Smile makeover

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The patient came to Materna Dental Clinic for a smile makeover. During her first visit, she told us about numerous unsuccessful visits to other dentists and constantly crumbling teeth. The patient was tired of repeated restorations using composite material. She came in with a prominent crown on tooth number 21 and many leaking fillings. The patient said she was dreaming of a Hollywood smile, so we got to work quickly.

During the prosthodontic consultation with Dr LAVA (a nickname of Dr Tomasz Materna), an intraoral examination, a panoramic radiograph, a CT scan and an intraoral scan were performed to determine the treatment plan.

Missing teeth were found in the upper arch: no 14,15 and 25. In the lower arch, no 36 and 46 were missing. The patient was informed of the possibility of restoring the missing teeth with implants or prosthetic bridges. The choice fell on Cerkon Full Contour crowns and prosthetic bridges.

Treatments performed:

1. Professional EMS AirFlow hygienization with our hygienist Marysia Górka.

2. Conservative treatment, i.e. replacement of leaking fillings and removal of tooth decay: teeth number 17, 24,27,28,32,33,34,35,38,44,48 with Dr Anita Myśliwiec.

3. Root canal treatment: teeth number 17,26,33,45 and re-endo (root canal re-treatment) of teeth number 16,35,31,27. In order to re root canal treatment of tooth no 21, it was necessary to remove the prosthetic crown by cutting it and then removing the old cement and standard metal post. After treatment, tooth 21 and the other root canal-treated teeth were reinforced with fibreglass posts.

4. Prosthetic restoration:

4.1. The occlusion was raised during bite registration with an intraoral scanner, the missing teeth were planned to be restored with prosthetic bridges. Teeth in the upper arch were ground for crowns and prosthetic bridges, an intraoral scan was performed and the order was sent to the DentalArt laboratory. Temporary crowns were fitted.

Due to the positioning of the teeth and the missing ‘fifths’ in the upper arch (the teeth shifted in the arch in such a way that it was not noticeable – 16 and 26 shifted in place of 15 and 25), a new smile was designed for 12 crowns covering the 17-27 range.

4.2. Once the digitally designed smile was accepted, PMMA crowns in BL3 were tried on to verify the patient’s expectations regarding the tooth colour, length and shape. The medial line and symmetry of the smile were checked. Several corrections were made to the shapes and comments were passed on to the DentalArt laboratory.

4.3. Cerkon Full Contour crowns in colour BL3 were tried on.

Digital photographs were taken, to get a better look at the details. Once the shape and colour of the crowns and bridges were accepted by the patient, they were set on permanent dental cement.

An intraoral scan was performed to check the occlusion map and an equilibration was performed.

4.4. During the next appointment, the lower arch was shaved for crowns and bridges, an intraoral scan was taken and temporary crowns were placed. The patient received a relaxation splint, which is a transparent night cap that covers the crowns and bridges in the upper arch. The relaxation splint has a positive effect on the temporomandibular joint by eliminating masseter muscle tension and protecting the mechanically fitted crowns from excessive clenching of the teeth at night.

4.5. The designed smile was presented to the patient and PMMA fabricated after acceptance of the design.

4.6. PMMA was fitted in the lower arch, some adjustments were made and patient’s comments were passed on to the DentalArt laboratory.

4.7. Cerkon Full Contour crowns in colour BL3 in the lower arch were tried on. Digital photographs were then taken, to get a better look at the details. Once the patient was happy with the shape and colour of the crowns and bridges, they were set in place permanently using strong adhesive – dental cement. An intra-oral scan was taken to check the occlusion map and equilibration was performed.

Take a look at what the patient’s smile looks like after the makeover!

Mrs Karolina can finally enjoy her beautiful smile.

Nothing is impossible for Dr. LAVA.