After practicing dentistry for 20 years, I love a dental challenge! One of the hardest things to do esthetically as a dentist is to recreate a front tooth so that it exactly matches the surrounding teeth. Though I enjoy doing full mouth veneers and implants, some of my most rewarding experiences as a dentist have been artistically recreating a single front tooth. Teeth have unique characteristics, and trying to duplicate those can be quite difficult. But 6 years ago, our practice invested in a new CAD/CAM technology and a set of custom stains and ceramics that we can use to create perfectly matching dental restorations in just a few minutes.
Recently, a patient called us in the middle of his workday and let us know that he had just banged his right front tooth with a glass and had broken half of it off. We told him to come right over. Using our CAD/CAM software, we were able to copy the adjacent tooth and mirror image it to recreate the one that he had broken. His ceramic CAD/CAM crown was then custom pigmented to match his teeth…a slightly yellow-brown hue at the gumline and white speckling at the edge. When he saw the finished crown in the mirror, he exclaimed, “My wife is never going to believe I broke my tooth today!”
On another day, an attractive grandmother came to us as a new patient just wanting a new dentist for her exams and cleanings. When I asked her how she felt about her mismatched crown on her front tooth, she said, “Oh, it has been redone three times, and they could never get the color right.” I asked her to let me try using our CAD/CAM system. Her shade was tough! We made a beautifully shaped crown and added custom stains, but when we tried it in, it was a little too grey. Since it was the end of the workday, I sent her home with the “too grey” crown cemented in place temporarily and told her I would recreate another crown overnight that we could try in the next day. It took a bit of work to get the pigmenting just right, but when she returned, we had a perfectly matching crown! She was so thrilled having previously thought that she would always have unattractive, mismatched front teeth.
Just this month, a teenage girl was brought to us by her mother, unhappy with the bonding that had been placed on her front tooth a few years ago. The bonding had discolored and chipped and was no longer esthetic. We decided to use our CAD/CAM system to make a ceramic veneer. Her mom was skeptical of whether or not it would match, stating that another dentist had recommended that BOTH front teeth be veneered to ensure symmetry. I convinced her to let me try custom staining a single CAD/CAM ceramic veneer custom made for her in our office. After adding a little blue near the edge to mimic her translucency, some light yellow chroma at the gumline, and some faint white speckling, we bonded the veneer in place. When she looked in the mirror she said, “I can’t believe it! I am now so obsessed with my front teeth!”
CAD/CAM technology has revolutionized how quickly we can recreate a perfectly shaped tooth. Designing the crown on the software and then custom staining it to get an exact match adds an additional artistic component that my team and I truly enjoy. Knowing we can give someone an immediate, beautiful repair of a smile they have been trying to hide is one of the reasons we LOVE what we do.