One tooth smile makeover...

Sometimes one tooth can disrupt the entire smile line...with this patient, a middle aged woman...she had what is called a peg lateral where the lateral incisor is in the shape of a peg. This is not an umcommon finding and there are a number of ways to treat it. In this case I decided to place an all porcelain jacket on the tooth to get the most esthetic result possible...take a look at these two images of the tooth before any treatment.


The first step is to file or prepare the tooth so that a jacket can be placed over it...in this picture you can see the finished preparation...

And one week later the patient returned and we tried in and cemented a beautiful porcelain jacket that matched the adjacent teeth and immediately changed her smile...she still has an unesthetic tooth on the other side but that tooth does not bother her and we are leaving it alone for now.


Now...if she would only let me do the tooth on the other side of the smile!!

everybody needs implants

Implants are now the first choice for restoring missing teeth.
We don't have to involve other adjacent healthy teeth to make a bridge..with implants we are only dealing with the patient's missing tooth/teeth situation.
Here is a case where a patient lost three teeth in the lower front jaw. Years gone by we would have made a bridge where we grind down the adjacent healthy teeth..but no more.
As you can see here, in the photo above, the patient had two implants placed into the area of missing teeth..these two implants will now hold three porcelain teeth.
First the lab makes a metal framework for me that I try into place...in this photo you can see the framework that was tried in..

the framework then goes back to the lab and porcelain is then baked onto the metal framework and as you can see it is made to appear as three distinct teeth.

and in the next photo you can see that this is not cemented into place but rather we are making this as an implant case which is screwed into place.

The screw holes will be filled with a tooth colored acrylic and will not be visible and the patient will not feel anything unusual in that area.
of course now the problem is that the remaining teeth that the patient has really look old compared to the new teeth..but that will be changing as the two teeth remaining are scheduled for some cosmetic work...we were not going to make the new teeth look like the old teeth!

porcelain and gold ..a winning combination.

Gold..still the best metal that dental scientists have to offer us..but you would be hard pressed to find a patient willing to accept any gold showing when you make them teeth, no one wants any gold showing.

So here is a case where i used gold for the posts underneath and then porcelain crowns on top.
The implant surgeon placed 5 implants and I made 5 gold abutments/posts...on top of those posts we place a 10 unite porcelain splint..done in two sections...
in the photo above you can count 5 posts and one natural tooth upon which the porcelain bridgework will be made.

I decided to make this case in two sections...lower left and then lower front...



First I cemented the lower left for the patient and then lower front...
the patient feels great and loves the fact that by giving a slightly different size and angle to the teeth they look like they are his teeth and not just another set of straight caps with an artificial look.