Sunday, August 2, 2009

Permanent porcelain crowns came in and they look horrible.?

I chose to have porcelain crowns put onmy front teeth for cosmetic reasons. The permanent ones (I rejected them) came in too short, uneven, slanted inward and with a gap. They are like nothing that I pictured. I bawled. The dentist offered me my $ back and said I could find another dentist if I didn't want to resend them to the lab. Now I have to specify what I want...I assumed it was understood that I wanted symmetrical, straight, perfect front teeth. I have to show the office what I want based on pictures from their office booklets that they sent me home with so they can instruct the lab to make them exactly as I want. In addition to all the above, in the office light, the color reminded me of old crowns I have seen on older people that look to be about 20+ years old. I am devastated. This is a procedure I looked into thoroughly before making my decision and now I feel I made a mistake as there is no way to restore my natural tooth.

Permanent porcelain crowns came in and they look horrible.?
It sounds to me like something went terribly wrong with the impression procedure. Crowns are made from the impression and if it's not good, the crowns won't be either. The lab always says "they are only as good as the impression." I should know, my son works in a lab and we have detailed discussions. It's the only thing the lab has to go by, what your teeth looked like before they were prepped for the crowns. I'm assuming you didn't have short teeth with a slant or a space in between them. Did you have a problem when the impression was made, choke perhaps or did they have you bite into a tray? There are several things that could flaw the impression, even allowing the material to set too long before placing it in the mouth. This step is crucial, and I always tell my patients to hold that thought for a moment, I need the use of their mouth. Depending on the material (and there are plenty of different ones) will determine if the dentist held the tray or if you bit into a triple tray. The reason the teeth were short, tells me the tray wasn't positioned correctly and the space and slant of the teeth was due to movement of the tray in the mouth before the material set. Your dentist should take two impressions, one of a full arch upper tray, and he should hold this tray in position, and another one using an either a full or anterior triple tray to see how the teeth set together. Most of the dentist will take a bite registration showing how the teeth fit together when you close or occlude. You should also ask that the "dentist" do these impressions if he didn't last time and some don't. I'm sorry but I can't blame it on the lab even though most dentists do when something isn't just right. Too many signs point to a faulty impression. One other thing you can ask the dentist if he took an alginate impression of your upper arch and pour it up in stone for a study model. This would give you a replica of your natural teeth. In your case it would be used to check the size and shape of the teeth. I'm wondering how well the temporaries turned out. Hopefully they were good. I would give him another try, but take your own photo in and ask for new impressions to be made and let the lab use the photo. In some cases the lab may ask that you come in for them to look at your teeth for size and shade. Even your shade was off, so ask the dentist to call the lab to come over for the shade analysis. They do it all the time for dentist that have trouble judging shades. The best way to get a shade match is to use "natural daylight" by going outside especially if he has florescent lighting. If he wants to blame it on the lab, don't believe him and take your money and go elsewhere, but get any study models he made to take with you. Any reputable dentist can take an accurate impression and have full porcelain crown made with no problems. So you had a lot of problems and things didn’t work out well the first time, give him one more chance to make it right. Hopefully he will make sure the impression and shade is perfect. Good luck and I’m sure it will work out next time, if not find a dentist with more experience in crown and bridge work.
Reply:MAYBE THIS DENTAL LAB DOESN'T KNOW WHAT THEY'RE DOING, BUT THE DENTIST SHOULD HAVE SENT THE CROWNS BACK BEFORE YOU SAW THEM.


BECAUSE THIS IS SO IMPORTANT TO YOU I WOULD FIND A DENTIST WHO ATTENDED THE ADVANCED STDIES AT THE LVI INSTITUTE AND IS MORE THAN QUALIFIED IN COSMETIC DENTISTRY.


http://www.lvidocs.com/
Reply:You were correct in rejecting the crowns that you didn't like. However, you should never assume that someone knows what you want your smile to look like. Be extremely specific, the doc should be experienced in cosmetic dentistry (not necessarily a student of LVI---I prefer the Pankey philosophy). If your doc can't please you, take your $ and find another who can. Ask to see photos of their work and do not accept anything you don't love!
Reply:I had to get my two upper front teeth crowned 6 years ago and the dentist did a bad job. They looked awful and my bite was thrown way off whack and felt horrible. Eventually I had to hire a lawyer to sue the dentist and have them redone by a better dentist. Whatever you do, dont sign anything they dentist gives you (he will try and waive your rights so you cant sue him). I would recommend retaining a lawyer and going to a new dentist....



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