Esthetic rehabilitation in fixed prosthodontics: esthetic analysis — A systematic approach to prosthetic treatment Volume 1

Edited by:
  • M. Fradeani
(Ed) UK: Quintessence price £156, pp352 ISBN 1850971080 | ISBN: 1-850-97108-0

This is a high-quality textbook with over 300 pages of information about assessing patients who are seeking aesthetic dental treatment. The numerous illustrations, on glossy pages with a black background, are superb in terms of clinical quality and photographic reproduction.

This is the first of two volumes and covers the aesthetic analysis of the face, lips, speech, teeth, and intra-oral soft tissues. Volume 2, which is yet to be published, will cover prosthetic rehabilitation.

There are many examples of high-quality dentistry on patients with healthy soft tissues, excellent oral hygiene, and a desire to have an improved smile. The cases demonstrate the author's and technician's blend of artistic and clinical skills, but the treatments are not conservative. Cases tend towards the full mouth ceramic reconstruction and there is an assumption that all spaces will be closed with a bridge or implant retained restoration.

The post-op views, where shown, are outstanding and the quality of clinical work and laboratory work is unquestionably of a very high standard. Unfortunately not all cases used in the text are shown with post-op views and it would also be preferable to see a few cases illustrated at a recall several years later to be able to assess the longer-term aesthetic gain.

The text begins with patient communication and surgery design showing Dr Fradeani's beautiful surgery in Italy. The next section is on facial analysis and, while this cannot be manipulated by dental work alone, it is of interest. Some advice such as looking at the patient from a distance to view the face, and closer to see the mouth and intraoral tissues, seems rather basic. However, the level of detail is generally suited to both the undergraduate and experienced clinician.

Subsequent sections go on to analyse tooth shape and the use of modified transition lines to provide illusion in tooth shape and size. Tooth proportions — the use of the Golden Proportion — dealing with crowding and spacing is also covered in detail, again supported by excellent illustrations and diagrams. The section dealing with mandibular incisors is particularly helpful. Further chapters cover function, aesthetics, occlusion, soft tissues and there is a short section dealing with aesthetics in patients with periodontal disease.

The book is very well presented in a readable style with a balance between text, examples and cases. Checklists provided in each section act as an educational reminder. There is a good example of an entire case assessment at the end of the book and an example of an assessment pro-forma that could be used by the reader.

This is a book to challenge the thinking of the reader, reminding the clinician to spend more time looking outside the patient's mouth and learn what is possible with current materials and techniques. All in all, an outstanding quality production which will inspire and educate at a level of detail suited to almost all members of the clinical team involved with aesthetic dentistry.