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News International

Dec 29, 2011 | News International

A year in review (Part 2): Cosmetic Dentistry

by Dr Sushil Koirala, Nepal

Aesthetic aspects do increasingly play an important part in clincical outcomes. In this second part of our exclusive commentary series, Dr Sushil Korailal from Nepal speaks about new developments and trends that shaped the field of cosmetic dentistry in 2011.

was written by:

Dr. Sushil Koirala Dr. Sushil Koirala

Since I have been involved in cosmetic dentistry, the field has been dominated by the Hollywood concept of wide and symmetrical white smiles regardless of age, sex and ethnicity. Cosmetic orientation has also been influenced for many years by fashion and the media that have been encouraging clinicians to compromise biological function in favour of the cosmetic desires of the patients.

Fortunately, public taste in smile aesthetics is moving towards the naturo-mimetic concept and the one-fit-for-all smile design concept is slowly fading. Nowadays, an increasing number of clinicians are adopting a customised smile design approach that respects patients’ actual needs, age, sex, ethicality and financial resources.

With an increased advocacy of ethical cosmetic dentistry on a global scale, clinicians are becoming much more aware about the loss of biological function in the treatment they are providing. It has been very encouraging to see that during the recent IFED meeting in Brazil, many of the speakers discussed concepts like minimally invasive cosmetic dentistry (MICD), which they are applying in their practices. With this in mind, I can clearly foresee that in the years to come cosmetic dentistry will fully embrace the MICD concept and treatment protocols that promote healthy, functionally balanced and aesthetic smiles.

With new digital diagnostic and restorative tools, accuracy and the period necessary for treatment are becoming important factors in cosmetic dentistry. Treatment using high magnification and good illumination combined with digital case documentation could become mandatory clinical protocol in the years to come.

Another area of change will be case finishing. Currently, the field focuses primarily on micro-aesthetic components such as colour, optical properties, shape, proportion, texture, and surface and margin finish, while neglecting biological factors like individual tooth contact forces and timing, which are key to achieving a functionally balanced bite. This lack of force finishing in cosmetic dentistry can result in frequent restoration fractures or myofascial pain dysfunction syndrome, a condition that often occurs after treatment. Cosmetic dentists will most likely adopt the force finishing concept in their finishing protocol.

Harmonic teeth, muscles and joints (TMJ) will become major criteria by which to evaluate clinical success in cosmetic dentistry. The value of function will be much better understood by cosmetic dentists and the concept of TMJ harmony will be implemented to promote naturally pleasing and functionally balanced smiles.

As far as restorative materials are concerned, the field will see a rising demand for healing effects, for example, to prevent hard and soft tissue loss. Restorative technologies will also more likely move towards direct restorative processes.

It is difficult to predict what technologies will shape the field of cosmetic dentistry in the future, but in my view, technology in general will be more focused on decreasing the loss of biological function, while minimising financial costs and time spent on treatment. It will be more focused on the holistic goal to achieve overall health, function, aesthetics and positive psychological impact after treatment.

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