Weinstein A R
Children's Hospital Medical Center, Cincinnati, Ohio.
Dent Clin North Am. 1993 Jul;37(3):391-409.
The esthetic expectations of our patients can be met by doing a thorough initial examination with emphasis on periodontal health, caries incidence, occlusion, possible orthodontic corrections, esthetic needs, and economic concerns. Through proper communication with the patient, a written treatment plan can be developed that uses the various techniques of bleaching, cosmetic recontouring, direct resin bonding, porcelain veneering, or crowning to meet the patient's restorative needs. The most conservative noninvasive techniques should be evaluated first. Often, bleaching and partial direct bonding are all that is needed. If the dentition is badly worn or discolored, then more extensive treatment is indicated. Patients frequently have concerns about longevity of restorations or require very high levels of esthetic correction, which can only be accomplished with more invasive techniques. When patients understand what can be accomplished and are involved in the treatment decision, then successful results are assured. Esthetic restorative dentistry is probably the most rewarding aspect of practice today, but it is also the most challenging. New materials appear and techniques change so rapidly that it is sometimes difficult to keep up. Practitioners should acquire a thorough knowledge of available methods and materials, learn the limitations of these materials and techniques, and master skills through continuing education (courses, journals, and newsletters) as well as chairside repetition as new procedures become available.
通过进行全面的初步检查，重点关注牙周健康、龋齿发生率、咬合、可能的正畸矫正、美学需求和经济问题，可以满足我们患者的美学期望。通过与患者进行适当沟通，可以制定书面治疗计划，采用漂白、美容重塑、直接树脂粘结、瓷贴面或牙冠修复等各种技术来满足患者的修复需求。应首先评估最保守的非侵入性技术。通常，漂白和部分直接粘结就足够了。如果牙列磨损严重或变色，则需要更广泛的治疗。患者经常担心修复体的使用寿命，或者需要非常高水平的美学矫正，而这只能通过更具侵入性的技术来实现。当患者了解可以实现的目标并参与治疗决策时，就能确保取得成功的结果。美学修复牙科可能是当今临床实践中最有意义的方面，但也是最具挑战性的。新材料不断涌现，技术变化如此之快，有时很难跟上。从业者应全面了解可用的方法和材料，了解这些材料和技术的局限性，并通过继续教育（课程、期刊和时事通讯）以及随着新程序的出现进行临床操作中的反复练习来掌握技能。
