Another Game of Guess The Restoration
Collaborative case with a team approach to restoring the restoration. Dentistry in this photo done by Dr. Kevin Kwiecien. Whats the tooth and whats the material?
Often times esthetics is not just white straight teeth. Esthetics is matching what is currently there. The case in question posted in a photo is of a provisional restoration. The restoration was fabricated with CEREC. The restoration is phase 1 of a long sequence of treatment obviously there is lots of work to be done. However as you can see from the photo, which ever tooth (teeth) was treated, matches the existing restorations well. And when the final treatment will be done we will make all the teeth look good.
Step #2 is to get the patient to work on his hygiene which has lapsed.
#8. NO idea what material, but obviously a very nicely customized restoration. Did he get a toothbrush with the crown???
Edit: Been thinking about it: I'm going with RealLife and you tipped the block to the point that the dentin shows through on the facial. Just a guess though.
I'll take a guess. #10 EMax LT block. 1 wing Maryland bridge off of #9? Maybe implant there? Great job.
On 7/15/2015 at 10:09 am, Ernie Johnson said...Did he get a toothbrush with the crown???
No but he got his ass kicked for his poor hygiene!
I taught Kevin everything he knows! (Make sure to tell him that). I guess I forgot about patient homecare. Just kidding, great job. I love those single central cases because they require so much skill. Also, a non A1 case is even better because of the technique required.
That's very great execution on a difficult case, but why not clean the "fur" off the rest of the teeth in the arch and match a more ideal shade instead of duplicate it. I wonder if microabrasion (and daily hygiene) would remove the staining... smoker? coffee?
On 7/15/2015 at 1:58 pm, Ryan Hamilton said...That's very great execution on a difficult case, but why not clean the "fur" off the rest of the teeth in the arch and match a more ideal shade instead of duplicate it. I wonder if microabrasion (and daily hygiene) would remove the staining... smoker? coffee?
This is phase one of treatment. Upper veneers coming next. Obviously after debridement and perio is controlled.
On 7/15/2015 at 1:10 pm, Peter Eliopoulos said...Must have been fun staining that case.
you referring to sam or the pt?
His hygeine is not really as bad as this picture shows... maybe he just did not brush teeth today. Here is a planning video on his case:
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So you are in the temp phase now to try and get the distal papillae to fill in. It also looks under contoured on the facial to give allow the facial tissue to move coronally. Not that it needs it but I would always rather have more than not enough. How long are you temping him for?
On 7/15/2015 at 4:08 pm, Darin O'Bryan (Faculty) said...So you are in the temp phase now to try and get the distal papillae to fill in. It also looks under contoured on the facial to give allow the facial tissue to move coronally. Not that it needs it but I would always rather have more than not enough. How long are you temping him for?
Give me time to get further along in the case. Lots going on here and next step is to get a wax up done so that we can treat the upper teeth and make them more esthetic. This is just provisional #1 so he no longer has to wear a maryland bridge and worry about it coming off.
On 7/15/2015 at 2:48 pm, Sameer Puri (cerecdoctors.com Founder) said...On 7/15/2015 at 1:58 pm, Ryan Hamilton said...That's very great execution on a difficult case, but why not clean the "fur" off the rest of the teeth in the arch and match a more ideal shade instead of duplicate it. I wonder if microabrasion (and daily hygiene) would remove the staining... smoker? coffee?
This is phase one of treatment. Upper veneers coming next. Obviously after debridement and perio is controlled.
No offense intended and I should have known that it was just the temp phase. Ironically, this winds up being a bread and butter case oftentimes in my area with the old dude that only wants his tooth replaced.
I would have guessed #8. I'm glad the restoration is a temporary and that further treatment is planned. Regarding what Ryan has posted, I am currently working on one of those "...old guy just wants his front tooth replaced" cases. I'll post pics when it's finished for everyone to critique.
On 7/16/2015 at 6:06 am, Ryan Hamilton said...No offense intended and I should have known that it was just the temp phase. Ironically, this winds up being a bread and butter case oftentimes in my area with the old dude that only wants his tooth replaced.
No offense taken my friend. None at all. :)
It is ironic that someone pays good money for an implant, but seemingly can't afford a toothbrush. ;)
Glad pt finally has a game plan together and is working towards better health. Definitely in good hands! Great job
On 7/16/2015 at 3:20 pm, Sabrina Hinkle said...It is ironic that someone pays good money for an implant, but seemingly can't afford a toothbrush. ;)
Glad pt finally has a game plan together and is working towards better health. Definitely in good hands! Great job
Unless of course some idiot did the surgery for free....
Also: Whoever photoshopped the coronal positioning of the gingiva on the left side overdid it a little since the teeth are now shorter than the contralateral side.
And: The distal papilla is saying "Help, Help....They are choking me to death". Hang in there little fellow....I am coming to your rescue on July 29th.
Farhad
On 7/16/2015 at 10:35 pm, Farhad Boltchi (Faculty) said...And: The distal papilla is saying "Help, Help....They are choking me to death". Hang in there little fellow....I am coming to your rescue on July 29th.
Farhad
Whoever did the surgery is a mad genius for sure.
However - the distal papilla is far from choking. That area was deliberately opened up quite a bit. Ill post more photos later.
