The 3STEP Technique - Theory - Dr. Francesca Vailati

Full-mouth Adhesive Rehabilitation of Severely Eroded Dentitions

Erosionsskadade tänder är ett allt ökande problem hos våra patienter. Därför är det viktigt att vi har kunskapen om hur vi ställer en tidig diagnos, och inte minst hur vi behandlar så vävnadsbevarande som möjligt innan skadan blivit för stor.

 

De traditionella behandlingssätten med kronterapi innebär att mycket frisk tandvävnad tas bort. Alternativa metoder, baserade på adhesiv teknik, har använts och beforskats på protetikavdelningen vid Universitetet i Genève med mycket lovande resultat.

DAY 1 MORNING

1

With the improvement of adhesive techniques questions arise on the necessity of still relaying on friction to deliver dental restorations (360 degree preparation).

2

Removing intact tooth structure is an inevitable requirement in case of crown preparation to allow for a single path of insertion. The biological loss may be dramatic and often underestimated.

3

Since the biological success is the goal of this adhesive rehabilitation, to guarantee the thickness of the restorations, an increase of vertical dimension of occlusion (VDO) is planned for every patient.

4

The only limiting factor to the increase of the VDO is the position of the final contact points at the level of the anterior teeth.

5

Thanks to the use of palatal veneers, the incisal edges are reinforced and the pulp protected, eliminating the need of aggressive therapies (elective endodontic treatments and/or crown lengthening).

6

In case of major destruction of the vestibular aspect of the maxillary anterior teeth, another restoration (a ceramic facial veneer) may be delivered to the patient. The use of two veneers to restore a tooth is called Sandwich approach.

7

In case of Sandwich approach, clinicians may decide if the will remove completely the length added by the palatal composite veneer (total removal) and replace with the facial veneer or if the prefer to leave some of the palatal veneer’s length (partial re

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Thanks to the two different paths of insertion of the two veneers, palatal and facial, the mesial and the distal crests could be almost entirely preserved.

9

In addition, the vestibular aspect is also preserved by additive techniques, where the final restorations are always bulkier than original teeth restored.

10

The esthetic result of a full-mouth rehabilitation is very predictable, since the gingiva responds very well to veneers.

11

At the same token, teeth restored with crowns often present gingival inflammation and/or recession, pushing patients to ask for a crown remake.

12

Clinical outcome up to 7 years of full-mouth adhesive rehabilitations, following the 3 Step technique, shows aesthetic, mechanical and biological success very promising.

DAY 1 AFTERNOON

the CLASSIC 3 STEP Technique will be explained

Francesca Vailati - 3STEP - classic 3STEP 1

Francesca Vailati - 3STEP - classic 3STEP 1
How much increase the VDO? Which arch Distribution?

Francesca Vailati - 3STEP - classic 3STEP 2

Francesca Vailati - 3STEP - classic 3STEP 2
1. step of the 3 step-technique

Francesca Vailati - 3STEP - classic 3STEP 3

Francesca Vailati - 3STEP - classic 3STEP 3
2. step of the 3 step-technique

Francesca Vailati - 3STEP - classic 3STEP 4

Francesca Vailati - 3STEP - classic 3STEP 4
Direct Provisional Restorations

DAY 2 MORNING

Fabrication & evaluation of the palatal veneers

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The palatal veneers are innovative restorations for the maxillary anterior teeth, which allow the maximum tooth preservation with a very satisfactory result. However, their fabrication to their delivering is very sensitive to the clinician’s capacity of handling. In this theoretical part of the course, l details will be illustrated to facilitate the task.  

Clinical examples of mistakes will be illustrated. The participant will gather sufficient information to evaluate the work of their laboratory technician and to start comfortably this type of restorative procedure.

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DAY 2 AFTERNOON

Advanced approach of the 3 STEP technique will be shown

Clinical cases less complicated will be solved saving time and reducing the fee. This is called MODIFIED 3 STEP technique, which is perfect to treat patients affected by other problems such as bruxism.

The 3 step technique:

Full Mouth Adhesive Rehabilitation of Severely Eroded Dentitions

PROGRAM:

  1. Dental Erosion Ethiology and Conventional Therapy
  2. Ace Classification
  3. Classic 3 Step Technique Part 1 
  4. Classic 3 Step Technique Part II
  5. Palatal Veneers
  6. Treatment Planning for a Full Mouth Rehabilitation
  7. Modified 3 Step Technique: Reduction of the fee and the time of the therapy
  8. Bruxism and Dysfunctional Occlusion

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