cosmetic dentistry

What is the goal of cosmetic dentistry

improve the look and appearance of teeth, oral structures and correct/restore function.

Esthetic Dentistry

focuses on enhancing the smile's aesthetics through direct and indirect restorative materials, or by using whitening techniques.

Types of cosmetic procedures

placement of bridges, crowns, veneers, tooth whitening, straightening of teeth, lengthening of teeth, recontouring of gingival tissues, correcting bites, closing gaps, repairing chips/fractures and replacing missing teeth.

Psychological factors

personality, desires and expectations that can influence a person's perception of their smile and decision to undergo cosmetic procedures.

Sociological influences

Media, television, and advertising that set the standards for what is deemed acceptable and attractive in society

Occlusion

Occlusion refers to the alignment of teeth when the jaws are closed, and restoring proper occlusion can enhance both the aesthetics of a smile and the overall functionality of the mouth.

What type of dental specialist can make changes to a person’s bite/smile/function of the mouth.

An Orthodontist

Choosing a cosmetic dentist

referrals, credentials, availability

First steps

diagnosis, treatment planning, legal forms (consent)

Oral Photography

case presentation, patient records, lab communication, insurance, marketing and education

Extraoral

full face and profile

intraoral

various views, uses mirrors and retractors

Fundamentals of cosmetic dentistry

light, colour, illusion, shape and form

Hue

Name of colour

Chroma

Intensity or quality of the hue

Value

Brightness of the shade of the tooth

Vitapan classic shade guide

16 shades, white with varying degrees of grays, yellow or orange, use natural light when choosing shade

blurry but what is this

Vitapan Shade guide

Specific conditions

1. discolouration due to extrinsic or intrinsic staining

2. anomalies caused by developmental disturbances

3. abnormal spacing between teeth

4. trauma

Bonded restorations

Bonded restorations use a process of adhesion creating a contact
of one material to another.

Non-Bonded restoration

Restorations are retained by mechanical retention between
restorative materials and tooth structure.

Direct restoration

applied to the tooth while the material is pliable/flexible. Some examples are amalgams, composites, glass ionomer, etc

indirect restoration

created in the lab, also known as castings. Can be gold or ceramic, final cast is either bonded or cemented into place.

Restoration completed in 1 visit

direct

restoration completed in 2 visits

indirect

CAD/CAM

Indirect restoration without the wait, computer-aided design and manufacturing, can make crowns, bridges, veneers, inlays, onlays, and surgical guides

what type of restoration is this

indirect

Inlay

covers portion of occlusal and proximal surfaces (INNNNNlay)

Onlay

Covers proximal and most or all occlusal surfaces (ONNNlay)

This restoration would be?

Onlay

this restoration would be?

inlay

Veneers

Thin, tooth coloured material, applied to facial surface of tooth.

Direct technique uses ____ material to create a veneer

composite resin

indirect technique uses ___ material and is ___ to the tooth

porcelain, cemented

tissue contouring

electrosurgery or laser to enhance the appearance of gingival tissues due to excessive or inflamed gums

Bleaching

Free radicals, breakdown of pigment during tooth bleaching procedures

tooth whitening

abrasive agents contained in a dentifrice to remove extrinsic stain

Chemicals involved in tooth whitening

Hydrogen peroxide, carbamide peroxide, sodium perborate

Carbamide peroxide or Hydrogen peroxide

Various concentrations: 10%, 16%, and 22% for patient applied techniques

sodium perborate

weak oxidizing agent, once used with water to whiten non-vital teeth

hydrogen peroxide

high concentrations are added for non-vital teeth

whitening techniques

non-vital bleaching, vital bleaching in office, home whitening.

vital whitening

one full arch at a time

non-vital whitening

one tooth at a time

Adverse effects of tooth whitening

1. thermal hypersensitivity (vital teeth)

2. tissue irritation

3. root resorption due to heat used during application (non-vital tooth)