ry vol. 31 issue 4 vol. Cosmetic Dentist Cosmetic of 2016 al n INTER W The Dentin-Enamel Complex: & Opacity Translucency Evaluating A Powerful Protocol for Protocol A Powerful Details Intrinsic Color Replicating Amazing Transformations David M. Sarver Dr. Jour JOURNAL OF COSMETIC DENTISTRY VOLUME 31 • NUMBER 4 WINTER 2016 www.aacd.com Introducing Tetric EvoFlow ® Bulk Fill High Performance Posterior Flowable 4mm Tetr ic EvoCeram Bulk Fill 4mm Te tric EvoFlow Bulk Fill This will change the way you look at FLOWABLES! Tetric EvoFlow Bulk Fill features opacity shifting technology and the new Ivocerin® light-initiator for the high-performance dentin replacement material you’ve been looking for! NTED TE A P ™ Ivocerin R O L T 1 IG I A • SIMPLE - Restore deeper cavities in just two layers. H T INIT • FASTER - Cure increments up to 4mm in just 10 seconds.2 • BETTER - Self adapting technology resulting in improved marginal adaptation. SEESEE A 3D DEMONSTRATIONDEMONSTRATION 1 2 3 OFON HOW TOTO SAVE SAVE TIME TIME WITH WITHTETRIC TETRIC EVOFLOW EVOFLOW BULK FILL! ivoclarvivadent.us/evofl ow-bulk 1 Cavities up to 8mm 2Using curing light with an intensity ≥1,000 mw/cm2. © 2015 Ivoclar Vivadent, Inc. Ivoclar Vivadent, Ivocerin, Tetric EvoFlow and Tetric EvoCeram are trademarks of Ivoclar Vivadent, Inc. 8518_TEFBF_JCD.indd 1 11/19/15 2:23 PM A PEER-REVIEWED PUBLICATION OF THE AMERICAN ACADEMY OF COSMETIC DENTISTRY EDITORIAL REVIEW BOARD Pinhas Adar, MDT, CDT, Atlanta, GA vol. 31 issue 4 Irfan Ahmad, BDS, Middlesex, United Kingdom Gary Alex, DMD, AAACD, Huntington, NY Journal of Cosmetic Dentistry Edward P. Allen, DDS, PhD, Dallas, TX Chad J. Anderson, DMD, MS, Fresno, CA EDITOR-IN-CHIEF Edward Lowe, DMD, AAACD Elizabeth M. Bakeman, DDS, FAACD, Grand Rapids, MI Vancouver, BC, Canada, [email protected] Lee Ann Brady, DMD, Glendale, AZ EXECUTIVE DIRECTOR Barbara J. Kachelski, MBA, CAE, [email protected] Ricardo M. Carvalho, DDS, PhD, Vancouver, BC, Canada MANAGING EDITOR Tracy Skenandore, [email protected] Christian Coachman, DDS, CDT, Sáo Paulo, Brazil John C. Cranham, DDS, Chesapeake, VA EDITORIAL ASSISTANT Denise Sheriff, [email protected] Michael W. Davis, DDS, Santa Fe, NM ART DIRECTOR/DESIGNER Lynnette Rogers, [email protected] Gerald E. Denehy, DDS, Iowa City, IA GRAPHIC DESIGNER Sherry Misener, [email protected] Newton Fahl Jr., DDS, MS, Curitiba-PR, Brazil EDITORIAL CONSULTANT Juliette Kurtz, [email protected] Jonathan L. Ferencz, DDS, FACP, New York, NY MANUSCRIPT Scott W. Finlay, DDS, FAACD, Arnold, MD DEVELOPMENT LIAISON Allison DiMatteo, MPS, [email protected] Hugh D. Flax, DDS, AAACD, Atlanta, GA David A. Garber, DMD, Atlanta, GA CHIEF MARKETING OFFICER Michael DiFrisco, [email protected] Ronald E. Goldstein, DDS, FACD, FICD, Atlanta, GA Steve D. Hoofard, CDT, AAACD, Hermiston, OR Kenneth Hovden, DDS, AAACD, Daly City, CA CONTRIBUTING EDITORS Julie M. Gillis, DDS, AAACD, Grand Junction, CO Nelson Y. Howard, DDS, AAACD, San Marcos, CA James H. Peyton, DDS, FAACD, Bakersfield, CA Ronald D. Jackson, DDS, FAACD, Middleburg, VA J.A. Reynolds, DDS, AAACD, Franklin, TN Sang K. Jun, CDT, Monterey, CA Gregory B. Wright, DDS, FAACD, Southlake, TX Michael J. Koczarski, DDS, AAACD Woodinville, WA John C. Kois, DMD, MSD, Seattle, WA Gerard Kugel, DMD, MS, PhD, Boston, MA EDITORIAL MISSION Cobi J. Landsberg, DMD, Tel Aviv, Israel The mission of the Journal of Cosmetic Dentistry is to educate AACD members, as well as other Ryan Langer, AAACD, Eagle, ID professionals in the field, on the art and science of cosmetic dentistry. We will endeavor to David A. Little, DDS, San Antonio, TX do this by publishing well-researched, peer-reviewed articles accompanied by high-quality, Robert A. Lowe, DDS, Charlotte, NC comprehensive clinical imagery. The objective is to enhance readers’ knowledge and skills while Robert C. Margeas, DDS, Des Moines, IA showcasing the latest cosmetic techniques and procedures. The Journal of Cosmetic Dentistry Frank J. Milnar, DDS, AAACD, St. Paul, MN will strive to help readers become better clinicians, so they can offer their patients the best— and most responsible—treatment possible. Ricardo Mitrani, DDS, MSD, Mexico City, Mexico Carlos A. Munoz, DDS, MSD, Buffalo, NY ADVERTISING POLICY Thomas W. Nabors lll, DDS, AAACD, Nashville, TN All advertising appearing in the Journal of Cosmetic Dentistry (jCD) is approved by the editorial W. Peter Nordland, DMD, MS, La Jolla, CA team. Advertisements are not endorsed by the jCD or AACD. Aikaterini G. Papathanasiou, DDS, Boston, MA Gary M. Radz, DDS, Denver, CO AACD OFFICE Christopher D. Ramsey, DMD, AAACD, Jupiter, FL Nelson A. Rego, CDT, AAACD, Santa Fe Springs, CA 402 West Wilson Street, Madison, WI 53703 Dwight G. Rickert, CDT, AAACD, Indianapolis, IN 800.543.9220 • 608.222.8583 Robert G. Ritter, DMD, Jupiter, FL fax 608.222.9540 • [email protected] • www.aacd.com Matthew R. Roberts, CDT, AAACD, Idaho Falls, ID Henry Salama, DMD, Atlanta, GA Maurice A. Salama, DMD, Atlanta GA Advertising: 800.543.9220 • 608.222.8583 or [email protected] Michael R. Sesemann, DDS, FAACD, Omaha, NE Editorial: 800.543.9220 • 608.222.8583 or [email protected] Michael Sonick, DMD, Fairfield, CT Rhys D. Spoor, DDS, AAACD, Seattle, WA Thomas T. Teel, DDS, Fort Wayne, IN Thomas F. Trinkner, DDS, AAACD, Columbia, SC Reprints Eric Van Dooren, DDS, Antwerp, Belgium High-quality reprints with possible customization are available for authors and advertisers. Marcos A. Vargas, DDS, Iowa City, IA Please contact [email protected] and the jCD editorial staff will work with you to get the Nondas Vlachopoulos, CDT, Athens, Greece exact reprint you would like for your presentations, lectures, or patient literature. Dennis J. Wells, DDS, AAACD, Brentwood, TN Barbara Warner Wojdan, CDT, AAACD, Oldsmar, FL Journal of Cosmetic Dentistry 3 Journal of Cosmetic Dentistry • Winter 2016 • Volume 31 • Number 4 A peer-reviewed publication and member benefit of the AACD Features 42 Clinical Cover Case Severe Malocclusion: The Importance of Appropriately Timed Treatment v David M. Sarver, DMD, MS 54 Laminate Veneers & Flapless Crown Lengthening v Cristiano Soares, CDT Luciana Mara Soares, DDS, MSc 42 Guilherme Ferreira Duarte, DDS, MSc 70 Different Materials for Different Situations (CE article) v CE Alexandre dos Santos, CDT CREDIT Milko Villarroel, DDS, MS, PhD Andrea Sousa Villarroel DDS, MS, PhD Diana Garrigós Portales, DDS 82 AACD Self-Instruction Continuing Education v Column 54 8 Editor’s Message Time Well Spent... Edward Lowe, DMD, AAACD 70 HAVE YOU MOVED? ARE YOU PLANNING TO? LET US KNOW! Do you have a new address? Please help us to deliver your Journal of Cosmetic Dentistry (jCD) in a timely fashion. If you have a new mailing address, contact: [email protected] and let us know where we should deliver your copy of jCD. Thank you! 4 Winter 2016 • Volume 31 • Number 4 Isn’t it time your patient fi nancing measured up to your patient care? “ Same-day treatment acceptance has gone up since incorporating Lending Club Patient Solutions into our treatment presentation.” —Christina C., Senior Treatment Coordinator, Georgia “ Their high-quality customer service is unbeatable, plus they cost less than any other patient-fi nancing providers—a win for our patients and our practice.” —Dee Dee R., Patient Concierge, Texas Discover a new approach to patient fi nancing and see why we continue to get rave reviews. To learn how easy patient fi nancing can be: Call 844-766-7283 (844-766-SAVE) or visit lendingclub.com/providers. Formerly Springstone Patient Financing ©2015 Lending Club Patient Solutions products and services provided through Springstone Financial, LLC, a subsidiary of LendingClub Corporation. Payment plans made by issuing bank partners. Lending Club Patient Solutions Bleed = 8.875” x 11.375” Journal of Cosmetic Dentistry Ad - full page ad with bleed Trim = 8.375” x 10.875” Journal of Cosmetic Dentistry • Winter 2016 • Volume 31 • Number 4 A peer-reviewed publication and member benefit of the AACD Departments 10 Behind the Cover Smile Worth the Wait! v David M. Sarver, DMD, MS 14 Scientific Session—Toronto 2016 Orthodontics & Esthetic Dentistry: 14 Mission Possible! v David M. Sarver, DMD, MS 28 Accreditation Essentials Don’t Gamble in the Anterior Zone v Paul E. VreNon, DDS, MAGD 38 Examiners’ Commentary v Replicating Nature with a Dental Implant James H. Peyton, DDS, FAACD 28 The Journal of Cosmetic Dentistry (ISSN 1532-8910), USPS (10452), published quarterly. $200 per year (U.S. & Canada) or $240 per year (All other countries), single issues available upon request, by the American Academy of Cosmetic Dentistry®, 402 West Wilson Street, Madison, WI 53703. 800.543.9220 OR 608.222.8583. Periodicals postage paid in Madison, WI, and additional offices. POSTMASTER: send address changes to: AACD MISSION STATEMENT Journal of Cosmetic Dentistry American Academy of Cosmetic Dentistry The American Academy of Cosmetic Dentistry is dedicated to 402 West Wilson Street Madison, WI 53703 advancing excellence in the art and science of comprehensive cosmetic dentistry and encouraging the highest standards of ethical conduct and responsible patient care. Peer-reviewed articles are denoted with the following symbol: v Statements of fact and opinion are the responsibility of the authors alone and do not imply an opinion on the part of the officers of the AACD. Materials may not be reproduced without written permission. Contents© 2016 American Academy of Cosmetic Dentistry® The Journal of Cosmetic Dentistry maintains signed patient release forms for all articles featuring clinical or other patient photography. 6 Winter 2016 • Volume 31 • Number 4 EDITOR’S MESSAGE Time Well Spent... When I became editor of the Journal of Cosmetic Dentistry (jCD) five years ago, I was excited yet a bit apprehensive about how to fit this new opportunity into my already bursting schedule. While writing my first jCD editorial, I thought, “Why am I doing this?” The answer might surprise you.