My Before-and-After photos

If

a pic is worth a thousand words, how much are twelve pics worth?

I post; you decide.

1. Top. 
Before: Front view
BEFORE. All these "before" pictures are of my old crowns, which were 16 years old when these photos were taken in December 2010. The crowns were placed in 1995 by a North Carolina prosthodontist who liked "Dicor" as a crown material. You can see chips on the upper incisors (circled). These chips were caused by age and wear of the old crowns. I wish I could show you photos of my original teeth, but such photos don't exist. The North Carolina dentist tried to take them, but they got lost. Or something. This was an harbinger of trouble to come.

2. Bottom. After: Front View
AFTER. All the ''after'' photos were taken in April 2011. I like that all the crowns have unique shapes. This material is ''Prettau'' zirconia, which is solid zirconia with *no* porcelain facing. It was chosen for strength and durability rather than appearance. Even so, I am very pleased with these crowns. People interested in aethetics should consider emax or porcelain-fused-to-zirconia, which are more lustrous and even prettier than Prettau. Look at the natural gum line on the upper teeth (circled) and compare that with the gum line in the previous photo. That ''before'' gum line really isn't natural at all. (Google images of real smiles, and you'll see how important a natural gum line is for a beautiful smile.) If you look really carefully at this photo, you'll notice that the upper teeth are ever so slightly darker than the bottom teeth. Had I noticed this before they were cemented in, I would have asked Dr. Prada to send them back to the lab. This crown color is ''B1,'' the lightest natural color in the yellow hue. If I had to do it again, I would go even lighter and probably out of the yellow hues completely. The dentist was Dr. Vinicio Prada of DDS Dental in Costa Rica. All these crowns were made at Lorenzo Favini's dental lab, for which I paid a $75/crown surcharge.

3. Top.  Before. Close-up front view
BEFORE. This photo shows severe wear on all the lower incisors (yellow circle), and a deep gum pocket (pink circle). The gums are unhealthy throughout. Telltale gum inflammation can be seen around most teeth.

4. Bottom.  After. Close-up front view
AFTER. Notice how long the new crowns are. This photo shows the subtle shading on the teeth: Look at the two central incisors on this and photo #2. Near the gums the teeth are shaded yellow to look natural. Dr. Gonazles did crown lengthenings all over to accommodate my short "preps" (tooth stubs). (The dark lighting makes the gums look very red and the top surface of the molars look dark. In fact, the gums are light pink and the tops of the molars the same color as the front.) Dr. Gonzales did a gum transplant to fix the pocket while I was under sedation for the crown lengthenings (normally this is an expensive procedure, but he did it for free). Finally, notice that the biting edge of the incisors is not perfectly straight but has a wavy pattern (circle). This was done on purpose. Lorenzo thought that this looks more natural, and I didn't have a preference. But I'm sure he can accommodate anyone who wants crowns with perfectly straight edges.

5. Top.  Before. Back teeth.
BEFORE. Showing severe gum inflammation in the back, and motley crowns.

6. Bottom.  After. Back teeth
AFTER. Back teeth showing healthy gum tissue and matching crowns. (The horizontal streaking in these photos is a photographic artifact.)

7. Top.  Before. Another side shot
BEFORE. Another shot showing inflammation around crowns in the back.

8. Bottom.  After. A side shot
AFTER. Another side shot showing long pretty crowns and healthy gums. (The back teeth on the left of the photo are streaked because of photographic distortion from the digital camera.)

9. Top.  Before. Bad margins
BEFORE. Bite-wing x-ray of molar teeth showing poor margins on some teeth (arrows). These were a defect of the original crowns and were not due to the age of the crowns.

10. Bottom.  After. Fixed margins

11. Top.  Before. More bad margins
BEFORE. Bite-wing x-ray of more teeth showing more bad margins. I count six really bad margins, and a couple of questionable ones. How many do you count?

12. Bottom.  After. Excellent margins
AFTER. The same teeth with the new crowns showing excellent margins.



[DISCLOSURE Updated 5/26/2019:  Since I originally wrote this post in August 2011, I heard third-hand that this clinic is offering fees to former patients who refer new patients.  I have never taken advantage of any such referral fees, though I cannot rule out doing so in the future.  In any case, such fees played no part in my motivation for starting this blog or reviewing this dentist.  When I talk with prospective Costa Rica dental travelers--as I do once or twice a year--I typically give them several dentists that I think might suit them. I never leave them with just one name to research.]

 

 

For my detailed experiences with Dr. Prada and DDS, Press Here.

 

 

For some Questions and Answers with Dave, Press Here.

 

 

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