DR. DENNIS HARTLIEB
Zirconia Bridge Technique: Conservative Esthetic Tooth Replacement
Discover how to use resin cement to secure Zirconia Bonded Bridges and create minimally invasive, esthetic tooth replacement.
Drag to resize
(Read time 7-9 minutes)
It’s Not Your Dad’s Maryland Bridge
The need for conservative dental treatment to replace a missing anterior tooth – i.e. dentistry that doesn’t destroy the neighboring teeth with preparations for traditional crown and bridge treatment has been a concern for dentists for decades.
The movement towards minimally invasive dentistry has been advanced with the improvement of adhesive and restorative materials, and the bonding techniques to ensure restorative success. With proper adhesive protocols, utilizing minimal tooth preparation techniques, tooth replacement restorations can be created that are both esthetic and functional. Minimizing tooth reduction for the restoration (less drilling) should improve the long-term survivability of the patient’s teeth.
Write your awesome label here.
Write your awesome label here.
Write your awesome label here.
Write your awesome label here.
Drag to resize
Three Reasons why the Replacement of Anterior Teeth Might be Necessary:
-
There is an estimated 2% of people born with congenitally missing maxillary lateral incisors1 that need tooth replacement options during their adolescent years.
-
Teeth that have been lost due to trauma, such as cases where the tooth has been completely avulsed, or ‘knocked out.’
-
A tooth that has been lost secondary to previous trauma.
Write your awesome label here.
Write your awesome label here.
These traumatized teeth can manifest with resorptive lesions or peri-radicular breakdown secondary to root fracture.
Write your awesome label here.
Write your awesome label here.
The replacement of these missing anterior teeth must be completed in an esthetic manner, with an understanding that both the tooth structure and soft tissues (gum tissue and mucosa) may need to be replaced or enhanced.
Also, paramount to restorative success is an understanding of the functional and parafunctional tooth contacts as patients use their teeth in their day-to-day living.
Also, paramount to restorative success is an understanding of the functional and parafunctional tooth contacts as patients use their teeth in their day-to-day living.
Write your awesome label here.
Write your awesome label here.
Drag to resize
Removable Treatment Options to Replace the Missing Anterior Tooth
There is a myriad of prosthetic options to replace the missing anterior tooth in today’s dental world. There are several removable treatment options to replace missing teeth, including the use of a removable partial denture (a metal-based prosthesis that “clasps”, or grabs onto other teeth in the dental arch with a denture tooth, or teeth, to replace the missing teeth).
1. Dental Flipper
A dental ‘flipper’ which has an acrylic, or plastic base that supports a denture tooth – is a commonly used prosthesis for adolescents that are missing their teeth for temporary tooth replacement.
2. Utilizing a Patient's Invisalign Tray
Another common technique currently used for short term tooth replacement is to utilize a patient’s Invisalign tray, or a similar clear plastic retainer, with a tooth colored resin or acrylic inside the clear shell to make it appear that the patient has a tooth in place while wearing the retainer.
While all of these options have the advantage of minimizing dental treatment to the surrounding teeth, and the financial investment may be minimized, many patients are unhappy with the challenges of wearing a removable appliance.
While all of these options have the advantage of minimizing dental treatment to the surrounding teeth, and the financial investment may be minimized, many patients are unhappy with the challenges of wearing a removable appliance.
Six Potential Challenges Presented by the Removable Prosthesis
- Eating with the
appliance can be difficult as the appliance can ‘move’ during chewing
- Speech may be
affected due to the necessary thickness of the base material necessary to
support the denture tooth (teeth)
- Esthetic Limitations - There are esthetic
limitations of the replacement teeth
- The ‘losability’ of
the appliance – it is not uncommon to hear that a flipper or temporary
removable retainer was accidently thrown out or lost when a patient had left
the appliance out of their mouth
- Uncomfortable - Many patients will
find the appliance uncomfortable and will wear only socially
- Social Limitations - There can be social
issues related to having a missing front tooth. In my 30+ years of dental practice, I have yet to have an adolescent, or an adult, excited to have a removable prosthetic option for their missing front tooth.
Drag to resize
Drag to resize
FEATURED RESOURCE
Zirconia Resin Bonded Bridges:
Key to Single-Wing Prep Design Success Guide
Key to Single-Wing Prep Design Success Guide
Drag to resize
Drag to resize
"Fixed" Treatment Options to Replace the Missing Anterior Tooth
The alternative to a removable prosthesis is what is referred to as a ‘fixed’ dental restoration. The term ‘fixed’ implies that the restoration, or prosthesis, is not removable by the patient. The prosthesis could be cemented (glued), bonded (chemical adhesion), or screw-retained (yep, exactly as it sounds – a screw – or screws – are used to hold the prosthesis to dental implants)
For the missing anterior tooth, there are several fixed, or non-removable, options used commonly today.
For the missing anterior tooth, there are several fixed, or non-removable, options used commonly today.
1. Traditional, or Conventional Bridge
With a traditional, or conventional bridge, the teeth adjacent to the missing tooth space are prepared for crowns, and a dental bridge is fabricated by a dental laboratory. The bridge, or ‘fixed partial denture’ is cemented to the neighboring teeth. These bridges can be made from a variety of materials, including the use of a metal base with porcelain baked onto the surface of the metal to create an esthetic tooth replacement. More currently, Zirconia, a tooth colored dental restorative material, can be used to create the bridge for the missing tooth maximizing the esthetics.
Dental bridges are still commonly used in dentistry, and can be used when working on natural teeth, or dental implants. The disadvantage of dental bridges is the inherent drilling necessary to the ‘abutment’ teeth that support the bridge. The teeth that are drilled become more compromised due to the treatment, and are more prone to nerve damage issues along with other potential problems. There are, however, still many indications for traditional bridges where other treatment options are not reliable, predictable or practical.
2. Cantilevered Bridge
A cantilevered bridge is also an option for replacing a missing anterior tooth. If the abutment tooth that is supporting the cantilevered pontic is healthy with appropriate preparation height, root length and stability, it may not be necessary to include both teeth on either side of the pontic space in the restorative treatment. I have used both a maxillary central incisor as single abutments:
Write your awesome label here.
Write your awesome label here.
Write your awesome label here.
and canines as single retainers with cantilevered lateral incisor pontics with long-term success with multiple patients.
Write your awesome label here.
Write your awesome label here.
Write your awesome label here.
Dental implants have evolved as a tremendous opportunity to replace missing teeth with an estimated 450,000 dental implants placed annually around the world.2
Dental implants have
the advantage of providing the patient with a tooth without any additional
treatment to the neighboring teeth.
Write your awesome label here.
Write your awesome label here.
Limitations of Dental Implants
There are some limitations to dental implants however – there must be adequate space between the neighboring teeth and there must be sufficient bone and gum tissue to support the implant.
1. Placement
It is critical that the implant is placed in the appropriate 3-dimensional space by the surgeon and that care is taken by the restorative dentist when fabricating and placing the crown onto the implant.
2. Patients that are Still Growing
Dental implants should not be placed on individuals that are still exhibiting facial growth. An implant will maintain its position in the patient’s facial bone, and if there is facial growth, the teeth will move downward, and forward, as the face grows. The clinical significance of placing an implant too early is that the implant will not move and emerge with the teeth, creating a discrepancy in the positioning of the implant tooth relative to the natural teeth.
The implant tooth will appear shorter at the incisal edges, relative to the other teeth in the smile as the teeth move downward and forward with the facial growth. As a result, the gum line of the dental implant will be more apical, creating an imbalance at the soft tissue level.
The implant tooth will appear shorter at the incisal edges, relative to the other teeth in the smile as the teeth move downward and forward with the facial growth. As a result, the gum line of the dental implant will be more apical, creating an imbalance at the soft tissue level.
3. Age
Recent evidence suggests that dental implants should not be placed in the esthetic zone until a person is in their 20’s, perhaps even into their 30’s because of latent facial growth3.
This is of course a real concern for adolescents and the young adult population that have congenitally missing teeth or for those that have had teeth lost due to trauma.
How the Rochette Bridge Became the Maryland Bridge
Prior to the development of dental implants, an option for conservative tooth replacement was presented in 1973, by Dr. Alain Rochette4.
The restorative solution, described as a ‘Rochette Bridge”, was a two-winged metal-based bridge that utilized pin holes and retentive preparation designs on the lingual or palatal surfaces of the abutment teeth to support a cemented bridge.
These metal-based tooth replacements where the first step in conservative based dentistry to replace a missing front tooth. With the advent of adhesive dentistry, the Rochette Bridge was transformed and later became better known as the “Maryland Bridge”.
The Maryland Bridge was the first ‘Resin Bonded Bridge’ (RBB) and was developed by Drs. Livaditis and Thompson, from the University of Maryland College of Dental Surgery.
The Maryland bridge design and technique were dependent on utilizing a specific metal etching technique which made the retentive holes, slots, or other preparation features found in the Rochette Bridge unnecessary.
However, there were challenges with the Maryland bridges, including, the shine thru of the metal through the teeth which could make the neighboring teeth look dark, or create a grey, unaesthetic cast to the teeth.
The restorative solution, described as a ‘Rochette Bridge”, was a two-winged metal-based bridge that utilized pin holes and retentive preparation designs on the lingual or palatal surfaces of the abutment teeth to support a cemented bridge.
These metal-based tooth replacements where the first step in conservative based dentistry to replace a missing front tooth. With the advent of adhesive dentistry, the Rochette Bridge was transformed and later became better known as the “Maryland Bridge”.
The Maryland Bridge was the first ‘Resin Bonded Bridge’ (RBB) and was developed by Drs. Livaditis and Thompson, from the University of Maryland College of Dental Surgery.
The Maryland bridge design and technique were dependent on utilizing a specific metal etching technique which made the retentive holes, slots, or other preparation features found in the Rochette Bridge unnecessary.
However, there were challenges with the Maryland bridges, including, the shine thru of the metal through the teeth which could make the neighboring teeth look dark, or create a grey, unaesthetic cast to the teeth.
Also, despite the advances in adhesion in dentistry in the 1980’s, it was not uncommon for one, or both of the metal retainers to debond from the neighboring teeth.
Potential Complications from the Maryland Bridge
One Debonded Wing
The most severe complication with the Maryland Bridge would be when one wing remained bonded to its tooth, while the other wing debonded. The debonded tooth would invariably suffer from dental caries as bacteria would be trapped under the ‘loose’ wing with the patient unable to clean the area.
Improper Preparation
These debondings could occur from improper treatment of the metal by the lab technician or by poor preparation design or adhesion protocols employed by the dentist.
Occlusal Forces
However, unilateral debondings could also occur from the occlusal forces from the patient, even if there was strict attention to proper protocols by the dentist and lab technician. These debondings could occur secondary to occlusal pressures from chewing and other occlusal forces on the teeth.
Considering the replacement of a maxillary lateral incisor, during normal function, we would expect occlusal forces to ‘push’ the central incisor abutment tooth in a facial direction. However, in a normal Class I occlusion, the forces on the canine would be more in a lateral direction.
These occlusal forces, being in opposite directions, create tension in the adhesive interface and commonly, with one of the wings debonding from the abutment tooth.
Considering the replacement of a maxillary lateral incisor, during normal function, we would expect occlusal forces to ‘push’ the central incisor abutment tooth in a facial direction. However, in a normal Class I occlusion, the forces on the canine would be more in a lateral direction.
These occlusal forces, being in opposite directions, create tension in the adhesive interface and commonly, with one of the wings debonding from the abutment tooth.
Drag to resize
Drag to resize
FEATURED RESOURCE
Zirconia Resin Bonded Bridges: Mastering Materials and Cementation Technique Guide
Check your inbox! We sent the file to your e-mail address. You may also download the cementation guide now.
Drag to resize
Drag to resize
How long do Zirconia Bridges Last?
Multiple clinical studies have compared unilateral, or single-winged Zirconia Resin Bonded Bridges’ survival rate with the two-winged RBB’s.
Write your awesome label here.
Write your awesome label here.
Matthias Kern reported a 92% 5-year success of single-wing RBB’s compared to a 67% survival rate for two-winged RBB’s.
Kern’s 10-year study showed a 91% survival rate demonstrating that these single-winged bonded restorations can be a reliable conservative tooth replacement option for the missing anterior tooth.
In his book, “RBFPD’s – Resin-Bonded Fixed Dental Prostheses, Kern states that the sole reason for failure of the bridges in their study was due to fracture of the restorative material. The restorative material utilized for the RBB’s at the time of his studies Alumina Oxide, more commonly recognized as InCeram.
While InCeram was an improvement in the strength of tooth colored, non-metal restorative materials, its strength falls significantly short of the zirconia materials available in dentistry today.
Kern noted that none of the bridge failures were related to adhesive failures. Given that our materials and understanding of adhesive bonding is significantly advanced over the last several decades, we should conclude that a single-winged bridge made of a stronger material (zirconia) with improved adhesive techniques should match, or exceed, performances previously recorded.
While InCeram was an improvement in the strength of tooth colored, non-metal restorative materials, its strength falls significantly short of the zirconia materials available in dentistry today.
Kern noted that none of the bridge failures were related to adhesive failures. Given that our materials and understanding of adhesive bonding is significantly advanced over the last several decades, we should conclude that a single-winged bridge made of a stronger material (zirconia) with improved adhesive techniques should match, or exceed, performances previously recorded.
Overall, there are several reasons for treatment planning single winged ZRBB’s including higher long-term success rates, improved hygiene with the ability to floss in between the non-restored contact and slide the floss under the pontic, and reduction in preparation complexity with only one abutment.
While single winged bonded restorations may be advantageous in many single tooth replacement situations, two-winged zirconia bonded bridges still may be appropriate when more than one tooth is being replaced, or for treatment considerations when additional restorative treatment is needed on anchoring teeth.
While single winged bonded restorations may be advantageous in many single tooth replacement situations, two-winged zirconia bonded bridges still may be appropriate when more than one tooth is being replaced, or for treatment considerations when additional restorative treatment is needed on anchoring teeth.
Write your awesome label here.
Write your awesome label here.
Write your awesome label here.
Write your awesome label here.
How Thick Should a Zirconia Bond be for Maximum Bondability?
There is no universal agreement on the wing design for the Zirconia RBB.
Sillam et al reported in their paper “Influence of the amount of tooth surface preparation on the shear bond strength of zirconia cantilever single-retainer resin -bonded fixed partial denture”5
that the key determinate for survival of the single-wing, or cantilevered RBB is the connector site being 4mm x 3mm, or 12 mm2.
The shear bond strength to dislodge a 7 mm wide wing had no statistically significant difference compared to a 3.5 mm wide wing. Failures of all the bridges tested were adhesive in nature, with no failure of restorative material reported.
Additional information on zirconia research has demonstrated that the minimal thickness of the zirconia material should be 1.0 mm6. Based on this information, it can be concluded that a retainer wing should be 1.0 mm thick, 3.5 mm from proximal to the cingulum, and about 4.0 mm tall.
The shear bond strength to dislodge a 7 mm wide wing had no statistically significant difference compared to a 3.5 mm wide wing. Failures of all the bridges tested were adhesive in nature, with no failure of restorative material reported.
Additional information on zirconia research has demonstrated that the minimal thickness of the zirconia material should be 1.0 mm6. Based on this information, it can be concluded that a retainer wing should be 1.0 mm thick, 3.5 mm from proximal to the cingulum, and about 4.0 mm tall.
Critically, the proximal box must be 12.0 mm2 for sufficient zirconia bulk at the connector site (the area where the pontic joins the wing).
I have found from clinical practice that the seating and delivery of the single-winged cantilevered restoration can be more predictable with a larger wing. With a small wing, there can be reduced stability of the prosthesis during bonding of the zirconia RBB.
APC Protocol for Securing Zirconia Resin Bonded Bridges
Dedication to precise protocol during bonding of the bridge is critical for predictable adhesion. The ‘APC’ concept promoted by Dr. Marcus Blatz is generally considered to be the standard for zirconia bonding technique7.
The ‘A’ of the ‘APC’ concept stands for air abrasion – the zirconia should be lightly air abraded with 25-50 micron aluminum oxide. I also air abrade the tooth restorative surface to clean the preparation and maximize bond strength prior to cementation.
The ‘P’ refers to the need to prime the zirconia surface. Primers that contain the 10-MDP monomer (methacryloyloxydecyl dihydrogen phosphate) are critical for zirconia bonding.
10-MDP is found in many of the Universal resin cements currently used in dentistry, including Panavia V (Kurrary), Rely X Unicem (3M) and SpeedCem Plus (Ivoclar).
The third step, or the ‘C’ in the zirconia bonding concept, is that an adhesive composite resin is utilized for the cementation.
How I Use Resin Cement to Secure Zirconia Bonded Bridges
Step 1.
The resin cements used for zirconia bonding should be dual-cured, as the zirconia may be too opaque for complete light curing options.
Research has found that the though the dual-cure cements can be cured with only the chemical initiation, light activation has proven to create a stronger resin cement.
Research has found that the though the dual-cure cements can be cured with only the chemical initiation, light activation has proven to create a stronger resin cement.
Step 2.
After isolation, the tooth should be etched and appropriate adhesion protocol followed. The restoration should be properly positioned and excess cement removed with artist’s brushes, microbrushes, and floss prior to light curing.
After light polymerization, excess cement can be removed with scalers, surgical blades and rotary instrumentation.
After light polymerization, excess cement can be removed with scalers, surgical blades and rotary instrumentation.
Step 3.
The patient’s occlusion is checked to minimize excursive forces on the pontic and the connector site.
It is critical that the connector area is not thinned from adjusting – if necessary, the opposing tooth contact(s) should be adjusted to maintain the 12.0 mm squared thickness of material.
It is critical that the connector area is not thinned from adjusting – if necessary, the opposing tooth contact(s) should be adjusted to maintain the 12.0 mm squared thickness of material.
Step 4.
Final polishing of the resin cement and the zirconia surfaces is critical for the long-term success of the restoration.
Write your awesome label here.
Write your awesome label here.
Write your awesome label here.
Write your awesome label here.
The Zirconia Resin Bonded Bridge Technique:
A Restorative Treatment Option for Patients Missing Anterior Teeth
The Zirconia RBB has proven to be an important restorative treatment option for my dental practice. The treatment of adolescents and young adults that either have congenitally missing anterior teeth, or have lost teeth due to trauma, require conservative tooth replacement restorative solutions.
The restorative replacement of the missing tooth should have minimal tooth preparation and must be esthetic and long lasting. Special attention to preparation design and cementation protocol is critical to the long-term success of the zirconia resin bonded bridge.
The restorative replacement of the missing tooth should have minimal tooth preparation and must be esthetic and long lasting. Special attention to preparation design and cementation protocol is critical to the long-term success of the zirconia resin bonded bridge.
Connecting Dentists with Quality, Interactive Dental Training
My goal is to promote information that provokes authentic, comprehensive, continuous, creative, and challenging learning experiences, and invite others to give their feedback.
If you feel strongly about Zirconia Resin Bonded Bridges, join our community and participate in the discussion.
If you feel strongly about Zirconia Resin Bonded Bridges, join our community and participate in the discussion.
Drag to resize
Related courses:
→ A New Perspective on Occlusion and TMD with Dr. Jim McKee
→ Masking the Dark Tooth with Direct Resin
→ Masking the Dark Tooth with Direct Resin
Drag to resize
Citations
1) Agenesis of the permanent lateral incisor: distribution, number and sites. Stamatiou J., Symons A.L. J. Clin. Pediatr. Dent. 1991;15(4):244–246
2) Current trends in dental implants, Laura Gaviria, John Paul Salcido, Teja Guda, and Joo L. Ong , J Korean Assoc Oral Maxillofac Surg. 2014 Apr; 40(2): 50–60.
3) Effect of age on single implant submersion rate in the central maxillary incisor region: a long-term retrospective study, Devorah Schwartz-Arad, Nitzan Bichacho, Clin Implant Dent Relat Res 2015 Jun;17(3):509-14
4) RBFPD; Resin-Bonded Fixed Dental Prostheses: Minimally invasive - esthetic – reliable, Kern, M, October 2017, Edition: 1, Quintessence
5) Influence of the amount of tooth surface preparation on the shear bond strength of zirconia cantilever single-retainer resin-bonded fixed partial denture. Charles-Ellie Sillam 1, Sibel Cetik 1 2, Thai Hoang Ha 1, Ramin Atash 1. J Adv Prosthodont. 2018 Aug;10(4):286-290.
6) Load-bearing capacity and the recommended thickness of dental monolithic zirconia single crowns, Sun, T et al, J Mech Behav Biomed Mater. 2014 Jul;35:93-101.
7) How to Bond Zirconia: The APC Concept, Blatz, M et al. Compend Contin Educ Dent. 2016 Oct;37(9):611-617
Dennis Hartlieb, DDS, AAACD
DOT Founder
Share this page
Join 10,000+ dentists who get tips bi-weekly.
Thank you!
By signing up you agree to our Privacy Policy.
Latest from our blog
Our vision is to provide online continuing education workshops and mentorship that are comprehensive for dentists learning at all career levels. DOT is developed for dentists that love to learn online.
CONNECT
Write your awesome label here.
Join over 10,000+ dentists who get restorative tips bi-weekly!
Check your inbox! We will send you the video in the next few minutes.
Materials Included
Light Brown tints, Enamelize, Unfilled Resin Flexidiscs, Flexibuffs 1/2", #1 artist’s brush, Silicone Polishing Points, IPC Off Angle Short Titanium Coated Composite Instrument
Materials Needed, not Included
- Loupes
Meet Dr. Dennis Hartlieb
Dr. Dennis Hartlieb owns his own practice in Chicago,IL and has been teaching dentistry for over 30 years. Dr. Hartlieb is the CEO and the main instructor at Dental Online Training. He is an active member in the American Academy of Cosmetic Dentistry where he’s both an Accredited Member and Examiner for Accreditation.
Dr. Hartlieb is also the President of the Chicago Academy of Interdisciplinary Dentofacial Therapy, and a member of the prestigious American Academy of Restorative Dentistry.
Dr. Hartlieb is also the President of the Chicago Academy of Interdisciplinary Dentofacial Therapy, and a member of the prestigious American Academy of Restorative Dentistry.
Meet Dr. Angela Luek
Dr. Angela M. Lueck is a Wisconsin native and was the youngest female in her class from Marquette University in 1998. Since completing her residency she has consistently taken more than 100 hours a year of continuing education to keep current on the latest trends, techniques, and materials available in dentistry.
She volunteers her time to teach at Marquette University providing the students additional training with anterior and posterior bonding techniques as well as dental photography. She is also the co-chair of the mentorship program at the University. Dr. Lueck has been voted as one of Milwaukee’s top dentists multiple times by Milwaukee Magazine.
She volunteers her time to teach at Marquette University providing the students additional training with anterior and posterior bonding techniques as well as dental photography. She is also the co-chair of the mentorship program at the University. Dr. Lueck has been voted as one of Milwaukee’s top dentists multiple times by Milwaukee Magazine.
Meet Clare O'Neill
Clare O’Neill is the Director of Operations at Dental Online Training and has a professional background in digital marketing. Clare has certifications in content marketing and digital advertising. Clare has expertise in social media marketing, email marketing, content marketing, website management, and project management. Clare has been using Canva for over 5 years and is a self-proclaimed Canva Queen.
Clare graduated from Georgia State University with a Bachelor’s degree is Sociology. Clare wanted you to know that she is a dog person, loves the colors emerald green and periwinkle, and would eat french fries at every meal if she could!
Clare graduated from Georgia State University with a Bachelor’s degree is Sociology. Clare wanted you to know that she is a dog person, loves the colors emerald green and periwinkle, and would eat french fries at every meal if she could!
Meet Dr. Jim Mckee
Dr. McKee is a member of the Spear Resident Faculty. He has maintained a private practice since 1984 in Downers Grove, Illinois where he treats a wide variety of cases with a focus on predictable restorative dentistry. He is a member of the American Academy of Restorative Dentistry and former president of the American Equilibration Society.
He has lectured both nationally and internationally for over 25 years and directs several study clubs. Dr. McKee graduated from the University of Notre Dame in 1980 and earned his dental degree from the University of Illinois College of Dentistry in 1984.
He has lectured both nationally and internationally for over 25 years and directs several study clubs. Dr. McKee graduated from the University of Notre Dame in 1980 and earned his dental degree from the University of Illinois College of Dentistry in 1984.
Meet Kirk Behrendt
Kirk Behrendt is a renowned consultant and speaker in the dental industry, known for his expertise in helping dentists create better practices and better lives.
With over 25 years of experience in the field, Kirk has dedicated his professional life to optimizing the best systems and practices in dentistry.
Kirk Behrendt is the founder of ACT Dental, and his vision is driven by the commitment to provide highly personalized care to the dental profession. By creating a talented team of experts, Kirk and his team continue to positively impact the practice of dentistry on practice at a time. Kirk lectures all over the world to help individuals take control of their own lives.
With over 25 years of experience in the field, Kirk has dedicated his professional life to optimizing the best systems and practices in dentistry.
Kirk Behrendt is the founder of ACT Dental, and his vision is driven by the commitment to provide highly personalized care to the dental profession. By creating a talented team of experts, Kirk and his team continue to positively impact the practice of dentistry on practice at a time. Kirk lectures all over the world to help individuals take control of their own lives.
Meet Dr. Melissa Seibert
Melissa Seibert is a comprehensive dentist proudly serving in the Air Force. She holds a dual faculty appointment at Uniformed Services University and Creighton Dental School. She serves on the editorial board for Inside Dentistry.
Her current research projects involve investigating ceramic overlays, zirconia and salivary contamination of universal adhesives. Dr. Seibert is the creator and host of the top dental podcast, Dental Digest. She lectures to national and international audiences.
Her current research projects involve investigating ceramic overlays, zirconia and salivary contamination of universal adhesives. Dr. Seibert is the creator and host of the top dental podcast, Dental Digest. She lectures to national and international audiences.
Meet Olivia Wisden
Olivia Wisden is the founder & CEO of TwoLips Creative. What started as an events discovery app pivoted into a creative agency that specializes in working with startups, small businesses, and organizations who are looking for bold, impactful designs and strategies.
She has worked with dozens of brands over the years ranging from the City of Madison to product launches and beyond.
She has worked with dozens of brands over the years ranging from the City of Madison to product launches and beyond.
Meet Dr. Sofya Kats
Dr. Sofya Kats is local to Milwaukee, WI. She grew up in Bayside and attended Nicolet HS, UW-Milwaukee and Marquette University School of Dentistry. Dr. Kats is a member of the Greater Milwaukee Dental Association, Wisconsin Dental Association, American Dental Association, and The Forum Study Club (oldest Dental Study Club in the United States).
Dr. Kats loves the art of dentistry, and healing it can bring to her patients. She volunteers her time by going on international dental mission trips and local events, such as the Mission of Mercy (free dental care sponsored by the Wisconsin Dental Association).
Dr. Kats loves the art of dentistry, and healing it can bring to her patients. She volunteers her time by going on international dental mission trips and local events, such as the Mission of Mercy (free dental care sponsored by the Wisconsin Dental Association).
Follow along
You are Registered
We’re excited to have you join us! You’ll receive email reminders at with the link to join this event.
If you have any questions in the meantime, feel free to reach out to us at dot@dothandson.com—we’re here to help!
Day 1 (8 - 4 pm CST)
-
Erosion and wear – the why and the how
-
Adding length to teeth – when is it safe
-
Opening VDO to compensate for lost tooth structure – where to begin
-
Records visit and key points you need to understand before you start
-
The smile – the 7 strategic points to consider when evaluating the smile
-
Anterior tooth shape, morphology
-
Clinical case review
-
Upper Putty matrix construction
-
Build lingual incisal wall with putty matrix #6 - #11/ Upper anteriors
-
Full contour build-up #6, #7, #8, #9, #10, #11, shape and polish/ Upper anteriors
Day 2 (8 - 2 pm CST)
-
Who – which patients are candidates
-
Why – explaining to patients the value of the prototype
-
How – step-by-step techniques to maximize predictability, efficiency and success
-
Getting to Yes: conversations with patients about esthetic and reconstructive dentistry
-
The ‘Smile Preview’ – techniques to show the possibilities
-
Lower Putty matrix construction
-
Build lingual incisal wall with putty matrix #22 - #27 / lower anteriors
-
Build-up #22 - #27, shape and polish / lower anteriors
-
Build-up lower occlusal posteriors
-
Demonstration of Smile Preview