Cosmetic Dentistry


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Digital Smile Design

What is digital smile design (DSD)?

DSD means planning and designing a perfect smile that reflects your special nature and own personality.

It is not just teeth that makes up a beautiful smile, there are lips, cheeks, eyes in fact the whole face.

In DSD we look at your whole picture, how you will look while talking, smiling and laughing not just for that smile you see infront of the mirror.


Why does this technology arise?

Have you ever seen a smile that doesn't look right! , teeth of different sizes and shapes that don't match your smile were made by dentists in the past, but nowadays people's demands have changed from just having a mouth free of functional issues to a desire to own a naturally beautiful smile.


What are the benefits of DSD?

- It helps you to see what will be the result of your treatment before even starting it.

- DSD ethically involves you in the smile enhancement process by making you the co-designer of your own smile by sharing and expressing your desires and expectations with your dentist.

- It increases your comfort throughout the treatment process.

- It saves time because treatment becomes more accurate and simple requiring fewer appointments.


Now you can design, modify, and 3d print your smile before working on it

All we need to make a DSD is digital photographs taken correctly and in a good resolution to study your smile, make analysis of your facial and dental proportions, and plan the treatment virtually.

Hollywood Smile

What is it ...?

1) It is a new smile design, designed for everyone, to beautify the teeth and to beautify the shape and color to match the shape of the jaw and mouth of the patient.

2) They are veneers or crowns placed on natural teeth designed specifically for each individual.

3) To design this smile you should visit the doctor first and find out what is the best solution to beautify your teeth.


This smile depends on several factors:

1) Patient’s face; skin color, eye, mouth shape.

2) Dental condition, if it has caries, missing teeth or any blanks.

3) Patient’s budget.


This smile can be designed in several forms:

Fixed

Veneers:

(1) They are thin crusts that are specially made for each individual and cover only the front part of the tooth.

(2) Made from E-max material.

(3) It is possible to put them on all teeth that have problems or teeth that appear in the smile that the patient wants to embody, it can be placed on all teeth or anterior teeth only.


It solves many problems, including:

1- Teeth that have acquired dark color & stains.

2 - The presence of spaces between the teeth.

3 - There is difference in the shape of teeth in length and size.

4- Bad Inclination of the teeth .


It requires number of visits to the doctor, for the doctor to examine the teeth and make sure of the possibility of making veneers and to make computerized design of the smile where we can see the result in advance, and this design is adjustable & can be changed so that the patient can get the best result that’s satisfactory to him in terms of shape, color and size of new teeth.


Steps:

1 - Preparation of teeth and removal of the external surface of the tooth that’s the enamel layer & it’s the same thickness of the veneer that will be put on the tooth .

2 - Taking impression of teeth.

3 - Receive the veneer and this is a week after taking the impression, and the doctor tries it and then he pastes it with adhesive material specific for veneers.


Advantages:

1 - Provides the patient with a natural shape of teeth.

2 - Correct the problems of teeth and beautify them.

3- The color remains constant for life.

4- It doesn’t require too much preparation of the tooth , so it doesn’t harm all the tooth surfaces.


Disadvantages:

1 - The tooth is prepared and its shape can not return again to the previous form.

2 - It is possible for the teeth to become sensitive with the hot and cold things because of the removal of the enamel layer.

3 – It’s expensive.


How to take care of it..?

1 - If these veneers fell, they can be broken and they're difficult to repair, so you should get away from biting on the solid things.

2- The veneers remain in place for 5-10 years before replacing them, so the patient should take care of good oral hygiene , using the tooth brush and the dental floss.

3 – The patient should reduce the consumption of foods and beverages that have dyes.

Zirconium crowns:

(1) They are specially designed for each person covering all parts of the tooth.

(2) They are made of Zirconium material .


This material is characterized by:

1- Very resistant to breaking, it’s very hard.

2 - Completely free from minerals, making it suitable for the mouth and gums, causing no inflammation of the gums or foul odor of the mouth.

3 - Do not cause any discoloration in the gums, such as what happens and caused by other types of crowns.

4 - Transparent, it allows the passage of light, and it is a colorable material with the same natural teeth, which gives the teeth a natural appearance.


It can be placed on all teeth that have problems or teeth that appear in the smile that the patient wants to embody, it can be placed on all teeth or on anterior teeth only.


It solves some problems, including:

1 - When tooth is lost or set of teeth and compensated by zirconium bridges.

2 - After the treatment of the nerve of any tooth , a zirconium crown can be put on this tooth to avoid its fracture.

3- For beautification, if the patient wants to change the color or shape of the teeth.


It requires several visits to the doctor for him to examine the teeth and make sure of the possibility of making crowns , and to make computerized design of the smile where we can see the result in advance, and this design is adjustable or can be changed so that the patient can have the best satisfactory result in terms of shape, color and size of new teeth.


Steps:

- It does not take long time to prepare and place it, it needs two visits, the first is for preparation and the second is for the trial & insertion of the crowns.

1- Preparation of teeth and taking impression in one session.

2 - The trial of crowns and paste them with adhesive material after a week of taking the impression for these crowns.


Advantages :

1 - Very resistant to breaking, it’s very hard.

2 - Completely free of minerals, making it suitable for the mouth and gums, causing no inflammation of the gums or foul odor of the mouth.

3 - Do not cause any discoloration in the gums, such as what happens and caused by other types of materials.

4 - Transparent, it allows the passage of light, and it is a colorable material with the same natural teeth, which gives the teeth a natural appearance.


Disadvantages:

1 - If the doctor or patient wants to remove the crowns to examine the teeth under it, it is very difficult to remove & may be broken while being removed.

When removed, the teeth do not return to their previous shape.

3- It’s expensive for the patient.


How to take care of it:

1 - Oral care and teeth washing three times a day, and the use of dental floss once a day and the use of mouthwash cleanser after brushing teeth.

2 - You should go to the dentist every 6 months to perform a periodic check on the teeth in general.

Snap on Smile

Snap – On Smile

(1) It is a smile design made of Veneers being worn when necessary.

(2) Dental preparation is not needed as it is not applied to the teeth, but is removable and can be installed again at any time.


Steps:

1 - The doctor take the impression of the teeth and go to the laboratory to make the design of it .

2- Insertion at the second visit to the doctor.


Advantages:

1 – It never harms the tooth, they do not require the preparation of teeth, which prolongs the age of teeth.

It is not painful in its preparation.

It needs less time and less cost.

It is possible for the patient to choose the right color for him, give the teeth a good shape and give the patient a beautiful appearance.

5 - It can be used for health and therapeutic reasons such as night protection to prevent night squeaks and helps to rest joints.

6- Can be installed and removed at any time.

7 – It is a cosmetic solution and painless and it doesn’t harm teeth.


The allowable cases:

1 - Fill the gaps between the teeth.

2 - For those who can not make veneers , bridges or implants.

3 - For those who wish to make Hollywood smile in less time and cost and without any damage to their teeth.

4- If there are any pigments on the teeth.


The contra-indicated cases:

1 - If there is a strong inclination in the teeth or problems in occlusion, because there will be problems in the impaction of food between the composition and the teeth, and can be broken because of the non-homogenous distribution of chewing forces on all teeth.


How long does it last and how is it maintained?

- It may remain for too long, provided it is taken care of.

- Care should be taken to the teeth and cleaning the composition so as not to drown the remnants of food.

- Remnants of food should be removed from it when it’s removed.

- Avoid chewing hard foods.

- Do not clean with a tooth paste so as not to cause scratches on its surface.

- Only soft food is enough to be eaten on them.


What’s its effect on teeth?

- Since it does not need to prepare teeth, so it gives excessive thickness of the teeth and the patient will feel it which may lead to some problems in the pronunciation at first.


Disadvantages:

1 - Do not put on the teeth during eating or sleeping, and kept in the box of its own.

2 - It is a temporary solution because it is not a therapeutic or functional solution, it does not dispense with the essential treatments necessary for teeth.


Drawbacks of Hollywood Smile:

1) Tooth decay: The teeth are exposed to decay, as they are still exposed, it can be decayed if not cleaned well.

2) Loss of the natural shape of the teeth, it requires the preparation of the tooth in a way that allows to place the veneer or crown on it.


Hollywood smile advantages:

1) You gain a color that does not change over time.

2) Give aesthetic shape to the teeth and patient.


Contra-indicated cases for the Hollywood smile:

1) The smile is not suitable for those who have a deep bite or for those who make excessive pressure on their teeth during sleeping or eating as bruxism or clenching because it will be cracked or fractured easily, so the patient should put a protective night guard on the teeth to protect it.


How to take care of it..?

1) It must use a tooth brush, paste and dental floss.

2) He should visit the doctor every three months to check and polish the crowns / veneers.

Teeth Whitening

What is it.. ??

1) It’s a change in the shade of color of the teeth to a whiter shade .


2) It’s one of the ways to reach the Hollywood Smile. It gives us white teeth at the end, but it is a temporary solution since it is not possible to control the duration of the bleach, and we can not control the result of whitening or color that teeth will reach after bleaching.


3) It is considered a temporary solution for the teeth to be white and not a permanent solution, since the white teeth that we see in the television are not because of bleaching, but it is a layer of porcelain in the form of coatings or veneers or Lumineers made of Zirconium or E-max, It is placed on the teeth to be equal in shape and has a bright white color, and this layer can be controlled in color, and we can treat some minor defects in teeth such as unevenness of teeth, or the big difference in color between teeth . The color is permanent and does not change.


What is the expected outcome of bleaching .. ??

Bleach result varies from person to person, regardless of the doctor or material used or the device used for bleaching,

So, It is not possible for the doctor to know to which grade the teeth will be bleached , or for how long the result will last , because it depends on several factors, including:


1) The response of the tooth layer (enamel and dentine) to whitening, according to the method of composition and construction of the tooth and the amount of mineral salts in it.


2) The patient following the doctor’s instructions after bleaching.

So, It is possible that the patient repeats bleaching several times if its result found to be satisfactory for him,


However, if he wants to reach a final and permanent result, this can be reached by means of the covering the tooth, with crowns, Veneers or Lumineers.


Advantages of bleaching .. ??

1) It is possible for the patient to reach a satisfactory result and the teeth have acquired white color after bleaching without any need to prepare any parts of the tooth.


2) It is possible for the patient to repeat this process at any time without any problems or damaging in the teeth.


3) After 6 months, the teeth begin to gain stains from any food or drink that has stains, because this is the expected time to keep the result of bleaching, and if there are stains , the teeth will return to its original shade before bleaching and this does not change after bleaching.


What are disadvantages of bleaching .. ??

Does not have any disadvantages at all, as it does not damage the layers of tooth internal or external, but it is possible that the patient feels some sensitivity in the teeth and this feeling lasts for only a few hours.


The doctor also uses a material after bleaching that reduces sensitivity.


What instructions should the patient follow after bleaching .. ??

1) The patient should stay away from drinks and hot foods for at least 48 hours.


2) The patient should stay away from smoking and alcohol for a month.


3) The patient should stay away from the foods and drinks that have the pigments as much as possible, and for at least 24 hours, as the teeth after bleaching are able to gain stains 6 times more than teeth that have not exposed to bleaching.


4) If any of the foods or drinks that contain stains are taken, the patient should wash his teeth and rinse directly to remove any remnants of food or drink that has pigments.


5) The patient should take care of his oral hygiene after bleaching to keep the result of bleaching as much as possible, and he has to wash his teeth in the right way to ensure the cleanliness of the mouth and teeth.


6) It is possible for the patient to take pain reliever on the day of bleaching to reduce the sensitivity in the teeth caused by bleaching.


What are the contraindicated cases for bleaching .. ??

1) If there are any genetic problems in the pulp in the teeth.


2) If there is decay in the outer layer of teeth and this is the enamel layer as this is the layer on which we put the bleaching material.


3) If there are cosmetic fillings in the front teeth, because the difference in color shades between fillings and parts of the tooth will appear after bleaching.

Gingival Depigmentation

What is gingival depigmentation?

It is one of the cosmetic procedures that you seek when you are suffering from dark gums that loses its normal pink colour, and you are not satisfied with your smile.

It is a one visit treatment which is painless, easy and quick.


What causes your gingival colour to become dark with black pigments?

Gingival pigmentation comes from a substance named Melanin which is found naturally in your body. If your body has an over production of this Melanin specially in the gum region this will cause a dark appearance, this darkness vary from one person to another.


Factors that cause over production of Melanin:

If you are a smoking person (The intensity of darkness depends on the intensity of smoking).

Genetic transmission from your parents.

Endocrinal disturbances.

As an effect of some drugs.


What are the ways that the dentist use for gingival depigmentation?

There are several ways of removal of this pigments, some of them are surgical with massive bleeding and severe pain, but at Royal Dental Care we use the latest technology that deals with oral soft tissues, this device is named BIOLASE the soft tissue laser device that uses the laser light to remove safely all the pigments found in your gums, it is the most comfortable procedure, easy, painless and without bleeding at all.


Gingival Depigmentation after care:

After removal of this dark layer of gingiva, the area will be red in colour for one week, this red colour will resolve quickly to the normal pink colour and this will improve your esthetics and help you to smile with confidence.

You may need to take an analgesic for 1 to 2 days if needed.


How long does the gingival depigmentation effect last?

This is according to the cause of this pigments, if it comes from smoking and you stopped this habit so the effect will last forever, the same with drugs when you stop using it.

But if it is due to a genetic or endocrinal cause recurrence will occur after 1 to 2 years, once this pigments appear again in your gingiva you can come and make this procedure safely again.

Gummy Smile Treatment

A gummy smile, known as excessive gingival display, is when you smile and too much gum tissue shows above the top teeth.


WHAT CAUSES A GUMMY SMILE?

There are a number of causes of a gummy smile, however, the most common ones are:


- Teeth that appear short because they erupted improperly and remain partially covered by gum tissue

- Teeth that are small in comparison to the gums due to genetics or wear

- An upper lip that is too short

- A hyperactive upper lip that is normal in length when the face is resting but lifts too high when smiling exposing a lot of gum tissue

- Gums that are long or enlarged, known as gingival hypertrophy

- An overgrowth of the upper jaw, called vertical maxillary excess, that makes gums bulge outد


GUMMY SMILE TREATMENT

As we mentioned previously, the appropriate gummy smile correction will depend on what’s causing it. Options include:


- If the underlying reason for excessive gingival display is mild and due to the jaws or teeth, it can sometimes be fixed with orthodontics alone to shift the bite into the correct position and make the gums appear less prominent.


- For moderate to severe jaw protrusion, the best course of action is orthognathic surgery, or jaw surgery, combined with orthodontic treatment. An oral surgeon will recontour the upper jaw so that the correct size and then move it upward into its ideal position before securing it with plates and screws. This is done under general anesthesia and requires a hospital stay.


- Veneers or crowns can make the teeth appear longer and improve the tooth-to-gum ratio if the teeth are too short thanks to wear or genetics.


- If too much gum tissue is the issue, a periodontist can perform a gingivectomy. In this procedure, they remove the extra gum tissue and reshape it to expose more of the teeth and improve your smile aesthetics.


- If the teeth fully erupted, crown-lengthening surgery, which involves removing gum tissue and/or bone to expose more tooth and let the gums retract back to their correct position is a viable option.


- Lip repositioning surgery followed by orthodontic treatment can be a good alternative to jaw surgery if the excessive gingival display is the result of a short or hyperactive upper lip.


- Laser gum contouring procedures can remove extra gum tissue without the need to go under the knife for those with gums that extend too far down covering their teeth.


- Botox is a newer contender and a much cheaper gummy smile treatment option than surgery. However, the results are temporary and last about three to four months and it will only work when the upper lip is the culprit. A doctor injects the lip with Botox, which paralyzes the muscle and prevents it from lifting too high when you smile.

Gingival Recession Treatment

It’s the process in which the margin of the gum tissue that surrounds the teeth wears away, or pulls back, exposing more of the tooth, or the tooth's root.

When gum recession occurs, "pockets," or gaps, form between the teeth and gum line, making it easy for disease-causing bacteria to build up. If left untreated, the supporting tissue and bone structures of the teeth can be severely damaged, and may ultimately result in tooth loss.

Gum recession is a common dental problem. Most people don't know they have gum recession because it occurs gradually. The first sign of gum recession is usually tooth sensitivity, or you may notice a tooth looks longer than normal. Typically, a notch can be felt near the gum line.

Gum recession is not something you want to ignore. If you think your gums are receding, make an appointment with your dentist. There are treatments that can repair the gum and prevent further damage.


Why Do Gums Recede?

There are a number of factors that can cause your gums to recede, including:


Periodontal diseases. These are bacterial gum infections that destroy gum tissue and supporting bone that hold your teeth in place. Gum disease is the main cause of gum recession.


Your genes. Some people may be more susceptible to gum disease. In fact, studies show that 30% of the population may be predisposed to gum disease, regardless of how well they care for their teeth.


Aggressive tooth brushing. If you brush your teeth too hard or the wrong way, it can cause the enamel on your teeth to wear away and your gums to recede.


Insufficient dental care. Inadequate brushing, flossing, and rinsing with antibacterial mouthwash makes it easy for plaque to turn into calculus (tartar) a hard substance that builds on and between your teeth and can only be removed by a professional dental cleaning. It can lead to gum recession.


Hormonal changes. Fluctuations in female hormone levels during a woman's lifetime, such as in puberty, pregnancy, and menopause, can make gums more sensitive and more vulnerable to gum recession.


Tobacco products. Tobacco users are more likely to have sticky plaque on their teeth that is difficult to remove and can cause gum recession.


Grinding and clenching your teeth. Clenching or grinding your teeth can put too much force on the teeth, causing gums to recede.


Crooked teeth or a misaligned bite. When teeth do not come together evenly, too much force can be placed on the gums and bone, allowing gums to recede.


Body piercing of the lip or tongue. Jewelry can rub the gums and irritate them to the point that gum tissue is worn away.


How Is Gum Recession Treated?

Mild gum recession may be able to be treated by your dentist by deep cleaning the affected area. During the deep cleaning -- also called tooth scaling and root planing -- plaque and tartar that has built up on the teeth and root surfaces below the gum line is carefully removed and the exposed root area is smoothed to make it more difficult for bacteria to attach itself. Antibiotics also may be given to get rid of any remaining harmful bacteria.

If your gum recession cannot be treated with deep cleaning because of excess loss of bone and pockets that are too deep, gum surgery may be required to repair the damage caused by gum recession.


What Type of Surgery Is Used to Treat Gum Recession?

The following surgical procedures are used to treat gum recession:


Open flap scaling and root planing: During this procedure, the dentist or periodontist (gum doctor) folds back the affected gum tissue, removes the harmful bacteria from the pockets, and then snugly secures the gum tissue in place over the tooth root, thus eliminating the pockets or reducing their size.


Regeneration: If the bone supporting your teeth has been destroyed as a result of gum recession, a procedure to regenerate lost bone and tissue may be recommended. As in pocket depth reduction, your dentist will fold back the gum tissue and remove the bacteria. A regenerative material, such as a membrane, graft tissue, or tissue-stimulating protein, will then be applied to encourage your body to naturally regenerate bone and tissue in that area. After the regenerative material is put in place, the gum tissue is secured over the root of the tooth or teeth.


Soft tissue graft: There are several types of gum tissue graft procedures, but the most commonly used one is called a connective tissue graft. In this procedure, a flap of skin is cut at the roof of your mouth (palate) and tissue from under the flap, called subepithelial connective tissue, is removed and then stitched to the gum tissue surrounding the exposed root. After the connective tissue -- the graft -- has been removed from under the flap, the flap is stitched back down. During another type of graft, called free gingival graft, tissue is taken directly from the roof of the mouth instead of under the skin. Sometimes, if you have enough gum tissue surrounding the affected teeth, the dentist is able to graft gum from near the tooth and not remove tissue from the palate. This is called a pedicle graft.

Your dentist can determine the best type of procedure to use on you based on your individual needs.


How Can I Prevent Gum Recession?

The best way to prevent gum recession is to take good care of your mouth. Brush and floss your teeth every day and see your dentist or periodontist at least twice a year, or as recommended. If you have gum recession, your dentist may want to see you more often. Always use a soft-bristled toothbrush and ask your dentist to show you the proper way to brush your teeth. If a misaligned bite or teeth grinding is the cause of gum recession, talk to your dentist about how to correct the problem. Other ways to prevent gum recession include:

Quit smoking if you smoke.

Eat a well-balanced and healthy diet.

Monitor changes that may occur in your mouth.

Cosmetic Dental Filling

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Onlay and Inlay

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Sonic-Activated Dental Filling

We at Royal Dental Care are offering the new advanced SonicFill 3 SingleFill™ Composite System.


What is it..??

- It’s the industry’s first sonic-activated bulk fill composite system that helps us craft quality restorations with greater ease and speed compared to an incremental layering technique.

- SonicFILL is a technique created to seal cavities with minimal drilling, and filling the tooth with a non-metal composite resin material.

- New SonicFill™ 3 is the first Sonic Activated bulkfill composite that acts as a flowable in terms of adaptation and quick placement, but also as a sculptable composite when it comes to carving and contouring.

- it achieves long-lasting restorations in one efficient step.


What are its benefits..??

- 5mm depth of cure with SingleFill Composite System

- Improved adaptation to the internal walls and restoration margins

- Better non-sticky handling

- Simpler to extrude during placement

- Low shrinkage stress for lasting marginal integrity

- The best benefits of both a flowable and sculptable composite in one.

- its use prevents post-operative sensitivity complaint following the use of the traditional composite systems.

- it increases our speed and deliver an excellent adaptation, lasting marginal integrity, and reduce post-operative sensitivity.

- The non-sticky, non-slumping nature of the material allows for quick, easy shaping and sculpting.


These benefits combined with a high depth of cure and low shrinkage stress allow a technique in which a cavity up to 5mm in depth can be filled and cured in a single bulk increment, hence the single fill concept. So, we will have adequate working time before the material starts setting.

Dental Jewellery

What is it..??

- It’s a cosmetic dental procedure in which diamond or any other stone is attached to the tooth surface .


How is it applied..??

- They’re just few millimeters in size, applied on tooth surface with adhesive , they’re temporary & need no drilling.

- Not painful , it takes several minutes.


Technique..:

1- Isolate with cotton roll, clean tooth with cotton roll.

2- Put etch 20 seconds on tooth.

3- Remove etch with cotton, then clean with wet cotton.

4- Put bond on tooth then Flowable composite then put Vaseline on the back of brush then put the crystal on its back and apply it on the tooth , reposition the crystal with the probe then cure for 20 seconds on each side .


How long does it last..??

It can be :

- Temporary: will last from 1-6 W or for months.

- Semi-temporary: will stay on until you decide to remove it.


Disadvantages:

To put it on the tooth , adhesive is applied on the tooth , So:

- Enamel may wear away from tooth.

- Increase tooth decay chance.

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