Case Presentation: Anterior Veneer Replacement

Today's patient came to us with a set of porcelain veneers on their two front teeth, where one had become cracked along the gum line. Defects in this location are particularly problematic, as they create an easy place for bacteria to enter the tooth and are cosmetically unpleasing. After discussing options with the patient, we decided to replace both veneers with new Emax lithium disilicate units. Lithium disilicate is an engineered dental material that is about five or six times stronger than porcelain, along with having more "natural" cosmetic properties. By replacing both veneers, we were able to repair the defect, add length to the teeth (the original veneers were short of optimal) and create overall more natural contours. The result is a beautiful and more youthful smile. If you are interested in veneers or any other cosmetic dental procedures, please give our office a call!

Case presentation: Full Anterior Veneers

Take a look at this beautiful transformation performed at our office! In the before pictures, notice how the biting surfaces of this patient's anterior (front) teeth are worn down and uneven. Flattened and discolored teeth create an older appearing smile, regardless of age. The new veneers allowed Dr. Hong to develop a uniform and well rounded smile, while correcting the tooth shade. The results are absolutely stunning! If you would like to know more about veneers or any other cosmetic services offered at our office, please let us know!

Case Presentation: Veneer Transformation

In many cases, veneers provide a drastic change to the the teeth and smile appearance. This patient was no exception, where cosmetic veneers were used in conjunction with a full Invisalign treatment. By removing a small amount of tooth structure, Dr. Hong created room for a set of lithium disilicate veneers to be placed on the four front incisors. These veneers corrected for irregularities in tooth shape, size and dimension. They also allowed her to develop a more robust and youthful profile by adding contour to the front of the teeth. The overall effect is instantly noticeable and we are very happy with the results! If you would like to know more about veneers or would like to schedule a consultation with our office, please give us a call!

Case Presentation: Esthetic Veneers Part 1

For many patients, cosmetic veneers are a great way to transform their smile with a short turnaround time. This patient is a grandmother who always wanted to close the gaps in her front teeth. Using veneers, we will both close the gaps and create a beautiful and natural looking smile. We just finished the first part of her treatment, where we prepared her four front teeth, took impressions and made the temporary veneers. She will return in about two weeks to cement the final product!

Before

Before veneers, this patient's teeth had large spacings and were not completely symmetrical. 

After

Here is the same patient with her temporary veneers on. You can really see how this procedure will create a more esthetic smile!

The "after" photo shows our patient in acrylic temporary veneers. They are created immediately following the preparation to hold space for the permanent restoration. Right now, our dental lab is working on the permanent veneers, making sure they have the right color, shape and opacity to match the rest of her teeth. We are eagerly awaiting the final product and will post as soon as we deliver it!

The Golden Proportions: A Case Study

Last month, we posted a blog article on  The Golden Proportion, a set of dimensions based on ideal proportions found in nature. When it comes to the smile, these proportions are only one piece of the aesthetic puzzle. The position of the lips framing the teeth, the angulation of the teeth, and the location of the dental midline are all examples of factors that influence our interpretation of a pleasing smile. However, the golden proportion is an interesting feature to study, as it is so deeply rooted in mathematics.  To better explain how the golden proportion helps define facial esthetics, we assembled a few real-life cases for you to examine!

Case 1

Central tooth width to length ratio: 74% (ideal is 75-80%)

Golden proportion ideal measurements based on a 2D picture:

• Central 1.618
• Lateral 1
• Canine 0.168

Golden proportion ideal measurements, assuming the central is ideal width:

• Central 7.4
• Lateral 4.6
• Canine 2.8

Comments:

Case 1 has centrals that follow an ideal width to length ratio at 74%.  In evaluating the golden proportion, the laterals and canines are wider than ideal. The frame of the lips is much wider than in Case 2 or 3, so the gum tissue above the gum/tooth margin is very visible.  

Case 2

Central tooth width to length ratio: 96% (ideal is 75-80%)

Golden proportion ideal measurements based on a 2D:

• Central 1.618
• Lateral 1
• Canine 0.168

Golden proportion ideal measurements, assuming the central is ideal width would be

• Central 8 
• Lateral 4.9
• Canine 3.0

Comments:

Case 2 has centrals that are nearly 1:1 in the width to length ratio and have a square appearance.  It appears that the centrals have some wear on the biting edge and that they could stand to be 1-2 mm longer.  The laterals and canines are slightly wider than the golden proportion measurement.  The patient's lips frame the overall smile so that hardly any of the biting edge or gum/tooth margin of the teeth show.  Thus, the aesthetic discrepancies are less noticeable.

Case3

Central tooth width to length ration: 90% (ideal is 75-80%)

Golden proportion ideal measurements based on a 2D picture:

• Central 1.618
• Lateral 1
• Canine 0.168 

Golden proportion ideal measurements, assuming central is ideal width:

• Central 9
• Lateral 5.6
• Canine 3.5 

Comments:

In reviewing the three cases presented here, Case 3 has nearly exact golden proportions.  The central tooth width to length ratio is slightly greater than ideal at 90%, but the upper lip covers enough of the gum/tooth margin of the centrals that this ratio isn't as relevant in evaluating aesthetics.  Also, the upper and lower midlines are slightly off center from one another, but the upper central midline is perpendicular to the floor of the mouth and centered with the patient's nose.  Thus, the midline is aesthetic even though the upper and lower midlines don't match each other.