Aesthetic dentistry; It is an important branch of dentistry that deals with the reorganization of the mouth and teeth area in terms of health and aesthetics. Its main theme is a healthy smile design. Smile design is to renew the ideal smile with health and naturalness. The important thing is to create an aesthetic smile expression that suits you within the scope of medical rules. In addition to their main functions (chewing, speaking, etc.), our teeth also greatly affect our self-confidence in society in terms of aesthetics. Our smile is a very important factor in our communication with people. Color and deformities in the teeth can cause problems up to psychological disorders in the individual. Studies have shown that an individual who trusts his smile is much happier and more successful in his social, business and daily life than other individuals. Our teeth reflect our smile and our smile reflects our energy. A beautiful smile means personal self-confidence. The branch of science that deals with this in dentistry is called ‘aesthetic dentistry’.
The aesthetic dentist should first know the patient and perceive their expectations. It should not be forgotten that the treatment that should be applied to each individual is different. Here, our patients’ special tastes, socio-economic level, occupational factors, etc. Many issues such as Then physical factors come into play. The aesthetic dentist should design a smile that the patient will perceive as pleasant and attractive and correct the defective image. Its purpose 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 patient’s diagnosis models and photographs should be taken, and the expected result should be expressed fully and clearly. Aesthetic dentistry is a very sensitive scientific study. Health should not be compromised in order to provide an ideal image. Aesthetic surgeons and aesthetic dentists continue to work within certain medical rules. Below we will tell you which factors are effective in aesthetic arrangement.
There are certain angles and proportions available in the mouth, face and head region. When the treatment is performed according to these rules, it will be almost guaranteed to achieve an aesthetic appearance. 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 beautiful, someone else may not find her beautiful at all. Therefore, understanding the expectations of the patient is the most important criterion in aesthetic dentistry.
As a result, the dentist will decide on the technique applied and the material used. Before starting the treatment, the quality of the material and its suitability for the patient should be determined. The ability to make a sound decision, the desire to develop technical skills and the effort to be constantly informed about the new products available should be combined with the natural aesthetic perception and vision, which is the most important feature that your physician should have.
FACTORS AFFECTING SMILE
Color, shape and arrangement of teeth
As we age, some changes occur in our face.
For example, while the distance between the hairline and the eyebrows, between the eyebrows and the tip of the nose, between the nose tip and the chin tip is equal at young ages, the nose tip and the chin tip 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 and the wear of the teeth over 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 effective treatment method is porcelain onlays covering the chewing surface of the teeth and porcelain laminate veneers in the anterior region. Thus, 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. Tea, coffee, cigarettes, alcohol, etc. consumed for years. Sometimes, some color changes occur in the teeth as a result of the wear of the enamel layer, which is the tooth layer. 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 women, 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 between the anterior 4 teeth. In women, the laugh line follows the lower lip slopingly. In men, the laugh line is straighter.
There is a harmony between natural teeth and face shape. For example, if you have an oval face, the shape of the teeth is oval or close to oval. Square, angular, rounded turns will look nicer on square faces. Sometimes
we find it difficult to achieve 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, SHAPE AND ORIGIN OF TEETH
If there is a color problem in the tongues, 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, an effective solution 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 to only with very little abrasion from the front surface of the tooth. If there is a gap (diastema) in the teeth, the closest treatment method is porcelain laminate veneer applications or composite applications. With these techniques, the gaps between 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 the same methods. If there are old fillings in the front teeth, these fillings should be renewed and evaluated aesthetically. But this is related to the planning of the physician, as we said at the beginning. For example, in an individual who consumes large amounts of tea, coffee, and cigarettes, the filling edges will recolor in a short time. In this case, the most suitable 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 effective in determining the color of the application to be made. In individuals with dark skin tones, very light-colored teeth will detract from the naturalness of the image. 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. Thus, with the most protective method, the teeth will be both healthy and ideal aesthetics will be provided. Proper alignment of the teeth is as important as effective chewing and smooth speech in aesthetic consultation.
Having healthy gums is the most important criterion in oral and dental health. But sometimes even if the gums are healthy, they can spoil your appearance, even the most beautiful 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 be treated.
They are porcelain leaves that stick 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, coatings with metal in them appear as black spots, as if they were not in the mouth). The light transmittance of laminates also varies according to the porcelain used and the construction 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. Doctor and patient get the chance to reach a consensus on this 3D model. Thus, you have the chance to see how you will look in 3D before your teeth are cut.
Then the teeth are prepared with a short and painless procedure, and the impression is taken. Plastic temporary veneers made in the form and length that you and your doctor decide together are adhered. These are also important to protect your teeth until porcelain veneers arrive. At the same time, these temporaries act as a second 3D model for necessary corrections. The compatibility of the teeth with the face is checked, the ideal smile suitable for the face is determined with the necessary abrasions and additions. Porcelain veneers are prepared and adhered according to this model in the laboratory.
Although porcelain veneers are very thin, they are very resistant to breaking when glued. The bonding process takes place with a special method (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 agents 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 and differences between teeth. Beans-front angle
click (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 satisfied with the color of their teeth (Tetracycline discoloration, etc.)
For crooked teeth, if the patient does not want orthodontic treatment
Those with gaping teeth
Those who are not satisfied with the shape of their teeth (long, short, small, etc.)
In gaining a wide -U-shaped smile line and thus providing an energetic and natural beauty
Laminate veneer can be applied to anyone who wants to have a beautiful smile without damaging their teeth.
WHAT ARE THE ADVANTAGES OF LAMINATE VENEER?
It is one of the most conservative (preventive) 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 material 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 a brand new smile in 2 or 3 appointments.
With the model that will be specially prepared for you, you can see what your mouth will look like in 3D before your teeth are cut.
It is the teeth that are integrated with the face of the person so that they cannot be noticed by other people when they are made with the right indication, the right technique and a good smile design.
It is not possible to distinguish it from a natural tooth because it has a light transmission feature. The more light transmission a laminate veneer has, the more natural the result will be.
Its very well polished porcelain surface minimizes the formation of calculus.
It does not change color with external factors such as coffee, tea, cigarettes.
It is quite fragile in 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 from the tooth surface by abrading 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 a good clinical and laboratory work.
Physicians and dental technicians must have full technical knowledge and artistic ability on this subject.
METAL-SUPPORTED FULL PORCELAIN AESTHETIC CROWS
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 a tooth so that it looks natural despite all its perfection and it is not obvious that it is artificial.
Porcelain teeth have been a preferred material in dentistry for a long time due to its closeness to the natural structure and durability.
However, when compared to natural teeth and metal-supported porcelains, light transmittance, color formation, dullness in appearance, color changes in the gums, etc. It has been observed during the long application years that it has negative advantages and solutions to this problem have been sought. The metal infrastructure under the ceramic superstructure was seen as the reason for these disadvantages, and new alternatives that were equally robust but more aesthetic were produced.
Metal-free ceramics began to be used as a result of this search.
Although many things affect the appearance of crowns, the most important is their response 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 SUPPORT
Full porcelain crowns; Since their light transmittance is identical to the natural tooth structure, they create an aesthetic appearance, while metal-supported porcelains have a dullness and artificiality, even if they are very well made. For this reason, full porcelain crowns are preferred especially for anterior teeth.
Metal-backed 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-supported porcelains appear exaggeratedly white in some lights (purple light, flash and spotlights, etc.), the existing natural teeth give the appearance of a dark space as if they were not in the mouth. In full porcelain, this distinction is not clearly felt.
In porcelains without metal support, prostheses do not press on the gums due to their tooth cutting characteristics, gingival disorders and gingival recession are less common.
When the gingiva recedes, full porcelains preserve their aesthetic appearance, while metal-supported porcelains create a bad appearance in the area where they are combined with the tooth.
There is no risk of allergy to some metals (nickel, etc.) used in the infrastructure in full porcelain.
Zirconium oxide is a tissue compatible substance and does not cause allergies.
In the researches, it has been determined that it is perfectly compatible with the gums.
Temporarily pasted and tested
It has a feature.
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 good light transmittance. It is not sufficiently resistant to chewing forces, especially for the posterior region. However, high aesthetic advantages in the anterior regions are the reasons for preference.
ZIRCONIUM BASED BRIDGES
In this system, zirconium, a white alloy, is used instead of metal as a substructure. It is the only material that has the ability to present this state-of-the-art infrastructure with aesthetics and durability. The biggest advantage of the system is that it provides a full aesthetic appearance in the 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 era has opened with the application of zirconium, which has been 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 allow us to achieve aesthetics and function 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 a resistance of 900 Mpa-1200 Mpa has started a brand new era in dentistry by covering the highest physical values, as well as light transmission, tissue compatibility 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 the patient in metal-ceramic and all-ceramic restorations are definitely eliminated.
WHERE CAN IT BE USED?
Single tooth crown restorations
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 Federal Institute of Technology Zurich, zirconium oxide has become economically available in dentistry. Zirconium has also been used in medicine since the 1960s. The reliability of the material 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 harms, and does not cause allergies.
Zirconium is an element that is resistant to high temperatures, impacts, light, does not conduct heat and electricity, and can transmit light.
In addition, it is a healthy material that does not cause taste disorders, gingival 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 aided 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 size 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 support can be successfully made with zirconium oxide, which is a high-tech product.
COMPATIBLE WITH BODY AND TEETH IN ALL DIRECTIONS
There are also some important 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, good 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 important 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 product with the highest quality achieved so far in terms of aesthetics, durability, tissue compatibility and naturalness, which are the basic requirements of modern dentistry.