Creating beautiful smiles to last a lifetime.
New Bridge Enhances New Smile
Elizabeth's smile before
Elizabeth had just moved to Colorado from Florida and was ready for a new smile to go with her new start. Friends had recommended she see Dr. Adler of Adler Cosmetic & Family Dentistry. Elizabeth felt that her smile didn’t look good and wasn’t happy with how some of her restorations were looking. She had a Maryland bridge on her upper left front teeth to replace tooth #10 for about 8 or 9 years. She also had a very small lateral incisor, #7, that had been “built-up” to give it a larger appearance.
Maryland bridges are a slightly different design than traditional bridges. Traditional bridges have crowns on the two teeth adjacent to the missing tooth and are fused to a pontic crown which replaces the missing tooth. A Maryland bridge has a pontic fused to a crown on one side and a rest that attaches to the tooth on the other side. Maryland bridges can cause undue stress on the crowned tooth since it is taking the load of two teeth where as a traditional bridge distributes that pressure between two or more teeth. Since anterior teeth have a single root then it is important to have the load distributed among more teeth to insure that the root of the tooth is not reabsorbed because of the undue stress. 
Elizabeth wanted to replace her bridge and make the small incisor that was built up also look better. Most of all she wanted her whole smile to look good and balanced. She was tired of her smile looking pieced together. Dr. Adler recommended that she replace her Maryland bridge with an all porcelain bridge and also place porcelain restorations on five of her remaining upper anterior teeth to insure that her smile would be symmetrical and look amazing.
Elizabeth first whitened her teeth with the ZOOM! Whitening system so that her lower teeth would be as white at her new upper teeth would be. During the Zoom whitening procedure, all of her gum tissue was isolated to keep it from getting exposed to the whitening solution and activating light. The whitening solution and Zoom light were applied in four 15 minute sessions. Elizabeth was dramatically whiter by the end of the Zoom treatment.
Elizabeth's great new smile
Eight of Elizabeth’s upper anterior teeth were prepped for the restorations including the bridge. Once the teeth had been properly shaped for the restorations, temporary crowns and bridge were placed. The temporaries looked almost as good as the crowns would and better than what she had had before. The impressions of the prepped teeth were sent to the lab for fabrication. Each restoration is custom made to insure that the overall smile is symmetrical, functional and aesthetically appealing. Once the crowns and bridge were back from the lab the temporaries were removed and the crowns were chemically bonded to the teeth to insure the strength and longevity of the restorations.
The results are dramatic. Elizabeth looks like a new woman with her great new smile.
Tags: boulder, Colorado, cosmetic dentist
Denver Cosmetic Dentist | Adler Cosmetic Dentistry Expands Service Availability to Denver Area
Adler Cosmetic Dentistry of Boulder announces expanded cosmetic dentistry service availability for the greater Denver metro area. LVI trained cosmetic dentist Dr. Michael Adler provides nationally recognized cosmetic dentistry services from his Boulder located office.
Boulder, Colorado, April 26, 2010 – The cosmetic dentistry office of Dr. Michael Adler today released an announcement confirming the expansion of cosmetic dental services to the Denver metro area. Dr. Michael Adler has received advanced training in cosmetic dentistry and holds a fellowship from the Las Vegas Institute for Advanced Dental Studies (LVI). Adler Cosmetic Dentistry is widely known in Boulder, along the Colorado Front Range, and nationally for its exceptional skills in the practice of cosmetic dentistry.
Adler Cosmetic Dentistry is committed to providing the highest level of cosmetic dentistry services to all patients interested in enhancing the aesthetic appearance of their smiles as well as improving overall dental health. Cosmetic dentistry services today are very affordable for most patients. More extensive procedures can easily be financed by a wide variety of lending companies that specifically work with Adler Cosmetic Dentistry.
Cosmetic dentistry includes everything from safe teeth whitening, veneers, white fillings, to complete smile makeovers. The results are often times dramatic in improving patients’ smiles and self esteem simultaneously. The practice features a variety of case histories with before and after images on its website and blog.
For misshapen teeth, unsightly gaps, or deep discoloration, porcelain veneers may be the best approach. Veneers are thin porcelain coverings that fit over and are bonded to your teeth, look natural, and are made from the most advanced dental ceramics available. Since veneers are so thin, often little to no tooth reduction is necessary. For teeth whitening Adler Cosmetic Dentistry recommends the ZOOM Teeth Whitening system. The ZOOM Teeth Whitening system can be applied in a single office visit.
Adler Cosmetic and Family Dentistry is open weekdays by appointment. Additional information about the practice and services offered is available at www.adlerdentistry.com.
About Adler Cosmetic and Family Dentistry
The cosmetic and family dental practice of Dr. Michael Adler is based in the Colorado community of Boulder, a convenient and scenic drive from most locations in the Denver and Front Range areas. Boulder, Colorado is also an inviting destination location for visiting out-of-state patients seeking Dr. Adler’s specialized attention. Dr. Adler is nationally recognized for his work and is committed to providing his patients with the highest level of care in both cosmetic and family dentistry. The practice maintains a website at www.adlerdentistry.com and regularly publishes information on its blog at www.adlerdentistry.com/blog.
Contact
Name: Heather Ramsey
Email: heather@adlerdentistry.com
Phone: (303) 449-1119
Adler Cosmetic and Family Dentistry
1810 30th Street
Boulder, CO 80301
Tags: cosmetic dentist, denver
Whiter Teeth and Veneers in Time for Wedding
Jonathan Before
Jonathan came to Adler Cosmetic & Family Dentistry at his fiancé’s recommendation. He wanted to make sure his teeth were going to look good in time for his wedding. This was a major concern for Jonathan because two of his front teeth were dark and discolored from previous root canals and he didn’t like the spacing or color of his other teeth.
Dr. Adler addressed Jonathan’s concerns by offering him several treatment options. One option was Zoom whitening to brighten the color of his other teeth, Invisalign to straighten all of his teeth, a post for #8 (his upper front right tooth) for support and veneers for his front teeth since teeth darkened because of root canals would not lighten to the extent of his other teeth with just Zoom alone. A second option was veneers on the front four teeth with a post in #8 and the Zoom whitening with no Invisalign. This second option would fix spacing issues only in the front four teeth but not any of the other teeth. Jonathan chose the second option in order to have the treatment completed in time for his wedding and will consider doing Invisalign in the future.
Jonathan started the Zoom whitening after having a thorough cleaning to insure healthy gums and a good result. It is important to have a cleaning within 6 months prior to whitening to insure the best results. Whitening dirty teeth is about as effective as painting a dirty car. During the Zoom whitening, Jonathan’s gums and soft tissue are protected by a liquid dam. The whitening solution was then applied to the teeth and the activating light was used. The process was repeated in four consecutive sessions. The whole process took approximately two hours. Customized whitening trays were made during the appointment to allow for any needed touch ups at home. Jonathan was at least two shades lighter by the end of the appointment.
In order to fabricate the veneers and post, impressions were taken of Jonathan’s teeth and set to the laboratory so they could create a wax-up. A wax-up is a wax model of what Jonathan’s veneers will look like on actual models of his teeth. This was used to insure that the look and size of the veneer would be correct to give Jonathan the most aesthetic smile. Once approved, Dr. Adler prepared the four upper front teeth for the veneers and post. Veneers require very little of the natural tooth to be removed in order prepare the teeth. The post on #8 was needed to give added support since that tooth had been root canalled previously. Temporaries are then placed on the teeth until the final crowns are ready. Even with just the temporaries on, Jonathan’s teeth were already looking good.
When fabricating any teeth, especially front teeth, Dr. Adler and the lab make sure that they have the best color match possible to give the patient a bright but natural smile. The aim is to have great looking teeth but not be able to pick out which ones are real and which ones are not. Careful consideration was taken to make sure that Jonathan’s teeth were both well shaped and shaded. Once the custom fabrication was completed, Jonathan returned to have the final restorations cemented. The temporary veneers where removed and a high quality translucent cement was used to chemically bond the veneers and post to the teeth. The results were dramatic.
Jonathan After - The Happy Groom
Now Jonathan has strong great looking front teeth. Jonathan was all smiles for his wedding pictures.
Tags: boulder, Colorado, cosmetic dentist, teeth whitening, veneers
Boulder Dentist Restores Broken Tooth with Veneers
- Adam After the Accident
Ice is one of the hazards of winter that has slipped us all up at some time or another. Adam was no exception to this. He slipped and fell hitting his face on the ice. His face took the impact of the fall and tooth #8 (upper right front tooth) was severely broken. He immediately sought treatment from Dr. Adler of Adler Cosmetic & Family Dentistry. Dr. Adler used x-rays and images from the interoral camera to help determine the extent of the damage during his examination of Adam. Tooth #8 was severely fractured through the nerve space, causing pain. It is unusual to see damage to only one tooth when someone falls. The adjacent teeth need to be evaluated carefully for damage or trauma. The interoral camera revealed that the adjacent teeth also showed signs of fracture.
To relieve Adam’s pain, Dr. Adler preformed a root canal on tooth #8 and removed the damaged nerve. The root canal was necessary because the severe fracture exposed the pulp of the tooth to bacteria that live in the saliva. If left untreated, the tooth would continue to be a source of infection and eventually weaken the body’s immune system. The pulp is contained within an inner chamber of the tooth called the pulp chamber. Pulp is commonly referred to as the nerve but is actually a soft tissue make up o nerves, arteries, and veins. The pulp extends from the pulp chamber down through narrow channels, called the root canals, to the tips of the roots. The fear and pain associated with root canals are over rated. For most patients, getting a root canal is no more traumatic that having a filling done. During the process of the root canal, the doctor goes into the tooth and removes the pulp, cleaning the cavity. After the root canal, the tooth was temporarily bonded to give it a normal appearance while Adam was completing his treatment.
Prior to the crowns being custom made, Adam had his teeth whitened using our in-office ZOOM laser whitening. The main ingredient in Zoom is hydrogen peroxide, which works by oxygen enter the enamel and dentin was it breaks down. The oxygen bleaches colored substances and doesn’t harm the tooth structure. The Zoom light aids in activating the hydrogen peroxide and helps it penetrate the surface of the tooth. It is a simple procedure that can produce great results. With this new brighter smile, Adam was ready to have the shade taken for his new crown and veneers.
Once a root canal has been performed, the tooth is structurally weakened and prone to fractures and breaking if left as is. In Adam’s case, tooth #8 was crowned not only because of the root canal but because of the fractures caused by the accident. A carbon fiber post was placed on tooth #8 to adequately support the crown so the bite force would be properly distributed so that the tooth did no fracture.
Due to the fractures, teeth #7, 9, and 10 were prepared for veneers. A veneer is a thin shell of porcelain that is bonded to a tooth to improve its color or shape. A veneer generally covers only the front and top of a tooth. Veneers can be used to close spaces between teeth, lengthen small or misshapen teeth, or whiten stained or dark teeth. When teeth are fractured, as in Adam’s case, or beginning to wear, veneers can protect them from damage and restore their original appearance.
Adam's Great New Smile
The teeth were prepared for the crown and veneers by removing any damaged areas. The teeth were then shaped to securely hold the crown/veneers. An impression of the teeth were then taken so the dental lab could make an accurate model of Adam’s mouth and then created a crown that precisely fit his mouth and bite. Unlike porcelain fused to metal crowns, all porcelain crowns are translucent and allow light to pass through the tooth like a natural tooth opposed to reflecting all the light which can make the tooth appear dark. Porcelain fused to metal crowns can also have a dark ring near the gum line which is not present with all porcelain crowns. The shade of the teeth is also very important to maintain the natural appearance. An underlying shade is taken of the prepared tooth, known as a stump shade, to better match the natural and subtle hues of the tooth. The shade of the crown is also determined by the adjacent teeth. Whitening was done before this outer shade was taken to make sure the crown closely matched the other teeth and because crowns are not effected by the whitening process and so remain the same color as they are made.
Now Adam has a great new smile that he can’t help but show off and the results are dazzling.
Tags: boulder, Colorado, cosmetic dentist, veneers
Titanium Dental Implants | Zirconium | Fractured Tooth Replacement
- Barbara After Extraction
As a child, Barbara had had a root canal done on her upper right front tooth, tooth #8. Over the years, Barbara had several crowns on that tooth but never really liked how they looked. For 45 years, the tooth did not cause any pain until one day she began having pain and pressure especially when chewing. This is when she first sought treatment from Dr. Adler. Based upon the exam, x-rays, and prior history of a root canal, Dr. Adler recommended that Barbara have an apicoectomy.
An apicoectomy is usually performed after a tooth has had at least one root canal but continues to develop infections. Root canals are very complex, with many small branches off the main canal. Sometimes, even after root canal treatment, infected debris can remain in those branches and possibly prevent healing or cause re-infection later. During Barbara’s apicoectomy, the root tip was accessed directly through the bone instead of up through the tooth as in a root canal treatment. The root tip, or apex, was removed along with the infected tissue. A filling was then placed to seal the end of the root and a suture is placed to close the access opening. In order to stabilize the tooth, Barbara then had an all porcelain crown and carbon fiber post placed.
Healing Cap
For a year after the apicoectomy, the tooth was symptom free but unfortunately the tooth became infected again forming an abscess. A tooth or root abscess is pus enclosed in the tissue of the jaw bone at the tip of an infected tooth that usually originates from a bacterial infection that has accumulated in the soft pulp of the tooth. If left untreated, an abscess can continue to grow and may become large enough to perforate bone and extend into the soft tissue. It will continue to follow the path of least resistance and spread either internally or externally which can lead to severe complications. Dr. Adler performed another apicoectomy in an effort to save the tooth hoping that it was another root tip infection. During the procedure, Dr. Adler saw a fracture in the tooth that extending from tip to crown and it was determined that the tooth could not be saved due to the vertical root fracture.
Ziconium Post
The tooth was extracted and a bone graft, allograft, was placed by Dr. Cheri Brown to help replace the bone that had been lost due to the abscess. Dr. Cheri Brown, a periodontist, works with Dr. Adler at Adler Cosmetic & Family Dentistry. A removable temporary partial, custom made prior to the appointment, was fitted so that Barbara was able to leave the office without a gap in her smile while she continued to heal. While the graft was healing, Dr. Adler was able to perform guided tissue recontouring. Guided tissue recontouring reshapes the gum around the tooth giving a more aesthetic look. This was done for Barbara by slowing adding material to tooth on the temporary partial where it presses against the gum line. Overtime the tissue is gently formed into the desired shape to better match the other teeth.
Barbara After
Once the graft had healed and become stable, Dr. Brown placed the titanium implant. The implant was placed during a surgical procedure, directly into the jawbone and under the gums. The implant with a healing cap attached was then allowed to heal for four to six months so that the bone will grow around the implant and “osseo-integrate”. Dr. Brown later placed a soft tissue graft because Barbara needed more connective tissue to support the implant. After six months of healing, Dr. Adler placed a zirconium implant post, also known as an abutment, that connected to the implant. The post was made of zirconium to allow for ideal translucency once the all porcelain crown was place about a month later. So today, Barbara is no longer bothered by that troublesome tooth and she looks great.
Barbara's New Smile
Tags: boulder, Colorado, cosmetic dentist, dental implant, titanium dental implants
Full Mouth Reconstruction Improves Patient Bite and Enhances Smile
- Patrick’s Smile Before
When Patrick came to Adler Cosmetic & Family Dentistry he was concerned about his bite being off and how his smile looked. He wanted straight natural looking teeth but didn’t want the hassle of wearing braces as an adult. Patrick was over closed meaning that his upper teeth covered his lower teeth when his teeth were together. He also had a limited opening and was aware that he clenched and ground his teeth. He had been told in the past that he would need jaw surgery in order to get his bite corrected. Patrick wanted to correct these issues without having major surgery.
Note Patrick's Deep Bite
Dr. Adler noted in his exam that although Patrick was not having a severe amount of jaw pain, that his bite did need to be corrected. His teeth showed distinctive wear patterns and were crowded. The alignment of his teeth and his midline was off center. His deep bite also concerned Dr. Adler because that indicated muscle fatigue and an incorrect bite. Dr. Adler recommended a K7 evaluation in order determine exactly what Patrick’s muscles were doing and the best way to correct his bite issues.
The K7 evaluation consisted of running a series of test using non-invasive computerized electronic instrumentation. It began with taking diagnostic cast so we have an accurate model of his mouth and bite. The K7 produces scans that measure the muscles, range of motion, and joint noise among other things. EMG or electromyography measures the muscles at rest and during function-clench. CMS (computerized mandibular scan) measures joint function, habitual freeway space, swallowing, and range of motion. Sonography measures joint sounds. TENS or Transcutaneous Neural Stimulation relaxes the muscles in the face and neck to find their true resting state and establish the occlusion at that position. Material is then placed in the patient’s mouth to capture that ideal position, known as the bite registration or myobite. Patrick’s scans showed improvement when preformed with the bite in place. Based upon the information gathered during the K7 evaluation, it was determined that the best course of treatment would be for Patrick to be fitted with a fixed orthotic that would be bonded to his lower teeth would reposition his bite and jaw into its ideal position. Dr. Adler recommended that once Patrick’s bite had settled into the proper position to then do a full mouth reconstruction where all of his teeth would be crowned to rebuild his bite into the correct place permanently without the continued use of an orthotic.
Patrick After
The bite registration was used by the laboratory to fabricate the fixed orthotic that was bonded to his lower teeth to establish that ideal position. The orthotic was worn and adjusted for several months and gave Patrick a good trial run for how his bite would feel after permanent restoration was completed.
Patrick's Great Smile After
Once Dr. Adler was confident that Patrick’s bite was in its ideal position, phase II began in which his entire mouth was reconstructed into its new bite. In just one visit, all of Patrick’s teeth were prepared for his crowns and the orthotic was removed. Temporary crown that matched the shape and size of the new permanent teeth were fitted over the prepared teeth until the permanent ones were completed. Impressions of Patrick’s ideal bite, including the bite registration, were sent to Aurum Ceramic Laboratories for use in the fabrication of the final crowns. Each crown was custom made into Patrick’s ideal bite so that an orthotic would no longer be necessary. During fabrication the lab also took aesthetics into account so the crowns were made to be the most aesthetically appealing for the patient’s individual smile. Once the lab had completed fabrication, Patrick had all the permanent crowns placed in just one visit. The final results were amazing. Not only does Patrick have a great looking smile but now his bite is also corrected and without the need for surgery.
Tags: boulder, Colorado, cosmetic dentist, Cosmetic Dentistry, full mouth reconstruction
Dental Implant Placement Completes Broken Smile
- Tony Before
For someone who has had a broken smile for a number of years, today has been a long time in coming. We met Tony in the beginning of 2007 and began soon after to restore his smile. A titanium implant and bone graft were placed where tooth #7 used to be.
If a tooth is missing, the gums and bone it was attached to are no longer stimulated by the blood supply and activity of that tooth. Therefore, with the tooth gone, the surrounding bone and gums may resorb or melt away. Furthermore, the opposing tooth (on the opposite jaw) no longer has something to bite against, and may grow towards the space created by the missing tooth. Implants not only stabilize the restoration that sits on top of it, but also stimulate bone growth around the implant.
Tony with Complete Smile
The implant was placed during a surgical procedure, directly in the jawbone and under the gums. The surgical site with the implant was then left (under the gums) to allow the bone to grow around the implant and “osseo-integrate”. Six months after the first surgery, the implant was uncovered from under the gums. An “abutment” or implant post was then connected to it, and the gums were given time to heal around this abutment. About a month later, a final tooth restoration is custom-made to fit onto the abutment. Today was that day. After waiting patiently, Tony was able to come in today and have his custom-made crown permanently fitted and left with his mouth restored. Today we completed a smile.
Tags: boulder, Colorado, cosmetic dentist, Cosmetic Dentistry, dental implant
Cosmetic and Emergency Dental Treatment Restores Smile After Traumatic Accident
- Ryan after the accident
Ryan suffered a traumatic fall that severely damaged his front teeth. Tooth #8 (his upper front tooth on the right) had sustained the most damage and had had a third of the tooth broken off. Ryan was suffering pain and sensitivity due to the fracture. Tooth #9 (located to the left of #8) was also fractured but not to the same extent.
Dr. Adler performed a root canal on tooth #8 as part of his emergency treatment to get the patient out of pain. The teeth were temporarily bonded to make the teeth look normal while Ryan was completing his treatment. The root canal was necessary because the severe fracture exposed the pulp of the tooth to bacteria that live in the saliva. If left untreated, the tooth would continue to be a source of infection and eventually weaken the body’s immune system. The pulp is contained within an inner chamber of the tooth called the pulp chamber. Pulp is commonly referred to as the nerve but is actually a soft tissue make up of nerves, arteries, and veins. The pulp extends from the pulp chamber down through narrow channels, called the root canals, to the tips of the roots. The fear and pain associated with root canals are over rated. For most patients, getting a root canal is no more traumatic that having a filling done. During the process of the root canal, the doctor goes into the tooth and removes the pulp, cleaning the cavity.
Once a root canal has been performed, the tooth is structurally weakened and prone to fractures and breaking if left as is. Crowns are a common option for a root canalled tooth. In Ryan’s case, both tooth #8 and 9 were both crowned not only because of the root canal but because of the fractures caused by the accident. The teeth are prepared for the crown by removing any damaged areas and/or decay. In the case of tooth #8 a carbon fiber post was placed to adequately support the crown so the bite force would be properly distributed so that the tooth did no fracture. The tooth is then shaped to securely hold the crown. The crown is either custom fabricated in the office using CAD/CAM Cerec system or sent to a laboratory. Ryan’s was sent to a laboratory and an impression of the tooth was taken so the dental lab could make an accurate model of his mouth, and then created a crown that precisely fit his mouth and bite. Ryan received all porcelain crowns on #8 and 9. Unlike porcelain fused to metal crowns, all porcelain crowns are translucent and allow light to pass through the tooth like a natural tooth opposed to reflecting all the light which can make the tooth appear dark. Porcelain fused to metal crowns can also have a dark ring near the gum line which is not present with all porcelain crowns. The shade of the teeth is also very important to maintain the natural appearance. An underlying shade is taken of the prepared tooth, known as a stump shade, to better match the natural and subtle hues of the tooth. The shade of the crown is also determined by the adjacent teeth. Whitening is done before this outer shade is taken to make sure the crown closely matched the other teeth and because crowns are not effected by the whitening process and so will remain the same color as they are made.
Prior to the crowns being custom made, Ryan had his teeth whitened using our in-office ZOOM laser whitening. The main ingredient in Zoom is hydrogen peroxide, which works by oxygen enter the enamel and dentin was it breaks down. The oxygen bleaches colored substances and doesn’t harm the tooth structure.
Ryan After
The Zoom light aids in activating the hydrogen peroxide and helps it penetrate the surface of the tooth. It is a simple procedure that can produce great results. With this new brighter smile, Ryan was ready to have the shade taken and the crowns seated.
Tags: boulder, Colorado, cosmetic dentist, Cosmetic Dentistry
Full Mouth Reconstruction Creates Beautiful New Smile
Richard
Richard originally came to Adler Cosmetic & Family Dentistry because he was unhappy with his smile. He was concerned that his bite had been changing over the years including changing color, crowding, and problems with his gums. He wanted to keep his teeth and gums healthy and get an updated smile. He had spent a lot of time in the dental chair at other offices just fixing one tooth at time without getting the overall results that he wanted. At the time Dr. Adler had recently begun studying at the Las Vegas Instituted (LVI) expanding his knowledge of both cosmetic and neuromuscular dentistry. Instead of just evaluating Richard’s problems as individual teeth to be fixed independently, he looked at Richard’s mouth as a whole and addressed all the issues together. Dr. Adler realized that the training he had received at LVI was just the solution that Richard was looking for.
Richard Before
The first step to a healthy smile is healthy gums. Richard had periodontal disease, a chronic bacterial infection that affects the gums and the bone supporting the teeth. If left untreated, a serious infection can lead to bone loss and tooth loss. To treat his periodontal disease, Richard had scaling and root planning done. During this procedure, the hygienist, Susan, numbed quadrants of Richard’s mouth, since the gum tissue was inflamed and sensitive, and then scaled out the bacteria and calculus (tartar) that had built up under the gum tissue. After the procedure, Richard had to make sure to get his regular cleanings done every three months (as opposed to the usual recommendation of every 6 months) in order to maintain healthy gums and manage his periodontal disease.
Once Richard’s gums were healthy, then Dr. Adler focused on his bite problems. A K7 evaluation was performed to determine exactly what was happening with Richard’s bite and the best way to approach fixing the problem. The K7 evaluation consisted of running a series of test using non-invasive computerized electronic instrumentation. It began with taking diagnostic cast so we have an accurate model of his mouth and bite. The K7 produces scans that measure the muscles, range of motion, and joint noise among other things. EMG or electromyography measures the muscles at rest and during function-clench. CMS (computerized mandibular scan) measures joint function, habitual freeway space, swallowing, and range of motion. Sonography measures joint sounds. TENS or Transcutaneous Neural Stimulation relaxes the muscles in the face and neck to find their true resting state and establish the occlusion at that position. Material is then placed in the patient’s mouth to capture that ideal position, known as the bite registration. Based upon the information gather during the K7 evaluation, it was determined that the best course of treatment would be for Richard to be fitted with a fixed orthotic that would be bonded to his lower teeth that would reposition his bite and jaw into its ideal position. Once his bite had settled into the proper position to then do a full mouth reconstruction where all of his teeth would be crowned to rebuild his bite into the correct place permanently without the continued use of an orthotic.
Richard is Smiling Now!
Richard After
Richard, who was Dr. Adler’s first full mouth reconstruction case, met Dr. Adler and his assistants in Las Vegas at the Las Vegas Institution to do the final restorations under the guidance of LVI’s highly trained instructors. During the first procedure, the fixed lower orthotic was removed and all of Richard’s teeth were prepared for the crowns. Temporary crowns were then placed while the impressions were sent to Aurum Ceramic Dental Laboratory where Richard’s crowns would be custom fabricated into his new bite and better looking smile. Once fabrication on the crowns was complete, Richard returned to LVI with Dr. Adler to have the case seated. The temporary crowns were removed and Richard’s amazing new crowns were cemented into his ideal bite with strong clear cement. Now Richard is smiling all the time and is proud to show off his teeth.
Tags: boulder, Colorado, cosmetic dentist, Cosmetic Dentistry, full mouth reconstruction
Porcelain Crowns | Inlay Onlay
Jamie's Amalgum Filling - Note the discoloration
Inlay/Onlay
The Other White Crown
It is a common myth that silver amalgam fillings last forever. They are very durable but are not indestructible. There are several reasons why a silver filling can fail. Fillings have to endure an incredible amount of biting force and over time, they become worn and turn black, and their edges wear away. Moisture and temperature changes can also cause the filling to expand and contract. This expansion can create a wedging effect in the tooth, which can fracture or break off tooth structure. The expansion can also lift the surface of the filling slightly creating a gap where the filling meets the tooth and allow bacteria into the tooth.
Jamie had begun to have sensitivity when flossing in her lower right molar, which had a large silver amalgam filling. Dr. Adler diagnosed recurrent decay in the tooth and recommended that an inlay be placed.
An inlay is similar to a filling and lies in between the cusps of the tooth. They are custom-made to fit the prepared cavity and are then cemented into place. An onlay is a more extensive reconstruction that replaces one or more cusps of a tooth. Onlays are indicated in situations where a substantial reconstruction is required. However, more of the tooth structure can be conserved compared to the placement of a crown. To repair damage to the tooth’s biting surface, rather than using a simple filling, or a crown, Dr. Adler will often use an inlay, or an onlay. Inlays and onlays are made from porcelain because of its strength and ability to match the natural color of the tooth.
Jamie's Almost Invisable Inlay
Dr. Adler prepared Jamie’s tooth by removing the old amalgam filling and the underlying decay. He then painted a reflective powder over the prepared tooth. Using a special camera, he took an accurate picture of the tooth which was then displayed on a computer screen, where he designed the inlay. Then CEREC took over and automatically fabricated and shaped the restoration. CEREC is an acronym for Chairside Economical Restoration of Esthetic Ceramics. With CEREC there was no need for us to make an impression and send it to a lab. The inlay was then permanently bonded to Jamie’s tooth. The whole process took about an hour and Jamie was able to leave with a beautiful and healthy white tooth verses the discolored and decayed one that she came in with.
Tags: boulder, Colorado, cosmetic dentist, porcelain crown
Creating beautiful smiles to last a lifetime.
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