Aesthetic Dentistry

Smile design allows us to analogically or digitally evaluate the form, shape, position and aspect of the teeth in relation to patient’s face. As a similitude, the skin and the lips are our “frame” of the “picture” (teeth and gingiva) which we have to paint.

We take pictures of the patient, and with them we will perform the analysis of the smile. This design will even allow us to perform an “in situ” essay, directly over the mouth of the patient (using a provisional material) without “touching” the teeth of the patient, it is a simulacre of the final result: a MOCK-UP. With this technique, the patient can imagine how he will look like at the end of treatment.

For the patient, it provides the illusion to know how the final smile can be. For the professional, it provides the peace of mind to know how the final result will be. Diagnosis and planification are essential!

It is necessary to master all the techniques related with dental aesthetics, to combine them adequately in every particular case. We have designed and directed for many years courses about dental aesthetics to learn and teach how to perform these techniques.

Dental aesthetics is one of the most creative parts of dentistry. In Clínica Dental Padrós-Creus Muntaner we have a room where we start the case study, taking fun, non-serious images, which are necessary for the aesthetic evaluations.

If you want us to study your case without compromise, don’t doubt to contact us.

A diastema is a separation between the teeth. The most common diastema is the one that develops naturally between the two upper central incisors. Although some people like it because they consider that it gives them personality, other wish to close that space. In this case, a good alternative is to make it with composite resins, without touching the tooth. In this case, we will adhere directly on the tooth enamel, place where the adhesion with resins is very effective.

Patients with periodontal diseases, who have suffered the loss of interproximal bone (between tooth and tooth) can develop “black triangles”, spaces between tooth and tooth which let the back of the mouth to be seen, significatively ageing the smile. This space can be filled with composite increments in both teeth, enhancing the aspect of the smile.

This same phenomenon can be seen in teeth with an excessively triangular shape, where the union is only present on the incisal border. As there is too much distance with bone (Tarnow’s law), gingival tissue (papilla) cannot fill all the space, and a black triangle is created. The only way to give the sensation that gingiva fills it is changing the shape of the teeth and transform them with composite in rectangular teeth.

Often wear is developed on the neck of teeth due to aggressive brushing or occlusal overloads. This type of defects on the surface of teeth can be repaired with composite resin, achieving an unnoticeable restoration.

Composite is a material which allows us to reconstruct quickly a fracture on a tooth, enamel defects… In only one session patient can solve the aesthetic problem. When the occlusion (how we close the mouth) is not favourable for the resistance of the material, we recommend to look for a stronger material. Nevertheless, if the repaired tooth does not receive unfavourable occlusal charges, the restorations can last for many years.

Sometimes shape changes are required to harmonize smiles; for instance, in cases of conoid lateral incisors (small and unproportioned), short lateral incisors – the use of composite is ideal. Besides, if the teeth of the patient have different tones, the use of different tints perfectly masks the restoration integrating it in the smile.

Colour changes in a unique tooth can also be achieved with composites, performing very thin layers with composites of different tones, even opaque ones.

Composite veneers are an exceptional treatment for patients who want to achieve a smile change without practically touching their tooth. Today microparticle composites on the final covering layer can guarantee a fantastic polishment. We recommend them especially in young patients, who don’t smoke, and with favourable occlusions.

Ceramic veneers are the “star” product for dental aesthetics. They are very thin coverings made of ceramic, which adhere to the tooth through adhesives and resin cements. They permit to change the form and colour of the teeth enhancing the smile. Ceramic is a very fragile material, but when it has been adhered to the tooth it increases not only its resistance, but also the resistance of the tooth.

Ceramics are a material with fantastic translucency and brightness, and, with time, it does not change its colour. Unfortunately, it requires to “touch” the tooth in a higher or lesser degree, but always a little bit at least.

Today there are different types of ceramics and we have to work with one type or another depending on the need to change more or less the colour, if we require more or less resistance, …

If we look for a radical change in the smile we need to evaluate the number of teeth that are shown in a full smile; these will be the ones which should be covered by veneers.

A great enhancement for the cases of dental veneers is to be able to make a Mock-Up, that is, an “in situ” try-on of the studied final result. This try-on allows the patient to have an idea about how his or her case is going to end, and to know if it covers the expectations. For the doctor it is a guide of the whole procedure which should be followed. Mock up is really a great tool for communication and help.

Today we have monoblock ceramics which are designed with surprising technology to be exceptionally hard and aesthetic. For this reason, except in wide prosthetic structures, in many cases it is not necessary to use metal. The absence of metal allows to make highly aesthetic and natural restorations, thanks to its great translucency.

The constant innovations in this area of dentistry have caused to look for different types of ceramics for the different cases: feldspathic ceramics with colour grading, lithium disilicate with different opacities, …

The monobloc ceramics are trimmed with digital 3D technology and later are tinted, or loaded with other ceramics to give them the “magical touch” of more naturality.

Today we can highly trust the adhesion that can be achieved with dental tissues, and this lets us perform complete rehabilitations for the whole mouth with minimally invasive techniques in the treatment of severe wears due to bruxism or acid attacks (bulimia).

The philosophy to treat these cases, where we need to re-gain the dental structure which has been worn through adding material and trying to preserve as much remanent tooth as possible, follows a very precise working protocol, and it is based on the 3 steps technique described by Dr. F. Vailati. It is a technique to increase the vertical dimension of the patient, trying to restore the lost height when closing both maxillae, because of dentitions wear.

The standard protocol includes a previous evaluation to determine what will exactly need to be rehabilitated. The result of this study will be moved to the mouth of the patient in the form of a try-on (Mock-Up), with the objective to check that everything is correct, both for the patient and for the doctor. The mouth will be rehabilitated globally following a very clear and personalized sequence, working first with resin and later with ceramics. The combination of both materials in the working sequence allows the patient to adapt to the vertical dimension changes.

To increase your self-esteem, you can improve your smile by showing whiter and brighter teeth, making it easier to smile to life. Dental whitening can be your solution.

In Clínica Dental Padrós Muntaner we use different whitening systems searching the best alternative for every case.

To achieve a more durable and predictable result we usually use the treatment in the clinic combined with in-house treatment; meaning that the patient comes once a week to the office, where we apply the whitening product activated by a L.E.D. light Luma Cool, which will increase the effect of the whitening agent, and while the sessions in the office last, the patient applies the whitening agent with a lower concentration, thanks to the use of whitening trays individually adapted depending on the election of the system. Those trays will be used in the house of the patient only during a determined time or during all night. It is important to remark that trays will allow us to perform “remembering” sessions once a year, increasing the duration and effectiveness of treatment.

Among the different existing brands, we have chosen:

• Opalescence: With it we can obtain brilliant results with its great with the guarantee that they have been working for more than 20 years of scientific investigation and innovation in this field.
• PrevDent: We indicate it for patients who refer dental sensitivity, because this product contains hydroxyapatite nanoparticles, which re-mineralize the tooth surface.
• WHITENESS PERFECT: It is indicated for the whitening exclusively at home, because of its viscosity and composition, especially designed to prevent sensitivity.

          Smile to live with a white and bright smile! We can help you!