The Esthetic-Add-On: Treating Small Esthetic Issues
Did you know that you could use Emax to change the contour, shape or color of an unprepared tooth that may be an esthetic solution on its own or even compliment some of your own restorative work? Maybe patient finances dictate that you treat #8, #9 and #10 only, even though #11 is too short for overall smile symmetry. With lithium disilicate, you can now safely bond ceramic length to a short tooth like this at a reasonable cost. We call these pieces esthetic-add-on’s or EAO’s. How about the diastema that your patient wants you to fix with composite, but you don’t want to own the future staining and chipping cost that goes with it. What about the wounded crown or bridge? Every practice will occasionally see fractured porcelain on their fixed restorative cases and these EAO’s can be the perfect solution. Translucent lithium disilicate will always mimic the color that it is bonded to, so the chipped porcelain area can be a great canvas for a small repair over the existing ceramic! All of this is about etching and bonding! Today the lab can fabricate very beautiful, well fitting pieces of translucent Emax that will draft the color of the underlying tooth and be virtually undetectable. Fig. A thru E.
When we focus on a patient’s anterior teeth, it can be rewarding to imagine what small contour changes could be made to make a large esthetic difference. You may be committed to comprehensive esthetic dentistry, but remember, every practice has patients that want a beautiful smile without having to pay for the number of prepared teeth necessary to get there. Most of you are committed to conservative preparations without realizing that preps aren’t always necessary or need nothing more than light enamel plasty. No matter what, you want to use all of the tools in the box to reach maximum esthetic success on each and every case!
Many times the #6 thru 11 case you want to do, turns into the five-unit case that esthetically defaults to the questionable shape or size of the untreated loner. We can sometimes make a three-unit case appear like a six-unit case, by placing only one esthetic-add-on. Fig. F through K.
Maybe you have restored a patient’s upper anterior and the Para-function of the pre-existing teeth left some of the lower teeth worn short. This is an easy fix when you use Emax to reclaim the correct length. Fig. L, M, and N.
Always bear in mind that the rules for hiding margins is pretty much the same as it is for composite. Vertical margins tend to disappear more easily than horizontal margins. If you have to use a horizontal margin, avoid making it a straight line and always finish every margin flush with the enamel. Finely finished and polished margins are critical to esthetic success.
Our lab has been using esthetic-add-ons for over five years and it has been fun and rewarding! We learned a lot about the when and where to use these small restorations and the most surprising part has been in how many situations they can be applied. Once you know it can be done, the only limit is your imagination. Have fun and create!
- Dene LeBeau
Dental Street Blog