Our case of the month for April was one involving E Max crowns by Ivoclar, which is our opinion, give the best aesthetic results. In the past, tooth coloured dental crowns had a layer of metal underneath for strength with the ceramic bonded on the outside. Now these could look perfectly acceptable but there were issues. Having two layers means that more of the underlying tooth has to be cut down to accommodate the material. For any of you that has read any of our posts knows that we believe in minimally invasive dentistry, cutting away more tooth than necessary just does not sit right with us. Another issue with metal ceramic crowns is that the metal layer may become visible over time as the gums recede which gives that classic grey line around the tooth. Not very desirable. One of the main advantages of ceramic crowns is that there is no metal underneath and this grey line will never be an issue. 

The aesthetic qualities of E max crowns are second to none. Our case shows that the crowns can be fully customised with translucency at the edges, varying shades, light reflection and opaque areas to name a few. The skill of the dental technician plays a huge role here and we work with some excellent laboratories know for excellence. 

For our case, Ceramic Studios in Kensington made the wonderful E max crowns fully which were fully customised.
 

Dental crowns are one of the most common dental procedures but many people are not aware what a crown is exactly. To be very simple, a crown is a new tooth surface that sits over your existing tooth to protect it.
 

We pride ourselves on being progressive and leading the way in modern cosmetic dentistry. In the old days, cosmetic dentistry was more about being invasive and cutting healthy tooth enamel for multiple veneers or crowns. Due to the advances in technology and materials this has all changed. These days, if a tooth does need a veneer or crown, then we will match this tooth with the other teeth as best as possible. This way, the adjacent teeth do not need to be harmed in anyway. Here is a classic example. Our patient required a front tooth crown. After some tooth whitening, a new crown was made in all ceramic. Just look at the result:
 

Our next case involved two front teeth which had two crowns. The patient was unhappy with the colour, shape and overall appearance of them. The main request was to provide a natural replacement. Front teeth are the first point of eye contact and as such extremely important in cosmetic dentistry. A number of factors must be assessed before treatment can begin and this starts with thorough planning. Initially, study models were prescribed and a diagnostic wax up. This is to enable the patient to see the anticipated final shape and contour of the crowns and compare them with the current situation. The wax up will also be used as the template for the final crowns and for the temporary crowns. The following photographs show how we dramatically improved the situation with cosmetic dentistry.
 

We are running a series of case studies to demonstrate the treatments and outcomes that have been achieved at Progressive Dentistry. Our first case was a long and complicated case involving failing crowns and bridges, which required a full upper arch rehabilitation. Initially the gum disease was treated by our Dental Hygienist and Therapist, Jenny Wiggins. This was done over a number of sessions with superb results. After all the failing crowns and bridges were removed, the patient wore a set of temporary teeth to allow the gums to heal and ensure that they could get used to the new design and bite. This was left for a period of 3 months. After full healing and adaptation, the temporary crowns and bridges were removed and a new set could be made. The difference in the gums and overall oral health was outstanding. The overall result was natural, aesthetic and met all of the patient requirements. 

Please view the series of photographs below:
 

Dental crowns are often an excellent way of restoring badly broken down teeth. However, for teeth that have failing fillings or have part fractured then adhesive dentistry is often the answer. With minimally invasive techniques and the latest technologies, we are able to restore teeth with inlays and onlays. These are made from gold or ceramic (porcelain) and only replaces the damaged part of the tooth. Crowns are destructive and involve stripping the tooth of precious enamel. Inlays and onlays adhesively bonded to teeth are far less destructive and provide a long lasting alternative to crowns. Porcelain is also a highly aesthetic and indistinguishable from natural tooth, an added bonus!