There are many reasons patients seek a smile makeover. Perhaps a prior lack of knowledge on the importance of oral self-care is the source of blame for undesirable aesthetics, as could be a long-term unbalanced diet, chronic health issues, or a current/former dependency on drugs and/or alcohol. Regardless of the circumstances, it is well documented in the literature that a bright white smile boosts self-confidence and the chance of making a good first impression and has even been attributed to greater opportunities for personal and professional success.1,2 Taking these facts into consideration, those with less-than-perfect smiles may face barriers to becoming what they consider the best versions of themselves.
While not everyone is born with a perfect smile, it is also true that not all patients have the financial means to achieve their desired aesthetic results. Commonly prescribed aesthetic solutions (such as crowns, veneers, orthodontics, and implants) are not only costlier, but they may also require multiple visits over many months to achieve the final desired aesthetic result. Furthermore, the reality is that many patients may not have the monetary means or time to spare.
For patients in my practice who are short on time and/or money, I have found an affordable, functional, immediate solution in Snap-On Smile (DenMat). This removable dental appliance is made of durable resin, requires no preparation of existing tooth structure, eliminates the need for dental injections, and does not utilize cements or adhesives. As its name suggests, this appliance snaps snuggly over existing teeth, which limits its moving or shifting during everyday activities, such as talking and eating. The appliance does not cover the palate or impinge on the surrounding gingiva, allowing patients to utilize this solution for as long as they see fit. Snap-On Smile can be easily removed should prior limitations to long-term treatment options subside, making it a completely risk-free, noninvasive, affordable solution for patients seeking immediate improvement to their smiles. As a clinician, the biggest benefits of the Snap-On Smile can be found in the increased level of personal satisfaction that my patients experience because of a more aesthetic smile, increased overall self-confidence, and much better day-to-day functionality.
 |
 |
| Figure 1. A male patient presented with multiple compromised teeth. | Figure 2. A digital radiograph shows strategically placed implants and sites of tooth extraction. |
 |
| Figure 3. Upon complete osseointegration of the implants, the appropriate implant abutments (Glidewell Laboratories) were selected and torqued. |
Indications for Use
In my practice experience, I have found many indications for the Snap-On Smile, with the most common being for patients who present with missing teeth or teeth with coronal damage, and are unable to proceed with extensive restorative treatment due to financial limitations; patients undergoing implant dentistry who desire an aesthetic provisional restoration during the course of treatment, prior to delivery of their final restorations; patients who are seeking an alternative to traditional orthodontics; patients who present with healthy teeth but wish to improve their smile without committing to crowns or veneers; patients who require the opening and restoration of vertical dimension; patients with missing molars who require posterior dentition for function; and edentulous patients (spanning up to 40 mm). The indications are vast but, when treatment is done properly, all can end with the same result—excellent patient satisfaction.
CASE STUDY
Diagnosis and Treatment Planning
A 52-year-old male presented with multiple compromised teeth (Figure 1). Due to long-term alcohol dependency, the patient had not held a job in 3 years. He expressed his desire to improve the aesthetics of his smile in order to gain confidence, improve self-esteem, and attain employment.
He had been a long-term patient in my practice; his dental history included the fracture of tooth No. 8 from a sports injury. It had been extracted, and an implant was placed more than 21 years ago (NobelReplace [Nobel Biocare]). I was pleased to see that the bone around this implant remained healthy so many years after placement. However, the patient’s remaining upper teeth were beyond saving, so a full-arch restoration with dental implants was recommended as the best treatment option. While the same treatment was needed on the lower arch, the patient could not afford a full-mouth rehabilitation. The Snap-On Smile was recommended, which would allow the patient to delay treatment on the lower arch until it was financially feasible for him. In the meantime, the appliance would also greatly enhance the aesthetics of his existing dentition.
 |
 |
| Figures 4 and 5. A single monolithic zirconia screw-retained bridge. |
 |
| Figure 6. The final, completed Snap-On Smile (DenMat) appliance. |
 |
 |
| Figure 7. The delivered and seated Snap-On Smile appliance. | Figure 8. The upper monolithic zirconia screw-retained bridge and lower Snap-On Smile appliance provided a harmonious aesthetic solution that was a very appropriate option for this patient’s circumstances. |
The patient presented with strategically positioned mandibular teeth on which the appliance could snuggly affix. It was determined that the lower arch could provide the necessary support to achieve the desired final outcome. It was explained to him that the Snap-On Smile would be functionally and aesthetically harmonious with his upper restorative work until he would be able to afford implants on the lower arch—be it in 1 year or 10 years. The final treatment plan was presented to, and accepted by, the patient.
Clinical Protocol
The first step in the treatment plan was to extract all the remaining upper teeth, as well as some hopeless teeth on the lower arch (Figure 2). Implants (Hahn Tapered Implants [Glidewell Laboratories]) were placed in the maxilla and allowed to heal for 4 months. During the healing phase, the patient wore an immediate temporary maxillary denture that was lined with a soft reline material (COE-SOFT [GC America]) to protect the surgical sites. At the time of exposure, the appropriate multi-unit abutments (Glidewell Laboratories) were selected and torqued to 35 Ncm (Figure 3). Full-arch vinyl polysiloxane (VPS) (Splash!Max [DenMat]) impressions were taken and sent to the dental laboratory team for the fabrication of the maxillary implant restoration. Given the size, location, and number of implants, as well as the opposing natural dentition, it was determined that a single monolithic zirconia screw-retained bridge would best serve the patient (Figures 4 and 5).
For the lower arch, the Snap-On Smile appliance was prescribed for its functionality, aesthetics, durability, and cost effectiveness. The Snap-On-Smile restoration needed to be fabricated to fit against the final maxillary implant restoration. Upon delivery of the final zirconia implant bridge, the patient’s lower arch was cleaned and prepared. This involved extensive scaling and root planing, caries removal, and so on. Then full-arch upper and lower impressions and a full occlusal bite (Vanilla Bite [DenMat]) were taken. In addition, photos of the patient’s existing dentition were taken for the lab team. The laboratory prescription included detailed information related to the desired case design and shade; any changes in tooth length (both incisally and gingivally); and tooth width, contour, and arch position. The impressions, bite registration, photos, and Rx were packaged and sent to DenMat Lab (Lompoc, Calif) for restorative fabrication of the Snap-On Smile.
Laboratory Fabrication
The case, once received by DenMat Lab, was digitally designed, and a digtal mock-up of the Snap-On Smile was sent to me for review and approval. I approved the digital mockup, at which point the appliance was fabricated and finished at DenMat Lab per my detailed instructions.
Final Delivery
After the completed Snap-On Smile (Figure 6) was received back in the dental office, the patient returned for follow-up and delivery. In just 20 minutes, the fit of the Snap-On Smile was confirmed and the appliance was delivered, and instructions for care and maintenance were given to the patient. The patient was thrilled with the final outcome of the Snap-On Smile (Figure 7).
CLOSING COMMENTS
The aesthetics, durability, and retention of the Snap-On Smile, in tandem with the other dental work provided, immediately improved this patient’s confidence (Figure 8). His improved smile gave him the gift of self-assurance to interact with others. During a follow-up visit, the patient shared with me and my team that—thanks to the dental work done for him, including his new Snap-On Smile—he was able to gain employment. He stated that this was due to the improvement in his overall appearance. He said, “The Snap-On Smile gave me my life back!”
There are many instances in which patients come to us for a smile enhancement, but not every patient has the financial means to follow what we may consider the ideal treatment plan. Thanks to the Snap-On Smile, which is not only aesthetic and durable but also cost effective, dentists and patients now have a treatment option that can generate smiles for everyone involved.
References
- Godoy R, Reyes-García V, Huanca T, et al. Do smiles have a face value? Panel evidence from Amazonian Indians. J Econ Psychol. 2005;26:469-490.
- Newton JT, Prabhu N, Robinson PG. The impact of dental appearance on the appraisal of personal characteristics. Int J Prosthodont. 2003;16:429-434.
Dr. Hahn earned his DDS degree from The Ohio State University College of Dentistry and completed postgraduate courses at Boston University, New York University, the University of Michigan, and the University of Kentucky. A pioneer in the field of implant dentistry, Dr. Hahn has been placing and restoring implants for more than 45 years. He developed the NobelReplace dental implant system for Nobel Biocare and oversaw the design of the Hahn Tapered Implant. Dr. Hahn was honored with the Lifetime Achievement Award from the American Academy of Implant Dentistry in 2015. He can be reached via the website
dentalimplantcincinnati.com.
Disclosure: Dr. Hahn is the inventor of the Hahn Tapered Implant and receives royalties from Glidewell Laboratories.
Related Articles
Glidewell Dental Symposium Scheduled for October
DenMat’s Snap-On Smile Earns US Patent
The Hahn Tapered Implant System
