COSMETIC EVALUATION

Cosmetic Evaluation

Cosmetic Evaluation

Introduction

In today's climate of sophisticated dentistry and extremely high patient expectations, it is essential for the restorative dentist to avail herself of the not only the most advanced techniques in restorative dentistry but to also combine these techniques with those available from complementary disciplines within dentistry. The integration of multidisciplinary dentistry allows for the execution of the optimized treatment plan when carefully strategized in terms of patient scheduling and expectations.

Various disciplines may be necessary to allow for the idealized treatment to be successfully completed. These disciplines may include orthognathic surgery, orthodontics, endodontics, periodontal therapy and soft-tissue management to provide for optimal gingival contours, now recognized as “pink esthetics”. Composite (tooth-colored) and silver amalgam fillings are used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a filling and bonded into place.  It usually only takes one appointment to place a filling. While the tooth is numb, Dr.  will remove any decay, thoroughly clean and prep the tooth before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function. When the fillings are first placed, you may have some hot and cold sensitivity, but this will subside. It is important to follow the care instructions given to you.

Case Study

Presented here is a case study of the combined disciplines of restorative dentistry, orthodontics and periodontics facilitated by the use both conventional periodontal surgery and the use of the erbium yag Key 3 laser (Kavo) to correct iatrogenic damage from improper endodontic post placement which resulted in deep subgingival post perforation and chronically inflamed gingival tissues, Restorations placed on other teeth concurrent to the above mentioned perforated tooth were less than ideal marginal contours the result of which was chronically inflamed marginal gingival.

This patient presented for a consultation about improvement of her dental esthetics with respect to maxillary anterior teeth. The patient's previously virgin dentition was severely damaged as a result of sudden loss of consciousness after bathing and subsequent impact on a bathtub wall. The patient awoke in the hospital to find that several of her front teeth were broken and others luxated out of position. Due to the urgency of the situation, her dentist restored the broken teeth of 12,11,21,22 following immediate endodontic treatment of these teeth.

Due to the haste in which these teeth were restored, the final result was less than ideal and the restoring dentist replaced these restorations six months after the initial restorations. However, it was not until the completion of the second treatment was completed that it was observed that the canines were luxated and healed out of position, hence the midline was restored in a canted manner and subsequently so too was the occlusal plane which had been straight prior ...