Smile Design Cases
Transform a Smile with Advanced Cosmetic Dentistry: Precision, Aesthetics, and Long-Lasting Results
Case 75
Cosmetic Dentistry in Toronto
Before Smile Transformation
A 73-year-old patient arrived at Dr. Johnson Ozgur’s Toronto Smile Design - Yorkville Dental office, seeking help for severe dental issues that had progressively worsened over the years. The patient’s teeth were profoundly worn, eroded, and stained yellow, leaving the entire dentition devoid of functional elements such as cusps, anterior guidance, or canine guidance. This extensive deterioration compromised his ability to chew and speak and adequately impacted his confidence and social interactions. The patient described struggling to eat various foods, frequently experiencing discomfort while speaking and avoiding social situations due to embarrassment over his smile. His dental health issues required an advanced and comprehensive approach to restore both function and aesthetics.
Digital Smile Design Planning of the Smile Transformation
Worn Out Teeth = Collapsed Bite
The patient’s excessively worn-out teeth had led to a significant collapse in the vertical dimension of occlusion (VDO), a critical factor in maintaining facial harmony and functional stability. As the teeth eroded over time, the reduced VDO caused the lower jaw to move closer to the upper jaw, altering the patient’s facial proportions and giving him a prematurely aged appearance. This collapse also affected the soft tissues around the mouth, resulting in decreased lip support. The lack of adequate dental structure to support the lips led to a hollow facial profile, accentuating wrinkles around the mouth and creating an overall appearance of fatigue and advanced aging. Functionally, the compromised VDO disrupted the balance and alignment of the jaw, contributing to difficulties in chewing and phonation. The combination of these factors highlighted the urgency of addressing the aesthetic concerns and restoring the dental framework's structural integrity to rejuvenate the patient’s appearance and improve his oral function.
Intraoral Picture of the patient before Smile Makeover
4D Dentistry: Crucial Step for Functional Treatments
Before proceeding with Digital Smile Design (DSD) documentation, Dr. Johnson utilized the MODJAW device to record the patient’s dynamic jaw movements, a step of paramount importance in a case of this complexity. MODJAW, the first of its kind in Ontario, enables precise, real-time tracking of jaw function, capturing the intricacies of the patient’s articulation and occlusion. For this patient, whose collapsed vertical dimension and lack of anterior or canine guidance had destabilized his bite, understanding the jaw’s functional patterns was crucial to designing a treatment plan that would restore balance and harmony. By analyzing the dynamic relationship between the jaws, Dr. Johnson could identify aberrant movements, pinpoint functional deficiencies, and predict the biomechanical impact of the proposed restorations. This comprehensive data allowed for a tailored approach to rebuilding the patient’s occlusion, ensuring that the new restorations would fit aesthetically and function seamlessly within his unique jaw mechanics. Accurate jaw movement records are the foundation of any full-mouth rehabilitation, as they enable a design that promotes long-term stability, minimizes strain on the temporomandibular joint (TMJ), and enhances the overall success of the treatment.
Crucial Step: Creating a Digital Patient
At Toronto Smile Design - Yorkville Dental, no treatment plan is ever proposed without a meticulous design and 3D simulation to ensure predictability and precision. For this 73-year-old patient, after obtaining dynamic jaw movement data with MODJAW, we proceeded with a comprehensive set of documentation, including intraoral and extraoral photographs, high-resolution portrait images, videos, and facial scans using the Ray Face scanner. Each piece of information plays a critical role in building a holistic understanding of the patient’s current condition. Intraoral photographs and scans reveal the state of the teeth and soft tissues, while portrait images and videos capture how the patient’s smile interacts with their facial expressions and features, ensuring that the final design harmonizes with their overall appearance. Facial scans provide a digital framework for integrating the planned restorations seamlessly into the patient’s natural anatomy.
The Necessity of Advanced Dental Imaging: Full Skull CBCT
To complement this data, we requested a full skull CBCT scan, a cornerstone of sophisticated treatment planning for complex cases. The CBCT allows us to visualize the patient’s craniofacial structure in three dimensions, providing unparalleled detail of the teeth, bone, sinuses, and surrounding anatomical structures. In this case, segmentation of the skull and mandible enabled us to analyze the temporomandibular joint (TMJ) in motion, offering critical insights into how the jaw moves during various functional activities. This level of visualization ensures that we can identify any underlying joint issues, assess the impact of the collapsed vertical dimension on the TMJ, and design restorations that restore functional equilibrium. Without these advanced diagnostic tools, it would be impossible to create a treatment plan that ensures both functional integrity and aesthetic excellence, making this step an indispensable part of the smile design process.
Preparing for the Mock Up & Increasing the VDO
For a case as complex as this patient’s, creating a new occlusal surface to open the vertical dimension of occlusion (VDO) is a non-negotiable foundation for successful treatment. The patient’s collapsed VDO not only compromised his facial aesthetics but also disrupted his bite dynamics and functional stability. Re-establishing a proper VDO allows us to rebuild the smile curve in the anterior region, which is critical for achieving a natural and harmonious appearance. The anterior smile curve, defined by the contour of the upper front teeth in relation to the lower lip, is a key element in creating a youthful and balanced smile. Without addressing the underlying occlusal framework, even the most cosmetically appealing restorations would fail to function correctly and could lead to further complications.
Focusing solely on the visible front teeth for cosmetic enhancement would be a superficial and short-sighted approach. While this might temporarily improve the smile’s appearance, it would not resolve the fundamental structural issues caused by the eroded posterior teeth and collapsed VDO. Neglecting the posterior occlusion would likely result in an unstable bite, excessive strain on the temporomandibular joints (TMJ), and the potential for premature failure of the restorations. By contrast, designing and restoring the entire occlusal surface provides the functional support needed to stabilize the bite, distribute chewing forces evenly, and create a robust foundation for the anterior aesthetic work. This comprehensive approach ensures the treatment's longevity and success, delivering a beautiful smile and a fully restored quality of life.
Mock Up: The Test Drive of a New Sew smile
Providing a mock-up is an essential step in the treatment process for a complex case like this 73-year-old patient. A mock-up serves as a tangible preview of the proposed restorations, allowing the patient to visualize and experience the functional and aesthetic outcomes before committing to the final treatment. For this patient, whose teeth were extensively worn and whose VDO required significant adjustment, the mock-up played a critical role in demonstrating how the new occlusal surfaces and smile curve would transform his facial appearance and restore his oral function.
The advantages of the mock-up are manifold. First, it provides the patient with a sense of reassurance and confidence, helping them understand the scope of the changes and how the restorations will improve their quality of life. By wearing the mock-up, the patient can physically experience the impact of the increased VDO, improved lip support, and enhanced smile curve on their speech and chewing abilities. Functionally, the mock-up allows the dentist to test the dynamics of the new occlusion in real-time, ensuring that the design integrates seamlessly with the patient’s jaw movements and TMJ health. Additionally, the mock-up acts as a communication tool, enabling the patient to provide feedback on the proposed restorations' shape, size, or aesthetic details. This collaborative process ensures the final outcome aligns perfectly with the patient’s expectations and needs. Without a mock-up, the treatment process would lack the precision and predictability necessary for a case of this complexity, underscoring its critical importance in full-mouth rehabilitation.
“In an era of rapid change, standing still is the most dangerous course of action.”
— Brian Tracy
Comprehensive Smile Transformation: Full-Mouth Rehabilitation with Digital Dentistry at Toronto Smile Design—Yorkville Dental
At Toronto Smile Design—Yorkville Dental, every smile is a unique masterpiece crafted with cutting-edge technology and artistic precision. Dr. Johnson Ozgur’s expertise in cosmetic and restorative dentistry transforms not just smiles but lives, combining advanced techniques with a patient-centered approach to deliver stunning and functional results.
A recent case exemplifies our dedication to excellence. A 73-year-old patient came to us with severely worn, stained, and eroded teeth, suffering from a collapsed vertical dimension of occlusion (VDO), diminished lip support, and difficulty eating, speaking, and socializing. His case required a comprehensive and innovative approach, leveraging the latest in digital dentistry to restore both function and aesthetics.
The journey began with an in-depth consultation and documentation using state-of-the-art tools like the MODJAW for real-time jaw motion analysis, the Ray Face facial scanner for seamless smile integration, and a full-skull CBCT to evaluate his TMJ movements and bone structure in exquisite detail. This digital-first approach enabled us to design a new occlusal surface to rebuild his VDO and create a balanced, youthful smile curve.
To ensure the best outcome, the patient was provided with long-term temporary restorations, which acted as a trial phase to test function, comfort, and aesthetics. During this period, we refined the smile design, optimized the anterior teeth’s length and angulation, and used MODJAW’s dynamic data to ensure the restorations worked harmoniously with his TMJ and natural jaw movements.
The final phase was a collaboration with RDT Dental Lab, where the patient’s permanent restorations were crafted with unmatched precision. Each porcelain crown and veneer was designed to fit perfectly, restore proper function, and enhance the patient’s facial aesthetics. The result was a rejuvenated, natural-looking smile that restored the patient’s confidence and transformed his overall appearance.
At Toronto Smile Design—Yorkville Dental, we are committed to blending the art and science of dentistry to create results that are as functional as they are beautiful. Whether you require a full-mouth rehabilitation or a cosmetic enhancement, our team will tailor a solution to your needs, guided by advanced technology and a passion for excellence. Contact us today to begin your journey to a life-changing smile!
