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The next live case presentation is on June 18th at 8pm EST. Not a member? Join today to gain access.

Live Case Presentations are hosted monthly for members. During each one-hour session, we review cases, ask questions and discuss treatment plans.

Previous Case Sessions:

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Achieving Longer Teeth Through Comprehensive Dental Restoration

This case is centered on a patient's desire for longer teeth, a common esthetic concern among individuals with otherwise healthy dentition. However, addressing this request involved a nuanced approach considering various factors, including occlusion, facial structure, and lip support. Despite the initial simplicity of the request, a thorough examination uncovered underlying issues such as wear patterns indicative of bite problems. A comprehensive treatment plan was devised, incorporating orthodontic intervention to correct tooth alignment before proceeding with restorative work.

 

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Prioritizing Pre-Restorative Orthodontics for Functional Excellence

The primary challenge in this case stemmed from the patient's complaints of pain, discomfort, and underlying airway issues. Addressing these concerns required identifying a comfortable orthopedic position and determining how restorative procedures could restore function while aligning with this position. Key questions regarding the feasibility of using Invisalign to achieve the desired outcomes and the extent of restorations needed were carefully considered throughout the treatment planning process.

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Minimally Invasive Veneer Case 

The patient's chief complaint was not showing any teeth when smiling, leading to esthetic concerns. The dental and medical history revealed no functional issues, with the patient reporting no eating difficulties, joint pain, or jaw discomfort.

It was decided to deprogram the patient to address the esthetic issue and initiate a treatment plan involving opening the vertical and performing veneers and crown-lays from teeth #3-14. Despite the absence of reported functional problems, the decision to deprogram was due to the need to alter the vertical dimension, utilizing a proper orthotic position, specifically centric relation. While vertical dimension can be achieved by orthodontics and/or restorative, this patient's esthetic goal resulted in the restorative approach for this specific case,

 

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Comprehensive Consultation for Maxillary Restorations and Smile Transformation

The patient sought a restorative consult due to previous maxillary restorations. Referred by a periodontist, she expressed dissatisfaction, citing marginal redness and bleeding. Her dental history included orthodontics, difficulty eating certain foods, occasional teeth clenching, and dissatisfaction with the previous dental work. Seeking esthetic improvement, she desired whiter teeth and had concerns about redoing recent crowns. In repose, her canines appeared balanced, and her smile displayed well. The patient's primary concern was aesthetic, emphasizing the need for comprehensive evaluation and potential restorative procedures. 

 

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Managing Spacing Across the Entire Upper Arch: Minimally Invasive and Cost-Effective 

The case analysis involved evaluating the patient's dental-facial esthetics and identifying discrepancies in tooth size and spacing. With ongoing orthodontic treatment, there was an opportunity to guide the final outcome strategically. Various methods of planning and communicating the treatment plan were discussed, including digital smile design software, and injection molding as transitional restorations. The emphasis was on achieving a balanced, esthetically pleasing result while minimizing invasiveness and cost. Ultimately, the consensus leaned towards utilizing injection molding as an efficient and economical approach to address the patient's concerns.

 

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Where do we put the teeth within the face?

In this complex case, the patient presents with implants, veneers, and crowns, with a prominent gray discoloration as the primary concern. Additionally, there is a slight lip imbalance attributed to previous surgeries. Using Dental Facial Analysis (DFA), the smile and lip dynamics were analyzed. The patient exhibits excessive tooth exposure, necessitating careful decisions regarding tooth placement within facial proportions, while maintaining minimal invasiveness. For treatment planning, it is proposed to consider shortening the anterior teeth and potentially using Invisalign to intrude the canines, thereby enhancing the smile curve. Discussion was had regarding the most suitable material for this combination case. The proposition of splinting the implants is suggested to facilitate the housing of pink porcelain, simulating natural papilla. Furthermore, a comparable case is presented wherein adjustments to tooth proportions yielded significantly enhanced aesthetics.  Finally, emphasis is placed on the paramount importance of effective communication with the laboratory for optimal material selection and seamless blending, thereby optimizing outcomes.

 

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Harmony in Esthetics: Choosing the Right Materials

During this session, we’ll explore the intricacies of finding the balance between esthetic goal and minimizing the risks associated with tooth structure integrity, which play a crucial role in material selection for achieving a beautiful outcome. Special guest Nelson Rego, CDT, AAACD will elaborate on the considerations and decision-making process involved in selecting the most appropriate material for this particular patient case.

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Recordings

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