A Tale Of Two Smiles: Or Wisdom Vs. Wheels

Posted by Pi Dental Center on Mar 20, 2012 2:37:00 PM

A Smile Decision

A few years back, a dapper new retiree from a flourishing company wanted to celebrate his retirement with a treat to himself.  He knew his smile was not his best feature and that it actually distracted from his appearance.  He visited the Pi Dental Center and had a comprehensive treatment plan designed to give him a sparkling, healthy smile that was sure to take a dozen years off his face and carry him through for the rest of his life.  Let’s call him Ed.  Ed was not able to value orient the worth of a confident smile, so instead of dental treatment, he opted to purchase a new BMW.  For several months, he was well noticed for his flashy car.

Today, the car no longer turns any heads and is worth but a fraction of what he paid for it.  His teeth have gotten grayer, his face has aged, the money is spent and there is little left to show for it.

The same year, an actively practicing physician and university educator, regretted the grumpy look he had on his face in his daughter’s wedding album.  He was hiding a twisted and discolored lack of a smile.  On the verge of buying a new Porsche, he quickly switched gears and decided to invest in himself instead.  Let’s call him Joe.

Joe visited the Pi Dental Center and experienced Teeth in a Day™ His instant new handsome appearance infused him with a deep pleasure every time he had reason to see himself in a mirror.  It built self-confidence; it built energy; it made him feel he had transferred his wealth to the right place.  Today his engaging smile makes everyone around him feel the glow.  The smile will never depreciate.  Joe hopes to buy his Porsche in a few more years, but if it never happens, he believes his smile was the secret to mid-life crisis and a dream he wished he had grasped sooner.

Who made the best life decision, Ed or Jo?

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Tags: smile makeover, patient self esteem study, dental treatment planning

Winter 2011 Insights Newsletter Highlights Dental Treatment and Planning

Posted by Thomas Balshi, DDS FACP on Mar 15, 2011 11:55:00 AM

Insights NewsletterThe Importance Of Attention To Detail

To provide consistent high quality restorations, whether for single crowns or full mouth reconstructions, attention to detail is essential from treatment planning to prosthesis delivery. We all know the critical marks of excellence. The oral examination must be thorough and include cancer screening. A written treatment plan is the ideal roadmap for sequencing the indicated treatment. The tooth is prepared allowing sufficient room for the thickness of the restoring material and with particular consideration to the health of the soft tissue response following delivery. Proper height of contour, immergence profile and correct interproximal contours are all details that impact quality care.
Before and After Photos

Once the tooth preparation is finalized, other important steps also require attention to detail. Retraction of gingival tissues is key. Consideration must be given as to whether the tissue is thick or thin and friable. When a retraction cord is used, size and the exertion of pressure placing the cord are both critical. Fibrous connections must never be compromised.

The Final Impression is a Detail of Utmost Importance.

The dental laboratory can only provide the natural looking, perfect crown we are expecting if we provide them with the most exact impression possible. Each practitioner has his or her own techniques, usually based on vast experience, for achieving the ideal impression, but what is often overlooked in this equation is the quality of the impression material being used. This is where attention to detail points to accuracy and provides for a more predictable result.
Before and After Photo

ENTER EXA’lence | this is an impression material that is clearly “new”.

Developed by GC America, EXA’lence combines vinyl and polymer to produce a totally new impression material set apart from all of the others. It is intrinsically hydrophilic without surfactants for wet-ability. It has a high tear strength that allows for easy removal from the mouth and multiple accurate pours for stone casts. In addition, its chemistry minimizes bubbles and voids, resulting in very clean and sharp impressions. The following complete implant prosthodontic rehabilitation was achieved with EXA’lence impression material.

Attention to detail is the hallmark of good dentistry and should be essential in every phase of treatment. We as dentists have autonomous control of our implant placement, our crown preparations, proper vertical dimension and articulation. What we need is to place more importance upon our choices of dental materials.

Dentists who are currently using EXA’lence report that it is both pleasant to use and consistently accurate, allowing for sulcular moisture control and very exacting subgingival and marginal detail. Lab technicians’ report that it both pours easily, allows for second pours if needed, and provides well-defined impressions. In a recent Catapult Evaluation, 81% of the evaluators said they would integrate EXA’lence into their practice. For further information on EXA’lence, please go to gcamerica.com or call 215-646-6334.


With the National Cancer Institute estimating approximately 36 thousand new cases of oral cancer for 2010 and the likelihood that close to 8 thousand will result in death, our responsibilities as dentists significantly increase. Identifying lesions early is the key to preventing fatalities. Oral cancers that present at an advanced stage have a higher death rate than breast cancer, prostate cancer, melanoma or lymphoma.

It is important that the dental profession take seriously our responsibility to identify lesions in the mouth quickly and to educate the patient thoroughly in treatment protocol. We recently presented a case study in which an older Caucasian female received maxillary and mandibular implant-supported prostheses (1992) and subsequent meticulous follow-up had no indications of any soft tissue abnormality. In 2008, the patient presented with a “rough area” on the tongue. A 5x7 mm fibroma-like elevated lesion was noted and attributed to mechanical trauma. Surface adjustments were made and the patient was advised to return for a follow-up appointment in two weeks.

This patient did not return for further evaluation but moved out of state. We requested that she immediately consult a specialist in her new location. Follow-up was then lost.

In 2010, the patient returned to Pi complaining of a sore on her tongue. She had not followed our advice and had not been seen by any dental specialist since her 2008 visit. Examination of the patient revealed an ulcerated mass on the right lateral border of the tongue, which extended onto the ventral and dorsal surfaces. The lesion was hard and irregular. A regional cancer center confirmed squamous cell carcinoma. The patient declined further care and expired a few weeks later.

Cases such as this indicate the importance of regular oral screenings for cancer and meticulous follow-up when suspicious lesions are found. It is equally essential that time be taken to carefully explain to the patient that oral cancer is curable when found early and treated accordingly. Similarly, we must also indicate the seriousness of leaving such findings untreated or approaching them holistically.

Tags: dental implants, dental treatment, dentistry, dental treatment planning