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Before and After 2013: Smile Makeover – Implant Zirconia Bridge with Gum Porcelain

An Asian patient in her 40s was depressed about the aesthetics of her smile. She had several attempts to replace the restorations to achieve natural aesthetics, which she found difficult. She was looking for “a durable, functional and, most of all, a beautiful smile” in her words.   The treatment plan is to replace the existing restorations – 12-22 Screw-Retained Implant Bridge, and crowns on the canines - 13 and 23. To maintain the same property and material in the superstructure, we decided to use Zirconia with Ti interface abutment for the implant connections.   Fig 1 shows the pre-op condition. The aesthetical and functional issues we need to address are: correction of the midline cant achieving a sense of symmetry on the central...

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Reproducing Nature Part 4: Smile Design

LVI Visions featured Yugo’s article titled ‘Reproducing Nature: Smile Design in 2008 (published language: English).   Introduction:   Today, creating a natural-looking smile is essential in cosmetic/aesthetic dentistry. As I mentioned in the first part of this article (European Journal of Eesthetic Dentistry Winter 2008), many people think that white “Hollywood Smiles” look fake but is it true? Have you thought about bleached natural dentition? I think it looks healthy and attractive but doesn’t look fake at all. That is the type of benchmark I set for myself when the patient is after a perfect smile – i.e., bright yet natural.   Now, what is the definition of “perfect” anyway? Does it mean that it’s perfectly in proportion, perfectly adapted to the patient’s desire or could...

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Before and After 2009: Soft-Tissue Management at the Socket on Pontic Sites

A Caucasian male in his 70s had presented with failed roots on the lateral incisors (12 & 22). The patient was also concerned about the aesthetics of the overall smile, wanting to have a youthful look. We commenced the case with 2 x Zirconia bridges 13-11 & 21-23.   Fig 1 shows the pre-op condition. 12 and 22 were extracted, and the soft tissue was managed during the temporary stage by the treating prosthodontist. Fig 2 shows the remarkable state of the soft tissue recovery.   Communication in the shade taking is essential between the clinician and ceramist. The shade tab should be placed edge to edge position, as shown in Fig 3. Fig 4 shows the completed Lava zirconia bridges (13-11 & 21-23). Note...

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