Porcelain veneers

Let’s explore the porcelain veneer. Porcelain veneers combine the esthetics of feldspathic porcelain with the strength of tooth bonding on tooth enamel. A skilled ceramist creates a thin covering of the tooth surface that improve color, shape, size and alignment of the teeth. Porcelain veneers are strong, durable and resistant to decay when bonded to etched enamel. The edge or margin of the veneer usually is placed at the level of the gum tissue, so there is no adverse affect on periodontal health.

If your teeth are significant misaligned, limited tooth movement with orthodontics (Invisalign) may improve the final porcelain veneer result. This prevents excessive removal of the enamel that exposes the underlying dentin. This is important because the bond strength to dentin is far below enamel, which can result in bonding failures.

The most important consideration – in any cosmetic endeavor, how much of my original tooth structure will remain? Before you decide, the ceramist can usually make a “mockup” of the proposed porcelain veneers prior to beginning treatment.

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What's trending

Dental Hygiene, Tooth Whitening, Other Procedures Can Improve Appearance.

Fashion & Style reports on “How To Achieve Your Ultimate Smile In 2015,” also the title of the piece. The article stresses the importance of dental hygiene, which it says starts with regular dentist visits. “If you want to keep your great smile, you need to visit your dentist on a regular basis,” the article reports. The article then highlights several cosmetic dental procedures, including tooth whitening, cosmetic veneers, and gum lifts that dentists may use to improve the overall look and health of a patient’s smile.

What are your options to replace dentures?

Patients who have lost all of the teeth face difficult challenges to regain normal chewing function. Fortunately, dental implants allow you to enjoy all nutritional foods.

What are your options? Implant overdentures, fixed denture or a ceramic fixed bridge.

Implant-supported overdentures are retained by two or four dental implants and gives you increased masticatory function far beyond conventional full dentures.

The fixed denture (hybrid denture) requires more implants. The bridge has denture teeth that are supported by a computer designed titanium metal framework. Should the denture teeth need to be replaced after years of function, this can be done in a day when coordinated with the dental technician.

The ceramic fixed bridge represents the ultimate in personalization. The number of implants is usually the same as for the hybrid denture. Because our in-office master technician creates your unique bridge with a result that is unique to you alone.

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What's treading?

The New York Times reported that the Swedish orthopedic surgeon who accidentally discovered the modern dental implant, Dr. Per-Ingvar Brånemark, died on December 20 in Gothenburg, Sweden at the age of 85. In a study not originally focused on its dental applications, Dr. Brånemark discovered in 1952 that titanium would fuse with bone tissue. The Times went on to chronicle the history of Dr. Brånemark’s implant discovery.

We cannot overemphasize the contribution that Dr. Brånemark has made to the fields of implant dentistry and orthopedics. Previous to his discovery of titanium’s potential to bond with bone, dental implants were considered the domain of charlatans.

On a personal note, I was exposed to this bias in dental school. In 1984, I was educated in this new and well-researched dental paradigm. Several major advances have occurred in the past 30 years following my dental implant training. We are now able to offer patients a variety of alternatives that will successfully address missing teeth.

Dental Implants: From the Past to the State of the Art

We have provided our patients with dental implant-supported crowns, bridges and dentures since 1985. 

Although the field of implant dentistry has dramatically progressed over time, the history is remains interesting. 

Please share my passion from my introduction to the UCSF, Advanced Education in General Dentistry (AEGD) implant syllabus that was published in 1997. 

 

“Human history is replete with attempts of dental implantation for missing teeth. Archeological findings show that the Egyptians, Arabs, Greeks, Romans, Etruscans, and Chinese transplanted teeth from one person’s mouth into another.

The practice of tooth transplantation developed later in Europe. Generally, only the wealthy or the nobility would receive a transplant—the teeth generally acquired from the poor, who either sold the teeth for money or simply had them removed against their will.

Dental implants that employed artificial materials became popular over

100 years ago. Beginning in 1887, a lead root containing a platinum pin was fused to a porcelain crown and then inserted into the jaw. Other materials included silver capsules, gold or iridium tubes, and corrugated porcelain teeth.

Vitallium, a cobalt–chromium alloy, was introduced to dentistry in the 1930s

as a metal for removable partial dentures. Screws were machined from Vitallium

and first placed in human jaw bone in 1937 at the Brigham Hospital in Boston.

In 1952 Dr. Per–Ingvar Brånemark, a Swedish orthopedic surgeon, began his extensive study of cylindrical, threaded implants revolutionizing the world of dental implants. In 1986, the Brånemark system received provisional acceptance by the American Dental Association. Although many clinicians contributed to the development root–form implants, it was the extensive documentation from Dr. Brånemark that precipitated the major interest of implants in the United States.

Titanium has been used in orthopedics for more than 20 years without one

documented case of incompatibility. This material also has many favorable

characteristics ideal for dental implants. Titanium is inert in tissue, possesses good mechanical properties and stimulates bone anchoring.

Currently, more than 125 million Americans suffer from the loss of natural teeth. After complete loss of teeth, the jaw begins to shrink in size. Ultimately, this leads to problems with denture fit and function.

Osseointegration is a process by which dental implants integrate with the bone, allowing permanent replacement of teeth and normal function. Dental implants are artificial substitutes for natural tooth roots. Replacement teeth are attached to the part of the implant that projects through the gums.

Dental implants can provide non–removable tooth replacement in the toothless jaw, stability for a full denture, support a fixed bridge eliminating the need for a removable partial denture, and also restore a single missing tooth without the need to alter the adjacent natural teeth.

The placement of dental implants involves three basic stages of treatment. The initial evaluation typically consists of a thorough examination of your oral tissues and supporting bone in the jaw, specialized x–rays that show the jaw bone shape and height, study models of your upper and lower teeth to analyze the bite and tooth positions, and consultation with the implant surgeon.

The surgical treatment consists of placing the implants into the jaw bone.

Most often, simple local anesthetic ensures patient comfort during this procedure. Patients typically have minimal discomfort following implant surgery and can quickly return to their normal activities. Over a period of six weeks, the implants undergo become intimately attached to the bone.

Lastly, the replacement teeth are created and securely attached to the abutment posts. This phase of therapy is very technically demanding and will require several appointments to ensure a cosmetic, functional, and long–lasting result.

Maintenance and follow–up care are extremely important with visits typically scheduled every three to six months.

Osseointegration is predictable. Our personal success rate is over 98% in both jaws, which makes this one of the most predictable procedures available in medicine or dentistry. If properly cared for, your implants should serve you the remainder of your life.

Successful implant rehabilitations require close communication between the dental implant team members in all phases of treatment. The dental implant team consists of the surgeon, restorative dentist or prosthodontist, dental technician, and other dental specialists as needed. Only when each clinician is involved at the onset of therapy will optimal results consistently be obtained.”

What is dry mouth (xerostomia)?

Xerostomia is the condition of not having enough saliva to keep the mouth wet.  Dry mouth can happen to anyone occasionally – for example, when nervous or stressed.  However, when dry mouth persists, it can make chewing, eating, swallowing and even talking difficult.  Dry mouth also increases the risk for tooth decay because saliva helps keep harmful germs that cause cavities and other oral infections in check.

Dry mouth occurs when the salivary glands that make saliva don't work properly.  Many over-the-counter and prescription medicines, as well as diseases such as diabetes, Parkinson's disease and Sjogren's syndrome, can affect the salivary glands.  Other causes of dry mouth include certain cancer treatments and damage to the glands' nerve system.  It's important to see your dentist or physician to find out why your mouth is dry.

Depending on the cause of your dry mouth, we can recommend appropriate treatment. There are also self-care steps you can take to help ease dry mouth, such as drinking plenty of water, chewing sugarless gum, and avoiding tobacco and alcohol.  Good oral care at home and regular dental check-ups will help keep your mouth healthy.

The CAMBRA protocol that was established by the UCSF School of Dentistry analyses the risk for decay and recommends individualized preventive measures. 

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