Dan Lazar

Dan Lazar, graduated from the Faculty of Dentistry in 2005 in Cluj-Napoca, Romania, followed by many post-graduate trainings in prosthetic and restorative dentistry in Romania and Europe. From 2007-2009 he was teaching at the Faculty of Dentistry, the Restorative department. Since 2005 is working in a private practice in Oradea, Romania. The passion of beauty push him to study more about dental photography from technical to art and the aesthetic perception of smile and balance design of anterior region. Dan Lazar is lecturing in Romania and abroad since 2009 on different topics: direct composite restorations, anterior prosthodontics and dental photography.
Dan Lazar, graduated from the Faculty of Dentistry in 2005 in Cluj-Napoca, Romania, followed by many post-graduate trainings in prosthetic and restorative dentistry in Romania and Europe. From 2007-2009 he was teaching at the Faculty of Dentistry, the Restorative department. Since 2005 is working in a private practice in Oradea, Romania. The passion of beauty push him to study more about dental photography from technical to art and the aesthetic perception of smile and balance design of anterior region. Dan Lazar is lecturing in Romania and abroad since 2009 on different topics: direct composite restorations, anterior prosthodontics and dental photography.

EVENTS BY THIS MEMBER

Dental photography in the last years is increasingly playing a very important role in presenting the clinical cases. To obtain a very good dental, practical and artistic photography depends a lot on the clinical operator. The knowledge about camera settings and use of the light/lights are the key for best dental photography, and must be known. Dental photography could be classified in three parts: medical photography, aesthetic photography and artistic photography. The first two are very useful for medical purpose. The medical purpose and the last one together, instead may be useful to enhancing the quality of our job, for a higher impact to the audience, or to expose all our passion for dental practice.

ARTICLES PUBLISHED BY THIS AUTHOR

The use of the composite materials to restore form and function of posterior teeth damaged by disease, age or trauma is gaining wide acceptance by the dental community. The dental practician and also the patient have the same desire regarding the posterior composite restorations, which is that those restorations has to last many years. While there are numerous recommendations regarding preparation design, restoration placement, and polymerisation technique, current research indicates that restoration longevity depends on several variables that may be difficult for the dentist to control. These variables include the patient’s caries risk, tooth position, patient habits, number of restored surfaces, the quality adhesion and the ability of the material to produce a sealed tooth- restoration interface. So, the success of posterior restorations depends a lot on the dentist’s procedure and his clinical experience. In this article is described a clinical step by step procedure in order to create and develop a protocol for daily practice. Working with an understandable and clear protocol, the dental clinician can pay attention on many details during composite reconstruction, can prevent the technical errors, can hold the “flow” estate, leading to a better result with every restoration.

As we know from the thousands articles, in the Literature, about adhesion, isolation is a mandatory procedure. On the other hand, this step is sometimes not so easy to carry out, and we are pushed to give up quickly.

The need to work under dry conditions in the oral cavity has been recognized for many decades now, and the idea of using a rubber sheet to isolate the tooth dates more than 150 years! The use of the rubber dam was first described in 1864 in New York by a dentist, Sanford Christie Barnum, who demonstrated the advantages of isolating the tooth with a rubber sheet. Imagine that, in that period of time, there was no adhesive procedure, so the question that comes to mind is: “Why, in the first place did he choose to work with a rubber dam?”

 

A good isolation - what does it mean?

You will get a good isolation when you will physically separate the teeth you want to operate from the surrounding environment and keep them dry and clean during the whole procedure.

The first thing to aim for is a very good INVERSION, that means placing the rubber around the cervical area and in the sulcus, and keep it there until the end of the restorative process. In other words, we should place the rubber under the limit of our preparation. Good isolation also means:

Dry working field;

Having a large working field;

Maximum tissue retraction;

Minimal interference with restorative procedures.

In order to find new solutions for better and faster inversion, different techniques and materials were developed different.

Additive wax-ups, silicone guides and corresponding diagnostic templates are very helpful for the dentist to get a preview of the aesthetic and functional outcome of a case and also for the patient´s satisfaction. To get an instantly better preview of what the eventual outcome will be, the utilisation of a composite mock-up is wonderful as an aid (Galip G.) Analysis of the patient´s face, the neighboring tissues and teeth provide three dimensional information which is necessary to give the restoration the correct volume and shape. A diagnostic ``composite mock-up´´ which is the direct application of composite without surface preparation, is indicated when such elements are missing, or when an alteration of tooth form is necessary ( Galip G.) The step by step procedure to get a clean and useful mock-up is described as follows: 1. A very clear chief complain of the patient 2. The pictures of the patient - extra-oral and intra-oral 3. Stone cast for both arches 4. Intermaxillary registration 5. The aesthetic analysis of the patient, the smile design construction - digital, manually, direct 6. The wax-up, based on the smile design analysis 7. Impression of the wax-up 8. The transfer of the wax-up inside the mouth 9. Validation of the mock-up together with the patient

The quality of dental restorations is influenced by different criteria, including the dentist's experience, the type of tooth, the restoration design, the type of restorative material, the size of the restoration and the patient's age. The main problem you run into when using composites is polymerization shrinkage and stresses, which depend on multiple factors such as the configuration factor, chemical properties of resin composites, various incremental placement techniques and different modes of curing. According to Karthick et al, to overcome this problem, various methods have been employed; the incremental curing technique being one of them. The various incremental techniques used are facio-lingual layering (vertical), gingivo-occlusal layering (horizontal), three site technique, wedge-shaped layering (oblique), successive cusp build-up technique, bulk technique, and centripetal build-up. This technique has many disadvantages, e.g. difficulty and long time to place the material. If the layers are not properly done, shrinkage can result from polymerization hence leading to marginal leakage. In this article a dual cure material is combined with a conventional composite material, in order to save time in restoring and reducing the usual mistakes related to the multilayer technique.

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