Case Presentation: Calculus Removal

Today's patient is a great example of why you get regular dental cleanings. These teeth looked completely healthy and normal when viewed from straight on. However, a through exam revealed that the lower teeth were in definite need of dental care. 

Dental plaque tends to build up in hard-to-see areas; behind the lower teeth, around the molars, etc. Over time, this plaque hardens to form calculus (also called "tartar") and becomes impossible to remove with brushing and flossing alone (as seen here). Calculus harbors bacteria that cause periodontal disease, decay and bone loss. At a regular dental cleaning, we use instruments and techniques that rid the teeth of calculus.

This patient received a special type of cleaning called a debridement, where large collections of calculus are removed prior to a normal dental cleaning. They are well on their way to complete oral health! If you would like to know more about cleanings, gum disease or any other health topics, please give our office a call. 

Case Presentation: Midline Correction

Here's a great example of one of the more dramatic changes we can achieve using ceramic crowns. This patient came to our office with white and appropriately shaped front teeth, including a crown on the front-left incisor. However, their midline had a noticeable leftward tilt.

In dentistry, midlines have a huge impact on how we perceive teeth and cosmetics. If the line between the two central incisors isn't perfectly horizontal and centered on the face, we perceive the overall smile as crooked or uneven. To correct this patient's midline, we removed the existing crown on the left central incisor and changed the underlying tooth to face more horizontal. We then corrected the right central and lateral incisors to match. Even in temporaries, this patient's smile is instantly more esthetically pleasing. In two weeks, our lab will deliver a set of ceramic crowns that will complete the transformation If you want to know more about midlines, crowns or cosmetic dentistry, please give our office a call!

Case Presentation: Temporary Veneers

Check out this radical transformation! Today's patient came to us dissatisfied with the color and shape of their anterior teeth. After an exam and consultation, we decided to prepare the teeth to receive cosmetic veneers. For this procedure, only the front and biting surfaces of the teeth are modified to accommodate a thin sheet of esthetic ceramic material.

These before-and-after photos show our patient wearing their temporary veneers. While our lab fabricates the permanent ceramic restorations, these temporaries allow the patient to leave our office with a brand new smile. The final product will be even more natural, symmetrical and translucent- a perfect match to natural teeth! If you would like to know more about veneers, how they are made and if they are right for you, please give our office a call. 

Case Presentation: Veneer Transoformation

This case is a great example of the amazing transformations that can be achieved using dental bridges! Today's patient came to us with significant decay on their upper anterior teeth and periodontal disease on their lowers. A thorough examination revealed that the teeth weren't savable and unfortunately needed to be extracted.

While the patient healed, our lab designed upper and lower bridges to replace the missing teeth. In this instance, bridges allowed us to provide permanently fixed and natural appearing restorations. There are no removable parts (as with dentures) and there was no need for surgery (as with implants). Overall, this solution created dramatic and life-changing improvement for this patient's smile!

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: Polishing an Existing Filling

Over time, dental fillings tend to pick up stains from the foods and beverages we consume. This isn't a big concern with the posterior teeth, where restorations are generally hidden during daily activities. However, discoloration can become a  genuine cosmetic concern in fillings on anterior teeth.

This patient had a filling placed years ago by a different dentist to correct for abfraction, or the loss of enamel near the gum line due to stress and clenching. This type of restoration is very common and usually affects the canines and premolars (both visible in a typical smile). They were dissatisfied with the dark line around the filling that drew the eye towards that tooth. With a 10 minute appointment to polish and recontour, the filling looked brand new! 

It is important to note that we checked the seal and fit of the filling first, to make sure we weren't just polishing a defective restoration. Many times, discoloration is a sign of recurrent decay, where the entire fillings needs to be replaced. If you would like to know more about fillings, their lifespans and how to care for them, please give our office a call!

Case Presentation: Crown Delivery

Take a look at the amazing work we can accomplish with the help of our dental labs! This patient came to us needing a crown repaired in the front of their mouth. As always, our main concern was delivering a restoration that looked completely natural. After preparing the tooth and making impressions, we took a number of diagnostic photographs to capture the nature of the patient's smile. Using just the photos and impressions, our lab created an unbelievable new crown. The color, shaping and opacity are a perfect match to the existing teeth. If you would like to see more of the esthetic work we perform at our office, check out the "cosmetic dentistry" section on our blog index!

Case Presentation: Maxillary Dentures

With the rise of implants and implant dentistry, many patients assume that dentures are no longer a "modern" treatment option. On the contrary, dentures are a great way to replace missing teeth without the need for additional surgeries or trauma. Pictured above is a complete upper denture fabricated for one of our patients. It is in the wax try-in stage: this is a proposed shape for the final denture made out of adjustable wax. Once we confirm the fit and cosmetics of the prosthesis, we will have a permanent acrylic version made by our lab. 

Dentures have a number of advantages of implant supported prosthetics (and vice-versa). From a functional standpoint, dentures allow us to "replace" both teeth and soft tissue. A well made denture can create the appearance of gums in deficient areas or level out resorbed bone. Implants have a more limited range of soft tissue enhancement and frequently require other procedures to get the full effect. Furthermore, dentures have a considerable cost advantage over implants, especially for replacing full arches of teeth. 

When this denture is seated in the patient's mouth, it will be nearly undetectable during daily activities. However, some may find the idea of having a removable dental device objectionable. This is why our office offers a number of restorative services- from bridges and dentures to implants. If you would like to know more about the tooth replacement options available to our patients, please give us a call!

Cosmetic Reconstruction With Emax Crowns and Veneers

Today's case is a great example of the importance of color and translucency when designing a crown or veneer in the anterior region. This patient came to our office dissatisfied with their current dental restorations and overall smile esthetics. The crowned teeth appeared unnaturally opaque and presented with a sharp change in color where the teeth met the gum tissue. These crowns were created using porcelain fused to metal (PFM), a classic technique for fabricating tooth colored crowns. While they make very functional restorations, PFMs take away from the natural translucency of teeth due to their solid metal underpinnings. This patient's condition was exacerbated by gingival recession, which revealed contrasting natural tooth structure underneath the crown.

To create a completely natural smile, we utilized Emax lithium disilicate crowns and veneers across the maxillary and mandibular teeth. These crowns are made of a single type of translucent material, and thus transmit light like natural enamel. Similarly, the single piece construction makes these crown very strong, allowing us to replace the PFMs in the posterior region as well. By working closely with our dental lab, we created a set of crowns and veneers that are uniform in shape, color and shade. The final product is a natural and youthful smile designed to stand the test of time! If you would like to know more about crowns, veneers or any other esthetic service offered by our office, please give us a call. 

Case Presentation: Anterior Smile Perfection

Another Great veneer case from Dr. Kari Ann Hong! 

This patient came to our office wanting to restore the esthetics and proportions of their smile. The maxillary anterior teeth appeared jagged and uneven due to a combination of grinding and dietary acid wear. The unnatural sharpness in tooth structure lends itself to an older appearing or "worn down" smile. Additionally, old composite (tooth colored) fillings had begun to show contrast against the natural tooth structure. As teeth age, they tend to pick up stains and wear at a rate different from composites. Over decades, these small differences can become very evident, particularly in patients who consume lots of dark liquids (coffee, soda, red wine, etc.).

In recreating this smile, Dr. Kari used a series of eight lithium disilicate veneers. These restorations give the teeth a uniform shape and color, while mimicking the natural opacity of dental enamel. In just two weeks, this smile looks years younger! If have any further questions about veneers and what they can do for your teeth, please give our office a call!