We were introduced to Tricia in the summer of 2019. She came to our office for a cleaning and a checkup and expressed that her main concern was the wear areas around her gum line. In the past, fillings were placed to restore these areas, but they always seemed to come off. Tricia also communicated that she has dealt with consistent jaw pain for several years and that she has a habit of clinching her teeth while she is working. Dr. Nebrig discussed how all of these issues were related to one another. If we could repair the trauma that was done to the teeth and find a way to prevent further trauma from occurring, then we could make the fillings around the gum line last much longer. Tricia and Dr. Nebrig created a plan to place some very esthetic tooth colored fillings over the wear areas and ultimately to minimize the clinching of her jaws with therapeutic Botox injections. Finally, a night guard would be fabricated in order to balance the forces that her jaws were placing on her teeth at night. Treatment occurred according to plan, and Tricia was seen on a regular basis for the next year.
At one of Tricia’s subsequent cleaning appointments, she expressed further concerns about the esthetics of her teeth. She said that they looked worn and that some of the old crowns in her mouth were not the same color as her natural teeth. She wanted everything to match! After a comprehensive exam with Dr. Nebrig that was focused on her parafunction (clinching and grinding) and her cosmetic desires, the decision was made to conduct a full mouth rehabilitation. This procedure would provide complete control of the esthetics of her teeth as they related to her smile, and also allow Dr. Nebrig to create proper function of her jaw that would help minimize further wear of her “new teeth”.
The road to her new smile began with a “diagnostic wax up”. This was an artistic rendering of what her new teeth could look like. Following extensive discussions between Dr. Nebrig and Tricia regarding what Tricia considered beautiful, Dr. Nebrig communicated the functional and cosmetic specifics to the lab that would guide the design and creation of this “road map”. The lab returned the wax up to our office, and we used it as a guide to create Tricia’s functional temporaries. After wearing her temporaries for a few weeks, Tricia was able to direct Dr. Nebrig on what small changes should be made to her final restorations in order for them to be perfect in her eyes. Minor tweaks were made to the temporaries and the perfect shape was agreed upon. Using digital impression technology, Dr. Nebrig was able to email digital models of Tricia’s teeth to the lab in order to have the final crowns and veneers fabricated.
Delivery day came and Tricia’s temporaries were removed and final restorations were placed. Minor esthetic changes were made to her canines, and her bite was perfectly balanced. A new night guard was fabricated in order to protect Tricia’s new investment. With proper maintenance, Tricia’s should be able to enjoy her new smile for decades to come.