Esthetic Dentistry

All these blue titles done by Doc Hemp.

640x480 picture

Reminder: Some of the New Image photos are mirror images so left looks like right.

Before photo above & 3 after photos below

This is one of my very best friends .... Dr. Mike Birkhoff from Germany ... He sells used Cerec machines and lectures all over the world. I did this case on him in one afternoon .... I had to do a lot of cosmetic shaping first to be able to create the cuspid to lateral and closed space effect. Doc Mike also does my dental work. .... We are a fine looking pair ... (grin)

12-14-05 ... Below is a nice case we finished today after one year of orthodontics to move the teeth out of their 100% End to End bite ... the lower anteriors were pulled in a little as there was some room and the max was moved out ... we were able to prolly double the length of these teeth with veneers or more like overlays ... We have done tons of cases just like this over the years with phenomenal success. Never even one TMJ Syndrome developed.

The 2nd photo shows the case half done ... not finished and still a little long .. but does show how much we can add when we can get a normal overbite. I have never had one of these ever come off or fracture ...either in Porcelain or Composite .. These are not typical crowns in the sense we cut nothing down but add over them with traditional or Cerec ceramic and or chairside composite ...and if they do fracture .... Porcelain repairs can be done in many cases ... take one of Ray Bertolotti's courses.

The 3rd Photo shows the almost finished case ... # 8 and a few others were still fine tuned. The length is perfect and the patient was speaking perfectly almost immediately .. On the F words the max anteriors lightly touch the lower lip perfectly. Usually it takes the patient and spouse a few weeks to get used to this big a change .. in this case not so ... they both loved these immediately!

The following case early 2005 ... The patient refused orthodontics as recommended for years period! ... We extracted one lower central that was totally trapped to the lingual ... Photo #1 ... I then cosmetically ground the distal corners off the laterals ... and veneered the lower 3 anteriors which straightened everything up .... The patient is thrilled .. It has been just about a year and no relapse in the bite. It is very rarely we treat a case like this because 95% of the time we have these cases treated with orthodontics. But this shows what can be done if a long time patient and friend refuses and would go elsewhere if it wasn't done this way ... See Photos 1 & 2 below.

Now back to our old stuff below that has been on this page for eons.

Cosmetic Dentistry Case #1

  • Before
  • 9 months later
  • During treatment with my removable orthodontic appliance
  • With cosmetic sculpturing
  • 11 months later
  • Porcelain veneers in place
Notes: I always recommend traditional orthodontics before I
do just cosmetic orthodontics with my removable appliances.

Cosmetic Dentistry Case #2:
Crown Lengthening

  • Low gingiva (arrow) where surgery was performed
  • After simple gum surgery
  • 3 weeks later with veneers added

Cosmetic Dentistry Case #3

  • 3 porcelain veneers
  • Closed space & wrapped the chewing edge
  • Total time was 2 weeks

Cosmetic Dentistry Case #4

  • Before
  • After my removable orthodontic appliance & cosmetic sculpturing
  • Porcelain veneers
  • Total time was 4 months

Cosmetic Dentistry Case #5

  • Before
  • 3 weeks later
  • Veneers in place

CASE # 7

This is the after about 3 1/2 years later, there is very little stain on these hybrid composites. I think crowns on these teeth (except for the really bad one - after build up) actually weakens the teeth & is a big waste of tooth structure & money! S.E. Prime & Bond or Photobond and I would use TPH now.

Case #9 - 8 Porcelain Veneers



Seated this case today - 8 veneers - 9/24/97 - lightened it 11 shades & straightened with cosmetic grinding, No ortho first.

I think we have had such PHENOMENAL success with our countless numbers of porcelain veneers over the years since 1983 or so because they are ALWAYS FINISHED on as much ENAMEL as possible! I will go through into dentin in spots if we have to, but will move the teeth orthodontically rather than EVER do a root canal for cosmetic purposes! The bond of glass to enamel will always be stronger than the bond of glass to dentin. The enamel, which is 98% inorganic calcium phosphate salt called hydroxyapatite, with similar coefficients and rigidness as glass, takes the porcelain along for the ride!
The newer stronger dentinal adhesives of Silane & S.E. Prime & Bond certainly strengthen the dentin to glass bond much much more. We have been successfully bonding composite to dentin in Class V's ....And porcelain inlays and crowns to dentin for many years now. But with veneers all I'm saying is if you can save enamel to bond to it's a for sure thing! In over 22 yrs we have never had to ever use a temporary or even numb up 99.9 % of our veneer cases as they have been .1 mm very thin overlays and are stronger than all get out! This is conservative dentistry.

We also allow around 30 minutes to seat each veneer and custom color each from under the glass so there is never any custom lab staining to brush off in 2-5 years! External staining is only temporary! We have the lab fabricate the veneers on Platinum foil so they can be removed from the model during fabrication & micro metered for thickness to keep them as thin as possible when desired. I vary the opaquers in the glass and luting material beneath for each individual tooth as needed & am usually able to 100% match an individual fractured tooth that is not a darkened root canaled one to begin with.

We have also been doing some veneers in the very cosmetic all porcelain CAD/CAM Cerec restorations now in our 4th year ....
Visit our Cerec page here

My Anti-Bleaching Page .. Short and to the point ... Below some other old Anti Bleaching Sites .. am sure there are many more now days ... google problems with bleaching teeth

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