On Friday May 27th 2016, “Smile Project”, the 1st Dental Aesthetics Meeting, took place in Pamplona, organised by the Navarra College of Dentistry and Stomatology. I attended the event because of my interest in dental aesthetics, an essential part of all treatments at our Clinic.
The course was directed by Dr Ricardo Pérez Ramírez and the prosthetists Andrade and Ramírez, from the city of Pereira in Colombia. In that country, like in Venezuela and other Latin countries, great importance is placed on aesthetics, both in dental and general aesthetic surgery. There they work on the basis of a slightly different point of view to us, and I was curious to find out more about it.
They told us about what has recently been dubbed as “Ceramic Lens”, which are like the porcelain veneers we have been using for years, but a little finer. The idea is to do as little preparation work on the tooth as possible, only preparing the enamel slightly or not at all, even if the difference between the Ceramic Veneer, in itself very fine, and the Ceramic Lens is rather unclear. In any event, the two can be combined with one another.
Ceramic lens are used to improve the aesthetics of the tooth shape and colour in the upper front area.
But not only are lens used from canine to canine, which would be 6 pieces, they are also used from the second premolar on the right to the second premolar on the left, i.e. 10 upper pieces, which are the ones we show when we smile.
This means that we must carefully study the occlusion or the way the patient bites. Being very fine and delicate ceramic pieces, in patients who clamp their teeth or who show quite a lot of wear due to bruxism, the lens could break.
Ideally, the patient should not suffer from bruxism, i.e. they should not grind their teeth. It is also preferable that, when they bite with all teeth, they leave a small separation between the upper and lower teeth in the anteroposterior direction. This means that the ceramic would suffer less and that it would have a better prognosis and duration.
Regarding the concept of aesthetics in their country, they explained that treatments using fine veneers or ceramic lens are above all applied to young women, although they are also used on somewhat older women and on men.
Some patients prefer natural-coloured teeth, i.e. with different shades on a same tooth, as is usually preferred in Europe.
These are teeth with different shades closer to the root, on the body of the tooth, and on the cutting edge. However, some patients want their teeth to be completely and intensely white from top to bottom. These teeth go by the name of “Queen” or “Miss”. They are very popular too in the United States and they look bigger and wider due to being so white. To give them a more natural aspect, the laboratory has to work hard on the shape to make them look longer and less artificial.
We also heard about the technique for preparing teeth, taking impressions and fixing the veneer in place. It was a very interesting course for learning other points of view.