Dental Education Lecture: Cosmetic Dentistry

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In our life, good thing happens when we have a good plan.  Cosmetic dentistry is no exception.  One day Mr. Johnson returned to my office for emergency.  One of his front teeth (#8) was chipped; the other (#9) was discolored (Fig.1).  These two teeth were not in the same level.  X-ray showed that #9 had root canal (red arrowhead) and a post (pointed by two black arrowheads, Fig.4).  We could do external and internal bleaching for the discolored tooth (#9).  To do internal bleaching, we need to created a space inside the crown.  To create the space, we need to remove the post from #9.  It is usually very difficult to remove a post without damaging to the tooth.  Furthermore, bleaching may improve the color, but it does not tooth leveling problem we just talked about.  Therefore whitening is not an appropriate treatment modality.  We thought that it would be good to have a veneer for #8 and a crown for #9.  To make sure of it, we took impression, made plaster models, and sent the latter to lab for fabrication of diagnostic wax-up (Fig.2).  It appears that our planning was feasible.  After obtaining patient's approval, we finished the planned treatment.  Fig.3 shows the final result.  Fig.5 is final X-ray.  No matter how many veneers/crowns we are going to do, we need a good and complete planning.  Diagnostic wax-up is a key.  To see more cosmetic cases, please check here.

Xin Wei, DDS, PhD, MS 1st edition 02/02/2009, last revision 02/08/2009