Smile Repair Using Bonding and Emax Crown

Today's patient came to us with complaints of mismatched central incisors. The patient's right incisor had a large composite (tooth colored) filing that had become worn and stained over time. Their left incisor had a crown that was too light and opaque compared to the surrounding teeth. Both of these esthetic problems are very common, as teeth tend to age differently from the materials we use in dentistry. Composite fillings pick up stain and erode more quickly than enamel while crowns do not respond to color changes like surrounding teeth. The result is that restorations in the front of the mouth gradually become more obvious and less natural over time. 

Dr. Kari Ann Hong set out to repair this smile by placing a new filling on the left incisor and using an Emax Lithium Disilicate crown on the right. The new restorations add natural coloring, opacity and shape back to the patient's smile. In the before picture, the existing dental work is fairly obvious. The new crown and filling blend naturally and bring harmony back to this smile! If you would like to know more about crowns, fillings or other cosmetic procedures we perform at our office, please give us a call!

Case Presentation: Anterior Crowns

Everyone wants beautiful and uniform teeth, but can you create a smile too "perfect?" In these before pictures, notice how this patient's teeth are smooth, consistently colored and similar in shape. While these qualities sound good on paper, they add up to a less than natural looking smile. We replaced the older porcelain and metal crowns with brand new Emax lithium disilicate restorations. The incisors were lengthened to fill out the smile line and gentle variations were added to the fronts of the teeth. Additionally, the translucent nature of Emax reacts to ambient light similarly to natural teeth. These small changes better mimic real dental enamel, and thus create a more life-like smile. 

If you would like to know more about our cosmetic dental services, please contact our office. We pride ourselves in creating beautiful smiles customized to the individual patient's wants and needs. Schedule an exam today!

Lower Incisor Implant Restoration

The top photos show the shade guides used by the lab to match the adjacent teeth. The metal pieces indicate the location of the implants for the impressions. The bottom photo highlights the great job Opus One Lab did in matching the colors of the teeth and gums!

Bet you've never seen implants like this! Today's patient came to us after having lost their lower anterior incisors due to periodontal disease. Periodontal problems are common in this area due to a combination of plaque buildup, poor access due to crowding and (sometimes) tension of the lower lip on the gum tissues. Unfortunately, losing these teeth can have many undesirable effects, such as problems tearing food and lack of esthetic support for the lower lip. 

In treating this patient, two implants were placed by a specialist next to the lower canines. Once the surgical sites were healed, impressions were taken and sent to Opus One Dental Laboratory. At the lab, Four prosthetic teeth were created in a bridge from implant to implant. To correct for the missing bone, pink porcelain was added to the bottoms of the teeth to simulate gum tissue. The result is a very functional and natural looking replacement! If you would like to know more about amazing transformations we can achieve with dental implants, please give our office a call!

Dental Questions: Why do teeth need root canals?

When most patients think of endodontics (root canal procedures), they usually assume it is being provided to treat an infection.  While the most common reason for a tooth to need a root canal is infection, there are a whole host of procedures and conditions that benefit from endodontic therapy. Take a look at this list of typical reasons that teeth need root canals!

Infection- Indeed, the most common reason most patients need root canals is from bacteria growing around the roots of the teeth. In the classic model of tooth infection, tooth decay spreads to the dental pulp, causing the tissue to become necrotic. This dying tissue becomes a food source for the bacteria, allowing them to flourish. A root canal treats these infections by removing the remaining tooth pulp, sterilizing the interior of the tooth and cutting off the bacterial food supply. 

Fractured Teeth- Fractured teeth are often impossible to see and difficult to diagnose. Many times it takes the imaging technology found at an endodontist's office to reveal the location and extent of the crack. Most fractured teeth are impossible to restore and require extraction. However, some smaller cracks can be rectified through a combination of a root canal and crown. 

Post Placement- If the top of a tooth is broken off at or near the gum line, placing a crown on the remaining structure is impossible. In certain occasions, a root canal procedure can be performed along with a post placement to save the tooth. A dental post is a metal or composite rod that extends from the root of the tooth to above the gum line, creating a new substructure for a crown to be fashioned. 

Trauma- Many times, dental trauma will cause the internal tooth pulp to recede or become necrotic. A clear sign of this is a tooth becoming darker or red-toned following injury. In order to preserve the tooth and minimize risk of infection, a root canal is often performed. After the root canal is finished, internal bleaching can be used to lighten the tooth back to a natural tone. 

We hope you found this article helpful! If you have any more questions about root canals, dental trauma or dental crowns, please give our office a call!

Specialist Spotlight- Opus One Dental Lab

When having a crown or bridge placed, your ultimate goal is to have it look, feel and function like the natural tooth that was there before it. While this process is never “easy,” it becomes even more difficult when dealing with anterior (front of the mouth) teeth. For these complicated lab cases, we are proud to work with Opus One Dental Lab and it’s owner, Uri Yarovesky.

Uri standing with his many awards and honors. 

Uri has over 40 years of experience in the dental field as a technician, lab owner and world recognized lecturer. He has made crowns and bridges for celebrities, heads of states and even as prosthetics for blockbuster movies. His credentials include countless awards from the most prestigious dental publications and institutions. Opus One Lab was designed as an extension of his years of experience- cutting edge techniques with a personal touch. In addition to the typical technologies and instruments you would find in most labs,this office houses a research facility used to develop and manufacture new ceramic technologies. For some of the services the lab offers, they are the only location in the entire world with this technology available.

Crowns on anterior teeth need to be a near identical match to the surrounding teeth. Small deviations in coloration, shape, size or translucency can translate to a product that looks “fake” or out of place. It takes careful examination and years of experience to deliver a perfect prosthesis that feels great. Opus One delivers this by offering customs shade matching appointments, where you meet with Uri one on one to design and perfect your dental crown. He and his team have a deep appreciation for dental restorations and can meet your desires on shade, feel and even age appropriateness.

We love working with Opus One because they are both a local business and a global leader in dental technology. Uri’s lab understands the importance of both esthetics and function in delivering a quality product. Their crowns and bridges fit and look great, which results in happier and more satisfied patients.

Specialist Spotlight-Synergy Dental Lab

At Thousand Oaks Family Dentistry, your appointment is much more than meets the eye. Behind the scenes, a network of dental specialists, labs and technicians help ensure that you receive outstanding esthetic results from our office. Today, we would like to highlight Synergy Dental Lab and its owner Andy Knapp, for their efforts in delivering our patients beautiful crowns and bridges.

Synergy Lab's owner, Andy Knapp.

At Andy’s lab, a team of technicians bring together over 70 years of design, ceramic and modeling expertise. They use a combination of proven techniques and the latest CAD/CAM technology to deliver products that fit and look wonderful. This ultimately means less time spent in our office, away from your friends, family or work. Even difficult cases can be handled with ease, through the use of digital photography and shade matching. The end result is a crown or bridge that looks, feels and fits like a natural tooth.

An example of the incredible work that comes out of Synergy Dental Lab. Through a combination of time, effort and technology, the quick impressions we take at our office become beautiful crowns and bridges. 

Synergy is a locally owned and operated business. Aside from being a part of the Thousand Oaks economy, this allows them to provide quick turnarounds and immediate support. Difficult time constraints, complicated cases and other concerns can be addressed in a matter of hours or days, instead of weeks.

We love working with Synergy dental lab because they offer a high quality product with excellent customer service. The speed, accuracy and support offered by this lab allows us to provide more convenient appointments at our office, ultimately saving you time and money. If you have any questions about Andy’s lab, or any of the other offices we work with, please give us a call. We are here to make your entire dental health experience as easy and confusion free as possible!

Emax Lithium Disilicate Crowns

    When it comes to dental crown materials, there are many different options to suit a multitude of different scenarios. Some, like full porcelain crowns, provide excellent esthetic results. Others, such as full gold units, provide extreme durability along with desirable tooth-like physical properties. However, what options offer both beautiful cosmetic results along with enduring strength?

For many years, porcelain-fused-to-metal (or “PFM”) crowns were the cornerstone of “form meets function” in crown materials. These units are made by taking an alloy metal core and attaching a thin layer of porcelain over it, resulting in a durable tooth colored restoration. Unfortunately, this process is not without it’s downfalls. The porcelain has a tendency to crack and break between the opposing tooth and the hard metal sublayer. Additionally, the alloy substructure is extremely opaque, and prevents the overall crown from having the translucency of a natural tooth. This detracts from the overall esthetics of the final product.

While PFM crown still have a very useful place in dentistry (and are still regularly placed at our office for various reasons), modern technology has provided us with newer and more elegant solutions. Today, we can offer Emax as a means of creating a beautiful crown or bridge with long term durability.

An example of a finished Emax dental bridge (right) and crown (left)

Emax is a lithium disilicate material that combines the translucency of porcelain with incredible strength. On average, these restorations can withstand 360-400 megapascals of force before breaking. What does this mean? Essentially, you could hammer a crown made of Emax into a plywood board and pull it out without damaging the structure. This incredible resilience means that Emax can be placed in almost any location in the mouth with extreme confidence.

In terms of esthetics, Emax rivals porcelain in that it provides an incredibly toothlike translucency. One of the most obvious “tells” of a dental crown is poor transmittance of light. Crown that do not respond to ambient light like natural teeth are just as visually jarring as poor tooth shade matching. Emax offers this low opacity in conjunction with the ability to have natural artifacts “baked” into the crown’s surface. Surface lines, color gradients and staining can be added to the crown to blend it perfectly with the adjoining teeth. Overall, this step helps detract from the “chiclet gum” look that is imparted to certain crown.

Of course, Emax in only one of the excellent crown options offered at our office. While it has some great properties, it can be a poor choice of restoration depending on a number of factors. Your crown material should take into account mouth location, neighboring teeth and your personal expectations. We regularly work with a number of different materials because our patients regularly need a number of different materials. If you have any questions Emax, or any other materials we offer at our office, please let us know at your next appointment!