Broken Front Teeth: Ceramic Crowns vs. Cosmetic Bonding
From Dr. Jill B. Smith, DMD
When patients come to me with dental issues like broken front teeth, chipped teeth or tooth discoloration due to accidents such as a fall or sporting injury, I am often faced with the task of determining what cosmetic dentistry procedure and dental material would be best to replace the missing tooth structure. Peter came to our office looking for a solution for his discolored bonded front teeth. His teeth had broken many years ago and had been repaired with composite bonding several times.
Composite bonding, also known as plastic or resin materials, has been used in front and back teeth for many years. For small chips, this is a conservative restoration, but for larger repairs, composite bonding has some drawbacks. First, plastic does not mimic tooth structure aesthetically so composite bonding lacks the translucency and glass-like qualities of enamel. Secondly, composite materials and their adhesives stain over time and usually become visible and noticeable on front teeth within five years or less. Lastly, composite materials used to replace several millimeters of tooth structure are not as strong as natural tooth or their porcelain ceramic alternatives such as veneers and crowns, and may break unexpectedly. Modern ceramics such as the ones we use for veneers and crowns have many advantages over composite. The glass-like materials mimic the color and translucency of natural teeth and can be custom mixed to match tooth color exactly. The surface texture resists staining and remains the same color for the lifetime of the restoration. The materials are strong, and can withstand chewing and biting forces similar to a healthy tooth.
Peter’s before photos are good examples of what composite bonding can look like after several years. From Peter’s own admission, his prior dentist did not specialize in aesthetics or cosmetic dentistry, so the bonding materials and techniques used are outdated and showed wear and staining. The color did not match his natural teeth and the plastic materials look artificial and unnatural. The length and bulkiness of the front teeth due to prior dental work made the teeth appear to stick out and were noticeable when Peter smiled.
Peter Before – Worn and Stained Cosmetic Bonding
Peter is a successful business man with a very public profile in the Financial District of downtown Boston, and was bothered that his teeth were detracting from his professional appearance. Peter wanted a more natural looking, long-lasting solution but did not want extensive dental work. My objective during cosmetic consultations is to educate patients on all of their options and guide them in a direction that will achieve their goals and objectives. Peter wanted to treat only his two front teeth and chose all ceramic crowns by Aurem Ceramics and Britesmile tooth whitening as his treatment plan. Other treatment options could have included adult orthodontics such as Invisalign or Six-Month Smiles to correct the crowding, but Peter was more than pleased with the results we achieved in this long lasting conservative smile makeover!
Peter After – Ceramic Crowns and Britesmile Teeth Whitening
Patient Peter L. explains, “They conducted a comprehensive analysis of my dental needs and put in place a plan designed to address my immediate issues and take care of other priorities over time. I am extremely pleased with the result of my new front tooth from a cosmetic and practical point of view. Dr. Smith absolutely exceeded my expectations in every way. I had no idea that this level of dental care even existed. The entire team is obsessed with excellence and is passionate about delivering the absolute best result. I had been unsatisfied with the bonding of my front tooth for years due to discoloration, roughness and its unnatural look. Dr. Smith provided a permanent solution that has the added benefit of outstanding aesthetics. The size, color and texture of my new tooth looks completely natural and changed my whole smile. It was the best decision I ever could have made.”