Successg In Cosmetic Dentistry

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Successg In Cosmetic Dentistry

  1. 3. Success in Cosmetic Dentistry 2010 and Beyond Steve Bader, DMD Ultimate Aesthetics Harvard School of Dental Medicine Las Vegas Institute for Advanced Dental Studies Fellow Hosted by:
  2. 4. Goals For Today <ul><li>Cosmetic success tips you can use tomorrow </li></ul><ul><li>Case selection and treatment planning for success </li></ul><ul><li>Expand your multidisciplinary vision </li></ul><ul><li>Visualize your final results: digital imaging, waxups, templates </li></ul><ul><li>Improvising without templates </li></ul><ul><li>Final results that help build future success </li></ul>
  3. 5. Case Selection And Planning It Starts At The Beginning <ul><li>There are no simple cases </li></ul><ul><li>To know where to start you must know where </li></ul><ul><li>to finish </li></ul><ul><li>Planning takes time and pays off in the end </li></ul><ul><li>Sometimes you can only do what the patient wants – offer options </li></ul>
  4. 6. What Is A Full Evaluation? <ul><li>Oral Cancer, Dental, Periodontal of course </li></ul><ul><li>TMJ Screening </li></ul><ul><li>Occlusal Evaluation </li></ul><ul><li>Muscle Examination </li></ul>
  5. 7. Evaluating For Success <ul><li>Initial evaluation records – diagnostic casts, photos, measurements </li></ul><ul><li>WHAT ARE YOU TRYING TO FIX?? </li></ul><ul><li>Don’t be afraid to ask (will they accept other more comprehensive treatment options?) </li></ul>
  6. 8. S.M.I.L.E.S. <ul><li>Size and Golden Proportions </li></ul><ul><li>Midline and Canting </li></ul><ul><li>Axial Inclination </li></ul><ul><li>Lip Line vs. Incisal Edges </li></ul><ul><li>Extra Hard Tissue Guidelines </li></ul><ul><li>Soft Tissue Conditions </li></ul><ul><li>Developed at the Las Vegas Institute </li></ul>
  7. 9. .
  8. 10. Guess What She Wants!
  9. 11. Can You Replace My Old Crown?
  10. 12. Crowding Does Not Bother Her Moderate Incisal Wear
  11. 13. Can You Replace My Old Crown?
  12. 14. Crowding Does Not Bother Her Moderate Incisal Wear
  13. 15. S.M.I.L.E
  14. 16. Treatment Plan Option <ul><li>4, 8, 12, 14 Upper Restorations </li></ul><ul><li>Invisalign </li></ul><ul><li>Increase Occlusal Vertical Dimension </li></ul><ul><li>Lower Restorations </li></ul>
  15. 17. Emergency Chipped Tooth
  16. 18. Crowding, Large Composites
  17. 19. Incisal Wear Patterns
  18. 20. Crowding And Wear
  19. 21. S.M.I.L.E
  20. 22. Treatment Plan Option <ul><li>4, 8, 12, 14 Upper Restorations </li></ul><ul><li>Invisalign </li></ul><ul><li>Lower Restorations for Teeth with Larger Composites </li></ul>
  21. 23. More Complex Problems
  22. 24. Grossly Uneven Wear Neuromuscular TMD Symptoms
  23. 25. Migration, Abfractions, Recession
  24. 26. Visible Occlusal Plane Discrepancy
  25. 27. Incisal Wear, Visible Vertical Fracture
  26. 28. Gross Incisal Wear
  27. 29. S.M.I.L.E
  28. 30. Treatment Plan Options <ul><li>Neuromuscular Phase 1 Therapy </li></ul><ul><li>Full Mouth Occlusal Reconstruction </li></ul><ul><li>Crowns And Veneers On All Teeth </li></ul>
  29. 31. Common Pitfalls <ul><li>Can you make my teeth longer? </li></ul><ul><li>Why are my teeth so uneven? </li></ul><ul><li>I only want (one, two, three ….) teeth fixed </li></ul><ul><li>I don’t care about my back teeth </li></ul>
  30. 32. Planning For Success <ul><li>Digital Imaging like Smilevision by Smilevision Lab in Watertown, MA </li></ul><ul><li>Waxups according to your Rx </li></ul><ul><li>Templates from the waxup for preps, mockups and temporaries </li></ul><ul><li>Siltech flexible matrix, rigid 2 piece stents </li></ul><ul><li>Mockup in the mouth with impression </li></ul>
  31. 33. SmileVision Before
  32. 34. SmileVision After
  33. 35. Initial Study Model
  34. 36. Waxup For Four Veneers
  35. 37. Before Waxup
  36. 38. Incisal Waxup View
  37. 39. Siltech Flexible Matrix
  38. 40. Mockup Using Matrix
  39. 41. Temporary Before Finishing
  40. 42. Temporary At Insert Visit
  41. 43. Smile Vision 2 Part Matrix
  42. 44. Fill With Bis-Acryl Temp
  43. 45. Insert Both Sections
  44. 46. Remove Templates
  45. 47. Trim And Polish
  46. 48. SmileVision Sample Imaging
  47. 49. SmileVision Sample Imaging
  48. 50. SmileVision Sample Imaging
  49. 51. Improvising <ul><li>Preplanning is great – what if there is no time or a change in the plan </li></ul><ul><li>Mockup with flowable or composite </li></ul><ul><li>Take an impression </li></ul><ul><li>Use impression for your temporary </li></ul><ul><li>Photograph and model for the lab </li></ul>
  50. 52. Day Of Four Tooth Prep
  51. 53. Temps From Mockup In Mouth
  52. 54. Note The Dark Cervical
  53. 55. ‘ Dickerson Ditch’ At Cervical
  54. 56. Symmetry Bite
  55. 57. Temps At Insert Visit
  56. 58. Mounted Study Models
  57. 59. Lab Photos of Final Waxup
  58. 60. Photos Photos Photos <ul><li>You only get one chance to take BEFORE photos </li></ul><ul><li>Part of your cosmetic record </li></ul><ul><li>Laboratory communication </li></ul><ul><li>Marketing and case presentation </li></ul><ul><li>Lester Dine, Norman Camera for a good SLR digital package </li></ul>
  59. 61. Beautiful Smiles <ul><li>4 teeth or 14 teeth with the same predictability </li></ul><ul><li>Initial smile design and imaging followed from treatment plan to insert </li></ul>
  60. 62. First Meeting Photo
  61. 65. Final photos After Invisalign, Laser Recontouring, 4 Veneers & Lower Incisal Recontouring
  62. 66. Initial Visit
  63. 67. 4 Weeks Without A Retainer!
  64. 68. Initial Visit
  65. 69. 4 Weeks Without A Retainer!
  66. 70. Invisalign, 2 Veneers, 2 Crowns, Laser Recontouring
  67. 71. First Visit
  68. 72. Neuromuscular Full Mouth Reconstruction
  69. 73. Please Join In Now To Have Your Questions Answered. <ul><li>Steve Bader, DMD </li></ul><ul><li>Ultimate Aesthetics </li></ul><ul><li>1400 Center St., Newton Center, MA </li></ul><ul><li>617-795-7170 </li></ul><ul><li>www.ultimateaesthetics.com </li></ul><ul><li>Harvard School of Dental Medicine </li></ul><ul><li>Las Vegas Institute for Advanced Dental Studies Fellow </li></ul>

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