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Cosmetic Dentistry All dentistry should be and can be cosmetic in appearance. Dental treatment should result in a smile that both looks and feels natural, and encourages one to smile and communicate with others with confidence. Today we have a variety of dental materials and techniques to replace decayed or broken parts of teeth, to replace missing teeth, and to improve the appearance of your teeth and smile. The selection of the appropriate dental material and technique depends upon the size of the restoration and location of the tooth or teeth in your mouth to be restored. To restore small decayed areas of a tooth, tooth-colored composite resins are usually indicated. |
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Tooth-colored composite resins not only restore the function of the tooth, but also the appearance. Since tooth-colored composites are bonded within the tooth, the tooth is strengthened to help prevent fracture or chipping of the tooth while under chewing forces. Silver amalgam “fillings” have been used to restore teeth for many years, but do have disadvantages. Because the silver amalgam is metal, the metal is malleable under chewing forces. The metal begins to change shape and small flashes of metal begin to chip around the edges of the restoration. This chipping of the amalgam restoration around the margins results in “leakage” spaces between the tooth and amalgam restoration. This microleakage between the tooth and the amalgam restoration allows bacteria to migrate down the sides of the “filling”, leading to decay underneath the restoration. |
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Another disadvantage of silver amalgam restorations is that because they are metal (and up to 50% mercury) the restoration expands and contracts with temperature changes. This expansion and contraction of the “filling” within the tooth causes stress within the tooth structure causing cracks. Cracks within the tooth can cause sensitivity or pain with temperature changes and chewing. In some cases parts of the tooth, usually the cusps, can break off. |
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| To restore large decayed or broken areas of a tooth, porcelain restorations are indicated because of their strength and longevity. Porcelain restorations include porcelain inlays and onlays, and crowns. |
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| Porcelain inlays and onlays not only esthetically restore large areas of tooth, but when bonded into your tooth, will also restore the tooth back to nearly 100% of its original natural strength. Porcelain inlays and onlays are either made in a dental lab from an impression of your tooth, (necessitating that your “wear” a temporary plastic restoration in your tooth for almost 2 weeks) or are made from Cerec (CAD/CAM) technology. We utilize Cerec technology in our office to fabricate your porcelain restorations. Your all porcelain restoration is milled by a computer while you wait, thus avoiding impressions, a temporary, and a second appointment. |
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Teeth weakened from large decayed or broken areas may need to be restored with a full coverage crown (a “cap”) in order to provide a more durable chewing surface. Crowns may be made from several different types of materials. Dr. Martinich uses high quality, highly trained professional dental laboratory technicians located here in the Denver area. Crowns are made of porcelain fused to a high quality gold. In some cases, all porcelain crowns can be made for the front teeth. Tooth-colored composite resins can also be used to restore broken teeth. This patient was too young to restore the fractured portions with porcelain veneers or crowns, so a composite was bonded to restore the teeth. |
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This patient has beautifully shaped, white teeth, but wanted to close the space between her two front teeth. We decided on a conservative approach by bonding composite resin onto each tooth to close the space.
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Smiles with crooked teeth, discolored enamel or large fillings, or with uneven spacing can be restored with porcelain veneers, porcelain crowns, or with a combination of orthodontic tooth movement and veneers or crowns. Porcelain veneers are made of a thin (about 1 to 2 mm thick) layer of porcelain that is then bonded onto the front of the tooth. Porcelain veneers are a more conservative treatment technique for mild to moderate discoloration, malformation, decay, and malalignment. Porcelain veneers look very natural and can restore your smile for many years of use.
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If teeth are mildly crooked, but moderately decayed or weakened, or worn down or discolored from large fillings, porcelain crowns may be the treatment of choice. Weak teeth require protection from further breakage, and porcelain crowns can look and feel very natural and last a lifetime with proper care and maintenance. Most smiles can be restored to perfection in just 2 to 3 weeks with porcelain crowns.
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The anterior crowns Dr. Martinich designs are very natural, with all porcelain along the gum line margin on the front of the tooth. This patient wanted his old crowns with metal showing along the gum line replaced with more natural looking crowns.
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The following patients wanted “smile makeovers” in just 2 weeks. These crowns look very natural and created a new, confident, winning smile.
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To make your teeth look whiter and more youthful, teeth whitening (“bleaching”) may be indicated. There are several tooth whitening techniques available, but they fall into just 2 categories: In Office whitening; and At Home whitening. In office whitening may be more convenient for the patient who wants an immediate result. However, in office whitening requires more “dental chair” time and therefore, the fee is higher to the patient. Also, in office whitening tends to be more temporary, with the teeth relapsing back several shades darker from the final result days later, although not all the way back to the original darker shade. This is due to the initial whiter appearance of the teeth resulting from dehydration of the enamel. Once the teeth have rehydrated several days later, the color of the teeth has relapsed partially back. Our office utilizes the At Home whitening technique for many reasons: Less chair time for the patient, therefore lower fee; Whitening results last longer; The patient owns the whitening gel and mouth trays kept at home, therefore, controls the results and future whitening at their discretion.
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Orthodontics (also refer to section entitled “Invisalign and Orthodontics” on the Home Page) can align crooked teeth that are otherwise healthy and white, to achieve a perfect smile. If teeth are extremely crowded and are discolored from large fillings, orthodontics may be necessary before restoration with veneers or crowns. Many of our patients achieve perfect smiles with Invisalign (the nearly “invisible braces”) or conventional orthodontics when they whiten after orthodontic treatment. Our office provides both Invisalign and conventional braces for our patients. Our office also provides Cosmetic Imaging to enable you to see what your smile could look like before treatment is started. With our Computer Imaging Smile Analysis you can assist Dr. Martinich in the design of your smile on a computer screen and receive a Before and After picture of the desired changes. Cosmetic Imaging is a great tool to help you convey to the doctor your desires and expectations. Now you can have a realistic presentation regarding your dental concerns that answers your questions and clears the way for you to make a comfortable and informed decision. |
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