ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Pascal Magne Part #3

Music And

so when I look at this picture, a full crown preparation on the case of a non-vital tooth,

I'm always sad because I did that and I did it a long time ago,

but I tell you I wouldn't do that anymore today and I'm prepping less and less crowns.

I want to say even I am not prepping crowns anymore.

I am replacing crowns when they exist already.

Otherwise, I always try to use a biomimetic approach, using adhesion, using a selective preparation of the tooth, not a full preparation.

And these mistakes I did in the past, I show you another example.

I want to humble myself on that.

I want to say this was wrong.

maybe right at the time

but this is wrong today we don't want to kill the pulp in the name of prostodontics

because when we do that then we need to use post

and core buildups and and different things that are very difficult to restore

and I want to show you that today we don't need

that anymore we need just to replace what is required

and no more and many times the palatal

or the lingual surface of the tooth is intact

and doesn't need any preparation

so I want to show you now a little tour a

little tour on the indications of the the spectrum of indications then we'll talk about tooth preparation

and and provisionals and we'll finish with some aspects of bonding procedures.

And please believe me, one hour and a half is nothing to present what I want to tell you.

However, I tried to make a really concentrate for you of what I think is important.

And in the indication, I just want to remind you, there are different types of bonded porcelain restorations the anterior dentition

and I call them type 1 type 2

and type 3 according to the amount of tooth substance that we are replacing according to the amount of interdental preparation

and as you know the type 1 restoration the typical type 1 was described in the early 80s by Horn Calamia,

Simonson, and it was really about minimal approach,

minimum preparation or no preparation, reduced incisal coverage.

And this is really the typical type 1, what I call type 1.

And all these papers taught us that, including my friend Mark Friedman, who published a 15 year follow-up review,

they taught us that as long as you prep in enamel, you are fine.

If you exposed a significant amount of dentin, you are in trouble.

That was true back then, it isn't true anymore today

and I will explain why in the 90s we have an extension of the indication towards more tooth substance replacement,

type 2 and type 3 restoration.

This is more the daily bread of bonded porcelain restoration because the early indications,

the type 1, today we solve them mostly by bleaching.

Now, about these possibilities, we have,

as I said, bleaching will address most of type 1 indications however still we have some indications

that will not be covered by bleaching like severe discoloration non-response to

and internal bleaching for instance we have type 2 are going

to be more tooth substance replacement conoid teeth diastema triangle incisal prominence to be restored incisal guidance to be restored.

Type 3 will be about extensive loss of tooth substance, coronal fracture, and extensive loss of enamel by erosion and wear.

So a very classical example of type 1 for me is the case of endodontically treated teeth,

like these two central and lateral incisors in this case.

And a lot of people believe that veneering endodontically treated teeth is not a good idea.

And Iowann really opposed to that.

It is an excellent idea.

If bleaching is not successful, if there is an indication for restructuring the shape, the length of the tooth,

then veneers or bonded porcelain restoration are the perfect choice.

We have to know that endodontically treated teeth are more brittle not because of the loss of the pulp per se,

but because of the loss of tooth structure.

The tooth structure loss becomes the primary cause of failure, not the pulp removal.

In this context, the more conservative approach of veneer will maintain more remaining tooth substance,

especially in a situation like this one, a 360 shoulder preparation would result in a total loss of the coronal substance.

And the next thing you would have to think about is which type of post and core I want to use.

And of course, this is a question we don't like too much and we want to avoid.

And we know from many scientific publications that the best post is no post.

And therefore, if we choose to use a porcelain veneer type approach in these teeth, we know that we are going to get the same reinforcement that we need.

We are going to recover the stiffness, especially because the ceramic, as a stiff material,

will act like a surface post or call it a skin post.

I don't know how to say that.

but it will apply the stiffness where it should be recovered, not at the level of the pulp, but at the level of the enamel layer.

And so if we apply the porcelain veneers the right way by increasing the volume of enamel, then we can restore the original stiffness of the tooth,

even on an endodontically treated tooth.

And that's what we did in this case on the central, the lateral incisor.

We included the contralateral central because it had a defect

and we wanted also to improve the cohesiveness of the smile line

and including the two centrales allowed us to develop a very nice curvature of the incisal edge lines,

cohesive with the lower lip line.

You see on the right the teeth after preparation.

You see how conservative is the preparation.

And the veneer is going to really like it as a surface post to give these teeth back what they have lost,

which means stiffness and rigidity.

And plus we have increased, we have improved function by guidance, by anterior guidance.

And I will tell you about that again.

Anterior guidance is your friend.

If you know how to bond the restoration, interior guidance is your friend.

เทคนิค Shadowing คืออะไร?

Shadowing เป็นเทคนิคการเรียนรู้ภาษาที่ได้รับการรับรองทางวิทยาศาสตร์ พัฒนาขึ้นสำหรับการฝึกนักแปลมืออาชีพ วิธีการนี้เรียบง่ายแต่ทรงพลัง: คุณฟังเสียงภาษาอังกฤษจากเจ้าของภาษาและพูดตามทันที — เหมือนเงาที่ตามผู้พูดด้วยช่วงเวลาห่าง 1-2 วินาที การวิจัยแสดงว่าเทคนิคนี้ปรับปรุงความแม่นยำในการออกเสียง ทำนองเสียง จังหวะ การเชื่อมเสียง การฟังเข้าใจ และความคล่องแคล่วในการพูดได้อย่างมีนัยสำคัญ

ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Pascal Magne Part #3

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