Aesthetic optimisations: results of treatment by Dr. D. Heller
Click to enlarge the photos.
It's a big challenge matching an individual crown perfectly to the
neighbouring teeth. The new all-porcelain crown blends in perfectly with the surrounding teeth after the treatment and as such is no longer visible.
The result of this reconstruction (periodontal therapy with implants) has to be aesthetically appealing a all events. In this case the shape, colour and position of the tooth was improved and the unsightly «black spots» (black interdental spaces) were eliminated.
A smile «with no visible teeth» looks unflattering. In young patients the teeth are always visible when speaking but indispensable when smiling. Since teeth become shorter over decades of use (grinding and attrition) and the upper lip also becomes longer through a weakening of the lip muscle tonicity over time, the teeth of older patients can become «invisible» and thus alter the optical impression of the face in a negative way.
Care therefore has to be taken during the reconstruction to ensure that a visible tooth length is achieved when speaking (ideally in a passive state too) and naturally when smiling. The ideal proportions are thus restored along with the patient's youthful appearance. Scientific parameters, but above all experience and an understanding of aesthetics on the part of the dentist and dental technician are crucial here.
The detailed view of the reconstruction with all-porcelain crowns shows harmonious proportions for the teeth. A straight (in line with the eyes) occlusal plane and minor «adjustments» in detail that make the reconstruction appear beautiful, but not unnatural.
A disproportionate ratio between «white and pink» aesthetics is noticeable in this patient. The teeth (white ) are too short relative to the very visible gums (‹gummy smile›, pink aesthetics), that dominate the smile.
The patient was also troubled by the gap in the teeth (diastema).
The teeth could be enlarged and the gap in the teeth closed with 4 veneers. The harmony between the teeth and gums (pink and white aesthetics) was restored when smiling. The gums were trimmed back using a laser. This correction is carried out with a local anaesthetic, is absolutely painless after the operation and heals perfectly within 4-5 days.
This well-known celebrity wanted a smile design. The upper jaw was widened using veneers in the sense of an «important» smile and the position of the teeth was harmonised.
The «black lateral corridors» are now no longer visible when smiling.
The occlusal plane was levelled (in accordance with the eye line). The crowns / veneers were personalised at the cutting edges and surfaces and thus achieved a natural look. The canines were only whitened (bleaching) and received no further treatment.
This distracting gap in the front teeth was closed in 8 months using the invisible brace Invisalign.
A so-called «retainer» was stuck to the rear of the teeth at the end of the treatment to stabilise the result. The result thus remains permanently stable.
Teeth appear to become longer if the gums recede. This is not just aesthetically unsightly but can also be accompanied by a so-called «sensitivity of the neck of the tooth».
The method of choice here is a so-called recession cover. The gingiva is hereby reconstructed during an operation; in difficult cases this sometimes requires a gingival transplant from the gums.
Strong enamel abrasion and erosion call for a total reconstruction by means of all-porcelain crowns and veneers.
Teeth with gaps and teeth that appear to be too small (agenesis of the canines) make this patient look «childish».
The gap could be closed and the teeth harmoniously enlarged through the incorporation of 6 veneers.
Typical crowns from abroad: berry-shaped teeth, visible crown edges, opaque look due to the metal core and lack of personalisation.
All existing crowns replaced by all-porcelain crowns.
The ceramic implant satisfies all the criteria for perfect aesthetics: the gums are free from inflammation and are perfectly in line. The implant does not shimmer through thanks to the white colour. Excellent biocompatibility
The case studies shown here were all carried out by Dr. D. Heller Fontana herself. The before and after photos may only be used for private purposes. Any other use, in particular their duplication by electronic or conventional means for commercial purposes, requires the written consent of Dr. D. Heller Fontana.