DentAlDente Oral and Dental Clinic, Istanbul

What Should Be Taken Into Consideration In Smile Design?

Following the standard procedures such as general examination and x-ray films, aesthetic treatment plan and options are decided upon detailed investigation of face and teeth photos and videos, since the aesthetic needs and expectations of each patient are different.

Factors such as the profession of the patient, complexion, face shape, age and gender should be taken into consideration as a whole for a proper smile design. The combination of aesthetics, function and biological compatibility is important when performing these procedures. An aesthetic but non-functional dental treatment will not please the patient in a long run. Let’s not forget that we do not use our teeth just to smile!

Proper planning is the first and foremost element. The orthodontic treatment option should always be considered as a priority in eliminating the misalignment in the teeth. In the smile design, the level differences in the gums are arranged before the laminate veneers are made.

It is possible to have a preliminary information about the result by testing the smile design in patient’s mouth (mock-up).

Generally, for porcelain laminate veneer applications, tooth preparation (filing) either is not performed or it is performed minimally. At the trial stage, the compatibility of the fabricated laminate veneers is checked and some changes can be made by taking the opinion of the patient about the aesthetics.

If it is required, the smile design can be supplemented with dermal filling and similar medical aesthetic applications on the lips and face, according to the patient’s request.

Laminate Veneers

These are very thin porcelain laminates applied only on the visible front surface of the teeth, and they are made of glass ceramics or composite. It is a treatment method designed and applied to solve aesthetic problems such as discolored teeth, mild distortion or diastema.

Porcelain Laminate Veneers

This is a technique that is used to give the patient a healthy and beautiful smile by changing the size, shape and color of the teeth with thin porcelain leaves. A design is prepared with the help of the photos, in accordance with the aesthetic expectations, face and lip shape of the patient, and it is tried in the patient’s mouth first. After the patient’s approval, mouth preparations and impression taking procedures are started. When necessary, a minimum of tooth filing is made with the help of the anaesthesia. The porcelain laminate veneers are fabricated in the dental laboratory and adhered to the front surface of the tooth by the dentist.

What are the advantages?

The most prominent advantages are meeting high aesthetic expectations, no color change of ceramic veneers in time and requiring minimum abrasion at the tooth structure.

Is anaesthesia necessary during treatment? Is it a painful procedure?

Anaesthesia is performed for the comfort of the patient when gentle grinding is required on the teeth surfaces

Is it possible that the porcelain laminates might fall off?

Porcelain laminates are not likely to fall off when appropriate techniques and materials are used. The risk of fracture is not different from the natural teeth.

How to maintain the porcelain laminates?

With regular control and routine oral care, porcelain laminate veneers will serve patients like their own teeth for many years.

Composite Laminate Veneers

It is a method used to close the gap with bonding applications, to eliminate small color and shape distortions in the teeth with aesthetic arrangements, and to obtain a proper tooth alignment.

Special composite materials are used in bonding applications. This application is also called composite laminate due to the material used.

Composite laminate is a practical method which is used to fix color and deformity on the teeth and it is possible to obtain good results in the same session. In composite laminate procedure, abrasion is not performed if not necessary. Therefore, anaesthesia is not required during application. Compared to ceramic laminates, the risk of discoloration is higher due to the nature of the material. With regular control, good hygiene and care practices, composite laminates can serve patients for a long time.

For successful results, composites with different light transmittance solely produced for these process should be used.

Teeth whitening (Bleaching)

It is the lightening of the teeth procedure for the patients who are not satisfied with the color of their teeth. There are basically two types of whitening.

Vital bleaching

Vital tooth bleaching refers to application of a chemical solution to a tooth surface in order to achieve a lightening effect.
There are two techniques used in the application
– Dentist-applied office bleaching
– Patient-applied home bleaching

Home bleaching

By taking a simple impression from the patient’s mouth, an individual silicone plate (tray) is prepared. The patient smears the whitening gel into this plate and applies it at home, as prescribed by the dentist. The whitening process is completed in an average of 4-7 days. Patients should wear their plates for about 2-6 hours a day.

Office bleaching

It is applied and usually activated with a special light, under the control of the dentist. Application time is between twenty minutes and one hour. During this proces, special measures are taken by the dentist to protect the gums, tongue and surrounding tissues.

Devital bleaching

It is a whitening process applied on teeth which have lost their vitality after root canal treatment. Non-vital bleaching involves the use of oxidizing agents within the coronal portion of an endodontically treated tooth to remove tooth discoloration.

Is tooth whitening harmful?

According to the studies, tooth whitening is a highly effective and harmless application under the control of a dentist, with the right concentration and when the right materials are used. Teeth and gums are not damaged in any way.

Will the teeth return to their original state after whitening?

Teeth will always be white after the whitening process. However, the effect of the whitening process may differ depending on personal factors. Yellow teeth are whitened more easily, while the gray-colored teeth whiten more difficult and longer. The patient’s tea, coffee, smoking habits and general oral hygiene are decisive in the whitening process. Depending on the amount of discoloration, shorter reinforcement treatments may be required, in every 1-2 years.

Pink Aesthetics

For a beautiful smile aesthetics, it is important to have tooth proportions and gum levels in harmony. Problems such as gums being more visible than the usual, gum level differences, swelling and redness and dark spots in the gums influence dental aesthetic undesirably. After analyzed by a dentist, these problems could easily be solved by classical periodontal treatment methods and laser procedures and a healthy gum profile in harmony with the teeth is established.

Prosthesis

Dental Crown

If teeth with a lot of substance loss due to caries and fractures cannot be treated with any filling material, crowns are made. Teeth that lose their vitality and elasticity after root canal treatment are recommended to be covered, as the teeth become brittle.

Before the crown is made, the tooth is treated if there is caries. If the living tissue of the tooth is damaged, root canal treatment is performed. It is very important that the gum around the tooth is healthy in all these processes. The tooth to be crowned (capped) is reduced in accordance with the anatomical form, the impression is taken, a temporary crown is made and the impression is sent to the dental laboratory. Crowns fabricated in accordance with the molds of the patient are adhered after the intraoral check.

Dental Bridge

It is the process of reducing the teeth adjacent to the space and filling the gaps in between in the absence of one or more teeth. Teeth on both sides of the gap are covered with crowns, and the artificial tooth that will replace the missing tooth is connected to these crowns.

Metal Supported Crowns and Bridges

These are crowns and bridges made by processing porcelain on a metal alloy substructure. Since their light transmittance is weak, they are not preferred in the restoration of the frontal regions where the aesthetic expectations are high. It is a durable and long-lasting treatment option when applied in the right place.

Full Ceramic Crowns Without Metal Support

Specially reinforced porcelains are used in the construction of all ceramic crowns without metal support. Full ceramic crowns without metal support provide the closest aesthetic result to the natural look due to their light transmittance similar to enamel. Biological compatibility with surrounding tissues is the most prominent feature of this crown.

Today, it is used extensively in aesthetic dentistry applications and the most successful aesthetic results are obtained with this technique.

Zirconium Supported Crowns and Bridges

It is a white, semi-translucent and semi-metal material that can be used instead of standard porcelain fused to metal restorations . The biggest advantage is that they are a good and more aesthetic alternative to metal supported porcelain bridges due to their high resistance to chewing forces.