3StepAcademy number 3 STEP Academy | 3STEP ONE & TWO – Milan

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3StepAcademy number 3 STEP Academy
3STEP ONE & TWO
Milan

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A clinician who would like to follow a basic 3STEP training has the option to attend two two-day courses, called ONE and TWO.The first course (ONE) will focus on the basic diagnosis of dental wear, especially considering dental erosion. The STEP 1 (esthetic mock up) and STEP 2 (white bite) of the 3STEP will be discussed, with particular attention to the increase of VDO and the planning of the progressive wax up.
The second course (TWO) will deal with the restoration of the anterior teeth, especially the palatal veneers. The participants will fabricate with their laboratory technician 3-6 palatal veneers ready to be bonded, using the models of a real case. In addition, they will bring a case of dental wear to be discussed together. ONE and TWO are also indicated for laboratory technicians, since the interaction between clinician and technician is fundamental for the success of the 3STEP.

STEP Academy | 3STEP ONE & TWO – Milan

3STEP ONE

June 2020, Friday 26th

Dental wear is a frequently underestimated pathology that nowadays affects an increasing number of individuals.
Teeth in general are wearing down faster, not only for the excessive presence of the acid in the mouth, but also because of parafunctional habits.
Generally, the affected patients are left untreated until more damage occurs and conventional treatments are more justified (subtractive dentistry based on crowns).
Postponing the therapy is not the correct attitude. Non-invasive (ADDITIVE) adhesive restorations should be proposed instead, to protect the remaining dentition from further degradation.

LEARNING OBJECTIVES:

  • Learn the rational behind an ADDITIVE non-invasive approach versus traditional subtractive dentistry.

Before starting any dental treatments, a diagnosis of the origin of the tooth wear should be made. Even though loss of tooth structure is often multifactorial, clinicians should try to identify the cause, to explain patients also how the restored dentition will be ageing in the future.
The participants will learn how to recognizing the signs of early tooth wear and be capable to predict the type of evolution if the dentition is left untreated.
LEARNING OBJECTIVES:

  • Learn to identify the signs of dental erosion
  • Know the evolution of untreated mouths affected by dental erosion
  • Make the differential diagnosis between erosion and parafunctional habits

Despite the tendency for adhesive techniques to rather simplify the involved clinical and laboratory procedures, treatment of patients affected by severe dental erosion still remains a challenge.
An innovative approach, called the CLASSIC 3 STEP technique has been developed by Dr. Vailati. The 3 STEP technique is a structured approach to achieve a full-mouth ADDITIVE adhesive rehabilitation with the most predictable result, the minimal tooth preparation, and the highest level of patient acceptance.
Fundamental before starting the rehabilitation the communication with the patient and the laboratory technician on the esthetic final outcome. Thanks to a simplified less expensive mock-up, the patient can make an informed decision if he/she is willing to start the more comprehensive rehabilitation.
In this session, the participants will learn how to start developing a full-mouth rehabilitation, starting from two fundamental parameters, the incisal edges and the esthetic occlusal plane.

LEARNING OBJECTIVES:

  • Avoid full-mouth waxup
  • Plan an INTELLIGENT esthetic outcome for the future rehabilitation
  • Learn how to communicate with the patient and the technician by means of the 3 STEP mock-up.

Since the main objective of the 3 STEP technique is to avoid the removal of healthy tooth structure, while restoring worn down dentitions, an increase of vertical dimension of occlusion (VDO) is always advocated.
The role of the clinician to determine the new VDO is fundamental.
Once the project in wax is clinically validated, the posterior teeth are reconstructed, using transparent silicon keys. These keys are loaded with composite and positioned in the mouth to fabricate the posterior restorations (the white bite).
In this session, details on how decide the increase of the VDO will be given. Special attention to the communication with the laboratory technician in the fabrication of the wax up of the posterior quadrants will be stressed.

LEARNING OBJECTIVES:

  • Learn to understand the clinical validity of a more comprehensive waxup Determine the increase of VDO for each 3 STEP rehabilitation

June 2020, Saturday 27th

Since the main objective of the 3 STEP technique is to avoid the removal of healthy tooth structure, while restoring worn down dentitions, an increase of vertical dimension of occlusion (VDO) is always advocated.
The role of the clinician to determine the new VDO is fundamental.
Once the project in wax is clinically validated, the posterior teeth are reconstructed, using transparent silicon keys. These keys are loaded with composite and positioned in the mouth to fabricate the posterior restorations (the white bite).
In this session, details on how decide the increase of the VDO will be given. Special attention to the communication with the laboratory technician in the fabrication of the wax up of the posterior quadrants will be stressed.

LEARNING OBJECTIVES:

  • Learn to understand the clinical validity of a more comprehensive waxup Determine the increase of VDO for each 3 STEP rehabilitation

Often laboratory technician do not know how to correctly make the transparent keys, leading to clinical complications during the fabrication of the white bite. Errors, such as incorrect occlusion, or interproximal excesses can be reduced if clinicians are able to evaluate the quality of the posterior waxup first and the quality of the transparent keys later. Examples of laboratory and clinical mistakes will be shown during this practical part, where the participants will fabricate a correct transparent key by themselves.
Even with both a correct waxup and a transparent key, potential risks of mistakes may still be present during the II clinical step, when the key is used to fabricate the white bite directly in the patient’s mouth. Critical step could be how clinicians handle the transparent key, the quantity of composite loaded, the quality of composite used, the pressure applied on the key etc. These steps will be evaluated, using clinical examples, while participants will use their transparent key and fabricate the white bite themselves.

LEARNING OBJECTIVES:

  • Learn to analyse a posterior waxup Learn to fabricate a transparent key
  • Avoid clinical errors while handling the transparent key in the mouth

A solid initial documentation is fundamental for a correct treatment plan.
To avoid waste of time, clinicians should know what is really necessary when it comes to data collection during the first visit with the patient.
In this session it will also be explained how to register the patient’s occlusion, the type of impression to take, how to mount the casts etc. In addition a list of essential photos will be described. Very few clinicians understand the fundamental importance of documenting their work with photos. Some of them take pictures only to communicate shade to the technicians, other to show the patient aesthetics.
Following the 3 STEP technique, instead, there are several crucial photos to document clinical parameters necessary for the treatment plan.
In this part of the course, the participants will be instructed to take only the necessary pictures and they will be capable by looking at those to identify the critical parameters for the diagnosis and the treatment plan.

LEARNING OBJECTIVES:

  • Learn how to collect the initial date for treatment planning of a 3 STEP
  • Learn which are the essential pictures and which clinical parameters they show
STEP Academy | 3STEP ONE & TWO – Milan

3STEP TWO

October 2020, Friday 2nd

During the period of time between the 3Step One and the 3 Step Two courses, the participants will have the time to look at their patients differently, making diagnosis of dental erosion, and even treating some of these patients.
After a brief review on the fundamental aspects of the previously explained, this course will start with the CONTROL visit. After the increase of VDO with the white bite, patients present an anterior open bite, which will be restored by means of palatal veneers. After 1 week, before passing to the next step, it is crucial evaluate the patient’s posterior support, the new VDO and the occlusal comfort in general with the white bite.
Occlusal adjustments are one of the 8 steps necessary to prepare the patient for the III STEP, which will be explained in this session.

LEARNING OBJECTIVES:

  • Learn how to evaluate the occlusion after the white bite Learn to prepare the patient for the palatal veneers

After the increase of VDO with the white bite, patients present an anterior open bite, which will be restored by means of palatal veneers. Before passing to the next step, it is crucial to evaluate the patient’s posterior support, the new VDO and the occlusal comfort in general with the white bite.
Occlusal adjustments are one of the 8 steps necessary to prepare the patient for the III STEP, which are part of the CONTROL visit.

LEARNING OBJECTIVES:

  • Learn how to evaluate the occlusion after the white bite Learn how to prepare the patient for the palatal veneers

This part of the course deals with the difficulties that clinicians and laboratory technicians may find in planning palatal veneers. Few lab technicians know how to do these uncommon restorations and in Dr. Vailati’s experience more than 80% of what the participants bring to the course should be remake or at least modified before be delivered to the patient.
To help clinicians to evaluate the laboratory work, 10 laboratory parameters should be considered.
The palatal veneers brought by the participants will be photographed and evaluated together with the group to decide if they are clinically acceptable.

LEARNING OBJECTIVES:

  • Learn to evaluate if palatal veneers are clinical acceptable on the cast Evaluate participants’ palatal veneers

Before coming to the course, the participants will receive the models of a real patient of Dr. Vailati, who was restored using palatal veneers. The participants will collaborate with their lab technicians to fabricate similar restorations ready to be delivered in the mouth. Dr. Vailati will take pictures of the lab work and she will show them to the group to give her critical view on the quality of the restorations, which could range from perfect, clinical acceptable or impossible to be used.

LEARNING OBJECTIVES:

  • Learn to fabricate palatal veneers
  • Evaluate laboratory work following 10 parameters
  • Judge the work of their own lab technician

October 2020, Saturday 3rd

Palatal veneers are an outstanding treatment for eroded anterior teeth. However, since it is also an unusual one, clinicians may be not familiar with this type of restorations. In this session, each step on how to deliver them in the patient’s mouth will be explained, stressing the importance of a correct adhesive protocol.
The choice of the correct dental material will be stressed for the estetic and mechanical better outcome.

LEARNING OBJECTIVES:

  • Learn the operative steps of the adhesive protocol to bond palatal veneers

Clinicians are generally not very keen to start treating patients affected by parafunctional habits (e.g bruxism), since they are afraid of the mechanical failure of the restorations delivered. A common attitude is to wait for more damage to occur, to be then obliged to intervene. However, this late intervention is responsible for a further degradation of the original dentition, and a more complicated and expensive therapy. Generally subtractive techniques are then selected and healthy tooth structure removed, leading to further weakening of the dentition. Nowadays, however, these conventional rehabilitations (based on crowns) are very rarely accepted by patients, not only for their biological loss, but also for their important cost.
If dentists are not prepared to treat parafunctional patients, and patients are reluctant to restore their teeth with subtractive techniques, questions on the time of intervention should be raised.
ADDITIVE dentistry can be the alternative to propose to this population of patients, based on an early intervention with the maximum preservation of their tooth structure. In addition this approach allows a test drive to stabilise patients and to see how they react to the new restored dentition.

LEARNING OBJECTIVES:

  • Discuss why dentists cannot reconstruct all the different mouths following the same standardised ideas.
  • Place attention on the importance of function (#youcantskipfunction).

In this session, cases of dental wear of the participants’ patients will be analysed.

It is recommended to select cases of dental erosion. Each participant will be asked to select one patient and documented the initial status with maximum15 clinical photos and one video. These pictures will be transmitted to dr. Vailati and analysed with the group during this session. The attention will be placed not only on the quality of the documentation, but also on the diagnosis. Advices on the treatment plan will be given. The session will be based on the interaction between dr. Vailati and the participants, especially on the type of dental material selected for the rehabilitations.

LEARNING OBJECTIVES:

  • Evaluate the documentation to analyse erosive patients
  • Treatment plan of the participants’ cases
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October 2020, Friday 2nd

During the period of time between the 3Step One and the 3 Step Two courses, the participants will have the time to look at their patients differently, making diagnosis of dental erosion, and even treating some of these patients.
After a brief review on the fundamental aspects of the previously explained, this course will start with the CONTROL visit. After the increase of VDO with the white bite, patients present an anterior open bite, which will be restored by means of palatal veneers. After 1 week, before passing to the next step, it is crucial evaluate the patient’s posterior support, the new VDO and the occlusal comfort in general with the white bite.
Occlusal adjustments are one of the 8 steps necessary to prepare the patient for the III STEP, which will be explained in this session.

LEARNING OBJECTIVES:

  • Learn how to evaluate the occlusion after the white bite Learn to prepare the patient for the palatal veneers

After the increase of VDO with the white bite, patients present an anterior open bite, which will be restored by means of palatal veneers. Before passing to the next step, it is crucial to evaluate the patient’s posterior support, the new VDO and the occlusal comfort in general with the white bite.
Occlusal adjustments are one of the 8 steps necessary to prepare the patient for the III STEP, which are part of the CONTROL visit.

LEARNING OBJECTIVES:

  • Learn how to evaluate the occlusion after the white bite Learn how to prepare the patient for the palatal veneers

This part of the course deals with the difficulties that clinicians and laboratory technicians may find in planning palatal veneers. Few lab technicians know how to do these uncommon restorations and in Dr. Vailati’s experience more than 80% of what the participants bring to the course should be remake or at least modified before be delivered to the patient.
To help clinicians to evaluate the laboratory work, 10 laboratory parameters should be considered.
The palatal veneers brought by the participants will be photographed and evaluated together with the group to decide if they are clinically acceptable.

LEARNING OBJECTIVES:

  • Learn to evaluate if palatal veneers are clinical acceptable on the cast Evaluate participants’ palatal veneers

Before coming to the course, the participants will receive the models of a real patient of Dr. Vailati, who was restored using palatal veneers. The participants will collaborate with their lab technicians to fabricate similar restorations ready to be delivered in the mouth. Dr. Vailati will take pictures of the lab work and she will show them to the group to give her critical view on the quality of the restorations, which could range from perfect, clinical acceptable or impossible to be used.

LEARNING OBJECTIVES:

  • Learn to fabricate palatal veneers
  • Evaluate laboratory work following 10 parameters
  • Judge the work of their own lab technician

October 2020, Saturday 3rd

Palatal veneers are an outstanding treatment for eroded anterior teeth. However, since it is also an unusual one, clinicians may be not familiar with this type of restorations. In this session, each step on how to deliver them in the patient’s mouth will be explained, stressing the importance of a correct adhesive protocol.
The choice of the correct dental material will be stressed for the estetic and mechanical better outcome.

LEARNING OBJECTIVES:

  • Learn the operative steps of the adhesive protocol to bond palatal veneers

Clinicians are generally not very keen to start treating patients affected by parafunctional habits (e.g bruxism), since they are afraid of the mechanical failure of the restorations delivered. A common attitude is to wait for more damage to occur, to be then obliged to intervene. However, this late intervention is responsible for a further degradation of the original dentition, and a more complicated and expensive therapy. Generally subtractive techniques are then selected and healthy tooth structure removed, leading to further weakening of the dentition. Nowadays, however, these conventional rehabilitations (based on crowns) are very rarely accepted by patients, not only for their biological loss, but also for their important cost.
If dentists are not prepared to treat parafunctional patients, and patients are reluctant to restore their teeth with subtractive techniques, questions on the time of intervention should be raised.
ADDITIVE dentistry can be the alternative to propose to this population of patients, based on an early intervention with the maximum preservation of their tooth structure. In addition this approach allows a test drive to stabilise patients and to see how they react to the new restored dentition.

LEARNING OBJECTIVES:

  • Discuss why dentists cannot reconstruct all the different mouths following the same standardised ideas.
  • Place attention on the importance of function (#youcantskipfunction).

In this session, cases of dental wear of the participants’ patients will be analysed.

It is recommended to select cases of dental erosion. Each participant will be asked to select one patient and documented the initial status with maximum15 clinical photos and one video. These pictures will be transmitted to dr. Vailati and analysed with the group during this session. The attention will be placed not only on the quality of the documentation, but also on the diagnosis. Advices on the treatment plan will be given. The session will be based on the interaction between dr. Vailati and the participants, especially on the type of dental material selected for the rehabilitations.

LEARNING OBJECTIVES:

  • Evaluate the documentation to analyse erosive patients
  • Treatment plan of the participants’ cases
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*For any informations contact us: mail@3stepacademy.com

*For any informations contact us:
mail@3stepacademy.com