Read about Dr. Fiss in A Reason to Smile in Today’s Chicago Woman (May 2011)
Read about Dr. Fiss in Open Wide- The Dentist Office Revisited in Today’s Chicago Woman (February 2005)
Read Dr. Fiss’ article Simple Makeovers Improve Image With Ease in Chicago Health Magazine (June 2005)
Patient presented with severe periodontal disease causing bone loss, tooth mobility, greatly reduced function and most of all decreased self-confidence due to poor cosmetics. As all of the patient’s teeth were hopeless, they were removed. A total of 11 implants were placed. Six implants in the upper arch and five implants in the lower arch. Upper and lower hybrid screw down prosthetic appliances were fabricated using the most natural looking materials available. No acrylic or denture teeth were used. Each hybrid appliance consists of a titanium bar with individual Emax all porcelain crowns cemented on to them. The Emax porcelain crowns possess all of the depth of color and translucency of natural tooth structure and enamel. The final result is beautiful and natural. The patient feels that she was born with these teeth.
Pictures 1-3 The patient presented with a severely worn , collapsed and decayed dentition. Years of grinding and poor dental care caused the patients teeth to overclose or loose vertical dimension……making him look much older then his actual age. You can also see that both his teeth and gum height was severely angled or sloping from right to left.
Pictures 4-6 Over several visits 21 -EMAX porcelain crowns were placed correcting the vertical dimension…we were also able to reverse both the sloping gum height and tooth alignment….restoring the midline. The final result demonstrates healthy gums and a youthful natural smile.
(1) pictures 1-3 demonstrate crowded, chipped and worn dentition. The dark stripes are caused from tetracycline stains. Although his teeth and gums were healthy the patient hated to smile.
(2) pictures 4-6 To enhance the patients smile 16 emax porcelain restorations were placed…..blocking out the dark intrinsic discolorations…correcting the crowding and lack of symmetry….creating a youthful and natural appearance.
(1) pictures 1-3 Patient presented with spacing or diastema between her 2 front teeth….a narrow arch (lacked a broad smile)….crowded and misshapen lower anterior teeth. She wanted a whiter, broader -natural looking smile.
(2) pictures 4-6 The patients teeth were cleaned and zoomed….16 porcelain emax porcelain restorations were placed were placed-closing the diastema….balancing the size and shape of all teeth…creating symmetry. Her smile was broadened….lining up the upper and lower midlines. The final result is extremely natural “looking like she was born with those teeth“.
Photos 1-3: Patient presented with undersized 4 front teeth. The teeth had varied colors and the gums were swollen.Her teeth were thoroughly cleaned…intense home care regimen was instituted.
Photos 4: The gum heights across these teeth are uneven making the teeth adjacent to the 2 front teeth look like baby teeth. To correct that the gum tissue on these teeth they were trimmed creating a more even line left to right.
Photos 5-7: Once the tissue healed the patients teeth were zoom whitened. Her uneven lower teeth were reshaped to create smooth straight appearance. To finalize the cosmetic makeover 4 veneers were placed on the front teeth- creating an amazing lifelike sparkly result.
Pictures 1-4
This patient presented with 3 major issues affecting his smile
(1) Severe chemical erosion caused by frequently sucking on lemons which almost completely removed the enamel of his 8 front teeth making them look brown.
(2) The existing cosmetics were made worse by the patient’s tooth and jaw position in the front of his mouth creating an edge to edge bite (usually the top teeth sit in front of the lower teeth)
(3) The patient had poor home care which allowed a lot of stain and calculus to buildup
Pictures 5-8
Initially we thoroughly cleaned and zoom whitened his teeth spending alot of time educ the patient regarding proper methods of brushing and flossing.
I then prepared and completed 8 EMAX all porcelain crowns ( full coverage veneers)on the 4 front top and bottom teeth …..correcting shapes, position ,contour and color ….dramatically improving the patient’s smile and occlusion.
6 Porcelain Veneers, Zoom Whitening & CLEARCORRECT™
Pictures 1-8
Patient presented with multiple cosmetic discrepancies
1. Severely crowded dentition
2. Chipped , missing and misshapen teeth
3. Total lack of symmetry: tooth #7 is undersized and peg shaped-its mirror counterpart #10 is missing…the larger eye tooth #11 has moved into its space.
Steps used to improve the patient’s smile
1. Initial therapy consisted of a thorough cleaning and Zoom whitening
2. The patient’s mouth was scanned….Clear Correct clear Aligner trays were fabricated and worn to correct the upper and lower anterior crowding.
3. Once the teeth were in an ideal position 6 EMAX porcelain veneers were placed correcting the size,shape,color and symmetry of the patient’s smile . The final dramatic result looks incredibly natural
4 PORCELAIN VENEERS AND ZOOM WHITENING
Patient presents with multiple cosmetic concerns
Pictures 1-4 demonstrate
1. Lack of symmetry and tooth position on the 4 front teeth
2. All 4 front teeth are a different color…the dark gray tooth previously had root canal treatment
3. Moderate to severe stain and build up from poor home care
4. Chipped and worn teeth from grinding
Pictures 5-8 demonstrate treatment provided
1. After a thorough cleaning and enamel reshaping …Zoom whitening was performed
2. Porcelain veneers were then placed on the patient’s 4 front teeth correcting shape,size,position,midline,symmetry and most of all color-creating an incredible natural result. As with all cases completed appliances were fabricated to prevent grinding.
Pictures #1-3 The patient presented with a severely worn , stained and somewhat crooked smile. In addition he also had an “OPEN BITE “. An open bite occurs when there is a space or gap between the upper and lower front teeth when closed.
Pictures # 4-6 After a thorough cleaning was performed the patients’ lower front teeth were reshaped ….giving a smooth less crowded appearance. Zoom whitening was performed bringing the shade up at least 5 shades. Four veneers were placed on the top front teeth ….blending not only color, shape and contour but closing the “OPEN BITE” creating a youthful natural result.
Pictures 1-3 patient presented with peg-shaped lateral incisors and a gap or diastema between teeth #8,9 (central incisors )…wanting an ideal smile
Pictures 4-6 after a thorough cleaning and zoom whitening clear correct clear aligners were used to close the space between #8,9….once closed 2 porcelain veneers were placed on the peg-shaped laterals incisors …..creating a beautiful natural smile.
Photo #1 Tooth #9 fractured…was removed and an implant was placed
Photo #2 A porcelain implant crown and abutment was fabricated for #9 using an angled screw channel
Photo #3 Implant crown #9 was screwed into place…. creating an ideal emergence profile
Photo #4 Tooth #8 previously had root canal treatment…a porcelain crown and post core was cemented in place.
Photo #5 The final result shows ideal gum height, contour and esthetics
Pre-op 4 pictures:
Demonstrate moderate to severe wear and chemical erosion -the visible darkening of the 4 front teeth was caused by loss of enamel allowing the underlying darker “brown“ dentin to show through.
Post-op 4 pictures:
After Zoom whitening and Laser recontouring of the gum tissue I was able to rebuild and restore the patient’s enamel on her front teeth using 4 porcelain veneers – duplicating surface anatomy ,depth of color, iridescence, shape and contour …….creating a very natural lifelike result.
BEFORE:
A 57 year old female. Attractive but worn dentition exhibiting vertical cracking, slight rotations, yellowing, incisal chipping and irregular wear from years of grinding
AFTER:
Full mouth rehabilitation with Emax porcelain restorations exhibiting a youthful correction to tooth position, shape, size and color. An increase in fullness was added to the porcelain restorations to improve lip support and broaden the smile. Although the whitest porcelain was used, incisal translucency was built into the porcelain creating an amazing depth of color and natural result. 10 years of aging wiped away in a matter of a few visits creating a youthful appearance.
Pictures 1-3 demonstrate several issues (1) lower arch crowding…teeth are all different heights (2) upper arch shows great differences in gum height, tooth shape and contour creating a total lack of symmetry. The uneven color is caused by old fillings and root canal treatment.
Pictures 4-6 show the improvement after 6 veneers were placed creating lifelike symmetry, color and tissue height. The lower arch was corrected simultaneously using CLEAR CORRECT clear aligners
#1 & 2 These pictures demonstrate severe wear from grinding-the translucency (grayish tones) were caused from chemical erosion (drinking pop,gastric reflux). When a worn dentition is present the 2 front incisors are shorter then the eye teeth or cuspids. The result of all this wear causes the patient to “over close“.
#3 photo demonstrates this by the lack of visible teeth showing and deep facial wrinkles when smiling.
#4 & 5 These pictures demonstrate the result after porcelain restorations were placed only on the top-correcting the collapsed bite and thin gray teeth.
#6 The deep wrinkle lines have diminished – a beautiful broad and natural smile is the result. The worn smile is gone replaced with a more youthful one-creating a facelift effect without the surgery
These 2 photos give an overview of the life changing effects implant and reconstructive dentistry play in a persons life. The before and after pictures are of a young woman born without teeth on top and missing some permanent teeth in the lower. The first picture demonstrates this -as she presents with a full upper denture and lower malposed and poorly shaped dentition. 4 implants were placed in the upper arch after which a hybrid “all on 4” appliance was screwed into place. To restore the lower arch 3 implants and 12 porcelain crowns were placed. This restored the patient’s function and cosmetics creating a lifelike result.
Single tooth implant replacement…from start showing the hopelessly decayed (gray) tooth to its removal and placement of a custom temporary. Once the implant was placed and healed a custom zirconia (tooth colored) abutment was screwed down to the implant and a very translucent and natural all porcelain crown was cemented creating a lifelike result.
The above eight pictures outline start to finish the cosmetic rehabilitation of a severely worn and chemically eroded dentition.
After Zoom (teeth whitening) eight veneers were prepared and placed creating a very natural lifelike result.
The final post-op photo looks like he was born with that smile!
All the teeth were removed in the upper jaw due to decay and bone loss. 4 implants were placed as seen in the picture of the upper working model. An acrylic full upper appliance was fabricated with a titanium bar inside – this was screwed on to the 4 implants – creating a beautiful and lifelike result.
All on 4 – Teeth in a Day hybrid implant prosthesis
6 veneers were placed after zoom whitening restoring an ideal shape, size, color and tooth contour. Note how midline and tissue contour has been corrected.
Photo 1: Patient presented upset about her smile. It was clear that the midline was off, the gum tissue was misaligned and each tooth was a different size, shape, and color.
Photo 2: I used this photo to demonstrate to the patient and lab how improvements were to be made. Tooth sizes, shapes and proportion were selected presenting desired result.
Photo 3: Temporaries were placed after the teeth were prepared for the veneers, correcting many of the issues the patient initially presented with.
Photo 4: Photo taken immediately after the 6 Veneers were placed. The ideal shape, size, color and contour have been achieved. Note how the midline and tissue contour have improved.
5 & 6: These two photos have been taken after 10 Veneers were placed.
Patient presented with poor fitting anterior porcelain to metal crowns ( note the black at the gum line ) and severe cracked and malpositioned lower anterior teeth. The patient’s teeth were whitened using Zoom bleaching-porcelain crowns were placed in both areas creating an ideal natural result.
Patient presented with dark and irregular shaped teeth adjacent to the front teeth. After Zoom bleaching 2 veneers were placed creating an ideal result.
Patient presented with dark and irregular shaped teeth adjacent to the front teeth. After Zoom bleaching 2 veneers were placed creating an ideal result.
Patient presented with 4 completely asymmetric front teeth. After Zoom bleaching 4 veneers were placed at the correct longer length creating a beautiful symmetric smile.
Note the translucent incisal edge.
6 Veneers placed to close open bite, creating a perfect ideal smile.
20 Veneers placed creating a youthful smile. Improving color, shape, and contour of teeth.
Patient presents with congenitally missing lateral incisors and the cuspids were moved forward orthodontically and implants were placed completing her smile.
Bleaching and 8 veneers completely changed this patients smile with natural looking results.
Bleaching and 2 veneers created a subtle, natural result far better than the previous existing bonding. Correcting the length and midline.
An older patient presented with severally eroded and cracked teeth. Bleaching and 4 veneers created a natural result.
Patient suffered a severe fall, teeth # 7 and # 9 were severely cracked and # 8 was completely lost. 2 porcelain crowns were placed on teeth # 7 and # 9. An Implant and porcelain crown were placed on # 8 creating an amazing, natural result.
Patient presented with 2 unattractive porcelain to metal crowns, note how irritated the gum is around them. Post Op a completely natural result with 2 porcelain crowns, note how the gum has healed completely.
Two three unit bridges were replaced from porcelain to metal (dark at the gumline to all porcelain bridges) giving the patient a youthful smile
One implant and four all porcelain restorations changed this persons life from being afraid to smile to smiling constantly
This picture demonstrates instant orthodontics achieved using bleaching and six porcelain laminate veneers. Note the realistic translucent edge of the front incisors as well as the natural lip contours.
Another demonstation of instant orthodontics utilizing bleaching and twelve porcelain laminate veneers. Note how the teeth now have more ideal symmetry in size, shape, and contour. Also, note the improvement in the gum tissue.
Another case of instant orthodontics displaying both the front and top views before and after the procedure. Once again, note how the gum tissue has improved as the position of the teeth have changed.
Another case of instant orthodontics displaying both the front and top views before and after the procedure. Once again, note how the gum tissue has improved as the position of the teeth have changed.
Another demonstration of instant orthodontics utilizing bleaching and twelve porcelain laminate veneers. Note how the teeth now have more ideal symmetry in size, shape, and contour. Also, note the improvement in the gum tissue.
This picture demonstrates instant orthodontics achieved using bleaching and six porcelain laminate veneers. Note the realistic translucent edge of the front incisors as well as the natural lip contours.
After Invisalign: Teeth still poorly shaped and discolored. No existing symmetry from left to right.
After veneers were placed: Picture taken same day that a total of twelve veneers were seated, six on top and six on bottom, showing slight gum irritation. The result: contour, alignment, and color were greatly improved; plus note incisal translucency.
Pre-op: Poorly placed bonding and obvious recurrent decay are visible. Patient never smiled due to lack of lip contour; premature wrinkles could be seen.
Pre-op: Existing poorly placed veneers and old crowns. Crowns have metal underneath: note unattractive dark line and lack of natural translucency. Poor tooth symmetry and lip contour exist.
Post-op: Dramatic improvement visible after six metal free restorations were placed. Note improvement in health of gum tissue and lip contour. Tooth symmetry, size, and translucency make teeth look real.
Pre-op pictures: Thick poorly placed bonding making teeth look short, fat, and unattractive. With this dentition, the patient looks twenty years older.
Post-op pictures: Ten veneers later, the teeth are correctly proportioned, the gum tissue is healthy, and the symmetry and tooth size are both restored. The patient has regained his youthful smile.
Pre-op pictures show worn dentition, irregular gum height, a porcelain to metal crown which looks too opaque, and tooth symmetry, size and contour that are incorrect by a wide margin.
Post-op pictures: This patient did not want surgery to correct gum height. These pictures were taken the day ten veneers were placed. Note the dramatic improvement in tooth symmetry, contour and color.
Pre-op pictures: Older patient after gum surgery showing older discolored restorations with recurrent decay and overall unattractive cosmetics.
Post-op pictures: Natural looking dramatic reconstruction, including twenty four crowns. Ideal lip contour, tooth size, and symmetry have been created. Note how chewing edges were adjusted to show natural signs of wear.
Pre-op pictures: This patient was actually attempting day to day functions such as speaking and eating with great difficulty. This is an older patient showing severe breakdown and worn dentition.
Post-op pictures: 16 crowns, 4 extractions, and a lower removable partial denture later, the patient shows off his youthful restored smile.
Pre-op photos show severely worn teeth and porcelain to metal crowns. (Restorations which lack cosmetic appeal) Bleaching, ten veneers, and four visits later, a dramatic improvement is visible.
First photo: After orthodontia was removed the teeth are in an ideal position for future veneers.
Second Photo: After veneers were placed, a photograph of the occlussal view is taken to demonstrate how the veneers wrap around the teeth. This also demonstrates how the closed spaces created an ideal perimeter.
Third photo: Frontal view demonstrates a total of eight veneers in place, bleaching results, and an overall healthy gingival, or gum response.
First photo: After orthodontia was removed the teeth are in an ideal position for future veneers.
Second Photo: After veneers were placed, a photograph of the occlussal view is taken to demonstrate how the veneers wrap around the teeth. This also demonstrates how the closed spaces created an ideal perimeter.
Third photo: Frontal view demonstrates a total of eight veneers in place, bleaching results, and an overall healthy gingival, or gum response.
Pre Op Xray of Hopeless Dentition
Before photo of Patient
Future Hybrid Implant Retained Dentures
Hybrid Dentures with Attachments Inserted
Post Op showing natural smile line Dentition
An amazing makeover with the placement of only three veneers and cosmetic enamel recontouring-note how exact the custom staining is creating lifelike results
Veneers Along with Zoom Whitening
Pictures 1 and 2: Patient presented with existing veneers on her four front teeth. The pictures demonstrate that each tooth was a different color, size and shape. The existing shape was very triangular and her teeth were flared out. The cuspids or eye teeth adjacent to the existing veneers were small and undersized creating an imbalance.
Pictures 3 and 4 : After a cleaning and zoom whitening I created a treatment plan to not only change the existing veneers but add veneers on the eye teeth as well. Six veneers were placed changing the shape of the patients teeth to rectangular and in doing so correcting the color, size and symmetry. I also eliminated the flaring or protrusion that existed creating a beautiful natural result.
Dental Implant & Porcelain Crowns
Picture #1: Patient presented post trauma regarding his top front 7 teeth #6-12. Teeth #7, 8, 9 were missing. Teeth #8, 11, and 12 needed root canal treatment.
I created a treatment plan for the surgical placement of 3 implants, 3 root canal procedures, 3 post cores and 7 porcelain crowns.
Pictures #2-6: The day the case was finished. 3 Cast posts were cemented in the completed root canal treated teeth. 3 screw down porcelain implant crowns were seated. The final 4 porcelain crowns were cemented. The pictures demonstrate an incredibly natural result. All 7 teeth are now individual….the patient will be able to floss, eat and function as if they were his natural teeth .
9 Veneers, Zoom Whitening & CLEARCORRECT™
Picture #1 : Patient presented with chipped, worn, malaligned teeth with severe chaulky spots . There was a total lack of symmetry. The top front 2 teeth were too long and improperly balanced with the adjacent teeth. The upper arch was collapsed creating a narrow smile….the upper back teeth were not visible.
Picture #2 : The patient’s teeth were cleaned and Zoom whitened. I created a treatment plan to place 9 porcelain EMAX restorations in the upper arch to correct the malalignment, chaulky spots, collapsed arch and symmetry. Clear correct fabricated Clear Aligner trays to correct the alignment in the lower arch.
Picture #3/4 : Demonstrate the 9 porcelain restorations in place in the upper arch… correcting not only the alignment but the color, symmetry and collapsed arch. The upper front 2 teeth were shortened slightly-the adjacent teeth were created in ideal proportions creating a broader ideal but natural smile. The crowding in the lower arch was corrected after 5 CLEAR CORRECT trays.