Rosemary's Before and After Dental Makeover

Beautiful Smiles are within your reach! Improvement in ones appearance can lead to greater confidence and zeal for life. See how Rosemary achieved her newly enhanced smile with the use of dental crowns.

                                       

Why was Rosemary a good candidate for these procedures?

She was motivated to improve her quality of life and her smile.  Her oral hygiene was good as well.

                                                   Before

After

 

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

We always start with exhaustive records.  We determine the challenges of the patient's bite, teeth and the surrounding structures. We discuss the patient's concerns and goals and set forth a realistic treatment plan that takes into account the patient's budget.  In addition, a  discussion of the procedures involved and the physical and emotional tolerances of the patient. This may include fears and length of treatments.
Was her treatment out of the ordinary?

The treatment was extraordinary in that it involved rather large space between the front teeth. We discussed all options from orthodontics to close the space to going directly to the restorations (i.e. Porcelain veneers and crowns).  Consultation with our ceramics lab prior to treatment, which included a diagnostic wax up (i.e. a wax mock-up of the final restorations), revealed that a satisfactory result was possible without the use of orthodontic treatment.  This meant that treatment could be completed in several weeks instead of several months or a year. Significant savings were possible by eliminating the orthodontic component. 

                                    Dr. Mark Librach, Dentist

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

Diane's Dental Makeover

Diane underwent several months of dental treatment to achieve her new smile. This included periodontal therapy, dental implants to support an anterior implant bridge and additional crowns on her upper teeth.

before

after

1. Why was Diane a good candidate for these procedures?

This patient presented with an advanced chronic Periodontal infection which required many steps in order to achieve healthy tissues and improve her overall health.

The fundamental basis of implant treatment is to make sure that the overall condition of the patients mouth is absolutely healthy. Otherwise, we can compromise the health and longevity of implant and prosthetic treatment. After treating the Periodontal disease and achieving a stable and healthy condition of the patients gums,then we proceeded with planning for the replacement and rehabilitation of the missing teeth.

2. How did you develop a plan for treating Diane's concerns?

The front teeth required removal as they were too compromised to keep them and treat them periodontally. The patient knew this from the outset and she also knew that the ultimate replacement will be done with an implant supported fixed prosthesis.

Once her teeth were extracted in the upper front, a bone graft was placed in order to maintain and regenerate her jaw bone which would provide an adequate anatomical area to place two implants. We allowed a period of 6 months of healing from the time of tooth extraction, bone grafting and implant placement.

A cone beam CT scan was done at the 6 month period and a virtual implant surgery was done in order to make a custom surgical guide. This guide was used during surgery I. Order to place the implants in he exact position required for this particular case.

 

3. Was her treatment out of the ordinary?

Her treatment consisted of first bringing back health to her gums and teeth, making sure that a stable periodontal condition was present in order to continue with her implant treatment plan. It's a very detailed plank which requires many steps in order to prepare the mouth for dental implant surgery.

4. How long did Diane's transformation take?

The treatment time was 16 months (?) I don't have marks notes so not sure when re placed the final bridge.

5. Is there an ideal candidate for these procedures?

The ideal candidate is always one which is healthy, complies with all appointments and instructions, and of course protects the final prosthesis with wearing a night guard and keeping all maintenance dental visits.

 Dr. Mark Librach Dentist

 

         

 Dr. Dana Levy - Periodontist & Implant Dentistry

 



Jonathan Mursic                                                        Connie

 5 Axis Lab                                                                Treatment Coordinator

 

 

Harry's Dental Makeover

Harry underwent a few procedures to achieve his new smile. This included crown lengthening of upper anteriors, new fillings and crowns on upper teeth.

Why was the patient a good candidate for the procedure?

This patient was a good candidate for the procedure because the anterior teeth that were involved, were constantly chipping and cracking for many years.

It was a long time goal to prevent and protect these teeth from further damage.

The restoration of crowns or caps were indicated.

The patint also followed a good oral hygiene regiment and was eager and compliant with respect to treatment.

 

 

Was his treatment ordinary?

Crowning vulnerable teeth is a typical practice in dentistry.

How long did the patient's transformation take?

There were a few preliminary procedures that were necessary prior to the actual placement of the crowns that involved a few extra appointments. The actually crowns took two appointments, two weeks apart, to complete.

What steps do these procedures involve?

Good oral hygiene must be a priority before any major restorations are placed. Tooth decay must also be eliminated with no symptoms present. One of the involved teeth required some gum reshaping and and root canal therapy in order to accept a crown.Subsequently, the crowns were prepared at one visit, and the crowns were permanently placed two weeks later.

Are there any homesteps patients should follow after procedures like this?

Continuous good oral hygiene is essential to maintain teeth and especially crowns

This includes regular checkups to the dentist.

A night guard is also recommended for certain procedures such as Harry's.

This is a guard that is worn during the night to protect the new crowns and prevent wear on the opposing teeth.

Dr. Michelle Lanys

Dentist

Dr. Dana Levy                                                             Connie

Periodontist                                                                  Treatment Coordinator

Jonathan Mursic RDT

5 Axis Lab



Dentistry on Dundas