Bridge, Crowns & Veneers
Rob did not like the appearance of an old fixed bridge at the front of his mouth that replaced a missing upper right lateral incisor. The 3-unit bridge was made of porcelain and metal and did not blend with the corresponding teeth on the left hand side of his mouth. He also wanted to brighten and enhance his smile over-all.
It was decided to replace the old bridge with a new one made without a traditional metal framework. Ytrium stabilized zirconium oxide, “zirconia” as it is known in dental circles, would be used instead to provided the strong underlying framework for the 3-unit bridge and then lithium disilicate porcelain would be layered on top to provide natural-looking esthetics. The combination of a zirconia framework and layered lithium disilicate would provide a strong, long-lasting and attractive alternative to the old porcelain-fused-to-metal (PFM) bridge.
Teeth behind the bridge on the upper right and the corresponding teeth on the upper left would also be treated with porcelain crowns or veneers to complete the smile make-over. A total of 10 teeth were planned for restoration. Besides improving Rob’s smile, worn away tooth structure would be replaced and his bite improved to help prevent further tooth loss and wear. A nightguard would be made at the end of treatment to help protect both his teeth and the new dental work from nighttime grinding.
Records were obtained so that the work could begin and detailed instructions were given to my dental laboratory so that they could create a “wax-up” of the desired smile design. The wax-up allows for previewing of the final result and the fabrication of various putty matrices that are used during the procedure. One of these matrices is used to fabricate the temporary or “provisional” bridge, crowns, and veneers that Rob would wear during the time the definitive restorations were being created at the lab. The provisionals protect the prepared teeth and allow us to preview the final result – to “test drive it” so to speak. If modifications are needed, such as bite adjustments or changes in shape or length, then the alterations can be made before the case is finished. This technique ensures a predictable result that pleases both the dentist and the patient!
On the day of treatment, all the indicated teeth were prepared, impressions and bite registrations taken, photographs obtained for communication with the lab and the provisionals fabricated. A detailed prescription was written out for the lab to follow. When Rob left that day he had a new smile, albeit not the final result, but one that was functional and that looked good. He would return in 3 weeks to have the final product inserted.
At the insert appointment, the provisionals were removed, all the teeth cleaned and disinfected and the new porcelain teeth tried in for fit. After I was satisfied that everything fit as it should we sat Rob upright and both he and the team had a look at the appearance. We all agreed that it looked great!
The new porcelain bridge, crowns and veneers were cemented and bonded into place and Rob left that day with a wonderful new smile! We were all happy with the great result.