Before and After
Crown and Bridge Treatment
TWO FRACTURED INCISORS
This 19-year-old student fractured her two upper teeth to such an extent that the nerves in both teeth had to be removed to save them.
Cast metal posts were constructed to strengthen and help prevent future fracture of these teeth. After insertion of these two gold posts, two full porcelain crowns were made for two fractured teeth. Note how form, texture and highlights are used to match the corresponding teeth in the arch to create a natural appearance.
CHIPPED PORCELAIN CROWNS AND CROWDED LOWER TEETH
This 31 year old leading vocalist was concerned because her crowned teeth were beginning to chip and fracture. She also wanted lighter-colored teeth since her profession required her to be under stage lights much of the time. She was also unhappy with the appearance of her crowded lower teeth.
The six new crowns where constructed entirely of porcelain rather than a combination of metal and porcelain. They were carefully textured to give maximum reflection of light. Although the metal-reinforced porcelain crown is stronger than the all-porcelain crown, the latter type usually provides greater translucency. The lower front teeth were straightened with a removable appliance.
FRACTURED TEETH IN A YOUNG CHILD
This 12 year old girl fractured her two front teeth in an accident and was referred to an oral surgeon to have the teeth removed. Fortunately for her, the oral surgeon felt the teeth could and should be saved. He then referred the patient to a specialist, who removed the nerves from the teeth and preformed periodontal (gum and bone) surgery
Following surgery, two metal posts were constructed to reinforce the teeth. Finally the front teeth were crowned with porcelain to produce the beautiful new smile shown. Never assume that severely fractured teeth have to be extracted – it may be possible to save them. The function of dentistry is to maintain the integrity of the dental arch and to preserve the living structure. For this patient, this goal was achieved. One reason for saving the individual tooth is that it is much easier to clean an individual tooth than it is to clean underneath a bridge.
Orthodontics
GUMMY SMILE, PROTRUSIVE LOWER JAW AND OPEN BITE
This eighteen year old woman sought correction of her high lip line and protrusive chin area.
The patient underwent about eighteen months of pre surgical orthodontics. Surgery involved removal of a wedge of bone from his upper jaw to help reduce her gummy smile, her open bite and the protrusiveness of the lower jaw.
UPPER TEETH NOT VISIBLE
This 25 year old woman had an upper jaw problem. Her upper teeth were not visible when her upper lip was relaxed.
After extensive pre surgical orthodontic therapy, a bone graft was constructed to lengthen her upper jaw. The patient is shown here about eighteen months after surgery. Her smile line is much closer to normal and enhances her overall appearance.
LARGE SPACE PLUS EROSION
This 60 year old airline reservationist had an extremely large space between her two front teeth. She also had an advanced erosion that can be seen as a “ditching in” at the necks of the teeth on the upper right side.
Although orthodontics is the best treatment for patients with large spaces, sometimes a compromise plan can be achieved. Success was accomplished for this patient by creating spaces between the adjacent teeth through cosmetic contouring and then closing the spaces with composite resin. The result is a totally new smile with well-proportioned teeth rather than two oversized front teeth closing the space. This procedure was accomplished in one appointment for approximately one third of the cost of crowning. The fact that the teeth did not have to be reduced for crowns, and that the erosion was also corrected with a more conservative procedure, was very important to this patient.