Katherine A. Brown, DDS

Timothy W. Leary, DDS


Gallery: Bioesthetics

Because bioesthetics is so much more than restorative or cosmetic dentistry, each bioesthetic case tells a story. Below are the stories of some of our favorite patients who have undergone the journey of bioesthetic dentistry.

Rachael’s Story: Bioesthetics to Relieve Pain (Case by Dr. Brown)

Rachael initially presented to our office with the hopes that some sort of night guard would help her with her chronic migraines, headaches, and neck pain. Already a beautiful woman with a beautiful smile, she had no concern and no idea that there might be anything wrong with her teeth.

Before Images

An initial NTI (noscioceptive trigeminal inhibitor) brought about considerable relief and it was our first hint that her bite relationship and joint were in part to blame for her pain.

Two years later, Rachael presented again with the hope of doing something more dramatic to bring about relief. In the previous years, she had lost her NTI and her symptoms had become disabling. She was unable to work and spent most of her day in bed. She underwent MAGO therapy to discover her stable joint position, and then we analyzed models to determine what dentistry would be needed in order to bring her teeth together while her joint stayed put.

Initial examination of her diagnostic models revealed that there was considerable discrepancy between how her teeth relate when she bites down and how the teeth relate when she lets her jaw rest in the joint.

Just look at the difference in these models. Now imagine trying to bite all the way down if your joint wanted to go the the position you see in the second photo, but the teeth wanted to go to the position you see in the first photo. Do you think it might hurt a little bit to pull the teeth together?

Bite relationship needed to bring the teeth together

Bite relationship when her joint is resting in a stable, comfortable position.

We derived a treatment plan for Rachael that involved small reductions in the height of the back teeth and conservative (no prep, no drill) augmentation of the front teeth. The dentistry performed in Rachel’s case was very conservative. The result was a stunningly beautiful smile. But more importantly, Rachael was able to liberate herself from pain and live a more complete life.







Penny’s Story: Bioesthetics for Function and Esthetics (Case by Dr. Brown)

When Penny presented to our office, she was interested in her overall health and dental wellness. She also wanted to improve her smile. She was unsure of what she wanted to be done, but she had an objection to the spaces between her teeth.

How do you solve this problem with cosmetic dentistry? You can’t. There is no room to close the space. If you just put veneers on her front teeth, she will knock them off due to the way she bites. An orthodontist might squeeze the upper teeth together, but then the patient would need to pull the lower teeth back so that everything fits. This can be achieved with surgery, slenderizing (cutting down) the lower teeth, or extracting a tooth. Not an appealing solution to many patients.

OK, so how do you solve this puzzle with bioesthetic dentistry? Again, we stabilized the joint relationship with MAGO therapy and then reassessed the models to determine how we can bring the teeth together while still maintaining the stable, comfortable joint position. For Penny, the solution turned out to be simple, conservative onlay restorations on her back teeth, crowns on her upper front teeth, and direct composite (white fillings) to her lower front teeth.

Tom's Story: Bioesthetics to Repair Cosmetic Dentistry (case by Dr. Leary)

This patient had undergone "cosmetic dentistry" many years earlier to treat his broken and chipped upper teeth. Unfortunately, the cosmetic dentistry soon began to fail. The upper veneers were chipping and breaking and they began to damage his lower teeth. When he presented to Dr. Leary, he wanted a thorough exam and a holistic plan that would address all causes of disease.

Dr. Leary diagnosed him with occlusal disease and abnormal forces. The signs of occlusal disease were evident in his chipped and broken teeth as well as the strained appearance in the face, especially around the eyes. Notice how his bite is "too closed" and his face looks short. This relationship caused excessive wear on his lower teeth and added years to his facial appearance.



This patient underwent MAGO therapy to determine his comfortable, orthopedic joint position. Once this relationship was determined, he underwent esthetic oral rejuvenation. Notice the proper face length and relaxed muscles in the "after" photos. The harmony of a proper bite, stable jaw position, relaxed muscles, and natural tooth form results in lasting health, comfort, and excellent appearance.



Kasey's Story: Premature Failure of Cosmetic Dental Treatment (case by Dr. Leary)

Prior to coming to see Dr. Leary, Kasey had significant "cosmetic" dental treatment to address her smile. Despite this, she continued to suffer from an uncomfortable bite, headaches and broken teeth requiring root canal treatments and repeated repairs to her porcelain veneers. Why would her dentistry fail and be so uncomfortable and unnatural? Because she never received a diagnosis of her chewing system. All of her prior dentistry was dialed into a diseased and poorly functioning bite relationship. Even though she continued to repair tooth after tooth, the cause of the tooth damage (poor bite) continued. And her poor bite didn't just damage the teeth. It also causes muscle tightness, discomfort, headaches, loss of gum and bone tissue, and an aged appearance.

Before Images

Under Dr. Leary's care, Kasey completed diagnosis of the chewing system, stabilization of the jaw joint, and esthetic oral rejuvenation. The harmony of a proper bite, stable jaw position, relaxed muscles, and natural tooth form results in lasting health, comfort, and beauty.

After Images

*Note Patient names were changed.

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