Cosmetic Incisal Bonding

Today's patient came to us with a chipped maxillary central incisor that did not extend to the tooth's nerve. They had no symptoms of pain and simply wanted the tooth fixed. This is a very typical dental injury- particularly with young children and patients who play contact sports. The maxillary incisors are the most commonly chipped teeth due to their vulnerable position in the mouth and thin enamel edge. 

After discussing treatment options, we decided to solve the cosmetic concern with composite bonding. Here, filling material is added to the tooth using a special adhesive and bonding technique. Once the restoration was cured to the tooth, Dr. Kari Ann Hong reshaped it to match the contours and length of the neighboring incisor. Since this material closely matches the optical properties of natural teeth, the effect is a natural and unnoticeable restoration!

It is important to note that not every type of chipped tooth can be fixed with composite bonding. Chips extending to the tooth nerve will need a root canal and crown to treat any residual pain and remove the inflamed tissue. Larger chips will also require veneers to reliably replicate large amounts of tooth structure. Finally, certain types of occlusion (the way the teeth come together when you bite) will limit the amount of repair that can actually be done to the teeth. It is impossible to decide what treatment option is best without a complete examination. For more information on dental bonding, crowns, veneers and other cosmetic treatment, please give our office a call!

Dental Questions: What are my options in improving the esthetics of a single tooth?

This new tooth was restored using only bonding and disking. What a change!

Teeth can become cosmetically damaged through a number of different means; from chipping to fractures, staining, decay or even as a result of problems in development. Likewise, our office offers a variety of ways to restore your teeth and make them appear natural in your mouth once again.

As with any procedure, we start the process by making sure the tooth in question is sill alive and healthy. There is no sense in restoring a tooth with serious underlying problems. Secondly, we assess the extent of the damage. For minor chips and blemishes, a combination of bonding and “disking” may be the perfect fix. This process is virtually drill-less and conserves as much tooth structure as possible. You may be surprised to see what we can achieve without a crown or veneer!

For teeth with larger blemishes, or those missing a substantial amount of structure, we will often elect to utilize a crown or veneer. Cosmetic veneers are usually placed on anterior (front) teeth to modify their appearance. Since they are cemented to only one surface, they do not add any additional structural integrity. In other words, the underlying tooth must be in good condition to receive a veneer. In contrast, crowns can be used to improve the cosmetics of a tooth that has lost a significant amount of structure.  Since crowns wrap around the tooth, they can restore shape in every dimension while adding strength and rigidity to the underlying enamel and dentin.

In any instance, the result of your treatment will be a beautiful and natural looking tooth. We pride ourselves in offering high quality cosmetic solutions, no matter what the problem. If you would like to know more about bonding, veneers or crowns, please give us a call!

Cosmetic Veneers

Today’s technological advances have afforded a great deal of flexibility in modern dentistry. We can now treat a wider range of concerns with more precision and less invasive techniques. Ultimately, this has lead to more “conservative” treatment options- solving the same problems with less collateral interference. One of the best examples of this new approach and ideology is the rise and popularity of dental veneers.

Although veneers have been around for many years, new technology has made them an excellent long-term treatment option for esthetic concerns. In it’s most basic form, a veneer is a thin piece of material that is used to replace the lip side of anterior (“smiling”) teeth. This material is made by a dental lab and used to correct the shape, color, length or spacing of the teeth.

1) an existing tooth has become discolored or misshapen. 2) a minimal amount of tooth structure is removed to accommodate the new veneer 3) The new veneer is tried on to ensure esthetics 4) the final product is adjusted and cemented

In the spectrum of cosmetic dentistry, veneers occupy the space between cosmetic bonding and full coverage crowns. Large deficits in size and shape cannot be reliably addressed with bonding composites. Since a veneer is a single piece of solid material, it offers more overall rigidity. Additionally, a veneer can be made to match adjacent teeth in ways bonding never can. Color gradients, shapes and artifacts can all be added to the veneer to make it blend in perfectly with the rest of your smile. Conversely, since veneers only address cosmetic concerns, they are less invasive than a full coverage crown. Less natural structure has to be removed as the underlying tooth is still structurally sound.

A number of recent technological developments have perfected veneer preparation and placement. We now make veneers out of an engineered lithium disilicate called Emax. Emax is a translucent, tooth colored material that combines unmatched esthetics and incredible strength. It is perfect for anterior teeth as it is both functional and beautiful. The labs we work with will schedule a shade-matching appointment to make sure your Emax unit is flawlessly matched to your surrounding teeth. They will help guarantee that the color, gradient, shape, length and width are in perfect harmony with the rest of your mouth.

In addition to developments in the veneer material, the bonding agents we use have made the process easier and more predictable than ever. Since Emax is extremely translucent, the color of the underlying “glue” can severely alter the appearance of the final product. With this in mind, we use a combination of clear cement and mock try-in material known as Cosmedent Insure/Prevue. The Prevue material has the same viscosity and value as the Insure cement, and allows us to confirm esthetics without actually cementing the veneer. Once we are satisfied with the esthetics of the restoration, Insure is used to create a strong, lasting bond.

If you have one, two or more defects or deficiencies in your anterior teeth, veneers could be an excellent option to restore your beautiful smile. At our office, we place veneers to fix everything from single teeth to entire anterior arches. However, we evaluate each case for its appropriateness to be solved with veneers. Often times a combination of cosmetic bonding, orthodontics and smoothing/disking can offer similar results, albeit with a different time frame. If you are considering veneers, we urge you to schedule a consultation with Dr. Kari to best evaluate your personal needs, desires and expectations from our treatment!

Cosmetic Bonding

Often times, patients will be very satisfied with their oral esthetics aside from one feature. Thier teeth can be straight, white and well spaced, saving for a single tooth. In these cases, orthodontics may be impossible or unnecessary for purely esthetic results. Here, cosmetic bonding proves to be the most predictable and reliable treatment to a perfect smile.

In this case, bonding was added to compensate for a short lateral incisor (left of center).

Cosmetic bonding is one of the most underappreciated cosmetic procedures offered in dental offices. Using the same tooth colored material as fillings, we rebuild and recontour teeth to better fit and fill out your smile. This material is extremely durable, and can be used to lengthen, widen or "even out" the appearance of your front teeth. Our patients are always satisfied with the results, as the transition from natural tooth to filling material is virtually undetectable.

Here, bonding was used to close the gap between the patient's two front teeth.

Your appointment will begin with a short consultation on esthetics and a few photographs. We strive to match your expectations and desires before we start working in your mouth. Once a decision has been made on how and where to add bonding, we use high pressure air abrasion to temporarily roughen the tooth surface. This step is comparable to rubbing wood with coarse sandpaper before painting. After the tooth surface is prepared to accept composite, we add our bonding agents to the indicated area, followed by the tooth colored composite. Our composites come in a variety of shades and color, and can match practically any tooth shade. The material is added slowly, contoured to your tooth, and set solid via a high intensity curing light.

After we select an appropriate tooth color and light cure it, we begin shaping the material to resemble a completely natural tooth. The refinement process utilizes  sanding discs, polishing points and a number of sensitive techniques. The results look and feel completely natural in your mouth.

However, there are limitations to cosmetic bonding. It can generally compensate for deficiencies in tooth structure, but cannot address size issues such as overcrowding. Additionally, once structure has to be built out over 3-4mm, bonding becomes a less reliable long term cosmetic solution. For these in-depth cases, we typically recommend more involved esthetic procedures. Finally, bonding can interfere with teeth whitening or whitening results. Since bonding material does not respond to hydrogen peroxide, it does not change shade proportional to your natural teeth. Hence, we recommend you complete a bleach treatment prior to performing esthetic bonding.

Many consider veneers, orthodontics and whitening  as the standard of dental esthetics. However, we urge you to consider bonding to address your mild to moderate cosmetic dental concerns. The minimally invasive nature of these procedures makes them convenient and accessible to many patients. Feel free to call our office with any questions or concerns you have about the process, materials or results behind cosmetic bonding.