When it comes to achieving a perfect smile, Charlotte, NC cosmetic dentist Patrick J. Broome, DMD specializes in the three Rs: restoring, rebuilding, and, in some cases, totally recreating. We recently sat down with Dr. Broome, who shared the breakdown of the art behind the “redoing and rescuing” a smile.
What is a “redo” or a “rescue” cosmetic case?
A cosmetic “redo” case typically requires us to address subjective objections (color, contour and position) the patient has with their existing smile. A much more complicated redo category is what we call a cosmetic “rescue” case. Rescue cases are significantly compromised and/or complicated situations that impact a patient’s smile and are exponentially more difficult than the originally planned treatment.
What is the most common redo or rescue cosmetic case you perform at your practice?
The most common “redo” or revision we perform involves removal and redesign of porcelain restorations, implants and/or composite bonding. Many patients share with us that their primary focus revolved around the fee and they didn’t realize that every office didn’t provide the same results. The focus quickly becomes all about the result once they see a smile they do not like featured front and center on their face. The most common “rescue” cases we see involve multiple dental implants placed without any planning related to the final smile design.
Are “redo” and “rescue” cases more difficult to perform than the first-time original surgery?
Yes, these cases are more difficult than the original treatment. When we have the opportunity to be involved with a patient’s original treatment, we can properly outline existing challenges and issues, plan for their management, and design the end result that works with these considerations in mind. This also allows us the opportunity to foresee potential complications and have contingency plans in place, should they occur. Redo cases introduce an additional level of complexity and often present issues that require us to engineer our way around them. Rescue cases present very serious complications. Patients usually are not happy about their results but the underlying reasons why it is not satisfactory are more complicated.
Is a “redo” or “rescue” surgery always caused by a bad doctor, a bad surgery or can it be from other factors?
For cosmetic “redo” cases we find that it usually is not a bad doctor. The procedure performed may be compromised in some manner but, usually, the problem revolves around unmet aesthetic expectations. We find complex cosmetic “rescue” cases usually involve dental implants that were placed without any pre-planning of the final restoration. There are a variety of problems with this approach—but the most significant issue is simply the poor aesthetic outcomes. Without proper planning, the restorative doctor is forced to use correction parts and laboratory artistic magic. Sadly, this usually does not meet the patient’s expectations. The good news is the advent of digital planning, 3D imaging and computer manufacturing is making it safer, and easier, so the planned end results can be predictable and stress-free.