Aesthetic dentistry deals with dental aesthetics, both in the anterior and posterior sectors.

The harmony of the smile is the concept that best expresses the aesthetics of the teeth, and not only involves the teeth in the strict sense (shape and color), but also the conformation of soft tissues (gums), and the position of the elements.

What makes a smile beautiful and harmonious is often the combination of all these factors, also in relation to other facial features.

It is not said that an "imperfect" smile needs to be changed, maybe just a few simple procedures are needed to improve it, identifying which factors to work on.

Dental cosmetics: simple procedures to improve a smile

Case 1: A simple case of agenesis (lack) of the lateral teeth: the patient was dissatisfied with her smile, but did not want to undergo any invasive surgery. In this case the concepts of "additive" dentistry were applied, which allowed us to "transform" the canine teeth into the lateral, the left premolar into canine and give greater importance to the central teeth, simply adding the missing material, based on a decisive diagnostic project together with the patient. Two sessions at the armchair were sufficient to achieve the result.

Case 2: Another case solved without any sacrifice of healthy dental tissue. A home bleaching was performed by the patient and, at the end, the old restorations were simply removed and the proportions between the elements changed a little. The patient was satisfied with the final result, achieved in a few sessions, without resorting to any complex prosthetic therapy. The smile has "imperfections" but reflects what is desired by the patient.

Tissue conservation is always the most reliable procedure for obtaining and maintaining excellent long-term results. This concept is well matched with the term " invisible dentistry" that is very dear to us. The final result, in fact, should not only be pleasant and harmonious, but also invisible to the human eye.

Nobody would like to know that those who are close to us think that our teeth are beautiful, but are "fake".

Case 4: Another case of simple correction: the patient was not happy with the color of her teeth and the surface of the enamel, which was altered. In the first phase, the patient performed a home bleaching of the upper arch. In the photo on the right you can see the difference between the upper and lower arch (the lower tooth whitening will be performed later).

An operational phase and the final result, immediately at the end of the enamel correction session. The difference in color between the upper and lower arch is even more evident, where home bleaching has not been performed. In this way you can see the effectiveness of this type of treatment!

Continuing in this overview of aesthetic dentistry, we can have cases in which the use of prosthetic veneers in ceramic or composite material, associated or not with inlays or crowns on the posterior sectors, is indicated. This is necessary when the missing dental tissue is conspicuous, or the chroma or height (vertical dimension) of the teeth should be substantially modified.

Case 5: The case of M. required the use of veneers in ceramic material, and of direct restorations in composite material on the lateral teeth and on the lower incisors. Also, in this case the intervention was additive, without useless demolition of healthy tissue. This same type of intervention can also concern the posterior teeth, as shown below.

Case 6: In S. there was an important erosion of the enamel-dentinal surface of most of the posterior teeth, which was restored by occlusal inlays.

Case 7: Another case, analogous to the previous one, in which the patient G. applied composite inlays on the posterior teeth to increase the worn vertical dimension. Also in this case all the teeth have been left alive and vital!

Case 8: Preoperative and reconstructive phases, before insertion of the inlay (photos 1 and 2)

The inlay immediately after cementation and polishing. Given the saving of dental tissue, even if the element has been devitalized, it has an excellent chance of long-term maintenance

Aesthetics does not only concern dental tissues, but also gingival ones: a deep recession can be equally anti-aesthetic, as well as causing dentinal sensitivity problems.

The case of a lower incisor, associated with a hypersensitivity of the collar, such as not to allow the correct oral hygiene maneuvers in this area.

In such cases, a classic vicious circle is formed that determines the deterioration of the initial lesion: recession-hypersensitivity-incorrect oral hygiene-inflammation-deepening of the recession.

In this case too, minimally invasive periodontal plastic surgery techniques are able to reform the tissue so profoundly altered by recreating gingival, as shown in the following image.

Case 9: before surgery Case 9a: after periodontal plastic surgery

In the following cases, we will have to correct increasingly severe defects, both on the teeth and on the soft tissues.

We start with a single implant, in an aesthetically very important position.

Case 10: Our patient's request was to hide the exposed and dark root part on the right upper incisor, and to improve the aesthetics of the left one, especially in reference to soft tissues. Added to this was the presence of serious defects in the bone support of these elements. In particular, the left incisor had a loss well above 50% of bone support.

This defect resulted in the forced extrusion of the left incisor, using orthodontic forces,

to bring the level of the gingival margin back to a position more similar to the adjacent teeth. Substitution of the element that was no longer maintainable was then carried out by inserting an implant. All this, only after eliminating all the periodontal pathology affecting the entire mouth, an absolutely necessary condition for implant treatment.

10a The care of our patient has involved, as a final act, the application on both prosthetic crown incisors with zirconium oxide structure.

10b In this image we can see how the soft tissue architecture has been corrected, and even the desired aesthetic criteria have been achieved.

Let's look at the following two cases: dental elements lost in areas of high aesthetic and phonetic value. In both cases it was necessary to insert an implant, simultaneously with the extraction of the irremediably compromised tooth, and carried out an immediate load by applying a prosthetic resin element, during the same day. Once the time necessary for the complete integration of the implant has passed, the final ceramic prosthetic crown has been applied on a zirconium oxide structure.

Case 11: S. appears in the clinic with a fracture of a central left incisor. The root of the tooth was also very compromised and, in agreement with the patient, the implant solution was opted for.

11a The case after the application of the final crowns. The patient is very satisfied. The photos show the case at 6 years from the load: the gingival margins around the prosthetic crowns have maintained position and shape, aesthetically superimposable to the natural elements; this thanks to perfect oral health, the result of a regular hygienic maintenance program organized by our clinic and followed by our patients.

Case 12: analogous to the previous one, the replacement of a left upper canine, by implantation. In the left image, we can see the excellent integration of the ceramic crown with contiguous natural teeth.

In the image that follows, we notice an aesthetic problem due to an upward shift of the gingival margin, of the two premolar teeth, with a thinning of the gingival tissue itself: the application of periodontal plastic microsurgery techniques allows to bring back the gingival tissue to its natural size, covering the exposed and dark root part, without having to modify the pre-existing prosthetic crown.

Certainly obtaining a "beautiful smile" is the result of the application of correct reconstructive techniques, both on the dental and gingival tissues; it is undoubtedly linked to the collaboration of the dental practice team: operators, hygienists, assistant staff, dental laboratory; it is certainly based on the careful interpretation and respect of the needs of our patients, and in the final analysis it is achieved by taking care of the people who trust us in the most professional and passionate way possible.

Contact our cosmetic dentistry center for more details.