Aesthetic dentistry is an important branch that deals with the reorganization of the oral and dental region in terms of health and aesthetics. The main theme is a healthy smile design. Smile design is to renew personalized ideal smile with health and naturalness. The important thing is to create the aesthetic smile that suits you within the medical rules. In addition to their main functions (chewing, speaking, etc.), our teeth also affect our esthetic self-esteem in society.
Our smile is a very important factor in our communication with people. Teeth color and shape disorders can cause problems up to psychological disorders in the individual. Research has shown that an individual who trusts his laughter is much happier and more successful than other individuals in his social, work and daily life. Our teeth reflect our smile and our smile reflects our energy. A beautiful smile means personal self-confidence. The branch of science that is interested in this is called ‘aesthetic dentistry’.
Aesthetic dentist should first recognize his patient and perceive his expectations. It should not be forgotten that the treatment to be applied to each individual is different. Here, special tastes of our patients, socio-economic level, professional factors, etc. Many issues such as should be examined. Then physical factors come into play. The aesthetic dentist should design a smile that the patient perceives as pleasant and attractive and correct the defective image. The aim is to produce a dental sequence that is aesthetically acceptable and biologically compatible for the patient. If necessary, pre-examination should be kept too long, diagnostic models and photographs of the patient should be taken and the expected result should be expressed clearly and completely.
Aesthetic dentistry is a very sensitive scientific study. Health should not be compromised in order to provide the ideal image. Aesthetic surgeons, aesthetic dentists, work under certain medical rules. Below we will tell you which factors are effective in aesthetic regulation.
There are certain angles and proportions present in the mouth, face and head region. When treated according to these rules, it is almost guaranteed to achieve an aesthetic appearance. But we want to point out that aesthetics is a relative concept, and not everyone’s aesthetics can match. For example, while I find the person ‘A’ very nice, another may not find it very nice. Therefore, understanding the patient’s expectations in aesthetic dentistry is the most important criterion.
As a result, the dentist will decide the technique and the material used. The quality of the material and its suitability for the patient should be determined before starting treatment. A solid decision-making ability, a desire to develop technical skills, and an ongoing effort to stay informed of new products should be combined with the natural aesthetic perception and vision, which is the most important feature your physician should have.
FACTORS AFFECTING SMILES
- Facial features
- Color, shape and sequence of teeth
As we age, there will be some changes in our faces.
For example, while the distance between the hairline and the eyebrows, between the eyebrows and the nose tip, the tip of the nose and the tip of the chin is equal to each other at a young age, the tip of the nose and the tip of the chin approaches each other. In other words, the lower 1/3 of the face is shortened. This is caused by the sagging of some areas by gravity and the time-worn erosion of the teeth and the decrease of the vertical dimension as a result of bone resorption.
For example, when we laugh at a young age, more upper teeth appear, and as our age progresses, more lower teeth appear. In such a case, the most effective treatment method is porcelain onlays, which include the chewing surface of the teeth, and porcelain laminate veneers in the anterior region. Thus, both the 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 coloring.Consumed for years tea, coffee, cigarettes, alcohol, etc. sometimes also As a result of abrasion of the tooth enamel layer which is the tooth layer, some color changes occur in the teeth. In this case, this problem can be solved by first polishing and bleaching. The important point is that these processes appear as natural as possible.
There are significant differences between smile and teeth in both 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 are smaller. In men, there is no significant size difference between the front 4 teeth. In women, the laughing line follows the lower lip inclined. In males, the laughing line is flatter.
There is a harmony between natural teeth and face shape. For example, if you have an oval face, the form of the teeth is close to the oval or ovale. Square on square faces, rounded corners on round faces will look more pleasant. Sometimes it is difficult to achieve this harmony and we resort to some illusions. For example, a fat and long-faced person, long teeth can be made by making the face look thinner and longer.
COLOR, SHAPE AND ORDER OF TEETH
If there is a color problem in the tongue, polishing should be done first and then teeth whitening should be done. If the treatment does not produce any results (in some discolorations, it is difficult to achieve the desired result with tooth whitening), it would be appropriate to cover the tooth surfaces with porcelain laminate veneers or composite filling material. In some cases both can be applied.
Porcelain laminate veneers can provide effective solutions if the teeth have deformations. In this case, for example, your lateral tooth, which is too small, will be aesthetically captured with porcelain laminate veneers adhered to it with only minimal abrasion from the front surface of the tooth. If the teeth have a diastema, the closest treatment method is porcelain laminate veneer or composite applications. With these techniques, gaps between teeth can be closed easily.
If there are abrasions and fractures on the front teeth, you can easily reach an aesthetic smile with the same methods. If there are old fillings in the anterior teeth, these fillings must be renewed and evaluated aesthetically. But, as we said at the beginning, this is related to the planning of the physician. For example, in an individual who consumes a large amount of tea, coffee, cigarettes, the filling edges will soon be colored again. In this case, the most suitable solution would be porcelain laminate veneers. The reason is that the laminates absorb color.
Another issue that should be considered in color problems in teeth is the skin color of the person. Skin color is very effective in determining the color of the application. In individuals with dark skin color, very light teeth will remove the image from naturalness. In individuals with light skin color, these teeth will look much more natural and aesthetic.
Orthodontic treatment (dental braces) should be recommended if there is a perplexity in the teeth. Thus, the teeth will be both healthy and ideal aesthetics with the most protective method. Correct alignment of teeth, effective chewing, proper speech is as important as aesthetic
Healthy gums are the most important criteria in oral and dental health. But sometimes even if the gums are healthy, it may spoil your appearance, even the most beautiful teeth may not look impressive. Healthy gums look like pink and orange peel. Swollen, red, bright-looking gums should be treated due to periodental disease.
Porcelain leaves that stick to the front faces of the teeth. It is one of the most conservative treatments. This is due to the small amount of tissue removed from the tooth so that veneers can be made. An average of 0.3-0.7 mm is sufficient to remove the tooth tissue. The veneers are then prepared and adhered to the desired color and form. They are very aesthetically successful because they are very thin and do not contain metal.
Laminate veneers have a unique ability to allow light to pass through, making the teeth to which it is applied look like real. With this feature, it looks like a real tooth in flash and disco lights. (In these lights, the metal-containing coatings appear as black spots like they dont exist in the mouth). The light transmittance of the laminates also varies according to the porcelain and construction technique used.
The treatment process is short. In the first examination, a measurement is taken from the patient before the teeth are cut. With this model, a special material mock-up is applied in the laboratory. The doctor and patient have the chance to agree on this 3D model. This way, you will have the chance to see how you will be in 3D before your teeth are cut.
Then, the teeth are prepared by a short and painless process and taken. Plastic temporary veneers made in the form and length that you and your physician decide together are adhered. They are also important for protecting your teeth until porcelain veneers arrive. At the same time, these transients serve as a second 3D model for the necessary corrections. The compatibility of the teeth with the face is checked and the necessary smile is determined with the necessary abrasions and additions. Porcelain veneers are prepared and adhered in the laboratory according to this model.
Although porcelain veneers are very thin, they are very resistant to breakage when bonded. Bonding with a special method (bonding resin) takes place, and once bonded, it is not possible to separate the laminate veneer from the tooth. However, they can be removed by abrasion as natural teeth.
Laminae are indistinguishable from natural tooth because they require minimum preparation, they are not stained with agents such as cigarettes, tea, coffee, and light transmission properties. Therefore, it has become the most ideal aesthetic treatment method applied today.
WHO CAN APPLY LAMINATE VENEER?
In the front teeth fracture
level between teeth, color, to eliminate differences.
Beans-anterior opening (if the patient does not want orthodontic treatment)
In case of eroded upper surface.
Anterior teeth with large fillings and dark teeth
Are not satisfied with the color of their teeth (Tetracycline coloration, etc.)
Crooked teeth, the patient does not want orthodontic treatment
in the dental range
Unsatisfied with the shape of the teeth (long, short, small, etc.)
To gain a wide -U-shaped laughing line and thus provide energetic and natural beauty
Thus, laminate veneer can be applied to anyone who wants to have a beautiful smile without damaging their teeth in providing energetic and natural beauty .
WHAT ARE THE ADVANTAGES OF LAMINATE VENEER?
It is one of the most conservative treatments. This is due to the small amount of tissue to be removed from the tooth for veneers to be made. Only 0.3-0.7 mm of material is removed from the front surface of the tooth. Thus, no teeth need to be cut (reduced).
The treatment period is short. You get a whole new smile on 2 or 3 dates.
With the model that will be prepared for you, you can see how you will have an appearance in your own mouth in 3D without cutting your teeth.
The right indication is the teeth that are integrated with the face of the person when they are made with the right technique and a good smile design.
It is not possible to separate it from the natural tooth since it has light transmission. The more light transmission a laminate veneer has, the more natural the result is.
The highly polished porcelain surface minimizes calculus formation.
It does not change color due to external factors such as coffee, tea and cigarettes.
The material is quite fragile. However, when fully bonded to the enamel, its resistance to tensile and tensile forces is very high. For example, it is not possible to remove a stuck veneer from the tooth as a whole. However,
it can be removed by abrading from the tooth surface with diamond burs.
it has high abrasion resistance
WHAT ARE THE DISADVANTAGES OF LAMINATE VENEER?
It costs more than other treatment alternatives.
It is a delicate technique.
Requires good clinical and laboratory work.
The physician and dental technician must have full technical knowledge and artistic ability on this subject.
FULL PORCELAIN AESTHETIC CROWNS WITHOUT METAL SUPPORT
Estetik bir diş yapmanın en temel kuralı yaptığımız dişin doğala en yakın görünümde olmasıdır. Yani şöyle de söyleyebiliriz,
The most basic rule of making an aesthetic tooth is that the tooth we make is the closest to nature. So we can say,
Let’s make a tooth so that despite all its perfection, it seems natural and it is not clear that it is artificial.
Porcelain teeth have been a preferred material in dentistry for a long time due to its proximity to natural structure and robustness.
However, when compared to natural teeth and metal supported porcelains, it has been observed that light transmittance, color formation, opacity in appearance, discoloration of gums etc. have been observed during long years of application 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 have been produced which are equally robust but more aesthetic.
Ceramics without metal support were used as a result of this search.
Although many things affect the image of crowns, the most important is their response to light.
Natural teeth pass the light. As a result, the depth and vitality of the tooth is revealed.
Porcelain crowns without metal support have a greater depth and vitality due to their light transmission properties, thus achieving the closest visual results to natural teeth.
ADVANTAGES OF FULL METAL CROWNS WITHOUT METAL SUPPORT
Full porcelain crowns; While their light transmittance is identical to the natural tooth structure, it creates an aesthetic appearance, even if it is very well made, metal supported porcelain has a dullness and artificiality. For this reason, full porcelain crowns are preferred especially in the front teeth.
Metal supported porcelains are mechanically bonded to the teeth. Full porcelain is attached to the teeth mechanically and chemically. Therefore, they have a much higher retention than metal supports.
Since there is no metal in the substructure in crowns without metal support, a dark line does not occur at the crown-gingival level. A more aesthetic appearance is provided at Kole filling endings.
Metal-supported porcelains appear exaggerated in some lights (purple light, flash and spot lights, etc.), while the natural teeth present give the appearance of a dark void as if it doesnt exist in the mouth.
In full porcelain this distinction is not clearly felt.In porcelains without metal support, prosthesis does not put pressure on the gum due to its tooth cutting properties, gingival disorders and gingival recessions are less common.
When the gingiva is pulled, full porcelains retain their aesthetic appearance, while metal-supported porcelains create a bad appearance in the area where they merge with the tooth.
In full porcelain, there is no risk of allergy to some metals used in the infrastructure.(nickel etc.)
Zirconium oxide is a tissue compatible substance and does not cause allergies.
It has been found that it shows perfect compatibility with gums.
It has the ability to be temporarily bonded and tested.
IPS – EMPRESS II CROWNS
It is obtained by compressing the reinforced porcelain in special machines and firing at high temperature. Particularly, it is preferred in the front teeth because of its very good light transmittance. It is not sufficiently resistant to chewing forces, particularly for the posterior region. However, high aesthetic advantages are the reasons why they are preferred in the anterior regions.
ZIRCONIUM BASED BRIDGES
In this system, zirconium, a white alloy, is used instead of metal. It is the only material capable of presenting this infrastructure with aesthetic and durability together. The biggest advantage of the system is that it provides a very aesthetic appearance on the bridges in the back region with its very high durability.
WHAT IS ZIRCONIUM?
For many years, a metal substructure was used under the porcelain tooth for durability in porcelain applications. Since it is known that this metal substructure has gums, bad breath, general body health and most importantly aesthetic disadvantages, the search for an alternative material to metal in porcelain infrastructure has been going on for years. Zirconium, which has been used successfully in other fields of medicine, was replaced by porcelain metal in dentistry.
Because these new zirconium substructure porcelain coatings not only doesnt cause any gingival problems and allergies, but also provide light aesthetics and function close to natural teeth.
The crowns and bridges made by placing porcelain on top of the zirconium are referred to as CERCON, which is a combination of the words Ceramic and Zirconium. The system with 900 Mpa-1200 Mpa resistance has initiated a whole new era in dentistry by including the highest physical values, light transmittance, tissue adaptation and many different indications.
The success of the material has been proven in 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 aesthetic concerns of metal-ceramic and full-ceramic restorations in the patient are absolutely eliminated.
WHERE CAN I USE?
- Single tooth crown restorations
- Various bridges
- Implant crown-bridge studies.
HIGH TECHNOLOGY FOR EXCELLENT RESULTS
To date, zirconium oxide has not been used in dental applications due to the high cost of production. Thanks to a project developed by the Zurich Federal Institute of Technology, zirconium oxide has become economically available in dentistry. Zirconium has been used in medicine since the 1960s. The reliability of the material has been proved by long-term studies.
Zirconium has been used for various purposes in various parts of the body, especially hip joint prostheses.
up till today, it has been found that it has not had any side effects or harms, and does not cause allergies.
Zirconium is a high temperature, impact resistant, lightweight, heat and electrical conductive, light transmissible element.
It is also a healthy material that does not cause taste disorders, gum problems and bad breath in the mouth.
A wax model of your teeth is being prepared on the model prepared with the measure taken on your teeth. A computer-aided device (CAD CAM) prepares the infrastructure of your teeth by eroding a zirconium oxide block in accordance with the information it receives from this model. The milled block is colored with a special length and technique that works in the structure in accordance with the color selection. Painted substructures are placed on the appropriate color ceramic and tooth form is given and polishing process is completed.
Now, Zirconium oxide, which is a high-tech product, can successfully make strong and aesthetic prostheses without metal support.
COMPATIBLE WITH BODY AND TEETH IN ALL ASPECTS
Cercon applications have some important advantages for users. The cercon ceramic placed on the zirconium oxide substructure reduces the rate of adherence of food waste and microorganisms to the tooth surface. Thus, good oral hygiene is provided. Zirconium oxide does not transmit heat, and when you eat hot and cold foods, your teeth do not develop sensitivity.