Posts for category: Dental Procedures
While there’s usually a period of months between implant placement and the permanent crown, a new technique known as same-day tooth replacement installs both the implant and a temporary crown during the same visit. But be advised — it does have its risks and isn’t for everyone.
Successful same-day replacements require special attention during the three phases for implants: the removal (extraction) of the existing tooth; placement of the implant in the bone; and attachment of the crown, the visible tooth, to the implant. The tooth extraction lays the foundation for the entire process; the extraction procedure must be performed carefully to avoid undue damage to the socket. In addition, if infection or disease has compromised the site, an implant may not be possible immediately.
The implant must then be placed in the bone so that it’s stable and immovable. All implants stabilize with time as the bone grows and adheres to them, but we need greater stability for a same-day tooth replacement when an extraction is performed.
Our last consideration is positioning the implant so that the attached crown blends in naturally with the surrounding gum tissue and adjacent teeth. We must place it at the proper depth below the gum tissues so that the crown appears to emerge from them in the proper tooth length.
Taking extra care during all these phases, including the angle of crown attachment, will increase our chances of success. We still run a risk of implant damage or failure, however, from biting forces before the implant fully integrates with the bone. This means avoiding chewy foods and other situations that might increase the force on the implant. We may also use a temporary crown that’s slightly shorter than adjacent teeth so it won’t make full contact with the opposing tooth.
If you’d like to know if you’re a good candidate for a same-day tooth replacement, see us for a detailed examination. After reviewing your needs, we’ll be able to discuss with you the risks and benefits for a new look in one day.
If you would like more information on same-day tooth replacement, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Same-Day Tooth Replacement with Dental Implants.”
Cosmetic and restorative dentistry is filled with a varied array of procedures, materials and techniques that can address any shortcoming with your smile. Whatever your condition, there’s a means to correct or enhance your smile.
The real question, though, is whether we’re both, patient and dentist, on the same page as to what’s best to enhance your smile. Dentists have a different perspective on smile outcomes than the average layperson. We’re clued into aspects like tooth alignment with facial features or gum-to-lip distance influenced by our professional training and experience. You, though, may see your smile in terms of other features that define beauty like mouth expressions or lip shape.
Bridging these differing points of view requires open and honest communication. Here are three considerations to make that happen.
Build trust between you and your dentist. It’s natural for us to have differing views on what constitutes proper smile aesthetics based on the perspectives previously mentioned. Working through those perspectives to arrive at a unified plan requires trust that both of us desire the same outcome: a beautiful smile you’re happy to display to the world.
“Seeing” your future smile can help ease your misgivings. It’s one thing to try to imagine a certain treatment outcome — it’s quite another to actually see it beforehand. And you can, through computer simulation that takes a picture of your current face and smile and then augments them digitally so you can see how your smile will appear after proposed treatment. It’s also possible in some cases for you to wear temporary or “provisional” restorations so that not only can you see how they look, but also how they feel and function in the mouth.
Understand what “type” of restoration patient you are. Although everyone is different, we can usually characterize patients and their expectations in two ways. Some patients are “perfect-minded” — they want restorations that offer the maximum symmetry, regularity and tooth brightness. Others are more “natural-minded” in that the changes they seek don’t drastically alter their natural appearance, but are just enough to look different and create a sense of character. Knowing what you really want — a drastic change or a subtle enhancement — will help you communicate your desires more clearly and help us design the treatment options that best fit your expectations.
If you would like more information on fostering communication between dentists and patients, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Great Expectations.”
Lasers have transformed our everyday lives, especially in healthcare. These intense beams of light of a single wavelength have revolutionized all manner of diagnostics and treatments, from general surgery to cosmetic therapy.
Dentistry has also been influenced by the laser revolution. Here are just a few of the areas where they’re growing in use and popularity.
Early disease detection. Laser instruments can take advantage of “fluorescence,” the tendency of bacteria to “glow” when exposed to certain wavelengths of light. This is proving more effective in detecting early tooth decay in pits and fissures (very tiny areas in a tooth’s biting surface) than traditional needle-like probing instruments called dental explorers. Newer lasers can now detect the same fluorescent qualities in soft tissues, which may reduce the detection time for oral cancer and make the difference between life and death.
Dental caries treatment. Lasers have become an alternative to the dental drill in treating teeth with dental caries (decay). Although with larger cavities lasers are somewhat slower than the conventional drill, they truly shine when it comes to early enamel caries and small cavities because they can be quite precise in the amount of tooth structure they remove. This feature allows them to be less invasive than a dental drill.
Periodontal treatment. Periodontal (gum) disease is an infection caused mainly by bacterial plaque and calculus (hardened plaque deposits) that have adhered to tooth surfaces. Lasers are emerging as an alternative to conventional periodontal (gum) surgery to treat voids or spaces below the gum line called periodontal pockets that have formed because of gum tissue detachment as supporting bone is lost. With their ability to target and destroy infected tissue without damaging nearby healthy tissue, lasers can achieve similar outcomes as traditional techniques but with less tissue damage and discomfort to patients afterward.
Research and development into laser technology continues to perfect these and other applications that promise to make dental procedures less invasive and more comfortable for patients.
The traditional way to restore a tooth with an artificial crown takes several weeks and multiple office visits: from tooth preparation and impression molding to crown production by a dental laboratory, followed by adjustments and cementing. Now, there’s an alternative that reduces this process to a fraction of the time, and all from your dentist’s office.
Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) is a digital system that enables dentists to create dental restorations with laboratory-grade materials in minutes rather than weeks. As it continues to innovate, you’ll see more and more dentists investing in the new technology for their patients.
A crown restoration with CAD/CAM begins like any other with decay removal and preparation of the tooth. It diverges, though, from the traditional in how an impression of your teeth and gums is obtained: instead of rubber-like molding materials to create a physical impression, we lightly dust the mouth interior with a reflective powder. Using a scanning wand, the reflective powder allows us to capture multiple, detailed images of your mouth that the CAD/CAM computer transforms into an accurate three-dimensional model.
We use the model to first assess if the tooth has been effectively prepared for a restoration. If so, the design feature of the system will provide us with thousands of tooth forms to choose from to match with your natural teeth. You’ll be able to view the proposed size and shape of the new crown via computer simulation before signing off on the design.
Next is the actual manufacture of the crown that takes place right in the dentist’s office. A pre-formed block of ceramic material is inserted in the milling equipment where, following the pre-determined computer design, the milling heads carve the ceramic block. After milling, we fine-tune the crown surface and apply stains or glazes fired to create a life-like color and texture that matches your natural teeth. We can then adjust the crown in your mouth and permanently affix it to the tooth.
While much of the CAD/CAM system is automated, ultimate success still depends on the dentist’s expertise and artistry. CAD/CAM enhances those skills with greater precision and in much less time than traditional crowns. It’s certainly a growing option for many people to restore the form and function of decayed teeth.
If you would like more information on computer-aided dental restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Creating In-Office Dental Restorations with Computers.”
Porcelain veneers are excellent for restoring otherwise sound teeth that are stained, chipped or slightly misaligned. But the question for many is, are they long-lasting?
Just as the term is used in building construction, a dental veneer is a thin covering of material that’s bonded to the outside of a tooth to conceal blemishes. Very thin layers of dental porcelain (a form of hardened glass colored to match a patient’s natural teeth) are created by a dental lab technician to achieve the preferred shape and size of the patient’s tooth. Unlike crowns or other restorations, veneers require very little tooth preparation to accommodate them.
As to their longevity: if cared for properly, a veneer could last for twenty years or more. While the veneer itself isn’t subject to the effects of dental disease, the tooth and the gums that support it are. Shrinking gum tissues as a result of periodontal (gum) disease, for example, could have a negative effect on the veneered tooth and subsequently the veneer. It’s important, then, that you properly practice daily brushing and flossing, along with keeping up regular office cleanings and checkups.
There’s one other important consideration: while porcelain veneers can withstand normal biting forces, if they’re subjected beyond their tolerance they could shatter. You should be careful not to subject your veneered teeth to an abnormal biting force, such as biting down on an extremely hard object. If you tend to grind your teeth at night, wearing a night guard can minimize the force created from the grinding.
It’s possible to repair and re-bond a loose or slightly chipped veneer. In some cases, though, severe damage may require a replacement. Still, by using common sense about what you bite down on and taking proper care of your teeth and gums, you can minimize the chances of damage and enjoy many years of a more attractive smile.
If you would like more information on porcelain veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Veneers: How Long will Your Porcelain Veneers Last?.”