COSMETIC CROWN Case studies by Dr Adam Glassford

The following pictures are all before and after cases prepared and completed entirely by Dr Adam Glassford and his ceramic technician. No photo re-touching or digital enhancement has been used whatsoever

Replacing old NHS PFM crown

This upper right central incisor crown had been present for many years and shows the classic black line around the margin from the metal core within. The crown was carefully removed to preserve tooth structure.
The teeth beneath was re-shaped and shade matching photographs taken to accurately copy the adjacent central incisor tooth
A temporary crown is fitted whilst the permanent crown is being produced.
The new all-ceramic crown in place. Note the excellent character and form copying the adjacent tooth exactly

Replacing an old crown upper front incisor

This patient is a fellow dentist that referred herself to me to have an old unsightly crown replaced. The tooth beneath had suffered trauma in the past and was root filled. As with many root filled teeth the actual tooth structure was quite dark and the challenge then is how to mask that without it shining through the new crown. The After picture shows an Elite level all ceramic crown fitted.


Restoring damaged teeth using crowns in a bruxist

The upper front teeth had been traumatically damaged some years before and repaired at the time unsuccessfully. The patient wanted a durable cosmetic end result so a combination of cosmetic ceramic crowns and minimal prep-veneers were used.
This shows the temporary crowns / veneers in place which were made from a diagnostic planning model. The patient wore these for around 2 weeks to ensure that he was happy with the change to the shape and size of the teeth. Changes can be made to these temporaries and then incorporated into the final work if required.IMG_0002IMG_9998
The final fitted work in place. The shade chosen was a close match to the rest of the natural teeth. In this instance the patient was happy with the shade of their surrounding teeth and did not opt for tooth whitening. The patient was also provided with a night-time bite guard to protect against future episodes of bruxism (night-time tooth grinding)

Replacement of patchwork old dentistry

These old crowns had been in place around 20 years and had served the patient well however she had become increasingly unhappy with the mismatch of colours and shapes
The characterisation of the crowns was chosen to be age-appropriate in this 70 year old patient.
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After planning the changes using photographs and models of the mouth, a diagnostic wax up set of models was produced. This showed the patient what the changes would look like before they were carried out. The teeth were changed to correct the smile lines and horizontal planes. Final Elite level crowns were characterised to the patients wish for a ‘healthy natural’ look and age appropriate. Phase 2 of the treatment will be correction of the lower teeth which the patient initially accepted but now wants improving after she saw how good the new upper crowns were! We are now planning rebuilding the entire lower set of teeth with a mixture of Elite level cosmetic crowns and veneers

Replacement crowns with reshaping of smile lines

This patient had old NHS crowns showing a dull opaque look as well as black margins common with this type of old restortion. Planning models were produced to plan changes to the profile of the teeth and smile lines.
The diagnostic planning models were transferred into the patients mouth using a ‘trial smile’ technique. this picture shows the trial smile set using a temporary composite material which is worn for 2 weeks whilst the permanent work is being created at the ceramic laboratory
The final work fitted. We opted for Elite level ceramic cosmetic crowns with mild characterisation. The patient chose a light shade and whitened the lower teeth . The trial smile demonstrated one shade option and this was modified to a lighter colour with the final work.
This side view shows how the tips of the new smile fit well with the lip being sat just on the vermillion border of the lower lip.