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This article demonstrates the use of a smile evaluation form as an adjunct in arriving at diagnosis and developing a treatment plan for a patient desiring Diastema closure. It also shows the importance of the diagnostic wax-up for temporization and visualization of case outcome. The case also demonstrates the use of soft tissue lasers to create a gingival harmony that enhanced the resulting esthetics. Feldspathic porcelain was used for the final restorations because they provide optimal esthetics and translucency., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Dentoalveolar surgery in children presents general dentists with unique challenges not encountered in adults. The long-term effects that treatments have on these children must always be taken into consideration. A clear understanding of the growth and development of pediatric patients is necessary to correctly identify dental abnormalities., (Published by Elsevier Inc.)

This article focuses on lasers and aesthetic dentistry and their unique parallel in history from their early development to their present day usage and application. The demand for aesthetic dentistry has had a major impact not only on treatment planning but also on the choice of materials, techniques, and equipment. It is this demand that has married the use of lasers with aesthetic dentistry. A short literature review on the five basic laser types precedes the basic premise of smile design and its critical importance in attaining the desirable aesthetic end result. A short review on biologic width and biologic zone reinforces their importance when manipulating gingival tissue. Four case reports highlight the use of diode, erbium, and carbon dioxide lasers. The end results show the power of proper treatment planning and the use of a smile design guide when using these instruments and confirm a conservative, aesthetic treatment without compromising the health and function of the patients.

Dental lasers contribute significantly to the field of cosmetic dentistry, providing an invaluable resource for clinicians who perform different types of esthetic procedures. Practitioners in this specialized field not only help patients acquire beautiful and ideal smiles and dental health, but also they assist patients in benefiting from tremendous clinical advantages, such as sterile surgical sites and increased comfort levels. Tooth whitening will always be an important component of cosmetic dentistry. Developing the most efficient and safe method of tooth whitening is the goal of power bleaching. Currently the argon laser has proved to be the most valuable energy source for power bleaching. Clinicians need to learn more about constantly updated technology and apply newly discovered methods and protocols to clinical situations to benefit patients and clinicians.

Laser use in reconstructive dental procedures (fixed, removable, or implant) provides a more controlled environment at the operative site. Control is a prerequisite for successful prosthetics and is accomplished by the unique ability of the laser to interact photo/thermally with biologic tissues using the lightest touch or none at all. Hemostasis is the result of this interaction by coagulating and sealing small blood and lymph vessels and vaporizing soft tissue. This hemostasis allows for more exact soft tissue contours to replicate or improve the periodontium before reconstruction, whether fixed or removable. The biologic seal is a unique phenomenon that occurs in the jaws of periimplant tissues of patients as a result of implant treatment. The biologic seal is paramount to the longevity and service of the implant. Use of dental laser technology provides the advanced laser and reconstructive dentist with the tool to improve the seal and improve the prognosis of the implant. The seal must be maintained by good oral hygiene and prophylactic procedures, however.

Minor preprosthetic surgical procedures used in correcting an existing problem or in preparing the mouth for prostheses must be based on an exact diagnosis and carefully planned and executed to satisfy clearly definable goals. This article emphasizes that philosophy and includes surgical techniques for managing commonly encountered problems as well as those problems associated with placement of immediate dentures. Predictable results with minimal complications can be expected when one adheres to these guidelines.

Mucogingival surgery currently encompasses surgical management of many defects thought to be untreatable when the term mucogingival surgery was introduced in the 1950s. Mucogingival surgery has now expanded beyond the treatment of recession and problems associated with attached gingiva. Additionally, it would now include correction of ridge form, exposing unerupted teeth for orthodontic treatment, crown lengthening for esthetic purposes, and frenal surgery. With this in mind, mucogingival surgery has been redefined as "periodontal plastic surgery."

Evaluation of periodontal status and proposed orthodontic therapy must be made prior to initiating tooth movement. Teeth with a compromised periodontium can be treated. Prior to initiation of orthodontic therapy, it may be necessary to perform periodontal surgery for pocket elimination or reduction, to perform mucogingival surgery, or to correct gross occlusal discrepancies.

Several of the abnormal conditions existing in the edentulous patient can be corrected surgically, prior to construction of dentures, to enable the patient to function more successfully following prosthetic restoration. The more common problems have been discussed which often require surgical correction. In some instances, articulated diagnostic models of the patient's mouth show that surgery can be avoided, or when surgery is necessary, these models help identify the exact locations of the tissue to be corrected. Alveolectomy has been presented with an eye toward conservatism since this procedure affects the quality of denture foundation and therefore denture stability. Alveolectomy should be performed only when there is a definite indication for the procedure. Correction of soft tissue abnormalities can substantially improve the patient's ability to function with dentures and solve many of the adjustment problems which confront the dentist. It is often better to correct the soft tissue abnormality rather than to circumvent the problem with an inferior prosthetic restoration. Since the introduction of resilient acrylics and tissue conditioning materials, the patient need no longer suffer the discomfort of denture withdrawal after surgery. Electrosurgery has emerged as a successful method of correcting many soft tissue abnormalities. Vestibuloplasty is receiving much emphasis as a possible treatment for atrophic ridges in which there is still enough alveolar bone from which to extend a sulcus. These sulcus extension procedures may offer some help in the future regarding the problem of resorbed ridges, but presently, more research is necessary before widespread use is recommended.