This procedure is conducted to remove excess gum tissue that may be overgrown on the teeth to provide a better aesthetic result and a better area to clean the teeth.
Gingiva Overgrowth
Several reasons why there is an overgrowth of gum:
Inflammatory-induced:
Biofilm (bacteria) and the host response, resulting in familiar forms of periodontal disease such as gingivitis and periodontitis. Swelling, erythema, and bleeding are signs of these diseases.
Usually due to poor oral hygiene, orthodontic appliances
Some mediation might trigger the growth of the gum tissue, such as:
Anticonvulsants (phenytoin, phenobarbital, lamotrigine, vigabatrin, ethosuximide, topiramate, and primidone)
Antihypertensives (calcium channel blockers such as nifedipine, amlodipine, and verapamil)
Immunosuppressant (cyclosporine)
Systemic diseases such as:
Pregnancy or puberty and vitamin deficiencies (mostly vitamin C) are some of the more common causes in this category.
Benign neoplasms—such as giant cell granuloma, papillomas, and fibromas—can cause enlargement of the gingiva.
Other more serious causes of gingival enlargement include leukemias, malignant neoplasms/carcinomas, as well as many forms of granulomatous diseases.
All these gum overgrowth can be corrected by reduce the cause factors or gum surgery (gingivectomy)
A case of Gingivectomy
A young lady complained that she didn’t have great smile. On examination, we found out that she had a very short teeth. Oral hygiene just moderate.
Using a dental chi gauge, it was confirmed that the patient had a short crown height
Dental scaling was done to improve oral hygiene
After taken radiograh to determain the bone height and biological width, surgical excision of 2mm of gum tissue above the gingiva margin.
Tooth loss is a serious oral health problem that can have a significant effect on overall quality of life, making it difficult to chew or embarrassing to smile. Dental implants are a solution for people who have lost one or more teeth due to periodontal disease, trauma or injury, or other reasons. Implants are artificial tooth roots that are placed into the jaw bone and are used to support the crowns.
Dental Implant
Traditionally, a dentist will create impressions of a patient’s teeth and gums. X-ray will also be done in order to get an image of the mouth structures before placing the dental implants free hand. These technique require the dentist’s experience and expertise. Computer guided implant surgery represents a giant step forward in the replacement of teeth with dental implants.
What is Computer guided dental implant surgery?
Computer-guided implant surgery is a great advance in dental implant treatment planning. A computer program, cone-beam CT 3D X-ray and intraoral scanner will be used for planning an accurate position of dental implants. The computer program will combine x-ray images, intraoral scans and cone-beam 3D CT images and translate into a 3D model of the jaw. The dentist will be able to plan the placement of dental implants and determine their optimum position with a high degree of accuracy. A surgical guide will be fabricated by our in house 3D printer for use during implant surgery for accurate placement according to computer planning.
Benefit of computer guided implant surgery:
Reduced Risks Computer-guided implant technology makes it possible to see the anatomical structures of the jaw, teeth, and surrounding tissue, thereby reducing the risks of unexpected complications during surgery as well as allowing the dentist to know exactly where the implant should be placed.
Reduced Surgical Time Because a precise surgical guide is created, there is no guesswork with guided implant surgery. This allows the procedure to be completed faster than traditional dental implant surgery so patients can start the recovery process sooner.
Better Patient Education Computer-guided implant technology is based on detailed scans of the oral structures. These images may be used to explain the dental implant procedure as well as to educate patients about their oral health.
Case Example: Patient of ours requesting for dental implant to replace his lower left first molar tooth.
Situation before dental implant placementComputer planning of implant placement on lower left first molar combining 3D CT X-ray, intraoral scan. Dental Implant planning is done virtually and surgical guide is designedSurgical guide printed out by our in house 3D printer in patient’s mouthDental implant placement according to computer planningFinal Implant crown screwed into place
At Prestige Dental, we are fully equipped with Cone Beam 3D CT X ray machine, Intraoral scanner and 3D printer to fabricate the surgical guides
Our new CBCT, OPG and Lat Ceph X-Ray unitIntraoral 3D scanner available in Prestige Dental3D printer for fabricating surgical guide available at Prestige Dental
These computers can also be a valuable tool when it comes to our explanation of how exactly your implants will be placed. The patient will be able to look at clear images, as well as ask any questions.
With the help of computer guided surgery, we able to better pinpoint the exact location within your mouth for each implant, considerably simplifying the overall procedure. As our patient, you can look forward to a less invasiveness procedure, safer with less complications, a shorter recovery time, and an overall process that is much smoother from beginning to end.
I’m sure some of you have been wondering about it. So here’s why dentist takes photo of your teeth and even portraits sometimes.
Photostudio in our clinic
Photography act as a vital communicating tool between dentist and the patient so that a clearer message or explanation can be delivered.
Imperfections that are not readily visible to the patient will be apparent in still photographs, patient get to visualise his/her oral condition.
Establish a baseline so that dentist able to monitor any recession or suspicious lesions that you may have in your mouth to discover if these conditions are getting better or worse.
Document cases by dentist for recording purpose.
DSLR Camera
Multiple system can be choose for dental photography and generally work well for practices. However, the digital single lens reflex (DSLR) camera still the most ideally suited for practices that to use photography for documentation for lectures or publications.
Basic kit for dental photography:
DSLR camera system
Macro lens (85–105 mm)
External ring flash / Dual Flash
Retractors
Mirror
Contrastor
Digital SLR Camera
105mm lens
Retractors and mirrors
Intra-Oral Photos
Multiple views of intra-oral photos will be taken. The basic views are:
Front view without retractor
Front view with retractor
Left buccal view
Right buccal view
Upper occlusal view
Lower occlusal view
Example of Intra-oral Pictures
Dentist might take some extra photos which specifically focus on a tooth/ area to focus on the problematic part.
Studio Photography
Sometimes additional extra-oral photos are needed. In our clinic, there’s a room set up with some additional tools for portraits such as NiceFoto TB-400C Flash with a diffuser/ softbox, and a white lighting board mounted on a wall.
Studio flash kit
Extra Oral Photos
For extra-oral, pictures of patient must include full face. The basic views are:
Dental intra-oral radiographs a.k.a X-rays. Dentists use radiographs for multiple reasons: to find hidden dental structures, malignant or benign masses, bone loss, and cavities.
How does x-ray of your teeth formed?
X-ray of your teeth is formed by a controlled burst of X-ray radiation which penetrates oral structures at different levels, depending on varying anatomical densities, before striking the film or sensor.
Teeth appear lighter because less radiation penetrates them to reach the film.
Dental caries, infections and other changes in the bone density, and the periodontal ligament, appear darker because X-rays readily penetrate these less dense structures.
Dental restorations (fillings, crowns) may appear lighter or darker, depending on the density of the material.
Should Patients Have Concerns About Radiation Exposure?
The dosage of X-ray radiation for dental is typically safe, around 0.150 mSv for a full mouth series, according to the American Dental Association website. It is equivalent to a few days’ worth of background environmental radiation exposure, or similar to the dose received during a cross-country airplane flight (concentrated into one short burst aimed at a small area).
Incidental exposure is further reduced by the use of a lead shield, lead apron, sometimes with a lead thyroid collar. Operator exposure is reduced by stepping out of the room, or behind adequate shielding material, when the X-ray source is activated.
Types of intra-oral radiographs
Bitewing
Periapical
Bitewing radiograph
Bitewings
Bitewing radiograph designed the placement of the film packet to reveal the coronal halves of the maxillary and mandibular teeth, inter-proximal contacts and portions of the interdental septa.
It is indicated primarily to detect or monitor interproximal caries if the proximal surfaces of the teeth cannot be visually or tactilely examined.
Occlusal caries, crestal alveolar bone level and secondarily for eruption patterns, caries and restoration proximity to pulp spaces, primary molar furcation pathology and developmental anomalies may also be detected with bitewing radiographs.
Periapical Radiograph
PA radiography describes intra-oral techniques designed to show individual teeth and the tissues around the apices. Each image usually shows two to four teeth and provides detailed information about the teeth and the surrounding alveolar bone.
Anterior PA
Posterior PA
Indications for PA radiograph are:
Detection of apical infection/inflammation
Assessment of the periodontal status
After trauma to the teeth and associated alveolar bone
Assessment of the presence and position of unerupted teeth
Assessment of root morphology before extractions
During endodontics
Preoperative assessment and postoperative appraisal of apical surgery
Detailed evaluation of apical cysts and other lesions within the alveolar bone
Full porcelain crown is a crown frabricated for highly aesthethic demand patient as people today want to see their crown to be as natural as possible and bleanch to the rest of his/her teeth.
This is where full porcelain material comes in!! It is made mostly of Zirconia or E-Max (lithium disilicate) material. The conventional porcelain is made of porcelain layer fused to a metal surface which make is less transucent and greyish.
With zirconia or E-Max material , no metal use, therefore, no greyish appearance and more natural!!
A crown is a replacement of the outside casing of your teeth that is permanently fixed to the tooth below. They are few types of crown depends on the material used:
Crown
Full porcelain (highly aesthetic crown)
Porcelain fused to metal (commonly used)
Full metal crown (either precious/non-precious metal crown)
Indications
Because full porcelain crown is highly aesthetic, it is used to improve the appearance of the front teeth. For those that are insecure about the appearance of their teeth or their smile, porcelain crowns can be a one-fix-for-all-problems solution.
Full porcelain crown mainly used :
to brighten teeth
to make the tooth slight translucent thus making it more natural
indicated for the front teeth where aesthetic demand is higher
close gap narrowing
fix teeth that stick out
reduce crowding in the mouth
The procedure
To fit the crowns, a thin layer is shaved off teeth that are to receive treatment, and this prepares them for the crowns. On the patient’s first visit of the treatment a mould is taken of their teeth in order to get the perfect shape for the next session. The crowns are then bonded onto the teeth using a bonding material of some sort. Once the bonding has taken place, which will normally take one session at the dentist, the patient’s can eat as normal.
Cases of Full Porcelain done in our clinic
Case 1
Before
This young lady presented with a discolour right lateral incisor and her right central slanting inwards. Two full porcelain crowns were fabricated to change the colour of the lateral incisor as well as to change the shape of the right central incisor (below).
After
Case 2
After tooth preperation
A case for prepared tooth (right lateral incisor) for impression taking. A full porcelain crown was fabricated and cemented onto the tooth (below).
Full porcelain crown cemented onto the tooth
Case 3
Before
This young gentleman presented with poorly restore filling material on his front teeth. The fillings were removed and the front teeth were prepared for porcelain crown.
Full porcelain crowns fabricated on the model
The full porcelain crowns were constructed on the model and finally cemented into patient’s mouth (below).
After
Case 4
Before
Another case of discolour tooth which was treated with full porcelain crown.
After
Case 5
Before
This man had a non-vital tooth (left central incisor) which was root treated had showed badly discolouration. The tooth was treated with porcelain crown.
After
Case 6
Before
Another case of discolouration which was treated with full porcelain crown
After
Advantages of full porcelain
Crowns are very popular because they have an excellent history of fixing dental issues, and their track record is proven to work in all countries in the world. Up until quite recently, crowns were bonded to the tooth using a metal-based framework (porcelain fused to metal) so that the crown could withstand the pressures involved with daily chewing of food in the mouth. Today, most of the time the metal framework is not required, since modern technology has advanced up to the point where pure porcelain is strong enough even for use on hard working molar teeth. The metal framework had an issue – after a few years the gum line of a patient would recede with age, revealing an ugly grey line at the top of the crowned tooth. Due to the color of the metal showing through, it was difficult to make crowned teeth look natural for more than a few years.
The advantage of using pure porcelain is that the crowns are near identical in color to the existing colors of the patient’s teeth, making it nigh on impossible for others to discern a crowned tooth from a real one. A dentist will match the color of the crown to the tooth color already in the mouth, and then they will place an order with a lab to create the tooth with the perfect color and shape, taken from the previously mentioned mold, and patients are very happy with the results, and their new smile.
Having to deal with a dental emergency is not something people think about. However, being prepared can make the difference between saving or losing a tooth. And in the case of a toothache, if it involves a bacterial infection, it can be a life-threatening situation.
Here are a couple of common dental emergencies and what to do about them.
A lost filling
Rinse out the cavity with warm water. Apply a temporary filling product such as Dentemp® which can be made into a ball and pressed firmly into the cavity. This can alleviate immediate pain, but it is important that you call your emergency dentist and arrange to have your filling replaced before the situation worsens.
Temporary filling
Lost Crown / Cap
Crown
Even though a missing crown is not immediately painful, it can become painful in a short period of time as food and other debris gather in the cavity. Unless the cavity is sealed up again, decay and infection can cause the tooth to ache. It is important that you visit your emergency dentist within a few days of losing your crown or cap.
You’re suffering with a toothache
Toothaches can be more dangerous than any physical trauma to a tooth. Rinse your mouth out with warm water and place some kind of cold compress against your cheek for twenty minutes to reduce the swelling. Then let it warm up for 20 minutes and then back to the cold compress.
Don’t put any kind of pain medication against the gum. The pain medication could burn the gum and cause more problems. The greatest risk comes if the toothache is from a bacterial infection. If left untreated, this could become life threatening. See an emergency dentist ASAP.
Source:
Shamblott Family Dentistry
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If you have any question, don’t hesitate to contact us, we are more than glad to provide you with the information you need!
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