Emax press...a hard task!

1 Rating(s).


Posted on By Cafadaru Mihnea In Ceramics/Veneers

This is a case with multiple problems, including perio, decays, aesthetic disharmony. We did everything without implants. Tooth 2.2 have almost no ferrule, but the tissues are stable and no guidance is present on that area. The implant in that area is a huge challenge, mostly because high lip line and thin biotype. We open the VDO with tabletops and pressed crowns and the occlusion is stable. Time will tell...




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10 Comments

Cafadaru;
Beautiful restorative dentistry!
In general, the lateral incisors are the worst teeth in the mouth to crown because of their size and the frequency with which they oppose the mandibular cuspids.

The overbite and overjet issues in this case make it all but certain that both laterals will have a relatively short life expectancy. That said, even implants would be compromised if placed into this occlusal scheme. Correcting the deep overbite with orthodontic intrusion/repositioning is the only solution.

Everything in dentistry is about function first with regards to managing forces. Another way to say this is: Proper diagnosis and treatment planning.

In today's environment many of us are afraid to say 'no' to our patients.
Regards,
gerald


Reply

Thank you so much for your advices! The occlusal scheme is changed. Dhe VDO is increased with lateral restorations and the overbite has decreased. The final photos show the approximative position of the jaw. You are right about the initial scheme, that is why we did the lateral occlusion first, and then the front. Greetings from Romania.


Reply

It is a pleasure to meet you Cafadaru and it is wonderful to see the quality of work that you are doing
Regards,
Gerald


Reply

Thanks Dr. Gerald! You are too kind! I have a long road ahead and my motivation is pure passion for dentistry!


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Very nice proportion and ceramic result...did you give any thought to slightly building out the right side and match it to a wider left side since you were treating it as well?


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Amazing work.
Any consideration/discussion regarding crown lengthening as part of the treatment plan.


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Dr. Mata thank you. The patient did not want surgey.


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Dr. Goldstein thank you for your advice! The proportions are an issue, but in dinamic it is not that noticeable. The patient is happy with the result and he does not want any surgery.


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May I suggest Cafadaru that you learn to do direct resin mockups so that you can SHOW your patients how fabulous they will look with proper treatment and then tell them that if they want what you have just shown them, they will need some minor changes in the gum tissues.

No one WANTS surgery! But people WANT the results that surgery will offer. The value in the outcome convinces patients that the surgery is a requirement to achieve the results that THEY WANT.


Reply

Dr. Benjamin you are right! I try to make direct mock up almost every time. Your advice is precious.


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