The Hybrid Implant Bridge

This is absolutely my favorite transformation. Rita had smoked for many years – not good for teeth and gums. What happens is that the bone resorbs, leaving long and loose teeth. Eventually these teeth fall out. The process can be delayed or halted with proper dental and periodontal treatment but, like so many people, Rita was afraid of having dental treatment. She also had a serious gag reflex. She was very happy to learn about us and about the care that we take with our patients and their dental health. She was very unhappy with her smile,  with her displaced and missing teeth. She would not smile – and Rita was a beautiful woman. Her teeth were beyond repair, and she was afraid to wear a denture because of her gag reflex.

 

Upper and lower hybrid implant bridges were the best solution to give her a beautiful smile without the embarrassment of removable dentures. The hybrid implant bridge is screwed into bone supported implants and functions like natural teeth. We call it a hybrid because the dentist can remove it, but the patient cannot. Some people call it “teeth-in-a-day” because the teeth are removed, implants are placed and the hybrid can be seated immediately. Sometimes we will seat the hybrid the following day for better cosmetics. This is a temporary hybrid – once the implants are integrated into the bone in approximately three months, we take impressions and measurements for a final hybrid. We give the temporary hybrid to the patient as a spare in case a repair is needed. All-around a wonderful service. Rita did beautifully; the result is spectacular. What you see in her photos below is the temporary hybrid. The final one will look even better! She is thrilled to have teeth again. Read what she says on our testimonials page at https://drterryshapiro.com/testimonials/.

 

Look what we can do in a day to change your smile!

 

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Thursday: Loose and displaced teeth

 

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Friday: Temporary screw retained upper and lower hybrid bridges

Ryan suffers from amelogenesis imperfecta, a hereditary disease in which there is imperfect formation of enamel, resulting in a brownish coloration and fragile teeth. These teeth are weak and tend to decay easily. Unfortunately, Ryan and other members of his family have this condition. All of his teeth were decayed; some were too decayed to be saved, others needed root canal treatment, and also periodontal treatment before we could create a fabulous smile for him with porcelain veneers.  Ryan is thrilled and is getting ready to have his lower arch restored.

 

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Before

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Several months ago I told Jay’s story on a blog post: https://drterryshapiro.com/world-trade-center-hero-teeth/. His teeth had been severely eroded by acid in the air after the World Trade Center attacks. He was a supervisor on the cleanup crew for more than four years.  We fabricated upper and lower anterior porcelain bridges for him and upper and lower precision partial dentures to replace the back teeth. He looks terrific, is comfortable and can eat anything without trouble.

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Severely eroded teeth.

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Porcelain crowns and bridges

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My patient, Ellen, went to a Hillary Clinton fundraiser at the home of a hedge fund manager in South Hampton. Don’t ask me how she got invited – along with her husband and grandson. Seems her husband knows someone who knows someone. A couple of years ago they went to a Clinton fundraiser in Manhattan.  Donations for such events probably are in the neighborhood of $1500-5,000 per person.  It is remarkable that they had this amazing opportunity to hobnob with the Democratic political elite.  Security was of course very tight.  They had to mail in photo identifications before the event. Bags were carefully checked – no guns allowed. Only photos of Hillary by the official photographer were permitted. But the event was lots of fun – even inflatable bounce toys for the kids.

So how do my teeth fit into all of this gaiety?  Well, Ellen, like everyone else at the event, had the chance to shake Hillary’s hand for a photo op.  And what do  you think Hillary said as she was shaking Ellen’s hand? “What beautiful teeth you have!” the Secretary and Presidential Candidate said to a broadly smiling Ellen.  But Ellen’s teeth have porcelain veneers, designed and prepared by me in my office. Nice that Hillary liked my teeth. And Hillary’s teeth could be just as beautiful if she came to me for her dental treatment. I asked Ellen if she gave Hillary my card but she didn’t.

Hillary at the Democratic Convention August, 2016.  She has crowns on her front teeth but they could look better.

I’ve written posts about Joe Biden’s teeth, so to be fair I thought it was time for me to write about Donald Trump’s teeth. I’ve been looking closely at his abundant images on the media and observing his teeth. Definitely expensive porcelain crowns, fair esthetics but dreadful color. Too white, making the teeth too prominent, too fake. 

Ciro Scotti in an August 21, 2015 blog post in The Daily Beast wrote about his encounter some 15 years ago with Trump and his teeth.  At that time, Scotti was at the office of a dentist he called “a fancy Upper East Side dental surgeon who specialized in cosmetic work.”

The dentist showed Scotti a set of teeth molds: “Do you know what these are?” he asked.  Then answered his own question:  “Donald Trump’s teeth.” The dentist said Trump would come to the office every six months or so complaining that his veneers weren’t white enough.  “I tell him that if they are too white, they won’t look real,” the dentist said,  “but he won’t listen. So he picks a shade, and I make them about one-quarter as white as the shade he selects, and he goes away happy.”

As they walked down the hall, the door to an examining room was open and Scotti could see the back of a famous head of hair in the dentist’s chair. 

I hope this dentist informed Trump that if he continued replacing his veneers every six months, he will soon have no tooth left to veneer – crowns, root canals, extractions, implants will be in his future, if the future is not already here.

Judy slipped and fell on the ice during our January snowstorm. Today the temperature climbed to 7o degrees – a record for early March so it is hard to remember that we were knee-deep in snow just two months ago.  My daffodils and crocuses are in bloom today.  But getting back to January and Judy’s fall.  Unfortunately she fell facedown, and she fractured two front teeth.  As you can see below, the right front tooth was beginning to darken from the trauma. You can also see fracture lines in that tooth and the one to the right of it.  One of the traumatized teeth required root canal, the other did not.  She then elected to have veneers placed on all four front teeth to cover and protect the fractured and discolored teeth and to achieve the beautiful smile that she had long wanted.  We lightened her tooth color and removed the space between the two front teeth. A nice result!

 

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Fractured Teeth Needing Restoration

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Sharon wasn’t happy with her smile. Her teeth seemed too small; her gums seemed too large. She wanted a makeover. She thought crowns would do the trick. We took some photos and talked about her smile.  As we spoke, she began to see that her gums were the problem – not her teeth.  Her overlarge gums covered her teeth such that the teeth appeared small.  She needed some periodontal work – what we call a “crown lengthening procedure” to scallop the bone and gums above the natural teeth.  I referred her to a periodontist who specializes in recontouring bone and supporting tissues. The work took one visit. The gums then took a couple of weeks to heal. The results were spectacular!  Sharon looks fabulous – her old teeth like new!

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See how her gums cover her teeth.

The lateral incisors look too small and she has what we call a “gummy” look.

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Now look what a beautiful smile she has!  The teeth are the same but the excess gum tissue was removed.

Sometimes a simple procedure can make a huge difference.

It’s all about proper diagnosis and treatment planning.

Jay is a hero. He was at the World Trade Center on September 11, 2001 – now 14 years ago. He saw horrific images. He then spent the following four years supervising cleanup at the site. Four of his co-workers subsequently passed away from rare cancers contracted from the pollution. Jay had his yearly checkups and was grateful every year that he passed his physical and was healthy.

 

Jay came into my office last month because he wanted a new smile – his teeth had dark black/brown stains and were severely eroded. He was very unhappy with his teeth. We spoke about this and I was very puzzled: what had caused this severe erosion? I had never seen anything quite this severe. Did he have any habits, did he suck on lemons? or anything acidic to cause this destruction of his enamel? My questions had triggered a memory and he lit up – it was the World Trade Center, he said. While he was on the cleanup he had a strong, acidic taste in his mouth that he couldn’t get rid of. He would rinse and brush his teeth but the taste stayed with him. He had never before made the connection but he said that the teeth damage had begun during that time. Before Sept. 11 his teeth were normal. I did some investigation about World Trade disabilities.  There is some data on dental damage but it is not something that has been a focus among so many other disabilities of the survivors and responders.

 

After completing a full dental examination I determined that most of Jay’s teeth could be saved as the roots and gums were healthy. We scheduled two appointments, one to place temporary crowns on the upper teeth and one appointment to place temporary crowns on the lower teeth. He was thrilled with the transformation.  Permanent crowns still to come!

 

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 Severely eroded teeth

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Temporary Crowns

A long-time patient came into the office last week for his six-month exam and cleaning. He was concerned that his teeth were not as white as they once were. As we age, our teeth also age and become darker – more yellow or more grey. This is what had happened to John and he wanted his teeth lightened. He asked about banana peel teeth whitening. The banana peel teeth whitening?  What is that? I had never heard of this. He explained that he had heard from several sources that he could rub a banana peel over his teeth and they would lighten. Now (as they say) I have heard of everything!

 

I needed to check this out so went to the internet. There were over 3,000 results for the search “banana peel whitens teeth”!  From what I can gather, the fad began with a Pinterest pin in 2012- now removed. Glamour Health & Diet then reported on the Pinterest claim that to “whiten teeth with banana peel is very safe and healthy for teeth as banana peels are a wonderful source of minerals and vitamins. They do not have the abrasiveness that other natural whiteners have and best of all they are inexpensive. Brush your teeth as usual with a natural toothpaste or you can use the banana peel first and then brush. Take a piece of the inside of the banana peel and gently rub around on your teeth for about 2 minutes.”  The Glamour article goes on to say that a Colorado dentist tried the banana peel whitening system for himself and after 14 days his teeth looked the same as when he began.  The author also tried it without results.

 

I have to admit that I was curious, so I bought some bananas and also tried the treatment. My teeth could use some whitening but bananas did not do the job. Bananas are inexpensive and a healthy food, but I am sorry to say that they do not whiten teeth.  In our office we whiten teeth with professional whitening gel and custom take-home trays.

 

 

Mary did not like her smile. Her front teeth were dark and uneven. She was ready for some cosmetic dentistry to give her a smile she could be proud of. We spoke about placing veneers on several of her front teeth but she wanted to see how we could improve her smile with minimal dentistry. I felt that we could achieve what she wanted by placing porcelain veneers on her two front teeth. The veneers would lengthen and brighten her smile. She is so happy with how her teeth look that she is now considering placing veneers and crowns on her other teeth that could also use restoration.

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Before: Broken teeth, stained and decayed.

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After: Porcelain veneers to brighten her smile.