Extensive restorative cases can be completed in as little as a few weeks to over a year, depending on the complexity of the case and the patient’s desires. Regardless of the duration of treatment, we always follow the same sequence of steps that have proven successful in case after case. A beautiful esthetic result is always the goal, but a beautiful smile won’t last long if it isn’t comfortable and stable. We want your beautiful smile to stand the test of time!
Patient DO noticed how his teeth had changed after looking at pictures of himself from years ago. Wear on the biting edges, older fillings picking up stains, cracks developing and the enamel getting thin all said to him “old” and he wanted to regain that youthful look to his smile. Our first step was to figure out why his teeth were wearing down in the first place (tooth wear is NOT a normal part of aging). After replacing some over-sized crowns on back teeth we were able to determine is proper bite position and then move forward with the four-step process of smile redesign: design on plaster models, design in wax models, place temporary restorations, and lastly place the final ceramic restorations. This process is time-tested and allows us to achieve the four goals of every successful case: esthetically pleasing, comfortable, functional, and hygienic. He was thrilled with the results and has since referred many friends and family members to our office!
Patient BK was concerned about the appearance of her front four teeth. The two front teeth (central incisors) were overlapped and different lengths and one had an old bonded filling on it that was starting to wear down. The two lateral incisors were of different length and contributed to the appearance of a “canted arch.” After preparing the teeth the provisional (temporary) crowns were placed and an immediate improvement was noticed. She wore these provisionals for four weeks and some minor adjustments were made to fine-tune the appearance and bite. The final restorations exemplify several principles in esthetic restorations: symmetry, the incisal (biting) edges follow the lower lip to create a natural-looking smile line, blended shading from the gumline to the edge, and a harmonious transition from natural teeth to the restored teeth. She was very happy with the results and couldn’t stop smiling when she left the office!
Patient RP is an excellent example of the dramatic change that can be recognized with esthetic restorations. For years he had been dissatisfied with the appearance of his smile and finally decided to see what could be done. After presenting him with the wax-up (final restorations created in wax on a model) he decided to move forward. The plan was to restore the upper front six teeth (canines, lateral and central incisors) to close the spaces, remove the older fillings, improve the color/shade, re-establish the proper arch form and improve the bite with the lower front teeth. After preparation the provisional (temporary) crowns were placed based on the wax-up and slight adjustments were made to the alignment and bite. No further adjustments were needed and three weeks later the final restorations were placed.
Patient AF had long been thinking about re-doing her upper front teeth. She was unhappy with the “black lines” at the edges of her old crowns at the gumline. Unfortunately this is an all-to-common situation with older porcelain-fused-to-metal (PFM) crowns. If the gums recede slightly the thin metal edge of the crown gets exposed and the classic “black lines” appear. Add to this some failing fillings on the canines (cuspids) and she was ready to get all front six teeth restored. I designed the new teeth in wax and we reviewed the desired end result together. Upon her approval we proceeded to remove the old crowns and fillings, prepared the teeth and made temporary crowns which she wore for about four months. This time period gave her the opportunity to make sure the look, bite and feel of the new crowns was to her liking. When she felt comfortable moving forward we had the final crowns made and bonded them in a week later. By following this process we only had to make some very minor adjustments and she reports everything has been very comfortable!
Patient SR was concerned about the wear on her two upper front teeth (central incisors). We discussed that bonded fillings would have worked for 2-3 years but would have needed replacement due to the same wear and chipping that caused her enamel to break down. In this situation we decided porcelain veneers was the best option for esthetics and durability. We could design the restorations to be in harmony with her lower teeth to minimize wear and still provide a beautiful esthetic appearance. After preparation of the teeth we placed the provisional (temporary) restorations and adjusted the contours to achieve the esthetic result she was looking for. After about four weeks we were able to bond in the final restorations which blend seamlessly with her natural teeth; the best of both worlds!