aesthetic dentistry; It is a valuable branch of dentistry that deals with the reorganization of the mouth and teeth area in terms of health and aesthetics. The main theme is a healthy smile design.
Smile design is to renew an individual ideal smile with health and naturalness. What is valuable is to create the aesthetic smile that suits you within the scope of medical rules.
In addition to their main functions (chewing, speaking..), our teeth greatly affect our self-confidence in society in terms of aesthetics. Our smile is a very valuable factor in our connection with people. Color and mood disorders in the teeth can cause problems up to mental disorders in the individual. He has shown that he is much more satisfied and successful in business and daily life than other individuals. Our teeth reflect our smile and our smile reflects our strength. A beautiful smile means personal self-confidence. The science that deals with this in dentistry is called ‘aesthetic dentistry’.
The aesthetic dentist should first know his patient and perceive his expectations. It should not be forgotten that the treatment that should be applied to each individual is different. Here, many bets such as our patients’ special tastes, socio-economic level, occupational factors, etc. should be examined. Then, physical factors come into play. The aesthetic dentist should design a smile that the patient will perceive as admirable and attractive, and correct the imperfect view. The goal is to create an aesthetically acceptable and biologically compatible set of teeth for the patient. For this, if necessary, the preliminary examination should be very long, the diagnosis models and photographs of the patient should be taken, the expected result should be expressed in a complete and clear form. Aesthetic dentistry is a very sensitive scientific study. Health should not be compromised in the name of providing the ideal view. Aesthetic surgeons, aesthetic dentists continue to work within certain medical rules. Below we will tell you which factors are effective in aesthetic arrangement.
There are obvious head angles and proportions present in the mouth, face and head region. When treatment is performed according to these rules, it will be almost guaranteed to achieve an aesthetic view. However, we would like to point out that aesthetics is a relative concept and not everyone’s aesthetics may fit. For example, while I find the person ‘A’ very pleasant, another person may not find it very pleasant. Therefore, understanding the patient’s expectations is the most valuable criterion in aesthetic dentistry.
As a result, the dentist will decide on the technique applied and the material used. Before starting treatment, the quality of the device and its suitability for the patient should be determined. A sound decision-making ability, a desire to improve his technical skills, and always trying to be aware of new works should be combined with his natural aesthetic perception and vision, which is the most valuable feature that your doctor should have.
FACTORS AFFECTING SMILE
3) facial features
5) Color, form and arrangement of teeth
As we get older, there are some changes in our face.Image
For example, while the gap between the hairline and the middle of the eyebrows, the middle of the eyebrows and the tip of the nose, the tip of the nose and the tip of the chin is equal at young ages, the tip of the nose and the tip of the chin approach each other as the age progresses. In other words, the lower 1/3 of the face is shortened. This is caused by the sagging of some areas by gravity, the wearing of the teeth depending on time, and the decrease in the vertical dimension as a result of bone resorption. For example, when we laugh at a young age, more upper teeth appear, while as we age, more lower teeth appear. In such a case, the most active treatment method is porcelain onlays covering the chewing surface of the teeth and porcelain laminate veneers in the anterior region. In this way, both ideal aesthetics are provided and the loss of distance caused by shortening of the teeth is corrected.
Another reason that occurs with age is physiological discoloration. Some color changes occur in the teeth as a result of the erosion of the enamel layer, which is the tooth layer, such as tea, coffee, cigarettes, alcohol, etc. consumed for years. In such a case, this problem can be solved by first polishing (tooth polishing) and bleaching (teeth whitening). The important point is that these processes look as natural as possible.
There are significant differences between smiles and teeth in men and women. In women, the teeth are more rounded and the corners turn softer. In males, the teeth are more straight and angular. In females, the anterior middle 2 teeth are larger and longer, and the lateral teeth next to them are smaller. In males, there is no significant size difference in the middle of the front 4 teeth. In females, the laughing border follows the lower lip slopingly. In men, the laugh line is straighter.
There is a harmony in the middle of the face form with natural teeth. For example, if you have an oval face, the shape of the teeth is oval or close to oval. Square turns on square faces, angular, and round turns on round faces will look more popular. Sometimes we have difficulty in catching this harmony and resort to some illusions. For example, a person who is fat and does not have a long face can be made to look thinner and longer by making long teeth.
COLOR, CONDITION AND ORIGIN OF TEETH
If there is a color problem on the tongue, polishing should be done first and then teeth whitening should be done. If the applied treatment does not give results (in some discolorations, it is difficult to achieve the desired result with tooth whitening), coating the tooth surfaces with porcelain laminate veneers or composite filling material will be the appropriate treatment. In some cases, both can be applied.
If there are deformities in the teeth, active analysis can be provided with porcelain laminate veneers. In this case, for example, your very small lateral tooth will be aesthetically pleasing with porcelain laminate veneers, which are adhered on with only minimal abrasion from the front surface of the tooth. If there is a gap (diastema) in the teeth, the closest treatment is porcelain laminate veneer applications or composite applications. With these techniques, cavities in the middle of the teeth can be easily closed. If there are abrasions on the front teeth and fractures at the ends, you can easily achieve an aesthetic smile with one-to-one techniques. If there are old fillings in the front teeth, these fillings must first be renewed and evaluated aesthetically. However, this is about the doctor’s planning, as we said at the beginning. For example, in a person who consumes a lot of tea, coffee and cigarettes, the filling edges will become colored again in a short time. In this case, the most appropriate solution would be porcelain laminate veneers. The reason is that the laminates absorb color.
Another issue to be considered in color problems in teeth is the skin color of the person. Skin color is very active in determining the color of the application to be made. In individuals with dark skin color, very light-colored teeth will distract the landscape from naturalness. In individuals with light skin color, these teeth will look much more natural and aesthetic.
If there is crowding in the teeth, orthodontic treatment (braces) should be recommended first. In this way, the teeth will be both healthy and ideal aesthetics with the most protective formula. Proper alignment of the teeth, active chewing, and smooth speech are as valuable in aesthetic consultation.
Having healthy gums is the most valuable criterion in oral and dental health. However, sometimes even if the gums are healthy, it can spoil your image, and even the nicest teeth may not look impressive. Healthy gingiva has the appearance of pink and orange peel. Swollen, red and shiny gums due to periodontal disease should definitely be treated.
Image These are porcelain leaves that adhere to the front surfaces of the teeth. It is one of the most conservative (preventive) treatments that can be done. This is because too little tissue is removed from the tooth for veneers to be made. It is sufficient to remove an average of 0.3-0.7 mm of tooth tissue. Then the veneers are prepared in the desired color and form and adhered. They are very successful aesthetically, as they are very thin and do not contain metal. Laminate veneers have a unique ability to allow light to pass through, making the applied teeth look completely real. With this feature, it looks like a real tooth in flash and disco lights. (In these lights, the metal coatings appear as black stains, as if they were not in the mouth). The light transmittance of laminates also varies according to the porcelain used and the manufacturing technique.
The course of treatment is short. In the first examination, an impression is taken from the patient before the teeth are cut. With this model, mock-up (rehearsal work) application is made from a special material in the laboratory. The doctor and the patient have the chance to reach a consensus on this 3D model. In this way, you will have the chance to see how you will look in 3D before your teeth are cut.
Afterwards, the teeth are prepared with a short and painless process and impressions are taken. Plastic discontinuous veneers made in the form and length that you and your doctor decide together are adhered. These are also valuable in protecting your teeth until porcelain veneers arrive. At the same time, these transients see a second 3D model mission for necessary corrections. The harmony of the teeth with the face is checked, and the ideal smile is determined with the necessary abrasions and attachments. According to this model, porcelain veneers are prepared and adhered in the laboratory.
Although porcelain veneers are very thin, they are very resistant to breaking when adhered. The bonding process takes place with a special procedure (bonding resin) and it is not possible to separate the laminate veneer from the tooth after bonding. However, they can be removed by abrading like natural teeth.
Laminas are indistinguishable from natural teeth as they require minimum preparation, are not stained with spies such as cigarettes, tea or coffee, and have light transmission properties. Therefore, it has been the most ideal aesthetic treatment method applied today.
WHO CAN APPLY LAMINATE VENEER?
* Those with broken front teeth
* In eliminating the level, color, differences in the middle of the teeth. Beans-anterior opening (If the patient does not want orthodontic treatment)
* Those who have worn upper surface of their teeth
* Those with large fillings and dark teeth in their front teeth
* Those who are not happy with the color of their teeth (Tetracycline discoloration, etc.)
* In crooked teeth, if the patient does not want orthodontic treatment
* Those with gaping teeth
* Those who are not happy with the shape of their teeth (long, short, small, etc.)
* Gaining a wide -U- shaped laugh border and thus providing energetic and natural pleasantness
Laminate veneer can be applied to anyone who wants to have a pleasant smile without damaging their teeth.
WHAT ARE THE ADVANTAGES OF LAMINATE VENEER?
• It is one of the most conservative (protective) treatments that can be done. This is because there is very little tissue to be removed from the tooth before veneers can be made. Only an average of 0.3-0.7 mm of matter is removed from the anterior surface of the tooth. Thus, no teeth need to be cut (reduced).
• The treatment period is short. You will get an original smile in 2 or 3 appointments.
• With the model that will be specially prepared for you, you can see what kind of image you will have in your mouth in 3D before your teeth are cut.
• The real indication is the teeth that are integrated with the face of the person so that they cannot be noticed quickly by other people when done with a true technical and adequate smile design.
• It is not possible to separate it from the natural tooth as it has a light transmission feature. The more light transmission a laminate veneer has, the more natural the result will be.
• Its beautifully polished porcelain surface minimizes the formation of tartar.
• It does not change color with external factors such as coffee, tea, cigarette.
• It is quite fragile as a material. However, when fully bonded to enamel, its resistance to tensile and tensile forces becomes very high. For example, it is not possible to completely remove an adhered veneer from the tooth. However, it can be removed by abrading from the tooth surface with diamond burs.
• It has high resistance to abrasion.
WHAT ARE THE DISADVANTAGES OF LAMINATE VENEER?
• Its cost is higher than other treatment alternatives.
It is a delicate technique. It requires an appropriate clinical and laboratory study. The physician and the dental technician must have full technical knowledge and artistic ability on this issue.
FULL PORCELAIN AESTHETIC CROWS WITHOUT METAL REINFORCEMENT
The most basic rule of making an aesthetic tooth is that the tooth we make is the closest to nature. So we can also say,
Let’s make such a tooth that it looks natural despite all its perfection and it is not certain that it is artificial.
Porcelain teeth have been a preferred material in dentistry for a long time due to their closeness to the natural structure and durability.
However, when compared to natural teeth and metal-based porcelains, light transmittance, color formation, dullness in appearance, color changes in the gums, etc. It has been observed during the long years of application that it has negative advantages and solutions have been sought for this problem. The metal substructure under the ceramic superstructure has been seen as the reason for these disadvantages and new alternatives, which are solid in form but more aesthetic, have been produced instead.
Ceramics without metal reinforcement have started to be used as a result of this search.
While many things affect the image of crowns, the most valuable is their reaction to light. Natural teeth transmit light. As a result, depth and vitality appear in the tooth. Due to the light transmission properties of metal-free porcelain crowns, their depth and vitality are greater, thus providing the closest visual results to natural teeth.
ADVANTAGES OF FULL METAL CROWS WITHOUT METAL REINFORCEMENT
• Full porcelain crowns; Since their light transmittance is identical to the natural tooth structure, they create an aesthetic appearance, while metal-reinforced porcelain has a dullness and artificiality, even if it is made very appropriately. For this reason, full porcelain crowns are preferred especially for anterior teeth.
• Metal-based porcelains are mechanically bonded to the tooth. Full porcelain is attached to the tooth mechanically and chemically. Therefore, their retention is much higher than metal supports.
• Since there is no metal in the infrastructure in metal supporters, a dark line does not occur at the crown-gingival level. A more aesthetic appearance is provided in collet units.
• While metal-based porcelains appear exaggeratedly white in certain lights (purple light, flash and spotlights, etc.), the existing natural teeth give a dark space image as if they were not present in the mouth. In full porcelain, this distinction is not clearly felt.
• In porcelains without metal reinforcement, prostheses do not press on the gums due to their tooth cutting properties, and gingival disorders and gingival recession are less common.
• When the gingiva recedes, full porcelains preserve their aesthetic appearance, while metal-reinforced porcelain creates an unfavorable view in the area where they join with the tooth.
• There is no risk of allergy against some metals (nickel, etc.) used in the infrastructure in full porcelain.
• Zirconium oxide is tissue compatible and does not cause allergies.
• Studies have shown that it is in perfect harmony with the gums.
• It has the feature of being glued and tested discontinuously.
IPS – EMPRESS II CORONS
It is obtained by compressing the reinforced porcelain in special machines and firing at high temperatures. It is preferred especially in anterior teeth because of its very smooth light transmission. It is not strong enough for the posterior region, especially against the chewing forces. However, its high aesthetic advantages in the anterior regions are the reasons for its preference.
ZIRCONIUM BASED BRIDGES
In this system, zirconium, a white alloy, is used instead of metal as a substructure. It is the only tool that has the feature of presenting this infrastructure, which is a state-of-the-art work, with aesthetics and durability in the middle. The biggest advantage of the system is that it provides a full aesthetic appearance in bridges in the back region with its very high durability.
WHAT IS ZIRCONIUM?
For many years, a metal substructure has been used under the porcelain tooth for durability in porcelain applications. Since it is known that this metal infrastructure has disadvantages in terms of gums, bad breath, general body health, and most importantly, aesthetics, the search for an alternative material to metal in the porcelain infrastructure has been going on for years. A new phase was opened with the application of zirconium, which was used successfully in other fields of medicine before, instead of porcelain metal in dentistry.
Because these new zirconium-based porcelain veneers do not cause gingival problems and allergies, as well as provide aesthetics and functions close to natural teeth with their light transmission feature.
Crowns and bridges made by placing porcelain on zirconium are called CERCON, which is a combination of the words Ceramic and Zirconium. The system with 900 Mpa-1200 Mpa resistance has started a brand new era in dentistry by including the highest physical costs, light transmission feature, tissue harmony and many different indications.
The success of the material has been proven in the field of medicine and industry. As a result of the researches started in 1988, clinical applications have been started all over the world since the beginning of 2002. With this new application, the patient’s aesthetic concerns in metal-ceramic and all-ceramic repairs are definitely eliminated.
WHERE CAN IT BE USED?
• Single tooth crown restorations
• Types of bridges
• Implant crown-bridge studies.
HIGH TECHNOLOGY FOR PERFECT RESULTS
Until now, zirconium oxide was not used in dental applications due to its high cost in production. Thanks to a project developed by the Zurich Federal Institute of Technology, zirconium oxide has become economically usable in dentistry. Zirconium has also been used in medicine since the 1960s. The reliability of the device has been proven by long-term studies.
Zirconium has been used for various purposes in various parts of the body, especially in hip joint prostheses, and it has been determined that it does not have any side effects or damages, and does not cause allergies.
Zirconium is an element that is resistant to high temperatures and impacts, light, does not conduct heat and electricity, and can transmit light.
In addition, it is a healthy tool that does not cause taste disorders, gum problems and bad breath in the mouth.
A wax model of your teeth is prepared on the model prepared with the impression taken on your teeth. A computer-based device (CAD CAM) prepares the infrastructure of your teeth by abrading the zirconium oxide block in line with the information it receives from this model. The milled block is colored with a special length and technique that penetrates into the structure in accordance with the color selection. The painted substructures are given a tooth form by placing the appropriate color ceramic on them and the work is completed with the polishing process.
Now, strong and aesthetic prostheses without metal reinforcement can be successfully made with zirconium oxide, which is a work of advanced technology.
COMPATIBLE WITH BODY AND TEETH ON ALL SIDES
There are also some valuable advantages of Cercon applications for users. Cercon ceramic placed on the zirconium oxide infrastructure reduces the adhesion rate of food wastes and microorganisms to the tooth surface. Thus, proper oral hygiene is provided. Zirconium oxide does not conduct heat, your teeth do not become sensitive when you take hot and cold foods.
One of the most valuable features of zirconium is its antibacterial properties. Bacteria cannot settle and reproduce in the zirconia structure. Therefore, the prosthetic foot is extremely advantageous because it protects the teeth and does not cause bad breath.
As a result, it can be said that; Cercon is the highest quality work ever achieved in terms of aesthetics, durability, tissue harmony and naturalness, which are the basic needs of contemporary dentistry.