Instant Orthodontics — Correcting Overlapped Teeth With Porcelain Veneers

This article showcases the  treatment of a female patient who sought the help of Tampa Cosmetic Dentist Dr. Saylor for Instant Orthodontics. She has overlapped & rotated front teeth and wanted a quick, attractive, and predictable solution. With Dr. Saylor’s expertise, they developed and accomplished a minimally invasive treatment plan for Instant Orthodontics.

Braces Vs. Porcelain Veneers

Traditional orthodontics (braces) take at least 12-18 months to achieve results like these (see photo below). Besides the lengthy treatment time, another downside to consider is the fact that both upper and lower arches need to have braces placed on them. Instant Orthodontics, which is utilizing veneers and/or crowns to achieve the illusion that the teeth are straight, allows a patient to have straight teeth in a few weeks, with no wires, brackets, or retainers involved! This particular patient decided to have 10 upper veneers bonded to give her the dazzling, movie star smile she always wanted!

A Lesson In Instant Orthodontics: How It’s Done!

These types of dental prostheses are extremely thin and delicate until bonded to the tooth structure. Even dropping them at the delivery appointment can be disastrous. The vacuum in the preceding photo is a great instrument for handling these tiny pieces of porcelain.

Instant Orthodontics requires great skill and an eye for natural esthetics on the part of the doctor. Color choice, shaping the teeth just right during preparation, and communicating how the finished veneers should look and fit to the dental laboratory are what determines the success of the case. Once these veneers are chemically bonded in the mouth, you will not be able to tell they are not the patient’s natural teeth.

The Results Are In — Instant Orthodontics Wins!

Accomplishing these veneers and achieving the esthetic we desired was very fulfilling for the patient and the dental team. This patient has waited a long time to upgrade her teeth and she hasn’t stopped smiling since she left the office! There are many solutions for correcting cosmetic dental problems. Consult Dr. Saylor or another reliable dentist for answers to your dental questions, specifically Instant Orthodontics!

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The following photos are the end result for this case. The veneers turned out beautifully and look so natural it’s a little scary. Dr. Saylor & team and the patient were glad they decided to go forward. Without the mock-up preview, this patient may have been too apprehensive to proceed with treatment. We know now that sometimes the previews are as important as the feature!

 The following case was a very interesting one with a few hurdles and difficult choices to make. This female teenage patient presented to the office with congenitally missing lateral incisors, meaning she was born without these teeth. Her canines had drifted toward the midline to fill the spaces, so the treatment plan took some time and serious consideration to develop. There are many ways to approach this issue, but Dr. Saylor had 2 plans of action in mind:

1. We could move the canines back into natural,optimally functional position with orthodontics and “build” new lateral incisors on top of implants. Moving these teeth towards the posterior would leave a thin ridge of bone where the laterals needed to be implanted, so a periodontist would perform a bone augmentation procedure to have a foundation in which to place titanium dental implants. (Longer, more involved treatment.)

2.  We could pull everything forward with braces to close the spaces and recontour the canines to look like the missing lateral incisors. (Easier of the two plans.)

-Dr. Saylor collectively decided along with the patient, an orthodontist and a periodontist to go with Treament Plan #1.                                                                                                             -Reason being: This course of treatment was definitely the best for the patient in the long run. The canine teeth are the sentries of the masticatory process. That is, the canines are the teeth that provide guidance for the function of the jaws in the chewing motion. If the canines are moved or have drifted out of position, the function may be compromised and cause the temperomandibular joint (TMJ) to become stressed and develop lifelong issues.

 The next photo is the patient after having the dental implants placed. The implant is left to integrate into the bone for 90-120 days and then the abutment screw is placed. An impression is taken of these abutments so that custom implant crowns can be fabricated. This picture looks a little scary, but illustrates quite a scientific advancement for the dental field.

  The following photo showcases the multi-purpose functions of today’s composite resin. Instead of a traditional temporary crown or veneer that is made out of acrylic from an impression of the original tooth structure, Dr. Saylor had to sculpt temporary crowns to cover the abutment screws, as we had no impression of the original missing teeth! These temporaries look pretty good and give us an idea of how to shape and prescribe the laboratory fabrication specifications. They are not nearly as perfect as the porcelain implant crowns will be, but are definitely easier to look at than the preceding photo!

  The photo below is of the porcelain crowns in place. One of the most difficult challenges to overcome when creating teeth for a patient is matching the angulation or “flare” of the natural teeth. What most people do not realize is that the shape, size, and angle of protrusion of the teeth has a huge impact on the “wideness” of the smile and also the formation and fullness of the lips. Most patients who are missing front teeth congenitally cannot pinpoint exactly why they are displeased with their smile. Usually, it’s because the smile is not a bright, wide smile and has the appearance of a child’s smile in an adult face. This case also presented a challenge to the dental team because the patient began treatment as a teenager and still had some physical maturing to do. Dr. Saylor had to account for this factor and try to foresee the end results in an adult face and frame.  The patient was extremely pleased with the results and has a beautiful, natural, and healthy-looking smile!

Yet another happy patient of Dr. Saylor’s!

     Many advances in dentistry have occurred over the last few years and are continually developing. Dental researchers and providers have formulated upgraded materials and perfected advanced techniques that have optimized dental care. These folks have examined the effect of oral health on overall health and the importance of considering a multitude of factors when placing a restoration. We’re not just “filling a hole” anymore. We are considering all the possibilities and impact that restoration will have on the patient’s whole mouth. Dr. Saylor attends many Continuing Education courses with his peers and leaders in the field of dentistry to stay abreast of all the new developments in the industry. He regularly introduces new and upgraded materials to his practice to ensure the best restorations for his patients. The following article is an example of how upgrading the materials of existing restorations can make a drastic improvement in a smile.  :)

This patient was dissatisfied with the Porcelain Fused To Metal (PFM) bridge that was placed in the front of his mouth. The existing bridge is bulky, monochromatic with little natural anatomy, lacks translucent characteristics, and doesn’t fit very well at the gumline or into the patient’s bite.

Restorations made of PFM are extremely strong, are tooth-colored, and have been used for many years successfully. Porcelain Fused To Metal material has a couple of drawbacks, though. For one, the opacity of the metal substructure in a PFM crown or bridge reflects most of the light off the restoration, making them appear dull, one color, and unnatural. Certainly another factor to consider with the use of a PFM restoration is the impact of the abrasive porcelain on the natural teeth of the opposing arch.  The before photo clearly illustrates significant wear of the enamel on the lower teeth caused by the bulky porcelain bridge on the upper arch.  This patient’s oral health has actually been compromised by the material used for this restoration.

 Dr. Saylor used all-ceramic e.max  bridge material for this patient and it has improved the appearance of this patient’s smile exponentially! All-ceramic restorations are translucent, like natural tooth enamel. Real enamel allows light to travel through it, leaving subtle shade variations in the appearance of the natural tooth. For example: the incisal edges, or the edges of your front teeth, will look lighter than the portion of the same tooth by the gumline. If this translucency and shade variance is no longer there, it draws the eye to it and makes the tooth/teeth look fake. All-ceramic restorations mimic this translucency, so they are ideal for use on anterior, highly-visible teeth. 

To add to the effect of upgrading the materials, this patient whitened their teeth. Dr. Saylor also restored the worn lower teeth with composite resin and ensured the bite fit together perfectly, so as not to cause anymore attrition. Dr. Saylor chose the e.max System, made of  Lithium Disilicate, for the bridge. This is a new material that combines strength and beauty. The end result is a restoration that is beautiful, natural-looking, and durable. See below for before and after photos.

If you or someone you know has a dental restoration that could be upgraded, search your area for a qualified cosmetic dentist like Dr. Saylor. It may not take a lot of work for your smile to be completely upgraded!

Attrition of tooth structures is basically the premature erosion or wearing of the teeth. This can be caused by dental work that is too bulky on one arch and is wearing against the natural tooth structure on the opposing arch. It could also be caused by clenching and grinding and can be exacerbated by a diet high in acid. This patient had severe wear present on all of his teeth.  It caused a quality of life issue for this person, both socially and physically. This patient was on his way to a full denture, but Dr. Saylor and the patient concurred that the best thing for this patient’s health and well-being was to save all the natural teeth they could.  While waiting for two areas in the back to be prepared for implants, we were able to restore his front teeth with all-ceramic restorations, yielding an incredible result.

Not only did this procedure have a cosmetic impact, but Dr Saylor and team  literally saved this patient’s teeth. Had this issue of attrition not been addressed, it is likely that this patient would have worn his teeth down to the gumline, causing the teeth to become non-restorable. This patient’s treatment has been complete for 3 years and the patient is still completely satisfied with the decision to invest in his dental health as well as his overall health and peace of mind. 

“This is the best money I have ever spent”, says this patient.

If your goal is the same as Dr. Saylor’s, which is to have the least amount of dentistry possible over a lifetime and to maintain your natural teeth until your death at 95 or older, then you should be aware of the amount of wear and tear you are exerting on your teeth. There are many preventive measures you can take, but they all start with the observations and actions of you and your dental professional.

In one of the other blog posts I illustrated how to close diastemas, or enlarged spaces between teeth, with composite resin material. The photos below allow you to see some of the highlights of a veneer procedure. 

There are many ways to improve the appearance of a smile. It may not take a whole lot of dental treatment to get you where you want to be.  A cosmetic consult  with a reliable and knowledgeable dentist who would be able to give treatment options for your personal dental situation would enlighten you. If you have general questions regarding different procedures or options for treatment, feel free to reply to this blog post!

     This patient came into our office with a common dental problem – a composite resin on a front tooth has chipped numerous times. This happens for many reasons, but most often because the patient’s type of bite was not considered when the restoration was placed. This particular patient has few posterior teeth, so the vast majority of masticatory forces (biting pressures) are placed on the front teeth. This means that any restorative material utilized in this area of the mouth has to be extremely durable or these intense forces can cause the restoration to break down, as in this instance.

     Dr. Saylor evaluated the case and offered the patient 3 viable solutions to her problem:

1. Simply replace with another composite resin, which would be immediate and least expensive, but the risk is great of this chipping again and taking with it a lot of the natural tooth structure.

2. Place full crowns on the 2 front teeth. The crown material would be able to withstand the biting forces, but wouldn’t look the most natural and the teeth would have to be prepared more aggressively.

3. Place veneers on the central incisors. A veneer would be able to withstand the masticatory pressure, look the most natural, and allow us to minimally prepare these teeth, conserving the most natural tooth structure.   

Dr. Saylor and the patient decided that Option 3 – Veneers, would be the best way to restore her front teeth. The patient felt strongly this was the best treatment plan for her smile in the long-run.

Click on thumbnails  below to see full photos and descriptions!

This last photo was added after the patient’s cementation appointment. This patient was ecstatic to have her front teeth back and better than ever!

The photos above illustrate what a difference a little tooth-colored  composite resin material can do to improve the appearance of these teeth.  A space in the front teeth has varying professional opinions on appearance and is a personal preference left for the patient to decide which action, if any, they would like to take. Diastemas can be hereditary or can form because of a malocclusion, which means the teeth are not fitting together the way they should be. If you have diastemas that have formed over the last few years, you should consult a dentist to determine whether or not you have a healthy bite.  An unbalanced bite can lead to problems in the jaw joint and muscles if not addressed. Generally speaking, and in this patient’s case, diastemas are merely a matter of looks and personal style.  

  Keep Smiling

Click on the photos at left for a synopsis of a composite resin restorative procedure for a central incisor. This is a relatively common procedure, as front teeth are traumatized rather easily. So how do we prevent these kinds of traumatic incidences? One way is to wear a mouthguard during vigorous physical activities or during participation in contact sports. Unfortunately for us, some accidents are unavoidable, so having a great dentist on standby to help prevent and/or resolve any dental issues you may have is a great step in the right direction.