Fractured Teeth Repaired With Bonding
This nine-year old boy fell while playing and fractured his two front teeth. To repair his teeth to their previous appearance, they were bonded with composite resin. Dr. Gregory is monitoring them to make sure the pulp and nerve of the teeth weren’t affected by the accident. When his adult teeth come in, Dr. Gregory will refer him to an orthodontist (if needed) to establish an ideal bite and smile. When he is in his 20’s, the teeth will need to be crowned.
Bonding “Peg Lateral” Teeth
This eighth-grade student just completed their orthodontic therapy but the teeth next to his front teeth had not developed fully. They were smaller than they should be. This kind of tooth is called a “peg lateral.” Dr. Gregory bleached the student’s peg laterals and used composite resin bonding to build them up to a normal size.
Dr. Gregory will need to wait till the child has completed facial growth and then see how his teeth have matured before permanent crowns are placed.
Anterior Crown and Bridge
This patient had a front bridge that she wanted redone. This was a complicated case that required a combination orthodontics and crown and bridge work. It also required ongoing communication and discussions between Dr. Gregory and the patient.
One decision is where to stop treatment? Many times we, as dentists, start out attempting “ideal” treatment and have to compromise due to limits with the teeth, the patient, and or costs. Dr. Gregory could easily continue and restore the other teeth trying to build out the smile corridor and eliminate the gray from previous silver restorations. Changing a smile is always a work in progress and depends on the patient’s age and circumstances.
Molar Filling Using Composite Resin
This patient had a cavity on the lower first molar. Dr. Gregory filled it with composite resin to ideal shape and occlusion. The end result is a tooth with a white filling instead of a metal amalgam, a much more attractive option that is also durable.
Bonding: Filling in Cervical Abrasions
The patient had severe abrasions from using a toothbrush that was too hard. The teeth were filled in with composite resin. If the patient had a high smile line (upper lip is retracted for the photo), a pink composite would have been used to match her gingiva and reduce the appearance of the long teeth.
Retreat Single Front Crown
This patient’s front tooth had a crown placed years ago but unfortunately the color, shape, and contour wore off. A new crown was made by reducing the bulkiness of the original crown. The gingiva was also reshaped through crown lengthening to match the shape of the adjacent natural tooth.
Ceramic Veneers on 10 Teeth
The patient had discolored teeth that were also worn down and the teeth had shifted over time. Veneers were the treatment option to idealize the patient’s smile and improve the color. The patient has a broad smile so Dr. Gregory needed to cover teeth in the back because she showed them when smiling. The lower front teeth were bleached at a later date to match the upper veneers.
Maryland bridge’s completed on a young man. These are interim restorations while waiting for the patient to mature and finish with facial bone growth BEFORE implants can be placed. In a couple of years, we will place two implants in the #7 and #10 sites and restore them with a crown.
If you place the implant BEFORE osseous growth is complete the natural teeth will move and the implant will remain in place setting up an aesthetic nightmare. We would normally take serial radiographs (cephalometric radiographs) to check and see that the facial growth has matured and ended.