Dr. Gangwisch - Hello. I’m Dr. Richard P Gangwisch. Today, we’ll be preparing some front teeth to accept porcelain laminate veneers. Porcelain laminates are a wonderful way to cosmetically alter the teeth with only having to take away a minimal amount of tooth structure in the process. Since the laminates are only placed on the front of the teeth, we are able to place them by removing only a minute amount of enamel. The laminates are extremely durable and color stable and they’ll last for many years. With them, we can create a dazzling Hollywood smile. So we’re here with Sherry today and she’s come to us with some problems with her smile that she’d like corrected and she’s got a bunch of spaces in her front teeth. Now, what we’ve got - that is you right now.
Sherry - That is true.
Dr. Gangwisch – Okay. What we have now is that we have sent off to the lab and they have made a mockup of what we are going to make a beautiful smile for her. So there you go Sherry, you get to take a look at that.
Sherry – OOOH!
Dr. Gangwisch – What do you think?
Sherry – I love it!
Dr. Gangwisch – Now, that’s what you had before and that is a very realistic expectation of what we should have on that.
Sherry – I’m very excited to get started.
Dr. Gangwisch – You like that?
Sherry – I love it!
Dr. Gangwisch – All right we’re going to get started soon on that. So here we are ready to take some of the enamel off the front of the teeth. Now we’ve been talking quite of bit about how small amount of enamel that we are taking off. It’s so small that we have to use a depth gauge so we know exactly how much we are taking off. Now you notice that there are three little tiers of that drill that we have in the handpiece and that is only a half a millimeter. Such a tiny amount that I can’t even tell how much that half a millimeter is. So we’re able to put those depth cuts in there and that will guide me in the rest of our preparation. So now we have those depth cuts in, we’ll go ahead and take the remainder of the enamel off. Now remember it’s only a half a millimeter, we’re still leaving a fair amount of enamel on there. The patient is comfortable; she is nice and numb; very important for that too. I like to spend a lot of time with each preparation. I basically find that the more time you spend on that, the better chance you have of having a good fit when it comes back from the lab. Have to make sure those preparations go well in between the teeth because you don’t want any exposed edges from the front. So, that’s what the preparations look like. You can see that the bulk of the tooth is still there. You just have a tiny amount missing on the front. Now we are placing some cord up underneath the gum. It’s very important that we can be able to see the edges of the tooth. That will be important when it comes time to make the mold of the tooth. We’ll let that set for a few minutes. Now, we can go ahead and take that cord out. That allows us to see all the edges and make sure that everything looks good. Now we’re able to refine things, now that we can see a little bit better. Make sure we get that preparation just under the gums. You don’t want the edge of the laminate to be irritating to the gums and we also don’t want the edge to be exposed either. So we kind of have to find a compromise on that. There are your finished preparations. All ready for an impression. Notice we made a mold of the teeth already and we have small little holes in the side of the tray. We’ll place the impression material inside and squirt that in and notice it will exude out the other side of the hole. What that does is it allows for not getting air bubbles trapped. It’s very important because the work on a porcelain laminate is extremely precise, even, the slightest little air bubble can cause an impression to not be good, so we always shoot for perfection. We let that set for a few minutes. All right, we are at the point we can start making a temporary for her. We like to get these in the same shape that the teeth will be in so she can she what to be expecting. Sherry, here, this is the time when we get to show you what your temporaries look like.
Sherry – Oooh!
Dr. Gangwisch – So what do you think?
Sherry – They look great.
Dr. Gangwisch – No more spaces and as I say those aren’t the perfect, final ones. So what do you think? Do you think you’re going to like the porcelain ones? What do you think?
Sherry – They look great!
Dr. Gangwisch – Well good. Well we’ll be looking forward to putting the porcelain ones in. They have to go to the lab. We’ll see you in a couple of weeks to put the porcelain ones in.
Sherry – Thank you!
Dr. Gangwisch – All right!