Tuesday, May 22, 2012

Extensive Decay on Maxillary Anterior Teeth

A young man comes to me regarding his maxillary anterior teeth, #7-10. He does not like the way they look, and wants to know what he can do about it. 

Clinically and radiographically, these teeth present with large existing composite restorations, and display extensive facial, lingual, and interproximal recurrent decay. Treatment options were discussed with the patient. Due to very little remaining healthy tooth structure, single unit full coverage all-ceramic crowns were indicated. 

Teeth #7-10 were prepared, all decay was removed, an impression was taken, and temporary crowns were fabricated. His aesthetic wishes were discussed, and we made sure that he was happy with the way his provisionals appeared. 

The permanent crowns were delivered a couple of weeks later. Occlusion and contacts were checked, margins were flush, and the patient was happy with his new smile!

Monday, March 12, 2012

Replacing a Retained Primary Tooth

Dental implants and bridges are common prostheses used to restore missing teeth. In the case below, this gentleman had a retained primary, aka baby tooth #H, which was never replaced by the permanent adult tooth #11, the left canine. Recently, tooth #H became increasingly mobile and was causing pain, resulting in the need for extraction. 

The patient's permanent canine, tooth #11, was in fact impacted, and still unexposed in his maxilla. We discussed his options: forced eruption using orthodontics, extracting the impacted canine and placing an implant, or a bridge. After a thorough evaluation taking the patient's wishes into account, we decided to replace the missing tooth with a three-unit bridge.
Above, the teeth on either side of the edentulous space were prepared for a bridge. 

With good oral habits, the bridge should last for years.

Saturday, March 10, 2012

Fractured central incisors

I've noticed that the majority of patients coming to me with an emergency are usually either in pain, or have fractured a tooth. Specifically a front tooth. The case below is something that I see quite often. 

This young lady was having a drink at a bar, and the beer bottle was knocked into her right central incisor, tooth #8. She wasn't in any pain, but was really self-conscious about her appearance. I noticed and asked her about her left central incisor, tooth #9, which had a chip as well. She stated that it's been there for as long as she could remember. After taking a radiograph to make sure the root of tooth #8 was unaffected, I got to work.

I selected a shade that would match her own teeth. Local anesthesia was not necessary, as the fracture didn't appear to be close to the nerve inside the tooth, and there was minimal preparation needed prior to restoring it. I evaluated the size and shape of her teeth, and placed a composite restoration on #8. The chip on #9 was restored with composite as well in order to achieve a more symmetrical smile and in turn, enhancing aesthetics.

She seemed very happy with the final result, which made my day!