March 14, 2011

Aging Dental Caps Cause 17 Years of Dental Anxiety

Sometimes people get used to the status quo.  For whatever reasons they stay firmly planted in their comfort zone.  J.E.  lived with her unattractive,  but not quite hideous dental caps for seventeen years.  The dental caps in Figure 1, looked back at her everyday, as she faced the world with an air of ever present self-consciousness.  Many people live with dental problems that do not create agonizing physical pain but create other problems….

One day, while browsing through Facebook, she came across her old high school bud, Joshua Polansky. Joshua is now the owner of Niche Dental Studio in Cherry Hill.  She loved the photos of the work he placed on his website.  Josh invited her to visit the dental laboratory which was located in my office, Cherry Hill dentist, Barry Polansky.

So she got in her car and drove up from Washington DC.

After the initial dental examination, we all concluded that a change needed to be made.  The dental caps were old, discolored, and short and very opaque.  J.E. was particularly displeased with the black line at the gum line.

Reasons for the black line:

  • After 17 years, especially in a growing adolescent…the gums receded.
  • The material used 17 years ago for front teeth was mostly porcelain fused to metal…usually some form of gold alloy which is dark.  Today our restorations are made of metal free porcelain, such as feldspathic or lithium disilicate (E-Max).
  • The bulkiness of the crowns caused the gum tissue to become rolled and inflamed.
  • And most importantly we noted J.E. had very thin gum tissues which is fairly common in may women.  This would become our greatest challenge.

We previewed the case with wax.

With all of our cases we create our desired result  on models, in wax.  J.E. loved our vision and decided to go forward with treatment.

It’s nice to see where you are going before you start.

She knew that after her first appointment she would be better off because we made her a great looking temporary to wear while the lab made the finals.

When J.E. returned…we all agreed that the case would not be satisfactory…so we remade it.  The challenge of making the caps blend into the gumline was difficult because of her thin tissue.

After all the anxiety for all those years…we needed to do everything to satisfy her.

She loved everything else…see Figure 2.

  • The shade.
  • The length of the front teeth.
  • The natural blending with the adjacent teeth and the lower teeth.
  • The angles.

But we had to shot for perfection.

Our next attempt was much better, and so ended J.E.’s 17 years of anxiety. She no longer feared the results of dental treatment. See Figure 3.

Here is what J.E. said:

“After several years of avoiding the need to have my crowns and veneers redone, I finally found Dr. Polansky.  The collaboration between Dr. Polansky and Niche Dental Studio is truly outstanding.  Dr. Polansky and his team want their patients to be completely happy and obviously will do whatever is necessary to make that happen.  This unique practice allows the patient direct interaction with the dental technicians (Josh & Emma)…something you won’t find elsewhere.  I highly recommend Dr. Polansky and Niche Dental Studio. They have renewed my smile and I couldn’t be happier! – J.E.

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