1 Overview /1
1.1 Development and Requirements of Micro Dentistry /2
1.1.1 Different Levels of Visual Basis Bring Different Levels
of Recognition /2
1.1.2 Development of Micro Dentistry /3
1.2 Application of Dental Microscope in Dental Specialties /3
1.2.1 Accuracy of Measurement Required by Each Dental Specialty Is Not the Same, and that of Endodontics and Prosthodontics Is Relatively Small /3
1.2.2 The Application of Microscope in Endodontics /4
1.2.3 The Application of Microscope in Periodonticsand Dental Implantology /4
1.2.4 The Application of Microscope in Prosthodontics /4
1.2.5 The Application of Microscope in Dental Technology /4
1.2.6 The Application of Microscope in Teaching,Scientific Research, and Clinical Skill Training /5
1.3 Development and Advantages of Micro Prosthodontics /5
1.3.1 In the Naked-Eye Age, the Complications of RestorationAre Mostly Related to Unclear Vision /5
1.3.2 Reasons Why We Need Micro Prosthodontics /5
1.3.3 The Relationship Between Digital Micro Prosthodonticsand Minimally Invasive Dentistry /6
Suggested Readings /7
Part I Analysis, Design and Preclinical Preparation of Micro Prosthodontics
2 Theory and Practice of Target Restorative Space (TRS) /11
2.1 Definition and Classification of Target Restorative Space (TRS) /11
2.1.1 Definition /11
2.1.2 Classification /11
2.2 The Significance of Target Restorative Space (TRS) in Prosthodontics /15
2.2.1 The Significance of TRS in Aesthetic Restoration /15
2.2.2 The Significance of TRS in Implant Surgery /18
2.3 Classification and Manufacturing of TRS Guide /18
2.3.1 Classification of TRS Guides /19
2.3.2 Transparent Dental Membrane TRS Guide /20
2.3.3 3D Printing TRS Guide /20
2.3.4 Two-in-One TRS Guide for Tooth Preparation and Implantation /21
2.4 Application of Target Restorative Space (TRS) Guide in Preoperative Analysis and Design /21
2.4.1 Application of TRS Guide in Aesthetic Restorationof Anterior Teeth /21
2.4.2 Application of TRS Guide in Functional Reconstructionof Oral and Maxillofacial System /22
2.4.3 Application of TRS Guide in Secondary Restoration/ 24
2.4.4 Application of TRS Guide in Dental Implant /24
2.5 Summary and Prospect /24
Suggested Readings /26
3 Microscope and Auxiliary Devices for Micro Prosthodontics /27
3.1 The Basic Structure and Working Principle of Dental Microscope /27
3.1.1 Definition of Dental Microscopes /27
3.1.2 Classification of Dental Microscopes /28
3.1.3 Basic Structures of Dental Operating Microscope /29
3.2 Auxiliary Devices for Micro Prosthodontics /35
3.2.1 Ring Flash/Twin Flash Device Around the Objective Lens /37
3.2.2 Lingual/Palatal Reflector and Its Holder /37
3.2.3 Variable Diaphragm /38
3.2.4 Enamel Chisel /38
3.3 The Basic Set-Up and Instructions of Dental Operating Microscope /39
3.3.1 Set-Up and Precautions of Dental Operating Microscope /39
3.3.2 Basic Adjustment of Dental Operating Microscope /40
3.4 Summary and Prospect /42
Suggested Readings /42
4 Posture and Microscopic View of Prosthodontic Microsurgery /43
4.1 Dental Microsurgery Technique and Ergonomics /43
4.1.1 Definition of Ergonomics /43
4.1.2 The Connection Between Dental Microsurgery
Technique and Ergonomics /43
4.1.3 Ergonomic Recommendations /43
4.2 Postures of Dental Microsurgery /44
4.2.1 Ergonomic Posture of Dental Microsurgery /44
4.3 Microscopic View of Each Tooth /46
4.3.1 Microscopic View of Maxillary Anterior Teeth /46
4.3.2 Microscopic View of Maxillary Posterior Teeth /47
4.3.3 Microscopic View of the Mandibular Anterior Teeth /49
4.3.4 Microscopic View of the Mandibular Posterior Teeth /50
4.4 Thoughts and Comments Regarding the Practice of Micro Prosthodontics /51
4.4.1 Using a Microscope Can Prolong the Career Longevity
of Dentists and Improve Clinical Results /51
4.4.2 Microscopy Does Not Mean Minimal Invasiveness /52
4.4.3 Application of Dental Microscope in Prosthodontics Teaching /53
4.4.4 “Five Difficulties” in the Practice and Teaching of Microscopic Prosthodontics /53
4.4.5 Consensus Should Be Achieved on MicroscopicProsthodontic Teaching /56
4.5 Summary and Prospect /57
Suggested Readings /57
Part II Sequential and Key Clinical Techniques
for Digital Micro Prosthodontics
5 Pain Management and Comfortable Treatment in Micro Prosthodontics /61
5.1 Local Anesthetics and Local Anesthesia Methods /61
5.1.1 How to Choose Local Anesthetics /61
5.1.2 How to Choose Local Anesthesia Method /62
5.1.3 How to Calculate Drug Dosage /64
5.1.4 Sedation /66
5.2 Clinical Operation Procedure /67
5.2.1 Evaluation and Preparation Before Anesthesia /67
5.2.2 Implementation of Anesthesia /68
5.2.3 Complications /69
5.3 Pain Control of Tooth Preparation /70
5.3.1 Principles and Mechanisms /70
5.3.2 Pain Control During and After Tooth Preparation /72
5.4 Pain Control of Dental Implantation /72
5.4.1 Principles and Mechanisms /72
5.4.2 Reasons for Pain after Dental Implantation /73
5.4.3 Pain Control After Dental Implantation /73
5.5 Summary and Prospect /74
Suggested Readings /74
6 Isolation of the Operative Field in Micro Prosthodontics: Practical Rubber Dam Technology /75
6.1 Rubber Dam and Accessories /75
6.1.1 Composition of Rubber Dam Kit /75
6.2 Basic Technology of Rubber Dam /77
6.2.1 Placement of Rubber Dam /77
6.2.2 Reminder for Rubber Dam Placement /79
6.3 Use of Rubber Dam in Special Situations /81
6.3.1 Gingival Sulcus Fluid or Saliva Microleakage /81
6.3.2 Large Defect of the Tooth or Poor Retention of the Crown /81
6.3.3 Isolation of PFM and Ceramic Crown /81
6.3.4 Isolation of Fixed Bridge Restoration /81
6.3.5 Tooth Neck Defect /81
6.3.6 Patients in Poor General Condition and Elderly Patients /81
6.4 Summary and Prospect /81
Suggested Readings /81
7 Introduction to Digital Micro Tooth Preparation Technology /83
7.1 Control of Tooth Preparation Amount /83
7.1.1 Biological Factor /84
7.1.2 Biochemical Factor /85
7.1.3 Esthetic and Functional Factor of Prosthesis /86
7.2 Control of the Preparation Shape /86
7.2.1 Requirements for the Shape of the Axial Surface of the Preparation /86
7.2.2 The Control of the Position and Shape of the Preparation’s Margin /87
7.3 Instrument Selection for Tooth Preparation /89
7.3.1 Types and Selection of Cutting Bur for Tooth Preparation /89
7.3.2 Types and Selection of Dental Handpiece and Motors /92
7.4 Application of TRS Guide in Tooth Preparation /94
7.4.1 Classification According to the Purpose of Use /94
7.4.2 Classification According to Manufacturing Technology /95
7.5 Classification and Characteristics of the Existing Micro
Tooth Preparation Techniques /96
7.5.1 Micro Groove Reference Tooth Preparation Technique /96
7.5.2 Micro Hole Reference Tooth Preparation Technique /99
7.6 Clinical Workflow and Preparation Method of High-Precision Margin /99
7.6.1 Three Determinations /100
7.6.2 Three Choices /101
7.6.3 Three Steps /102
7.7 Summary and Prospect /102
Suggested Readings /102
8 Digital Impression Technology /105
8.1 Classification and Characteristics of Digital Impression /105
8.1.1 Classification of Digital Impression /105
8.1.2 Characteristics of Digital Impression /108
8.2 Operation Procedure of Digital Intraoral Scanning System /109
8.2.1 Installation of Digital Intraoral Scanning System /109
8.2.2 Introduction to Home Page of Intraoral Scanning Software /109
8.2.3 Case Management in Intraoral Scanning Software /109
8.2.4 Scanning Scheme and Scan and Image
in Intraoral Scanning Software /111
8.2.5 Processing of Digital Intraoral Scanning Model /117
8.2.6 Storage and Export of Digital Intraoral Scanning Data /120
8.3 Common Problems and Solutions of Digital Impression /120
8.3.1 Common Problems and Solutions About Hardware /120
8.3.2 Common Problems and Solutions About Software /122
8.4 Summary and Prospect /123
Suggested Readings /123
9 Digital Depth-Hole-Guiding Micro Tooth Preparation for Porcelain Veneer /125
9.1 Overview and Indications of Porcelain Veneer /125
9.1.1 The Indications of Porcelain Veneer /125
9.1.2 The Characteristics of Porcelain Veneer /125
9.1.3 Materials of Porcelain Veneer /126
9.1.4 Types of Porcelain Veneer /126
9.2 Design of Targeted Restorative Space (TRS) and Porcelain
Veneer Preparation /128
9.2.1 TRS Design of Porcelain Veneer /128
9.2.2 Preparation Design of Porcelain Veneer /128
9.3 The Clinical Protocol of Micro Tooth Preparation
with Digital Guide for Porcelain Veneer /130
9.3.1 Veneer Preparation Using the Silicone Rubber Guide /130
9.3.2 Veneer Preparation Using the Transparent
Vacuum-Formed TRS Guide /136
9.3.3 Veneer Preparation Using 3D Printing TRS Guide /140
9.3.4 Finishing and Polishing /143
9.4 Gingival Retraction Technique Under a Microscope /143
9.4.1 Microscope Field of View for Gingival Retraction /145
9.4.2 The Procedure of Gingival Retraction Under a Microscope /145
9.5 Impression Making and Provisional Restoration /146
9.5.1 Impression Making /146
9.5.2 Provisional Restoration /146
9.6 Overview and Indications of Partial Porcelain Veneers /147
9.6.1 Indications and Contraindications of Partial Porcelain Veneer /147
9.6.2 Materials for Partial Porcelain Veneer /147
9.6.3 TRS Design for Partial Porcelain Veneer /148
9.6.4 Preparation Requirements for Partial Porcelain Veneer /148
9.6.5 Preparations for Tooth Preparation of Partial Porcelain Veneer /148
9.6.6 Preparation of Various Types of Dental Veneers /149
9.7 Summary and Prospect /151
Suggested Readings /151
Contents
xv
10 Digital Micro Tooth Preparation for Posterior Indirect
Adhesive Restorations /153
10.1 Overview of Posterior Indirect Adhesive Restorations /153
10.1.1 The Advantages and Disadvantages of PIAR /153
10.1.2 Material Selection for PIAR /154
10.1.3 Types of PIAR /155
10.2 Preparation Design of Posterior Indirect Adhesive Restoration /155
10.2.1 The Amount of Preparation /155
10.2.2 The Principle of Posterior Indirect Adhesive
Restoration Preparation /156
10.3 Micro Preparation Protocol for Posterior Indirect Adhesive Restorations /159
10.3.1 Basic Principles of PIAR Preparation /159
10.3.2 Preparation Before Tooth Preparation /159
10.3.3 Preparation Process of Micro Preparation Guided by TRS Guide /159
10.3.4 Preparation for Single-Surface PIAR /161
10.3.5 Preparation for MO/DO PIAR /162
10.4 Summary and Prospect /163
Suggested Readings /164
11 Digital Depth-Hole-Guiding Micro Preparation for All-Ceramic Crown /165
11.1 Overview and Indications of All-CeramicCrown /165
11.1.1 Indications of All-Ceramic Crown /165
11.1.2 Contraindications of All-Ceramic Crown /166
11.2 Classification of All-Ceramic Material /166
11.2.1 Slip-Casting Ceramic /166
11.2.2 Castable Glass Ceramic /166
11.2.3 Pressed Castable Ceramic /167
11.2.4 Infiltrated Ceramic /167
11.2.5 Machinable Ceramic /167
11.2.6 Zirconia Ceramic or Zirconia-Toughened Ceramic /167
11.2.7 Nanocomposite Ceramic /168
11.2.8 Ceramic-Resin Composite /168
11.3 The Clinical Protocol of Digital Depth-Hole-GuidingMicro Tooth Preparation for All-Ceramic Crown /168
11.3.1 Analysis and Design Phase /168
11.3.2 Micro Tooth Preparation of Anterior Teeth
Under the Guidance of the Transparent
Vacuum-Formed TRS Guide /170
11.3.3 Micro Tooth Preparation of Anterior Teeth Under the Guidance of the 3D Printing TRS Guideof Non-uniform Thicknesses /173
11.3.4 Impression and Temporary Restoration /175
11.4 Summary and Prospect /177
Suggested Readings /178
12 Immediate Dentin Sealing and Micro Bonding /179
12.1 Overview and Mechanism of Adhesion /179
12.1.1 Concept of Adhesive /179
12.1.2 Mechanism of Adhesion /179
12.1.3 Type of Adhesives /180
12.1.4 Bonding of Enamel /181
12.1.5 Bonding of Dentin /182
12.1.6 Immediate Dentin Sealing (IDS) /184
12.1.7 The Treatments of the Ceramic Prosthesis /185
12.1.8 Cementing of Temporary Restorations /187
12.2 Micro Bonding Process of Zirconia- and Glass-Based Ceramics /188
12.2.1 Characteristics of Bonding of Different Restorative Materials /188
12.2.2 Surface Conditioning of Different Restorative Materials /189
12.2.3 Surface Conditioning of the Preparation (Abutment Tooth) Which Is to Be Repairedwith Different Restorative Materials /190
12.3 Micro Bonding Process of Porcelain Veneer /192
12.3.1 Selection of Adhesive Resin /192
12.3.2 Try-In and Preparation /192
12.3.3 Surface Conditioning of the Tooth /193
12.3.4 Surface Conditioning of the Porcelain Veneer /195
12.3.5 Placement /196
12.3.6 Occlusal Check and Adjustment /198
12.4 Micro Bonding Process of All-Ceramic Crown /199
12.4.1 Selection of Adhesive /199
12.4.2 Try-In and Preparation /199
12.4.3 Occlusal Check and Adjustment /199
12.4.4 Surface Conditioning of the Tooth Surface /199
12.4.5 Surface Conditioning of the All-Ceramic Crown /201
12.4.6 Placement /203
12.5 Summary and Prospect /204
Suggested Readings /206
Part III Complications and Treatment After Micro-prosthodontics
13 Complications and Treatment After Micro Prosthodontics /209
13.1 Routine Maintenance /209
13.1.1 Brush Teeth and Use Dental Floss Correctly /209
13.1.2 Receive Regular Scaling and Treatment
in Time If There Is Any Problem /209
13.1.3 Apply Fluoride and Prevent Secondary Caries /209
13.2 Complications and Treatment /209
13.2.1 Chipping Fracture of Porcelain /209
13.2.2 Porcelain Cracking /210
13.2.3 Debonding of Prosthesis /211
13.2.4 Dental Allergy /211
13.2.5 Abutment Fracture /211
13.2.6 Discoloration at the Margin of the Prosthesis /211
13.2.7 Dental Pulp Devitalization and Secondary Caries /212
13.3 Summary and Prospect /212
Suggested Readings /212
Part IV Clinical Rehabilitation of Secondary AestheticPorcelain Restoration
14 Decisions on Clinical Rehabilitation of Secondary Aesthetic Porcelain Restoration /215
14.1 Possible Complications of Secondary Aesthetic Porcelain Restoration /215
14.1.1 Hypersensitivity of Abutment Teeth /215
14.1.2 Spontaneous Pain of Abutment Teeth /215
14.1.3 Loosening, Cracking and Discolouration of Abutment Teeth /216
14.1.4 Occurrence of Exacerbation of Periodontal Disease /216
14.1.5 Discolouration of Restoration /216
14.1.6 Loosening and Falling Off of Restoration /216
14.1.7 Cracking, Breaking and Perforation of Restoration /216
14.1.8 Dysfunction and Psychological Problems /217
14.2 Clinical Decision Tree of Secondary Aesthetic Porcelain
Restoration Guided by TRS Guide /217
14.2.1 Psychological Evaluation /217
14.2.2 Previous Treatment Evaluation /218
14.2.3 Prosthodontic Decision After Removing
the Old Restoration /219
14.3 Typical Cases of Secondary Porcelain Aesthetic Repair and Retreatment /220
14.3.1 Secondary Aesthetic Porcelain Restorations in the Anterior Area /220
14.4 Summary and Prospect /272
Suggested Readings /274
15 Occlusal Reconstruction Under the Guidance of Target Restorative Space /275
15.1 Comprehensive Assessment Before Occlusal Reconstruction /275
15.1.1 Clinical Consultation and Risk Assessment /275
15.1.2 Examination of the Oral and Maxillofacial System /275
15.1.3 Radiographic Examination /277
15.1.4 Mounting of Diagnosis Casts onto the Articulator /277
15.2 Typical Cases of Occlusion Reconstruction Aided by the TRS Guide /277
15.2.1 A Case of Secondary Aesthetic and Functional Porcelain Restoration of Maxillae and Mandible Aided by TRS Guide /278
15.2.2 A Case of Secondary Aesthetic Porcelain Restoration of Maxillae and Mandible Aided by TRS Guide /285
15.2.3 A Case of Occlusal Reconstruction Restored by Implant-Supported Fixed Prosthesis with the Aid of Whole-ProcessDigital Guidance /300
15.3 Clinical Application of Occlusion Adjusting Guidein Occlusal Reconstruction /317
15.3.1 Digital Clinical Workflow of Occlusion Reconstructionfor Cases with Insufficient Occlusal Space /318
15.3.2 A Clinical Case of Designing Occlusion Adjusting Guide /322
15.4 Summary and Prospect /334
Suggested Readings /334
16 Cases of Digital Micro Prosthodontics Guided by Target Restorative Space /337
16.1 Typical Cases of Digital Micro Restoration Guided by Wax-Up Surface /337
16.1.1 A Case of Crown Lengthening Combining with Porcelain Veneer Restoration of Maxillary Anterior Tooth Guided by Mock-Up Surface /337
16.2 Typical Cases of Digital Micro Restoration Guided by Silicone Index /344
16.2.1 A Case of All-Ceramic Crown of Maxillary AnteriorTooth with ETRS Guided by Silicone Index /344
16.3 Typical Cases of Digital Micro Restoration Aided by Transparent Dental Membrane TRS Guide /347
16.3.1 A Case of Digital Micro Restoration of Traumatic Maxillary Anterior Tooth with Ceramic Veneer Aided by Transparent Dental Membrane TRS Guide /347
16.3.2 A Case of Porcelain Inlay Restoration of Elongated and Rotated Maxillary Anterior Teeth Aidedby Transparent Dental Membrane TRS Guide /359
16.3.3 A Case of Porcelain Inlay Restoration of Defected Upper Anterior Teeth Aided by Transparent Dental Membrane TRS Guide /369
16.3.4 A Case of Porcelain Veneer Restoration of Maxillary and Mandibular Tetracycline Teeth Aided by Transparent Dental Membrane TRS Guide /381
16.4 Typical Cases of Digital Micro Restoration Aided by 3D Printing TRS Guide with Uniform Thickness /393
16.4.1 A Case of Digital All-Ceramic Restorations of Maxillary and Mandibular Anterior Tooth with Exogenous Severe Erosion and Extensive Caries Aided by 3D Printing TRS Guide with Uniform Thickness /393
16.5 Typical Cases of Digital Micro Restoration Aided by 3D Printing TRS Guide with Non-uniform Thickness /410
16.5.1 A Case of Digital All-Ceramic Crown of Maxillary Rotated Anterior Tooth Aided by 3D Printing TRS Guide with Non-uniform Thickness /410
16.5.2 A Case of Digital All-Ceramic Veneer of Maxillary Anterior Dental Fluorosis Aided by 3D Printing TRS Guide with Non-uniform Thickness /417
16.5.3 A Case of Immediate Restoration of Prefabricated Crown Aided by 3D Printing TRS Guide with Non-uniform Thickness /427
16.6 Typical Cases of Digital Micro Restoration Aided by Two-in-One TRS Guide for Implant Surgery and Tooth Preparation /436
16.6.1 A Case of Digital Micro Restoration Aided by Two-in-One TRS Guide for Implant Surgery and Tooth Preparation /436
16.7 Summary and Prospect /452
Suggested Readings /452
