I have been ordering my supplies recently from a new dentist-owned GPO (Group Purchasing Organization). I had been ordering from one of the ‘major’ dental supply companies but found them REALLY overpriced when I did a comparison to Synergy. The Synergy concept is to use a large group of dental professionals to negotiate reduced prices on supplies. Read more about it here.
So this gentleman is not ready to crown his teeth, but there is a large fracture. It doesn’t hurt, but esthetically it looks less than ideal. He’d like a temporary ‘fix’ until we can crown it (which, again, he is not ready to do right now). What to do???
This young man has recently finished braces, and the orthodontist sent him to us because of the gap that was left between these two teeth. All the other teeth were placed ideally, and if this space was closed the other teeth would be in the wrong spot so they would not function correctly or look right. So we talked about bonding to solve the problem.
And so to review…..we started with two very small lateral incisors.
Small laterals before ortho and bonding
Ultimately we decided to go with the first discussed option…..leaving ideal spaces and then bonding them closed. Now I have to warn you—-the orthodontist has to be VERY good for this work. If not, you will end with two teeth that do not match in size or proportion. Here’s the first tooth, before and after:
Small tooth with spaces before bonding
Tooth after bonding to close spaces and correct the size
We (the orthodontist and myself) discussed our two options.
1. Move the lateral incisors into the middle of the spaces, bond the teeth to make them ideal for size and proportion, finish the orthodontics.
2. Complete the ortho, leaving ideal spacing for the laterals, THEN bond the teeth after the orthodontics is finished.
Both are fairly difficult. We’ll talk about them in separate posts.
Ok. Just a little bit into the tooth and you can already tell there’s a more going on inside than you could originally see.
Hidden cavity
With the broken piece bonded into place this patient will be able to function just fine until he can get back with us to make a new crown for this tooth and the one next to it. He was just relieved to have the tooth back together in one piece!
Bonded broken porcelain
This tooth recently had a root canal. The specialist referred her so that we could improve the esthetics of the corner or edge. Our solutions included a veneer, a crown, or bonding. Although the tooth may need the other more invasive procedures later, we opted to try and improve the look by altering the existing bonding.
Tooth before new bonding
So we cleaned the cavity out of both, filling the front tooth and placing a porcelain crown on the one next to it. The resulting change was dramatic! And our patient was VERY happy to get both of these teeth fixed….and looking MUCH better! (Again, for reference, the old porcelain crown- with the obvious margin where the tooth and crown meet-is located directly behind our new crown).
Crown and filling-after
