Etelka's Smile Transformation Using Digital Dentistry

How our team of Dentists, Specialists and Digital Dentistry restored Etelka's smile and dental function.

Etelka grew up in Europe and had a lot of dental work as a child. After moving to Canada, she had further extensive dental procedures throughout her adult life, then came to Dentistry on Dundas in 2016. She was quite frustrated and self conscious about her oral condition and was committed to making a permanent change. This would include a multifaceted collection of procedures including periodontal surgery, Root canal therapy, orthodontics, fillings, dental implants and crowns. This was done by various specialists, including myself, Dr. Dana Levy, Periodontist and Dr. Mark Librach providing orthodontics.

Dr. Lanys:

1. Why was Etelka a good candidate for these procedures? She was an excellent candidate for this lengthy and comprehensive treatment plan. She was ready, eager and committed to creating an oral state of health which was aesthetically pleasing.

2. What were her biggest concerns about the procedure? Etelka had many concerns. She wanted to keep all her existing teeth and replace all missing teeth with implants. She did not want her upper anterior bridge any longer; for there was food impaction and she did not like the way it looked. She had an extremely "high demanding" job in downtown Toronto and wanted only evening appointments.

 

 

Before

3. How did you develop a plan for treating Etelka’s concerns? Etelka's concerns were rather challenging but definitely not impossible. There were compromises to be made and the main one was that the course of treatment was going to be lengthy and extensive. The treatment plan was devised with our team of professionals and specialists. There was a specific order of procedures that was essential to follow to ensure the best possible results.

                           Cone Beam Implant mapping Dr. Librach

4. Was her treatment out of the ordinary? The treatment was not out of the ordinary. All aspects of her treatment were quite routine. The challenge was that almost every tooth had to be treated or retreated. This was superimposed with a difficult "bite" that had to be corrected with braces. It was, therefore, all "ordinary", however, just a lot of timely "ordinary" work.

5. How long did Etelka’s transformation take? The entire course of treatment was approximately two and a half years.

6. What steps do these procedures involve? The order of steps was very important. Initially, there were various consultations, x-rays and exams in the different disciplines. Periodontal and restorative were necessary first. This would include cleaning, pocket reduction, fillings and extractions of hopeless teeth. Bone grafts were placed in those areas to prepare for implants. Lower braces were then placed to upright the teeth to create a more favorable bite to ensure the implants and crowns were in the correct positions. After the bone grafts healed for approximately 4 months, the implants were placed and also had to heal for a subsequent 4 months. Finally, all the crowns were placed.

                       Digital imaging for crown restorations, 5Axis

7. Is there an ideal candidate for these procedures? The ideal patient for this full mouth reconstruction must be committed emotionally, physically and must put in the time. Most patients have partial treatment of this kind or just a few procedures of this nature which is rather quick and routine.

8. Are there any at-home steps patients should follow after procedures like these? Once any treatment of any kind is completed, it is up to the patient to maintain a healthy and regular regime of home care with excellent oral hygiene, and also return for regular maintenance visits to the dental office. Quite often a night guard is recommended to protect the teeth from wear and keep the jaw in a good state.

 

After      

9.What advice would you give those debating whether or not to get dental surgery? I would recommend that anyone who wants to make a change for the better regarding any aspect of their health, to investigate all options and find the doctor that is right for them. In most cases, there is nothing more rewarding than watching a patient look in the mirror and seeing the look on their faces when they see the reveal!

Dr. Levy:

For our patient Etelka we provided different forms of treatment which included overall thorough Periodontal therapy which would provide a healthy foundation for all future prosthetic treatment. Among those treatments were included: deep cleaning of the gum pockets, antibiotic therapy, home care and physiotherapy, regeneration of advanced bone loss, extraction of teeth that were deemed non-treatable as a result of either decay or Periodontal (gum) disease.

1. Why was Etelka a good candidate for these procedures? Etelka was an excellent candidate since she was healthy, non smoker and very keen to achieve maximum results with a deep commitment to achieving all of our objectives.

2. What were her biggest concerns about the procedure? The biggest concerns were, of course, pain or discomfort, time to recover, making sure her teeth and replacements provided excellent aesthetics during all procedures.

 

3. How did you develop a plan for treating Etelka’s concerns? our treatment plan is always developed as a team approach: each practitioner does a comprehensive clinical exam, followed by any additional imaging or study models which will allow us to then brainstorm together which options are best for our patient, from good to better to best.

4. Was her treatment out of the ordinary? Treatment was not out of the ordinary as more and more adults which have had dental treatment done through their adult years, is starting to break down and the demands for proper treatment and oral health are higher, both from the patients perspective and the dental professionals.

 

5. Is there an ideal candidate for these procedures? Ideal candidates are always patients who are healthy and under regular care of their medical doctor as well as their dentist. Of course, non smokers will always achieve great results and patients tat are committed to having a healthy mouth will always be those who will see the outcomes which are hoped for from the outset.

6. Are there any at-home steps patients should follow after procedures like these?  patients receiving this and any type of complex dental care must know that proper home are and physiotherapy as well as frequent maintenance visits to the dental office are imperative in order to maintain the achieved outcomes and maintain healthy foundations for their prosthetic reconstruction.
7. What advice would you give those debating whether or not to get dental surgery? In order for patients to commit to complex care, it’s important to measure patients desires, objectives and realistic outcomes. Overall, wanting to achieve a beautiful smile and proper function, will require time commitment and perseverance as well as the knowledge that what took many years to occur, will not be resolved in one or two appointments. However, the ultimate result will far outweigh the hard work on behalf of their dentists and dental specialists and of course the hard work of each and everyone of our patients.

                                     Dr. Michelle Lanys, Dentist

                                                   
                                     Dr. Dana Levy, Periodontist

Dr. Mark Librach, Dentist

                                   Connie, Treatment Coordinator

Michelle's Dental Makeover!

Dr. Steven Millman explains Michelle's treatment plan....

Michelle's case is an excellent example of how we can use porcelain veneers to correct a person smile instantly without orthodontic treatment. 

The patient was very concerned with the symmetry of her smile and her mid-line being off. She also did not like the anatomical shape of her teeth.

                                                       Michelle before

A treatment plan was developed with the help of our lab technician Jonathan Murisac and our periodontist Dr. Dana Levy. Prior to treatment we created a wax mock-up of her smile in order to correct her concerns. Once the patient was able to visualize the changes we could  make to her smile, she accepted going ahead with this treatment.

The transformation was completed over a month of treatment. We started off by placing temporary veneers to correct the position of the gingival tissue and to create a symmetric smile. Once the patient was satisfied with the cosmetic result we then replaced the temporaries was permanent veneers. 

                                                           Michelle after

There are many potential patients that could benefit from this type of treatment. This is a relatively non-invasive treatment that can correct crooked misaligned teeth without orthodontic treatment. As you can see by the photos the cosmetic result was excellent. Both myself and the patient extremely pleased with the final results. 

The beautiful porcelain veneers can be easily maintained with routine brushing and flossing. We also highly recommend six month cleaning at the dental office with a skilled hygienist. 

From the Michelle....

1.     What made you decide to undergo these procedures?  Saw an orthodontist and due to the crowding of my teeth and the extended years of work that needed to be done they didn’t feel it was an good option for me at my age and I would not get the result I was looking for since I was missing the canine tooth. 

2.     Why did you choose Dentistry on Dundas/Dr. Millman?  He is my family dentist so didn’t feel the need to look elsewhere.

3.     What were your procedures like?  It was definitely time consuming, however this was due to my specific case as we were turning another tooth to appear to be a canine. Other than that, there was nothing intolerable. 

4.     How do you feel about your results?  Anyone who sees them think they look perfect and have had comments on how perfect they look from people who don’t know I had them done.  

                                                    Dr. Steven Millman

Laurie's Dental Makeover!

Laurie underwent a few small dental treatments to achieve her new smile. This included teeth bleaching, surgical crown lengthening of upper anteriors and two crowns on her centrals.

 

Before                                                           After

 



 

Here what she had to say about her experience at

Dentistry on Dundas!

 

What made you decide to undergo these procedures?

 

I was embarrassed to smile. This was primarily due to the crown on my right front tooth; it was beginning to show some of its metal near the gum line. When I smiled too big, it would show.

 

Why did you choose Dentistry on Dundas/ Dr. Lanys?

 

I have been coming to Dentistry on Dundas and seeing Dr. Lanys for over 10 years. She is always very professional, understanding and I felt confident in her work.

 

What were your procedures like?

 

The first step was to whitening my teeth. Due to genetics, my family's teeth yellow with age. I felt like they were aging me and if I didn't get the whitening done before the front teeth were crowned it would no longer be an option in the future as they would continue to darken. Next we removed the old crown and Dr. Levy skillfully contoured my gum above my right crown to match the contours of the left front tooth. It had not developed in the same way as the other tooth, possible as a result of having a crown for so many years (I was 8 when I first chipped my front right tooth). I was stressed about the procedure going in, but Dr. Levy was so friendly and so reassuring throughout the procedure; I couldn't believe how easy it was. The aftermath was surprising too. I expected to be sore for a long time, but I really had minimal pain for only about a week. The last step was to crown my two front teeth to match. To get the colour perfect, Dr. Lanys sent me to her nearby lab (5 Axis) to have the colour matched to my newly whitened natural teeth. After that I returned to the office to have them permanently placed. Dr. Lanys takes great care to get good results. I really respect and appreciate that.

 

How do you feel about your results?

 

I am very happy with my results. I no longer hesitate to smile!

 

Treatment provided by Dr. Michelle Lanys Dentist

 

 

and Dr. Dana Levy Periodontist

 

at Dentistry on Dundas

Dr. Librach receives the Fellowship Award from the American College of Dentists!

We are pleased to announce, this past week Dr. Librach was honoured with a Fellowship Award from the American College of Dentists. The American College of Dentists (ACD) is the oldest major honorary organization for dentists. Its members have exemplified excellence through outstanding leadership and exceptional contributions to dentistry and society. In response to serious problems facing the profession, the American College of Dentists was founded August 20, 1920, by the then leaders of dentistry to elevate the standards of dentistry, to encourage graduate study, and to grant Fellowship to those who have done meritorious work. The American College of Dentists is nonprofit and apolitical, and has long been regarded as the "conscience of dentistry."

 

Congratulations Dr. Librach! This is such an honour!

 

Small treatment creates BIG results!

Penny underwent a few small dental treatments to achieve her new smile. This included teeth bleaching, two new anterior crowns and cosmetic bonding.

 



Why was Penny a good candidate for these procedures?

Penny was a great candidate for her transformation. She was actually an extremely apprehensive patient that was nervous about most routine dental visits. Once she understood how standard the procedures were and how relatively quick they would be completed, she became more relaxed with each visit. She realized that a drastic result could be attained with ease, thus, a great case!

   

Before

 

After

 

How did you develop a plan for treating Penny's concerns?

In this particular case, during the initial examination, it was determined that a cleaning, some fillings and whitening were required before the front crowns were done.The first four appointments addressed the fillings and cleaning. These "easy" appointments were important to gradually help the patient relax with each session, and to create a healthy oral  environment. The whitening was done at home at  by the patient at their convienience. All it took to change the front teeth were the last two appointments. 

 

 

                       Before                                                                             After

Is there an ideal candidate for these procedures?

The ideal candidate for these procedures, or any for that matter, is a motivated individual who is committed to improving their oral care and esthetics. Everyone and every case is different. It may be few or many appoinments, however, there are always options where most issues can be addressed and improved upon. No matter how busy, the treatment can always be accomodated  to any schedule.

 

Are there any at-home steps patients should follow after procedures like these?

It is extremely important to maintain the health of any new restorations such as these crowns that were done on this patient. Home care and follow up cleanings are essential. Oral hygene instruction are reviewed and often, the patient is sent home with some special cleaning tools. Occasionally, a patient is asked to return one week later after a "large" case with many crowns, for example. This is to ensure the patient is satisfied, comfortable, and the tissues are forming to the new restorations appropriately.

Treatment provided by Dr. Michele Lanys at Dentistry on Dundas

 

 

 

 

 

 

 

 

 

 

Jonathan Mursic RDT, President of 5 Axis Dental     

 

 

 

 

 

 

Dental Implant Marketing: Truth vs Fallacy

We are all inundated every day with advertising and product placements for virtually everything that surrounds us. This includes as well marketing in the dental field which is directed to the public.
One of the treatment option we suggest, as Periodontists, are dental implants for replacing missing teeth. Today they are the best treatment option for single or multiple missing teeth.

From the moment that my patient is contemplating the possibility of replacing his/her missing tooth or teeth with implants, it is a very complex and well thought out process which includes: a thorough oral examination, digital X-rays, providing a comprehensive oral and periodontal exam, discussion of function (chewing and speech), discussion of aesthetics, and of course discussion of alternate treatment options. Within this framework I have to listen to the patient's desires and what are the long term goals and objectives when it comes to oral rehabilitation. Implant treatment carries as well a significant commitment on behalf of the patient, as long term maintenance is imperative for success.

Having said all of this, patients can be very confused by the myriad of treatment plans they receive when they are " shopping" for a general dentist, periodontist or surgeon that will deliver the implants and the prosthetic treatment that they are ultimately looking for. As part of our patient's education, I always stress the importance of comparing apples to apples, making sure that they are given the absolute best treatment care as well as making sure that all the preliminary steps have been taken in order to achieve maximum success and beautiful results.

I would like to direct you to this excellent blog post (see below) which shows how implant treatment plans can vary and how deceiving it can be if we don't really know what is being offered. Cost variation is extreme and can be misleading and it reinforces the fact that not every treatment plan is equal and / or as comprehensive as the next one.

As long as our patients understand how dedicated we are and the time commitment which we invest is crucial in obtaining optimal results, then I feel that we have given the best service to our patients.

Please take a moment to read an excellent blog from an Oral Surgeon in the US click here for link.

Dr. Dana Levy

Periodontics & Implant Dentistry

Welcome Dr. Cara Lindsay, Dentist

Dr. Cara Lindsay is joining the Dentistry on Dundas team! She graduated from The University of Western Ontario in 2006, receiving the Gold Medal in her faculty and obtaining a B.A in Psychology. She recieved her Doctor of Dental Surgery from The University of Toronto in 2010 where she won awards for her exemplary extracurricular involvement. As a student she served as social representative of Alpha Omega, Director of Dentantics, Student Council Representative, Fashion Show Producer and Head of Philanthropy for her class. Her fundraising initiative to increase oral cancer awareness helped foster the establishment of a research fund at the Princess Margaret Hospital specifically for oral cancer. She is an active member of many dental associations and organizations including the Canadian Dental Association, Ontario Dental Association, International Association for Orthodontics, North Toronto Dental Society, Alpha Omega Dental Fraterntiy and the Toronto Crown and Bridge Study Club. She enjoys all aspects of dentistry including orthodontics and enjoys keeping up to date with the latest dental trends by regularly attending continuing education seminars. In her spare time Dr. Lindsay enjoys sailing, dancing, travelling, music and art. There is also a family connection with Dr. Lindsay, she is Dr. Millman's niece!

Dentistry on Dundas Fireworks! July 23, 2011

Dr. Lanys interview on Bizymoms website

An interview with Dr. Lanys on Dental Implants.

What are Dental Implants?

Dental implants are metal root replacements for missing teeth that are placed into the bone. They take approximately 4 to 6 months to integrate with the bone at which time they are able to support a crown (cap), bridge or denture. Even if there is any bone loss from previous infection, periodontitis, etc., a bone graft can be placed before the implant to replenish some of the lost bone.

What are dental implants made of?
They are made of titanium and coated with a titanium alloy which is compatible with bone.

How long do they last?
Dental implants have a very high success rate of over 95%. A large advantage to this procedure is that if they are placed and subsequently integrated, they usually last indefinitely. There are, however, certain risk factors that may compromise the integration process or the longevity of the implant.

How are dental implants placed?

Implants are typically placed by an oral surgeon, periodontist, prostodontist, or a trained general dentist. This can be done under local anesthetic or sedation depending on the case and usually involves no discomfort during, and minimal discomfort after the procedure.

There are special x-rays or tomographs that are taken prior to placement to ensure all vital structures, such as nerves, are avoided and the implants are placed only within bone.

Before placement or on the day of surgery a temporary denture is inserted to ensure the patient never goes with missing teeth. When the implants are integrated some months later, the prostodontist or general dentist places the dentures, crowns or bridges securely onto the implants.

Risk factors or contraindications of dental implants.
The main risk factors associated with implants are smoking, poor oral hygiene, diabetes (especially if uncontrolled), other compromising diseases, and possibly some medications.

It is important to review your health history thoroughly with your dentist before commencing any dental treatment, including implants.

Will my implants feel like my natural teeth?

One of the main advantages of implants is that they do feel like natural teeth. They function and look like natural teeth, do not decay or require root canals. They maintain the surrounding bone, whereas if there was no tooth or implant, the bone would resorb or recede.

This is one of the only procedures that replace teeth without affecting any existing teeth in the mouth. They are by far the best treatment option to replace missing teeth and are widely used in my practice, resulting in many very happy patients.

Do you Snore?

Snoring could be a bigger problem than you think. It isn't just an noisy nuisance that disturbs both sufferers and their families, it is a disruption that can contribute to fatigue. It can leave the sufferer to fell tired, drowsy and inappropriately sleepy. The most important factor is that prolonged effects of lack of sleep can lead to slowed responses, memory problems, difficultly in paying attention and concentrating, which can all affect performance at the work place.



Dr. Steven Millman, DDS

When snoring is so loud that it disturbs the sleep of the snorers and their families, it may be a sign of a related condition known as Obstructive Sleep Apnea (OSA).

So what would be recommended? Firstly, determine if you have Sleep Apnea by booking an appointment with a sleep centre. Here they will monitor you sleep patterns to conclude an accurate diagnosis. If you are diagnosed with Sleep Apnea, you can consider the CPAP machine. While Continuous Positive Airway Pressure has long been considered the gold standard of care for sleep disordered breathing, patients find its use difficult and seek alternate treatments. One of these treatments is the Oral Appliance Therapy.


This oral appliance is a small plastic device similar to an orthodontic retainer or an athletic mouthguard. This airway orthotic is worn in the mouth during sleep to prevent the soft throat tissues from collapsing and obstructing the airway. Dentists with training in oral appliance therapy, such as myself, can construct and fit these appliances to meet their patients individual needs. By bringing the the lower jaw forward, the tongue is held off the back of the throat, which increases the airway size. This allows more air to flow freely while you sleep.

If you have any further questions or wish to book an appointment with me, please do not hesitate to call our office at 905-666-1555.

Dentistry on Dundas 2010 Scholarship Recipients are in!

Dentistry on Dundas gives back to the Community!

The dentists and staff at Dentistry on Dundas would like to take this opportunity to congratulate the recipients of the 2010 Dentistry on Dundas Scholarship Award.

For the past 12 years each scholarship, worth $500, was awarded to one student from each Whitby area high school. The scholarship is awarded to the student with the highest marks in math and sciences, with the condition the student is registered into a University Program the proceeding year. You can also check out the news in Snap magazine!

Congratulations to the following students!

Father Leo. J. Austin
Rick Buczynski

Sinclair Secondary
Francis Choi

Anderson C.V.I.
David Skinner

Henry St. Highschool
Katherine Ibsen

EcoleCatholique ST-Charles Garnier
Justin Babin & Cristina Lessard

All Saints Catholic Secondary

Matthew Sangoi

Donald A Wilson
Tanvi Medhekar

Voted Best Dental Office in the Oshawa/Whitby Reader's Choice Award.

Thank you for voting us Best Dental office 10 years in a row.
Dentistry on Dundas Creating Great Smiles for a Great Community!

We are the proud recipients of the Diamond Award in the Best Dental Office category!

And Congratulations to Dr. Librach for his Platinum Win in the Best Dentist Category!