You can click on the images to expand each one to see a larger view.
Replacing Old Mismatched Crowns and Veneers to improve the aesthetics
This patient presented to me to complain that she did not like the look of her veneers and one of the lower ones had moved our of its place. After a thorough clinical exam, i realized that the patient didn’t have four veneers on the upper arch but two porcelain veneers and two crowns. I explained to her the difference in materials used to fabricate the crowns and veneers is the reason they don’t look the same. Optical properties of different porcelain are vastly different and mix and matching them is not a good idea.
She asked me to do whatever was necessary to match the shape and shade of her veneers to idealize her aesthetics. I replaced the Old Mismatched Crowns and Veneers with a new set of four all ceramic crowns in the upper jaw and a set of three veneers & a single crown on the lower jaw to idealize the shade, shape and arrangement of the teeth. All the restorations were similar except the one crown on the implant in the lower arch, but it was characterized with various modifiers to match the shade of adjacent veneers.
Replacing Old mismatched crowns with Life-Like all ceramic crowns
Treating dentists is not an easy task. As a prosthodontist I was up to the challenge and felt privileged to be asked by my colleague to address his cosmetic concerns. Guiding the master ceramist to characterize the shade, shape and internal characteristics is something a prosthodontist can achieve for you to idealize your smile and bring back the lost confidence to smile.
This patient was previously treated to receive a single crown, where two cracks were found in his tooth. I recommended to my patient a more conservative approach than their previous treatment plan to cover the cracked part with an Onlay instead of a crown. I presented two excellent options for the onlay, gold or ceramic. To achieve maximum esthetics, the ceramic option was chosen.
An Onlay replaces what is missing in the tooth (such as cracks), unlike a crown that completely covers the tooth. It is a more conservative approach and significantly gentler to the gum (gingiva) when designed properly.
Porcelain Onlay to restore a molar with a chipped silver filling
Knowledge regarding resistance & retention forms is required when recommending this type of restorations, otherwise early failure is inevitable. There are many different ceramics. Each ceramic behaves differently and each one has a unique characteristic. The longevity of a restoration depends of careful choice of ceramic material, beside other factors.
Single Crown Replacement
PFM crown #30. A Metal Island on top of the crown indicates inadequate tooth preparation & poor design (left photo). The crown was replaced with an all ceramic crown due to an open margin and tooth sensitivity that did not go away for several months. Metal showing under the porcelain is usually a poor sign and shows a crown done improperly.
We replaced the inadequate crown with a natural-looking single crown that matched the shape and shade of the surrounding teeth. (right photo)
Porcelain Fused to Metal Crowns and Bridges in Smile Makeover
This middle aged female was frustrated with her front teeth and the way she had to cover her lips before smiling. A long term ailing dental implant, which was left unattended, had caused significant bone loss and could not be regenerated after two regenerative surgeries. Finally she was referred to me for a prosthetic solution. I never forget how she hugged me in tears for several minutes when the crown and bridge case was completed. She is still doing fine without any complications after nearly 5 years.
All Ceramic Crowns for the upper incisors.
This retired University professor was interested in treatment by a Prosthodontist, so she found me after her previous dentist dropped her dental insurance. She was initially interested in getting two veneers, however after a thorough clinical evaluation, I recommended two crowns to improve the esthetics and provide adequate longevity for my treatment plan. This decision was based on ideal treatment to provide predictable longevity. Veneers are conservative restorations for ideal situations, but when the tooth has a large restoration, veneers may not be as permanent as crowns.
One of my sweetest patients, she used to be a photo model in her teens and twenties. Due to age, loss of back teeth, bite collapse, wear of the remaining teeth, her smile and tooth function had deteriorated. Her main concern was to be able to chew better and to show more teeth the way she used to.
We provided a full mouth smile makeover, with a few visits for fine tuning her bite with T-Scan (dental occlusal analysis system). Her “After” smile is one of complete satisfaction.
There are many factors that would affect the longevity of restorations. In recent years there have been many advances in dental materials, especially dental ceramics. Porcelain restorations for the most part all look the same to the eyes of a lay person but ceramics behave differently in the mouth. Proper choice of ceramics (porcelain) for each case is one of the important factors that influence not only the esthetics but long term success of that restoration.