Cases
Smile Makeover in 2 appointments March, 2021
Patient complaint:
Not happy with teeth colour around the gum area. Hairline fractures were found in the enamel/dentine of multiple teeth
Discussion and proposed treatment:
1st option: Glass Ceramic veneers to address the colour issue and shape of teeth
2nd option: Full crowns + inlays/overlays for less damaged teeth
Time frame: 48 hours
After discussing all possible options with the patient, we made the decicion to go for full coverage of all teeth in question and replace 2 molars with inlays for a total of 22 Glass ceramic e.MAX restorations.
Old crowns were removed very carefully and there was no need for a laser coagulation of potentially bleeding gums. The patient had very good oral hygiene and good periodontal status
CEREC scanner was used to create digital impressions with much greater accuracy than a standart impression material. The upper teeth were scanned and designed on the first appointment and lowers – on the second.
Crowns were milled from Glass Ceramic blocks for maximum strenght and colour was chosen by patient on the day of the consultation few weeks earlier.
We scan, design and create 95% of all our patients ceramic work. This closed circle allows us to produce incredible results in matter of hours (sometimes minutes).
Waiting times for such a big case would usually be about 3 weeks if we used a 3rd party laboratory.
We managed not only to reduce the total price for the patient by eliminating the need for temporary crowns between the appointments, but also give him the smile he wants in just 2 days.
Teeth whitening (Philips ZOOM!) October, 2019
Patient complaint:
Not happy with current teeth colour
Discussion and proposed treatment:
1st option: Feldspathic veneers to address the colour issue and shape of teeth
2nd option: In-Office teeth whitening
Time frame: 1 hour or 2 weeks
After a short discussion with the patient about her expectiations and the time frame for the work to be carried out, we took the decision to bleech all upper and lower teeth.
Patient was pressed with time and wanted very quick results without the need to return for 2nd appointment.
Patient had history of ortho treatment in the past (braces). Upon detailed examination it was found that her orthodontst has left compostite material on most of her teeth, making it impossible to clean these surfaces. After careful removal of the glue, thorough scale and polish and additional polishing of the previously damaged areas, we started the procedure.
It took approximately 1 hour to achieve this result
6% ACP gel with High Intensity setting on the gel-activating light was enough to bleach even the darkest coffee stains on front teeth.
The patient didn’t report on any sensitivity after the treatment and on follow up call next week.
Complex smile makeover (orthodontics, whitening, veneer) JULY, 2019
Patient complaint:
Not happy with her smile
Discussion and proposed treatment:
1st stage: Orthodontic treatment of both upper and lower arches
2nd stage: Teeth whitening
3rd stage: Composite/Ceramic Veneer for upper right canine
Time frame: 8 months
Here we have a great example of multidisciplinary dentistry. Rotated front teeth, deep bite combined with uneven staining and colour, shifted midline (to the right) and mild localised gingivitis.
Options for full ceramic veneers or orthodontic apliances were given to the patient.
After short discussion we made a decision to use the more conservative and less invasive approach – orthodontics.
Such rotations can be tackled in many different ways with ortho methods – conventional braces or removable apliances like Clear Aligners, Invisalign or Inman Aligner. They all have their pros and cons. The system used in this case is Inman Aligner
The photo on the left shows the result of the orthodontic treatment which took approximately 8 months.
Whitening procedure with Philips Zoom! for 1 hour was done during the treatment. We let teeth to rehyrdrate for few weeks. No sensitivity was reported due to gentle gel used for the procedure.
We have achieved balanced smile line with natural looking incisors. Midline is returned to central position.
Now was time to think about the upper right canine. Since we wanted to keep the teeth as natural as posible, we chose composite veneer for redesigning the visible side of the tooth.
Prosthesis case (dentures) JUNE, 2019
Patient complaint:
Denture is not aestheticly pleasing
Discussion and proposed treatment:
Manufacture a new upper full denture with natural “pink” acrylic and significantly durable and far more aesthetic composite/ceramic teeth.
Time frame: 3 weeks
The challange with this case was the obvious gummy smile when the patient was laughing. The pale pink colour that was used for the old denture was dominating the smile. This could be tackled in couple of different ways. We can inject botulinum toxin into the deeper muscles around the nasolabial folds and limit their constriction, resulting in less top lip movement. The more common and non – invasive way is to choose slightly larger teeth. Combination of both can be used in some cases to achieve perfect results.
“Before” images not only show the wrong shade of “pink” used for the gingiva, but the lack of passion/expression on the patient’s face. It would be correct to say that she tries to “fake” the smile.
On the “After” photos, the patient looks happy, truly happy. This is not only because she was delighted with the result, but also because the so called “smile line” was correctly implemented.
We usualy show our whole canines during the smile process (After photo). They act as a nice “frame” to the whole painting. And a good painting deserves a good frame.