Being able to restore esthetics and function to a patient is just the beginning. Having teeth that are life-like and permanently attached to implants greatly improves one’s confidence to smile and allows for faster implant healing and less discomfort.
As an alternative to orthodontic treatment, this cosmetic enhancement is an example of what can be achieved chairside in just 1 visit. On a young patient, this result is more conservative than veneers as well as cost effective.
Composite Veneers can be a cost effective treatment option for patients that are not ready to have a porcelain bonded restoration. Composite can be a conservative method of achieving an equally esthetic outcome with minimally evasive treatment and less time. However, when compared to a laboratory processed restoration, the added durability and stain resistance of the porcelain over time reflects the additional cost.
In this particular case, the patient just completed her orthodontic treatment and wanted to improve the esthetics of her front four teeth. Her pegged laterals were narrow and the incisal edges of her front two teeth were chipped and unpleasant.
Here is a basic case that illustrates the effect of simply changing the contact between an implant crown and a tooth. Whenever we restore a implant restoration, particularly in the esthetic zone, we want to “close the gap” or “black triangles” as much as possible due to the loss of papilla. This is even more pronounced between two adjacent implants.
Depending on the width of the adjacent tooth, we are either adjusting the contact point back if we want to narrow the width of the tooth, or adding to the undercut. This creates a broader contact point between the two teeth. In this case the width was the same so we just added composite to the mesial undercut of #8 to create a long contact surface from the original contact point all the way down to the gingiva. We then placed a new implant provisional on #9 to follow the same mesial contours and eliminating the dreaded black triangle. On this particular case, it helps to manipulate the tissue with a screw retained restoration than can be placed to apply pressure and manipulate the gingival contours. The provisional was screw retained, but because of the implant placement, the final crown will be cement retained to avoid a facial access. Because the tissue is already shaped in the provisional stage, delivery the custom abutment and cement retained final crown will be predicable and easy.
Custom abutments have been a standard of care in our practice. With superior tissue support and response, better hygiene and fewer complications it’s a no brainer the custom abutment is better than a standard stock post. Manipulation of the tissue is essential prior to making an impression and selecting the right material can make or break the final esthetic result.
Often I get asked, “Why does a crown cost so much?” I simply reply, ” Would you rather have a tooth that looks like a crown? Or a crown that looks like a tooth?”
There are many factors that can influence a crown such as: materials (all porcelain ceramic vs a porcelain metal vs gold), the laboratory technician, and the skill of the dentist.
WE PUT THE DETAILS IN DETAILS:
Our goal is not to just give you a crown, but to deliver a product that mimics nature itself and has the esthetics and beauty of a natural looking tooth! Dentistry is an art and we set the bar high for our level of satisfaction. Some places may advertise a crown the same-day, but we’re not that type of office. We want your crown to look and feel amazing so we send it out to a laboratory where a skilled certified lab technician will spend the time to carefully craft your tooth. This means adding layers of porcelain, adding translucency and character. Each tooth has multiple shades, that is why we select up to three levels of shades per tooth to make sure we get that perfect match.
STRONGER, BETTER, BEAUTY:
When it comes to materials, we do everything we do everything we can to make your tooth look like a tooth. That means using materials and products such as Emax and Atlantis for our custom abutments that have been proven by research and literature be both strong and esthetically pleasing. Lets face it, some laboratories will cut corners to save on costs and thus provide an inferior looking crown or use a weaker material that may be prone to fracturing or chipping. We want our crowns to be an improvement over what was originally there.
Note: The last tooth is a crown recently done, compared to the older crown in front. Note the characterization and detail added on the side to match the characterization of the patients natural tooth.