Removable appliance is an appliance that is not fixed to teeth but can be removed by the patient. It usually contains spring, screws, clasps and acrylic base plate. This appliance is often used in situation whereby simple teeth movement are needed only and it can allow patients to perform better oral hygiene by removing it. However, this appliance requires compliance from the patient to wear it.
Fixed appliance is probably the most common type of orthodontic appliances in use today. They consist of small brackets that are attached onto the front surface of the teeth and a thin wire which is often held in place by elastic loops.This appliance allows multiple tooth movements simultaneously and more effectively as compared to removable appliance. The treatment usually lasts from 6 months to 30 months depending upon the severity of the problem. It is very important to maintain an excellent oral hygiene and dental health throughout the orthodontic treatment
Valplast® is a type of flexible, nylon resin that is developed for the use in flexible removable denture. Valplast® Flexible Partials were invented in the early 1950’s as an alternative to traditional metal and acrylic removable partial dentures (RPD’s). By using a flexible nylon base, Valplast® eliminates the need for metal frameworks or acrylic resins for the construction of removable partial dentures.
Tooth Replacement Options
When you’re ready to replace missing teeth, you have a number of potential solutions available, each with its own set of advantages and disadvantages. Replacing your missing teeth is a big decision and it is important to consider several factors.
When considering a removable partial denture, many people find the Valplast® Flexible Partials to be the most comfortable option, and the final restoration can be made very quickly. While the cost is often higher than a partial made with visible clasps, the results of the flexible partial are beautiful, and patient satisfaction is very high. The Valplast® Flexible Partials involves only non-invasive procedures, and gives you confidence in your restoration while talking, eating and most importantly: smiling.
If you can’t bear the thought of visible metal clasps or a series of temporaries that change with each appointment, Valplast® Flexible Partials is an option that looks very natural and will stay beautiful and comfortable for years to come. Even fixed restorations that look good at first could deteriorate over time due to gum recession or changes in your mouth.
Denture acrylics and metal alloys may be prone to breakage and fracture over the course of time. Valplast® Flexible Partials come with a lifetime warranty against breakage and fracture for the denture base under normal use. Valplast® Flexible Partials can also be rebase and have teeth added to it if modifications are necessary over time.
If cost is your primary consideration, removable restorations are the more affortable solution, Valplast® combines great value with excellent aesthetic that often rival the appearance of more expensive fixed restorations.
Duo:PCH is a Porcelain Composite Hybrid is an entirely new esthetics category, combining the convenience of a composite build-up with the finishing beauty of Cerinate ® porcelain. Formerly known as Lumineers, they are much more simple and affordable as compared with the conventional porcelain veneers.
Porcelain veneers in Duo:PCH ™ comes with different shape and size that allow the dentist to mix and match veneer to patient’s tooth. And finally, the veneers are bonded to the teeth using strong resin composite material.
Our case with Duo:PCH ™
This young lady complaint about her teeth discolouration due to tetracycline staining.
Six veneers were placed over the front surface of the incisors and canine.
End result… The lip at rest and smiling.
Traditional porcelain veneers vs Direct Porcelain Veneer –Duo:PCH ™ (or formerlly known as Lumineers)
Once referred to as Lumineers, Duo:PCH ™ are a special type of veneers that can be applied over teeth to repair small cracks or chips, hide discoloration or correct imperfections. Just like traditional veneers, Duo:PCH ™ can reshape the appearance of your smile. The main difference between Duo:PCH ™ and standard porcelain veneers concerns the material used to create them. Duo:PCH ™ are manufactured from a special porcelain – patented Cerinate porcelain – that is much thinner than the porcelain that is used in the making of traditional veneers. The thickness of Duo:PCH ™ is similar to that of contact lenses. While veneers placement is normally a irreversible procedure, with Duo:PCH ™ the procedure is so less invasive that it may often be reversible.
The main benefit of choosing Duo:PCH ™ is that they require minimal – if any – grinding or shaving so your natural teeth will pretty much be left intact. Traditional veneers require more tooth reduction and many patients are not convinced they want veneers for ever. Duo:PCH ™ are more suitable for patients who only wish to try dental veneers for a short period of time. Patients with serious problems however tend to prefer traditional porcelain veneers. Duo:PCH ™ are a great solution for slightly misaligned, stained, discolored or chipped teeth. Make sure you find an experienced cosmetic dentist who can properly place your Duo:PCH ™. You can easily switch from Duo:PCH ™ to traditional veneers whenever you consider yourself ready for a more permanent solution to your smile problem.
Periodontium is the tissue that immediately surrounds and supports the teeth. It consists of alveolar bone, periosteum, periodontal ligament, gingival sulcus, and gingiva; each of these components contributes to stabilizing the tooth within the jaws.
This young girl had an accident at home, causing two-third of her crown fractured and worse of all, the pulp of the tooth exposed.
We did an emergency root treatment over the tooth to reduce her pain and later on, build back the tooth (below)…
So, now she can smile confidently and pain free.
Air polishing is an alternative, non-contact, method of polishing teeth using a polishing cup and paste after teeth scaling. It requires a special ultrasonic unit (e.g. Air Flow from EMS) that allows use of this insert in the handpiece.
Air polishing uses medical-grade sodium bicarbonate and water in a jet of compressed air to “sandblast” the surface of the enamel smooth. Examples include the Prophy-Jet® and Cavitron Jet® (Dentsply Ltd.). The nozzle is held 3 to 5 mm from the tooth, centred on the middle third of the tooth. Use at 60° to the long axis of the root. Do not direct into the gingival sulcus.
White filling or composite resin is getting more and more popular currently as it produces a nice aesthetic result. Previously silver filling (amalgam) is preferred due to low cost, easy to handle and it has a good mechanical properties (amalgam is strong and durable). However, current composite resin is as strong and durable as amalgam and on top of that, it produce a ‘hard to see restoration’ on the tooth making it a preferred choice for dentist and patient. Anyway, Nobody wants their filling to be seen!!
Composition of composite resin
Composite resins are composed of:
Bis-GMA monomers or some Bis-GMA analog
a filler material such as silica and in most current applications,
Dimethacrylates are also commonly added to achieve certain physical properties such as flowability.
Further tailoring of physical properties is achieved by formulating unique concentrations of each constituent.Unlike Amalgam which essentially just fills a hole, composite cavity restorations when used with dentin and enamel bonding techniques restore the tooth back to near its original physical integrity.
Dental composite resin
In our clinic, we have multiple shade (or colour) to choose to mimic the original colour of the tooth in the mouth. For every restoration, we use different shade for each ‘layer’ during restoration.
Below are some of the cases done in our clinic.
Restoring Composite Resin
(Illustration in great depth)
An old amalgam was removed from a upper right molar and the tooth was ready for filling placement
Firstly, the enamel surface of the molar was treated with phosphoric acid 35%
Then, it was followed by the dentine which was located at the center of the tooth
Next, the cavity was cleaned and dried. A thin layer of adhensive solution was applied over the cavity
Light cure unit was used to activated the adhesive which was photo-sensitive
A metal band was used to wrapped around the molar
The metal band was checked to ensure that there was no gap between the tooth and the metal band. This was to prevent the filling material from overflow out from the cavity.
‘Dentine shade’ composite resin was placed at the center of the cavity to cover the darkish stain in the dentine area.
The composite was light-cured to make it harden
Next, ‘enamel shade’ composite was placed over the ‘dentine shade’ composite (layering technique) to get the translucency effect.
‘Enamel shade’ composite was placed at the side-wall of the molar and was cured (with light-cure unit)
The metal band was removed and more composite was placed at the side-wall of the molar so to achieve a nice contour and bulbosity.
This was the result after the composite harden
The composite excess was removed with a rotary white stone
The restoration was checked to look of any interference with the lower teeth during biting and chewing (with a bite registration tape)
And the red markings from bite registration tape was removed
Finally, for aesthetic reason, grooves and fissures was make on the tooth surface
And ‘stain’ composite was placed on the fissure to make it looked like the neighboor teeth
Lastly, light-cure unit used to harden the rest of the composite
The restoration was polished to make is glossy and shining
The Final Result!!
Before and after picture.
Another case: Replacing old silver (amalgam) restorations with composite restorations
This young gentleman came complaining of sensitive to hot and cold at his bottom right molars. On examination, he had a few siler fillings which cracked and had gaps noted at the margin fo the fillings.
The silver fillings were removed and replaced with white fillings. The fillings match with the colour of the tooth very well as if there was no filling done!!