DR. PEAK first came to NGD because he thought he might have a couple of cavities, but he also wanted to discuss cosmetic options for his front teeth.
Because of his dental background he easily understood the pros and cons of each option discussed. Other than the gap between his front teeth, he also had some white fillings in his front teeth that were discolored and breaking down.
The Comprehensive Exam uncovered several concerns. His TMJ (jaw joint) and Muscle Exam proved positive. He didn’t have jaw pain, but he did admit to bruxing (clenching and grinding) at night and his jaw popped and clicked. The health of the TMJ was a prime concern because of the number of crowns and extensive work that DR. PEAK was considering. We needed to proceed cautiously because we didn’t want to aggravate the TMJ issues. An effective nightguard was recommended.
After much discussion DR. PEAK chose to not have his Verticle Dimension (the way his teeth meet) opened. He did admit he needed a night guard. We recommended making the crowns in the back as Porcelian Fused to Metal (PFMs) rather than full Porcelian. The PFMs would be much stronger and bear the force of his bruxing better.
Here you see all his upper teeth are crowned and these are his temporaries. We removed gum tissue above the teeth to give a nicer dimension to the front teeth and less of a ‘gummy’ smile
He chose to wear these for several weeks to determine if the bite was right. We wanted to make bite corrections before ordering the permanent crowns. If his TMJ and jaw muscles became irritated or painful, we could correct the bite more easily.
Here we are getting final measurements to send his permanent crowns to the lab.
After months of treamtment, healing and waiting, DR. PEAK receives his new teeth. His lowers have been whitened, the upper color was matched to the whitened lowers. The upper teeth were lengthed (had tissue removed above the teeth) to give a very nice proportion to his teeth and smile.
Congratulations, DR. PEAK!!! Your smile is beautiful and we enjoyed working with you.
PS. Later DR. PEAK chose a SomnoMed rather than a plain nightguard. The SomnoMed corrects his sleep apnea.