Clinical Prosthodontics DL, King's College London University, London, UK.
J Esthet Restor Dent. 2012 Dec;24(6):367-83. doi: 10.1111/j.1708-8240.2012.00503.x. Epub 2012 Mar 5.
The choice of the most appropriate restoration for anterior teeth is often a difficult decision. Numerous clinical and technical factors play an important role in selecting the treatment option that best suits the patient and the restorative team. Experienced clinicians have developed decision processes that are often more complex than may seem. Less experienced professionals may find difficulties making treatment decisions because of the widely varied restorative materials available and often numerous similar products offered by different manufacturers. The authors reviewed available evidence and integrated their clinical experience to select relevant factors that could provide a logical and practical guideline for restorative decisions in anterior teeth. The presented concept of restorative volume is based on structural, optical, and periodontal factors. Each of these factors will influence the short- and long-term behavior of restorations in terms of esthetics, biology, and function. Despite the marked evolution of esthetic restorative techniques and materials, significant limitations still exist, which should be addressed by researchers. The presented guidelines must be regarded as a mere orientation for risk analysis. A comprehensive individual approach should always be the core of restorative esthetic treatments.
The complex decision process for anterior esthetic restorations can be clarified by a systematized examination of structural, optical, and periodontal factors. The basis for the proposed thought process is the concept of restorative volume that is a contemporary interpretation of restoration categories and their application.
选择最适合前牙的修复体通常是一个困难的决定。许多临床和技术因素在选择最适合患者和修复团队的治疗方案方面发挥着重要作用。有经验的临床医生已经开发出的决策过程往往比看起来要复杂得多。经验不足的专业人员可能会因为可用的修复材料种类繁多,而且不同制造商经常提供许多类似的产品而在做出治疗决策时遇到困难。作者回顾了现有证据,并整合了他们的临床经验,以选择相关因素,为前牙的修复决策提供合理实用的指导方针。所提出的修复体体积概念基于结构、光学和牙周因素。这些因素中的每一个都会影响修复体在美观、生物学和功能方面的短期和长期行为。尽管美观修复技术和材料有了显著的发展,但仍然存在显著的局限性,研究人员应该解决这些局限性。所提出的指南只能被视为风险分析的一个参考。综合的个体化方法应该始终是修复美容治疗的核心。
通过系统地检查结构、光学和牙周因素,可以阐明前牙美学修复的复杂决策过程。所提出的思维过程的基础是修复体体积的概念,这是对修复体类别及其应用的现代解释。