Caroline Werkhoven

Caroline Werkhoven graduated in 2002 at ACTA, the dental faculty in Amsterdam. She was a periodontology student trainee at Columbia University in New York. Frequently she attends national and international courses and hands-on training in the field of porcelain restorations, composite restorations, implantology en orthodontics. Since 2012 she teaches the Create Your Own Style workshops in The Nederlands and Belgium. She is a trainer and lecturer in large dental practices. She has specialised in esthetic restorative dentistry, varying from restoring cases of light wear to full mouth rehabilitation, all based on aesthetic adhesive dentistry. She is the owner of the Mooie Tanden Kliniek in Amsterdam, The Netherlands.
Caroline Werkhoven graduated in 2002 at ACTA, the dental faculty in Amsterdam. She was a periodontology student trainee at Columbia University in New York. Frequently she attends national and international courses and hands-on training in the field of porcelain restorations, composite restorations, implantology en orthodontics. Since 2012 she teaches the Create Your Own Style workshops in The Nederlands and Belgium. She is a trainer and lecturer in large dental practices. She has specialised in esthetic restorative dentistry, varying from restoring cases of light wear to full mouth rehabilitation, all based on aesthetic adhesive dentistry. She is the owner of the Mooie Tanden Kliniek in Amsterdam, The Netherlands.

EVENTS BY THIS MEMBER

Two day-course anterior layering Style Italiano and posterior composite
Workshop dual layering Style Italiano Concepts

ARTICLES PUBLISHED BY THIS AUTHOR

One of the biggest game changers in dentistry for many practitioners is starting the use of a silicone index in the anterior composite work. The palatal silicone index is an impression of the wax-up intended for transferring that information into the mouth during treatment. It allows the practitioner to fully focus on the application of the composite layers, as both the sagittal dimensions are already perfectly defined: the length and the incisal edge position of the desired final result, as well as the mesial and distal angles, the incisal thickness, the facial curvature of the restoration; you can completely rely on the matrix to guide you in making what your patient wants. Because it is that exact shape, form and length the patient approved during the mock-up phase which has been transferred to the mouth via the silicone index. In a layering case, most of the times a lot of attention and time is put in the dynamic incisal third of a tooth. By not using the patient-approved index the situation will occur in many cases that the patient asks for shortening of the just applied restoration. Thereby asking for removal of all preciously applied character of the incisal third. Using the silicone matrix based on the wax-up, that was patient approved on mock-up, guarantees the operator that the final occlusal and esthetic adjustments will be minor and fast. The characterization of the incisal third will be kept alive. But how to exactly make the guide to serve you best? This article will go through the steps.
With great restorative power comes great responsibility. When a young patient suffers a severe dental trauma and comes into our office for treatment, the dental team has a chance to do it right at the first attempt, which means we have the possibility and the duty of providing our patient with the best initial treatment, i.e. the best basis to work with later on. The final treatment will be about restoring the patients teeth and regaining the patient's beautiful smile without sacrificing any more tooth structure than the trauma already did. This patient had fallen in the bathroom and suffered uncomplicated crown fractures on the maxillary left and right central incisors. Teeth #12, #11 and #21 had been luxated; the dentist splinted the front teeth at the emergency visit. After a week the patient was seen by endodontologist Dr. Marga Ree and a CBCT scan showed that tooth #11 and #21 were still displaced out of their sockets. The splint was loosened and tooth #21 en #11 were handled to be repositioned more apically back in their sockets. Repositioning succeeded completely for tooth #11. The apices were fully developed. Root canal treatment had to be performed on teeth #12, #21 and #11. The splint was applied again to stay in situ for two weeks. The goal was to provide a restoration that would last long on all grounds, both functionally as esthetically so that the tooth could be kept untouched for as long as possible in the future. Direct composite is the material of choice for this restoration.
Who would not wanna predict the future? In direct composite in anteriors curiosity is always there during treatment... In starting the procedure we use wax-up and mock-up to see where to end up. We lightcure composite in the colour mock-up to try to see the outcome. Besides defining form and shape by silicone matrix and exploring the internal colour anatomy, we need one other crucial thing in the treatment to look forward in time: a pencil. To see the incisal thickness and to identify the transitional lines in our restoration. And to see if they match....Before the polishing stage there is no luster so you can not judge if they are in the correct place by lack of light reflection. And after polishing you absolutely do not want to touch and redo. This article will guide you through the steps to the desired and defined end result. The POWER of PENCIL-direct composite

Amsterdam is a great city. With its beautiful houses along the canals. And with a LOT of cyclists. This patient came to the practice after visiting the emergency room. She had unfortunately been involved in a bike accident. She had suffered two crown fractures of the two central incisors without pulp involvement. Both teeth were slightly more mobile than the neighbouring teeth. The exposed dentin was sealed with a glasionomer cement and xrays were taken. Tooth #11 displayed a pulp shining through giving the dentin a dash of pink colour. The two involved incisors were slightly more sensitive but not limiting the patient in her daily life. The patient wanted the two incisors to be restored: invisibly and naturally. The treatment of choice was a direct layering composite. In cases like these – involving relatively young patient trauma – we may encounter two extra challenges besides trying to create exact replicas of the fractured teeth. Because of the widespread use of an orthodontic fixed retainer on the palatal the possibility to correctly place a rubberdam is limited as well as  the acces for treatment. So usually removal of the retainer is indicated. Replacement is necessary to prevent any unwanted tooth movements after restoring. This means fabricating a new fixed retainer because of distortion occuring while removing it. Second is the issue of time after trauma. The patient often demands direct restoration. But for a longterm satisfying result the use of a silicone index based on a wax-up increases your chances of achieving that longterm goal. That means taking impressions for models, photography and referring to the lab for a wax-up. Delay of direct treatment is unavoidable. This case shows how we handled the challenges on the road and how the final outcome destination was reached within the estimated time of arrival

Academic programs

Scientific programs

FOLLOW ME

WRITE ME

Name (required)

Email (required)

Subject

Website

Message (required)


Privacy Policy