Primary Dental Journal

The UK has an increasingly ageing population, many of whom are retaining more of their own teeth. This has led to an increase in the prevalence of tooth wear and the need to replace pre-existing failing restorations. In many cases this will be achieved by fixed prosthodontics. This paper provides a brief overview of important occlusal concepts that should be considered when providing non-implant fixed prosthodontics using either a conformative or reorganised approach. The aim is to give general dental practitioners the confidence to provide these types of restorations in primary care. Clinical cases demonstrate how the occlusion can be controlled to optimise clinical outcomes.

With increasing patient expectation for aesthetic dental restorations, there has been a drive towards developing ceramic materials to meet this expectation. Multiple ceramic systems have been introduced over the past four decades with considerable advances in material properties. Survival rates of all-ceramic crowns differ by type of ceramic used, fabrication method and clinical indication. Zirconia and lithium disilicate are the most commonly used contemporary ceramic materials in dentistry. Survival data for these types of restorations appears to be promising; however, there is a lack of high-quality long-term clinical data on the success of these restorations. In the absence of robust longitudinal clinical research, laboratory studies have provided some useful information on the performance of ceramic restorations. Further high quality long-term clinical studies are needed to inform us of modes of failure of these restorations and the range of clinical circumstances in which each type of ceramic restoration may be used.

An accurate interocclusal record is essential for the successful delivery of fixed prosthodontic restorations. There are various materials and techniques used to obtain an interocclusal record in order to facilitate mounting of the dental casts on an articulator. The interocclusal record describes the vertical and horizontal relationship of the maxillary and mandibular teeth. In circumstances where the vertical relationship is not supported through a tripod of widely spaced opposing contacts, the interocclusal record will be needed to restore this vertical support to prevent inaccurate mounting. The clinician should understand when an interocclusal record is required and have an awareness of the different materials and techniques available to record an interocclusal registration.

The provision of indirect restorations utilising contemporary materials for single or multiple abutment units in primary health care is an essential requirement for all general dental practitioners to ensure predictable patient outcomes. This paper highlights the important considerations for comprehensive planning and adept treatment execution and delivery that can enhance the patient's dental experience and outcome. A selection of clinical cases highlighting established and novel restorative materials utilising conventional and adhesive clinical techniques is presented and discussed.

In 2019, in a world of instant gratification, what are the expectations of patients and dentists? Is training sufficient to meet these expectations? Decisionmaking in dentistry impacts the treatment choices patients are given, and may influence the outcomes of such treatment. It is therefore important to ensure as much standardisation as possible. In order to achieve this, it is important to know the current standard and the views of dentist as this will influence dental treatment planning.