Vertical Preparation: Updated Concept for Aesthetic Rehabilitation

Vertical Preparation: Updated Concept for Aesthetic Rehabilitation

Category: Prosthodontics

Instructor(s): Marco Maiolino

Course structure: Lessons: 17 lessons | Duration: 8 h 44 min

Course overview

Explore the precision and artistry of vertical preparation with Dr. Marco Maiolino, a Vertiprep-driven specialist!

It's very important to approach all aesthetic cases from a prosthodontic and periodontic standpoint. The aim of indirect restorations is to achieve both healthy periodontal tissue and an aesthetic smile. With the vertical preparation technique, you will provide your patients a pink and white aesthetic and long-lasting treatment!

Course lessons

Lesson 1: Why Vertiprep?

• Updates on the Vertiprep technique:
• Bur protocols designed specifically for the Vertiprep technique
• Minimal prep
• Verticrowns
• Lap protocols designed specifically for the Vertiprep technique.
• Soft tissue stability with the Vertiprep approach
• Step-by-step lab protocols to achieve biological stability with the Vertiprep technique.

Lesson 2: Why not vertical?

• The history of vertical preparation
• Dental specialists opinion on vertical preparation then and now
• Evolution of vertical preparation technique
• Critical evaluation of the vertical preparation technique
• Periodontal aspect to vertical preparation technique
• Literature review and analysis of clinical cases.

Lesson 3: The foundation of long term dentistry

• The endo-prostho approach to a long lasting restoration
• Treatment approach to endodontically treated teeth
• Advantages of vertical preparation technique. Minimal invasive approach
• Evaluation of tooth fracture risks in various clinical cases
• Occlusal load evaluation in the vertical preparation technique
• Compressive and tensile toughness of tooth structure and dental prosthetic restorative materials
• Material selection for prosthetic restorations
• The ferrule effect
• Analysis of clinical cases.

Lesson 4: Flame-shaped bur vs Batt-shaped bur. Indication, advantages and clinical application

• Features of of the flame-shaped bur
• Analyzing results of clinical cases using the flame-shaped bur
• The Toe-Heel Concept. Application of the Toe-Heel concept during preparation
• Preparation protocols using the flame-shaped bur. Evaluation of the most common mistakes
• Steps to dealing with supragingival and subgingival undercuts
• Indication and advantages of working the batt-shaped bur
• Conventional approach vs edgeless preparation approach
• When to take impressions: perfect timing
• Step-by-step video demonstration of tooth preparation with the vertical preparation technique using a batt-shaped bur
• Analysis of clinical cases and long-term results.

Lesson 5: Tooth preparation strategies and techniques and emergence profile

• The technique of maximum enamel saving
• The correct bur axis when preparing the tooth
• Excessive tapering of the restoration and how to avoid it
• Minimal invasive preparation for maximum dentin preservation
• Selective dentine drilling technique for anterior teeth
• Selective dentine drilling technique for compromised teeth
• The emergence profile consideration with vertical preparation technique.

Lesson 6: The inverted shoulder approach and minimal invasive approach of tooth preparation

• Critical biomechanical zones of the tooth
• Evaluation of occlusal contact
• Determination of the critical area of thickness for occlusal stability
• Protocols of inverted shoulder preparation
• Features of preparation, finishing the abutment and impression taking
• Clinical cases analysis of application of inverted shoulder preparation approach.

Lesson 7: Laboratory protocols of manufacturing provisional crowns

• Analysis of common mistakes when preparing a tooth
• How to avoid interference between the provisional crown and the tooth?
• Analysis of common mistakes when manufacturing provisional crowns
• A confirmed and recognized approach to provisional prosthetics. Clinical cases
• Step-by-step Video demonstration of analogic temporary crown fabrication:
• Fabrication protocols of posterior temporary crowns
• Fabrication protocols of anterior temporary crowns.
• Evaluation of tooth and soft tissue margins in relation to the temporary crowns
• Tricks and lifehacks of provisional prosthetics
• Analysis of clinical cases.

Lesson 8: Video guide of tooth preparation and laboratory protocols of manufacturing provisional crowns

• Video demonstration of a clinical case in an endo-prostho approach for clinical crown lengthening:
• Full steps of an endo surgery and retrograde obturation
• Tooth preparation protocols for a full crown restoration.
• Step-by-step protocols for manufacturing digital provisional crowns on EXOCAD
• Protocols of finishing and polishing of the digital provisional crown in the lab
• Protocols of delivering the digital provisional crown to the patient
• Protocol of in-office adjustment of the provisional crown
• Confederation of the most common mistakes with provisional restorations
• Mistakes when preparing teeth
• Step-by-step prosthetic restoration of endodontically treated teeth:
• Defining a missed canal, endo surgery and retrograde obturation
• Healing and follow-up
• Evaluation of the prosthetic restoration.

Lesson 9: The finish line of provisional restorations. Prostho-perio considerations

• Provisional restorations in relation to the periodontal tissue. Where to stop doing provisional restorations?
• Guided periodontal tissue adjustment with provisional restorations
• Adjustment of subgingival provisional crown margin
• Analysis of clinical cases:
• Application of the inverted shoulder approach when preparing the abutment tooth
• Fabrication and clinical adjustment of the provisional crowns.

Lesson 10: Post and core treatment approach. Is this treatment still valid? Part 1

• Defining of the interaxial dentin
• Occlusal force distribution on the coronal and apical part
• Literature and clinical analysis review of the success rate and failure of crown post and core treatment approach
• Clinical indications of fiber posts
• Adhesion of fiber posts to the tooth tissue
• Analysis of clinical cases:
• Failure of fiber posts
• Dr. Maiolino overview of fiber post restoration.

Lesson 11: Post and core treatment approach. Is this treatment still valid? Part 2

• Post and core approach to prosthetic restorations. Evaluation of treatment outcome
• The biomechanical aspects of a post and core restoration
• Comparing the advantages and disadvantages of metal cast posts and fiber posts
• Step-by-step video demonstration of metal cast post placement and abutment build-up and preparation
• Application of metal cast posts in the aesthetic zone:
• Laboratory aspects
• Clinical aspects.
• Analysis of clinical cases.

Lesson 12: Crown bonding. Prosthetic and die space

• What is the true prosthetic space and why is it important?
• Pros and cons of having a free tooth/abutment height
• Prosthetic crown thickness: consideration in different prosthetic crown materials
• Evaluation of the crown marginal seal and the occlusal seat in different clinical scenarios and in different tooth preparation techniques
• Die spaces and the precementation space of a crown
• The optimum thickness of the restoration
• The relationship between reliability, aesthetics and long-term restoration
• Reasons of chipping restorations at the stages of fitting and chewing
• Geometry and biomechanics of dental preparation for indirect restorations
• Analysis of clinical cases.

Lesson 13: Analysis of prosthetic crowns structural elements. The evaluation of different applied materials

• Literature review on the crown thickness and occlusal force load resilience
• Classification of cracks and fractures of prosthetic crowns
• The influence of preparation design on fracture resistance
• The effect of reduced occlusal thickness of a crown on fracture resistance
• Analysis of clinical cases. Follow-up on a prosthetic crown of the upper first molar.

Lesson 14: Edge and edgeless preparation protocols. Impression taking protocols

• Ideal time to take impressions
• Advantages and indications of delayed impression
• Advantages and indications of immediate impression
• Edge and edgeless preparation: indications and contraindications, pros and cons
• Detailed comparative characteristics of edge and edgeless preparation
• Clinical case: restoration of a severely damaged tooth. Choice of preparation method.

Lesson 15: Die preparation in an analog and digital method. Protocols of die spacer setting

• Die preparation: tools and techniques
• Step-by-step protocols of die preparation with digital and analog method
• Die preparation protocols during edge and edgeless preparation
• Pre-cementation retention (frictional fit)
• Post-cementation retention (cement fit)
• Die spacing for improving post cementation retention
• Setting for inverted spacing
• Using digital technologies to calculate spacing
• Processing of the gingival margin of the crown.

Lesson 16: Clinical protocols for indirect restoration cementation

• Materials for cementation and bonding of indirect restorations
• Comparative characteristics of luting materials
• Selection of the luting cement in accordance to the structural materials of the indirect restoration
• Clinical cases. Decision making strategy.

Lesson 17: Video guide of vertical preparation technique

• Ergonomics of working the with the dental microscope and red-ring hand piece
• Utilizing the coliberated notches for occlusal reduction
• Step-by-step video demonstration of preparing upper molar on a dental model:
• Protocols of occlusal reduction
• Protocols of interproximal separation and preparation
• Protocols of buccal and lingual reduction and the inverted shoulder approach
• Protocols of working with a batt-bur
• Edgeless vertical preparation protocols.
• Step-by-step video demonstration of fabrication of inverted shoulder:
• Bur selection
• Preparation technique
• Finishing and polishing.

Who is this course for?

This online course is designed for dentists and dental professionals interested in prosthodontics, clinical decision-making and evidence-informed dental practice.