After smile design, i.e. the planning and pre-visualization of the desired end result of the esthetic dental treatment follows the creation of the designed smile, which is actually the treatment itself.
There are several techniques of esthetic treatments. Your dentist has to decide with you which one to apply based on your current tooth conditions, the desired end result (i.e. the designed smile), the affordable budget and some other factors.
The length of the treatment period can also be important, and sometimes the reversibility can also play a role. The trend is applying more and more non- or minimal-invasive techniques, i.e. your dentist should keep from your original teeth as much as possible. Besides other aspects, the functional requirements should also be considered by the dentist to a maximal degree, after the treatment you have to be able to use your teeth at least you could use them before.
As your dentist should pay attention to the aspect of feasibility already at the phase of planning and pre-visualization, actually, the decision on the applicable technique is to be taken at the very beginning, before the pre-visualization.
Some techniques your dentist can use to create your smile:
Recontouring
Using a very fine polishing disc or diamond bur teeth can be reshaped or recontoured. The most angled tooth edges, the too convex, bulging or rotated part of the teeth can be slightly removed by polishing, not exposing dentine. By this method teeth can be rejuvenated, the smile can become more harmonious.
Direct veneers
This is a minimal-invasive method using specific esthetic composite materials according to a natural layering concept or anatomical stratification technique. Using these materials teeth can be reshaped or rebuilt by a very thin, tooth-colored composite layer coated to the outer surface of the teeth.
Veneers (indirect veneers)
For reshaping teeth, solving gaps, inherited or acquired tooth shape problems, treating discoloration problems or just making a new smile porcelain veneers are the perfect solution instead of crowns. For veneers 0.6 mm deep preparation is needed in the tooth structure before bonding them to the outer surface of the teeth.
Non-prep (tenuia) veneers, lumineers
Non-prep veneers. One of the most non-invasive procedures. This type of veneer is a 0.3-0.4 mm thin porcelain which can be placed without any preparation. However, recontouring is necessary before placing this type of veneers.
Prosthetic works
Prosthetic works include metal-fused porcelain works, full-ceramic or zirconium bridges, combined works, front crowns and dentures. For making a perfect smile new crowns may be needed or the old ones has to be replaced. It is also possible to make bridges from full-ceramic, metal-fused porcelain or zirconium materials. If you are toothless, a denture can be made. The rules of smile design and of the gnathology have always to be considered.
Implant works
For making fixed individual crowns or fixed bridges for toothless patients implant screws have to be placed into the bone. This is a specific method for dissolving toothless problems and simulating the feeling of natural teeth. The design of the suprastructure on the abuttment always has to be based on the rules of smile design and gnathology.
Smile makeover
Using some above mentioned techniques the patient’s old smile can be changed into a complete new one. Smile makeover is usually required in case of deep bite, disadvantageous teeth exposition during smiling or speaking and serious esthetic problems. Direct or indirect veneers, crowns, onlays can be made for changing the incisal curve, the smile type, the tooth shape, the tooth harmony or adjusting the deep bite. As the outcome of the treatment it can be possible to give the patient back a high level of smile and face harmony.
Smile rejuvenation
All the above mentioned techniques that can make younger your tooth shape, tooth character, or your whole smile can be called smile rejuvenation. Most common methods are veneers and crowns for the front teeth.
Instant orthodontics
In case of slightly crowded teeth recontouring or direct veneers are the best solution to straighten the teeth in 1 or 2 hours. Actually, all the methods that can solve crowding in a very short time are one kind of instant orthodontics.
Soft tissue management
Red and white esthetic in smile design are essential. Therefore for the perfect gingival contour it is sometimes necessary to reshape the gingiva. In case of slight asymmetry gingival contouring by laser might be enough. For solving gummy smile or low gingival horizon general or local crown lengthening is needed. In case of loss of papilla or gingiva soft tissue transplantation could be the best method. These are already very sophisticated surgical interventions. As the outcome can be influenced by several factors, a deep consultation is definitely necessary before the treatment.
Orthodontics:
Some smile design cases can be solved properly only combined with orthodontics. In case of overjet, overbite, narrow jaw, crowded teeth, gnathological problems, maxillofacial disorders, face disharmony problems one of the orthodontic treatments (conventional techniques, Damon system, Incognito system, Invisalign system, etc.) is recommended. The treatment can last for 1.5-3 years depending on the case.
Related methods
The effect of esthetic dental procedures can be highly influenced and enhanced by some cosmetic and plastic surgery interventions like refillers, botox, etc. These techniques can be suggested in some cases.
There are a lot of simple cases when creating the designed smile, but sometimes it is more complicated and a mix of different techniques is to be applied. In these cases the smile creation is suggested to be carried out by a dentist team.
The parodontologist can make a perfect marginal contour by applying crown lengthening techniques, soft tissue management and can create a healthy gum.
The orthodontist can widen the jaws, straighten the teeth, improve the exposition of the teeth during smiling or speaking, adjusting the bite high, reestablish the face soft tissue harmonious design or reestablish the perfect ratios.
The prosthodontist can reconstruct the tooth and soft tissue function by replacing missing teeth (denture, combined work, implant suprastructure).
The gnathologist can treat gnathological problems, TMJ disorders, and can create a harmonious function with the new dental work.
The esthetic dentist can create esthetic, harmonious dental work with special direct or indirect techniques.
The implantologist can place implants for solving missing teeth problems.
The dental technician can make a perfect, living ceramic work.
The overall smile makeover or smile designing should be harmonious with face and suit once personality as well.
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