When Hans first came to the Boulder dental group of Adler Cosmetic & Family Dentistry he was ready for a change. Hans had had fillings, crowns, root canals, and extractions in the past and he wasn’t happy with how his teeth looked or felt. He had lost teeth on the lower right side and had trouble chewing. Hans wanted to have his smile completely made over so it was functional. He also wanted his smile to look great. Hans is a very friendly outgoing guy with an active lifestyle and he needed a smile that matched his personality.
Dr. Adler saw that there were several different issues to be addressed to give Hans the smile he always wanted. The missing molars on the lower right had affected Hans’ bite and only allowed him to chew on one side. He also had teeth that were fracturing due to large amalgam fillings, teeth that were broken and decayed, and other teeth with fillings that had come out and continued to get cavities. Fixing these problems one tooth at a time would not give Hans the outcome he was looking for and would end up taking longer and costing more in the long run. Dr. Adler recommended that Hans fix all of his teeth at once and correct his bite with neuromuscular dentistry.
Dr. Adler began by addressing the immediate issue of a tooth that was causing Hans pain. The tooth on his upper left had broken a while ago but he had waited to get treatment due to a medical issue at the time. Now the tooth was beginning to cause Hans pain which is what prompted him to come in. A root canal was needed because the tooth had fractured and exposed the pulp chamber which had become infected causing the pain.
With Hans now out of pain, Dr. Adler could focus on finding Hans’ correct bite. A K7 evaluation was performed to determine where Hans’ bite should ideally be positioned. During the K7, a series of tests are run using non-invasive computerized electronic instrumentation.
Based upon the information gathered during the K7 evaluation, it was determined that the best course of treatment would be for Hans to be fitted with a fixed orthotic that would be bonded to his lower teeth to reposition his bite and jaw into its ideal position. Dr. Adler recommended that once Hans’ 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. Once his bite had stabilized then he was ready for the next step.
At this stage, impressions of Hans’ teeth and his new bite were sent to Aurum laboratory so they could do a wax-up. The wax-up is a wax model of how the final restorations and bite will look. This was done so that Dr. Adler could confirm that all the measurements for Hans’ bite were correct and that the restorations were the right shape and size to give Hans the best looking smile for his features and facial type. Once approved, Hans was ready to begin prepping his teeth for his final restorations.
In a single appointment, all of Hans’ teeth were prepped for his final restorations. The fixed orthotic was removed and each tooth shaped into the proper form for the final restoration. Impressions of the prepped teeth were sent to the lab and temporary crowns were placed that looked almost as good as the final ones would. This attention to detail was also very important in making sure that Hans’ final bite would be in the correct position.
Like the prep appointment, the crowns were seated in a single visit. The temporary crowns were removed and the teeth cleaned with a disinfectant. Each crown was then chemically bonded to the teeth to insure the strongest hold possible. The crowns were then cleaned and scaled by our hygienist to insure that any excess bonding material had been removed. By the end of the appointment, Hans’ teeth looked great.
Hans now has the smile to match his great personality and the transformation has been overwhelming. He not only looks great but he is finally able to chew normally again and his bite feels great.