Our case of the month for April was one involving E Max crowns by Ivoclar, which is our opinion, give the best aesthetic results. In the past, tooth coloured dental crowns had a layer of metal underneath for strength with the ceramic bonded on the outside. Now these could look perfectly acceptable but there were issues. Having two layers means that more of the underlying tooth has to be cut down to accommodate the material. For any of you that has read any of our posts knows that we believe in minimally invasive dentistry, cutting away more tooth than necessary just does not sit right with us. Another issue with metal ceramic crowns is that the metal layer may become visible over time as the gums recede which gives that classic grey line around the tooth. Not very desirable. One of the main advantages of ceramic crowns is that there is no metal underneath and this grey line will never be an issue.
The aesthetic qualities of E max crowns are second to none. Our case shows that the crowns can be fully customised with translucency at the edges, varying shades, light reflection and opaque areas to name a few. The skill of the dental technician plays a huge role here and we work with some excellent laboratories know for excellence.
For our case, Ceramic Studios in Kensington made the wonderful E max crowns fully which were fully customised.
The photos here show the workflow of the treatment. Unfortunately, our patient lost a front tooth biting on something hard during. After some wonderful root canal work by Dr Molina , Dr Patel was able to re build the teeth and place dental crowns to restore the not only the aesthetics but also the function. The key with such a demanding cosmetic treatment is going through the stages carefully. This involved a try in stage of the crowns to check for fitting, shape, size and bite. Once verified, we then send our patient straight to Ceramic Studios for full characterisation at the laboratory. This is where the magic happens with those final touches making all the difference. Once we are all 100% happy, the crowns can be fitted. Although there are a few visits and some travelling around, it is well worth it for your front teeth!
If you are in need of crowns and would like the very best treatment possible, please contact us or book a free video consultation and we will discuss how we can help you.
Our case of the month for March is a simple but great one- we love it so much! It features cosmetic bonding which is a favourite treatment of ours. People often ask what is cosmetic or composite bonding. Well the answer is simple. For many years, dentists have been using adhesive technology to bond fillings inside of teeth. The same technology can be applied to the outside of teeth to make them look pretty! In essence, if a tooth is worn down, fractured, uneven or discoloured then composite bonding can be used to enhance the tooth without having to cut the tooth down or destroy healthy tooth enamel. After all, dental enamel is the hardest tissue in the body for a good reason. It is there to protect teeth- why on earth would we cut it all away? The old days of Extreme Makeover (remember that show) are over.
Often cosmetic bonding can be used for very subtle treatments such as our case. In this example, we treated the front teeth using Social 6 lingual braces to straighten the teeth first and then use composite bonding to enhance the smile line to even the edges, make pointed teeth look natural and camouflage the canine teeth which were quite pointed. There was absolutely no drilling of the underlying teeth, no needles were required, an entirely pain free process. Take a look at the difference:
The treatment was completed in one session, approximately one hour in total. The after care is simple; simply look after the bonding like you would your own teeth. Clean well, floss daily and try to avoid heavily staining foods to avoid discolouration. Maintenance is also very simple. If the bonding does become stained, like natural teeth do, then a simple hygiene visit and polish will remove this.
We use the highest quality composite materials which can be polished superbly. These include Empress Direct by Ivoclar and G-aenial by GC. You simply cannot use cheap composite materials! If you are considering cosmetic bonding this year and would like to discuss how this could transform your smile, feel free to arrange a free video consultation and we will talk you through the process.
Treatment completed by Dr Nissit Patel our Clinical Director.
|At the end of orthodontic treatment, retainers must be worn otherwise you run the risk of undoing all of the hard work straightening your teeth. This is called relapse. We advise a combination approach of a fixed wire retainer placed behind the front teeth as well using a removable retainer at night.|
In most cases, we will place the fixed wire retainer immediately after the brace has been removed so that the risk of relapse is minimal. The great advantage of a fixed wire retainer is that it is bonded on to the teeth so that you do not have to worry about removing and wearing it. The wire itself is very low profile and hence non bulky. The glue is very smooth and overall, the retainer is extremely comfortable. Fixed retainers do require greater levels of maintenance and need careful cleaning on a daily basis. There is also the risk that the glue debonds or the wire fractures. If this happens, you must seek immediate advice. This is why we advise the use of a night time retainer as a safety net as well as a back up should anything happen to the fixed retainer.
There are many types of removable retainer. We normally recommend a vacuum formed retainer which is commonly known as an Essix retainer. These are made from clear plastic; either from polyethylene co-polymers or polypropylene polymers. They are latex and BPA free. Another common type of removable retainer is the Hawley Retainer. This is a robust retainer that has an acrylic base which sits behind the lower teeth or on the palate of the upper teeth and metal wire that runs across the front 6 teeth. It is held in by cribs which usually sit across the canine and molar teeth. Should you lose or break your retainer, it is essential that another is made as quickly as possible.
How long are retainers worn for?
Retention is for LIFE! If you are not willing to undergo a life time of retention, then you should not start orthodontic treatment. Immediately after orthodontic treatment, we advise the use of a fixed wire retainer as the definitive retainer coupled with the removable retainer at night for 12 months. The removable retainer can then be used 2 to 3 times per week.
Will retainers last a life time?
No. Due to natural wear and tear, retainers will need to be replaced over the years. This will depend on a number of factors such as your bite, cleaning habits, diet and whether you grind your teeth at night for example. Most retainers will need to be replaced every 2 to 3 years.
How to keep retainers clean
Fixed retainers should be brushed as normal using your manual or electric toothbrush. Inter dental brushes such as TePe or Piksters should also be used in between the teeth as regular floss will not pass through beyond the wire. Waterpik and Phillips Airfloss can also be useful to clean between the retainer. Removable retainers should be cleaned with an old tooth brush and toothpaste on a daily basis. Avoid using bleach or mouthwashes as this can lead to the retainer becoming cloudy and discoloured. The use of effervescent tablets such as Retainer Brite can also be useful with occasional use.
How much are orthodontic retainers?
The fee will vary depending on dentist or orthodontist. The fee at Progressive Dentistry for both fixed retainer and removable Essix retainer is £350. Individual fees for both retainers is £200. We take 3-D intra oral scans of your teeth to make the retainers hence should you lose the removable retainer, we can simply ask our laboratory to print another model and make a new retainer without you having to set foot within the practice! This is the beauty of digital dentistry.
Make an appointment
If you would like to make an appointment with us for orthodontic retainers or to discuss teeth straightening, please book online