Hello,
I am planning on getting alot of cosmetic work done to my teeth. I need around 10 implants on the top front of my mouth.
1. I wanted to know what you think of Astra implants from the UK?
2. I would like to know what you thought about Cercon smart ceramic zirconium crowns? I think I read on your site that zirconium is not as aesthetic as all porcelain crowns, but isn’t zirconium clear? They say that these particular crowns are as tough as porcelain fused to metal crowns, do you have a comment on them?
3. I had one dentist tell me that white colored metal fused to porcelain, or gold fused to porcelain, will not show a black line, Is this true?
4. are zirconium abutments for my implants, more aesthetic pleasing then all white abutments?
Thank you for answering my questions. It’s hard to get real answers on the topic of cosmetic dentistry.
– Edward from Connecticut
Edward,
I’m going to answer your question differently from what you’re expecting. I think your focus is wrong. You’re focusing on the materials. You should be focusing on the artist.
You start off saying you want cosmetic work on your teeth. Does that mean you want a beautiful smile? If so, then I believe you’re headed for trouble. Because you’re trying to decide yourself what are the best materials, as if you are planning to micro-manage your cosmetic dentist.
Imagine with me that as part of your employment you are asked to commission a painting to grace the hallway that leads into your corporate offices. And then you busy your time finding out what brand of paints and brushes will produce the best results, and the light you want your artist to use, the stool for her to sit on, and everything else. You will be stifling your artist. What you want to do is find the best artist, and one maybe that you feel a “connection” with, who feels motivated to please you, and then turn her loose on your project, and then YOU get the ARTIST the materials she feels she needs to produce the results you want. Creativity needs an atmosphere of trust and needs freedom in which to operate, if you’re going to get a beautiful result. Your dentist artist also needs to have a strong rapport with you in order to feel motivated to create a beautiful smile that you love. If you go forward with this micromanaging philosophy, your dentist is going to want to kick you out the door and won’t care WHAT you think, in the end.
Additionally, there is no way that you can learn enough about dentistry in the time frame you have to make an intelligent decision on these materials. There are pros and cons of each of the materials, and they depend on the mechanics and the demands of your case. You need a deep background in dentistry to be able to evaluate the claims of the manufacturers of these different materials and devices as well as the independent research. And even then, you won’t really know how they work until you try them. There are many stories of dentists using new materials where the research made them look like fabulous materials, but in clinical use there was a completely unexpected issue that arose that created a disaster.
And, if that weren’t enough, there is the issue of what material works best in your dentist’s hands. Most dental materials and techniques have a learning curve, and they work best when the dentist is fully familiar with the technique and the quirks of the material. You push your dentist to use a material she isn’t familiar with, and you’re asking for trouble.
Having said that, there is one of your specific questions that I’d like to answer, and that is about porcelain fused to metal. No, it isn’t true that porcelain fused to gold or to a white metal won’t show a black line at the gumline. I don’t understand what this dentist has told you, if he’s saying that only metals that aren’t white or gold show the line. Every metal we use in crowns is either white in color or gold. The line may not be black – it may be gray – but it will show if it is above the gumline. That’s because the line is the cement line. I often did porcelain fused to gold alloy restorations, or fused to platinum alloy, and they would show that line. Even fused to pure gold. It’s the bonding technique that eliminates the line, and the bonding technique is used with pure ceramic. There are techniques that MINIMIZE the dark line, such as cutting the metal back at the margin, giving you what is called a porcelain butt margin, but they won’t eliminate it.
And zirconium is white, not clear. It’s zirconium oxide, actually, and it is opaque white. But used properly it can produce very esthetic results, if it is covered with a more translucent ceramic. And yes, it is very tough.
– Dr. Hall
Helpful pages from www.mynewsmile.com:
Porcelain fused to metal crowns
Various types of all-ceramic or all-porcelain crowns
Dental implants
The difference between a cosmetic dentist, who is an artist, and a general dentist
More blog postings on finding a cosmetic dentist you can trust and developing a good working relationship with that cosmetic dentist.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
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