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in Dental Care

Cristina’s Smile Makeover Journey

Cristina’s Story

Cristina came to us after dealing with ongoing issues related to her existing dental bonding, which had been chipping and failing repeatedly. She expressed frustration with the short-lived results of previous treatments and was looking for a more reliable, long-term solution. 

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Treatment Goals

Cristina’s primary goal was to find a dental professional who would take a comprehensive approach—someone who could thoroughly assess her teeth, identify the underlying causes of the bonding failure, and recommend a treatment plan focused on both function and aesthetics. She was especially interested in achieving results that would not only enhance the appearance of her smile but also provide durability and longevity.

Before

After

Key Issues 

Cristina had already had composite bonding treatment at another practice but it kept chipping and failing. Cristina wanted to find out why this was happening and what could be done to fix it. 

  • Diagnosis (for Complex Cases):
  • Loss of Vertical Dimension as a result of grinding and clenching
  • Missing Lower Left First Molar
  • Unrestorable Lower Right First Molar

    Diagnosis Explained

    Cristina’s vertical dimension had reduced due to grinding and a lack of posterior support. Vertical dimension (VD) can be defined as the distance between any two points measured in the upper jaw and the lower jaw when the teeth are in biting together. The patient had already lost her lower left first molar and the lower right first molar was no longer savable. This had a profound impact as more of the pressure forces in the mouth were distributed towards the front teeth (which they are not designed to handle) as opposed to the posterior teeth. Thus resulting in accelerated tooth wear. 

Treatment Plan

Stage 1

We carefully examined her bite, jaw joint (TMJ), and teeth to determine how much vertical dimension needs restoring. We took digital Impressions and photos to help us to determine this new height and a digital wax up was created for the new design and height of the teeth. 

Stage 2

We placed an implant in the Lower left and lower right first molar position. These implants would help balance the bite and maintain the new proposed vertical dimension.

Stage 3 

The wax up design was tried in using temporary acrylic material to give the patient a chance to trial the new aesthetics and confirm if she was happy with the overall design of the teeth. Once confirmed we proceeded to the next step. 

Stage 4 

Composite table tops were placed using composite injection technique on
UR6, UR5, UR4 and UL4, UL5, UL6, UL7
LR5, LR4, LL4, LL5, LL7

Composite veneers were placed on the UR3,UR2,UR1, UL1, UL2, UL3 and LR3, LR2, LR1, LL1, LL2, LL3. 

Stage 5 

Review of new vertical dimension and tolerance checked ensuring the jaw joint was comfortable. 

Stage 6

A Digital scan was taken for the fabrication of the Implant crowns on the LR6 and LL6.

Stage 7

We then fitted these crowns to complete the bite and restore the missing spaces.

Stage 8

Once we were happy that the new bite was stable and the patient was happy with the outcome we placed ceramic onlays on the UR6 and UL6. These would serve as stops to prevent the bite from wearing down too quickly. 

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A try in of the new vertical dimension and a chance for Cristina to see the new aesthetics of the proposed smile. At this stage we were able to make aesthetic changes according to Cristina’s wishes.

We removed the mock up material from one tooth to show the difference in the height of the teeth before and how they would be after the treatment giving Cristina a chance to see how different the bite and aesthetics would be.