1A Grange Rd. Toorak 3141 Australia
(Level 1 corner of Grange and Toorak Roads)

Ph. 9867 6405

[email protected]

CLOSING GAPS
Text Box: COSMETIC BONDING Text Box: Bonding means adhering or gluing. It is one of the most exiting areas of dentistry. The technology has been used for almost forty years (believe it or not) but its potential is only just being fully realized, with materials becoming more sophisticated and dentists becoming more savvy. The most exciting and rewarding procedures involve improving the look of front teeth. While crowns and veneers are sometimes needed, bonding often provides a wonderful alternative. It is more economical and usually less invasive. In other words it rarely requires any drilling. I have written a number of articles on bonding for the ADA News Bulletin. Have a look in the Published Articles section. Probably, though, the best way to explain is to illustrate. Have a browse through the following Before and Afters and don’t hesitate to give the clinic a call for explanations.

Using white �Composite Resin� to close the gaps between teeth is one of the most simple cosmetic procedures. It has the great advantage over porcelain veneers of not requiring any drilling and the resin can always be adjusted and modified for shape and colour at any later date.

The technique has actually be been in use for decades.

FRACTURES

The repair of a fractured tooth should be seamless and invisible.� Modern dentists should have at least a dozen different shades of composite resin material available so as to achieve an imperceptible colour match with the real tooth.

Placing a crown or cap is not usually the best alternative since it requires massive drilling of the natural tooth which, in turn, can endanger the health of the inner, living pulp.

RESHAPING A SMILE

These smiles have either missing teeth or teeth that have rotated or tilted.

By sculpting and shaping the enamel in some spots and adding material in others, teeth can adopt a different identity and be made to appear straight.

I have published articles on this subject. See Mimicking Tooth Straightening and Treating the Cross-Bite Tooth.

FACINGS

To improve crooked, damaged or darkened incisors it is not always necessary to place crowns or porcelain veneers. Both require drilling of enamel and this can occasionally lead to nerve damage. In addition, when porcelain fractures it can never be reliably repaired. See the story on Ronnie Wood and the trouble he has had with his porcelain veneers.

Composite facings can be a viable alternative. They are placed in one visit and usually do not require any drilling at all. They are far less expensive too.

I recently published an article in the ADA News Bulletin on how composite facings can correct misshapen front teeth. You might like to have a look at Managing The Peg Shaped Lateral Incisor.

COMPOSITE CROWNS

Composite crowns have an advantage over traditional porcelain crowns in that they do not require drilling and can be placed in one appointment. As well as that, they are about one third of the price.

Porcelain may be hard and lustrous but its surface is also very brittle when subject to heavy biting forces. If an edge fractures it is difficult to repair.

Composite crowns, on the other hand, are easily repaired.

STRAIGHTENING A TOOTH

The eye tooth is crowded and protrudes while the side tooth is tucked in.

In this case, the eye tooth has been trimmed and reshaped, while the surface of the side tooth has been bonded, to effectively move it outwards into alignment.

See Treating The Crossbite Tooth.

The eye teeth were too crowded to be straightened except with orthodontics.

It was decided to extract them and made the teeth behind take on their appearance, by trimming and bonding.

See Cases Of Assumed Identity.

BOND, DENTAL BOND

Dental bonding has been around almost as long as 007, but lately it has become extremely sophisticated.

These days it is so strong, the bonding a dentist does to half a tooth is capable of supporting a man�s weight. Even �Q� would be proud of that achievement.

Probably the biggest advances are not so much in the adhesives, but in the white composite resins being bonded.

Their range is now as varied and versatile as the jobs they are asked to do, particularly on the front teeth.

When incisors are discoloured and dark, composite facings can give them a brand new surface. If front teeth are tucked in and crowded, facings can build them out into the correct position, mimicking the results of orthodontic treatment.

 

 

To produce a natural appearance, the resins are applied in layers, like the structure of a real tooth.

If it is necessary to cover up dark enamel, the initial undercoat consists of an opaque masking agent, similar to Liquid Paper.

Subsequent layers have only moderate opacity, but are designed to absorb the reflected light of the adjacent teeth and blend in for a �chameleon effect�. The final layer is translucent, highly polished and shiny.

If James Bond�s old sparring partner, Jaws, had known about dental bonding he would not have needed those terrible metal crowns on his front teeth.