At Thousand Oaks Family Dentistry, we offer an entire range of treatments and services for our patients. From pediatric exams to esthetic reconstructions, we have the knowledge, skill and equipment to handle any dental concerns. Today, we would like to highlight a recent case where we restored the esthetics and functionality of a patient with severe acid erosion.

Acid erosion affects many patients in one form or another. It can be linked to dietary habits such as sucking on lemons or certain types of medications that turn the saliva acidic. Most commonly, it is the result of a gastric disorder, such as acid reflux or bulimia. In rare cases, it can be attributed to genetic conditions that prevent dental enamel from "maturing" and becoming resistant to low pH. No matter what the origin, the results are always the same: decreased enamel thickness and tooth anatomy due to constant bathing in an acidic environment. 

 

Treatment

 Here, the patient needed their lower arch of teeth rebuilt from years of acid wear. When approaching a case like this, we have to be mindful of both esthetics and function. Close cooperation between our office and the dental lab assures that we deliver a final product that both looks great and respects the patient's jaw and chewing function. 

  Pretreatment photograph

Pretreatment photograph

  Stone modelwork of the patient before treatment

Stone modelwork of the patient before treatment

Here, we see the patient's pretreatment condition.  In order to best treatment plan for esthetics and function, stone models of their teeth were sent to our dental lab. The lab used wax on the models to mimic an ideal outcome. We were then able to show the patient what to expect when we treat the teeth. This waxed up model is also used to make temporary acrylic crowns, which hold space while the patient awaits the final crowns. 

 

  Initial waxup of patient’s left side

Initial waxup of patient’s left side

  Initial waxup of patient’s right side

Initial waxup of patient’s right side

After reviewing the wax models with the patient, we decided to do a combination of minimal preparation composite onlay crowns and lithium disilicate full coverage crowns.  Also, note the gap on the photo left (patient's right). Here, we added a bridge to replace the missing second premolar. After the teeth were readied for crowns, we sent impressions, previously waxed ideal models, pictures and instructions to our dental lab.

  Picture of the patient’s teeth, after being prepared for final crowns

Picture of the patient’s teeth, after being prepared for final crowns

Our lab then took all of this information and fabricated crowns for the prepared teeth. This process took two weeks. Special attention was paid in matching color, texture, tooth bulk and biting function to the patient's needs. 

  The final crowns on a stone model

The final crowns on a stone model

The crowns were then sent back to our office, where we checked them for color, fit and size. Once we determined the crowns were a perfect fit for the patient, we permanently adhered them with crown cement.

 

Results

  Overall final product

Overall final product

  Closeup of patient’s right side

Closeup of patient’s right side

  Closeup of patient’s left side

Closeup of patient’s left side

The finished product!  Not only did we restore the cosmetics of the patient's lower teeth, but we added back functionality and tooth structure. Both our office and the patient are ecstatic with the results!

As mentioned before, this patient represents a small portion of the services offered at our office. Every day, we treat a wide spectrum of dental problems, from fillings and cleaning to implants and full mouth veneers. If you would like to know more about the types of cases we treat and what they involve, please give us a call. We are always ready to meet all of our patient's dental needs!

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