Cosmetic Restorations are the area that Jacquelyn is passionate about. Celebrity culture means that many people would like bright white smiles. However sometimes this is not the case and people just want a restoration that precisely matches their existing teeth. At A & J Rollings we always aim to meet the needs and requirements of the individual patient as prescribed by the dentist.
Figure 2 Patients dentition prior to treatment Clinical work and images: Dr Paul Carroll
Figure 3 Patients new all ceramic crowns Clinical work and images: Dr Paul Carroll
This case shows the before and after images of a patient who asked their dentist for a ‘cosmetic result’. The new crowns on front incisor teeth 12,11, 21, 22 were made by Jacquelyn from a special ‘metal free’ dental ceramic material called Lithium Disilicate. Lithium Disilicate is a strong ceramic material that can be processed by either injection moulding or milling. Both of these processes require special equipment.
There are a number of other options for ‘metal free’ crowns and bridges, these include a very hard material called Zirconia. Strictly speaking Zirconia is not a Ceramic as it is the oxide of a metal called Zirconium.
The material is usually milled in a special machine. It is then carefully heated to a very high temperature of approximately 1450°C and then slowly cooled to gain maximum strength.
This material can then be overlaid with a special dental ceramic material to produce a beautiful restoration that is kind to the teeth that bite against it. This is the technique that is used at A & J Rollings.
More recently crowns and bridges that are constructed entirely from Zirconia, sometimes called ‘monolithic zirconia’ have come on to the market. These restorations have the advantage of being more economical to produce as most of the work is done by machine. However, it is more difficult to control the fine nuances of colour and the crown or bridge will be much harder than the natural teeth that it bites against. We do not routinely offer this technique at the present time.
There is also another category of metal free material called a ‘Dental Composite’. This type of material is a Polymer resin that is infused by the material manufacturer with tiny particles of Ceramic material. Sometimes this is called a ‘nano filled resin’. The Ceramic particles are included within the resin to improve the physical properties of the material. These materials can be milled from a solid block on a special machine or built to shape from a paste or putty like version of the material which can be set by either heat, light energy, a chemical reaction or a combination of these.
For larger restorations composite can be reinforced with a High Performance Thermoplastic material called PEEK plastic. This is similar to the material used to make artificial joints. A & J Rollings have invested in the special equipment to process this material and are pleased to offer it as a part of our metal free range of restorations.
Figure 4 Clinical work and images: Dr Louis Mackenzie
Figure 5 Clinical work and images: Dr Louis Mackenzie
This case shows a single post crown on tooth 21 that Jacquelyn has made for a patient who asked their Dentist to provide an exact colour match. This crown has an underlying ‘thimble’ of metal alloy which has a special ‘feldspathic’ dental ceramic enamelled on to it, this is called a bonded crown. This type of crown has been in use for many years, the alloy thimble provides underlying strength whilst the ceramic material provides the appearance of a tooth.
The ‘metal thimble’ stops light passing all the way through the restoration so can sometimes look less natural than a metal free restoration. However, this is not always the case and as can be seen here a very natural result can be achieved.
Over the years many different types of metal alloy have been used to construct the metal thimble. Those that include a majority of Gold and Platinum group metals are classified as Precious alloys. Those that only include base metals are classified as Non Precious. Precious alloys have become less popular over recent years due to their cost and the increasing popularity of Metal Free crowns and bridges.
Adrian and Jacquelyn offer their clients the choice of both Precious and Non Precious alloys. It is important to note that none of the alloys used at A & J Rollings contain either Nickel or Beryllium.