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Minimally invasive partial restorations: with a contactless impression and without the need to remove the nerve


Prof. Benedikt Spies, Medical Director of the Department of Prosthetic Dentistry of the Medical Center - University of Freiburg, explains partial restorations of teeth.

Loss of tooth structure is common in the general population and is caused by various factors such as caries, acidic food and beverages (erosion), or clenching (bruxism). This can lead to limitations in chewing function and esthetics, as well as functional disorders. The traditional treatment for this condition is a full-coverage crown or, if adjacent teeth are missing, a bridge. This involves circular removal of compromised but also healthy tooth structure, followed by conventional                               impression-taking and cementation of the final restoration.          

Thanks to improvements in adhesive technology and materials science, minimally invasive treatment protocols are being implemented at the Medical Center - University of Freiburg. Compared to the traditional tooth preparation design for a crown, only a significantly reduced portion (i.e. only the compromised area) of the tooth structure needs to be removed. Since healthy tooth structure can be preserved to a significantly increased extent, the risk of damage to the nerve by grinding the tooth is reduced to a minimum.

Intraoral scanners are used to make contactless impressions of the teeth. This procedure eliminates the need for impression trays and impression material. The intraoral scanner takes a large number of images within seconds - similar to a photo camera - and automatically assembles them into a digital model. Patients describe this procedure as pleasant and an enormous improvement compared to the conventional procedure - especially in the case of severe gag reflex.    

In addition to excellent biocompatibility, the applied ceramic materials are characterized by a high translucency, allowing the natural tooth to be visually imitated. Nevertheless, these ceramic materials are very stable and represent a suitable long-term restorative material. In a recently published study, very high long-term survival rates of ceramic partial restorations of over 97% were observed after almost 17 years. In addition, no significant differences in survival rates were identified in comparison to traditional full-coverage crowns.           

Prof. Benedikt Spies confirms the positive outcomes of partial restorations. He is convinced that "with the applied ceramic materials and protocols, long-term stable and esthetically pleasant results are achieved in our clinic - moreover, we preserve as much healthy tooth structure as possible". 


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