding) sacrifice of sound structures.

Resin Infiltration technique is contraindicated in cavitated lesions but instead is a treatment option in non cavitated incipient (interproximal) enamel lesions.

The problem in posterior teeth is the bitewing radiograph does not give any direct information on the surface integrity of proximal lesions.

Clinical studies (Bille et al) found comparably few cavitations in R3 lesions (radiolucency reaching the outer dentin on bitewings) lesions (22% to 52%), while several laboratory studies confirmed a considerably earlier cavitation with breackdown of surfaces in up to 100% of R3 lesions (Kielbassa et al).

The best solution should be to have direct vision to the tooth to be able to verify the presence/absence of cavitation and to be able to check the activity/inactivity of the lesion.

In this article we explain a tip that we use in our daily practice to achieve the direct vision to the lesions in the case of interproximal lesions.

This is case number 2 of a series of cases that have as their main goal to explain a technique to eliminate the enamel white spots. As Style Italiano members and friends we want to share our experience with the Resin Infiltration Technique using ICON. Icon is the name of the resin infiltrant produced by DMG. We present a series of cases where white spots lesions are present for different reasons. In this clinical case the reason for the appearance of white spots (initial demineralisation) is the presence of dental plaque around the orthodontic appliances. In general, in dental practices, white spots are treated for aesthetic reasons (typically after an orthodontic treatment) with remineralisation products (but did not solve the esthetic impairment in most cases because fluoride remineralizes only the surface) or with microabrasion and/or turbine (not well accepted for patients neither for dentists because is an aggressive approach, due to the lesions depth and extension much dental structure should be removed) Between these two techniques we have now another option that is called resin infiltration. Until now, there has never really been a satisfactory solution for treating the white spots which often occur after removing dental braces. Resin infiltration with Icon leads to a caries arrest at an early stage and disappearance of white spots. This means aesthetic results with minimum intervention in the tooth structure are achieved. At the beginning, the technique of resin infiltration was invented to arrest the caries progression. It was unexpected that the initial lesions (typical white spots) optically disappear. In this clinical case it is possible to appreciate some white spots that disappeared thanks to the resin infiltration technique and some deeper lesions, that were treated with the conventional turbine and composite method.

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