Wednesday, July 8, 2009

Instant Orthodontic

What do brides to be and air stewardesses have in common? They have no time to put on braces before that last interview with the airline management or the appointment with the photographer. Since 2003, our clinic has been helping many hopeful air stewardesses pass that last interview and take off on a high flying career with "instant orthdontics". We have also helped many brides and bridegrooms to be to get their smiles ready for the camera.

There is actually no such thing as "instant orthodontics"
. In fact, we don't do orthodontics at our clinic. The illusion of instant orthodontics is created by a technique which involves elective root canal treatment and the crowning for crooked teeth with full ceramic crowns. In some cases, additional procedures like gum surgery may be required.

Case: Hopeful Air Stewardess

This is a classic case that brought our humble practice in the Hougang heartlands into the recommendation list of an airline's management. The patient is a young and attractive teacher on her way to a new career as an air stewardess (or cabin attendant if you want to be PC). Below is a plaster model of her teeth before treatment.

From the inside, we can see that her two central incisors are protruding forward. The incisor on the right side was even rotated. Her lateral incisors were also sunken relative to the rest of her teeth. It's our duty to inform her that the ideal treatment for her case is orthodontics. She would have to extract a couple of teeth, put on braces for 2 to 3 years. She rejected the option because as an air stewardess, she would not be allowed to put on braces. She also needed to look good in time for her final interview.

I took impressions of her mouth and studied her case closely. The twisted right central incisor was marked (x) for elective root canal treatment. I would have to break off the crown and then rebuild it from scratch. The two lateral incisors only needed to be "thickened up" with crowns to put their outer surfaces in alignment. The tilted canine on the right side could be set straight also by covering it with a crown.

Below is what we call a diagnostic wax-up. It's similar to a mock up of the final result we can get. It's done by adding wax to recontour the original study model. Of course, the twisted crown was broken off on the model and reset in a new position. In this wax-up, I included the canine on the left. The patient decided to do just 5 Empress® crowns from her right canine to the left lateral incisor.

I performed the root canal treatment as planned and then cut the crowns accordingly. The impressions were sent to the lab and in a week, they were ready for cementation. The plaster models below was taken from the patient after the crowns were cemented. Note that we managed to completely realign 5 of her teeth by crowning. Root canal was only required for one tooth.

It should be noted that "instant orthodontics" is a compromised and less than ideal solution. Vital teeth which have been crowned in this case may require root canal and quite a bit of follow up treatment in future.

Cost Estimation
The above case would cost about S$4200 today

Case: Anxious Bride To Be

This young lady has canines that are protruding, lateral incisors with too much gum covering and tilted backwards. Straighten her teeth and make her gum level even? This bride to be became anxious and excited after she saw our website and realised that something can actually done to change her smile before she and her hubby go before the camera.

We first performed gum surgery on her 2 lateral incisors to even out her gum line before we even attempt to bring her lateral incisors forward. We can see from this picture on top that her two canines are bulging out.

The next step is to perform elective root canal treatment to remove the nerves inside her canines. The two protruding teeth were cut off at the top, glass fibre posts were cemented in the root canal spaces and built up.

All 6 of her front teeth have been prepared for crowning. However, her gums have not healed from the surgery yet. That's why we've decided to place temporary plastic crowns for her.

Here she is with her temporary crowns. They don't look very natural, but the straightening effect is already there.

Two months after the surgery, we took impressions for her final crowns. 6 emax crowns were then cemented. She's ready to go before the camera.

Cost Estimation

This case will add S$6000 to the wedding budget.

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