August 19, 2018

Missing Lateral Incisors and Illusions Created with Veneers Laguna Niguel

porcelain veneers replacing congenitally missing teeth

Johnny’s new smile with porcelain veneers to correct for his congenitally missing lateral incisors. A special technique using illusions in the shape of the porcelain veneers enabled Johnny to have a completed smile that obscured his missing teeth.

Johnny, a young man from Laguna Niguel was congenitally missing lateral incisors, the two teeth in a normal mouth that are next to the front teeth. He had had porcelain veneers placed fifteen years ago, and realized it was time to replace his old porcelain veneers.  However, this time he wanted to find a cosmetic dentist who could give him a really nice smile!

His dental history relating to his two missing teeth was simple, one very similar to many other people.  About 5% of the population are congenitally missing one or more teeth.  The most common congenitally missing teeth are the upper lateral incisors, like Johnny was missing. Other commonly missing teeth are the lower second bicuspids, lower second molars and wisdom teeth.

In Johnny’s situation it was obvious when he was nine years old that the two permanent lateral incisors were missing.  So, his parents took him to the orthodontist who put him in braces and closed up the two spaces so that he didn’t have any gaps between his front two teeth and his canine teeth.  However, after it was finished his smile still didn’t look right.  Since the canine teeth were moved into the spaces of the lateral incisors he had very big teeth there in the place where normal lateral incisors are much smaller. Not only are they smaller, they are supposed to be narrower and flatter as well.

original 4 porcelain veneers used to treat missing tooth problem

After orthodontics to close the spaces of the missing teeth and four porcelain veneers were placed Johnny still didn’t have a normal looking smile, and he really wanted a great looking smile! Dr. Huefner placed 8 new porcelain veneers (see photo top of page) which completely corrected the problem with the appearance of his teeth and gave Johnny the great smile he had always wanted.

He then went to his family dentist who placed four porcelain veneers to try to make the canine teeth look more like lateral incisors.  Still, treating just the four front teeth didn’t do the trick.  Exhausted with trying to correct the problem, and thinking that there were no other options to give him a great smile, Johnny and his parents settled for the smile created for him by the orthodontist and the general dentist.  Fifteen years passed and Johnny started researching cosmetic dentists in Laguna Niguel and came to Dr. Huefner’s cosmetic dental practice to see if new techniques were yet available in porcelain veneering that might solve his problem and give him a nice smile?

Fortunately for Johnny we did have a “special trick up our sleeves” that could give him not only a normal smile, but a great smile too!  By “normal smile” we’re referring to appearing as though he has a normal compliment of teeth, four front incisors followed by canine teeth, and then bicuspid teeth right behind those. Dr. Huefner suggested to Johnny that he do something special that he  had done for a number of other patients who were congenitally missing teeth – creating some dental illusions  with porcelain veneers!  We could place eight porcelain veneers but make them each look like the teeth that should normally occupy the position rather than making the porcelain veneers look like the tooth that it is actually on.

Specifically, in Johnny’s case we would make his canine teeth (which were in the position of lateral incisors) look like lateral incisors.  Then we would make his first bicuspids (which were in the position of the canine teeth) look like canines.  Making the second bicuspid look like a first bicuspid was easiest of all.  We would give the illusions that no teeth were ever mission or in the wrong position.

Johnny and his parents were really pleased to hear the solution we offered them.  However, they said that if they were going to do porcelain veneers again could we make his teeth whiter than the original old porcelain veneers?  The answer was “of course!”  We would guide him and recommend the color of the porcelain veneers that we thought would look best, but the final decision would be Johnny’s! ( He ultimately chose BL2.) We added that we would also design the actual shapes of Johnny’s new porcelain veneers to give him a masculine smile design.

The illusionary porcelain veneer treatment for Johnny was completed in just over three weeks time with results that looked fantastic according to Johnny.  (See top photo) His comments were that he really wished that the original cosmetic dentist who did his first four porcelain veneers fifteen years earlier had been able to do that for him.

Dr. Norman Huefner,
Orange County cosmetic dentisty, serving Laguna Niguel, Irvine, Mission Viejo and Rancho Santa Margarita

Orange County Dental Implants

Laguna Niguel dental implant

Top photo: Hopeless tooth removed and implant inserted into the space where the root was. Middle photo: After eight weeks of healing the dental implant was ready to accept the zirconia abutment. Bottom photo: An all ceramic crown (no metal) was cemented over the zirconia abutment. The implant crown matched the adjacent teeth in color, but actually looked better!

I  get a lot of requests for information on Orange County dental implants.  How much are dental implants?  How long does it take for the whole process of the dental implant?  What are the steps in making a dental implant?  Will my insurance pay for dental implants?  Renee is a patient I treated who came in with her upper right lateral incisor broken off.  I treated her with a dental implant to replace the broken off tooth.  Let’s go through the steps and answer some of the common questions.

Renee’s right lateral broken off.  She was devastated!  It was a front tooth and she couldn’t go around “looking like a hillbilly”.  After we assured her that we would make her a tooth replacement that she would have the next day, she relaxed a bit.  I explained that she had several choices to replace her missing tooth:

  • A fixed (permanent) porcelain bridge, which would mean placing new porcelain caps on the teeth on either side of the broken off tooth and a replacement tooth would be joined to those two new porcelain caps
  • A dental implant, which would mean we would just put a permanent crown into the space of the broken off tooth
  • A removable partial denture or a dental “flipper”, both which because they are “removable”, can be taken in and out

After hearing her choices Renee wanted to know more about Orange County dental implants and solutions to her problem.  I told her that I would take an impression to make her a removable temporary tooth replacement, called a flipper.  I would have that ready the next day.  Then the broken off tooth would be removed and an implant placed into the space where the root had been.  It would take about 8-10 weeks for the dental implant to completely heal and join with her jaw bone.  In the meantime, she would be wearing the flipper, so at no time would she be without a front tooth.

After the Orange County dental implant had completely healed I would attach a tooth colored zirconia abutment into the dental implant.  The dental implant is completely below the gums, but the abutment is above the gums and it is the abutment which would then allow me to then place a crown on top of it.   Thus there are three parts to an implant itself, the dental implant that goes into her jaw, the abutment that goes into the dental implant, and the crown that goes over the abutment.  I assured Renee that her new implant tooth would match her other teeth in color.

Her Orange County dental implants treatment went just as I described and was without any complications.  We started by taking a dental impression for Renee’s temporary replacement tooth, the flipper.  Her broken off tooth was removed and a dental implant placed into the space in her gums where her root was.  During the next two months she wore the dental flipper.  Then she returned and I placed the zirconia tooth colored abutment into the dental implant, took an impression of the abutment and then placed a temporary crown on top of the abutment.  From that point on Renee didn’t need to wear her temporary flipper any more.  Two weeks later Renee returned again, the temporary crown was removed and the new permanent all porcelain crown was cemented on top of the zirconia tooth colored abutment.  That completed her dental implant treatment!

To answer the question on how much Orange County dental implants cost?  That depends a number of factors and variables.  Does the tooth have to be extracted, or has that already been done?  Is there enough bone and/or gums to immediately place a dental implant, or do additional procedure(s) have to be done to correct the deficiencies?  Is the tooth in the front of the mouth or in the back?  That might determine whether a custom tooth colored abutment is fabricated or a stock prefabricated metal abutment utilized.  The former has a higher lab fee than the latter.  And finally, what type of crown does the patient choose to have?  Gold, porcelain fused to metal or all porcelain/non metal crown?  Again, the lab fee would vary depending on what type of crown the patient and dentist choose to use.  So the answer is that there is no average fee.  It’s at least a couple thousand dollars for a dental implant on a front tooth.  Compared to the cost of a fixed bridge and implant could be more or less, depending on the above mentioned factors.  To answer more accurately the cost I would have to see the patient for a consultation and evaluate the specific situation.

Will insurance pay for Orange County dental implants?  That depends on what benefits the policy has.  Some plans do cover implants, many don’t.  However, even if there are no dental implant benefits, they usually cover the benefit for the crown the goes onto the dental implant and abutment.

If you have questions on whether or not you are a candidate for Orange County dental implants, and you are living in the Southern California area, I am happy to offer you a complimentary cosmetic dentistry consultation to discuss a dental implant and alternative treatments to solve your missing tooth problem.

Dr. Norman Huefner, Laguna Niguel cosmetic dentist serving Orange County and surrounding cities of Rancho Santa Margarita, Mission Viejo, Irvine and Newport Beach


The Real Housewives of Orange County features cosmetic dentist Dr. Huefner

Dr. Huefner did a smile makeover on Vickie Gunvalson’s boyfriend Brooks Ayers, which will be aired for the first time on  June 12th, TONIGHT, on Bravo, 9pm (8pm central).

For a preview of the episode of The Real Housewives of Orange County check out:

Note that the “Vicki” segment starts about 40% into the program, so you might want to just fast forward or scroll to that.  You’ll see Pam, Kathy from our office and Dr. Huefner in the segment.

Dr. Norman Huefner, Orange County cosmetic dentist and serving Laguna Niguel, Mission Viejo, Irvine and Newport Beach, CA

The Real Housewives of Orange County

Bravo filmed three of Brooks' cosmetic dental appointments for the show. This photo is from the trailer clip that shows Vickie and Brooks in Dr. Huefner's studio at the initial cosmetic dentistry consultation.


Another clip from the trailer when Dr. Huefner discussing the cosmetic dentistry treatment with Vickie and Brooks.


Dental Implant to Replace Laguna Niguel Man’s Missing Front Tooth

Laguna Niguel dental implant with zirconia abutment and all porcelain crown

Lower photo: After the dental implant had healed a tooth-colored zirconia abutment was attached to the dental implant. Upper photo: On top of the zirconia abutment an all-porcelain crown was placed that matched Mark's adjacent teeth.

Dental Implant solves missing front tooth problem for Laguna Niguel man by Dr. Huefner

Mark, a Laguna Niguel businessman in his 40s had injured his front tooth playing football as a youth.  It abscessed and he had to have a root canal treatment to save it.  Over the years it just never “felt right.”  Finally one day he had pain and swelling around the front tooth and after taking an x-ray of the tooth we determined that the tooth had fractured all the way down the root and had to be extracted.  Mark was devastated! “Oh no, I can’t believe it.  All the rest of my teeth are great and now I’m going to lose my front tooth.”  We assured Mark that he is so fortunate to have been able to keep that injured tooth for so many years and now, with modern dental technology, he has two great options to replace his missing front tooth.

x-ray of dental implant and zirconia abutment

This is an x-ray of the dental implant after it had healed and the tooth-colored zirconia abutment was attached to it. The next step was to place the all-porcelain crown onto the abutment.

This was very good news to Mark.  “So what are my options?” asked Mark.  We explained that he could either have a dental implant or and all ceramic bridge.  We explained that if he chose the dental implant then we wouldn’t need to do any treatment to his other teeth and could actually use an all-ceramic crown over a tooth-colored zirconia abutment that fits into the dental implant.  His other alternative was doing a porcelain bridge, either the traditional porcelain-fused-to-metal porcelain bridge or the new all-ceramic non-metal EMax bridge.  However we went on to explain to Mark that by doing a fixed bridge it would also mean that we would have to place crowns on each of the teeth adjacent to the missing tooth.  After fully understanding his options Mark was adamant, he didn’t want to have to have crowns placed on his otherwise good front teeth that would be necessary if he chose to have a porcelain bridge, so a dental implant was definitely the way he wanted to go.

Upper front tooth with dental implant Laguna Niguel

The end result for Mark was a very natural looking smile that didn't even hint that he was missing a front tooth and had a dental implant.

So now that we knew which treatment Mark wanted to solve his missing front tooth dilemma we needed to do two other things.  First, make a temporary replacement tooth so that Mark didn’t have to walk around with a tooth missing in the front of his mouth.  We did this by making a removable appliance for Mark called a “Maxillary flipper”.  Second, we would schedule Mark’s visit with our oral surgeon to remove the infected broken tooth and place the dental implant.

Mark’s treatment went really smooth.  Our oral surgeon extracted the broken front tooth and placed the dental implant and the Maxillary flipper.  Mark left the oral surgeon’s office wearing the temporary replacement tooth (i.e. Maxillary flipper) so it was not apparent to anyone that he was actually missing a front tooth.  After several weeks his infection had gone away and the implant had healed.  Our next step was to place a tooth-colored zirconia abutment into the dental implant.  The abutment would serve the purpose of the natural tooth, allowing us to place the all-ceramic crown over the zirconia abutment.

The end result really pleased Mark!  His infection and pain were gone and he now has a great looking replacement for his  missing tooth and got back his great looking smile.  When looking at Mark the implant and crown matched his other teeth so well that one wouldn’t even imagine that he is actually missing one front tooth.  This Laguna Niguel man is very pleased with his natural looking dental implant and the treatment we provided him at Dr. Huefner’s dental practice.

Dr. Norman Huefner, Orange County Cosmetic Dentist

Missing tooth – dental implant or porcelain bridge for Gary from Laguna Niguel

porcelain bridge laguna niguel drhuefner

Lower photo: Gary lost his lower incisor due to infection. His treatment options were either a dental implant or porcelain bridge. Upper photo: Due to cost and treatment time Gary chose the porcelain bridge as a more expedient treatment to solve his "missing front tooth problem."

Gary from Laguna Niguel had experienced trauma to one of his lower front teeth when he was younger.  Like too many other people today he didn’t go to the dentist and just “toughed it out.”  After a while the pain subsided and he forgot about it.  However his dental problem didn’t go away.  The tooth became infected and eventually a huge abscess developed destroying the bone surrounding the tooth.  Years passed and Gary finally came in for a dental checkup. His main concern was that his front tooth was so loose that he thought he could pull it out himself!

After taking an x-ray and examining his tooth it was obvious that Gary had waited too long, his tooth couldn’t be saved.  The tooth required extraction to stop the infection from spreading to his adjacent teeth.  “Oh no,” Gary exclaimed.  “This is the front of my mouth, everyone will see that I’m missing a tooth!  I can’t let my customers see me with a missing tooth.  What can we do?”

Luckily we have a treatment that will allow the removal of Gary’s infected tooth and for him to immediately have a temporary replacement.  It’s called a “removable flipper“.  It would enable Gary not to go around toothless.   However the “flipper” is only a short term solution, as soon as the extraction area healed up and the infection cures he would be able to get either a dental implant or porcelain bridge.  Gary’s main concerns were cost and expediting the treatment, which both favored the porcelain bridge solution over a dental implant.

Thus, we proceeded with his treatment, extracted his tooth, cleaned out the infection and placed a flipper as a temporary solution.  After the extraction site had completely healed, which was about six weeks later, we fabricated a permanent porcelain bridge for Gary from Laguna Niguel.

Dr. Norman Huefner, Orange County Cosmetic Dentist

Lance’s Congenitally Missing Tooth and Disheveled Smile Becomes Handsome and Normal Looking with Porcelain Veneers Mission Viejo

old porcelain veneers and congenitally missing tooth

Lance had a congenitally missing front tooth and his dentist placed six porcelain veneers placed back in the 1980s. Over the years his gums receeded and he chipped one veneer. Lance decided to replace the six old porcelain veneers with new ones that were stronger, lighter and more natural in color and had better shaped teeth to hide the fact that one tooth was missing.

Lance from Mission Viejo, was congenitally missing his upper left lateral incisor.  In the late 1980, when porcelain veneers were first introduced into dentistry, Lance had several porcelain veneers placed by his dentist.  At the time it was a huge improvement.

After over twenty years had passed Lance experienced some gum recession around his veneers and then one day he hit his mouth while working with some equipment and one of his porcelain veneers chipped.  Lance realized it was finally time to have his porcelain veneers redone. But Lance’s first question was will they better than the first set he had a few years after porcelain veneers were first introduced to dentistry? One challenge to Lance’s treatment is that he had only had six porcelain veneers and all his other visible teeth were very dark.  If he wanted the color of his teeth to be consistent when he smiled he would best served by doing eight or possibly ten porcelain veneers.  But Lance was adamant that he only wanted to have the six old porcelain veneers replaced, and not have porcelain veneers placed on his dark side teeth.  Lance also asked us to know how different and improved the new design of his smile would look?

porcelain veneers mission viejo

Lance's masculine and natural looking smile with six new porcelain veneers by Dr. Huefner. Lance was extremely pleased with the end results of his new cosmetic dentistry.

The answers to Lance’s questions were encouraging. First, huge improvements in both the porcelain materials and bonding techniques have been made over the past two decades.  Second, using some advanced cosmetic techniques to mask the congenitally missing tooth and give the allusion that all teeth were present (called lateralizing the cuspid and cuspidizing the bicuspid) he would have a vastly improved smile that would look like he had the normal compliment of teeth.

improved results of missing tooth and porcelain veneers

Lance was pleased with how his new cosmetic dentistry masked the problem of his missing tooth, and the final results were an absolutely normal looking smile.

Lance proceeded with his porcelain veneer treatment, Lance was very pleased with the end result. He got a natural looking smile that was greatly improved compared to his original dentistry. We also used a stronger porcelain called “Empress pressed ceramic”.  Beginning to end, Lance’s new smile was completed in just two visits that were fourteen days apart.

Please feel free to comment or ask questions about porcelain veneers or smile makeovers when there are congenitally missing teeth.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of San Clemente, Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza, Rancho Santa Margarita and Lake Forest, CA.

Mission Viejo Businessman with severely discolored front teeth and congenitally missing lateral incisor tooth gets amazing smile enhancement with porcelain veneers

Porcelain Veneers for Mission Viejo Businessman

mission viejo porcelain veneers

Jeff had four porcelain veneers placed to give his front teeth a whiter, youthful and more attractive color and hide the fact that he had a fractured off his left central incisor and was congenitally missing his right lateral incisor.

Jeff from Mission Viejo has been a longtime patient and personal friend for decades.  Back in the 1980s his dog crashed its head against Jeff’s left front central incisor tooth and broke a good part of it off.  Porcelain veneers had not been invented yet, so Dr. Huefner came to Jeff’s rescue by placing a bonded plastic composite resin veneer which gave Jeff a normal looking front tooth again.  However 25 years passed and the old fashioned plastic veneer severely discolored and was very distracting.  Jeff finally realized it was time to replace his old dentistry and get his smile into shape!

Very clear about what he wanted, Jeff told Dr. Huefner he just wanted his four front teeth to look good and match with his other side and back teeth. He didn’t want a complete smile makeover, just to correct the major problems.

congenitally missing right lateral incisor before porcelain veneers

Twenty five years after having old fashioned plastic bonding that had severely discolored, Jeff realized it was time to get the appearance of his smile back into shape with cosmetic dentistry.

After closely examining Jeff’s teeth and smile Jeff’s cosmetic dental problems were determined to be:

  • right lateral incisor missing
  • right canine tooth (the long pointed tooth in the photo) had moved into the normal position of the missing lateral incisor
  • left central incisor was chipped off in half and restored over 20 years ago with old fashioned material that had now severely discolored to a dark brown color
  • left lateral incisor was also discolored brown

Jeff also said that he wanted not only his front teeth to match, but also if possible to make them a little lighter in color than his other teeth.  “Just a little whiter would be good,” said Jeff.

mission viejo porcelain veneers

Jeff got a terrific smile enhancement with four porcelain veneers. The four veneers were made whiter and slightly longer for a more youthful look. The gum on his left lateral incisor was reshaped with the dental gum laser to make it the same length as his right lateral incisor veneer. He was congenitally missing his left lateral incisor, so the left canine veneer was made the same shape as a lateral incisor, giving the illusion that Jeff wasn't missing a tooth.

The solution to Jeff’s problems was to make four porcelain veneers for him.  However, to make Jeff’s smile look its best we also added a few things to the design that really improved the overall look of his front teeth:

  • made his front two teeth a little longer (the size they originally were before the right central incisor wore down a little and the left central incisor broke off)
  • since his right canine was in the place of his right congenitally missing lateral incisor, we made the veneer for it the shape of a lateral incisor.  This gave the illusion that Jeff wasn’t missing his lateral incisor
  • since the new right lateral veneer was longer at the gum line, as can easily be seen from the pretreatment photo, we did some minor laser gum reshaping on Jeff’s left lateral incisor with the dental gum laser.  Our goal was for both lateral incisors to be as close to the same length as possible.
orange county porcelain veneer treatment

Jeff, a successful businessman from Mission Viejo with a younger, more attractive and professional smile with four porcelain veneers that goes well with his handsome features.

The end result for Jeff was a cleaner, more youthful and professional looking smile with the four porcelain veneers and minor laser gum reshaping on his left lateral incisor.  He got the whiter, more youthful looking smile that he had always wanted and it no longer looked liked he was congenitally missing his right lateral incisor.  Jeff was very happy with the end result and nothing pleased us more than to give our long time patient and friend from Mission Viejo a great smile, the smile he deserved to have!

Please feel free to comment or ask questions about Jeff’s porcelain veneer treatment and how we corrected his smile to hide the fact that he was congenitally missing his lateral incisor.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of San Clemente, Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza and Rancho Santa Margarita

“Yikes! My Front Tooth Broke Off, What Can I Do?” How an Orange County cosmetic dentist saved his patient from major embarrassment.

broken front tooth

Amy was devastated and in tears when her front tooth broke off near her gum line. When this happens sometimes the tooth can be saved with a post and core and new porcelain crown. Other times the treatment of choice is either a dental implant or non-removable porcelain bridge.

Amy is an attractive lady, a Realtor by profession.  Back in her 20s she had chipped her front tooth badly and ended up needing to get a root canal and crown on it.  She was content until one day she was eating and bit down hard on something in her food.  Wham…..her tooth broke off near her gum line.

Amy was devastated, actually in tears!

She came into our Orange County dental office in Laguna Niguel as an “emergency” patient and in tears.  “What can I do?,” she asked.  “I can’t go out in public or to work missing my front tooth.  There must be some treatment you can do to give me back a front tooth.”

What happened to Amy is unfortunate, but not all that uncommon.  If a tooth has a large cavity or substantial amount of tooth broke off, then root canal and crown treatment are often the two treatments to save the front tooth.  The only problem was that Amy’s tooth was already very weak, and then she suffered additional trauma when she bit down on the hard object.  That was way more than her weak tooth could handle.  Thus, breaking off the crown.

How much tooth is left is a major consideration when treating a broken tooth

When trying to salvage the tooth for Amy our first consideration was how much tooth was left ABOVE THE GUM LINE?  If there is 2-4mm or tooth ABOVE the gum line, then with some heroic dentistry a new crown can oftentimes be made.  But the patient must understand that there is absolutely no guarantee that the tooth won’t break again.

If the tooth breaks at or below the gum line, then it is unlikely that the tooth can be saved.  In that case, the tooth would be extracted and either a dental implant, fixed porcelain bridge or some cases a removable partial denture made to give the patient back their front tooth.

laguna niguel porcelain crown

Amy was fortunate that she had already had a root canal on her tooth and there was a minimal amount of tooth left above her gum line. A post and core and new porcelain crown were fabricated, saving her from the humiliation and embarrassment of not having a front tooth.

In Amy’s case, as one can see in the photo, there was some tooth left above the gum line.  So she was in luck!  Since her tooth had already had a root canal we explained to Amy that we could try to save her tooth by placing a post and core into her root canal filling and by doing that we could create enough tooth above her gums to place a new porcelain crown on.

Amy tears began to stop.

“When can you do that for me?” she asked.  “I have to go to work today and I can’t see clients looking like this?”

To Amy’s delight we said we could build up her tooth with the post and core and make her a temporary crown right then and there.  We would do what we needed to do, make her a new tooth and she would be done in just over an hour’s time and be able to go to work as normal.  In two weeks time her porcelain crown would be completed by our ceramist and we would then remove her temporary crown and cement on her final porcelain crown.

We were able to do everything exactly as planned and Amy got her new crown on her broken front tooth two weeks later. However, that being said, it must be stressed that this kind of heroic dental treatment to save a broken tooth cannot always be done and oftentimes it is not the best long term solution.  Again, alternative treatments options like a dental implant, fixed porcelain bridge or sometimes (but rarely) a removable partial denture are better ways to treat a patient with a broken off or missing front tooth.

Please feel free to comment or ask questions about Amy’s treatment.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza and Rancho Santa Margarita

Black Lines Eliminated Around Old Crowns and Bridges Replaced with New Porcelain Cosmetic Dentistry for Victoria from Mission Viejo

porcelain fused to metal bridge with black lines replaced with IPS e.max non-metal bridge

Below, Victoria hated her old bridgework. The teeth were yellow and she really objected to the black line around the gum line of the bridge. Top, Victoria smile makeover consisted of an all-ceramic (non-metal) bridge and one crown and several porcelain veneers.

In high school Victoria from Mission Viejo was a very competitive soccer player.  One day an opponent took a cheap shot and knocked her from the side, causing her to crash her teeth into the head of another player. Unfortunately, it knocked one of her front teeth out! Devastated, Victoria’s parents had their family dentist place a porcelain on metal bridge.  It solved the problem of showing that she had a missing tooth, but it still left Victoria with front teeth and a smile that had a lot to be desired.  Most notably was the black line around her gums caused by the metal used in the bridge.

Ten years past and after graduating from college and getting her first real job Victoria was ready to replace her old dentistry and “get a nice smile”. When Victoria came in for her cosmetic dentistry consultation with Dr. Huefner she was very clear about what she wanted done.  “My front teeth got ruined when I was a young, first by knocking out my front tooth while playing soccer, and second, by the ugly dentistry.  My teeth and bridge are way too yellow, I want white teeth.  Most of all, I can’t stand that black line around my old bridge.  Can you fix my teeth so that I don’t have a black line this time?”

Victoria is fortunate that in this day and age cosmetic dentistry now has the solutions she needed.  Techniques and materials have vastly improved over what she had done just a decade earlier.

yellow teeth and bridgework

Victoria's yellow teeth and yellow bridge gave her a very drab looking smile. An attractive lady, Victoria wanted a nice smile with white teeth.

After attentively listening to Victoria and her concerns, and after doing a careful dental examination, a treatment plan was customized to meet her needs:

  • Bleach her lower teeth with home teeth whitening
  • Replace her old porcelain-fused-to-metal bridge and crown with an all-porcelain bridge (without any underlying metal that might show) and crown.
  • Place several porcelain veneers on Victoria’s other upper front teeth

A point worth noting, when Victoria had her original bridge done 15 years earlier porcelain-fused-to-metal was the treatment of choice.  Her dentist was using the usual and customary technique and materials for her bridge at that time.  But the state of the art of cosmetic dentistry has vastly changed since then.  The evolution of cosmetic dentistry led to the development of several materials that didn’t require a dark metal substructure under the porcelain.  One of the most popular alternative to the typical porcelain-fused-to-metal bridge over the past ten years was zirconia (a white metal) with porcelain fused over it.  Most recently the state of the art material that has captivated most of the cosmetic dentists and their patients is called IPS e.max®.

all-ceramic bridge and porcelain veneers mission viejo

After her smile makeover with new all-ceramic bridgework and porcelain veneers Victoria had beautiful looking teeth and wasn't embarrassed to smile any longer!

Victoria’s treatment went smooth and her entire smile makeover with an all-ceramic e.max bridge and porcelain veneers was completed in just three weeks time.  As clearly shown in the photos, she got the incredibly beautiful smile that she always wanted and a bridge that looked as if she had never lost a tooth!  Best of all, no black metal line around the gums on this bridge because it was made entirely of tooth colored porcelain.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza and Rancho Santa Margarita

After Front Tooth is Lost, Creating a Beautiful Smile with Porcelain Veneers and Bridge for Dora from Irvine

crooked discolored teeth

Dora had crooked, discolored teeth. She had little interest in cosmetic dentistry until one day she developed a huge infection and lost one of her front teeth.

Dora from Irvine had crooked, discolored teeth.  Although she wasn’t very pleased with the appearance of her teeth and smile, doing something about it by treatment from a cosmetic dentist was never a priority for her….until, she lost one of her front teeth!

Usually if there is just a little infection the gums and tooth can be successfully treated, but in Dora’s case there was so much infection and bone lost around the front tooth that it couldn’t be saved and had to be removed.

missing front tooth

After Dora's infected tooth was removed and the area left to heal a "bony defect" remained. If the missing tooth was treated with either a dental implant or dental bridge, because of the loss of gum and bone the resultant tooth would end up being longer around the gum line than her adjacent teeth. If this was unacceptable with Dora a bone buildup procedure could be done for her, but that would delay her treatment by several months.

Now Dora was ready to do something about her teeth and smile. Unfortunately, because the infection had destroyed so much bone that when the area healed after the extraction there was a “bony defect”, meaning the bone wasn’t at the same level as her adjacent teeth.  This had esthetic implications, as when Dora smiled some of the lack of bone and gums could be seen.

Dora had to make some informed choices as to which way she wanted to complete her dental treatment.  We offered her these options:

  • A traditional 3 teeth porcelain bridge.  Drawback, if we only did that we would have to match the color of her other teeth and the false tooth attached to the bridge would end up longer around the gums because of the bony defect
  • Surgical treating the bony defect first, building up the bone and correcting the defect, then  traditional 3 teeth porcelain bridge that would also be made to match her other teeth.  Down side, the surgical procedure would take several months to heal up.
  • Surgical treatment of the bony defect and dental implant.  This would take approximately six months but only one tooth would then need to be made for her (replacing the one lost), and that one tooth made to fit onto the dental implant would be made to match the color of her other adjacent teeth as well.  For Dora, six months of treatment and healing was a huge drawback.
  • If Dora wanted all her teeth to be straight and a whiter, more attractive color then we could place a 3 teeth porcelain bridge, and porcelain veneers on five of her other teeth, resulting in eight beautifully aligned teeth.  However, the one tooth would still be longer near the gum line if she didn’t have the surgical treatment to build up the bone first.  Advantage, it would achieve a huge improvement in her smile!
temporary bridge and veneers

Dora in her temporary bridge and five temporary veneers. She approved of the design of her new smile, including the length, shape and color of her teeth. The longer tooth on the bridge was acceptable to her and gave us written permission to complete the fabrication of her new bridge and veneers following her approved design.

Dora was anxious be proceed with treatment, and did not want to go through the surgical procedure to build up the bone.  She accepted the last option, the 3 teeth porcelain bridge and 5 porcelain veneers, knowing that the false tooth on the bridge would then half to be a little longer around her gums.  Her teeth were prepared and a 3 teeth temporary bridge and 5 temporary veneers were placed to confirm the shape, color and length of her teeth.  Also to make sure that she was “ok” with the one longer false tooth on her bridge.  If she wasn’t, then she could still have the procedure to build up the bone.

porcelain bridge and veneers irvine

Dora's final smile with a three unit porcelain bridge and five porcelain veneers. Now she had straight, white teeth and no more missing tooth in the front of her mouth.

After wearing the temporary bridge and veneers for several days to adjust to her new smile and Dora returned to our office to give her written approval as to the design of her new smile.  She continued to wear the temporary bridge and veneers for two more weeks and then returned again for the final placement of her new porcelain bridge and porcelain veneers.  The end result for this wonderful lady from Irvine was superb, a huge improvement on Dora’s smile before losing her front tooth.  Also, Dora’s teeth were whiter and straight now, two things that she definitely wanted.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of Laguna Niguel, Irvine, Newport Beach, Mission Viejo and Rancho Santa Margarita
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