Family & Cosmetic Dental Care in a Relaxed Environment.

Exceptional Dentistry Las Vegas and Henderson NV Since 1999.

Dental Implants, Teeth Whitening, Porcelain Veneers, &
Botox Cosmetic.

Cosmetic dentistry has become such a common term that almost every dentist calls themselves a “cosmetic dentist”. The American Dental Association does not recognize

Cosmetic Dentistry Marielaina Perrone DDS

Cosmetic Dentistry As An Art

cosmetic dentistry as a specialty in dentistry. The fact is, that even though cosmetic dentistry is not officially recognized,  it does take extra skill, experience, and training. A good cosmetic dentist is concerned with both the esthetic outcome as well as the functional outcome working together in harmony.

Common procedures used in cosmetic dentistry include teeth whitening, porcelain crowns, dental implants, limited tooth movement, gum sculpting, dental bonding, and porcelain veneers. With the exception of teeth whitening, all of the other procedures require extra skill on the part of the cosmetic dentist. The goal in any cosmetic dentistry procedure is to have the final product look and feel as natural as possible. This includes proper treatment  planning before and skilled preparation during the procedure. Choosing the ideal procedures, utilizing the highest quality materials, and pairing with the best dental laboratories are what makes for ideal cosmetic dentistry results. Being able to correct or fix any issues that might arise are just as important.

Cosmetic Dentistry Case Example

Patient came to the dentist with a  list of things she did not like about her teeth. She did not like spaces between teeth, wanted whiter teeth, and also had a badly decayed tooth in the upper molar area.

Step 1 – Fully explain your wants and needs. You and your cosmetic dentist need open lines of communication. An agreement should be reached about what can and cannot be done based on time, budget, and  function.

Step 2 -Full treatment planning records need to be taken. Pre operative x-rays, study models, and digital photographs. These are essential for a good cosmetic dentistry outcome.

Before Cosmetic Dentistry Marielaina Perrone DDS

Cosmetic Dentistry – Before

Step 3 – Options for treatment should be presented. Discuss options and develop an agreed upon treatment plan. In the pictured case, the mouth was healthy (except for decayed molar) and free of periodontal disease. Patient was shown what the final treatment could look like. Such visual cues can be very helpful in decision making. In this case the treatment plan decided upon included:

-Removal of an extremely decayed molar, and replacement with a dental implant.

-Porcelain Veneers to correct shape, size, color, and spacing of the front six upper teeth.

-Teeth Whitening – This will allow the patient to whiten the teeth to a more desirable color, so that the new porcelain veneers, and implant crown can be matched to a more visually appearing, cosmetic color.

Step 4 – Patient has badly decayed molar removed and is referred to periodontist for implant consultation and placement. Following placement of dental implant patient will wait 4-6 months for healing and bone strengthening to occur before final porcelain crown can be placed.

Step 5 – Begin Teeth Whitening. This procedure can either be done in office (in one hour), or the patient can complete teeth whitening at home over the course of 2-4 weeks. This step is important as the final porcelain veneers and porcelain crown will be fabricated to match the new, lighter, final shade following teeth whitening.

Step 6 – Following teeth whitening, porcelain veneers procedure can begin. Porcelain veneers (also referred to as porcelain laminates) are super thin, custom fabricated

After Cosmetic Dentistry Marielaina Perrone DDS

After Cosmetic Dentistry

shells of tooth colored porcelain designed to cover the front surface of teeth to improve your smile’s overall aesthetic appearance. These shells are adhesively bonded to the front of the teeth changing their color, shape, width, and/or length. At end of this appointment patient will be sent home in temporary veneers while the laboratory can fabricate the custom porcelain veneers.

Step 7 – Placement and bonding of final veneers. This is a critical step in this case as the porcelain veneers must not only line up properly to close gaps but also be the right color and shape.

Step 8 – Placement of porcelain crown following healing of the dental implant.

Step 9 – Happy Smile!

Cosmetic Dentistry Conclusion

There you have the steps involved in a typical cosmetic dentistry case. Sometimes there are extra visits if any issues arise but if planned for properly the patient should know exactly what to expect in terms of the cosmetic dentistry treatment schedule as well as finances. Cosmetic dentistry can transform an ordinary smile into one that makes the patient smile bright for a long time to come.

Porcelain crowns have been a staple in cosmetic dentistry for years. It gives the dentist and patient a much more aesthetic appearance as a final product. In the past crowns and bridges were traditionally made of porcelain fused to metal (PFM). With the development of modern porcelain, which are incredibly strong and reflect light similar to natural teeth, full porcelain crowns can be used in most areas in which porcelain fused to metal crowns were used. This is especially true in a cosmetic area of the mouth.

Porcelain crowns are very versatile and used in many ways. The cosmetic enhancement use of porcelain crowns include, changing color of teeth, closing gaps between teeth, fixing teeth that are crooked or crowded, changing shape or size of teeth. Porcelain crowns are also used to cover and protect damaged teeth, (tooth that has a root canal, broken, cracked, large fillings), and to act as a new tooth in the case of dental implants. Their versatility gives the dentist 89014 a greater flexibility in using them to fix potential issues for the patient.

cosmetic dentist emax crown

Emax Porcelain Crowns

The first step often times includes impressions for study models and photos. The patient and dentist can then discuss and plan what the end result should be. The treatment includes preparation of the tooth surface for the porcelain crowns. The outer enamel and sometimes a bit of  the dentin are removed. This allows room for the porcelain crowns to fit over the teeth and be in perfect cosmetic alignment with the others. Impressions are taken of the newly reshaped teeth and temporary crowns are made.  The porcelain crowns are custom made in the dental laboratory. The porcelain crowns are then cemented or bonded onto the teeth using an adhesive bonding material. The placement of the porcelain crown will normally take about 30 minutes (depends on amount of porcelain crowns being placed). Once completed,  the patient can eat normally and enjoy the benefits of a beautiful new porcelain crown that matches and blends perfectly with the patients existing teeth. Only you and the dentist should know anything was done.

Advantages of All Porcelain Crowns

-No PFM gray or black lines at the Gum Line of Teeth. You may have noticed a person with a dark line in the gum area along a PFM crown edge. With PFM crowns, the soft tissue around the tooth can recede over time. This allows a reveal of the metal framework underneath. This cannot happen with an all porcelain crowns because they are metal free.

-Perfect Fit. Porcelain crowns are created in state of the art facilities. Porcelain crowns will fit so well you will even forget they are present.

-Cosmetically Perfect Match. All porcelain crowns have the ability with modern porcelains to match your existing shade of tooth color as well as mimic the light reflecting properties of your natural teeth. Porcelain crowns will be undetectable to anyone but you and your dentist. Dental porcelain can be shaped custom colored and sculpted to closely copy the look of your own natural tooth enamel. All the while providing the desired strength and resilience.

Some disadvantages of an all porcelain crowns:

-Higher cost over traditional PFM crowns.

-Durability. While porcelain crowns are very durable, they do not have the flexibility of natural teeth, they can fracture. Avoiding certain foods may be necessary. For example, Biting into sandwich with a hard bread. Patients who grind and clench their teeth will need to be fitted with a mouth guard to protect the porcelain crown from unnecessary and excessive pressures.

-Porcelain crowns may need a bit more reduction of tooth structure than traditional PFM crowns.

-Sensitivity may happen for a short time, (hot, cold sensitivity), especially with bonded porcelain crowns.

Follow-up Maintenance of All Porcelain Crowns

The maintenance of porcelain crowns is actually very easy.  They require routine brushing with non-abrasive fluoride toothpaste and regular flossing as well as regular visits to the dentist. A follow-up appointment will be scheduled to evaluate the porcelain crowns about 2-4 weeks after they are placed in the mouth This allows the dentist to review the work with tissues all healed and see how your oral tissues are reacting to the crowns. Even if you think the crowns are successful, this appointment is an important part of your future oral health.
There are several types of all porcelain crowns generally used in dental offices today. They have all proven to give the best cosmetic dental results.
-Zirconia Crowns or Lava Crowns (made by 3M Espe). This type of all porcelain crowns are made out of a zirconium core with porcelain pressed or layered over the crown to follow the natural contours of teeth. These crowns offer good strength and durability. Due to great strength, the material can be used to make a bridge.
-Procera Crowns (made by Nobel Biocare). These are made of an Alumina core with porcelain pressed or layered over the crown to follow the natural contours of the teeth. These crowns offer great strength and durability and are esthetically quite beautiful. Often used in the back of the mouth, (premolars, molars), these are cemented in with traditional cement and have less post-placement sensitivity.
-Empress II Crowns (made by Ivoclar Vivadent).These highly cosmetic porcelain crowns are used in the front of the mouth. They are used mostly for cosmetics, are very beautiful, but can fracture.
-eMAX Crowns or IPS e.MAX Crowns (made by Ivoclar Vivadent). These porcelain crowns are entirely made out of porcelain without a underlying framework. The absence of this framework offers a great advantage over Zirconia crowns, Lava crowns and Procera crowns in that e.MAX crowns allow for more light transmission through the crown translating to a more superior cosmetic dental result. The strength of these porcelain crowns is such that they can be used in any area of the mouth, can be made thinner than most porcelains, and can be used for an implant without much worry of fracture.
Cosmetic Dentistry is the art and science of creating a beautiful smile. The all porcelain crowns are just one more tool that the dentist can use to give you that smile you’ve always dreamed of.
Procera Porcelain CrownsLava Crowns Ivoclar VivadentPorcelain Crowns 3M Espe