The relationship between art and medicine may be more apparent in some medical specialties such as in plastic surgery or ENT (ear, nose and throat), where if we were to take a closer look at when a physician is suturing a patient’s hand, all his effort is focused on helping the patient’s skin return to its normal form and appearance. This matter is very important in dentistry. This is because, asides from the scientific aspect of the procedure performed, you are always in the process of reconstructing a patient’s teeth, whether that be with simple restorative procedures or with more advanced and artistically beautiful prosthetic procedures that allow the patient’s teeth to look more natural and similar to how they were created by God. This matter clearly demonstrates the importance of art in dentistry. The more artistic the dentists are, the more they will try to make use of their knowledge in dentistry and efficient use of different materials to offer their patients better results.
What is cosmetic dentistry?
If we were to discuss this in simple terms, whenever the front teeth, which are visible to others, are in need of a dental procedure, cosmetic dentistry comes into play. This can range from a simple restorative procedure, where a patient’s tooth is aligned with its neighboring teeth, to more advanced procedures such as reconstructive surgery, where a number of ill-positioned frontal teeth negatively affecting the patient’s smile are aligned. It is here that cosmetic dentistry comes into play.
The services provided in cosmetic dentistry can range from simple repairs to full ceramic laminates and composite veneers that can cover a larger number of teeth.
The difference between reparative and cosmetic dentistry is related to the frontal teeth in that they are visible and form an important part of the patient’s smile as well as their visibility when one’s talking. When you intend to work on repairing these teeth, you have entered the field of cosmetic dentistry. On the other hand, back teeth, which aren’t visible, undergo restorative procedures in which tooth decay is resolved and teeth return to their previous normal state. Color isn’t important for these teeth as is the age for frontal teeth and it is possible that the restorative procedure cause a variance in color that is negligible.
With time, humans worked towards gaining more beauty and harmony, whether that be in the field of house design, car design, or clothing. In the heart of this wave, cosmetic dentistry has also gained tremendous attention. Under the influence of the media, the current trend for people is to take Hollywood superstars, models, and media influencers as role models, where they seek to have the same quality and color of teeth. This slowly creeps into the minds of these people, raising their self-esteem and helping them in leading more confidence-filled lives. In the past 50 years, successful businessmen never felt the need to have well-aligned teeth. This isn’t true for our current times as each business now has its own kind of attire standards, from the watch to be worn, phone to be held, to the smile to be shown. Well-aligned teeth with appropriate coloring spread vibes of professionalism and confidence while misaligned, badly colored teeth are no longer acceptable.
How is my surgery performed?
You will undergo surgery under general anesthesia or local anesthesia with sedation. Our surgeons will make the right option depending on the type of rhinoplasty to be performed. There are two opening incision techniques in a rhinoplasty surgery. The first, Closed Rhinoplasty, is where incisions are hidden inside your nose. The second, Open Rhinoplasty, is where an incision is made at the base of your nose between your nostrils. These incisions raise the skin that cover your nasal bones and cartilages which then allow your surgeon to reshape the structure of your nose. Following these incisions, your surgeon will begin to reshape your nose in the way you discussed at your consultation. Sometimes cartilage grafts can be performed and so cartilage from the septum, or even the ear and in are cases the rib, are used. Once your surgeon has reshaped your nose, they will close the incisions and stitch them. These stitches will stay in place for multiple weeks until they dissolve or fall out. With that, your rhinoplasty surgery is complete.
Special substances that have a certain percentage of oxygenated water are applied to the teeth surface for whitening. One of the advantages of this method is that no surgical procedure is performed on the teeth and no damage is inflicted on the teeth. The disadvantage of this matter is that previous coloring will return with time. This procedure is much more popular than procedures that involve tooth shaving because of its non-invasive nature, lower cost, and shorter duration of time it requires (usually one session).
Composite veneers are one of the restorative cosmetic procedures where a layer of composite is applied on the entire surface of the tooth. Because this is done on the surface of all adjacent teeth, all teeth take on one uniform color and the color variations under those composites disappear. The appearance of teeth can also be manipulated to make them more appealing. In the second part of the question where it has been asked if dental cracks can benefit from composite veneer, not all cracks require reparative actions. If the cosmetic aspect of the matter is in discussion, cracks can be covered with composite so that not only will they not be seen but their appearance will be much better. This layering will be protective for the injured enamel.
Whenever you lose your teeth, you are forced to replace them with implants or bridges. Implants are undeniably the best solution if bone condition allows it, and we do our best to avoid bridging teeth together because the bone area left out without teeth will disintegrate causing the patient to run into some problems because one of the bridge pillars will have been lost. This isn’t true for implants where both bone is conserved and teeth are arranged one by one in such a way that if a tooth implant were to have any problem, only that specific tooth will need to be repaired. Whenever these implants are set to be placed in the frontal area it is very important that proper arrangements be made in regards to the gum leveling in such a way that both implanted and natural teeth are of the same height to give a more appealing look.
Laminates
laminates do the same task as composite veneer but uses a layer of furnace-baked porcelain material instead. One of the major differences is that light reflection is more prominent in laminates. Also, laminates are polished, furnace-baked, and have a glossy appearance. On the other hand, composites aren’t scratch-resistant and the scratches formed may later on take coloring. Furnace-baked porcelain laminates are also much more resistant compared to composite veneers. The level of resilience and choice of color is up to the patient. If the procedure involves a large number of teeth and includes both the upper and lower jaw, brighter colors can be used. On the other hand, when only the 4 frontal teeth are set to be laminated, the color of the adjacent teeth becomes much more important and there can’t be too much of a difference in coloring. Overall, the laminates can have very natural coloring or even have glowing white color and it is up to the patient to seek consult from their dentist in this regard and then choose the color of their liking.
Zirconium dental crowning
We must first compare between zirconium dental crowns and other dental crowns. In regular crowns, we have one metallic layer that is an alloy of chrome and cobalt which is black in color. The lab technician covers this coloring with a white layer so that a coloring powder can be put on it. When it comes to Zirconium dental crowning, this metallic layer doesn’t exist and the Zirconium element, which is naturally white in color, is used instead. Thus, with a small amount of powder, teeth are repaired more elegantly and with higher precision. We use Zirconium crowning in all our cosmetic procedures because they have more resemblance to laminates.
In some cases where teeth are very badly misaligned and overlap over each other, composite veneer can be used instead of orthodontic. In such cases, with limited shaving, composite can be put on teeth so that they can properly aligned. This is not the case in severe conditions or in jaw problems where composite cannot substitute for orthodontics.
In all, increasing tooth crown length is performed in 2 situations on the condition that the patient not suffer from any gum disease. The first is when dental growth inside the gums isn’t at the same level and size, in such a way that two of the patient’s teeth be higher or lower than the other teeth. Here, using periodontal surgery we try to arrange the teeth, using cosmetic restorations, in such a way that they look almost identical and aligned in one fashion. The second situation is what is known as “gummy smile” where a significant amount of the patient’s gum is apparent when one smiles. Sometimes, with periodontal surgery, surgical intervention to make the gums less visible when a person smiles can be performed. In this case, tooth length is increased and only a small segment of gum is visible, which helps in creating a charming smile.
Here, it is best to clarify the difference between the terms “aesthetic” and “cosmetic”. The appearance we hope to attain in aesthetic procedures is actually the natural beauty of the patient’s teeth, and we do nothing extraordinary in this regard. Tooth color is modified with relatively neutral, normal colors seen in the patient’s other teeth. Misaligned teeth are aligned so that they take on a more organized appealing appearance. There isn’t too much of emphasis on solving all of the patient’s beauty problems. In cosmetic surgery, on the other hand, every beauty problem matters. In this type of surgery, periodontics surgery is always done, and the slightest of color variation between teeth is always a concern to be addressed. The color “white” is much brighter in cosmetics. The number of teeth under procedure starts at 10 teeth in both the upper and lower jaw in such a way that we can both increase the length of teeth visible and expand the dental arch so that teeth become more apparent on smiling.
Smile enhancement helps patients gain more charming smiles. If the patient has short teeth and his or her smile isn’t too apparent, we try to elevate the dental crowns so that our patient’s smile becomes more beautiful. The same goes for expanding the dental arch of the patient and the other parameters in relation to this matter that all have the end-goal of attaining a better smile. It must be noted that no two smiles are alike and everyone has his own unique smile. This is because the form and dimensions of the face and lips, along with many other parameters, play a major role in this matter. It’s best that the dentist educate his patient about these person-specific factors and make use of those factors to help create a more charming smile. Sometimes patients insist that they want to have the smile of a certain actor or actress. These patients neglect the fact that a smile isn’t just teeth, but also includes numerous facial characteristics that are unique to that person which cannot be recreated for someone else.
All the new equipment and materials that are entering the field of dentistry are causing great transformations and “CAD/CAM”, without a doubt, is one of them. “CAD/CAM” is a device that can be used to design and create 3D models of the patient’s jaw and teeth. First, the model is designed on a computer and its parameters in terms of size and shape are designated. This model is then given to the CAD/CAM device so that it be carved out of a Zirconium block. The utility of such a method lies in its rapid action. If a dentist were to have such a device in his clinic, with a well-experienced technician at his aide, a model of a patient’s teeth can be designed, made, and delivered to the patient on the same day, thus shortening the waiting time compared to less-advanced techniques. Sadly, this device is very expensive and costs (with its scanner, carver, and final preparation furnace device) around 3.5 to 4 billion Tomans. For this reason, using such a device in a clinic isn’t justifiable. While this device may be used in some clinics, widespread use of it isn’t feasible because of the high costs, and its use is mostly limited to laboratories where more dentists can use it.
