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Smile Bible: A Communication Tool Between Dental Clinicians and Technicians, Clinicians and Patients and Technicians and Patients

Labline featured Yugo’s article for the ‘ACADEMY’ in 2016 (originally published in English and Hungarian).   There is a story behind every article I’ve created, and I cherish every single one of them. However, this particular piece is a standout because it compiles my philosophy into a single work.   The contents include: Dental Material Selections The Aesthetic Articulator Digital Dental Photography Shade Taking and Smile Design Consultation   I felt that the missing link in Dentistry was the communication between the clinicians and technicians with our patients, and how to educate our patients through effective correspondence to make each treatment step transparent and visually assessable.   The clinical philosophy is the driving force, and the clinicians should remain the captain of the ship, no doubt. However, the...

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Science – The Future of Human Evolution (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘In science, we must be interested in things, not in persons.’ – Marie Curie   ‘One must divide one’s time between politics and equations. But our equations are much more important to me.’ – Albert Einstein   ‘Science knows no country, because knowledge belongs to humanity.’ – Louis Pasteur   ‘Science is an integral part of culture. It’s not this foreign thing, done by an arcane priesthood. It’s one of the glories of human intellectual...

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Masterpiece – Visualisation with Precision: The Aesthetic Articulator

QDT featured Yugo’s article in 2016 (originally published in Japanese).   Having trained as a dental technician in Japan (at Osaka University Dental Hospital), being featured in the ‘masterpiece’ section of QDT is an honourable achievement. It is a privileged benchmark that the high-end ceramists in Japan aspire for recognition and respect within the field.   The actual storyline of the article is very similar to my previous post presenting the Aesthetic Articulator (https://smilevirtuoso.com/the-aesthetic-articulator-australian-patent-au2013100527/). However, the aesthetics of the presented case/restorations are probably the best I have ever presented from a technical perspective. The patient desired the highest level/degree of incisal translucency/characteristics, which mimics the complex nature of natural dentition. The outcome is so satisfying that even dental professionals cannot distinguish them from natural teeth.   When I design...

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Religion – Science vs. Religion (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘One religion is true to another.’ – Robert Burton   ‘Religion to me has always been the wound, not the bandage.’ – Dennis Potter   ‘So long as man remains free he strives for nothing so incessantly and so painfully to find someone to worship.’ – Fedor Dostoevsky   ‘My country is my world, and my religion is to do good.’ – Thomas Paine   ‘I count religion but a childish toy, and hold there is...

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Extreme Masking: Achieving Predictable Outcomes in Challenging Situations with Lithium Disilicate Bonded Restorations

The International Journal of Esthetic Dentistry featured Yugo’s article titled 'Extreme Masking: Achieving Predictable Outcomes in Challenging Situations with Lithium Disilicate Restorations' in 2014 (originally published in English, German, Italian, Spanish and Greek).   Aesthetically speaking, metal-free restorations are proven to be superior alternatives to traditional porcelain-fused-to-metal (PFM) restorations. However, one of the most significant challenges in metal-free dentistry is the reproduction of natural dentition without the influence of a ‘negative stump’ – i.e., a very dark or metalcore showing through the final restorations.   This article presents a unique ‘outside of the box’ technique that provides consistent, predictable and durable restorations, which provide the best possible aesthetic outcome.   If you ask me to nominate the milestone in my career, this is undoubtedly one of them...

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Punishment – Reintegration of Ex-offenders into the Community (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘All punishment is mischief: all punishment in itself is evil.’ - Jeremy Bentham   ‘Hanging is too good for him, said Mr Cruelty.’ – John Bunyan   ‘Punishment is not for revenge, but to lessen crime and reform the criminal.’ – Elizabeth Fry   ‘A Child, punishment by selfish parents, does not feel anger. It goes to its little private corner to weep.’ – Rose Tremain   ‘This is the first of punishments, that no guilty...

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Aesthetics of a Single Central Incisor with Soft Tissue Management

Clinica: International Journal of Brazilian Dentistry featured Yugo's article titled 'Aesthetics of a Single Central Incisor with Soft Tissue Management' in 2014 (originally published in Portuguese).   Meeting patients’ expectations is our goal regardless of the types of cases we treat. An ‘aesthetically pleasing outcome’ is ultimately judged by the patient. Without their satisfaction, the case should be considered unsuccessful even though there might be no fault with the outcome in the dental professionals’ eyes.   Regardless of who you are or where you are from when it comes to restoring a single central incisor, the desire comes down to one thing – we aim to blend the restoration with the surrounding natural dentition.   Today, accurate colour matching is not as challenging as in the past,...

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Poverty – The Fallacy of Foreign Aid (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘Make poverty history.’ - Anonymous   ‘Anyone who has ever struggled with poverty knows how extremely expensive it is to be poor.’ – James Baldwin   ‘Come away; poverty’s catching.’ – Aphra Behn   ‘Brother can you spare a dime?’ – Y. Harburg   ‘There’s nothing surer, the rich get rich and the poor get children.’ – Gus Kahn & Raymond B. Egan   Suggested Theme: Poverty (Section A) Time limit in the actual exam: 30 mins Chosen Quote: ‘Make...

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Restoration of Two Implants using Custom Abutments and Transverse Screw-retained Zirconia Crowns

The American Journal of Esthetic Dentistry featured Yugo’s article titled 'Restorations of Two Implants using Custom Abutments and Transverse Screw-retained Zirconia Crowns' co-authored with Dr Andrew Chio (Melbourne, Australia) in 2012 (originally published in English).   There is a myth that the popularity of cross-pin retained implant restorations exists in a specific geographical location – Melbourne, Australia. Cross-pinning uses a transverse screw to attach the restorations to an implant abutment when access for the abutment screw would compromise the aesthetics and structural integrity of the prosthesis.   This technique traditionally requires the final restoration to be completed as an all-metal or metal-ceramic prosthesis. However, this article explores the possibility to fabricate the restorations using metal-free Zirconia based systems. This case report presents an alternative technique...

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Money – How to become a millionaire (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘The almighty dollar is the only object of worship.’ - Anonymous   ‘Money is like muck, not good except it be spread.’ – Francis Bacon   ‘We could have saved sixpence. We could have saved fivepence. But at what cost?’ – Samuel Beckett   ‘Money speaks sense in a language all nations understand.’ – Aphra Behn   ‘The love of money is the root of all evil.’ - Bible   Suggested Theme: Money (Section A) Time limit in the...

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Fusion of Modern and Ancient: Feldspathic/Refractory Veneers using Zirconia Porcelain

As a young technician over a decade ago, I searched for ways of mastering the refractory veneer technique to achieve the ultimate aesthetics. When I found the refractory die material for Zirconia, the 'aha moment' came to me, and the rest is the history.   The presented technique remains how I fabricate the refractory veneers today, and it is beneficial for some instances with conservative/minimum preps.   It was an honour to participate in a book chapter amongst prominent dental professionals and pioneers such as: Oliver Ahlers, Paulo Battistella, Michael Behm, Gilberto A. Borges, Oliver Brix, Julian Conejo, Daniel Edelhoff, Fàbio Fujiy, Will Geller, Galip Gürel, Axel Gütges, Sascha Hein, Ralf Janda, Akito Kani, Manfred Kern, Peer Kulzer, Karl-Heinz Kunzelmann, Klaus Möller, Klaus Müterthies, Patrick...

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Love – Is Love Worth It? (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘There is only one happiness in this life, to love and be loved.’ – George Sanders   ‘A good teacher can inspire hope, ignite the imagination and instill a love of learning.’ – Brad Henry   ‘A friend is someone who knows all about you and still loves you.’ – Elbert Hubbard   ‘It is not a lack of love, but a lack of friendship that makes unhappy marriages.’ –Friedrich Nietzsche   ‘Love is the only...

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What made me who I am (Warning: it contains sensitive matters)

The following essay is what I produced at the University of Sydney in the Education unit (EDUF 1018), describing my personal experiences of schooling with teachers. I received 92/100 (higher end of High Distinction) for this essay, which captures what made me who I am today and how I construct a thought process. It presents my journey that some might consider “extraordinary”. I have come a long way, beating some obstacles that I’ve encountered. Those challenging moments, however, significantly contributed to strengthening my emotional and psychological stability. Looking back on those moments now, I find them as the inevitable tasks that I had to overcome to find happiness and the purpose/meaning of my life.   Go to www.smilevirtuoso.com/shop to read the article....

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Before and After 2020: Missing Tooth Replacement on Lateral Incisors (Part 2)

A Caucasian male patient in his youth was introduced to me upon a failure of the previous Maryland-Bridges on 13-11, 21-23. The restorations only lasted for a few months (done by another technician), and I couldn’t identify its cause or never given a specific reason by the treating clinician.   In part 1 of the ‘missing tooth replacement’ (click here to read), I presented implant restorations in Zirconia with Ti interface abutment to replace the lateral incisors. For this case, I present more of a conservative and cost-effective option – Maryland-Bridges in lithium disilicate (e.max) for optimum bonding strength.   Figs 1-2 show the pre-op condition.   Fig 3 shows my standard protocol in shade taking. I make sure to use three different shade guides to identify the...

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Knowledge – Knowledge is Power (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘Everyman, I will go with thee, and be thy guide, in thy most need to go by thy side.’ - Anonymous   ‘The fox knows many things – the hedgehog one big one.’ – Archilochus   ‘Knowledge is power.’ – Francis Bacon   ‘I know nothing except the fact of my ignorance.’ - Socrates   ‘Knowledge comes, but wisdom lingers.’ – Alfred, Lord Tennyson   Suggested Theme: Knowledge (Section B) Time limit in the actual exam: 30 mins Chosen Quote:...

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The Aesthetic Articulator (Australian Patent AU2013100527)

QZ featured Yugo’s article titled ‘The Aesthetic Articulator (Australian Patent AU2013100527)’ in June 2015 (published language: German).   Introduction:   Contemporary dentistry is increasingly using digital technology to plan and communicate treatment, and, in many cases, to aid in its delivery. CAD/CAM technology is a prime example of how high tech can be melded into the dental laboratory’s workflow and, increasingly, the dental clinic. This once novel process is now commonplace throughout the mainstream dental community.   Advancements in digital technology have also helped clinician and technician to communicate more clearly and precisely to achieve better patient outcomes, and involve the technician in delivering care.   More and more, technology is also employed to help clinicians understand and deliver on patient expectations. Due to the increasing dental knowledge...

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Before and After 2019: Missing Tooth Replacement on Lateral Incisors (Part 1)

A Caucasian female patient in her 20s was introduced to me upon completion of extensive orthodontic treatment to create enough space to replace the missing laterals. It has been a long journey for the patient to get to the point having the implants on the laterals and hoping to achieve the smile that she never thought was possible.   There were a few technical challenges that I encountered: the angulation of the screw channels colour matching with the surrounding natural dentition.   1: Today, close to 100% of my implant restorations are requested as screw-retained rather than cement-retained. When the angulation of the implants are not ideal, then my primary choice is to use dynamic abutment – an alternative to the genuine Ti interface...

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Friends – Friends vs Family (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘Walking with a friend in the dark is better than walking alone in the light.’ – Helen Keller   ‘A friend is one that knows you as you are, understands where you have been, accepts what you have become, and still, gently allows you to grow.’ – William Shakespeare   ‘Anybody can sympathise with the sufferings of a friend, but it requires a very fine nature to sympathise with a friend’s success.’ – Oscar...

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Before and After 2018: Smile Makeover – Replacement of Existing Restorations

A Caucasian female patient in her 40s flew in from Switzerland and stayed in Sydney, Australia, over the Xmas break for the smile makeover. Her existing veneers were only done 4-5 years ago by another technician, and she was unhappy with them due to being over contoured.   The treating clinician modified the shape clinically before sending the patient to my studio for a smile design consultation. Thus, her condition was close to ideal, and she was happy with them in general. My job was to identify where we can improve and determine the number of units required to achieve the best possible outcome.   Figs 1-3 show the pre-op condition.   Upon detailed discussion, I observed the following information.   Shape: As noted above, the treating clinician improved...

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Ultimate Zirconia Coping Design: Understnding Aesthetics and Function

eLABORATE Magazine featured Yugo’s article titled ‘Ultimate Zirconia Coping Design: Understanding Aesthetics and Function’ in Sep/Oct 2012 (published language: English).   Introduction: It has been a decade since Zirconia became available to the dental market, and it is now one of the premier alternatives to Porcelain Fused to Metal (PFM) restorations.   There are always pros and cons in selecting any material, and dental professionals need to treat their chosen material properly to ensure the longevity of the restorations. One of the common issues facing Zirconia is the potential fracture of the layering ceramic/porcelain (Fig 1 & 2). The general causes of the problem are: Firing program/conditions, Parafunctional stresses, Ceramic-Zirconia compatibility, and Insufficient support in the sub-structure.   Understanding of function/occlusion, visualisation of the outcome and an appropriate...

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Equality – Can ‘Freedom’ and ‘Equality’ co-exist? (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘I have a dream that one day on the red hills of Georgia the sons of former slaves and the sons of former slave owners will be able to sit down together at the table of brotherhood.’ – Martin Luther King   ‘Equality may perhaps be a right, but no power on each can ever turn it into a fact.’ – Honre de Balzac   ‘There is no method by which men can be...

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Before and After 2017: Smile Makeover – Achieving Super-bright Life-like Restorations

A Caucasian female patient in her 30s visited me for a consultation with temporary restorations in the mouth. She had her first set of veneers, which was about 16 years old. She recently had Invisalign, but the teeth moved out of the alignment. She is also concerned about the root exposure and uneven gingival level.   She had missing second premolars and wished to have a brighter smile, in fact, as bright as possible without making them look artificial. She commenced bleaching on her lower dentition to reduce the contrast. We decided to replace the existing restorations from 13-23 – right canine to left canine, and place conservative veneers on 14&24 – right and left first premolar, a total of 8 units...

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Education – Life-long Continuing Education (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘Education is an admirable thing, but it is well to remember from time to time that nothing wroth knowing can be taught.’ – Oscar Wilde   ‘Education is what survives when what has been learned has been forgotten.’ – B.F Skinner   ‘In education there should be no class distinction.’ - Confucius   ‘The empires of the future are the empires of the mind.’ – Winston Churchill   ‘The aim of education is the knowledge not...

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Establishing Protocol in Digital Dental Photography: Essential Communication Tool for Dental Professionals and Patients

Digital photography provides good clinical evidence and is an essential communication tool for dental professionals and patients. Therefore, capturing correct information is critical when exchanging digital images. The quality of the captured images significantly reflects the quality of the final restorations.   In an ideal scenario, the technician/ceramist should receive the necessary information from the treating clinician to perform to the best of their abilities, and provide the best possible outcome for their patients. The image captured by the treating clinician needs translation into the language/perspectives as the way the technicians/ceramists see and apply within their workflow – i.e., the clinician should be able to explain why they are capturing the specific photos, and the technician/ceramist should be able to understand the...

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Before and After 2016: Smile Makeover – Full Mouth Reconstruction with a Heart-warming Testimonial

A female patient in her 50s was referred to me for a consultation, who literally got ‘hit by a bus’ in an accident. Multiple facial reconstruction and surgeries had been performed, yet she was dissatisfied with the dental work provided.   After a lengthy discussion with the patient and the treating clinician, we decided to restore her brand-new smile with confidence by performing a full-mouth reconstruction. There were existing implant restorations from 12-22 – the right lateral incisor to the left lateral incisor, replaced in Screwed-Retained Implant bridge. The rest to be done in lithium disilicate (e.max).   Fig 1 shows the pre-op condition. The patient’s lower lip was still hanging down at this point (due to the trauma), and thus she showed more...

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Unbreakable Zirconia Abutments: New Lava and NeoLink Zirconia Abutments

eLABORATE Magazine featured Yugo’s article titled ‘Unbreakable Zirconia Abutments: New Lava and NeoLink Zirconia Abutments’ in Jan/Feb 2010 (published language: English).   Introduction:   Strength and aesthetics are foremost in the mind of today’s ceramist. The longevity of restorations has always been an essential factor. In the past, however, aesthetic compromises may have been tolerated, particularly in the posterior region. Thankfully today, achieving a lasting, highly aesthetic result technically has become far more accessible due to the development of new technology and materials. In the burgeoning field of implant dentistry, to maximise aesthetics, it is essential to create a customised abutment instead of using ‘off the shelf’ abutments. Custom abutments are necessary to control the emergence profile, as well as the Sub-Gingival Contour (SGC). Customised Zirconia...

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Death – Finding a Purpose of Life by Becoming a Hero (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘Nothing in his life became him like leaving it.’ – William Shakespeare   ‘It matters not how a man dies, but how he lives. The act of dying is not importance, it lasts so short a time.’ – Samuel Johnson   ‘It’s not that I’m afraid to die. I just don’t want to be there when it happens.’ – Woody Allen   ‘I have received two wonderful graces. First, I have been given time to...

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Before and After 2015: Smile Makeover – Replacement of 2 Teeth on 1 Abutment with Pink Ceramics

A Caucasian female patient in her 20s was just about to get married and wanted to look the best. She was missing laterals with vampire-like fangs that bothered her. Because of the timeframe, orthodontic treatment was not an option.   Since the teeth are all vital, we need to be conservative in prep generally, but the aggressive prep is necessary where required. Boding strength is another element we must consider. Thus, we decided to go with lithium disilicate (e.max) restorations – veneers on the central incisors and first-premolars, with joint crowns to replace the laterals and canines off one abutment for each quadrant.   Fig 1 shows the pre-op condition. When working a case like this, the communication between the clinician and technician is...

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Before and After 2014: Smile Makeover – Addressing Mid-line Cant and Proportion with Lateralised Canines

A Middle Eastern female patient was concerned about her smile’s asymmetry, cased by the midline cant and shift with missing laterals. The lateralised canines are as wide as the central incisors, so the overall proportion needs improvement. It is not visible in the initial smile photo, but the patient has a gummy smile, which she would like to address simultaneously.   When working on a case like this, initial planning is crucial to visualise the outcome from the beginning, and thus, diagnostic wax-up is a must. We have decided to idealise the gingival level by crown-lengthening/gum-contouring, to begin with, then lithium disilicate (e.max) veneers from 13-23, right upper canine to left upper canine, a total of 6 teeth.   Figs 1-4 show the pre-op condition. The...

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Courage – Courage to be Disliked for Authentic Happiness (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘Courage is the thing. All goes if courage goes!’ – J.M. Barrie   ‘None but the brave deserves the fair.’ – John Dryden   ‘Courage is not simply one of the virtues but the form of every virtue at the testing point.’ – C.S Lewis   ‘As to moral courage, I have rarely met with two o’clock in the morning courage: I mean instantaneous courage.’ – Napoleon I   ‘Perhaps those, who, trembling most, maintain a...

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Before and After 2013: Smile Makeover – Implant Zirconia Bridge with Gum Porcelain

An Asian patient in her 40s was depressed about the aesthetics of her smile. She had several attempts to replace the restorations to achieve natural aesthetics, which she found difficult. She was looking for “a durable, functional and, most of all, a beautiful smile” in her words.   The treatment plan is to replace the existing restorations – 12-22 Screw-Retained Implant Bridge, and crowns on the canines - 13 and 23. To maintain the same property and material in the superstructure, we decided to use Zirconia with Ti interface abutment for the implant connections.   Fig 1 shows the pre-op condition. The aesthetical and functional issues we need to address are: correction of the midline cant achieving a sense of symmetry on the central...

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Reproducing Nature Part 4: Smile Design

LVI Visions featured Yugo’s article titled ‘Reproducing Nature: Smile Design in 2008 (published language: English).   Introduction:   Today, creating a natural-looking smile is essential in cosmetic/aesthetic dentistry. As I mentioned in the first part of this article (European Journal of Eesthetic Dentistry Winter 2008), many people think that white “Hollywood Smiles” look fake but is it true? Have you thought about bleached natural dentition? I think it looks healthy and attractive but doesn’t look fake at all. That is the type of benchmark I set for myself when the patient is after a perfect smile – i.e., bright yet natural.   Now, what is the definition of “perfect” anyway? Does it mean that it’s perfectly in proportion, perfectly adapted to the patient’s desire or could...

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Before and After 2012: Smile Makeover – Achieving Significant Change in Proportion with porcelain veneers

A Caucasian male patient in his 30s was deeply concerned about the aesthetics of his smile. There are several issues we had to address: most notably, changing the proportion and tooth size within the aesthetic zone, crown-lengthening/gum-contouring, and a replacement of a missing tooth on 14 (right first-premolar).   We selected a Zirconia bridge on 15-13, and lithium disilicate (e.max) veneers for the rest – 12-26 (missing 25), from the right second-premolar to the left first-molar, a total of 10 units.   I must admit that this case was one of the most challenging smile makeovers I had encountered at that time, but the result spoke for itself. The patient was “over the moon” with the outcome.   The key to achieving such a result was...

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Before and After 2011: Setting a Benchmark in Digital Photography

A male patient in his 30s presented with the aesthetic concerns on the gummy smile and prominent hypocalcification on the central incisors. Hypocalcification is a condition where your tooth’s enamel has an insufficient amount of calcium. When this happens, the enamel still covers the tooth’s surface but parts can be thin and weak, giving teeth an opaque or chalky appearance.   We decided to proceed with crown-lengthening, to begin with, and lithium disilicate (e.max) veneers on the central incisors for the better blend with the rest of natural dentition.   Figs 1, 3 and 5 show the pre-op condition. Figs 2, 4 and 6 show after completion of the crown-lengthening for the upper arch. See the consistency in the provided photos – retracted view,...

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Ambition – Do you have what it takes to become someone? (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘Well is it known that ambition can creep as well as soar.’ – Edmund Burke   ‘I had rather be right than be President.’ – Henry Clay   ‘All ambitions are lawful except those which climb upwards on the miseries or credulities of mankind’ – Joseph Conrad   ‘He is loyal to his own career but only incidentally to anything or anyone else.’ – Hugh Dalton   ‘There is always room at the top.’ – Daniel...

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Reproducing Nature Part 3: Tooth Replacement with Root and Colour Matching Using Digital Photos

eLABORATE Magazine featured Yugo’s article titled ‘Reproducing Nature Part 3: Tooth replacement with root and colour matching using digital photos in 2006 (published language: English).   Introduction:   The technology available in dentistry in 2006 has improved significantly since I became a dental technician even though it’s been only eight years. Patients’ dental IQ and desires for beauty have also increased through exposure in the media.   Thanks to the advancement of software such as Adobe Photoshop, we can now give patients a new smile digitally/virtually before the commencement of work to provide them with a great idea of the final result with the projected outcome.   Material-wise, the trend has moved to metal-free restorations over traditional PFMs – higher aesthetics with less effort to achieve life-like restorations....

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Before and After 2010: Treatment of Cleft Lip and Palate – a “Pro-bono” Smile Makeover

A female patient in her early 20s presented with congenitally missing upper lateral incisors, and one canine, a total of 3 teeth seeking a fixed replacement. The patient has a cleft lip and palate bilaterally, which has been treated several times over the years with surgery to repair it. Implants are not possible as there is no bone in the surgical repair sites, and in fact, she still has an oro-nasal communication.   The patient had limited resources to pay for treatment and hoped that the federal Cleft Lip and Palate Scheme would cover the costs, which turned out that only extractions and dentures are eligible for the claim. Thus, the treating clinician – Dr Michael Mandikos and I had decided to treat...

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Yugo’s creation as a student at Osaka University Dental Hospital (in 2000)

I am privileged to be able to make a living by helping people to love their smiles. I do this by providing prosthetic teeth for cosmetic purposes, including crowns, bridges and veneers, as well as implant-supported restorations. I am a dental technician and my job title is ‘master ceramist’, a term used for artists specialised in crowns and bridges who reproduce natural aesthetics by mimicking nature with unmatched skills and knowledge. I am often asked why I’ve chosen this career path, and I always state, ‘ I wanted to become a doctor and an artist at the same time since I was a kid, and being what I am now is a fusion of the two with harmony’.   My educational journey...

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Before and After 2009: Soft-Tissue Management at the Socket on Pontic Sites

A Caucasian male in his 70s had presented with failed roots on the lateral incisors (12 & 22). The patient was also concerned about the aesthetics of the overall smile, wanting to have a youthful look. We commenced the case with 2 x Zirconia bridges 13-11 & 21-23.   Fig 1 shows the pre-op condition. 12 and 22 were extracted, and the soft tissue was managed during the temporary stage by the treating prosthodontist. Fig 2 shows the remarkable state of the soft tissue recovery.   Communication in the shade taking is essential between the clinician and ceramist. The shade tab should be placed edge to edge position, as shown in Fig 3. Fig 4 shows the completed Lava zirconia bridges (13-11 & 21-23). Note...

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Yugo – the man behind Smile Virtuoso: Past – Present – Future

It’s been a while since I disappeared from the forefront of dental education. For the past decade, having a presence in social media has become the norm regardless of who you are. If you are not actively promoting yourself online, then apparently you don’t exist. I’m not on anything –Facebook, Twitter, Instagram or TikTok – except LinkedIn. I’m not a follower, and I only act according to my beliefs.   The saying ‘work until you no longer have to introduce yourself’ is something I’ve believed in and kept in mind since the start of my career. The hours I have spent at work as a dental technician/ceramist would easily exceed Malcolm Gladwell’s 10,000-hour rule (i.e., the time required to be decent at...

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Reproducing Nature Part 2: Blending into Natural Dentition

eLABORATE Magazine featured Yugo’s article titled ‘Reproducing Nature Part 2: Blending into natural dentition’ in May/June 2006 (published language: English).     Introduction:   Isn’t colour matching a restoration to nature one of the hardest things for all of us to achieve? To be able to reproduce the colour, there are so many factors we have to consider and get right. The value, chroma, hue, translucency, characterisation and even the surface anatomy and shine control of the tooth are all essential considerations.   However, from my perspective as a ceramist, we have to consider another crucial aspect – the background. The teeth in the mouth are always under the influence of the colour from the gum, and it is very easy for human eyes to make misjudgements...

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CORRECTION OF MIDLINE CANT WITH A SINGLE CENTRAL INCISOR

The primary objective of treating a single central incisor is to create a restoration that blends in with the surroundings. The two front teeth - upper central incisors -are the most dominant part of the smile, and they are used to determine the position and cant of a facial and dental midline. Studies suggest that the most important relationship to evaluate the aesthetics is the mediolateral inclination of the maxillary incisors. If the incisors are inclined by 2mm right or left, laypeople regard this as unesthetic.   Figs 1 & 2 show a trauma case with damaged right upper central incisor – 11. The assessment of the facial midline can only determine with a full-face photo; however, the images suggest enough to indicate...

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Morphology: Traditional Wax-up Technique for Anterior and Posterior Teeth

Advancement of CAD/CAM technology has been a game-changer for both dental clinicians and technicians. It provides consistency with natural anatomy and aesthetics in the production of dental prosthetics without the possessions of highly trained hands-on technical skills. Understanding the anatomy of natural dentition – morphology – in depth is, however, essential for all dental professionals. The traditional way of reproducing teeth in wax remains critical as a way of training because the knowledge and technique are utilised in the application of composite restorations, diagnostic wax-up, and better understanding in the aesthetics and functions. The following technique is what I presented at King’s College London for a postgraduate masters course in Prosthodontics and Aesthetics candidates, and was well received with high praises.   Model Preparation:   After...

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Ageing – A Paradigm Shift in Ageing (GAMSAT Essay Example)

Consider the following comments and develop a piece of writing in response to one or more of them. Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.   ‘I recently turned sixty. Practically a third of my life is over’ – Woody Allen   ‘With full-span lives having become the norm, people may need to learn how to be aged as they once had to learn how to be adult.’ – Ronald Blythe   ‘The man who works and is not bored is never old.’ – Pablo Casals   ‘Every man desires to live long: but no man would be old.’ – Jonathan...

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Introduction: GAMSAT Section 2 – Written Communication

The Graduate Medical School Admissions Test (GAMSAT) is undoubtedly one of the most challenging exams that any aspiring doctor will have to face in postgraduate medical or dental courses at the top universities in Australia, Ireland and the UK. GAMSAT evaluates the nature and extent of abilities and skills gained through prior experience and learning, including the mastery and use of basic science concepts and the acquisition of more general skills in problem-solving, critical thinking and writing.   GAMSAT consists of three components: Section 1: Reasoning in Humanities Section 2: Written Communication Section 3: Reasoning in Biological and Physical Sciences   Section 2, the written communication component of the GAMSAT, assesses the ability to organise and express one’s thoughts logically and effectively. It is a...

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Before and After 2008: Welcoming my Inaugural Patient at Smile by Yugo

A Caucasian male in his 30s presented with a trauma case on the (patient’s) right central incisor (11) – had an accident while playing football. He was also concerned about the appearance of the (patient’s) right lateral incisor (12) – it appears too short and narrow in his words.   11 is a non-vital tooth with minor discolouration in the stump (c.f., Fig 1); thus, we selected a zirconia restoration. The opacity of Lava Zirconia was suitable for slight masking, and its aesthetic advantage in complex colour matching.   12 is a healthy, vital tooth clinically speaking (c.f., Fig 1), thus we required only a minor conservative prep to proceed with the refractory veneer. Additionally, bleaching was completed two weeks before the shade taking...

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Reproducing Nature Part 1: Understanding the Composition of Natural Dentition

Eminent peer-reviewed publication - European Journal of Esthetic Dentistry - featured Yugo’s inaugural international article titled ‘Reproducing Nature: Understanding the Composition of Natural Dentition’ in 2008 (published language: English, German, French, Spanish, Italian and Greek).   Abstract:   Ceramists may be able to produce excellent results, but none can improve on the natural dentition. Natural teeth are always the benchmark to which every ceramist should aspire. Becoming a better ceramist requires training and application, and one of the best ways of training is to copy natural dentition. The amount of information that can be gained just by examining natural teeth is enormous. Natural dentition is irregular, but it is also in proportion and perfectly balanced. By trying to reproduce natural teeth, the ceramist will appreciate...

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