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Smile for life-patient-centred Artistic DentistryConservative - not an “extreme” makeover!Helping to improve our patients’ lives with ONE SMILE AT A TIME. The aesthetic assessment is complex requiring considerable experience and training. When choosing your cosmetic dentist ask to see examples of similar cases performed by this dentist and not pictures copied from some other source. You should ask for your options of treatment and advantages and disadvantages of each procedure. Dr Nalbandian is highly trained in areas of cosmetic and reconstructive dentistry and will help you decide the most suitable treatment.
That perfect smile and how to create it.What makes a perfect smile? It’s the smile that complements a person’s facial expression and appearance. This is not just looking frontally (facing the mirror); but also laterally (sideways). When a person looks at the mirror directly, they usually notice the upper and lower six front teeth only. The request for aesthetic dentistry from the patient is usually in relation to the six upper and lower front teeth. Unfortunately, this is not the whole story for a full smile, which normally requires a minimum of twelve upper and lower teeth to be in harmony with the gums, lips and the facial complexion both frontally and sagitally (sideways). Then what is a perfect smile?Imagine a beautiful picture where the lips are the frame, gums the madding and the teeth as the picture. The harmony between these three factors, in conjunction with the facial appearance, creates that ultimate smile. The smile is both dynamic (during speech) and static (still photo) components. Today, the dynamic aspect of a smile is a major concern for most patients as with time, due to normal aging processes or heredity, many teeth do not show their upper teeth during speaking or smiling (refer to One Visit Smile Lift) on one side of the spectrum. On the other side, 25% of patients have a high, gummy smile-line (refer to gum lift).
The lipsThick lips (thicker picture frame) always helps to enhance the smile and hide any discrepancies. Thinner lips do not give a lot of flexibility for smile correction as all the picture is on show. This is difficult to correct and requires considerable skill to achieve symmetry and harmony. Lip augmentation (thicker frames) by a plastic surgeon provides tremendous improvement to the overall smile. However, in the above before and after photos we notice enhanced lip thickness without any lip augmentation. This occurred naturally by giving better lip support in ONE VISIT using composite technology developed by Dr Nalbandian at Designer Smiles.The gumsAgain, imagine thin lips, gummy smile and misaligned teeth. The smile is not in proportion. Patients who have perfect teeth may complain about the gummy appearance of their smile. If the gums are recontoured without lip augmentation, the smile may not be well balanced.Patients with thick facial tissues and lips requesting cosmetic dental procedures, are easier to correct than patients with thin facial tissues, and short upper lips. Having thicker frames improves the picture (smile) quality. Smaller teeth are easier to correct than patients with thin lips and large teeth, and if you add a gummy smile, we have a difficult situation. However, we can thicken the upper thin lips (see the above photos bottom before & after) using special composite or porcelain technology developed by Dr Nalbandian. The teethNowadays, when everyone has access to orthodontic treatment, people can expect straight teeth. The choice to have a beautiful tooth arrangement is available to all ages. At Designer Smiles, it is not uncommon for adult patients to have orthodontic treatment, followed by restorative treatment. The perfect smile is planned and the patient’s dental and photographic records are taken. A special temporary smile can be archived at the chair side, or direct composite mock up placed on existing teeth to assess the golden proportions of tooth arrangement, gum line, emergence profile of the teeth, smile line, lip line, how much gum is showing as well as the patient’s general appearance. All these procedures are completed before any cosmetic dental procedure.Once the patient is happy with the initial cosmetic mock up, if required, we then proceed with the assessment of gum-line symmetry. This can be achieved with tooth movement or gum contouring, followed by temporary restorations i.e. veneers or crowns, to assess the final smile line and harmony of tooth arrangement. The patient contributes to the final position of gums, teeth for correct aesthetics, function and speech. This also gives the patient an opportunity to discuss this with their partners and family. If the patient considers their temporary smile complements their facial expression then we proceed with the final construction. Considerable analysis is required to achieve the most optimal result.
This result was achieved with 10 upper composite veneers and small gum leveling on upper right two teeth: 11, 12 The Aesthetic-Restorative DilemmaWhich is the most important? The longevity of the restoration or the tooth that holds the restorations? There is nothing permanent in dentistry.Preserving the tooth enamel is the key with current aesthetic dentistry. It is the tooth enamel to which most restorations (porcelain and composite veneers, and crowns) are bonded. Reduced tooth enamel affects the bonding to the tooth and the longevity of any restorations. If minimal enamel and tooth structure is present then full crowning to protect the tooth is the best option. However, where we have a healthy tooth, other options are available, such as orthodontics to position the tooth correctly within the arch, followed by simple tooth whitening or applying thin veneers. This is an excellent long-term, conservative option. In many cases adults with worn, aged smiles requesting aesthetic improvement may benefit from tooth repositioning. This allows better symmetry of their smile, and offers ideal tooth shape, form and colour correction, as well as improvement in overall function. Patients with missing teeth would also benefit from the placement of dental implant-supported crowns and bridges. In severely worn dentitions, the facial height may have been reduced, making the face appear more aged. It is in these cases, teeth restoration is most difficult. Crown lengthening, where the gum level is lowered with the supporting bone, exposes more tooth structure for veneering and crowning, can assist. We can also create spaces by combining orthodontic and/or surgical repositioning of the jaws for optimal dental restorations (crowns, veneers, implants) at the correct facial height improving both the smile and the face. Therefore conservative aesthetic treatment is an optimal for improving our patients’ smiles and maintaining the integrity of dentition. |
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Designer Smiles Dental Centre: Cnr. Gerard and Winnie Streets, Sydney, NSW, Australia Designer smiles Home | About us | Where we are | Contact us | Our Team | What the media says | Programs | Referred Patients | Diagnostics | Site ©2006 Designer Smiles. All Rights Reserved |
