On 27 and 28 April 2018, I attended the course on “Interdisciplinary Aesthetic Dentistry” at the Gipuzkoa Dental Association, given by University of Valencia professors Dr Ignacio Faus, on Dentistry, and Dr Vicente Faus, on Dentures, who spoke about the different techniques available for improving our patients’ Dental Aesthetics.   

They stressed the importance of the initial photographic and video examination for studying the smile in its current condition and establishing the most important aspects to be taken into account, such as the length of tooth we can see when the mouth is at rest, when smiling socially and when smiling with enjoyment. Subsequently, using orthodontics, ceramic veneers or a combination of the two must enable us to come as close as possible to achieving the perfect smile.

Orthodontics are used to align or straighten crowded teeth. Furthermore, with orthodontics, we can sometimes move the teeth into a suitable position for their subsequent rehabilitation with porcelain veneers or crowns. Thus, if we want to rehabilitate the teeth with crowns or veneers bigger than their initial size, we will leave spaces at either side of the tooth, which will later enable us to fit a wider and longer ceramic tooth if required.

Furthermore, orthodontics allow us to lengthen or shorten teeth or molars. When a tooth is so badly worn that we can’t cover it with a ceramic crown, we can pull on it and lengthen it to obtain sufficient tooth surface to take the porcelain preparation. However, if a molar is excessively long due to the lack of a dental antagonist, we can sometimes shorten it with micro-screws inserted to the bone alongside the roots, using small springs to move the molar inwards.

Regarding the fixed ceramic prosthesis, in the shape of either veneers or crowns, we heard about the B.O.P.T (Biologically Oriented Preparation Technique). This technique is used to prepare or wear down the tooth inside the gum, leaving it flat at the end; i.e. without the shoulder or chamfer used in traditional preparations. On sculpting the tooth in the gingival sulcus we also cause an abrasion on the inner side of the free gum, causing it to bleed slightly and a creating a small coagulum which is kept between the gum and the tooth by means of a previously prepared, very fine provisional crown. This crown remains in place for 4-6 weeks, making the gum scar and thicken. Thanks to this process, on fitting the permanent crown, the gum remains stable with time, without receding.

This technique functions contrary to traditional sculpting methods, where we don’t touch the gum, and where said gum must also be healthy and show no signs of bleeding before sculpting. So the debate is on. It goes without saying that we also heard about the different materials used at each stage of the different dental aesthetics techniques.