Consultants’ Comments
- “Patients tended to wear it at fi rst then gradually decreased using it.”
- “Those still wearing Snap-On Smile after a year tended to use it for special occasions only.”
- “Patients must be diligent about rinsing or brushing after eating.”
Description
Snap-On Smile is a removable appliance made of tooth-colored resin that is worn over the existing teeth. It can be designed as a full-arch or unilateral device and may be used to replace missing teeth. Snap-On Smile is indicated for upper and lower teeth as a short- or long-term option, for establishing vertical dimension before starting full-mouth reconstruction, as a diagnostic tool, as a provisional for implant restorations, for cosmetic enhancement of color or alignment, or as a removable partial denture. Snap-On Smile is available in 22 shades.
Clinical Evaluation Protocol
Eight consultants had Snap-On Smile appliances fabricated for 29 patients. Laboratory fabrication of Snap-On Smile was completed by DenMat, and each case required a PVS impression of the treated arch, opposing impression or model and bite registration; photos were optional. Appliances consisted of temporary restorations used during implant treatment, trial options for cosmetic treatment, and replacements for missing teeth. Eighteen patients were available for follow-up at one year. Of these patients, 33% were still wearing their appliances occasionally and 67% had discontinued wearing them. At recall, appliances were evaluated on a 1-5 rating scale: 1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent.
Clinical Observations
Esthetìcs
The appearance of Snap-On Smile received a wide range of ratings from patients and consultants (Figure 1). Some patients loved it and thought that it greatly enhanced the appearance of their smiles. The monochromatic color and shallow embrasures led to some comments that the teeth did not look natural.
Retentìon/Fit
Snap-On Smile has a snap fit and maintained good retention after a year’s use (Figure 1). Since Snap-On Smile fits over unprepared teeth, it often produced a full feeling in the mouth. The bulkiness led to changes in speech and increased salivation. Most of the patients commented that Snap-On Smile was difficult to use functionally. Chewing was uncomfortable and inefficient.
Color Stability
The Snap-On Smile material maintained a glossy surface and was resistant to stain and discoloration (Figure 1).
Gingival Health
The main effect on the gingiva was related to eating and food becoming lodged underneath the appliance (Figure 1). Gingival health was dependent upon proper oral hygiene. No sores or irritation of the soft tissue were observed by
consultants.
Lack of Sensitivity
Some pressure was noted, and patients compared it to the feeling of wearing a retainer (Figure 1).
Effects on Teeth
No effects on tooth enamel from insertion/removal were observed by dentists or patients (Figure 1). Likewise, no wear on opposing dentìtion was visible (Figure 1).
Fracture Resistance
Only one instance of fracture was observed. A full-coverage maxillary appliance broke in the molar region at one week.
Overall Condition
Other than the appliance that fractured, Snap-On Smile appliances remained in good condition during the one-year evaluation (Figure 1). The fact that most appliances had occasional or short-term use likely contributed to the like-new condition.
Overall Patient Satisfaction
Satisfaction ratings were highly dependent on two factors: esthetics and function. Even though patients were nearly unanimous in stating that Snap-On Smile was difficult to use for chewing, those who found their appliances attractive would wear them to enhance their appearance.
Summary
Case selection and management of patients’ expectations are critical in achieving patient satisfaction with Snap-On Smile. Snap-On Smile appliances were most useful for short-term use (cosmetic trial, provisional for implant restorations). The appliances that were still in use at one year were in good condition. Snap-On Smile received a clinical performance rating of 84%.
