DuBoff Dentistry Casebook

Advanced Dental Solutions and Aesthetic Options

S TEVEN CRAIG DU BO F F, D M D , M . I . C . O . I .

Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

Steven Craig DuBoff, DMD, M.I.C.O.I.

When it comes to healthy, beautiful teeth, experience and a commitment to the art and craft of dentistry mean everything. For many years, patients from all over the New York, New Jersey and Connecticut tri-state area entrusted their dental care to Dr. Steven Craig DuBoff. After 18 years of practice in New Jersey, Dr. DuBoff and his family relocated to the Green Mountains of Vermont in the summer of 2007.

Dr. DuBoff is a winner of many prestigious awards from influential organizations such as the American College of Dentists, Dentsply International, and the New Jersey Academy of General Dentistry. His peers recognize him as a thoughtful and insightful leader in his field and an outstanding clinician who genuinely cares about the condition of his patients.

A graduate with top academic honors, including an induction into the National Dental Honor Society, Dr. DuBoff earned his Doctorate of Dental Medicine from the University of Medicine and Dentistry of New Jersey. He is an active member of the International Congress of Oral Implantologists from which he has received his Fellowship credentials. He has also attained his Masters designation from the ICOI, the first dentist in the state of Vermont to have achieved this goal.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

In 1990, I graduated from University of Medicine and Dentistry New Jersey with a love of dentistry. Over the past twenty years it has been my privilege to help people with both improving their health and their appearance.

For all of the people who have trusted me with their care, I humbly say “Thank you”.

The following case studies are a small sample of some of my past work and what dentistry can accomplish today. I hope you find them of interest.

Steven C. DuBoff, DMD I would also like to say “Thank You” to my laboratory support for their artistry and dedication to excellence; specifically Kuwata-Pan Dent (New Jersey), Van Hook Dental Studios (Arizona) and Steve Adam’s Dental Laboratory (New Jersey).

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

IMPLANTS AND CROWNS A DENTAL IMPLANT is an artificial tooth root.

It is a safe and medically proven device. An implant is made out of titanium. It is inserted into the jaw bone by a dental surgeon while the patient is under local and/or general anesthesia. The procedure is considered by most patients to be quick and painless.

You will never have to worry about recurrent decay or the need for a root canal with an implant. The overall success rate has been very predictable at over 97 %.

After several months of healing the body grows new bone directly to the surface of the implant.

Implant surfaces can and do vary. Some are etched, grooved or plasma-sprayed, and others are coated with bone accelerant agents. Most implants are tapered and resemble a root form. The most commonly used type of implant is an endosteal (in the bone fixture).

The implant can replace one tooth or several teeth. When used to support a bridge it can eliminate the need for a partial denture. For people who have dentures, implants can provide unrivaled support, comfort and security.

For a single tooth replacement the completed dental implant consists of three stages: the implant body; the abutment component, which connects directly into the fixture by means of either a gold or titanium screw; and the crown itself.

Whether you need a single tooth or several teeth replaced, dental implants can improve your self-confidence, appearance and dental function.

A DENTAL CROWN, also known as a cap, is used to restore and preserve the function of a damaged tooth. The crown covers the tooth to restore its shape, size, strength and appearance. We use crowns to protect weak teeth, to restore broken teeth, to hold a dental bridge in place or to improve aesthetics.

Permanent crowns can be made of various materials, such as metal, porcelain fused to metal, and all-ceramic. We choose materials based upon clinical demands, i.e., aesthetics, durability, strength and available space.

Metal crowns are usually made of a gold alloy. These crowns are primarily used for back teeth, since they need to hold up to extreme biting and chewing forces. For some people, the metal color is the main issue.

Porcelain-fused-to-metal crowns has been the predominant choice for restoration for several decades. Using porcelain as opposed to metal, we can match color to an adjacent tooth. These restorations have been a good choice for both front and back teeth.

All-ceramic crowns have become the gold standard for aesthetic dentistry.

The predominant material is either zirconium or aluminous materials.

These crowns are fabricated using a press technique or a CAD/CAM technique. For people with metal sensitivity, these restorations are an excellent alternative. However, they tend not to be as strong as the porcelain-fused-to-metal material.

The aesthetic cases in this book are full ceramic restorations (completely metal-free). Some of these cases use a cast /pressed ceramic while others are CAD/CAM. Both provided the patients a superior aesthetic result, perhaps better than Mother Nature. For full makeovers we can control size, shape, color and position. Cosmetic dentistry is, in its own right, a form of plastic surgery.

The doctor assumes a significant responsibility in creating a balanced and harmonious result for the patient.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

BONE GRAFTS A bone graft is a procedure to repair a defect in the bone, or to rebuild areas deficient in bone. After an extraction a graft can conserve and maintain the integrity of the jaw. For example, if you were to remove a potted plant from its container the remaining soil around the edges of the container will collapse. If however, one were to fill the hole with additional soil the continuity of the soil would remain. Many times it is necessary to build up the bone prior to having an implant. Grafting materials can also be used to grow additional bone in the sinus, this is known as a sinus lift procedure. There are four types of graft materials, Autograft, Allograft, Xenograft and Synthetic graft.

AUTOGRAFT • this graft is made with the individual’s own tissue, for example bone can be harvested from one site and transplanted into an area with an insufficient amount of bone.

ALLOGRAFT • this type of graft uses sterilized bone from another another individual that has been processed by a bone bank under rigid conditions to ensure complete sterility.

Donors are screened based upon overall health. Sterile allografts have a long history of clinical success.

XENOGRAFT • this graft is harvested from another species and undergoes rigorous preparation to be used for grafting. Two common types of xenografts are bovine and porcine.

SYNTHETIC • this type of graft is product produced in a laboratory under sterile conditions. Synthetic grafts support the growth of new bone in an implant site.

examples of Puros bone grafting material

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

IMPLANTS AND BONE GRAFTS non-restorative upper tooth

subsequent extraction

locating ideal placement for implant and opening sinus for sinus lift procedure

implant and sinus graft in place

restored implant with grafted sinus

actual restored implant

Bill presented with extreme decay under his existing crown. The tooth was non-restorable and was subsequently extracted. After the extraction, a large site graft was placed to maintain the integrity of the bone. After healing, additional bone was grafted as a sinus lift procedure to create an even greater volume of bone allowing us to place a larger implant. We felt this would afford him better function and an even longer term prognosis.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • scduboff@comcast.net • www.duboffdentistry.com

IMPLANTS AND BONE GRAFTS INFECTED AND FRACTURED TOOTH

GRAFTED SITE WITH COMPUTER OVERLAY OF PLANNED IMPLANT

SURGICAL GUIDEPIN PRIOR TO IMPLANT PLACEMENT

POST OPERATIVE OF IMPLANT AT TIME OF SURGERY

FINAL HEALED IMPLANT

Roberto presented with a badly damaged lower right molar. The roots were fractured and there was a signifigant infection around the area. After extracting the tooth and allowing several weeks for healing we then bone grafted the damaged area. Four months later we placed an implant. His next step will be to have a new tooth fabricated.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • scduboff@comcast.net • www.duboffdentistry.com

IMPLANTS AND BONE GRAFTS NON-RESTORABLE FIRST MOLAR

EXTRACTION OF FIRST MOLAR AND BONE GRAFT

TWO IMPLANTS READY FOR CROWNS

COMPLETED RESTORATIONS

Tom presented with a non-restorable lower left first molar due to deep caries in the furcation. The tooth was extracted and, at the same time, a site graft was placed with a membrane to regenerate the bone that was lost upon extraction. Three months later, the bone had regenerated to the point that two implants could be placed to make up for the lost molar. Tom couldn’t believe the result. “I experienced no pain during any of the treatment.

What a relief! The infection is gone and I have two new beautiful teeth in place of one badly damaged tooth.”

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

IMPLANTS AND BONE GRAFTS BEFORE

FINAL RESTORATIONS

IMPLANT POSTS IN POSITION

IMPLANTS AND ABUTMENTS

ACTUAL RESTORED IMPLANTS

Richard presented with a chronic endodontic infection of the terminal abutment of a four-unit fixed bridge. Because the tooth was non-salvageable, the fixed bridge also needed to be removed. Upon extraction of this tooth and sectioning of the bridge, his restorative options included a removable partial denture or implants. In this situation, we placed and restored two implants, providing Richard with full function and comfort.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

IMPLANTS AND BONE GRAFTS FAILING PRIMARY TOOTH

EXTRACTION AND GRAFT OF TOOTH

GRAFTS HEALED IMPLANT

IMPLANT OF FINAL RESTORATION

Mrs. S. arrived in our office, in pain, due to a combination of periodontal and internal root resorption infections around a primary molar that had been restored with a permanent porcelain-fused-to-metal crown. Extraction was the only option. We decided to graft the area to prepare the site to place an implant. After several months of healing, the implant was placed. Mrs. S. said, “I just wish I hadn’t waited so long to do this.”

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

IMPLANTS AND BONE GRAFTS

FAILING RETAINED PRIMARY TOOTH WITH COMPUTER OVERLAY OF PLANNED IMPLANT

HEALED IMPLANT

RESTORED IMPLANT

Jennifer retained one of her primary teeth because her adult tooth had not developed. Finally, the primary tooth had broken due to significant decay, of which she was unaware. We used implant-imaging software to determine the best implant size and position before any surgery was done. Her tooth was extracted; the implant was placed; and shortly thereafter, the final crown was completed. An implant in this situation is an excellent solution because no other natural teeth are involved.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COMPLEX SOLUTIONS

IMPLANTS AND PORCELAIN CROWNS SURGICAL SITE

LINE-UP FOR FIRST IMPLANT

IMPLANTS PARALLELED

IMPLANTS IN PLACE

AREA SUTURED

HEALED IMPLANT SITES

LAB MODEL OF ABUTMENTS

LAB MODEL OF CROWNS

TRANSFER JIG FOR ABUTMENTS

ABUTMENTS IN JIG

ABUTMENTS SEATED IN MOUTH

FINAL CROWNS IN PLACE

Carol had lost most of her teeth on the upper right side. She said, “It’s just hard to eat and I hate my partial denture.” Two implants later, her partial was gone and she found it a pleasure to enjoy her meals.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

IMPLANTS AND BONE GRAFTS FULL MOUTH RECONSTRUCTION

Lynn lost all of her upper teeth and could not comfortably use a partial denture. She wanted to know if it were possible to restore her teeth without resorting to dentures. The X-rays show the delicate placement of eight Zimmer TSV implants in conjunction with a Puros bilateral sinus lift. After proper healing, eight well-fitted crowns were attached and now function flawlessly, much to Lynn’s delight.

Materials in the previous section are primarily Puros Allograft from Tutogen Medical, Inc.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COMPLEX SOLUTIONS BEFORE

RESTORATIONS REMOVED

IMPLANTS WITH TEMPORARY ABUTMENTS

TEMPORARY BRIDGE

PERMANENT ABUTMENTS

FINAL CASE

LOWER TEETH PREPARED

LOWER CERAMIC CROWNS

FINAL CASE

It had been twenty-five years since Lynn had seen a dentist. Most of her teeth on the upper arch were nonsalvageable. Bilateral sinus lifts and eventually eight implants on the upper allowed us to reconstruct her smile.

She was so happy when the upper case was being finished, that she asked us to do a complete makeover on the bottom.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COMPLEX SOLUTIONS

SITE GRAFTING AND ALL-PORCELAIN RESTORATIONS BEFORE

PUROS GRAFT

COLLAGEN SUTURED

PREPARED GRAFT

TEMPORARY BRIDGE

PREPARED ADJACENT TEETH

GRAFT PLACEMENT

GRAFT CONDENSATION

ONE VISIT COMPLETE

COLLAGEN OVER GRAFT

6 WEEKS HEALED

EXTRACTION OF 8 AND 9

COLLAGEN IN PLACE

FINAL PORCELAIN BRIDGE

COMPLETED CASE The roots of Katie’s two front teeth had external root resorption, and could not be saved. To complicate the situation, she was congenitally missing both of her upper lateral incisors. Orthodontics as a teenager had moved her canines and bicuspids to create a smile without bridgework or a removable partial denture. We extracted the front teeth and immediate grafts were placed with a temporary bridge. The temporary bridge was designed to help us maintain the natural contour of the upper arch.

After several months of healing, the final four-unit bridge was placed along with several adjacent ceramic crowns.

In the end, we had a very happy patient.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COMPLEX SOLUTIONS

IMPLANTS, GRAFTING AND ALL-CERAMIC CROWNS PREOPERATIVE

IMPLANTS

PREOPERATIVE

FINAL CROWNS

Richard had been a professional soccer player who, as the result of several traumatic facial injuries, eventually lost two front teeth. Dental anxiety kept him from seeking treatment for an extended period of time. We removed his lateral and central incisors and over several surgeries, reconstructed the bone where the teeth had been lost. We then placed two implants with custom abutments and matching ceramic crowns on all of the front teeth. The final result was a happy patient and delighted spouse.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COMPLEX SOLUTIONS IMPLANTS AND OVERDENTURES

LOWER ARCH WITH FOUR IMPLANTS AND ATTACHMENTS

PREOPERATIVE CONDITION

UPPER ARCH OF TWO IMPLANTS AND LOCATORS

COMPLETED DENTURES AND LOCATOR ATTACHMENTS

A NEW SMILE

Alex had always taken care of others—his family, his customers, and his friends. Unfortunately, he had neglected his oral health. When he finally presented for treatment, nothing was salvageable. All of his upper and lower teeth were extracted and two immediate dentures were delivered. Several weeks later, we grafted almost every extraction site in order to maintain the integrity of his bone for future implants. Four months later, six implants were placed—two in the top and four in the bottom. After healing, we used these implants and specially fabricated attachments to connect to his dentures. The attachments allow his dentures to snap into place so he can eat almost anything he wants.

A HEALTHY PATIENT

Alex’s periodontal disease had destroyed the bone in his mouth and caused him to lose his teeth. It is important to know that this type of disease can directly affect cardiovascular health, adult-onset diabetes, and may be a contributing factor in developing certain types of cancer.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS PORCELAIN CROWNS AND VENEERS

BROWN AND FAILING COMPOSITE FILLINGS

CERAMIC RESTORATIONS

NEW AND IMPROVED SMILE

Six weeks before Brandon’s wedding, his future mother-in-law sought our assistance by giving Brandon a smile makeover wedding gift. Brandon presented with a combination of problems including periodontal inflammation, orthodontic misalignment of his teeth and failing old composite-bonded restorations. Brandon, being selfconscious of his appearance, tried to avoid smiling until we gave him this beautiful result using combined periodontal therapy, four Empress veneers and four Empress porcelain crowns. Now he can’t stop smiling!

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS PORCELAIN VENEERS

NOTICE THE INCISAL WEAR

A BEAUTIFUL SMILE

EXTREME WEAR ON TEETH AND GUMLINE

SIX PORCELAIN VENEERS

Amy is a busy practicing physician with enough stress that over the years, she ground her natural teeth down with her chronic grinding habit. Amy was also interested in an aesthetic makeover at this point in her life. Her smile was beautifully enhanced by changing the color, shape, and size of her teeth using six Empress veneers.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS PORCELAIN VENEERS

DANI WANTED AN IMPROVED SHAPE AND COLOR

A HAPPY PATIENT

FINAL CASE OF EIGHT PORCELAIN VENEERS

Danielle is a beautiful girl who wanted an improved smile. She was unhappy with the size, shape and color of her natural teeth. We were able to give her the result she hoped for by placing eight upper Empress veneers.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS

GINGIVAL RECONTOURING AND EMPRESS VENEERS BEFORE

AFTER

Christine’s original veneers never fit well, causing gum irritation as well as recurrent decay around the margins of the restorations.

She also felt that the restorations made her teeth look too small for her face. Initially, we recontoured the gums using a soft-tissue laser and then placed six beautiful porcelain veneers to improve her smile and boost her self-esteem.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS PORCELAIN CROWNS

BEFORE

BEFORE

AFTER

AFTER

Dennis came to us with his daughter’s wedding only a month away. He asked if we could fix a chipped tooth. We suggested that he fix all four front teeth. Four perfectly fabricated Empress crowns gave him a great smile for a memorable day in his daughter’s life.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COMPLEX SOLUTIONS

IMPLANTS AND PORCELAIN CROWNS BEFORE

AFTER

Francis’ upper teeth had been significantly damaged by uncontrolled periodontal disease and years of grinding his teeth. Although his upper front teeth were salvageable, all the posterior were lost. Bilateral sinus lifts were done and eventually eight implants were placed. For his remaining front teeth, we restored his smile with beautiful Lava crowns. He now wears a maxillary grinding appliance and has periodontal maintenance quarterly to ensure his long-term health and function.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS

PORCELAIN BRIDGES, PORCELAIN VENEERS AND PORCELAIN CROWNS

BEFORE

AFTER

Olga was unhappy with the appearance of her upper front teeth for several reasons, including the color of her canine crowns, the distinct black triangles between her front teeth, and the slight overlap of the two central incisors. We achieved dramatic results using Lava porcelain restorations and Empress veneers. While we were happy with her results – she was overjoyed.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS

PORCELAIN VENEER AND PORCELAIN CROWN ONE TOOTH WAS PREPARED FOR A CROWN; THE OTHER A VENEER

NOTICE THE TWO FRONT TEETH ARE NOT SYMMETRICAL OR COLOR-CORRECT

FINAL RESORATIONS IN PLACE

Melissa had a childhood accident that resulted in the fracture of her front tooth. At the time, the tooth was treated with a root canal and bonding. Melissa was always unhappy with not only the color, but also the symmetry of the tooth in relation to her other natural front teeth.

Our solution to provide her with a beautiful natural result was an all-porcelain crown with a matching porcelain veneer for the adjacent tooth. We chose Empress porcelain and Nexus clear cement.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COMPLEX SOLUTIONS PORCELAIN VENEERS

BEFORE

BEFORE

AFTER

AFTER TEN PORCELAIN VENEERS

John had just been promoted to the position of CEO of a large insurance company. He asked us to create the winning smile that would be commensurate with his new position. Ten porcelain veneers later, John’s makeover was a complete success.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS

CERAMIC CROWNS WITH ALL-CERAMIC BRIDGE BEFORE

BEFORE

AFTER

AFTER

Jim is the head of a large advertising agency who was too busy with work to take care of his dentistry. Finally, his wife dragged him in for a consult.

His biggest concern was how long the treatment would take. A short time later, Jim loved how he looked. He could not believe how fast and comfortable his transformation was, and he said that had he known, he would have come to us years earlier.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS PORCELAIN VENEERS AND CROWNS

BEFORE

NOTE THE CONGENITALLY MISSING CANINES AND RETAINED PRIMARY TEETH

FINAL CASE

Randy is a New York City professional in the public eye with what she thought was a less-than-satisfactory smile. We recontoured her gums and used a combination of Empress crowns and veneers to give her the incredible smile she desired.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS

PORCELAIN BRIDGE AND SINGLE PORCELAIN CROWN

As the result of an accident early in her life, Sue’s front teeth were an aesthetic and functional challenge.

The dental work we performed restored proper function and enhanced her natural beauty.

The material used was a Lava porcelain splint and single unit cap.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS PORCELAIN VENEERS

BEFORE

BEFORE

AFTER

COMPLETED VENEERS

Ronnie worked tirelessly between her position at Sloan Kettering Cancer Center in New York City and raising her two sons. For the first time in her life, she decided to do something purely for herself — she asked us to recreate “the smile of my youth.” Six Empress veneers later, Ronnie can’t stop smiling.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS

PORCELAIN VENEERS AND PORCELAIN CROWNS PREOPERATIVE CONDITION

FINAL CASE

Michael came to us with a complicated orthodontic and restorative situation.

He had lived with a bilateral cross-bite and an underbite for years, which over the last number of years had gotten worse, because the vertical dimension of his bite had collapsed. To complicate his situation, he was missing his permanent upper left lateral incisor and canine. In his previous consultation with another dentist, it was suggested that these problems could only be corrected with orthognathic surgery.

After carefully reviewing his situation, we were able to avoid the surgery that he dreaded and instead created a healthy, stable smile using Empress veneers and Lava crowns.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS PORCELAIN VENEERS

ORIGINAL UPPER VENEERS

VENEERS REMOVED. NOTE DEEP TETRACYCLINE STAINS

FINAL CASE

As a child, Lee was exposed to antibiotics, which caused severe tetracycline staining. A prior dentist had placed porcelain veneers, which Lee never liked due to their position and color. I removed the old veneers, and with the help of my expert laboratory technicians, created the smile that Lee had always wanted.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS PORCELAIN CROWNS

CLOSE-UP OF PRE-OPERATIVE WORK

HAPPY NEW SMILE

SEVEN CERAMIC CROWNS ON MODEL

PLACEMENT OF CROWNS AND NEW PARTIAL

Jane is a nurse and a mother who put her faith in us to recreate her smile. We meticulously prepared her teeth ensuring that the laboratory had a precise impression from which to create her makeover. Jane was delighted and only wished that she had done it years before.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com

COSMETIC SOLUTIONS

PORCELAIN CROWNS AND VENEERS TO CORRECT COLOR, SHAPE AND POSITION PREOPERATIVE

4 CERAMIC CROWNS AND 2 PORCELAIN VENEERS

FOUR CERAMIC CROWNS

Carol is a woman who took care of “everyone but herself” for 25 years. She was unhappy with her appearance due to the shape and position of her front teeth. We transformed Carol’s appearance using a combination of all-ceramic crowns and veneers. She is thrilled with the result.

Dr. Steven Craig DuBoff • Exceptional General and Restorative Dentistry • 802.773.1393 • drduboff@duboffdentistry.com • www.duboffdentistry.com