This dental implant case was completed about 2 years ago in our office. Originally, the upper right canine tooth fractured and extraction was needed. After exploring different options, we decided dental implant would be the best option to replace the tooth after extraction. Now, two years later, the dental implant looks and feels as great as it was 2 years ago.  

Dental implant is the preferred choice to replacing missing teeth and is considered the standard of care by most dentists. However, dental implant is not suitable in every case. To determine whether dental implant is suitable for you, please call us for a consultation appointment. 

A veneer is a thin shell of porcelain that is bonded to a tooth to improve its color and shape. A veneer generally covers only the front and top of a tooth. Veneers can be used to close spaces between teeth, lengthen small or misshapen teeth, or whiten stained or dark teeth. Sometimes, veneers can be done without cutting down natural tooth structure. Sometimes, a small surface layer of tooth is reduced. 

In this case, #10 is a suitable case for veneer. Contact and shape of the tooth are both restored with a single unit veneer.  

Case is presented with multiple decays on the top and lower teeth with several teeth non-restorable. The main concern is aesthetics. After much consideration and communication with the patient, factoring into cost, time, durability, and comfort, we have decided that a bridge, using suitable remaining teeth to support the missing teeth, would be the best option. This bridge option allows correction of teeth alignment to a certain degree and covers undesirable discoloration of tooth structure. In addition, the bridge option is also a great opportunity to treat any issues of involved existing crowns.  

Treatment of the month (combining both July and August) involved an anterior crown (more specifically upper right lateral incisor) with mismatched color and shade. Patient's chief concern was to change the crown so that it will look natural again. Upon inspection, the mismatched shade was quite obvious. One possible reason of this mismatch in color can be due to the darkening of the tooth itself; and this can be caused by trauma, root canal therapy, or other reasons. Another possible reason is that the rest of the teeth become brighter; and this can be achieved by teeth whitening. 

We have several shade guides to determine the appropriate shade of the tooth. The Vitapan classic is the previous standard of shade guide. It is still widely used but it has its limitation. For aesthetic zone, we decided to use the Vita3D master with the addition of bleached teeth shades. We were able to pick a shade that matches very well. The technology of all porcelain crowns nowadays is well-matured; but it is just as necessary to properly pick a matching shade for the tooth and the remaining tooth structure (stump shade) or else the lab technician would not be able to match the shade. 

Removal of the existing crown was achieved carefully to ensure minimal reduction of the remaining tooth structure. Additionally, we chose a subgingival margin to hide the border of the crown and tooth. In other words, you cannot see where the crown ends. 

For any crown, it is very important to make a provisional (temporary crown) that fits well and also aesthetically pleasing. For the fabrication of a provisional, we have multiple shades to choose from to ensure a good match. In addition to the color of the temporary, proper shape and polishing are essential to satisfy our dental patient while waiting for the actual crown to be fabricated.

The best indication of a well-made aesthetic provisional is that the provisional does not look much different than the final product, which was an eMax crown.