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Before and After

​​Creating Smiles... Changing Lives...​

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The following are cases I completed at New York University College of Dentistry with the permission of each patient to present the pictures. Each case was directed by the patient's main esthetic concerns and each patient was very satisfied with the results. I completed these cases as a student and therefore I have found areas which could be improved, but I gained tremendous experience from each case. Moving forward, I know which areas require meticulous attention and can lead to a successful esthetic outcome!

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Please click on the picture to enlarge and view the transformation.

Tooth Transformation

Lateral --> Central

Canine --> Lateral

Premolar --> Canine

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My favorite and definitely most challenging case.  Tooth #8 was extracted as a child and subsequent orthodontic treatment resulted in all the teeth from #2-7 being repositioned one tooth mesially. To improve his smile, thorough diagnostics and treatment planning suggested the re-contouring of the hard and soft periodontal tissue architecture and the use of porcelain veneer restorations.

​Deliberate bony hard tissue recontouring, soft tissue gingivoplasty, and tooth preparation were performed to achieve healthy post-operative tissue and a high aesthetic result. Meticulous attention to biologic width and  emergence profile allowed for well adapted soft tissue to the final restorations.

Severe Wear Pattern

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This patient presented with a severe wear pattern for which she wanted to have esthetic treatment completed to improve her appearance. She had just had a bridge completed from her right first molar to canine which was not going to be changed, she had it fabricated in B1 as she knew she wanted to have a smile makeover. After significant treatment planning, the patient was advised that she would have to wear a night guard after the restorations are cemented if we were going to proceed. She agreed, a wax-up was fabricated, a mock-up tried in, the teeth prepared with slight laser gingivoplasty, provisionals fabricated, and ultimately the restorations were delivered. The patient was ecstatic and loved the result. 

Multiple Diastemata

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​This patient came in with a concern about the spacing between her teeth. She was advised that she should consider orthodontic treatment first, but she was not willing to go down that route. After study models were poured, and a wax-up was fabricated, I tried in a mock-up for the patient and she was thrilled. Her whole appearance had changed with just the mock-up, she was very excited to complete the case. The preparation of the teeth was minimal, the shade was selected, and the patient left a changed individual. She came back for cementation with a new sense of confidence. She told me about all the changes she was making in her life, and that gave me a sense of pride for the impact I had made.

"Doc, my veneer broke off"

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I met this patient, and her main concern was that her existing veneer had popped off. On closer examination, I noticed that both the right premolar and canine veneers had been dislodged, the size and shapes of the existing veneers were not ideal esthetically, and there was staining around the margins. After discussing my concerns with the patient, and fabricating a wax-up of the ideal shapes and sizes of the teeth, the patient decided to replace her old veneers and proceeded with my proposed treatment plan. On delivery of her temporaries, the patient claimed that her "bite felt better" and she loved the look of the new teeth. The veneers were fabricated with IPS e.max lithium disilicate and had excellent esthetics.

​Old Composite Veneers
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This patient came in having just receiving a removable partial denture for his missing upper molars. His main concern when he came to me was that he wanted to replace his old composite veneers which were done approximately 15 years ago. He said he had them "repaired" from time to ​time but overall he was happy with the time that they served him. He now wanted a new set that would last for the next stage of his life. I mentioned the advantages of porcelain veneers and he was ready to start treatment. After a wax-up was completed, the teeth were prepared and temporized. The patient was amazed at how quickly the process was completed. When we delivered the final restorations the next appointment, he was in awe at the advances in the field and was happy with his new teeth.

I Broke my tooth!!!

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This patient presented as an emergency. He mentioned that he does not like going to the dentist and has not been to the dentist in years. He was supposed to get a crown on this tooth, but he didn't. Ultimately he lost his tooth and needed to have it "fixed." After comprehensive treatment planning, I told the patient that we could save his tooth and that the tooth beside it also had a big filling with decay underneath it. I mentioned that we would have to restore the teeth with two crowns but we would also have to do some periodontal work to maintain his gums and there were some other small cavities that needed filling. After temporization of the left central incisor, the patient continued with all the treatment despite being scared of the dentist.

Abraded Canines

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This patient was no stranger to dental work, she had crowns placed at different times of her life on both central incisors and both lateral incisors. She did not want to change anything except she was concerned with the abrasion on her canines and told me that these teeth look worn away. I gave her oral hygiene instructions to help her brushing habit. I also mentioned that I could restore the teeth with either composite or porcelain veneers. She opted for the porcelain veneers because she was concerned about staining of the composite and she wanted the material to match her crowns. When the final restorations were delivered, she was extremely happy with the result and started to refer her friends to me for their dental work.

Help... My flipper broke!

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I met this patient who had just broken his temporary removable appliance. He was given all the options of another removable appliance, a fixed conventional bridge, implants, or an implant supported prosthesis. To give him an idea of how the implants or the bridge would look like, a wax-up was fabricated and an intra-oral mock-up was done. The patient was very excited about the possibility of a fixed restoration that he opted to get a consult for implants. I had to pass on the case to a junior student because I would be graduating. The patient was thankful that I had presented him with so many options and was looking forward to his restorations.

Bridge + Veneer = SMILE!!!

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Another one of of my first cases, you can tell by the amateur photography in the before pictures. I then decided that to properly document and critic my cases I needed to take accurate photographs. This patient came in after not going to the dentist for a long time and told me that he thought his tooth was really rotten and was about to fall out. On closer examination, the tooth he mentioned was the right baby canine and it was about to completely exfoliate. I gave him multiple options, and he decided to go forward with a bridge from right premolar to central and a single veneer on the left central. He had not gone to the dentist for years but kept every appointment with me and in the end was thrilled with the result.

Broken Front Tooth

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My first anterior case with fixed restorations. The patient presents with a broken tooth, which after a detailed history, was actually a dislodged 3-unit bridge. The left central incisor had a poor prognosis and required to be extracted. After I poured study models and spent hours on a wax-up, I fabricated an indirect provisional. The provisional was fabricated with acrylic resin and I was determined to deliver a highly esthetic provisional that would be strong enough to facilitate canine guided occlusion. After provisionalization of the case, the patient did not come back for over a year because he was so happy with his temporaries. Finally, after much persuasion, the patient came in for the final impression and the final bridge was delivered with an excellent color match.

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