Doctor's Treatment Photos

Case 1 – Invisalign & Bonding Before and After Photos

After Invisalign Treatment

After Bonding Placement

Final Result

Case 2 – Implant Placement and New Crowns Before and After Photos

Before Treatment

Final Result following Implant Placement and New Crowns

Case 3 – Dental Implant and Crowns Before and After Photos

Missing Right back teeth

Following Placement of Implants to replace missing teeth

Placement of abutments which screw into the implants

Placement of final crowns

Case 4 – Dental Implant and Crowns Before and After Photos

Before Treatment

Case completed with implant and crowns

Case 5 – Crown Restoration Before and After Photos

Tooth fracture with a lost filling

After crown restoration

Case 6 – Ceramic Crown Restoration Before and After Photos

Old filling with decay

After Ceramic crown

Case 7 – Complete Cosmetic and Implant Restoration Before and After Photos

Cosmetic Dentistry Preoperative photos

Preoperative photos. Including missing back teeth

Following implant placement. Abutments and crown placement

Palatal view of implant supported crowns

Final result following complete cosmetic and implant restoration. Beautiful smile and result

Case 8 – New Ceramic Fillings Before and After Photos

Patient had old resin fillings which were decayed and needed to be replaced with a better material. Glass ceramic.

Old resin filling removed as well as decay

Final results when the ceramic fillings were placed. Second bicuspid followed by the first and second molar.

Case 9 – New Composite White Filling Before and After Photos

Preoperative of a molar with decay on the biting surface

Post operative with a composite white filling

Case 10 – Crowded Lower Teeth and Crown Restoration Before and After Photos

Preoperative Photos

Crowded lower dentition that were crowned due to the fact that old composite fillings had broken down. We were able to straighten them as well as correcting the decay from the old composite fillings.

Post operative photos from the lower crowned teeth

Final post operative photo of the patient’s upper and lower finished restorative result

Case 11 – Scale and Root Plane Treatment Before and After Photos

Before scale and root plane treatment. Buildup of tartar with gum inflammation

Post operative scaling and root plane

Following tartar removal, the root surfaces have undergone erosion due to the acidity of the tartar. Also, in removing the tartar and debris, the inflammatory byproduct has been removed helping the body recover from gum disease. Gum disease is a chronic infection that effects other systemic body function including, blood, kidney, heart, and liver function

Post operative scaling

Case 12 – Correction of Bone Defect in the support of a Fixed Bridge Before and After Photos

Caption shows the removal of an existing fixed bridge needing replacement. Prior to placing the new fixed bridge, it was noted from x ray and examination a huge bone defect proximal to one of the anchor teeth. This defect would compromise the prognosis and longevity of the new bridge. The defect would rapidly worsen causing further dental problems. It was determined that the defect be corrected prior to placing the new bridge.

Caption taken after the Periodontal tissue was opened. Here, we see the bone defect along side of the anchor molar. Upon surgical exposure, it was noted that the defect was larger than had been expected. The defect being both vertical and horizontal in nature.

Caption taken after the defect was thoroughly cleaned and debrided. Following cleaning and debridement, a new bone was added to the defective site. The bone being a denatured bovine bone. In most cases today it is not necessary to harvest the patient’s own bone for these procedures.

Following the bone placement, a Collagen membrane is placed over the bone graft. This caption shows this membrane in place. The Collagen membrane prevents unwanted scar tissue from growing into the replacement bone graft. The Collagen placed will integrate into the body and dissolve over a period of time. It will not have to be removed with a follow up surgery. This will enhance the overall prognosis.

Caption showing the closure of the surgical site with black silk suture.

Caption showing the new fixed bridge in place over the surgical site. These sutures will be removed in 6 weeks and the surgical site will be monitored periodically over years to come. Prognosis is good to excellent.

Six week follow up following suture removal and healing. Note that the soft tissue is healing well and there is nice adaptation to the root and crown structure of the tooth surgically repaired. With proper home care, we should have further tissue healing and a good to excellent prognosis.

Case 13 – Cosmetic Reconstruction with the use of Ceramic crowns Before and After Photos

Before Photos of a patient who presented with discolored upper teeth from mild case of tetracycline staining (A condition where the antibiotic Tetracycline is taken by the mother or her child when the permanent teeth are in their formative state). Our objective was to create a whiter more feminine smile.

Before photos in lateral view

Post operative photos taken a few moments after the final ceramic crowns and laminates were placed. Note that the gum tissue is tender and should settle after a few days which will enhance the patient’s overall smile and appearance. This patient was thrilled with these results.

One week following the final placement of crowns and laminates. Note that this patient has no more gum swelling and redness. The gum has settled nicely, and as indicated before, enhances her final result. This patient is extremely happy. She also is receiving multiple compliments on her smile.

Case 14 – Crown Restoration Before and After Photos

Patient presented with broken down lower front teeth which had been repeatedly treated with bonding. The photos illustrate space between each tooth and poor placement of bonding and complete discoloration.

In this second photo we see the teeth preparation prior to the placement of new crowns. It should be noted that Dr. Bell had to remove a tooth which had a poor prognosis and replace it with an implant. The metal, seen in the photo, is the abutment which comes out of the implant. The implant and abutment were both placed by Dr. Bell. The photo taken is prior to the final seating of the permanent crowns.

This photo was taken following the final seating of the crowns by Dr. Bell. We can now see that the teeth are uniform and spacing and the color compliments the patients overall appearance. There are no signs whatsoever of the placement of an implant. This patient was extremely happy with the final results.

Case 15 – Crown and Ceramic filling in the lower jaw Before and After Photos

Preoperative photos illustrating a broken down bicuspid with an old composite filling. Behind it, a molar with an old silver filling. Both teeth have decay and need to be addressed clinically

Final photographs showing the final restoration of the bicuspid and molar. A crown was placed on the bicuspid. Behind it, a ceramic onlay was placed. All old filling material as well as decay was removed from these teeth. If hygiene is kept up by the patient, this type of restoration can be maintained for a significant period of time. These materials are much more biologically compatible as well as esthetically pleasing for the patient.

Case 16 – Treatment of Decayed far back molars Before and After Photos

Lower back molars of the lower jaw. Left side molar shows missing crown and decay into the root structure with gum tissue migrating into the crown space. The lower right molar shows a broken down resin filling with subsequent decay. It was diagnosed that the lower left molar was so severely decayed that the remaining tooth had to be removed. The lower right molar could be saved with the treatment of root canal.

Following the removal of the back lower left molar, a large single rooted implant and bovine bone was placed into the missing tooth space. Six months of healing was necessary for the bone and implant to incorporate into the lower jaw. This is known as osseointegration. A metal abutment was placed into the implant which will now hold a new crown.

The back lower right molar, which could be saved, was treated with a molar root canal and built up with a post and core. It is now ready to hold a new crown.

Final seating and cementation of the back lower left molar over the implant abutment. The final result allows for the patient to function normally. Patients should understand that implant restorations do not decay due to the fact that the implant, abutment and crown are all metal based restorations. As long as this patient can maintain a healthy gum condition, the implant supported crown will last a life time.

These photos illustrate the final seating of the Porcelain fused to metal crown over the back lower right tooth which was saved with root canal treatment.

Case 17 – Metal Free Removable Bridge Before and After Photos

Partially missing lower back teeth requiring a removable bridge that is metal free. Patient was very concerned that no metal show in her lower jaw.

Final placement of metal free removable bridge. Notice that the removable bridge blends in nicely with the gingival and that no metal is present. The patient can rest assured that she can smile without worries that metal is showing.

Case 18 – Invisalign Before and After Photos

Before Invisalign treatment

Following Invisalign treatment

Following Invisalign treatment

After Invisalign treatment. Treatment lasted 12 to 18 months. Treatment consisted of Clear Template trays made from Computer tomography for specific tooth movement. Prior to Invisalign treatment, the patient was very aware of his poor smile. This was reflected negatively in his overall confidence and wanting to smile. I must say that following his treatment, as a clinician and person who dealt with him on a personal level, I noted a big change in his confidence and personality. He was overall happier with himself.

Case 19 – The Removal of the “Gummy Smile” followed by laminate and crown restoration

Pre­operative photographs of a 25 year old white male who presented to my office with the appearance of a gummy smile as well as small crowns which were aligned in non uniformity. My objective was to eliminate the gummy smile and create proper crown uniformity in order to match the size of the face as well as the skin tone. I also wanted to widen the smile due to the fact that his face was slightly longer and more narrow.

My approach was two fold. First, by surgically correcting the bone and gingival height, known as crown lengthening, followed by the restorative portion of treatment. This, being the placement of laminate (Veneer) and Crowns. Laminates from canine to canine teeth and crowning both first bicuspids on both sides.

This patient, who is an actor, is extremely happy with the final results and his smile. This was a very rewarding case for both patient and me.

Case 20 – teeth whitening, root canal treatment, and ceramic laminates

Preoperative photos of a 30 year old female who was getting married and wanted a beautiful smile for her wedding photos. Her upper left central tooth was also discolored due to trauma when she was younger and it has been continuously darkening over time. She also desired a more uniform appearance as well as a whiter smile. Several treatment plans were given to her. She opted only to have the two upper front teeth treated.

Lateral photograph of the upper left central incisor. You can see the discoloration from Trauma as well as old bonding on the edge of the tooth which is beginning to discolor. The treatment for this case consisted of teeth whitening, a root canal on the discolored tooth, followed up by two ceramic laminates on the two central incisors. In many cases teeth discolor from trauma because of the fact that the pulpal tissue inside the tooth dies and becomes necrotic.

Final photograph following whitening, root canal therapy, and final seating of laminates. Note that I wrap the laminates around ¾ of the back of the teeth for better support and durability. With this method, I never have to replace laminates. I also use a very hard glass which mimics the strength of natural enamel. Also note that there is slight swelling around the gum line following the placement. This is simply swelling from the operative phase and should settle beautifully.

Final lateral photographs. You can see uniformity and the overall desired outcome.

Case 21 – Treatment for TMJ induced Migraine Headaches

25 year old white male presented from Kansas City for treatment of TMJ induced Migraine. These Migraines stem from severe bruxism and spasm of the muscles of mastication(Chewing). It is now possible to reduce these Migraines significantly with the adjunct of Botox to a other TMJ treatments. It must be noted that Botox treatment for TMJ induced Migraine is still in its experimental phase. However the results are very good. Frequency is lessened significantly. Botox or onabotulinumtoxin A acts to inhibit acetylcholine release and is a neuromuscular blocking agent. It temporarily inhibits muscle function. These treatments should be indicated every three month for patients who exhibit chronic Migraine less or equal to 14 days per month. The patient should carefully monitor the frequency of these headaches following injection.

The frequency should lessen significantly following these treatments. After careful examination of the head and neck a CT scan of the head as well as a 3D image of the jaw was made. This patient experiences Disc displacement without reduction which is a more chronic state of the disfunction. He also admits to clutching and grinding his teeth during the day and night. My diagnosis of his condition indicates he does so because of a nervous condition.

Examination of the facial muscles indicated soreness and tension. He currently uses a guard which was made by his previous dentist. The guard is used at night and when the patient grinds and clenches during the day. A careful evaluation of his bite indicated several areas of the bite which could be equilibrated which could help improve his condition. To couple this treatment I injected 100 Units of Botox in 29 different sites into the head and neck.

My aim was to inject Botox into mainly the muscles of mastication (Chewing muscles). I also want to include upper neck muscles which represented significant tension in this patient. This patient will return in 3 months for a followup treatment. We will carefully monitor his improvement.

Case 22 – Dentures placed in mouth, locking into implant site

Dentures placed in mouth locking into implant site. Note there is no mobility of the upper and lower Dentures. This patient can eat and chew most everything with comfort.

Case 23 – Placement of crown to correct bite irregularity

These are the two preoperative photos of a patient with severe rotation of the lower second bicuspid tooth. The tooth had both contact problems with the adjacent teeth as well as the condition creating bite discrepancy. It was determined that crowning it would correct the problem.

This photo illustrates the model made of stone duplicating the lower arch. The Dental Laboratory technician will use it in order to cast a new crown and apply porcelain over the top surface in order to recreate the new crown.

These two photos show the tooth at its final tooth preparation phase. A full arch impression will be sent to the laboratory. The Dental technician will work to create a new crown which will be cemented into place in order for us to correct the problem.

This photo illustrates the new crown cemented over the prepared tooth following its fabrication at the laboratory. Note that the crown seats well and has arrested the contact problem. It fits uniformly with the adjacent teeth and the bite issue with the upper teeth has been resolved.

Another final photo of the lower arch following seating and cementation of the final crown. We can see that we can improve the functionality and appearance of the dental arch with simple crown restoration.

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