Producing the ideal restorative outcome depends on the dentist providing meticulous detail and devoting the necessary time for taking accurate impressions. The cutting-edge materials and techniques used in modern dentistry can help with tackling the challenges of managing the site. This article presents methods for gingival retraction and ways to select appropriate mechanical and chemical means for soft-tissue control. It will also discuss atraumatic methods for retraction of soft tissue and controlling bleeding and crevicular fluids.

The use of tooth-colored restorative materials for posterior teeth began with the earliest generation of bondable composite restorative materials in the early 1970s. Forty years later, the industry continues to search for a bulk-fill composite that can be used with the ease and predictability of dental amalgam. Clinicians using light-cured composite resins have continued to struggle with the clinical problems associated with shrinkage upon cure and the need to fill the cavity preparation in incremental layers to ensure complete cure of the resin. This article will explore the problems of posterior composite resin placement and demonstrate effective methods to create esthetically pleasing, long-lasting posterior composite restorations.

While the controversy over opening the vertical dimension of occlusion is dying down, the confusion over the process is not. Picking a working vertical dimension, communicating important diagnostic information with the laboratory and capturing the optimal vertical dimension of occlusion intraorally are difficult to achieve in practice. This article will attempt to reduce the confusion over altering vertical dimension and provide some guidelines and practical solutions to common problems.

Teeth fail from two primary reasons: bacterial assault or excessive or misdirected forces. This article presents insights on the importance of anterior guidance. Natural teeth and restorations will last longer if they are placed into a stable relationship. There are five requirements for occlusal stability, and there are five requirements for occlusal stability. The reality is that many clinical situations involve the need to use various combinations of the aforementioned five choices. Three case reports are given to demonstrate the interaction of the requirements.

The use of dental implants to replace the natural tooth system has become a common treatment planning option in the contemporary dental practice. As with any treatment option, impediments to their usage do exist. Some of these may include smaller edentulous intertooth space, reduced vertical or transverse dimensions at the residual ridge, convergent roots, and/or close proximity of root trunks. The use of smaller diameter implants has been documented in the dental literature for over 15 years, and their use is acceptable for treatment options ranging from immediate stabilization of bone augmented ridges to esthetic tooth replacement in the esthetic zone. This article will demonstrate a case report of a young individual presenting for the replacement of maxillary congenitally missing lateral incisors.

Color matching of direct composite restorations is often a frustrating and overlooked step for many practitioners due to the lack of education in the physical properties of current restorative composites in their armamentarium. Many practitioners also lack the elemental understanding underlying the science of human color perception. There are numerous steps that can be implemented to achieve a desired color match; these small but important steps can assure the practitioner and patient will be happy with their desired outcome.

When a patient is faced with replacing a missing anterior tooth, the available treatment options include: a removable partial denture (acrylic or cast metal-based); resin-bonded fixed partial denture (Maryland Bridge), either cantilever or end-abutment, conventional, full-coverage, fixed partial denture, or a crown supported by a single implant. The patient’s decision process may be driven by several factors, with convenience and cost/insurance coverage possibly playing a significant role. However, if the clinician and patient have a clearer understanding of the treatment outcomes for each available treatment modality, once a decision is made, treatment outcomes and expectations may be better realized for those involved.

Minimally invasive dentistry should be the goal of every restorative and esthetic dental procedure. The purpose of these case presentations is not only to show technique but to also stimulate the practitioner to start thinking about what they may be able to do to provide a successful outcome while minimizing trauma to healthy, natural tooth structure.

The ability to affix a restorative material adhesively to enamel and dentin not only advanced our ability to create more esthetic dental restorations, but also decreased the potential for damage caused by microleakage and recurrent decay by sealing the dentinal tubules. This article will discuss bonding to several substrates that cover a range of clinical applications to today’s restorative dentist. Some of the types of bonding that will be discussed include: bonding of glass-ionomer cement to dentin; bonding direct composite and porcelain to enamel and dentin; bonding new composite to old composite (composite repair); and bonding porcelain to porcelain (crown-and-bridge repair).

Many new materials have been introduced in the last decade. From this wide variety of materials, dentists can now choose those that meet their needs and those of their patients. However, it is difficult to ascertain long-term benefits as most of these materials have not undergone long-term clinical trials. This article will present guidelines to enable the clinician to assess these new materials and a clinical case will demonstrate the use of new materials and technology.