Prática de Shadowing: Pascal Magne Part #4 - Aprenda a falar inglês com vídeo
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two are going to be situations where we start replacing a certain amount of tooth substance in the proximal
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or in the incisal or in the buccal.
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It's like rebuilding the morphology, the correct morphology of the tooth.
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And my favorite cases are this patient with periodontic problems.
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This was a patient that was addressed by the periodontist because the patient had an aggressive,
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rapid evolutive periodontitis, as you can see with tooth migrations.
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and after the periodontist did an excellent work in addressing the periodontal problem, there's no bleeding, there's no pockets anymore,
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the supporting tissues are perfectly healthy, but we have a dramatic situation with the aesthetic,
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the teeth are intact, they're all vital.
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So how can I solve that problem by restorative means only?
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It is impossible.
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Of course, the first thing, whatever is the restorative solution going to be,
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we need to use orthodontics to reestablish homogenous spaces between the teeth.
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And that was obtained through a relatively short orthodontic treatment, as you can see here.
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Now we have to close the proximal spaces and reduce also the length, which is way too long.
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And we are going to study what can be done.
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But before, we need to know what restorative means we are going to use.
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And I tell you here, you have three options.
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Either your name is Michelangelo del Composito,
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and then you will apply direct restorations to these teeth and it's going to be a challenge to fit the shade,
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marginal adaptation, indenting, beautiful shape, length, etc. The other extreme would be cut crowns,
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and I let you imagine on this very small lateral incisor,
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the pulp is not going to be very happy with the 360 degree shoulder preparation.
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So in this case, really, the bonded porcelain restoration is the best approach,
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because it will allow you to use only a facial approach to the problem.
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We don't need to prep on the palatal.
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That's exactly what we did.
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The solution to that was to use a horizontal insertion path for the restoration by keeping the incisal preparation absolutely flat,
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but by extending as much as we could in the proximal area
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to allow the dental technician to develop inter-dental extensions to compensate for the loss of the papilla.
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And this is really the key in these periodontal cases, as well as in other cases.
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I don't have time to describe the whole spectrum here.
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But remember the frontal insertion,
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because in this case we can maintain the wide incisal volume despite a very small cervical width.
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So this very triangular shape of the tooth can be maintained.
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You don't need to taper the proximal walls.
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You can maintain proximal divergence in your preparation by having your restoration inserted through the facial aspect without an oblique angle.
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If you are starting to bevel or chamfer the incisal edge like it is here,
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then the oblique insertion will force you, in order to seed the restoration,
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to taper, to create convergence in the proximal walls.
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And this convergence is going to cost you a lot of enamel
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and also dentin and it will be a waste of intact tissues.
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Instead, choose a frontal insertion.
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I must tell you the frontal insertion with a butt incisal margin is a very universal approach to this type of restoration.
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And look at this little, very small lateral incisor and imagine the consequences of a full crown preparation on a tooth like that.
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and look in there at the right on the right side look the very conservative approach
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that we could obtain most of the preparation here is still
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in enamel there is a little bit of dentine exposed at the cervical aspect
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because it was already exposed before i i start preparing
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so i could not regenerate enamel
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but i could maintain enamel where it was already present
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and this is so precious and you can do that only with this horizontal insertion path.
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The incisal edge, as you can see, was prepped absolutely horizontally and flat.
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On the palatal side, you see the enamel is intact, absolutely intact.
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We didn't need to invade that area.
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My brother Michel made a wonderful job of refractory dye technique using
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feldspatic porcelain layered
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and he developed these little interdental mini wings of porcelain using a more opaque saturated type of porcelain
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and you see on this scheme a horizontal cross section through
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the proximal space through the extensive interdental preparation he could recreate
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the mini wings to compensate for the lack of the papilla
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and because we use a more opaque because we use a more saturated porcelain, it is not going to alter the general perception of the tooth.
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These teeth will not look bulky despite their extensive interdental surface or extensive interdental development.
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Now you have a summary of the case on the left side before the orthodontic treatment, on the middle after the ortho
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and on the right hand after placement of the these restoration
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it is not a hundred percent aesthetic case many things we
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couldn't do the way we would do it in a patient
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with an intact periodontium however it is a very nice
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and acceptable compromise and on these slides you can appreciate the beautiful work of the porcelain
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that is allowed through the full thickness layering using the refractory dye technique.
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The platinum foil technique will allow you also a full thickness layering.
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We believe in full thickness layering that allows you really to make this type of aesthetic outcome.
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Pressable ceramics will not really be able to give this type of result.
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Plus they will require more tooth preparation especially at the cervical area to allow the pressing process.
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Now you see the final outcome and you note that the proximal space is not 100% closed.
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That would not be possible if the preparation is not sub-gingival, which is the case here.
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If you want a 100% closure of that space, you need to prep sub-gingivally in order to give the dental
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technician the clearance to develop this inter-dental profile at a more apical level.
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didn't want to do that here.
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It's a six-year follow-up view on this case and you see here the palatal view showing the splint,
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the immediate splint that was placed.
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Of course the retainer is required straight after preparation,
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straight after cementation, otherwise the teeth are going to start moving again despite the contact points that are recreated,
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the teeth will start overlapping and moving again if you don't retain them in position.
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And the use of a flexible retainer like this one is very nice.
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It allows some micro-movement.
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This is a twisted wire allowing some micro-movement, so some compliance, but maintaining the teeth in their position.
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Again, a beautiful six-year follow-up view,
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you see the periodontium and the very nice tight relationship between the gingiva and the teeth or the restorations.
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So the next example I want to develop with you is the augmentation of the incisal length and incisal prominence.
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And for that, I want to show you the case of this patient with very worn down flat central incisors.
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And this is really ideal for the application of bonded porcelain restorations.
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This patient is really willing to develop again the incisal prominence.
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She's, she had received several generations of composite veneers on her facial surface of the central
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that you see a little bit of composite remaining here
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that have been polished and repolished and now the teeth have lost completely their prominence
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and their length and there has been some incisal wear.
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This is a perfect indication
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because the teeth have already lost a major part of their original volume
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and so the restorations are going to be used really as a recovery of enamel,
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of function, of aesthetics, of prominence.
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Basically in one shot you solve all the problems of these teeth and as you had noticed one tooth was non-vital,
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the tooth number nine.
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It was bleached and restored exactly the same way as the other tooth.
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You see the excess cavity that was restored with a composite.
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Sometimes the preparation involves a little bit of the composite in the incisal part,
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but usually we do not recommend overlapping the palatal access cavity with the porcelain.
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You don't need to do that.
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Just prep the tooth as if it was intact and ignore the fact there is a composite on the palatal.
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Ignore the fact sometimes there are composites in the proximal as long as these composites have been replaced before starting the treatment.
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You see now a comparative view at baseline and five years later
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and as you guessed there is very little change in this situation.
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The case is very stable.
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Now there are, a lot of people question the fact
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that we place a certain amount of porcelain on the incisal edge
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and I understand that because originally porcelain veneers were not prepared for incisal coverage for incisal overlap
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and now you will see cases where we have used two
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three four five six seven millimeters of porcelain to restore an incisal edge is that reasonable
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mechanically it is very strong and very sound
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and I will show you mechanical evidence for that
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but I I want to share with you also that there are functional evidence that we are allowed to do that.
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And I want to remind you that the key element in the development of a harmonious occlusion is the incisal guidance.
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And this is not me saying that, as you can see on the screen.
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This is a basic foundation.
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And we also know, and I agree with these authors,
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that the steepness of the incisal guidance is not important for neuromuscular harmony.
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And you know what?
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As long as the treatment is phased,
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and as long as you allow the patient to test in a certain time,
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to give the patient enough time to test the new incisal guidance.
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This is why all the cases I have seen so far, all these cases have been treated in three phases.
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And I didn't say that until now, but I want to make it absolutely clear.
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Phase one, we do an additive wax up on study models.
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And we fabricate the corresponding mock-up, an additive mock-up over the existing unprepared teeth.
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And you see that on the picture.
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This mock-up is finished, glazed to a perfect condition.
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It is used as a provisional for phase 2, which is the evaluation of this new functional aesthetic situation.
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We are going to test also phonetics.
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And the patient will have time to adapt because this mock-up will be bonded to the teeth to the teeth, I will show you.
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And phase three is preparing the teeth according to this final volume upon agreement of the final volume definition.
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And this is the only way we can solve these cases.
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In a real life situation, we don't use digital imaging to have the patient evaluate the aesthetic outcome.
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They need the volumes to be created in their mouth to evaluate that.
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Thank you.
Contexto e Antecedentes
No vídeo "Pascal Magne Part #4", o foco principal é a restauração dental em casos complexos, como aqueles que envolvem problemas periodontais. O orador discute a importância de abordar tanto a saúde bucal quanto a estética, ressaltando como a interação entre ortodontia e restauração pode levar a resultados eficazes. O vídeo é um recurso valioso para profissionais da odontologia e estudantes, mas também pode servir como uma excelente prática de escuta para aqueles que buscam melhorar a pronúncia em inglês por meio de técnicas de shadowspeak.
Top 5 Frases para Comunicação Diária
- "É impossível resolver esse problema apenas com meios restauradores."
- "Precisamos usar ortodontia para restabelecer espaços homogêneos entre os dentes."
- "A restauração de porcelana adesiva é a melhor abordagem."
- "Lembre-se da inserção frontal ao preparar a restauração."
- "Esse método conservador preserva o esmalte e a dentina."
Guia de Prática de Shadowing
Para aqueles que desejam aprimorar suas habilidades de shadowing em inglês, abaixo segue um guia passo a passo para abordar as dificuldades apresentadas neste vídeo:
- Assistir com atenção: Primeiro, assista ao vídeo sem legendas. Tente captar o conteúdo e o contexto geral discutido. Isso ajudará a preparar sua mente para as palavras e frases que serão usadas.
- Ouvir e repetir: Reproduza segmentos curtos do vídeo. Pause após frases importantes e repita em voz alta. Isso é essencial para melhorar a pronúncia em inglês, focando na entonação e ritmo do orador.
- Anotar frases-chave: Utilize as frases listadas acima como referência. Escreva cada uma delas e pratique a pronúncia. Essa técnica facilita a retenção e fluência durante a fala.
- Praticar com um parceiro: Se possível, encontre alguém para praticar as frases. A interação ajuda a fortalecer sua confiança e habilidades de conversação.
- Revisar e refletir: Após a prática, revise o que aprendeu. Considere os desafios enfrentados e pense em maneiras de superá-los na próxima sessão de shadow speak.
Utilizando esta abordagem, você não apenas se familiarizará com a terminologia de odontologia, como também aprimorará suas habilidades de inglês de maneira eficaz e prática.
O que é a Técnica de Shadowing?
Shadowing é uma técnica de aprendizado de idiomas com base científica, originalmente desenvolvida para o treinamento de intérpretes profissionais. O método é simples, mas poderoso: você ouve áudio em inglês nativo e repete imediatamente em voz alta — como uma sombra seguindo o falante com 1-2 segundos de atraso. Pesquisas mostram melhora significativa na precisão da pronúncia, entonação, ritmo, sons conectados, compreensão auditiva e fluência na fala.