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Aesthetic Dentistry Made Easy | New York Dentist

Facial Esthetics

By Michael Apa, DDS

With advances in science and technology, aesthetic dentistry continues to evolve. This is also a direct result of the advances in the abilities of the doctor-ceramist team, and what they can create together. The doctor-patient-laboratory relationship has become more clearly defined due to a better understanding of the limitations and expectations of what the ceramist can produce. New temporary materials, impression materials, cements, etc., have made attaining superior aesthetic results much more predictable. This article will demonstrate a step-by-step approach to creating the most naturally enhancing aesthetics in a very easy-to-follow format.

The Key to Predictable Aesthetic Results

The most important part of predictable aesthetics is diagnosis (examination and case selection) and treatment planning. It is important to be able to visualize the final result in order to properly and accurately describe the proposed treatment to the patient. Listening to the patient’s concerns and effectively communicating shape, size, and color are all significant factors in a successful result. One way that this can be accomplished is by doing a composite resin mock-up directly in the patient’s mouth.

Another way would be by using an accurate digital imaging program, such as Envision A Smile (envisionasmile.com). This software was designed by Dr. George E. Kirtley, who is an accredited member of the American Academy of Cosmetic Dentistry (AACD).

To read more of this article, including its case study, click here.

If you are interested in dental college courses, contact Aesthetic Advantage at 212-794-3552 to register today! Or visit aestheticadvantage.com for additional information.

What to Consider Before Getting Veneers on Your Teeth | New York, NY

You could be on your way to a perfect smile.

BY ROXANNE ADAMIYATT | JAN 1, 2021

There’s an old adage that you’re never fully dressed without a smile. And yes, a good grin is a great accessory — but what about those who are feeling somewhat less than proud of their teeth. Whether it’s crowding, crookedness or that your chompers are just plain worn down, there are plenty of reasons why someone might not be so willing to bare their teeth while they grin. Luckily, in the year 2019 there are a number of options available to give your smile a boost, one of which is a porcelain dental enhancement called veneers.

Typically, an expensive and collaborative process, getting veneers isn’t something one should do on a whim. Like any procedure, veneers require thought and consideration — and knowing the right questions to ask. And that’s where cosmetic dentists Dr. Michael Apa DDS and Dr. Victoria Veytsman DSS come in. We sat down with the veneer specialist (both of whom have a host of celebrity clientele) to find out everything you need to know about getting veneers.

What are veneers?

At their most simple, explains Dr. Apa, veneers are thin porcelain covers that go over the front of the tooth to give it a new shape and color.

What does the process of getting veneers entail?

One of the most important components of the veneers process is the consultation, according to our experts, who both collaborate with their patients to create their new smile. Taking into consideration the patient’s personality, facial traits (both behavioral and structural), their desired outcome, and their functional needs, the vision of what the new smile will look like is drawn up.

Typically speaking, dentists will take impressions and send them to the lab for a mock-up or a blueprint of what that smile and then, once this is reviewed, the mockup can be tested in the patient’s mouth.

“Once the preliminary design is approved, we then numb the teeth we are working on with local anesthesia. Then we re-contour the teeth removing only as much tooth structure as is necessary for the case,” explains Dr. Veytsman who elaborates that once impressions are taken for the ceramist, the patient leaves with nice temporaries, which are great for giving their smile a test drive. If the patient sees changes that need to be made while wearing the temp teeth, that can be conveyed to the lab.

Finally, once color is confirmed, the final veneers are tested before they are cemented on permanently and adjusted to perfection.

Who is a good candidate for veneers?

Anyone who is looking to change the color, size, shape and width of their smile. Ideally, one’s gums and bone structure should be solid and healthy. “A great cosmetic dentist can do a lot more with veneers in terms of changes to a smile than with any other cosmetic dental treatment,” says Dr. Veytsman.

What dental issues do veneers address?

Veneers can fix a number of dental issues including chipping, staining, old restorations and fillings, an uneven or narrow smile, spacing problems, crowding, a poor bite and even internal staining from antibiotics or fluorosis.

How do you determine whether veneers will work for your face?

It’s important to keep in mind that when it comes to veneers, it is not a one-size-fits-all solution. Every patient is going to be different. There are a variety of shapes, sizes, colors and smile designs that can come into play. “It is the cosmetic dentist’s job to have to take everything into account from the patient’s personality, to skin tone, eye, and hair color. We can design all this in the wax-up to see what this would look like in the temporary phase to adjust and make changes as needed,” says Dr. Veytsman.

She elaborates: “We can make a smile more masculine by keeping the edges of the teeth straighter, or more feminine by rounding out the corners. We can produce a more youthful look by having the front two teeth slightly longer than the rest, or take 15 years off of an older face by providing more lip support with veneers.” The takeaway here: there are a number of options that can be customized to suit your face.

Is it possible to veneer some of your teeth or do you have to do all of them?

The good news: you can choose to veneer some of your teeth. “We have done as few as one or four veneers for our patients, but also as many as 28 porcelain restorations on one mouth.” As with all dental procedures, the patient’s needs and preferences will differ.

How do you ensure that veneers look natural?

If you want your veneers to look as natural as possible, it all comes down to conversation with your dentist. Dr. Apa’s process for natural porcelain teeth is as follows, “Final results are created by layering various porcelain powders by hand with a paintbrush and water. This process allows us to mimic the varying layers of the tooth and ensure its opacity and reflective properties match the natural teeth in the patient’s mouth.”

What is the difference between partial and full veneers?

Fun fact: porcelain restorations encompass veneers, crowns and bridges. “It’s all the same material, what differs is the amount of the tooth that is being covered. And a lot of cases include a combination,” says Dr. Veytsman.

Does the procedure require anesthesia?

Local anesthesia is required when undergoing a veneer application.

Are there any side effects or recovery time?

While there are minimal side effects, in the short-term someone might experience tooth sensitivity. This could happen anytime you are having work done to a tooth, though, says Dr. Veytsman, who reminds that typically there is no downtime after getting veneers: “Patients typically go back to work the very same day or the next day, latest,” she adds.

Is there anyone who isn’t a good candidate?

“Sometimes crowns are more appropriate because of the amount of tooth structure lost due to one’s grinding,” explains Dr. Veytsman. Another reason someone might not be able to get veneers is that they have very large, old fillings left.”But, again, this has to be determined on a case-by-case basis as every treatment plan is different,” she says.

What does a full set of veneers typically cost?

Pricing typically varies depending on the city that you live in. While Dr. Veytsman estimates that it can range anywhere from $2,000 to $4,000 per tooth, Dr. Apa estimates that it can range from $400 to $4,000, pending the dentist.

How do you maintain your veneers?

At the end of the day, maintaining your new chompers comes down to common sense. Have regular checkups and cleanings. Dr. Apa advises that his patients come in at least once a year for routine maintenance. “I tell patients to treat their veneers like regular teeth, upkeep and all,” he says.

But use common sense, too. “Please don’t chew on things like pencils or acrylic nails,” adds Dr. Veytsman.

Do you need to get your veneers whitened?

Simply put: no. Veneers have good color stability compared to the natural tooth. But according to Dr. Veystman, over the years veneers can pick up some coffee and red wine stains

Do you have to get your veneers replaced?

If properly maintained, veneers last from 15-20 years.

If you are interested in dental college courses, contact Aesthetic Advantage at 212-794-3552 to register today! Or visit aestheticadvantage.com for additional information.

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.

If you are interested in dental college courses, contact Aesthetic Advantage at 212-794-3552 to register today! Or visit aestheticadvantage.com for additional information.

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

Utilizing a Restorative Approach to Correct an Adult Skeletal Class III Malocclusion | New York, NY

Gerard J. Lemongello discusses all the steps taken to correct the malocclusion

Edward H. Angle described class III malocclusion as one in which the mandibular first molar is positioned mesially relative to the maxillary first molar (Angle 1900). A class III skeletal relationship can occur as a result of a normal maxilla with mandibular protrusion, maxillary retrusion with a normal mandible, or a combination of maxillary retrusion and mandibular protrusion. A class III dental relationship can exist when the maxillary/mandibular relationship is normal.

A pseudo class III malocclusion is caused by a forward shift of the mandible to avoid incisal interferences (Proffit 1986). For many class III malocclusions, both surgical and orthodontic treatment are required. Depending on the amount of skeletal discrepancy, surgical correction may consist of mandibular retraction, maxillary protraction, or a combination of both procedures. For some minor class III malocclusions, or in the case of a pseudo class III malocclusion, surgical intervention may not be necessary.

To read more about this restorative approach, including a case study, 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.

Ensure Long-Term Protection of Patients’ Restorative | New York, NY

As the clinical challenges of debilitated dentition are addressed, clinicians must also consider the significance of occlusal rehabilitation and with this, occlusal protection. The following two case presentations represent different, but significant occlusal challenges. As each patient sought aesthetic improvement, often the solution involved major occlusal change. The use of an anterior splint device (ie, BiteSoft™) to manage occlusal disharmony and Bruxism may often be required to achieve long-term treatment success and preserve the patients, as well as the clinician’s restorative investment.

“For patients with Bruxism, BiteSoft™ provides a means to effectively manage the condition and offers peace of mind knowing that their investments are adequately protected.”

Want to read more, including Dr. Rosenthal’s case presentations? 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.

CAD/CAM Veneers and Crowns | New York, NY

By Dr. Dean C. Vafiadis, DDS

Recently, an influx of computer technologies and CAD/CAM designs have been introduced to the restorative dentist. These technologies have helped streamline our fabrication protocols, reduced clinical chair-time and reduced laboratory costs. In addition, the accuracy of these techniques has equaled our conventional techniques with high level of precision. Using a combination of CAD/CAM and robotics, the technology of final implant abutment fabrication and final CAD/CAM restoration is predictable for the clinician. The aim of this article is to demonstrate cases in which CAD/CAM technology was utilized for esthetic anterior restorations.

To read more from this article, 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.

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.

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.

Want to read more? Click here.

Utilising a Restorative Approach to Correct an Adult Skeletal Class III Malocclusion | New York, NY

Gerard J. Lemongello discusses all the steps taken to correct the malocclusion

Edward H. Angle described class III malocclusion as one in which the mandibular first molar is positioned mesially relative to the maxillary first molar (Angle 1900). A class III skeletal relationship can occur as a result of a normal maxilla with mandibular protrusion, maxillary retrusion with a normal mandible, or a combination of maxillary retrusion and mandibular protrusion. A class III dental relationship can exist when the maxillary/mandibular relationship is normal. A pseudo class III malocclusion is caused by a forward shift of the mandible to avoid incisal interferences (Proffit 1986). For many class III malocclusions, both surgical and orthodontic treatment are required. Depending on the amount of skeletal discrepancy, surgical correction may consist of mandibular retraction, maxillary protraction, or a combination of both procedures. For some minor class III malocclusions, or in the case of a pseudo class III malocclusion, surgical intervention may not be necessary.

Treatment objectives, whether utilizing surgery, orthodontic treatment, or restorative treatment, are the same: to correct the class III crossbite, create an ideal overjet/overbite relationship, achieve a dental class I occlusion, correct the occlusal/incisal plane, correct the midline, and restore the teeth to proper size and proportion. The objective is to provide the patient with an acceptable functional-occlusal relationship and an aesthetic dental/facial appearance.

Malocclusions are common. Patients with crowded and rotated teeth, spacing, or a crossbite who are unsatisfied with their appearance may not be interested in traditional orthodontic treatment or surgical correction. Their objections can be related to the length of time needed to complete treatment, or fear of extensive surgery with extended recuperation.

To read more about this case study, 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.

Esthetic and Functional Provisional Restorations Big Cases | New York, NY

by Dr. Marc Schlenoff

For the past ten years, I have had the honor and privilege to be an Instructor at the Aesthetic Advantage Hands-On Symposium, at the NYU College of Dentistry in New York, as well as an Instructor at the General Practice Residency at Morristown Medical Center. During this entire time, the most asked question from students and residents has been “How can I do more of the big cases in my practice?” I feel that in today’s world of economic uncertainty, the answers to this question are significantly different than even several years ago.

There was a time not that long ago that I would have answered by using examples of advertising and marketing to draw patients to the office specifically for esthetic treatment. There was a buzz about cosmetics, and the primary goal was to attract those people who had already made the decision to have these procedures done. The times have obviously changed, however, and the answers that I now give to the above question are very different.

The keys to being able to attract the large restorative cases in today’s world are communication and treatment planning. The number of patients coming in exclusively for esthetic dentistry has declined significantly in most practices, but the need for restorative care continues to grow as our baby boomer generation (myself included) continues to wear and break their dentition. This is the patient population that needs comprehensive, and thus esthetic dental treatment.

To continue reading this article, 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.