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Cosmetic Dentistry Photo Gallery

Dental Photography contained in this gallery represents real case histories and treatment plans belonging to patients who have been treated by dentists in their community. Before and after photos and actual picture sequences of procedures and dental surgery are provided for detail.

Tooth Filling Esthetics: Silver or Porcelain?

Resin composites and porcelain onlays, inlays and overlays have become the treatment of choice when filling teeth. They look great, feel great and can create natural tooth finishes that are almost indistinguishable from a person's natural teeth.

Cavities or filling needs that appear within a normal smile can be especially unattractive. Although gold and other metal alloys have been used decoratively as a filling material in days gone by... it is not uncommon for dentists to replace them with products that blend in rather than "be noticeable."

Before photo old amalgam Many restorative dentists have access to and use a variety of composite products for providing basic treatments for dental caries and creating assorted onlays and inlays. Today's advanced dental composites assure a level of dental function, cosmetic value and long term endurance that old fashioned metal-based restorations and amalgam fillings don't provide.

Real porcelain onlays, overlays and inlays are premium treatments for managing deep fillings and filling replacements. Fabricated in a fashion that is similar to porcelain crowns, they require a high degree of accuracy in tooth prep and bonding chemistry that assures the endurance levels of porcelain crowns.

Composite Resin Fillings

Two Basic Types

Although there are several brands and manufacturers of composite resin products, there are now two types of resin material that have structural differences.

Anterior Locations

One type is purposely designed to be used on anterior or our front-most teeth. The molecular and particulate structures within the resin compact tightly, thereby creating a tighter (low porosity) and smoother bonding material. This grade of resin can be finished to create a superb cosmetic result that can defy detection.

Posterior Locations

A second type, having a larger molecular structure is used mainly in the areas of the jaw where biting and chewing forces are greatest. The particulate matter is larger and does not compress as tightly as the finer particulate matter used in resins for anterior teeth, but can withstand the posterior biting forces.

Common Results of Mis-Match

Resin products designed for anterior applications typically fail within a short time when used on posterior teeth (e.g., molar fillings). Structurally, they cannot withstand the physical forces and lateral - abrasive action when we chew.

The not uncommon complaint of anterior resin bonding: "my teeth feel rough" may be an indication that the resin compound is too porous and is probably intended for posterior use.

Postop picture get rid of toxin potential

No One-Resin Solution

Dentists who tend to develop a flair for composite resin bonding, whether for tooth repair, new fillings or replacement of amalgam fillings tend to have a wider variety of composite resin products (different manufacturers and brands) along with several different products used in the actual bonding chemistry intended for a particular tooth.

Replacing Old Fillings

Most dentists agree that amalgam fillings should be replaced unless they are problematic or pose the risk of being a problem in the near future. The procedure of removing mercury based fillings does represent a short term exposure to small amounts of potential toxins.

Removing Amalgam: Points to Consider

The decision to remove amalgam fillings may be for immediate health needs that currently impact a patient's oral health or future oral health (suspected fractures, leakage).

Getting rid of amalgam-silver fillings can also be cosmetically motivated. Due to health concerns related to toxicity issues, patients should seek treatments from a dentist who has an established protocol.

A representative list of such protocols that assures patient safety is listed here:
  • Utilizing an effective oral suction system to contain amalgam particles and limit mercury vapors
  • Rubber dams should isolate and prevent swallowing debris
  • Operating a vacuum system at optimal efficiency
  • Removing large portions of the amalgam to minimize particulate and mercury vapor release
  • Providing a safe source of oxygen for the patient to breath during removal
  • Having the patient's hair, face and clothing covered during removal
Ara Nazarian, D.D.S.
Michigan Reconstructive Implant Dentistry
1857 East Big Beaver Road
Troy, Michigan MI 48083
(248) 457-0500

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