GENERAL AND COSMETIC DENTIST
GALLERY BEFORE & AFTER
Gallery Before & After
Before and After photos:
Below are before and afters of various procedures. These cases are all Dr Benic's work.
Case 1:
General discussion: Decayed and worn front teeth. The tooth decay was removed and the front 4 teeth built up in composite material, a lower right amalgam was also replaced with a white composite filling, a 2 week treatment of whitening was completed followed by 4 all ceramic crowns. The next phase of treatment is reconstructive dentistry to restore the missing teeth with implants or bridges.
Dentist discussion: Decay was removed and teeth restored with composite. Teeth were whitened using the Kor deep bleach whitening system over 2 weeks. 4 layered Emax all ceramic crowns were bonded with relyx unicem cement. A gingivectomy on tooth 12 would have produced great gingival symmetry, however the patient decided against this option. Invisalign for the lower arch and implants are next on the agenda.
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After
Case 2
General discussion: Discoloured old white composite fillings and a reinfected root canal on the upper right lateral incisor. The root canal was retreated and internal whitened, all teeth were then whitened externally and the anterior composite fillings replaced.
Dentist discussion: 2 stage root canal retreatment using the TF system followed by a 2 day internal bleaching using Kor deep bleach whitening gel. After 4 weeks the old composites were replaced with renamel microhybrid.
Case 3
General discussion: Discoloured front tooth as a result of trauma and stained old white composite fillings. After 2 weeks of external whitening the old composite fillings were replaced and a porcelain veneer bonded to disguise the discoloured tooth.
Dentist discussion: Teeth were whitened using the Kor deep bleach whitening system over 2 weeks. After 4 weeks post whitening, composites were replaced with renamel microhybid composite and the 21 Emax veneer bonded with relyx unicem cement.
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Case 4
General discussion: Lateral incisors were previously built up in tooth coloured filling held in place by amalgam pins. Unfortunately both lateral incisors broke at gum level. Long-term options of 2 x 3 unit ceramic bridges or 2x implants were decided on. The patient selected 2 x 3 unit bridges to improve colour, shape and length of her front 6 teeth. The 2 lateral incisors were removed, the gum contoured with a laser, teeth prepped, and bridges bonded 2 weeks later.
Dentist discussion: Lateral incisors were removed and abutment teeth prepped. Temporary bridge fitted. Time was spent getting the pontic emergence profile correct to promote gingival healing and symmetry. Bridges were constructed by Bay crown and bridge in layered Emax ceramic. A challenging factor was disguising the patient's dental cant (angle of occlusion). The next process will be removing the posterior amalgams and restoring the posterior teeth with composite fillings or ceramic crowns.
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Case 5
General discussion: An old porcelain fused to metal crown on the upper front right tooth, with an opaque bright white colour and an exposed metal margin was replaced by an all ceramic emax crown. The patient elected to maintain his diastema (midline gap). The gingiva of the upper right front tooth was contoured with a laser to achieve better symmetry. A nice colour match was achieved by Bay crown and bridge.
Dentist discussion: The PFM crown was cut off. Bone sounding was performed with a perio probe. A diode laser was used to remove 1mm of gingiva. The tooth was prepped, labial margin was placed 1mm subgingival due to dark cast post and core requiring masking. A layered Emax all ceramic crown was bonded using relyx after the crown was HF etched and silanated.
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Case 6
General discussion: An old porcelain fused to metal crown on the upper front left tooth, with an opaque bright white colour and an exposed metal margin was replaced by an all ceramic crown. The adjacent central incisor was also crowned with an all ceramic due to incisal chipping and stained vertical crackline. Ceramics by Bay crown and bridge.
Dentist discussion: There is still a slight purple halo around the left central incisor gingiva despite a crown margin prepped 1mm subgingivall to try disguise this. The gingiva is a thin biotype hence the root colour producing a purple effect. The tooth could not be internally bleached as the tooth has a metal cast post and core. A layered Emax all ceramic crown was bonded using relyx after the crown was HF etched and silanated.
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Case 7
General discussion: Whitening procedure, 5 shades of improvement.
Dentist discussion: Kor deep bleach whitening system was used for a 2 week period, followed by an in surgery 3x20min Kor max session.
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Case 8
General discussion: 2 old ceramic crowns on the central incisors with a history of debonding were replaced by 2 new ceramic crowns. The crowns were made more retentive by placing a post down the root canals and building a core of composite around the post. The after photo was taken directly after bonding and excess cement removal hence slight bleeding of the gingiva.
Dentist discussion: Microabrasion to the lateral incisors and canines to improve the enamel hypoplasia appearance. 5mm of GP left in place apically, prefabricated fibre post cemented with relyx unicem cement, composite core, full ferrule achieved. Emax layered crowns constructed by Bay crown and bridge and bonded with relyx after the crown was HF etched and silanated.
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Case 9
General discussion: 2 root canalled molars which have been symptom free for 12 months. Root canalled teeth are notoriously weak hence the back molar breaking and being patched with a temporary orange filling. A longterm solution of a porcelain fused to metal crown was decided on. Both molars were prepped, 2 weeks later crowns cemented. The 2nd premolar too is root canalled however I completed this a month ago therefore if symptom free in 11 months this too will be crowned for structural stability.
Dentist discussion: 27 and 26 root canalled teeth. 26 with an amalgam core, 27 with a composite core. Patient has a heavy bite hence the decision for a porcelain fused to metal crown. Both teeth prepped, full ferrules achieved, 27 required laser gingivectomy mesial due to subgingival break of mesial palatal cusp. 2 weeks later PFM crowns cemented with relyx. 25 will be crowned in 11 months as this was root canalled a month ago.
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Case 10
General discussion: Whitening procedure, followed by 3 composite veneers (2 central incisors and left lateral incisor). The midline diastema (gap) was the patients chief concern. The 3 teeth veneered were increased in length to achieve an overbite and disguise the increased width of the 2 central incisors. The next stage will be to replace the composite veneers with porcelain veneers for ultimate aesthetics.
Dentist discussion: Zoom take home whitening for 2 weeks. Wax-up, putty stent and trial smile in luxatemp for the patient to decide on treatment. A putty palatal stent was made to aid incisal contour and exact width of each central incisor. A clear strip was placed and each incisor built up separately. Renamel microhybrid composite was used. Softflex discs used to polish.
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