All posts by Aesthetic Advantage

Smile Design Enhanced with Porcelain Veneers | New York, NY

by Dr. Dean C. Vafiadis, DDS

Porcelain veneers within reason allow for the alteration of tooth position, shape, size and color. They require a minimal amount of tooth preparation – in this case reduction (approximately 0.5 mm of surface enamel) – and are, therefore, a more conservative restoration than a crown, which requires significant removal of sound tooth structure. Although not the only alternative for all esthetic abnormalities, they are truly a remarkable restoration when they are the treatment of choice.

To read more about smile design, click here.

Aesthetic Advantage has state of the art educational facilities that can help you take your career to the next level, call us at (212) 794.3552 for more information.

Aesthetic Advantage proudly serves New York, Atlanta, Florida, Chicago, Pennsylvania, Boston, Rhode Island, California, South Carolina and all surrounding areas.

Encourage Your Patients to Drink More Water | New York, NY

48% of American adults consumes at least one glass of soda and other sweetened beverages each day, according to a Gallup poll. Furthermore, statistics from the Centers for Disease Control and Prevention show more than 16 percent of children ages 2 to 19 have untreated cavities.

What you may not know is that bacteria feed on what you eat and drink, especially sugars, and this creates acid that can break down the tooth’s outer surface and dissolve the valuable minerals that protect teeth from decay. The more your teeth break down, the more likely you will develop tooth decay and other dental maladies in the future.

“Sipping sugary drinks gives bacteria in the mouth more power to create acid that weakens tooth enamel and causes cavities,” said CDA President-elect Lindsay Robinson, DDS. “In addition, sports drinks pose many of the same risks as other sugar-loaded beverages, such as irreversible dental erosion, and should not be substituted for water.”

CDA urges people to swap out sugar-laden drinks for a glass of milk or water this summer. Milk contains lots of calcium, which strengthens teeth and water produces saliva, which helps to keep bacteria from setting up shop in our teeth’s crevices.

“Water contains no sugar, no acids and no calories, so your teeth, and your body, will benefit,” said Robinson. “Water also helps keep gums hydrated and rinses away food particles that would otherwise remain in the mouth promoting bacterial growth that causes decay.”

Most importantly, protect teeth throughout the year by brushing for two minutes, two times a day with fluoride toothpaste, flossing regularly and visiting a dentist for a complete dental checkup on a regular basis.

Aesthetic Advantage has state of the art educational facilities that can help you take your career to the next level, call us at (212) 794.3552 for more information.

Aesthetic Advantage proudly serves New York, Atlanta, Florida, Chicago, Pennsylvania, Boston, Rhode Island, California, South Carolina and all surrounding areas.

Clinical Instructor Showcase: Dr. David Ward | New York, NY

Today we take some time to highlight one of our fantastic clinical instructors, Dr. David Ward.

A Rhode Island native, Dr. Ward is proud to have followed in his father’s footsteps, and has practiced in Woonsocket, RI for twenty-two years. He graduated with honors from Tufts University School of Dental Medicine. His practice focus is cosmetic dentistry and implantology. Combining these passions, he creates beautiful smiles.

Dr. Ward is a proud member of the American Academy of Cosmetic Dentistry, and is Treasurer of The New England Academy of Cosmetic Dentistry, The American Dental Association, The American Academy of Implant Dentistry and The International Conference of Oral Implantologists. He is an Associate Fellow in the American Academy of Implant Dentistry and a Fellow of the International Congress of Oral Implantologist. Dr. Ward is a Fellow of Pierre Fauchard Academy.

He has received commendation from The Rhode Island Foundation of Dentistry for the Handicapped for his work with disabled and elderly citizens and lectures locally.

Academic Affiliations

  • American Academy of Cosmetic Dentistry
  • New England Academy of Cosmetic Dentistry
  • American Dental Association
  • American Academy of Implant Dentistry
  • International Conference of Oral Implantology
  • American Academy of Implant Dentistry—Fellow
  • International Congress of Oral Implantologists—Fellow

Aesthetic Advantage has state of the art educational facilities that can help you take your career to the next level, call us at (212) 794.3552 for more information.

Aesthetic Advantage proudly serves New York, Atlanta, Florida, Chicago, Pennsylvania, Boston, Rhode Island, California, South Carolina and all surrounding areas.

A Systematic Approach to Full-Mouth Reconstruction of the Severely Worn Dentition | New York, NY

Dental Continuum

Restoration of the severely worn dentition is one of the most challenging procedures in dentistry. In order to successfully restore and maintain the teeth, one must gain insight into how the teeth arrived at this state of destruction. Tooth wear can result from abrasion, attrition and erosion. Research has shown that these wear mechanisms rarely act alone, and there is nearly always a combination of the processes. Evaluation and diagnosis should account for the patient’s diet, history of eating and gastric disorders, along with the present state of the occlusion. Emphasis must be placed on the evaluation of occlusal prematurities preventing condylar seating into the centric relation position. Behavioral factors that may contribute to parafunctional habits and nocturnal bruxism are also important to understand and manage in order to successfully restore and maintain a healthier dentition. Once a complete understanding of the etiology of the dentition’s present state is appreciated, a treatment plan can be formulated, taking into account the number of teeth to be treated, condylar position, space availability, the vertical dimension of occlusion (VDO) and the choice of restorative material.

While all occlusions wear to some degree over the lifetime of the patient, normal physiological wear usually does not require correction. Severe or excessive wear refers to tooth destruction that requires restorative intervention. Severe attritional wear can result from occlusal prematurities that prevent functional or parafunctional movements of the jaw. This wear can be seen at the site of the prematurity or on the anterior teeth as a result of the “hit and slide” forward. Restoration of the worn anterior teeth then becomes a challenge as the availability of space for prosthetics becomes limited. If lengthening the teeth is a goal in order to achieve a more esthetic smile, then the question of the need to alter VDO subsequently arises.

To continue reading the article, “A Systematic Approach to Full-Mouth Reconstruction of the Severely Worn Dentition” by Dr. Jay M. Lerner DDS, click here.

Aesthetic Advantage has state of the art educational facilities that can help you take your career to the next level, call us at (212) 794.3552 for more information.

Aesthetic Advantage proudly serves New York, Atlanta, Florida, Chicago, Pennsylvania, Boston, Rhode Island, California, South Carolina and all surrounding areas.

Tobacco Is Killing the Good Ones | New York, NY

It’s nothing new – we all know that smoking is bad for you. And while there are lots of ways to quit smoking on the market, many still haven’t made the choice to quit. But this goes beyond lung conditions and cancer risks, smoking is also affecting our smiles and dentists have a hard time advising their patients on the dangers of smoking. In order to help sway the masses, let’s take a look at what can happen if you continue to smoke or use tobacco products.

A new study has indicated that there is a reason why smokers suffer higher rates of oral diseases. It has been discovered that in smokers, good bacteria are essentially ejected by pathogens created by smoking. Believe it or not, but our mouths are the frontline when it comes to keeping diseases at bay. These good bacteria in our mouth work by keeping bad bacteria that causes infections and diseases (pathogens) away. In nonsmokers, good bacteria will repopulate the mouth shortly after cleaning and acts a shield to protect your mouth from disease. In smokers, good bacteria will not resurface and instead the mouth gets colonized by pathogens (bad bacteria). And it is these pathogens that will cause infections and diseases will rapidly develop. If you see these symptoms or find that your mouth is changing for the worse, we advise to talk to your dental professional about seeking treatment. Prevention is the best medicine and can keep your smile healthy and radiant.

Aesthetic Advantage has state of the art educational facilities that can help you take your career to the next level, call us at (212) 794.3552 for more information.

Aesthetic Advantage proudly serves New York, Atlanta, Florida, Chicago, Pennsylvania, Boston, Rhode Island, California, South Carolina and all surrounding areas.

The Hands-on Aesthetic Continuum | New York, NY

Dental Continuum

Here is your chance to observe over-the-shoulder or participate hands-on with a patient. Our 4-day program is spread over two weekends with a focus on comprehensive aesthetic and restorative dentistry. Through our lecture series, participating doctors are able to listen to lectures on step-by-step prep techniques, smile design principles, impression and cementation techniques, patient management, treatment planning, material selection, lab communication for a more predictable result, and more.

On our first clinic day, participants may bring a patient and prep a live case or participate without a patient and observe over the shoulder up to 10 to15 cases being prepped and temporized. One month later, participants will return, and through our lecture series, listen to lectures on cementation, occlusion, advanced cases, and marketing.

The following day, they will seat their cases in clinic. Participants who chose to observe will watch over the shoulder 10 to 15 cases being inserted.

It has been shown that the graduates of our long-running aesthetic/ restorative programs have seen their practices grow and flourish even in these challenging economic times. Let us infuse your practice with a new philosophy and fine-tune your skills to become more confident and passionate about the practice of aesthetic dentistry, setting yourself apart from others in your community!

CE Credits: 30

For tuition information, please contact us at 212.794.3552 (Mention code #495 and save upon enrollment)

Contact Aesthetic Advantage at 212-794-3552 to register for our courses today or visit www.aestheticadvantage.com to learn more.

Aesthetic Advantage proudly serves New York, Atlanta, Florida, Chicago, Pennsylvania, Boston, Rhode Island, California, South Carolina and all surrounding areas.

A Miracle of Collaborative Giving | New York, NY

It’s a new year…let’s start it off with a heartwarming story about how to look after each other during a time when it feels like we aren’t connecting the way we should.

On a rather ordinary day in March 2011, I met an extraordinary person. At the age of 55, Roger decided it was time to get the smile he always wanted. After cursory introductions and greetings, I sensed Roger’s uneasiness and asked about his health and medical information. He told me he’d recently seen a doctor for a medical problem and needed more tests. They suspected cancer. But Roger quickly became more upbeat and began opening up about his desire for a better smile. It was immediately clear that we’d have a great relationship and I’d enjoy providing him with a new smile…

Want to find out more? Click here to read the full article, “A Miracle of Collaborative Giving” by Dr. David Ward, DMD.

Contact Aesthetic Advantage at 212-794-3552 to register for our courses today or visit www.aestheticadvantage.com to learn more.

Aesthetic Advantage proudly serves New York, Atlanta, Florida, Chicago, Pennsylvania, Boston, Rhode Island, California, South Carolina and all surrounding areas.

Patient-Driven Treatment Options | New York, NY

Dental Continuum

Before we wrap up 2019, let’s take a look at how treatment options are tailored to our patient’s needs. Not only are our patients coming to us for their dental health, but they also want to have a smile they can be proud of. For many, visiting the dentist is a dreaded task. We need to change their minds. This is why it is so important to offer our patients the best care possible.

The practice of dentistry allows its practitioners the opportunity to diagnose and treat many dental problems. The methods that dentists typically select are the ones they feel most comfortable with, the ones they know will provide immediate results, and the ones they know will last the longest. Dentists look at each individual case presented to them and seek an evidence-based solution to correct the problem.

As new techniques and materials become available in dentistry, dentist now must choose between applying the treatments they are comfortable doing or to challenge themselves to learn to use new techniques and materials. By continuing education in a profession that’s constantly changing, dentists can provide endless possibilities for their patients.

Click here to read the full article on Patient-Driven Treatment Options.

Contact Aesthetic Advantage at 212-794-3552 to register for our courses today or visit www.aestheticadvantage.com to learn more about Program III – Masters Group.

Aesthetic Advantage proudly serves New York, Atlanta, Florida, Chicago, Pennsylvania, Boston, Rhode Island, California, South Carolina and all surrounding areas.

Program III – Masters Group

This level builds upon the concepts and techniques learned in Levels I and II and will help place you at the pinnacle of your profession. Master the technique and philosophy of smile design. This course will focus on more individual attention and smaller groups—this elite and exclusive group is limited to five participants. We will have small workshops on occlusion, working on models with face bows, and you will participate in an advanced hands-on workshop on aesthetic re-contouring on models. You will have the opportunity to wax up your own case and make your temporaries chair-side. You will work on more advanced cases in clinic. This is targeted toward a more individual learning experience in a much smaller setting at a more advanced pace. You will prep and cement an advanced case in clinic alongside an instructor. Participate in our marketing panel discussion and bring your practice questions in front of our group of talented dental professionals for resolution.

Program Prerequisites

This program is limited to five doctors and it is a prerequisite that you have completed Program I and Program II. You must bring a patient with you to our clinic on Saturdays with a need that falls within our guidelines.

About Our Clinical Session

Clinic takes place on Saturday – both sessions. You will be assigned an instructor personally trained by Dr. Rosenthal who will work alongside you during our clinic session. Your instructor will be available to help you from the beginning all of your case all the way to the insertion of your case. Dr. Rosenthal will also be available to assist you with smile design and applying the final finishing touches to your case. Our unique hands-on approach helps you to overcome any fears or obstacles you may have with regard to setting up your case, managing your patients and delivering a beautiful and aesthetic end result.

Course Tuition

This small, exclusive group is limited to five participants. Patients must be provided by you and are required only on clinic day

  • $8,695.00 – early enroll save $1495!
  • Staff Members (Dental Assistants, Dental Hygienist and Administrative Staff): $99.00
  • CE Credits: 30
  • Click here to download our brochure.

Contact Aesthetic Advantage at 212-794-3552 to register for our courses today or visit www.aestheticadvantage.com to learn more about Program III – Masters Group.

Aesthetic Advantage proudly serves New York, Atlanta, Florida, Chicago, Pennsylvania, Boston, Rhode Island, California, South Carolina and all surrounding areas.

Facial Esthetics – The Framework | New York, NY

Using facial landmarks to dictate tooth position can enhance esthetics and conserve tooth structure.

By Michael Apa, DDS

In order to create individual smiles that compliment patients’ facial features and enhance their overall facial beauty, clinicians can adopt a technique that uses facial landmarks to dictate tooth position. This method not only can enhance the esthetics, it can also ultimately allow the practitioner to be more conservative in tooth reduction.

Where Symmetry Comes In

To understand this type of procedure, it helps to have a general understanding of the word “beauty,” which is defined as the phenomenon of the experience of pleasure through perception of balance and proportion of stimulus. In short, something is perceived as beautiful when some type of harmony or balance exists. During the last decade of cosmetic dentistry, “smile design” has focused mainly on modifying the position and restoring the teeth of patients seeking a better-looking smile.1 This approach became the foundation for laboratories and practitioners communicating in the design process. It also resulted in perfectly symmetrical smiles’ being duplicated for each individual patient. However, if carefully analyzed, it is apparent that patients’ faces are not symmetrical,2 and that delivering or creating complete symmetry in an asymmetrical environment creates a disharmony that can be easily visualized. Therefore, it is of utmost importance to analyze the facial features or “the frame” in which the smile is being created. Within this process, the objective is to design the smile creating symmetry with features and, in a sense, tying the features of the face together by balancing them with the smile.

The challenge for educators in this situation is teaching something that is abstract in a clinical, methodical way. It is important to understand that esthetic dentistry combines both an artistic component along with a comprehensive dental approach.

Finding the Frame

The first instinct of practicing clinicians is to see the smile. The first exercise in these types of cases is to back up and see the progression of development that has occurred. The idea is to find the frame within which the smile belongs, then focus on parameters of smile design, and finalize by looking at individual tooth form.3 The parameters guiding the facial analysis are the horizontal plane, vertical plane, the relation of thirds of the face, and the strong side versus the weak side (Figure 1). These elements provide the frontal framework of the smile. In essence, the clinician should be able to visualize the proper incisal plane that the gingival plane should be paralleled to, the axial inclinations, the position of the teeth in the lower third of the face, and the angulation of the buccal corridor. Upper lip support, lower lip relation, and the occlusal plane all influence sagittal reference, and two characteristics of the smile that are best visualized in the sagittal dimension are overjet and incisor angulation. Finally, the clinician should focus on the oblique plane, which provides reference to the smile arc and orientation of the palatal plane.4 Diagnostically, the practitioner should consider the three-dimensional position of the smile, then use a knowledge of smile design and tooth proportion to finish creating natural esthetics.

Reference Points

Clinicians should orient themselves with a vertical and horizontal plane of reference. Those who have painted, sculpted, or sketched are aware of the need for perspective in space. This is referred to as the “Facial T” (Figure 2). Attractiveness results from a general sense of parallelism and symmetry between structural facial features, because parallelism is the most harmonious relationship between two lines.5 The interpupillary line represents the horizontal perspective that guides evaluation of the incisal plane, gingival margins, and the position of the maxilla (Figure 3Figure 4Figure 5). It should be noted that the interpupillary line is not always the only reference that can be used, because there are situations in which patients may have an asymmetrical position of the eyes. In this case, a second reference, which is perpendicular to the facial midline, can be used.6 The vertical element is the facial midline bisecting the center of the face and extending through the bridge (nasion) of the nose and philtrum. This midline becomes reinforced by the direction and axis of the dental midline. If the dental midline cannot be coincident with the facial midline, it is best to anchor the smile by creating the midline vertical. Severe discrepancies may indicate orthodontic movement (up to 2 mm off the facial midline).7,8 The facial midline aids in evaluating the location and axis of the dental midline along with mediolateral discrepancies in tooth position.

Next, the clinician should consider the growth and development of the patient to determine how to treat the anterior esthetics. The upper third of the face is the area bordered by the base of the hairline—or beginning of wrinkling of the forehead—to the top of the brow. The top of the brow to the base of the nose is the middle third, and the base of the nose to the base of the chin is considered the lower third. This evaluation will reveal any abnormalities in anterior facial height (Figure 6). As ramus length varies, both anterior facial height and tooth display vary. Not only can this determine the need for periodontal surgery or orthodontic movement, it also defines the buccal parameters of the buccal corridor. A short ramus with normal posterior eruption results in an obtuse gonial angle, or the “long, narrow face.” The patient may develop either an anterior open bite, which would indicate a combination of orthodontics and or prosthetics, or excessive gingival display, which would indicate maxillofacial surgery or hard-tissue crown lengthening and prosthetics. Conversely, decreased anterior facial height is due to a long ramus, an acute gonial angle, and results in inadequate maxillary tooth display and a “square face.” This can be treated orthodontically or restoratively. Again, these are generalizations, and each case has its own set of parameters. What is important to remember is that people’s faces are not symmetrical from right to left. The gonial angles are influenced by the strength of the masseter muscle—the stronger the masseter muscle (strong side), the more acute the gonial angle. From a frontal view, this creates an angle that should parallel the canine, premolars, and molars—which comprise the buccal corridor. Starting from the condyle to the pogonion, the canine and buccal corridor should parallel this angle in order for the teeth to “frame” the face. If the incisal tips of the canines or premolars are hanging over the lower lip, it means the teeth have been built out too far buccally; conversely, if there is too much negative space, the smile has not been built out enough. An important point, however, is to understand what building the smile out does to a patient’s face: It essentially widens, or gives horizontal prospective to, the lower third of the face. Women who have lost sufficient cheek fat can have a “smile lift,” which, in essence, gives the illusion of fuller cheeks. Understanding what the buccal corridor does is very powerful in creating the desired look.

In determining the guidelines from a sagittal reference, there are three factors to consider: upper lip support, lower lip relation, and the occlusal plane. Upper lip support is determined by the gingival two thirds of the maxillary central incisors. This is important in understanding the necessary changes to be made to the upper lip, if any. Lip incompetence is caused when the centrals are tipped too far facially; conversely, when the teeth are retruded, the upper lip falls over the teeth and becomes thin at the vermillion border. The second thing to note is where the incisal third of the maxillary centrals will lie; they should be just short of the wet-dry border of the lower lip. Finally, the occlusal and incisal edges of the occlusal plane should coincide with the Camper’s plane, which extends from the inferior border of the ala of the nose to the superior border of the tragus of the ear.

Once clinicians have established a three-dimensional framework, they can begin applying these principles to determine how to restore the patient’s smile.

Case Presentation: Patient Evaluation

A 29-year-old woman who had had an implant placed previously in the No. 7 site discussed her desire for overall improvement in her smile. After analysis of her face, it was determined that it was fairly symmetrical (mesofacial).9 The left gonial angle was lower than the right, making the patient’s left side the “strong side,” and the right the “weak side” (Figure 7). Upon radiographic examination, a large Class III composite restoration was seen between the anterior teeth mesially and distally. Clinical examination revealed a resin-bonded fixed partial denture (FPD) over the implant in site No. 7, bonding on tooth No. 10, and mild wear on the canines.

Treatment Plan and Preparation

The treatment plan recommended to the patient was to restore teeth Nos. 4 through 6 and teeth Nos. 8 through 13 with porcelain laminate veneers and site No. 7 with an implant-supported porcelain-fused-to-metal (PFM) crown.

The clinicians located the midline by finding the patient’s facial midline and relating it to her dentition. Next, they identified the interpupillary plane and related the gingival and incisal planes to it (Figure 3Figure 4Figure 5). They continued to find all of the facial parameters noted above until the framework for the smile was found. Once this was achieved, they moved into performing the dental analysis. In this particular patient, the desirable “golden proportion” seemed to be significantly off in the anterior central and lateral incisors, while the canines and premolars seemed to need minimal adjustment.10,11 To address the soft-tissue heights, which were also quite irregular, the clinicians planned to achieve gingival harmony through manipulation with a diode laser (Figure 8 and Figure 9).12,13 To establish the implant contact point, they needed to measure to the crest of bone from the mesial and distal—4.5 mm to 5 mm from the crest of bone to the contact point is needed to re-establish papillary growth.14,15 Note that prior to beginning any case, this exact “mental” diagnosis is performed to determine tooth position. The authors then prefer to mark up the mouth to do a quick mock-up in flowable composite (LuxaFlow™, Zenith/DMG, www.dmg-america.com) to achieve final shape. This is done prior to anesthesia, and it provides the practitioner with an accurate idea of what can be achieved; it can also be used as a preparation guide for proper reduction (Figure 10 and Figure 11).16

The most important factor with a mock-up is to follow smile design as a guide, but be able to see where the facial planes play a role in tooth position. The first step is to get the central incisor position vertical and centered with the facial midline. By altering line angles in teeth, it is possible to change the axial inclination, altering both gingival zenith and axial inclination. Incisal length and facial-lingual position are evaluated to determine if adjustments are needed. The laterals, in this case, were used to offset the centrals to create natural embrasure. Tooth No. 7 was rotated in a mesial-lingual direction to create a natural embrasure as well as raise the contact point to a more apical position for papillary regeneration. Tooth No. 10 was set back slightly to the lingual, again, simply to create a natural esthetic appearance. The canines and premolars were mocked up to parallel the planes of the strong and weak sides. Once the clinicians were satisfied, an alginate impression, which would serve as a provisional stent, was taken.

The teeth were then prepared using the mock-up as a guide for reduction. The clinicians used a feldspathic ceramic, which can be feathered to approximately 0.2 mm. This demonstrates that bulk reduction for material is not always the important issue. It is rather an understanding of initial tooth position and desired tooth position, along with stump shade and desired shade, which dictates preparation. Some controversy may exist as to the minimum thickness of porcelain laminate veneers.17 Studies have shown that a minimum thickness of 0.2 mm is needed for each shade change.18 As always, initial arch form preparation was done first, followed by soft-tissue recontouring (Figure 12Figure 13Figure 14), and, finally, final margin placement.19 Once these steps were completed, the provisional material (bis-acryl) was placed into the alginate stent and allowed to partially set for 1 minute. It is important to note that a thin layer of glycerin must be placed on the teeth first to inhibit polymerization. The provisionals can be pulled from the mouth and evaluated for thickness of material to see if the proper amount of reduction has been accomplished. After verification, final impression, and an accurate bite registration, the preparation shade and facebow were taken. The provisionals were then trimmed and temporarily bonded in place using the “spot-etch technique” and flowable resin (Figure 15 and Figure 16).20

The patient is always brought back the following day to go over the provisionals to check the occlusion and esthetics. In this case, minor adjustments were made and records were then completed to relay to the laboratory. Final measurements of the central incisors were taken, as were a full digital set of photographs, alginate impressions of the temporaries, and a bite registration. The goal is to provide as much information to the ceramist as possible to make it easier to replicate the shape, contour, and detail of the temporaries in the ceramic. The authors have found that a proper set of provisionals can eliminate a lot of the guesswork in communication between patient, doctor, and ceramist. While the shape of the smile three-dimensionally is a major factor in creating natural smiles, it is also important to consider color and texture. Some may say that this is the job of the ceramist, but it is crucial to be able to guide the ceramist in relaying the correct color and texture. Understanding the medium being used and having a sense of the spatial arrangement of the face guides the proper positioning of the smile.

To complete this case, the restoration was then inserted and the tissue around the implant was given 2 months to heal properly before any adjustments were made. Minor occlusal adjustments and nightguard therapy were performed to ensure longevity of the restorations (Figure 17Figure 18Figure 19Figure 20).

Conclusion

Following simple principles regarding the special arrangement of the face can guide the clinician in providing more natural smiles with less tooth reduction. The authors have found that offering this type of treatment requires that practitioners educate their patients in color and form. While patients may be initially resistant to “imperfect perfection,” when executed properly, it provides the ability to mimic nature. The end result is a proper reduction rather than over-reduction, and a smile that looks like the one the patient was born with.

Acknowledgments

Dr. Apa would like to thank Jason Kim, CDT, of Oral Design for the ceramic work in this case, and Albert Ambriz, DDS, for his research assistance on this article.

Contact Aesthetic Advantage at 212-794-3552 to register for our courses today or visit www.aestheticadvantage.com to learn more about CAD/CAM veneers and crowns.

Aesthetic Advantage proudly serves New York, Atlanta, Florida, Chicago, Pennsylvania, Boston, Rhode Island, California, South Carolina and all surrounding areas.