Page 26 - Dental Practice South Asia 18-6

multidisciplinary section MY TAKE

DR. UDATTA KHER

Dr Robert Molinari’s case
displays high level of clini-
cal skills combined with
judicious use of digital
technology to fulfil the
patient’s esthetic
demands. The workflow
following a traumatic avulsion of an anterior tooth
is the key to success. The initiation of treatment
FIG 52: Finished case FIG 53-55: Impact of the new smile on the patient's face with a bonded provisional restoration to prevent
the soft tissue collapse has enabled Dr Roberto to
maintain the soft tissue levels effectively. The hard
tissue graft and staging the implant placement
enabled good primary stability on the implant
which could immediately get restored with a screw
retained provisional restoration (also designed
using digital technology). The simultaneous soft tis-
sue grafting procedure allowed a better emergence
for the final restoration and also helped in improv-
ing the phenotype of the tissue, thus preventing
FIG 54 FIG 55
future bone loss. The final stages of treatment for
bonding all the restorations was meticulously done
ensuring utmost conservation of tooth structure. By
playing with the value and chroma of the restora-
tive materials, Dr Roberto has successfully man-
allows us to save enamel. We must not forget of accepted clinical protocols. aged to match the implant supported restoration
that dentin needs to be hybridized immedi- Technological innovations and the devel- with the veneer on the contra lateral central incisor.
ately if it is exposed. By engaging the newly opment of performance materials have That is a remarkable achievement. Overall this is an
discovered collagen fibers, you will increase allowed me, over the years, to reduce treat- excellent example of an esthetic makeover for a
the resistance of the bond adhesive. ment times and discomfort for my patients very high risk patient profile.
Waiting, in these cases, would result in and, in addition, to increase my profit mar- There are couple of steps in the workflow that I
the deterioration of the fibers and the conse- gin. This leads to a greater chance of invest- may have modified:
quent lowered resistance of the adhesive ing economic resources in the development 1. Since digital technology was being used in
bond. and technical advancement of my protocols designing the temporary and definitive restorations,
Equally important for the final aesthetic with the aim of always improving the final even the implant placement could have been done
result is the third point. Today there are col- results of aesthetic predictability and func- using a surgical guide to achieve the most accurate 3
ored cements on the market that allow us to tion (Figures 52 to 55). dimensional position for the implant.
modulate the final color of the prosthetic 2. The implant placement could have been done
mitigating the eventual discoloration of a using a flapless technique since the bone grafting
devitalized tooth or a too chromatic dentin, About the AUTHOR was achieved in the first phase of treatment. By
or slightly changing the "Value" of ceramics. going flapless the distal papilla recession could have
These products are marketed with the rele- Dr. Roberto Molinari initially been prevented. A small vestibular access to per-
vant colored glycerins as tests, by means of graduated as a dental techni- form the soft tissue graft could have been done to
which it is possible to select the color of the cian in 1986; continued studies bulk up the soft tissue. Different clinicians will
cement suitable for the case (Figures 49 to led to his graduation from approach a case differently. The ultimate goal is
51). General and Prosthetic always to meet the patient’s esthetic expectations
Dentistry with Honors at the which Dr Roberto has achieved using his knowledge,
CONCLUSIONS University of Bologna in 1993. skills and technology.
I hope that reading this article can be a stim- After training with the most
authoritative experts in modern
ulus to see your work with different eyes. My dentistry, he specialized in Periodontology, Implantology Dr. Udatta Kher graduated from Government
“vision” has led me to change my approach and Aesthetic Prostheses. He conducts courses for den- Dental College and Hospital, Mumbai in 1990 and fol-
and my work protocols continuously over tists on correct CAD/CAM techniques and Micro-implant lowed that up with Masters in Oral Surgery from the
the years and to look with critical eyes, dentistry and speaks at international congresses. He is a same institute. His main focus in practice is towards
always trying to improve. After so many Member of the Peers Board, Founding Member of the implantology, Laser Dentistry and Restorative
years of navigating the digital sea, I must Italian Academy of Digital Odontostomatology AIOD, Dentistry. He practices in Mumbai specializing in
admit that today, compared to 20 years ago, active international Key Opinion Leader for Dentsply Implant Dentistry. He is the Director of ‘Impart
procedures have become simplified and what Sirona for CAD-CAM techniques and is KOL for Zeiss for Education’ an academy for guiding and nurturing
was once considered pioneering, is now part Micro-dentistry. He lives and practices in Mantua. clinicians towards evidence based dental practice.

26 Dental Practice // November-December 2022 // Vol 18 No 6