So to review….we took a compromised situation with poorly-sized teeth that did not fit the face or smile of this pretty patient.
With a lot of work, the solution was to make teeth that were the correct proportion, design the bridge to fit the smile/face, and fill in the missing gum tissue with pink-colored porcelain. Everyone involved was really excited about the final, beautiful result!!
Here’s another view of the finished bridge. I wanted to show this view along with the old bridge to illustrate the difference having teeth the proper proportion can make.
This also illustrates the difference a real artist can make when crafting a dental restoration. Look at how life-like the new bridge appears.
What do we do when the gum tissue and bone is gone? We build it into the bridge! These teeth are properly proportioned in their width and height. The ‘extra’ area that existed before is now filled in with porcelain that is colored to look like gum tissue.
Also, notice how the tissue on the patient’s right side (or the left side of the photo) has begun to heal.
With the tissue/bone loss the teeth all looked the same. There was no differentiation between any of the front teeth.
And look to the left on the picture (or the patient’s right side). The gum tissue is very inflamed and irritated because of the poor fit of this existing bridge.
After the teeth were lost, the bone and gum tissue followed. This made for a very difficult esthetic situation.
How could she have ‘normal’ size teeth with all the bone and tissue gone? And to compound the situation she was trying to manage gum disease around the other existing teeth, with the help of a periodontist (gum specialist).
Now, since we’ve looked at the final result, let’s look where we started.
The patient lost her front teeth many years ago and so had to get a bridge across the front. When it was constructed the dentist did not take into account the shape of her lips or smile. So this old bridge has what we call a ‘reverse smile line’. That means her front teeth don’t follow the shape of the lower lip giving a worn, older appearance to the smile. This also occurs in many people that grind their teeth.
We’ll look at where we started in another post. But I want to emphasize this very important point. All the parties involved….the dentist, the patient and the ceramist….should have a ‘final result’ in mind. This is usually accomplished by making a ‘wax up’ on stone models of the patient’s teeth. This helps everyone envision what the finished product will look like. Think of it this way….when you build a house, what’s the very first part of the process? You make a blueprint of what you want to build. It’s the same thing in dentistry.
Sometimes we should start with the ‘end result’ in mind when starting a case. With this thought, take a look at this very nice case. You can see the teeth have lots of brightness and are very life-like. The tissue is healthy looking. And the shape and coutour of the teeth compliment this pretty ladies’ lips and face.
Look at Cleo’s smile before and after she had her teeth fixed. She asked for teeth that were straighter and whiter. We completed this with a bridge and some crowns. What a difference!
You’ll recall the tooth Cleo had to have extracted. The temporary was used to ’shape’ the tissue in this area and aid the healing process. Here’s the original condition of her teeth, and the final results:
It’s difficult to even see where the tooth was extracted! The ‘fake’ tooth looks as if it emerges from under the tissue just like all the others. A beautiful result.
