Details in the Fabric - Fine Cosmetic Dentistry is All About the Details

January 24, 2011 alexnguyen

Whether you like the shape of your teeth to be more square or more rounded, the key to a life-like porcelain restoration is the details of translucency layering, internal color structure, and reflection of light on the surface texture. Visually, depth is perceived in the fabricated piece of porcelain when light penetrates the porcelain to the same degree that it will penetrate natural tooth structure. Like a painter's canvas, the smile is my fabric.

Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

........................................................................................

Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

What Brand or Type of Porcelain Should We Use for the Best Cosmetic Result?

January 15, 2011 alexnguyen

A recent new patient consultation this week has inspired me to write this blog entry... Sometimes I hear this question during my discussions with the patients. In reality, as a patient you should not have to worry about the "name" or "type" of porcelain. In fact, it is always the "technique" employed by the dentist that makes a difference in the outcome of a case.

In the photo below, three front teeth are marked with arrows. They look different from the rest of the restorations because our eyes can see dark areas on the teeth. In particular, the patient was most bothered by the tooth on the far right of the screen. This lateral incisor had an extremely dark tooth structure build-up underneath. When the same "type" of porcelain is used in a series of teeth, color differences of the underlying tooth structure will affect how the final restorations look.

In this case, proper technique can be used to mask out the dark underlying tooth structure in order to allow better color blend. This "technique" is a coordination between the dentist and the ceramist, and it is not a choice that the patient would have to make.

In order for your restorations to look natural, a number of factors must come into play. Those factors are not limited to just ... the porcelain.

........................................................................................

So You Think You Can Crown? Don't Be Afraid to Smile Just Because You Have a Crown on Your Front Tooth ! ! !

January 6, 2011 alexnguyen

Three years after delivery, I saw this patient again yesterday for his periodic check-up. The patient had forgotten which tooth he fractured. I had to take a second look to refresh my memory on which tooth I had worked on. This is a crown success story. When science, art, and, care is coordinated between a dentist and a dental ceramist, nature is replicated in the form of teeth. To crown a tooth is one thing, but to give my patient back a tooth in the form of a crown is something else.

This photograph is a tribute to anyone who has crowns on his/her front tooth. It is also my way to say "Thank You !" to all the talented dental ceramists with whom I have had the opportunity to collaborate in the quest for perfection in our work. Thanks for supporting me in delivering nothing but the best result for our patients.

Smile on !

Before Treatment: Tooth # 8 was fractured, and it was the only tooth restored in this case.

Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

........................................................................................

2011 !

January 1, 2011 alexnguyen

Happy New Year ! ! ! May 2011 bring you the best of Health, Luck, and Prosperity !!!

Smile Makeover - From a Well-Informed Patient

December 19, 2010 alexnguyen

In a commercial market driven by advertisements and the desire for instant gratification, patients need to be well-informed about treatments involving cosmetic dentistry. A successful case must be built on multiple foundations which include: 1. Your bite

2. Esthetic principles

3. Your personal preferences

4. The science of today's materials and techniques

The following email was sent to me from a current case in progress. This patient has done so much research on his own that he knows all the details: from the tooth numbers, to the types of porcelain available, to the characteristic tooth shapes, etc. This is an example of what every patient should know before making a decision on important restorative treatments.

This type of clear communication enables me to coordinate the work with the ceramists who also need to hear the patient's concerns and feedbacks. I am privileged to have the opportunity to work with such well-informed patients.

___________________________________________________________

Email dated Dec 18, 2010

Hi Dr. Alex

Attaches is the "style guide" from where I took the smile that I showed you today.

None of the smiles match exactly what I'm envisioning, but a few come quite close: the Hollywood/Natural/Softened styles.

* Overall: something strong and youthful, but not overly aggressive or mature

* Central incisors: I like the shape/edges on the Hollywood/Natural (actually all three look the same)

* Laterals

* I like the shape on the Hollywood (similar to my current teeth), but they could go in (up) a little more deeper on the corners, especially the edges with the centrals. Actually, the right lateral (when looking at the photo, tooth #10) on the Natural is what I'm looking for. But I don't like the shape of the left incisor (#7) on the Natural--it's too round especially on the cuspid side

* I would play with the lengths of the central and/or lateral incisor to achieve an ever so slightly larger vertical difference (maybe 0.2-0.4mm more) so it looks like the Natural. What I said in the point above about the edges going up would probably achieve the look of more difference without really changing the lengths of the teeth all that much.

* Cuspids: I like the shape of the Softened: the Hollywood is too flat, and the natural too pointed/sharp. I also think the roundness on the Softened would fit in better with the shapes of my Bicuspids

* Bicuspids: I know we only discussed bonding only on #12 for now, but my thinking is that they would end up similar to the ones seen here (they all look more or less the same in all the styles)

I understand it needs to be customized for my mouth/face shape and my bite, but wanted to share my thinking/vision on some details of the cosmetics. Let me know if you have further thoughts/questions. I know its hard to discuss some of these details through email, we can also look at the image when I come in for the next appointment, if its not too late in the process then. I can also stop by sooner if you feel that would be helpful.

Have a good weekend!

........................................................................................