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e e
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[Music]
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in the name of Allah the most gracious
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the most merciful and peace on Prophet
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Muhammad sallallahu alaihi wasallam uh
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again here I am back I am back after uh
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two years of interruption and of not
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attending the denry online scientific
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days
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now we reached the 11th season actually
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I passed the ninth and 10th Seasons
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without without attending my last season
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was the eth one unfortunately I couldn't
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join last two years for a personal
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reasons uh welcome for myself first
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again for being here and uh much thanks
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and appreciations to my professors and
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the brother Dr maani for inviting me
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again the season this year becomes in um
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a sadness of us on the events in our
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beloved Gaza St in Palestine and also
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the recent updates in Syria the new
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interruptions and all the Arab nations
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are not in a well condition what we can
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do we can continue the pikot of uh this
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uh products of their products and we can
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make dos for them ask Allah to rescue
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them and any type of
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financial support we have to proceed for
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to um this what in our hands once we are
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not inviting to join the Arab armies so
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it's what only in our hands and also I
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would like to thank my loved wife she is
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an
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indst usually she's providing me with
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the materials and references from which
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I can prepare my lecture uh before I
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start and actually the she short list my
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time and she made the mission for me
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easy uh let's start directly
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today despite I'm an oral surgeon but
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all of us are working in cosmetics and
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also I taught uh multiple courses in
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conservative dentistry and in fix
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pontics out of my speciality so I will
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talk about the athetic alternatives for
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to Restoration actually I will not see
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something which is new or uh which is
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not known for the dentist but rather I
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will rather talk about things what which
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most of them know but I will summarize
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and collect them in a simple uh light
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presentation so let's go for the
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aesthetic alternatives for teeth
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Restorations and what are these
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Alternatives actually we have the
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veneers laminates veneers we have the
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modern Composites FiOS emance
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orthodontic aligners orthodontic
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aligners oppressive techniques tooth
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baching in Li Las and the crowns let's
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go directly without telling any
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introduction that uh from long time time
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we are telling commercially to our
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patient that we're going to do for you a
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Hollywood smile which is not scientific
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name at all it's a commercial trading
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advertising name that I will convert
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your teeth to be like the stars of
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Hollywood uh so we are talking about
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veneers laminates and lers Engineers are
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a pro name which include all these
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subtitles okay uh first when we know the
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veneers we know the composite veneering
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when we were removing a very little uh
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uh layer of the toothy Nel to uh reshape
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uh the tooth or to correct the tooth
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discoloration or to correct shap tooth
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part then it it was converted directly
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to do a very little minute fine lenses
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uh which cover the liar surface and the
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part parts of the proximal sures which
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were made of porcel and composits and we
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went for the uh laminates laminates are
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thinner than the traditional veneers
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when it it were known as a laminate uh
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we went very specifically to a thinner
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layer again it was made of porcelin and
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Ceramics whereas where are the pr name
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veneer the title veneer also included
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the Composites but when we went
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specifically for the laminates it was
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not fabricated from the Composites and
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the laminates have a different
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thicknesses and shapes which are
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customizable and we can send them to the
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lab whereas the lers lers are very thin
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lenses which are added to the tooth with
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minimal prep or no prep maybe maybe not
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including uh enam preparation or
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including a very L enamel preparation
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okay and the laminates have a very Sol
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thickness or a very layer thickness
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which is very limited which may reach
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2.2 mm if you divide the 1 mm to five
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halves or to five parts uh so one of
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these parts will be your lumer but the
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laminates uh the thickness May reach up
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to.5 mm which is a thicker uh layer so
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the luners are ultra thin like your
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contact lenses which you are wearing in
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your eyes and it requires a minimal
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tooth structure alteration actually the
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lers uh not including a tooth correction
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or uh correction of misaligned or this
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or fractured tooth it's more or less
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something which is cosmetic make
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mascular discoloration and give a white
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shiny appearance to the te but please
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please don't do Lum which you are seeing
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in the actors like pieces of chocolates
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or piece of Chas gum okay please do
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something which follow the proper
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occlusion and follow the proper
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elevation and please don't do a very
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white uh Lumineers for uh patient which
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appear totally uh AR ficial please
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select be a doctor be a select a proper
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shade which suits the patient and which
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match his face color which match his
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smile line don't do a PLS a PLS of teeth
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very white which look ugly until this is
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a Hollywood smile this is sorry it's not
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a smile it's an ugly
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smile these are the laminates and
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lemoners
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again Within Improvement of the ponding
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techniques and Technologies and with
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appearance of a recent uh technology in
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the ponding the ponding of the luners
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and lamin became an easy Mission if you
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follow the proper guidelines and the
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advancement in material materials and
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appearance of cement with different
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shades which doesn't affect the
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translucency of the lens it became a a
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good cosmetic option to to do elins or
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lers and also materials which MX the
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tooth enamel and now they are trying to
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see the hydroxy appetite crystals what
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what the composition and try to
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fabricate in a lab Lum which mimics
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dehydroxy appetite crystals formation
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these are a recent
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advancements what about the Composites
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all of us are using composits daily but
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please don't go to market and tell him
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please give me composite you have to
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know the physical properties of the
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composite and what are the particle
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sizes and where you use the composite
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and what is the shade of the composite
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for each layer of the tooth nothing is
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called that I will put a composite A1
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for a central insiders this is not
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applicable actually each layer of the
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tooth the cervical the middle the inal
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thirds have different shades please
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select a composite which match the shade
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of the area to which you are restoring
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in the tooth please use an enamel
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composite don't do a layer of dtin
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composite on the enamel please keep the
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translucency of the enamel and
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appearance of the mamons under or inside
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the Dentin to give a natural locking of
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your composits before very old we were
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using the microfil and microfil and the
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hybrid composite now the microfil became
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obsolete uh particles of composite sizes
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we are now using the Nano hybrid and
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micro fold particles of Composites which
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combine the polishability the good
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physical properties together and now the
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impregnation of recent particles of
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porcelain and zironia inside the
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composit improve their physical
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properties please please please don't do
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total H for your dentine please keep
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your Dentin vital don't remove the smear
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layer please dissolve the smear layer
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and please use the Seventh Generation
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which have all in one ponding agents
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which only dissolve the smar layer intin
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with total itching of enamel to increase
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the surface tension and totally remove
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The Spar layer from enamel but please
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only dissolve the smar layer of Dentin
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don't convert dentinal tubules to an
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open tubules with fluid movement and the
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patient complaining of hyper sensitivity
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from cold after adaptation of Composites
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and with this experience some doctors
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are telling to the patient you will
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adapt to this composite because it's a
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new restoration because he did a total
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etching of Dentin and by time the bulb
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will be converted to a necrotic bulb
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under the Composites with with a little
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science and knowledge of dentist and um
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I think it's a medical mistake it's
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malpractice to do a total etching of
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Dentin please use the selective etching
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recently they developed a new
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technologies in the Composites they
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fabricated a bioactive composite so
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which can release calcium and phosphate
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and also the recent Technologies made
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the composite can be adaptable with the
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change of the pH of the mouth it can uh
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differentiate between acidity and
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alkalinity of the mouth and also the
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recent Technologies in the fibers and in
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fabrication of the particles made the
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composite very resistant to staining and
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to appris also the updating in
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techniques before we were using the
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incremental layer to minimize the
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polymerization shrinkage and buckle
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application of the light and now the
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recent Technologies involve with
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application of or the use of pkf
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Composites in which we can put a
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composite in a uni layer in which the
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light on the different types of light
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cure modes can penetrate and my word to
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the fresh graduates please know the
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wavelength of the light cure which you
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will purchase from the market don't go
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and tell him give me light cure and tell
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me the prices you have to know the moods
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you have to know the light and please
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please keep in each clinical tester for
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the efficiency of the light cure to know
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if the light cure is still emitting the
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same light and change the lamp whenever
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needed don't use light cure for all over
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your life once it emits uh blue light
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that okay I'm using this light cure it's
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working meanwhile maybe the light
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penetration power decreased and you are
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still using the light Cure by time it
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will become very weak and the inner
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layers of coms it will not be cured and
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it will fail also I think this is a
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malpractice the using of digital shade
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guides also help to know the different
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shades of different layers of the tooth
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cervical mle and sial enamel and the
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advantage of the good of the of the
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digital uh guys like vamac and
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other generations of the digital devices
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made the uh problems of normal shade
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guide the selection of the color on
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light and darkness the wetability of the
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tooth or the tooth is dry uh we were
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taking before when we were students that
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you have to measure uh the tooth shade
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in first day of June in middle of United
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States at 10 a.m. like this this is
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there this was the ideal situation
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meanwhile now the digital solutions for
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selecting the shades of the different
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layers of the tooth meet the story very
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easy and made you very uh professional
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to know each layer's color and to do a
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professional
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composite also they use of fiber posts
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and emance the fiber post are now became
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an old technology not a new it was made
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of carbon uh or fiber glass okay the
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good advantage of the fiber po that it's
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very light in weight it's very athetic
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and it's compatible with the core
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material like composite and also
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compatible with the reasin cement which
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is sement them to the tooth before we
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were using the biometric post which are
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screwed they were made from metal and uh
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they were screwed to the tooth and cause
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vertical root fracture now the fiber
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boss are available and very easy it
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comes with the drill size which is which
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which mimic the oppos size and you can
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measure them very easy it come very
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clear in the radi graph and now their
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use become very very familiar by most of
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D and they carry a superior flexure
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strength also reduces the chance of root
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fracture and the chance of transmitting
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forces to the walls of the
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root and the use of glass emblin also
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became an athetic solution they are
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bioactive and they enhance the oo
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integration they are very good aesthetic
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solution when we are using them in anr
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actually I didn't use um let me to be
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honest I didn't use a glass impants or I
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didn't see clinically the glass implant
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just I read about it uh maybe some
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research researchers in our Symposium
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will provide me with better information
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about the glass ambulance only I read
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about them but I didn't see them uh
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clinically uh the recent advancements in
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the posts that now there are a posts
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which are customizable
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prefabricated prefabricated no we know
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only it's already made sizes now you can
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customize and adjust to the tooth so
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there is no excuse to use this old
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biometric screwed post which cause
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failure and root fracture also the
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surface treatment Technologies improving
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the surface tension and reability of the
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enamel and improving the ponding to the
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enam and dtin the made the uh
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post cementation to the tooth is a easy
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machine what about the orthodontic
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aligners also they are a good
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Alternatives when you have mild cases of
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M osion um now they are uh being
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fabricated by the 3D C cam softwares
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what are the aligners they are types of
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multiple series of uh invisible or of uh
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transparent uh tooth orthodontic
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removable orthodontic appliances which
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are fabricated by computer software
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meanwhile you are taking a digital
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impression to the truth the computer can
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analyze the problem of f occlusion again
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again we are talking about mild or
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moderate cases which doesn't improve
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which doesn't include Pawn abnormalities
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okay the uh aligners uh are now uh being
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controlled with the ai ai give a
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predictable uh results and the software
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the computer software and mobile
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software now the patient can have a
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feedback on his mobile about the
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Improvement in his treatment plan and
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also the dentist can use the mobile
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application communicating with the lab
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who is fabricating the aligners and the
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process can finish during the same day
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the patient can take with him the first
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aligner the computer will tell you about
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the aligners for example he will tell
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this patient will wear uh 12 aligners
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and each aligners will take first one
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will take take two weeks second one will
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take 3 weeks until the M cusion problem
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is corrected actually it's a very good
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aesthetic alternative other than the
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orthodontic brackets it's not uh an it's
00:19:43
not a replacement to them but it's
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aesthetic Alternatives if the patient uh
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condition or the patient profession or
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the patient
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nature doesn't permit for him to wear an
00:19:55
orthodontic appliances so so in this
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case the aligners will be a good options
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the
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3D printers made the process very easy
00:20:07
again and again the mobile softwares
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can't control the
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process and the use of oppresses
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oppresses they are uh there are many
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types of oppressive the micro oppresses
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like the diamond PS and discs which we
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are using for recontouring in the case
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of reshaping or enameloplasty in these
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cases if we need to make a little
00:20:33
correction if the DSD told to you that
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these to need a very little correction
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okay you can do with the micro
00:20:42
oppressive or with the desks you can
00:20:45
correct the angle of the tooth you can
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correct the shape of the tooth en in
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some areas if you want to fabricate a
00:20:53
restoration for one tooth and you want
00:20:55
the other tooth to look like you can
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modify the other tooths enam with the
00:21:01
micro apps with the discs and with the
00:21:05
diamond pairs also in the cases of
00:21:08
anoplasty in the posterior teeth in the
00:21:10
Deep bits and fishes in the case of
00:21:13
susceptible bits and Fishes you can use
00:21:16
it's out of our topic of thetic
00:21:18
Alternatives but these diamonds again
00:21:21
are used for this purpose and the use of
00:21:25
micro appr like the polishing base which
00:21:28
we are using in the uh tooth uh
00:21:31
polishing after scaling or tooth
00:21:34
polishing for other purposes like for
00:21:37
orthodontic ponding P brackets or for
00:21:41
fabrication of restoration and you want
00:21:44
to show the natural color of the tooth
00:21:48
for photography
00:21:50
issues any uh purpose for tooth
00:21:53
polishing we are using a
00:21:55
microparticles and the use of air appr
00:21:59
see the device on the right side these
00:22:01
air aives are now available or are very
00:22:05
old available it's fitted on the four
00:22:08
holes or two holes of the hand piece of
00:22:11
the unit and it emits an air in this
00:22:14
hole you will put your polishing powder
00:22:17
and you will uh push the polishing
00:22:20
powder by the pressure of the air and
00:22:22
you will start to polish the tooth and
00:22:24
also the digital solutions for air
00:22:27
pressures again
00:22:29
they are being controlled by the AI the
00:22:32
AI can tell you the amount of air that
00:22:35
should be pushed and the amount of the
00:22:37
powder that should be added okay in this
00:22:41
case um the powders and the amount of
00:22:45
Earth make a very good result for the
00:22:48
truth polishing recently the recent
00:22:52
Technologies and use of Nano diamond
00:22:54
abessive with high prision and
00:22:57
nanotchnology
00:22:58
made the story of uh mcro and micro
00:23:02
abrasives easier okay especially the
00:23:05
micro operas okay by using a very fine
00:23:09
Diamond particles which keep or which
00:23:12
conserve the tooth enam and help in the
00:23:15
minimal invasive
00:23:17
procedures the Ping most of our patients
00:23:21
dream to do pleaching because he think
00:23:24
he will come one visit the doel my teeth
00:23:27
will become White it's adaptable in a
00:23:30
very limited cases of discoloration
00:23:33
where the extr six stains are easily to
00:23:37
be removed but difficult to be removed
00:23:39
with the traditional scaling and
00:23:41
polishing we can use an in office highly
00:23:45
concentrated gel and in a very little
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cases of intrinsic stains also we can
00:23:53
use the high concentration gels and now
00:23:56
the recent Technologies made the
00:23:58
penetration of the gel to a deeper layer
00:24:01
to bring the intrinsic stains from the
00:24:04
tooth made the process of tooth baching
00:24:08
better and with a higher or a good
00:24:11
results so in office you can put your
00:24:14
chemical gel with changeful protection
00:24:17
or you can adapt this Zoom ultraviolet
00:24:21
rays or uh oxygen plasma whatever okay
00:24:26
uh to the gel to be activated in two or
00:24:29
three sessions uh but the problem
00:24:31
actually in this procedure that it
00:24:33
causes a postoperative hypers
00:24:35
sensitivity and it requires to treatment
00:24:38
sometimes we need uh strong analgesics
00:24:40
after the visit and the using of walking
00:24:44
pach what's walking pach in the case of
00:24:47
endodontically treated teeth where the
00:24:49
tooth become discolored because the
00:24:51
doctor did not remove the remance of
00:24:54
gure the tooth becomes discolored simply
00:24:57
you will open an access from the lingual
00:25:00
side of the tooth especially in the
00:25:02
anterior upper anterior teeth and you
00:25:04
will remove the excess gapa and
00:25:07
defective Restorations and you will put
00:25:09
your gel inside and close with aor
00:25:11
restoration like the glass animal or
00:25:13
like your temper filling and ask the
00:25:16
patient to walk to home so that it was
00:25:19
called a walking pach because the
00:25:21
patient will walk to home and then you
00:25:24
will again check his uh shade and please
00:25:28
also use the digital shade guide to
00:25:31
record on the computer uh the proper
00:25:34
shade okay and you will compare if the
00:25:37
patient will need another visit or no
00:25:40
and at home you give the patient
00:25:42
accustom made trays and low concentrated
00:25:46
gel he will use at home but with a very
00:25:49
little selected types of patients and in
00:25:52
a very limited conditions you can use at
00:25:55
home teaching recently the emission
00:25:58
theode assisting the pleaching the using
00:26:01
of light other than the laser and
00:26:04
UltraViolets made the process uh more uh
00:26:09
successful and made the complications
00:26:11
and sensitivity less the use of bide
00:26:14
free whitening agents which reduces the
00:26:17
tooth sensitivity also again it's
00:26:19
available commercially and it's very
00:26:23
good in results like the p and the using
00:26:27
of nanot Technology again and again n
00:26:29
technology in our work the N technology
00:26:32
wiers fabricated uh they have a very
00:26:36
good results in
00:26:38
whitening and our last options are the
00:26:42
inlays onlays overlays and Crown what is
00:26:45
the inlay inlay is a ready made or sorry
00:26:49
a custom made custom fabricated uh
00:26:52
Restorations which are adapted inside
00:26:54
the tooth after you took compression and
00:26:57
fabricated with your cat cam Uh custom
00:27:00
made restoration is cemented to your
00:27:03
tooth inside the tooth but it doesn't
00:27:05
cover the uh cusps in this case it's
00:27:08
called inlay if it covers the cusps it's
00:27:11
called onlay and if covers if it covers
00:27:15
the tot totally the TP and part of the
00:27:19
uh outer surfaces it's called overlay
00:27:21
but meanwhile if it covers all the tooth
00:27:24
it's called a crown from what it's
00:27:27
fabricated is fabricated from Composites
00:27:31
sorry from porcelain and zirconium from
00:27:35
before it was fabricated from uh lab
00:27:38
fabricated composits but now we are
00:27:41
using the uh cat cam in fabricating the
00:27:46
zironia and porcelin when the porcelin
00:27:48
was first introduced we had the
00:27:52
fpath porcelain uh or the traditional
00:27:56
porcelain like V Mark 2
00:27:58
IPS design then we had the lucide
00:28:03
reinforced glass Ceramics like the IPS
00:28:07
Empress which were fabricated by the CL
00:28:10
or vivident okay then the third
00:28:13
generation with the lithium disilicate
00:28:15
glass Ceramics like the IBS emac press
00:28:21
um max CAD also it's fabricated by EV
00:28:25
vient uh and then
00:28:28
the alumin
00:28:30
paced Ceramics like the Procera the
00:28:33
noble procure or the noble P sorry um
00:28:38
this aluminum pasted uh porcelain now
00:28:42
they are being used and recently we have
00:28:46
the zironia reinforcing grass ramics now
00:28:49
they are impregnated the zironia to the
00:28:52
porceline like the
00:28:54
crau uh and the fused Composites and
00:28:58
also in the zironia we have many
00:29:01
generations first we had 3% tiria
00:29:05
stabilized uh TCP and then 4%
00:29:10
5% okay uh and multi layer zironia like
00:29:15
Katana zironia uh from kurari uh these
00:29:20
generations of zonia are usually
00:29:24
improved started from the monolithic
00:29:26
zeronian CR
00:29:28
this zonum crowns provide a good
00:29:31
strength and natural appearance but
00:29:33
again there is dilemma about using it in
00:29:36
the long span uh usually we try to limit
00:29:40
the zonal used for the short span okay
00:29:44
and the digital work workflow the using
00:29:47
of the digital technology improve the
00:29:50
issue conclusively I would like to tell
00:29:53
that selection of the material is very
00:29:56
important okay first select the
00:29:59
technique you all use don't go behind
00:30:01
the patient the patient will tell you I
00:30:03
want veneer don't go for veneer tell him
00:30:06
the available options uh and try to be
00:30:09
conservative as much as you can if you
00:30:11
can do without tooth preparation if you
00:30:14
can do
00:30:15
without causing a postoperative
00:30:18
sensitivity please follow that don't go
00:30:20
for invasive unless there is uh no other
00:30:23
options and again please don't do total
00:30:27
h
00:30:28
for don't go to the lab and tell him
00:30:31
make for me a poring crown please ask
00:30:35
which type of por you are using which
00:30:37
generation which type are the types we
00:30:39
mentioned and read about the advantage
00:30:42
and disadvantage of each type uh it's
00:30:45
not a shame for you to read in front of
00:30:48
the lab technician about the advantage
00:30:50
of this type especially if he tell you
00:30:53
about a commercial type read about it
00:30:55
about its physical properties don't go
00:30:58
for prices we are not a salesmen we are
00:31:01
doctors and a dentist Allah subh give us
00:31:05
the knowledge the knowledge to
00:31:07
differentiate between different types
00:31:09
also for the zonum I saw before zonum
00:31:13
lab he made a zonum like a plastic which
00:31:17
is broken down like an acrylic okay uh
00:31:20
please see which type of zonia don't go
00:31:23
for the Sher lab go for the lab who is
00:31:26
using a re a recent Technologies and who
00:31:29
is using a good materials for
00:31:33
fabrication uh actually it was my little
00:31:36
presentation today uh and it was my
00:31:39
honor uh to be with you in this denry
00:31:42
online scientific days in its living
00:31:45
Seasons my regards to my professor Dr ma
00:31:48
dumani to Professor Dr Adan Habib and to
00:31:52
all my colleagues who will be
00:31:54
contributing to uh this event and in the
00:31:57
last uh I send my prayers to our
00:32:01
brothers and sisters in gazam Allah
00:32:04
secure them and inshallah when we come
00:32:07
next year for the 12 12th season Gaza
00:32:11
will be in a better condition and we'll
00:32:13
be repal and inshallah all people will
00:32:16
be in their houses and may Allah give
00:32:19
Mercy
00:32:20
to our brothers and sisters who
00:32:24
sacrificing themselves and in they are
00:32:26
sh
00:32:28
am
