Dr S R J Mahmoud

“DAILY DIRECTS PT.5” - multi shade layering for this lovely patient. We started off with a CL palatal wall then the used A3 for the next of the tooth, D2 for the body and a final layer of CL for the buccal. The patient was astonished with the final result

“PAULINE” - case finally finished. This wonderful patient first came to see me in the summer of 2022. After long discussions we agreed to improve her smile and rehabilitate her teeth following an extensive oral hygiene program and careful rehabilitation planning. Originally the patient wanted 6 porcelain veneers between both her canines to improve the shape and look. I personally wanted the patient to go for 8 because I felt that the smile would be too small for the mouth and she needed more width to really achieve a beautiful smile. After getting the 6 she understood what I was trying to explain and therefore wanted the other 2 on the top and to veneer her lower teeth too.

Originally we propped open her bite and increased her vertical dimension with composite and tested the occlusion for a few months. So I was happy that if we do veneer the lower teeth it wouldn’t be a problem.

To compliment the smile even more I placed 2 composite veneers on the two second upper premolars to increase the width of her smile even more.

Now we are just waiting for that partial acrylic denture. 🙌🏻 thanks for the ceramics as always and please hurry up with that denture 👀

“THAT TOOTH GETS ON MY NERVES”
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“DEFINITION” Bespoke definition, only the upper lip was injected with 0.3ml of derma-filler👄🎨
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“NATURAL LIFT” 👄🎨
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“FOUNDATION” - Sometimes a simple composite filling isn’t enough, when anterior teeth are broken down many dentists like to remove the tooth and to place a prosthesis to replace the gap. I am a strong believer in preservation. For this case we root treated the tooth, placed a core and restored with a composite. This is only a temporary solution until we place the place the permanent ceramic crown 👑 🦷🖌️🎨
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“REFRESH” - Patient attended the clinic after numerous years of dental neglect. After months of stabilisation work we were able to cement her final restorations. The patient was so happy that she can’t wait to finish off her aesthetic smile journey later down the line. Planning here and patience was of major priority. She is now smiling just in time for her new job as she has renewed confidence in her smile. Keep Smiling!

After picture was taken immediately post op after gingival conditioning and a final scale. Hence the bleeding 🩸

“ART OF PORCELAIN” - 6 Natural Looking Porcelain Veneers

“PATIENCE” - this wonderful patient first came to me in May with a failing UL2 veneer which was coming off even though it redone multiple times by another dentist. On examination I noticed that her lower teeth were quite worn down and she had a decreased vertical dimension with no canine guidance. The patient was keen to just redo the veneer and try again but I thought that without addressing at the cause of the constant debonding then it would be pointless to try again.
We finally agreed that we will take our time and try and do things properly so it lasts a longer time.
My plan was:
- rebuild the canine guidance and increase the vertical dimension at the same time
- Allow the posterior teeth to over erupt slightly to meet at the new vertical dimension.
- Trial smile the potential veneers in self polymerising acrylic
- Restore UR123 UL123 with layered Lithium Disilicate EMAX Veneers
Patience is a virtue and good things come to those that wait.
The patient was over the moon and would like to start a similar treatment for her lower teeth.

REMEMBER Aesthetics is FORM and FUNCTION
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“COVERAGE” - As dentists we need to protect the patent not just in the present but in the future. When we complete root canal treatments we have to think of the long term structural integrity of the tooth. On larger teeth we remove quite a lot of tooth material when performing the root canal, the tooth becomes something like an empty box. We need to try and fill the tooth back up and protect it for the future. This is why cuspal coverage after a root canal is strongly recommended especially on posterior teeth where you will be masticating food. 🖌️🎨🦷

“BB” - BLEACH AND BOND. When patients are wanting to improve their smile aesthetic with new restorations like composite for example, it is important to bleach the teeth to their desired shade as we composite can not bleach later on if the patient opts for whitening. The composite would therefore have to be redone. For this patient we restored some natural brightness to the teeth and took away her previous bonding/composite as well as camouflaging the white fluoride spots with composite matching the shade of her teeth. Venus pearl was used🖌️🎨🦷

“EDGE” - Natural Edge Bonding
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“PRIMARY” - Customised primary impression using a stock tray. My new found interest in my profession is how to take the perfect impression. In the past I have found it very challenging. I have been on the search of better techniques, looking at papers, Instagram and asking colleagues.
I can safely say the best way to take an accurate impression is to do it by stages.
👷‍♂️🏗🦷

“STEP 1” - Primary step on this patients smile journey. We identified that the UR123 had previous composite fillings which in turn have leaked and failed over time hence her requiring removal of the old restorations and undergoing root canal treatment. We decided to undergo all three teeth at the same time in a long appointment which had the patient in the chair all afternoon.
The plan of action was as follows:
1 - remove all the old composite restorations and underlying decay
2 - RCT UR123 using wave one gold
3 - Use air abrasion to toughen up the remaining enamel
4 - Etch the enamel
5 - Use a fourth generation bond (Optibond FL)
6 - Build up the UR1 and ensure a good core
7 - Build up and core UR3
8 - Build up and core UR2
Aesthetics here were not my main concern and due to the lack of time I was not able to implement secondary or tertiary anatomy on the restorations.
After dealing with the rest of the decay these teeth will the later prepped into crowns for her definitive crowns - along with some other indirects but let’s not ruin the surprise just yet.

😜🖌🦷

“VONLAY” - sometimes a direct composite won’t be sufficient enough to substitute the strength and integrity of the tongue so we have to use an indirect approach. Here we used a Veneer-Onlay (Vonlay) to substitute to the function and aesthetics of the tooth. done an amazing job on the ceramic🖌🦷

Patient was not happy with the appearance of her upper front teeth. The patient wanted a resolution to the natural wear that has occurred on her teeth. We both agreed upon a treatment plan to fix the front four teeth using dental ceramics. We placed 4 Emax Veneers to restore shape and function.
Thank you to and for their help on the ceramics and case.
Keep Smiling 🦷😁

“COLOURS” - wash impression taken ready for her smile makeover

“MONOCHROME” ⚫️⚪️

“REAWAKENING” - This lovely patient came in to see me in February. She wasn’t happy about her crown on the right central incisor. In addition, she wanted to try and improve the aesthetics of her smile. We then planned together what and how we can reawaken her smile. We discussed different materials and methods we can use to achieve different results. The patient liked the idea of stability. Using porcelain made in a dental laboratory it can assure patients with correct dimensions, shape and colour.
We first started the treatment plan with oral hygiene instructions followed by stabilisation of dental caries. After a noticeable improvement has been made and maintained we then started the cosmetic journey with a course of whitening by Enlighten. The patient was then called in by Queensway lab to take the correct shade of her teeth following the whitening.
Next up prep time. We then used minimally invasive preps to veneer the UR2, UL1 and UL2 and ghe UR1 was debonded, prep was cleaned and retouched for a new crown. The materials of choice was EMax Lithium Disilicate.
The patient was put in temporaries for 1 month to test occlusion and function - once occlusion and function were checked and verified we then proceeded in fitting the final restorations.
The transformation was truly remarkable and has been my favourite case as of yet. I am very and truly blessed to have been trusted by this wonderful lady and hopefully will see her back again in the dental chair soon. 🦷🖌

“TRAUMA” - This young child came in to the practice. The complaint: a chipped tooth due to an accident whilst playing. We used a layering technique and photography to try and achieve natural aesthetics 🙏🏽🖌🦷