Esthetic Dentistry

Esthetic Dentistry

Not only meeting the esthetic expectations of the patient but also a long term structural, functionaland biological success is very important for both your dentist and technician.

Making teeth that will look natural is not only about the color. They are made taking the color tone, saturation, brightness and translucence into consideration. 

Natural Look in Dental Esthetics 

Pale and opaque look of the teeth make patients think translucence of the teeth is insufficient. 

The dentist pays attention to several parameters. Cutting edge of the teeth and their structures are also very important. 

Color in Ceramic Teeth 

It is very important to make the color analysis for both porcelain teeth and partly laminated teeth which we practice on the outer surfaces of the teeth. First we choose a primary color. Color saturation, brightness and translucence of the teeth are evaluated afterwards. If the color value of the teeth is not compatible with the other natural teeth, you can feel they are artificial. Incompatibility of other properties can only be distinguished by a dentist. There are some differences in porcelain laminated teeth. The most important point to consider is to avoid excessive corrosion and leaving even a little enamel tissue under the lamination. This is important to get a more natural look as the teeth under the lamination reflects.

 

What is Smile Analysis?

It is the analysis of the compatibility of your teeth, lips and your facial structure in order to get the ideal smile. This analysis is usually made as follows;  

First appointment 

In the first appointment patient is invited to a comfortable and tranquil place and is asked about his/her problems, needs and expectations. Expectations of the patient is important since unreasonable expectations lead to dissapointment. In this session, psychological assesment and character analysis of the patient is made. Denstist makes the patient talk so as to analyze the teeth-jaw-face relationship (maxillo-facial relationship). Photographs of intraoral, extraoral and facial structures are taken as well as photographs of the patient’s smile and lip closure. Lower and upper jaw mock ups are made. Teeth color of the patient is recorded and panaromic film of the patients teeth and jaws is taken. 

Presenting Treatment Options

As a result of analyzing some personal and physical characteristics of the patient such as the age, skin colour and facial structure, your dentist comes up with an idea on how your teeth should be. In this process, acquired data is evaluated and treatment options are presented. Information about different treatment options and cost details are given. Model of the mouth and photographs are analyzed together with the patient. The dentist and the patient talks about the final and the probable appearence of the teeth, in line with the expectations of the patient. 

Treatment Plan

In this process, the most suitable treatment plan is confirmed with the patient. In fact, every dentist wants to present the most suitable treatment plan to his/her patients but there may be some factors to restrict your dentist such as the socioeconomic levels of the patients and cultural structures. Dentist explains how the final conditions ( as a result of the treatment and esthetic arrangement) should be.

Porcelain Laminate Veneers

Laminate porcelains are very thin ceramic materials we especially use on anterior teeth. They are largely used for patients that are not satisfied with the colour of their teeth or have broken, abraded, overlapped teeth, as well as patients with diastema. The most essential property of the application is the preparation of the teeth by abrading approximately 0,5 mm of the surface.

Laminate porcelains are fixed to the teeth with a very special technique called “today’s adhesive techniques”. How come such a thin and fragile porcelain shows such a strong structure? laminate porcelains shows the same physical characteristics as the tooth enamel after it is fixed on the teeth. Practices such as the abrasion of the teeth, making the measurements, production and applicaiton process of the laminates are for the porcelains that are prepared much meticulously. Otherwise, patients may experience negative outcomes.

Laminate Porcelains Are Suitable For…

• Patients with broken or notched anterior teeth, and structural defects
• Patients having colour defects or patients that are not satisfied with their tooth colour
• Patients having stains on their teeth due to tetracycline or excessive use of fluorine
• Patients whose teeth changed colour due to root canal treatment or trauma
• Patients with diastema on anterior teeth
• Patients who have structural defects on the anterior teeth and reject orthodontic treatment

First Appointment

This is the first appointment your dentist analyzes your teeth. First of all, all your jaw and facial structure records, photographs, lower and upper jaw models, your present tooth colour and your panaromic films are taken. Your demands and expectations are evaluated. Temporary laminates are made on your previously measured mock ups, and a general opinion is formed about the final condition of the plate. 

First Step Is The Preparation of the Teeth: Cutting the Surface of The Teeth 

Anesthesia may be used if necessary. The purpose is to make as little cutting as possible. Depending on the case, your dentist cuts your teeth from 0,5 mm. ile 2.00 mm. We want to produce a laminate surface with the same thickness so cutting is made in accordance with your teeth. Sometimes the natural position of your teeth is so behind the align that there may be no need to make any cuts. 

Making Measurements

Measuring laminate porcelains are made by very sensitive impression materials. Then, your mock ups are prepared in the laboratory. In this process, your dentist and the technician consult eachother.

Temporary Laminate

After the cutting you will feel the ragged surface on your teeth as well as sharp or cornered areas. Since the level of tooth enamel becomes less on the surface, you may feel your teeth has become sensitive to hot and cold things in some cases. Due to these reasons, temporary laminates are applied o your teeth in this process. These laminates are made of composite material and it takes a little time to make them. They are not very enduring and they may break. Your temporary laminates provide approximate information on how your laminate porcelains will look like. 

Fixing laminate porcelains 

Before fixing your laminates, we make a try-on to make sure everything goes according to what we planned. Your dentist may sometimes make some changes altough your laminates are in an ideal shape. Real colour of porcelain laminates show up only with the cement that will be fixed. As laminates are very thin and they are not fixed during the try-on process, you cannot see the exact colour. So your dentist will show you the colour tone you initially agreed only after your laminates are fixed. You will see that this colour is the one you agreed on with your dentist. There are water-soluble trial pastes. These can also help you see the final colour. The technique for fixing these laminates are different from fixing other porcelain crowns. In fixing process teeth and laminates are prepared at the same time. They are both washed and dried. In the first phase, surface of your teeth are etched with phosphoric acid. Etching is made on a microscopic level and helps the adhesive stick properly on the teeth. Later, bondings are made. They help the cement be fixed by chemical route. Meanwhile, laminates are treated. They are silaned (a chemical procedure), treated with hydrofluoric acid and porcelain bonding is applied. Application of these chemicals are performed meticulously. Later, the adhesive is positioned to the inner surface of the cemented laminate in a way that it runs over a little. Excess adhesive is cleaned very carefully. A certain wavelenght of light is applied on each surface of the teeth. Your dentist contols your lip closure for the last time and puts finishing touches to end the procedure.

Non-Metal porcelain crowns

There are many non-metal porcelains in structures like zirconium or alumina. Your dentist decides on which non-metal porcelain to use after the examination.

Zirconium teeth are prefered for the posterior teeth as they are durable and provide an esthetic look whereas, other non-metal porcelain structures are prefered for the anterior teeth.  

Zirconiums have an durability degree of 900-1400 MPa. Metal porcelains are durable approximately up to 800 MPa or less. Use of zirconium is also common for 3-4 unit bridges. As they have the same colour as your teeth, you will not see gray reflections in the gum area.

 

Esthetic (Tooth Coloured) Fillings

Among composite fillings, they are the tooth coloured filings that contain silicon dioxide particles. Today, they are applied to all tooth surfaces including posterior teeth. Dentists started using them as an alternative to amalgam fillings. 

Decays on teeth are removed, bonding is made and later the composites. Today, we have considerably durable composite fillings that do not change colour. 

Porcelain Inlays & Onlays

Your dentist may remove your amalgam fillings on your posterior teeth and replace them with porcelain inlay fillings. Porcelain fillings are hard, durable and esthetic fillings put on the cavities (after cleaning the decay) your dentist makes on your teeth. They are fixed with special a cement or bonding (chemical and multi-staged fixing system) methods. Inlay porcelains are fillings prepared only for the chewing surface of your teeth. Onlay porcelains, however, are larger fillings that include lateral surfaces of the teeth. 

Properties of Porcelain Inlays/Onlays

Porcelain fillings are made to avoid too much loss of the tooth. Only the decay is cleaned within specific rules. Measurement of the tooth and the modelling is made. It is sent to laboratory and your porcelain onlay is fixed on the tooth. They have several properties. 

Main properties are as follows; 

• Your dentist does not cut the tooth as in crowns and they prevent structure loss of the tooth. Only the decay is cleaned. Loss substances are placed firmly as puzzle or a key-lock.

• They do not change colour in time as in composite fillings (fillings made according to tooth colour). As they are made of porcelain, they cannot be fixed on colourific substances. 

• They protect the tooth against forces due to their solid structure. 

• They do not cause loss of esthetics as in amalgam fillings. They look natural. They are designed according to the natural colour of your tooth. 

• It only takes 2 sessions to make them. 

• As their surface is polished, remains of food do not stick on them. Hence, they are hygienic. 

• As they are made of porcelain, you do not experince “polymerization shrinkage” that can be seen in composite fillings after they are fixed, thus, you will not experience sensitivity against hot or cold and tooth decay will not repeat. 

• For teeth with excessive substance loss and especially root canal, porcelain onlays can be used to repair the lost parts of the teeth with the help of adhesive systems.

Metal - Porcelain Crowns

These crowns are made if there is tooth decay under the gums, too much substance loss on the tooth or if your teeth are broken. There are two types of crowns; metal and non-metal crowns. Metal crowns are used largely on the posterior teeth due to gray reflections that can be seen on the gingival line and their opaque look.

Non-metal porcelain restorations are mainly called esthetic porcelains. 

Natural teeth transmit the light but metal crowns reflect the light and this shatters the feeling of depth and vitality. However, dentists have been able to make very thin metal porcelains with the spray process recently. Metal porcelains are more affordable compared to other porcelains.

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