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A porcelain veneer is the ideal choice for those seeking the finest, longest lasting restorations available in the world today. Porcelain veneers have become the flagship procedure in cosmetic and restorative dentistry. Their success can be traced to NASA and the space shuttle program in the late 1970's. Having trouble with missing tiles during re-entry, NASA developed a method of bonding the porcelain tiles to the space shuttle's undercarriage. This bonding technology was adapted to dentistry, and allowed us to bond porcelain directly to the tooth surface. The mechanical chemical bond creates an amazingly sturdy restoration, which is as strong as natural tooth structure and one that will not stain.

The common uses of porcelain laminate veneers. 

1. Restore decay, erosion, attrition, tooth loss
2. Create uniformity of surface morphology
3. Improve symmetry and orientation
4. Change shapes – length, width
5. Change chroma and value or brightness 
6. Changing occlusion

The porcelain veneer can be very thin (as thin as 0.2mm), allowing for minimal or no tooth reduction, and in some cases requires no anesthesia. Preservation of the strong enamel tooth structure provides for a longer-lasting tooth and is minimally invasive. The semi-translucent veneer can be made to match the light transmitting properties of natural teeth, and being metal-free, eliminates the hated "black" marginal line found around traditional porcelain to metal crowns. Exquisite natural esthetics are achieved with this restoration, and it is most often used to close spaces, replace worn enamel, repair broken or chipped teeth, re-shape crooked or misaligned teeth, and to cover permanently stained or discolored teeth. The porcelain veneer will appear as a natural tooth, in other words totally invisible.

Example of porcelain veneer that is so thin, it exhibits a contact lens effect at margin

Porcelain veneers on actual patient with invisible margins

No-Prep Veneer

Dr. Fondriest has always been on the forefront of new innovations in dentistry. Teamed with world famous ceramist Matt Roberts CDT, our office is proud to announce the development of the No Prep Veneer system, the newest most advanced restorative product in the world today. The No Prep Veneer now allows Dr. Fondriest to create such incredibly thin veneers, that zero or minimal tooth structure need be removed! Unlike the similar highly marketed product, Lumineers, our no prep veneers are built with multiple artistic layers with varying colors and levels of translucency of porcelain as opposed to the single colored one-dimensional Lumineers. Much greater and natural esthetics can be achieved with no removal of enamel.

Many patients are uneasy and apprehensive about enamel removal, especially when the teeth are in healthy condition. No Prep Veneers offer the conservatism of composite bonding while delivering the durability and beauty of porcelain veneers. The very thin contact lens like veneer bonds directly to healthy tooth enamel with no tooth reduction and in many cases no anesthesia. This type of veneer is especially useful in cases where the teeth are too small, due to advancing wear or genetics.

Cosmetic Bonding

Cosmetic bonding refers to restorations made from composite plastic material, and is used similarly to the porcelain veneer. The cosmetic bonding requires no outside lab procedure, and is built directly onto the tooth surface by the dentist. Durable, tissue compatible, and kind to the opposing teeth, Dr. Fondriest is able to make absolutely the thinnest restorations using this material, which preserves the greatest amount of natural tooth structure. Exquisite natural esthetics can be achieved, as all of the light transmitting qualities and shades of natural teeth are available. It is most often used to close spaces, replace worn enamel, repair broken or chipped teeth, re-shape crooked or misaligned teeth, and to cover permanently stained or discolored teeth. Composite bonding is very often used to replace less attractive silver fillings.

Porcelain Crowns

Porcelain crowns, sometimes called "caps" are often used to restore a tooth to beauty and full function when a substantial amount of tooth structure has been lost due to breakage, decay, or a large old filling that has failed. Dr. Fondriest prefers to use all-porcelain crowns over crowns made of porcelain fused to metal. Porcelain is more biocompatible than metal and can be made thinner thus requiring less tooth reduction. The all-porcelain crowns can be more aesthetic, and will never develop an ugly black line at the gumline. The all-porcelain crown can be made to closely match the light transmitting properties of natural teeth and will not stain or change color. Although the all porcelain crown is very strong, there are many circumstances when a porcelain fused to gold crown is a better choice. The porcelain fused to gold crown is often used when destructive night grinding is a problem or when long span bridges are needed. Fabulous results can be achieved with both all porcelain crowns and porcelain fused to gold crowns if a true ceramic artist is employed to create it. Because Dr. Fondriest uses some of the most talented ceramists in the world, amazing results can be achieved with either type of crown.

Porcelain Fused To Metal Crown

This type of restoration has been the most commonly done crown in dentistry for 35 years. Tooth colored porcelain is baked on top of a metal substructure for the ultimate in strength. The longevity and esthetics of these restorations can vary significantly depending on the quality of the laboratory technician that makes it and the talent level of the dentist. Depending on what market niche your dentist is operating in will determine what this restoration will look like. An average American dentist will contract with a laboratory to construct a crown for about $155. This cost is usually hidden and rolled into the fee for service that the dentist charges the patient. An average crown will have medium quality porcelain baked over a base (non-precious alloy) metal. It will approximate the shape and coloration of a natural tooth. The metal will be exposed at the margin or edge. For $60 more, the dentist could request a porcelain margin so if the gum receeds around the crown, a black line of metal will not appear. Because all the lab costs are rolled into the price of the service, patients are rarely informed of what their dentist is prescribing for them. A cheap dental office will pay as little as $35 for a laboratory to make a crown. At this level of quality, the metal will be cheaper and the porcelain will be more opaque. Cheaper metal will not fit as well and has less biocompatibility. Dr. Fondriest uses gold (high-noble alloy) under the porcelain. Gold's warm color is easier to mask with the porcelain and less tooth reduction is required to make it attractive. Gold will cast better producing a much better marginal fit and it is far more biocompatible. High quality laboratories charge the dentist about $500 per crown but if the particular case has complexity or many teeth are being done at the same time the laboratory costs to the dentist will rise to $1000 for each crown. At this level of quality, porcelain fused to gold crowns will mimic nature's beauty.

Dental Implants

Dental implants have become our favored way to replace missing teeth. Acting as a substitute tooth root, implants bond with the bone to form a stable foundation for permanent replacement teeth that look, feel, and function like natural teeth. The dental implant actually helps preserve the bone by providing the stimulation that was previously provided by the natural tooth roots. This helps maintain the integrity of facial structures.

There are numerous advantages of dental implant treatment over other traditional treatment options. For instance, it is not necessary to grind down the adjacent teeth for a bridge, or secure a partial denture to them with clasps that can eventually loosen the natural teeth. By utilizing dental implants, people who are missing teeth may be spared the many problems associated with traditional false teeth.

Dr. Fondriest works very closely with local specialists who surgically place the implants. He then places the permanent restorations over the implants, which are not made with "one size fits all" universal parts off the shelf but rather are custom made to maximize the esthetics, cleansability, and longevity as well as producing a perfect bite.

Bridges

Choosing the best tooth replacement technique depends upon several factors, including the condition of teeth adjacent to the space, bone condition, gum appearance, esthetic concerns, long term health of the gums, and budget considerations. Dr. Fondriest works with his favorite specialists to achieve some amazing results, and is often able to replace teeth with bridges, implants, and / or partial dentures that are undetectable to the eye.

Dr. Fondriest was able to replace the missing front teeth on this patient with fixed bridgework, giving her a uniform and radiant look. "My teeth look and feel perfectly natural, and I'm so proud to smile. Dr. Fondriest's team made it happen!"

TMJ/TMD (Temporal Mandibular Joint Dysfunction)

According to the American Dental Association, more than fifteen percent of American adults suffer from chronic facial pain. We have found that 50% of our patients exhibit some signs or symptoms of TMD. Some common symptoms include headaches, cold sensitive teeth, pain in or around the ear, tenderness of the jaw, and clicking or popping noises when opening the mouth. These symptoms are commonly referred to as TMJ, or more accurately as temporal mandibular joint dysfunction. Common jaw joint symptoms include:

There are many causes of TMJ disorders including traumatic injury to the chin, jaw, or TMJ itself, missing back teeth and/or poor alignment of the jaws, poor alignment of the teeth, wisdom teeth, bruxism (night teeth grinding), chronic clenching, arthritis, stressful situations, or poor dental treatment that does not respect how the teeth come together.

Many sufferers of these symptoms have found relief with treatment offered by Dr. Fondriest. It is our goal to achieve maximum improvement with comfort and normal function, while using the least invasive and conservative treatment possible. For some patients, the ideal can be achieved, while for others, depending on the nature and stage of the illness, effective management is the maximum goal. Depending on the nature and severity of an individual patient's condition, the appropriate therapy is determined. For some, a night guard designed to relax muscles and reduce inflammation is used. For others, more comprehensive diagnostics and dental restorations are needed.

Dr. Fondriest has had extensive training in TMJ therapy at the world renowned L. D. Pankey Institute in Key Biscayne, Florida, where he now works as a senior faculty member. The Pankey Institute specializes in the study of occlusion (bite) and treatment of TMJ disorders, and is considered by many to be the world's leader in research and treatment of TMJ disorders.

One of the most effective cosmetic tools available is the Gum-Lift to improve a "gummy smile". By gently removing excessive gum tissue, dramatic cosmetic effects can often be achieved. "We have learned that very often the tooth has not fully erupted and emerged from the gum tissue. This procedure is actually designed and prescribed by Dr. Fondriest but performed by one of the highly respected periodontists that supports Dr. Fondriest's work. By removing this excessive gum tissue, we are able to reveal the correct proportion and beauty of the underlying tooth," says Dr. Fondriest.

Smile before a gum lift and veneers

Smile after a gum lift, veneers, and of course, lipstick!

Home Whitening/Bleaching

Nothing freshens up your appearance like a whiter, bright smile. The whitening toothpastes at the grocery store just can't give you the whitest possible smile. Our office uses the latest technology from Discus Dental called Nite White Excel 3. Nite White is a liquid gel that safely and effectively whitens your teeth while you sleep. FDA has recognized the active ingredient in Nite White, carbamide peroxide, for many years as an oral antiseptic. This technology is especially helpful for removing stains caused by food, coffee, tobacco, aging, and other sources. Most of today's bleaching methods are safe for the teeth and surrounding soft tissues.

Home bleaching can give you overnight results. Maximum results may require bleaching the teeth nightly for thirty to sixty days. The bleaching gel comes in a variety of carbamide peroxide concentrations ranging from 7.5% to 22% strengths. For sensitive teeth, we offer Day White Excel 3 from Discus Dental. Day White Excel 3 is a low sensitivity daytime tooth whitener that is used for only thirty minutes twice a day. It comes in 7.5% and 9.5% hydrogen peroxide concentrations.

All Night White and Day White products use an advanced dual barrel syringe, which allows the Peroxide chamber to remain separate from the activator chamber until the moment of use. This allows the freshest blend of gel to be dispensed every time. The shelf life of these products is three years.

Dr. Fondriest does not do nor does he recommend in office bleaching. Because in-office bleaching brightens teeth primarily by dehydration and not stain removal, the benefit is short lived and must be followed up with tray bleaching to actually bleach the organic colorants in your teeth. Due to the lack of actual color removal and the possible negative side effects such as gum tissue and pulpal irritation, in office bleaching is not recommended.