A 20-year-old patient, unsatisfied with the position of his teeth, did not want orthodontic therapy so we applied a prosthetic one.
An impression was taken, based on which our dental technician made a model. After analysing the model, we came to a conclusion that it was possible to make a prosthetic solution which would satisfy all aesthetic criteria.
The teeth were first made from wax on a plaster model before any invasive procedure was performed in the mouth of the patient. The patient could see the shape, size and position of the teeth and decide whether he liked the solution.
Since the patient liked our suggestion, we could start with the procedure.
Incisor teeth in the upper jaw were abraded, tooth 21 was devitalized and a fused crown was fitted. At the same time, we surgically leveled the gumline on tooth 21 using Erbium-Yag laser. In order to make the abrading as precise as possible, a guide based on the wax-up model was made of silicone.
Both photographs that show the final result were taken immediately after the cementing of the prosthetics, which is the reason why the gums around the teeth visible in one of the photographs are under a small inflammation which wears off in several days.
A 25-year-old patient was unsatisfied with the appearance of her teeth.
The patient had already had a prosthetic solution she was not satisfied with. The examination showed that the level of the gumline around front upper teeth was asymmetrical because of which her left central incisor tooth and lateral incisor tooth (which was missing and was a part of the bridge) were longer than the right ones. The patient also disliked the gap between her central incisor teeth.
The approach in this case was multidisciplinary.
An impression was taken, based on which our dental technician made a model.After analysing the model, we came to a conclusion that it was possible to make a prosthetic solution which would satisfy all aesthetic criteria.
The teeth were first made from wax on a plaster model before any invasive procedure was performed in the mouth of the patient. The patient could see the shape, size and position of the teeth and decide whether she liked the solution.
Since the patient liked our suggestion, we could start with the procedure.
First we removed the old bridge.Based on our dental technician’s wax-up model of her future teeth, we made a surgical guide with the help of which we surgically leveled the gumline of the front upper teeth (gingivoplastic was performed). In other words, we extended the clinical crowns of her right central and lateral incisor teeth. Along with that procedure a frenulectomy was also performed. Erbium-Yag laser was used in this surgical part of the therapy. On the same day, temporary crowns were fitted which were identical in shape, size and position to the permanent ones.
After a period of healing which in this case took one month, permanent porcelain-fused-to-metal crowns were fitted.
A 30-year-old patient, unsatisfied with the shape and the position of her teeth.
The approach in this case was multidisciplinary.
An impression was taken, based on which our dental technician made a model. After analysing the model, we came to a conclusion that it was possible to make a prosthetic solution which would satisfy all aesthetic criteria.
The teeth were first made from wax on a plaster model before any invasive procedure was performed in the mouth of the patient. The patient could see the shape, size and position of the teeth and decide whether she liked the solution.
Since the patient liked our suggestion, we could start with the procedure.
Based on our dental technician’s wax-up model of her future teeth we made a surgical guide with the help of which we surgically leveled the gumline of her front upper teeth (gingivoplastc was performed). Erbium-Yag laser was used for this surgical intervention.
In this case, we waited for two weeks after which we abraded six front upper teeth and fitted six solo porcelain-fused-to-metal crowns.
The photograph that shows the final result was taken immediately after the cementing of the prosthetics which is the reason why the gums around the teeth are under a small inflammation which wears off in several days.
A 20-year-old patient. After devitalization performed on central incisor teeth some years before, the colour on teeth 11 and 21 changed. Whitening of those teeth was not possible since great part of tooth substance was compensated with fillings.Our patient agreed with our decision to fit two all-porcelain crowns.
A 20-year-old patient,not satisfied with the appearance, postion and shape of his teeth.
Clinical examination showed that the patient had irregular position of his upper incisor teeth- augmented horizontal tooth overlap and decreased vertical tooth overlap.
As in most cases, the approach was multidisciplinary.
An impression was taken, based on which our dental technician made a model. After analysing the model, we came to a conclusion that it was possible to make a prosthetic solution which would satisfy all aesthetic criteria.
The teeth were first made from wax on a plaster model before any invasive procedure was performed in the mouth of the patient. The patient could see the shape, size and position of the teeth and decide whether he liked the solution.
Since the patient liked our suggestion, we could start with the procedure.
All four upper incisor teeth had to be devitalized in order to put them in the right position by fitting fused crowns. An impression was taken and four solo porcelain-fused-to-metal crowns were fitted.
The photograph that shows the final result was taken immediately after the cementing of the prosthetics which is the reason why the gums around the teeth are under a small inflammation. This reaction wears off in several days.
A 27-year-old-patient, teeth 21 and 11 (central incisor teeth) changed their colour due to a devitalization performed some years before.
In this case, whitening of those teeth was done using American product Opalescence. Filling from the inner side of the tooth was removed and material containing 35 % hydrogen-peroxide was put into the cavity after which a new filling was placed.
The patient returned after three days and the same procedure was repeated. We waited for another three days after which we were satisfied with the result, whitening product was removed and a permanent filling was placed.
In this case, we repeated the procedure twice until the right shade was reached. Sometimes it is enough to do the procedure once, and sometimes it needs to be repeated two or three times, depending how much the colour changed after the devitalization of the tooth.
In the photographs below, you can see the appearance of teeth before and after the take-home method of teeth whitening with gel containing carbamide-peroxide. The difference in colour is obvious and in spite of the irregular position of the teeth, it contributes to the beauty of the smile.
The patient in the photograph turned to us wanting to improve aesthetic of her smile since she disliked the shape of her upper incisor teeth and the presence of diastema.
We decided to leave the central diastema as ’’a part of her personality’’ and change the shape of her central incisor teeth using composite, while in the case of her lateral incisor teeth a more radical approach was chosen using all-porcelain crowns. After changing the shape of her central incisor teeth, an improvement could already be noticed.
After this, fitting veneers changed the shape of her lateral incisor teeth as well and the aesthetic of the smile was evidently improved.
The case in the photograph below shows the range of the reconstructive dentistry today. The patient came with a complex condition in his mouth: loss of great number of teeth, remaining teeth and supporting tissue in bad state, discrepancy in the interjaw relationship, lost normal bite height. All this with an existing orthodontic irregularity was a true challenge for a dental practicioner.
After a detailed examination, it was decided to use a combination of fixed and removable prosthetics.
With the combination of porcelain-fused-to-metal dental bridge and partial skeleton denture joined together with modern system of clasps, dental rows of both jaws were reconstructed and the bite was rehabilitated which greatly improved the appearance and the patient regained his self-confidence.
A 37-year-old patient, unsatisfied with the colour and the position of his teeth. The tooth discoloration was caused by the use of tetracycline antibiotics in the patient’s childhood.
Apart from this, there were several fractured posterior teeth. Tooth 17 was indicated for extraction due to a fracture and secondary caries. Tooth 21 was longer than tooth 11 due to the occurrence of gingival recession around tooth 21.
During the first dental treatment tooth 17 was extracted and bonding procedure with fiberglass (non-metal) posts was performed on all posterior teeth. Tooth 12 had a metal bonding which we replaced with a all ceramic one, since it was planned to fit all ceramic crowns. Also, using Erbium-yag laser, gingivoplastic surgery was performed in the region of tooth 11 in order to lengthen the clinical crown of the tooth. We also performed frenulectomy using CO2 laser.
After we had waited for 3 weeks, we abraded the anterior teeth and we finished the preparations on the posterior teeth. An impression was taken and sent to Olivera and Sinisa Vucicevic’s dental laboratory ’’Fleshdent’’.
The final result can be seen on the photographs. Solo crowns were fitted, with the exception of region 18-16 where tooth 17 was missing. An all-ceramic bridge was placed in that region.
When the patient decides, a similar procedure will be performed on his lower teeth.
