Dental Crowns - Case 1
This patient is a yacht captain that travels around the world but spends the off season in fort lauderdale. He had seen a dentist only for emergencies over the past decade or so which led him to the condition of missing several teeth and having others in bad shape. We decided on a combination of porcelain bridges, porcelain crowns and porcelain veneers. Notice how even though there are three different types of restorations being used adjacent to each other and all of varying thicknesses, they all appear uniform. This is not by accident and is one of the subtleties of advanced cosmetic dentistry.
Dental Crowns - Case 2
So looking at big cosmetic makeovers is nice but what if finances are limited and a patient just wants to improve their smile for, let’s say, their daughter’s wedding with what little funds they have available? That was the case with this European transplant that now lives in Fort Lauderdale. She obviously needs her entire mouth rehabilitated and she is committed to doing that but the first priority was improving her smile for her daughter’s wedding so we agreed to do that stage first.
Some dentists will draw a line in the sand and present an “all-or-nothing” option. As long as we know we can provide a durable functionally stable result, we will do what we can to address the patient’s chief complaint. This case was completed with porcelain crowns fabricated by the CEREC from Sirona system using EmpressCAD material from Ivoclar Vivedent.
Dental Crowns - Case 3
This patient lives full time in London. She works for a company that has an office in Fort Lauderdale and was in town working for a week. She broke a front tooth on a Monday and came in to have it fixed. She reported that her from teeth chipping was a constant problem and that back in England, she was constantly going to the dentist to have them "patched up". We explained to her that the reason for this was that her front teeth were being repaired with resin bonded composite or "bonding" and that the ratio of bonding to remaining healthy tooth structure was very unfavorable. We discussed that the proper treatment should be porcelain crowns. She was concerned that she was only in town for four more days and she knew that it took "several weeks to have that kind of work done". Not when you're got tech, it doesn't. We saw her a few days later when we could schedule the proper amount of time, approximately three and a half hours in this case. We designed and fabricated four ceramic crowns using the CEREC by Sirona system and EmpressCAD from Ivoclar Vivedent. She left for England the next day and emailed us that she had no post operative issues. She even left us a nice Facebook message a month or so later.
Dental Crowns - Case 4
This patient presented with a chief complaint of “I haven’t been to the dents in twenty years and want to fix my smile”. After careful examination, we determined that this patient suffered from multiple large cavities, fractured teeth and other issues. She also wanted a significant cosmetic enhancement. So we chose to do a full cosmetic rehabilitation in which all of the visible smile teeth are restored with crowns so as to not restore them esthetically but also functionally and positionally. This treatment was done in only two half day visits using the CEREC system (Sirona Denal Systems) and a combination of Emax lithium Disilicate and Empress leucite reinforced feldspathic porcelain multi layered.
Dental Crowns - Case 5
This is a very interesting case and would spark lots of debate between dental professionals but in the end, teaches us a good lesson. This patient presented to us with the chief complaint of "I want a prettier smile and all I've ever been told was that I need my jaw broken, wired shut and then a few years of braces." After careful examination, we determined that orthognathic or jaw surgery followed by orthodontics would be the ideal course of treatment to not only correct the bite but also the patient's skeletal profile. However, the patient strongly declined this option for several reasons. She was already in her 50's and did not want to invest two to three years in her treatment. Her skeletal profile did not bother her, just her smile which brings us to the final reason. Even after going through surgery and ortho, her teeth themselves would still need to be enhanced to make them white and pretty. We knew we could do it another way. Through a careful diagnostic wax up process in which we design the changes we are going to make ahead of time, we determined that we could make a significant cosmetic change while correcting her bite in the process. We executed her case in two six hour visits, one for each arch. We used the CEREC system (Sirona Denal Systems) to design and fabricate her case from IPS EmpressCAD (Ivoclar Vivedent) in a shade of A1 with custom characterization.
Dental Crowns - Case 6
This patient was referred to us by a local charity that we work with. She had been knocked off a horse and damaged many of her front teeth including one that had to be removed. After careful examination and discussing options with the patient, she opted for a fixed ceramic bridge from canine to central and single unit ceramic restorations over the other three front teeth. This case was done using the CEREC system (Sirona Dental Systems) and Emax lithium dislocate (Ivoclar Vivedent) in a single morning appointment.
Dental Crowns - Case 7
This patient presented with a chief complaint of "I hate my smile". Upon examination, we determined that she had multiple failing restorations including temporary crowns, bondings and old crowns. We decided to restore everything with porcelain laminates, crowns and bridges where indicated. The laminates and crowns were fabricated from Empress CAD and the bridge was fabricated from Emax CAD from Ivoclar Vivedent. This case was started at 9 am and complete by 3 pm using CEREC technology from Sirona.
Dental Crowns - Case 8
This patient presented to our office with a chief complaint of "I have always been missing some teeth. I got an implant but do not want to finish my case with that dentist". I evaluated the patient's needs and determined that 10 units of ceramic restorations were required to properly rehabilitate his smile. The implant was restored with a single crown. The other missing spaces were restored with a bridge or space distribution. The material used was EMAX CAD lithium dislocate from Ivoclar Vivedent and method used was CEREC Inlab by Sirona.
Dental Crowns - Case 9
This patient presented to us with a chief complaint of "I finally want to fix my teeth". His daughter had just graduated dental school at Nova and told her dad that Dr. Stanton was the only dentist he should go to based on her experience with him as an instructor at Nova. After careful examination, we determined that the patient was a heavy bruxer or grinder and had worn his entire dentition down. When someone's bite is collapsed, the only way to properly treat it is to rehabilitate back to its proper height which can only be done with normal sized which can only be accomplished by crowning every remaining tooth. This is know as a Full Mouth Rehabilitation. We performed this FMR in three visits, one for the back teeth, the second for the upper front and the last for the lower front. A typical FMR normally takes more than ten visits over a several month span. We used the CEREC system (Sirona Denal System) to fabricate them out of Emax (Ivoclar Vivedent) in a B1 shade with custom characterization.
Dental Crowns - Case 10
This patient presented with a chief complaint of "I am missing a bunch of teeth and I don't like my smile." Upon exam, we determined that this patient suffered from a collapsed bite due to grinding his teeth at night without protection and lack of posterior support from missing teeth. We chose to replace his missing teeth with dental implants and then place single crowns on the remaining teeth and implants we placed. By opening his bite back up to where it used to be, we gained the necessary space to create crowns that were of the ideal size and shape. We used EMaxCAD fabricated by the CEREC in three consecutive morning appointments with no temps and no impressions. We also did twenty veneers on this patient's wife a few years prior to his treatment.
Dental Crowns - Case 11
This patient presented with a chief complaint of "I don't like my small yellow teeth and the spaces between my front teeth." Upon exam, we discovered that he had genetically small teeth for his jaw that had been further shortened by a lifetime of grinding his teeth without protection collapsing his bite down to a constricting vertical height. In order to rebuild his teeth to the proper height and contour, we would need to regain the space he had lost. The only way to do this is to restore every tooth back to its original height with ceramic. We scheduled him for three consecutive mornings. We did his back teeth on the first day, his upper front teeth on day two and lower front teeth on day three. He received no temps and no impressions. The entire case was done digitally using EmpressCAD and EMaxCAD on the CEREC.
Dental Crowns - Case 12
This patient presented with a chief complaint of “My mouth is totally messed up. I never smile and I have pain everywhere.” This patient obviously has what we refer to as “global” problems meaning it isn’t just a matter a cavities here or there or spacing here or there but rather the entire mouth has a bite that is not equilibrated, rampant cavities throughout and orthodontic misalignment with multiple teeth out of position and multiple teeth missing. It was obvious early on that we would have to restore every tooth with a crown. Ideally, we would do orthodontics also to move the teeth into a more ideal position prior to putting on finalized crowns. However, we did present her with an option of skipping the orthodontics and going straight into the full mouth rehab because we had determined that we could achieve a good esthetic and functional result without the ortho. She chose this option. We scheduled three visits. At each visit, several crowns were started and finished. So by the end of the third visit the entire mouth was finished with no temps and no impressions. This case would have been extremely difficult and hard to control using a dental lab and temp crowns.
Dental Crowns - Case 13
This patient presented with a chief complaint of wanting to correct her overall smile and get an implant crown finished that was started at Nova Dental School two years prior. We decided to do ten units of ceramic with gum contouring using a laser. The purpose of the laser contouring was to alter the original gumline to create more symmetry and proper proportion. This entire procedure was still performed in one sitting with no temps and no impressions. The patient had very little post operative discomfort and was ecstatic with the results. She was a real pleasure to work with.