This lady was playing with her todler son and smashed her teeth on the back of his head knocking out her front tooth. To restore her smile, I whitened her teeth and replaced the missing tooth with a cemented dental bridge.
This patient presented with a broken 25 year old bridge replacing a missing front tooth. I re-prepped the teeth, digitally scanned the impression, computer designed a new bridge, 3D printed it out and cemented it in. Totally awesome!!!
This patient had a non-restorable decayed upper first molar tooth. I recommended a bridge since his adjacent teeth already had crowns on them. We extracted the infected molar and placed a temporary bridge. Following healing I prepared the adjacent teeth and fabricated and cemented a fixed 3 unit zirconia porcelain bridge. Here’s the before and after pictures.
For this patient, I replaced his lower right missing bicuspid tooth with a porcelain fused to metal bridge. Normally we would place an implant, however, in this case his mandibular bone was very thin in this area, and the distal tooth was very badly decayed and needed to have a crown. So I recommended a bridge to replace the missing tooth.
This next patient was missing a lower molar and the adjacent teeth were badly broken down. We elected to try to save the remaining teeth and made a porcelain fused to metal bridge to replace the missing molar and restore the adjacent posterior teeth. The other option would have been to extract the 3 broken down teeth and place dental implants to restore the lower left quadrant. Here’s the before picture showing the broken down teeth, and after with the bridge cemented in place.
This patient was super pleased with his new teeth. His 4 upper teeth were broken down and needed to be extracted. We did a bone graft and placed 2 implants. Following healing I made him a 4 unit porcelain bridge cemented over custom abutments. The entire process took about 6 months. During the healing phase he wore a partial denture.
This patient was very unhappy with her smile and wanted me to help. We discussed different treatment options and what would work best. I took study models, waxed up an ideal smile and made a provisional bridge of the ideal smile. At the treatment appointment I prepped the canines and centrals for the bridge, extracted the lateral incisors and adjusted, fitted and cemented, the provisional bridge. The provisional bridge will stay in place for 3 months while the extraction sites heal. Following healing I will re-prep the teeth and take the final impression for the porcelain bridge.
This patient I saw today, grinds and clenches his teeth, and as a result he has broken and worn down all his teeth. After discussing options for restoring his lower right quadrant, he elected to have me restore his teeth with a 4 unit fixed bridge. I made 3 teeth with porcelain and did the last molar in metal. Since the last tooth doesn’t show, I did it in metal because there was not much space and if I used porcelain he would fracture the porcelain off with his clenching and grinding. This bridge looks great and is strong and will last.
This was a challenging implant restoration case due to the alignment of implants. In order for the implant to osseointegrate firmly into the jaw bone we like to place the implants where the jaw bone is the thickest and strongest. In this case the best bone was not lined up nicely so we had to stagger the implants. I was still able to make the final implant crowns line up perfectly in the mouth.
Before and After
On these 2 crowns, the first porcelain and second gold, that I did last week in my office I show how I place retention grooves in my crown preparations to help lock my crowns in. These grooves prevent rotation and help secure the crowns in place. These slots allows for more surface area for the cement and results in a longer lasting restoration that holds firmly in place. This is especially important in short weak teeth. With this technique I am able to save teeth that otherwise would need to be extracted or require periodontal crown lengthening surgery.