Show the After, see what it looked like before in the blog post

Esthetic Correction of Failed Color Match

The patient presented with a discolored filling on the tip. The old filling was made partially translucent, which normally looks very nice and very natural. In this case, the patient's natural teeth are mostly opaque, which makes the filling look slightly darker. Separately, composites are known to slightly yellow in shade over time. So, the before picture shows an older filling that due to yellowing and translucency, now looks darker than the natural tooth. Before (#9) Central Tooth with discolored filling Before (#9) Central Tooth with discolored filling - view 2 After (#9) Central Tooth with completed replaced filling After (#9) Central Tooth with completed replaced filling - view 2 When replacing the filling, I chose a more opaque and very bright white filling to match the opacity of the tooth. It is not wrong… Read More »
fractured tooth

Fractured Tooth – Before and After

When a patient fractures a premolar, it depends on the angulation of the fracture, whether it can be saved with a crown or not. If the angle of fracture is oblique, (and comes out at a 45° angle, or even vertically then turns 90°,) then, a block of tooth breaks off, and the tooth can be rebuilt with a build-up and a crown. I will often rebuild these with minim pins placed very carefully 1.5mm from the outer edge of the tooth, this prevents tooth fracture, and keeps it out of the pulp chamber. Then, I will cure composite back onto the tooth and into the space around the pin(s) that are intended to retain the build-up. Then, you can make a crown. For premolars and anteriors, I like the beauty and strength of Obsidian… Read More »
Discs make all the difference

The Importance of Being Polished

I was working on fillings for my patient and I noticed some of her old composite work, which was completed by a different dentist at her old office, was starting to show it's age. Composites, the white resin fillings, often look impeccable the day that they are placed. Little by little composites tend to lose their beauty because they discolor around the margins, due to stains collecting at these areas. I use discs to polish the margins of my composites because it makes a meaningful difference in their finished appearance. So, in this case, I was looking at the old composites and I asked the patient if she would mind if I smoothed off the edges of the old composites. She said, "Oh, sure. I guess so." I went over the edge of the composite… Read More »

Incisal Chipping from Bike Accident

When you have a bike accident, you have options. Sometimes the fractured teeth require veneers or crowns. In this case, we were able to restore the teeth with composite. I wanted to try a brand new composite that claims it can match any tooth. So, we placed this as the first layer, but, it was too dark, although adequately translucent. So, I moved this initial composite toward the lingual side, and we blended in Filtek Supreme Plus 'B1' with Filtek Supreme XL Bleach shade. The three composites together acted to created a visual layering effect. Before and After: (left) showing result of fracture from bike accident (right) showing layered composite restoration. If you need an appointment, call us 512-454-2744, or Book Online. [instagram url=] Hope you like it, J. Russell McFarlane Read More »
Deep Bite Correction

Before and After Invisalign Class II div 2

Here is a wonderful case that illustrates how effective Invisalign can be. One of the challenges we face when completing orthodontic treatment, (formerly braces,) is the resistant idea from some patients saying to themselves or out loud, 'A clear plastic tray couldn't move my case.' (or) 'My case is too tough for clear plastic trays.' So, here is a before and after that shows how significant changes to the bite, archform and tooth position can be completed with clear plastic trays, using a clear aligner strategy. AfterAfterAfterAfterAfterAfterAfterAfterBeforeBeforeBeforeBeforeBeforeBeforeBeforeBefore [instagram url=] I hope you enjoy this case. Thank you to the patient who graciously encouraged us to share her before and after photos so that other patients could be educated about what is possible. If you need to book an appointment, please call 512-454-2744 (or) Book Online… Read More »
Root Surface Care Options

Remineralization is Real: reversing bracket scars and discolored roots

Shows demineralized roots with and without intact root surfaces and treatment using a remineralization protocol and alternatively with a composite. This case epitomizes how many options we have as restorative dentists to repair, restore, and in this case remineralized root surfaces. The outcome may look similar to the naked eye, but, the long-term impact of our approach to treatment really matters. Let me explain it simply, the remineralized teeth did not require any cutting with a drill or any other cutting tool. The remineralized teeth were treated with topical applications, (which I will describe in technical details below.) The teeth that are eligible to be remineralized in the photo above meet the following criteria: 1. They have discolored and demineralized tooth structure (limited mostly to enamel,) **2. They have an intact outer surface without physical… Read More »

Fractured Teeth – Conserve Tooth Structure with an Inlay

When a tooth fractures, an inlay can be a conservative option if a full crown is not required due to structural requirements. Inlay to restore a fractured tooth adjacent to an old amalgam In this case a tooth had a thin area of tooth along the MB of #14 (photo taken in patient mirror.) The thin remainder of tooth fractured vertically and horizontally immediately adjacent to the old amalgam. This fractured off box of tooth structure was small enough that by extension, using the old preparation of the amalgam, we were able to replace the amalgam with an all-ceramic inlay. This inlay was completed with Vita Enamic (a dual matrix ceramic) milled in-office on the TS150e, same day. This restoration was scanned into the computer and completed immediately, without having to temporize the tooth. We… Read More »

Erosion, the Slow Path to Tooth Destruction Reversed

This case shows one of the dental conditions that is very familiar to anyone who has had a history of grinding and clenching. One of the complicating background factors of this case is a history of dry mouth. Dry mouth tends to accelerate erosion because there is not adequate salivary flow to flush off acids and sugars from the food we eat. Above: Images 1 and 2 show wear through the enamel and into dentin, which are scooped out. Below: Images 3 and 4 show the (4) lower anterior teeth with Obsidian-type all-ceramic crowns. Restoring the tips (incisal edges) of these teeth with composite was completed a few years ago. The composites were a stop gap restoration to slow the continued erosion. Because the teeth continued to erode around the edges of the composite, the… Read More »

Fractured Front Teeth Repaired with Composite

Fractured anteriors #8 and #9 repaired with composite (before and after) Accidents happen: 10-yr-old fractured his front teeth in apparent fall accident. The patient presented for emergency evaluation of his front teeth. The coronal portion of the tooth fractured in half, but, did not break into the pulp chamber. The teeth were fully erupted and a typical central incisor is 11mm long. His teeth were broken off at an oblique angle leaving only 2mm of tooth remaining on #8 near the midline and 1.5mm of tooth remaining on #9 near the midline. At some point in the future, we may elect to place all-ceramic restorations, e.g. an Obsidian-type crown (lithium silicate,) but, since the patient is young and still very active with sports and athletic recreation, we have elected to place composites on these teeth… Read More »
Bonding to Veneers

Replacing old composite bonding with porcelain veneers (Lumineers) Minimal Prep Veneers

By: Russell McFarlane In 2011, we completed composite bonding on the patient's peg laterals. A peg lateral is a tooth that naturally is smaller due to a genetic variation. Peg laterals or even missing laterals (Tooth #7 and #10) are very common. So, patients with peg laterals or missing laterals are often looking for a solution. Minimal Prep or No Prep Veneers can work very well on a case like this, so, for this case we used Lumineers with a guided minimal prep. Photo from 2/7/2019 showing composite bonding (completed 2011) on the laterals. Photo from 2/7/2019 showing the peg laterals with the composite bonding removed. Photo from 3/7/2019 case follow-up, after seating the porcelain veneers on 2/26/2019, then, letting the gums heal before the final photos were made. This case shows how attention to… Read More »