Tag Archives: oral care

The Myths and Misconceptions of Proper Oral Health | New York, NY

Oral care and hygiene are paramount to our ability to maintain and retain our teeth as we age. With so much information about oral care practices online, we felt it was important to demystify some of the most common dental myths and misconceptions we hear and offer advice on how to move forward.

Myth 1. Sugar Causes Cavities.

Sugar itself is not the cause of cavities, though the bacteria that eat the sugar can be. The starches and sugar themselves attract bacteria that thrive on the surface of your teeth and release an acidic compound that promotes tooth decay. Regular brushing and rinsing after eating particular sugary foods will go a long way toward preventing decay.

Myth 2. Enamel Loss Causes Sensitivity.

We may experience sensitivity for many reasons, and enamel loss doesn’t happen overnight. Tooth grinding, abrasive toothpaste, aggressive brushing, and lack of regular proper oral hygiene all contribute to both sensitivity and a loss of enamel. Should you lose your enamel, however, you will likely experience tooth sensitivity as well. 

Myth 3. Hard Brushing Cleans Better.

This action is counter-productive, as excess pressure on your teeth can work to damage enamel rather than support it. Hard brushing also hurts our gums and can lead to a recessed gum lining over time. We recommend taking care to brush gently with a soft-bristle brush.

Myth 4. Chewing Gum Helps Clean Teeth.

Chewing gum is certainly not a replacement for brushing. Chewing gum can be a great way to combat sugar cravings or a candy habit, but while it makes your breath smell better, it cannot replace the benefits of brushing.

Myth 5. Baby Teeth Don’t Need Brushing.

Good oral care practices begin when we are young and proper oral care for a child’s first set of teeth matters. Tooth decay in a baby tooth can lead to complications as an adult, so we recommend a twice-daily brushing routine as soon as the child has teeth.

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.

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Frequently Asked Questions About Veneers | New York, NY

Veneers have no higher incidence of decay, provided they are properly cared for with regular flossing and brushing with toothpaste.

What happens to teeth after veneers, and will I ever get cavities?

The integrity of veneered teeth is only marginally compromised, and the veneer is bonded to the existing teeth. There is no higher incidence of decay provided the veneers are properly cared for as previously mentioned with regular flossing and brushing with toothpaste. Keep your sugar consumption low and confined to meal times, good dental advice generally to prevent decay.

How long will porcelain veneers last?

In my experience they can last from seven to twenty years. While the veneer itself is inert and non-living, the tooth or teeth to which they are attached, and the surrounding gum tissues are living and may change. For example, gum line shrinkage may expose or reveal root surfaces. If a veneer comes off it can generally be rebonded. If it chips it can sometimes be rebonded or otherwise replaced.

If I have my upper teeth treated with porcelain veneers, will my lower teeth still be a different color, or more yellow?

This is certainly a factor that will be discussed during your evaluation and smile design so that everything matches and blends well. Most patients usually whiten the lower teeth with whitening (bleaching) procedures to ensure a good match.

Do porcelain veneers stain with normal things like coffee, tea and wine?

Porcelain veneers should never stain; however, if your teeth have a propensity to stain you should try to avoid or minimize the behaviors that lead to staining and look after them as recommended above with normal hygiene and maintenance procedures.

Does dental insurance cover porcelain veneers?

Some insurance companies will cover up to 50% of the fee they deem customary. However, it depends upon what your employer has contracted for with your insurance company rather than what your dentist is charging. Don’t forget your dentist also has to pay the dental technician who actually fabricates the veneers, a critical component in the fee.

To read more about veneers, click here.

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Using Visual Technology for Case Presentation | New York, NY

The most direct path to treatment acceptance is hastened using visual technology.

By Dr. Alvin W. Neff, DDS

Case presentations that use visual technology can become the integral component of success for the modern-day practice. Our patients must be able to clearly see their existing conditions, understand treatment recommendations, and visualize the anticipated results before they can accept and approve treatment.

Historically, dentists have used complicated dental terminology, x-rays, and study models to communicate a proposed treatment plan. Patients were expected to accept recommendations without being able to visualize the anticipated results. Patients often left the dental office confused about treatment recommendations and uncertain about the final outcome.

The most important aspect of case presentation is the ability to clearly communicate the treatment goals to the patient in a manner that will help them make a decision toward treatment acceptance. The most direct path to treatment acceptance is hastened using visual technology. The use of digital photography, upgraded display monitors, and computer imaging can create dramatic case presentations that will result in scheduled appointments for needed treatment. There is nothing more revealing than a close-up view of your own teeth or a full-face view of your own smile. Using this new format of case presentation, patients will become engaged in a co-diagnosis type of conversation and they will begin to ask for treatment. Clinicians can avoid most sales tactics and rehearsed scripts once the patient sees their case presentation with their own eyes. They see the existing condition of their teeth and the image of the anticipated desire and answers many of their concerns that had been getting in the way of case acceptance.

To read more about using visual technology for case presentation, 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.

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Steps in Creating a Beautiful Smile | New York, NY

We all want the smile of our dreams – a smile that lights up every room we walk into. But for many of us, it doesn’t come naturally. We need the help of trained dental professionals to produce the smile we’ve always wanted. The following is Dr. Hamlett and Dr. Rosenthal will take us through those steps:

The single most important factor in creating a beautiful smile is the ability to visualize the final result before you begin. Laboratory communication, including photographs and models of the approved temporaries, is key to success. A thorough lab prescription detailing shade, texture, central length, incisal translucency, and any other pertinent information helps to facilitate a predictable result. To develop properly proportioned teeth, it is essential to properly address many characteristics, such as contours, shade, size and length of centrals, phonetics, and occlusion. This leads to a key artistic technique—the art of recontouring—with both temporaries and, if necessary, the final restorations.

To read more about how to get the smile you’ve always wanted, click here.

Is Cosmetic Dentistry Vain? | New York, NY

No one wants to be thought of as vain, but in this day and age, a large stress is placed on the way we look. If we don’t like something about ourselves, we try to change it. We go on diets, we dye our hair – there is a myriad of options we can do to improve our appearance. Cosmetic dentistry is the branch of dentistry that mainly deals with the appearance of teeth. There are several procedures involved, like teeth whitening, teeth straightening, veneers, crowns, bleaching and reshaping. While it is true that cosmetic dentistry is “elective” in more ways than one, in just as many ways, cosmetic dentistry also offers plenty of benefits from an improved smile.

A better-looking smile helps improve your self-confidence and self-esteem significantly. This then makes it easier for you to go out, smile and socialize with other people. By helping you become more confident about yourself and feel more attractive, you have a much better chance of living a better and more positive life.

The word “cosmetic” always gives off the impression that the main, and only, beneficiary is one’s appearance and that it’s only done to improve one’s look. Though, as far as cosmetic dentistry goes, it’s not always just about esthetics, it’s also about improving your oral and overall health.

Not only that, but there are many other cases where cosmetic dentistry helps in improving the overall function your teeth. Those with misaligned teeth or bites often develop worse dental problems that may result in painful areas outside of one’s teeth and this is something that cosmetic dentistry can help with.

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 Miracle of Collaborative Giving | New York, NY

A smile makeover gives new hope to a cancer patient.

By David Ward, DMD

I’ve often had patients come and go with very little fanfare. It’s not that I don’t want to know more about my patients’ personal lives; it’s just that the day’s pace leaves me with precious little time to ask more than the typical superficial questions: How are the kids? How is your spouse? Congratulations on your new baby!

But 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.

After discussing his goals and desires for his smile, we started discussing a budget. We obviously wouldn’t be able to complete the full plan of crowns and veneers he’d hoped for due to financial constraints, but we agreed on a staged treatment over a period of time. Roger left after chatting with just about everyone on my team, which became a common occurrence that we all came to enjoy during the course of his treatment.

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Snoozing Your Way Through Dental Appointments | New York, NY

Of all the health professionals feared most by adults, the dentist is at the top of the list. Dental Anxiety (DA) is the actual diagnosis for this fear and adults everywhere have it. Dental professionals everywhere have been busy making huge strides in order to calm those fears. Some are turning their dental offices into more of a spa feel than a dental one. Aromatherapy, soothing music, weighed blankets – if you can think of a soothing way to relax, chances are your dental professional has it. And if you still need “something stronger”, there’s sedation dentistry.

Sedation dentistry is the way your dentist relaxes you enough to handle the dental procedure through the use of medication, in addition to the numbing agent applied to the area that will be worked on to alleviate any pain caused by the procedure. The use of sedation is to make you as comfortable as possible as they do their job and to make recovery time minimal.

If you don’t need much to relax you, chances are you will receive nitrous oxide, or laughing gas. It is given to you as you breathe through a mask, so zero pain or needles are involved. If you need to be calmed with more than a little gas, the next step up is an oral sedative so no pain or needles are involved to make a patient groggy, but you will be awake during the procedure. IV sedation takes affect a lot quicker, but the dentist also has the ability to adjust the amount as needed. Administered by medications prior to your procedure, deeper sedation methods will render you unconscious and unable to be awakened easily.

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.

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.

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CAD/CAM Veneers and Crowns | New York, NY

Dental Continuum

We, as dental professionals, understand that patients aren’t the most apt to jump into the dental chair more than they have to. Not only to dodge the idea of dental pain, but because restoration procedures can last more than one appointment. Thankfully, we have considered these issues and made developments to the technology to address their concerns.

Over the years, the increase in computer technologies and CAD/CAM designs have be introduced to restorative dentists. These new technologies have helped modernize fabrication protocols, reduced the patients chair time and also reduced laboratory costs.

By taking advantage of these advancements in CAD/CAM and robotic technologies it has made final abutment fabrications and final CAD/CAM restorations more predictable for clinicians. Anterior restorations now can be fabricated in one visit, as where before it took many visits to match the shade characteristics. Furthermore, the use of this technology has enhanced the education experience of newly trained professionals.

Click here to read the full article on “CAD/CAM Veneers and Crowns”.

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.