Orthodontic wire was then bonded with composite from canine to canine for stability. It was explained to Marc and his mother that we could only wait for now and review conditions over the next couple of weeks. They knew that it was possible the teeth involved would require root canals, post and cores and crowns, maybe even extracting and placing implants. Time would tell.
48 hours later, the patients upper lip was swollen, but strangely enough, the patient felt no pain with his teeth. Marc and his mother knew that he was not out of the danger zone yet, but things were looking promising. Poor Marc said, “I had such great looking teeth, now look at me”. I assured him that once everything was stabilized, he would once again be proud of his smile.
It was a couple of weeks later that the teeth started turning dark and bothering Marc. Another course of antibiotics were prescribed and Marc had root canals on 3 teeth. Meanwhile, the swelling of the lip had gone down and you could barely tell on the outside anything happened, but when Marc grinned, all one could see was a metal wire attached to chipped teeth.
Once the root canals were performed (which by the way was tricky on the tooth that had a mid root fracture), post and cores were placed , the ortho wires removed and composite build ups were placed to once again, resemble teeth. Although it was a vast improvement from when I first saw Marc, he still was not happy with his smile. We sat down with Marc and his mother and planned out the next phase of his treatment. This would include: power bleaching, four all-porcelain Empress crowns and two porcelain veneers. Marc was also a night time teeth grinder so a bite splint was also part of his treatment plan. Photos were taken with a computerized mock up of what his smile might look like. Marc liked what he saw and was excited to get started on his smile makeover.
Study models were taken along with a bite registration and a series of photos for the laboratory. Specifications for the wax up were made and in a couple of weeks the wax up was back at the office for Marc and his mother to view and confirms that it was what he wanted. Later that week, Marc came back for the procedure.
The day of the procedure, he was led back to his operatory suite and wrapped up in a blanket with headphones and a movie of his choice was set up on the overhead monitor for him to watch . He settled in for the morning’s procedure quite comfortably. A few hours later we were finished and Marc left the office with a great looking smile, although just in temporaries, they were designed to look as close to the final result as possible.
Marc was seen 24 hours post operatively to make sure things were comfortable and that he like the way they looked. We then picked out the color to match his bleached lower teeth, notations were made to fine tune the shape of the incisal edges and the case sent out to the laboratory for fabrication.
A couple of weeks later, Marc’s case came back and Marc could hardly contain himself when we told him how beautiful they looked and we could hardly wait to put his new smile together. We were happy with the look, but Marc was ecstatic. He said, “I have my smile back and it looks better than the original!”. The shade was confirmed after trying in 2 different colors of try-in cement, and we were ready to bond them into place. The teeth were etched, dried, and bond applied. A curing light was used to light the bond, the restorations loaded, seated and taken to a gel state cure. Cement was removed and a layer of oxidation inhibitor was placed and cured to a final cure. The margins were then polished and the occlusion checked for any interferences in protrusive and lateral movements. A custom nightguard would be fabricated in a day or two. Marc was so please with the results he hugged everyone. The process had taken a while to complete, but overall, Marc was happy that the results exceeded his expectations.