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Dental implants have evolved over time and become an ideal replacement for a lost tooth or teeth. The long term success rate of dental implants is well over 95%. What once was a product offered to very few has now become a mainstream dental care service available to most.

Options For Dental Implants

Depending on each, unique, individual person, each dental implants case will be personalized. Depending on how many teeth are missing as well as the available quantity and quality of bone present. Below are some of the situations where dental implants can replace lost teeth:

-Loss Of A Single Tooth. At one time, this meant wearing a removable appliance (commonly called a “flipper”) or removing natural tooth structure from surrounding teeth to create a fixed bridge of dental crowns. The flipper tends to be uncomfortable to wear and may affect speech. The 3 unit bridge compromises the support teeth by having them do the work of the lost tooth, and by making them more susceptible to decay. The long term success rate is lowered due to difficulties in cleaning under and around the bridge. A single tooth dental implant, when completed properly, will last a lifetime and function just like a natural tooth.

-Loss Of Multiple Teeth. When missing multiple teeth in a single area, dental implants can be used to form a fixed bridge. The beauty of this arrangement is stability and the ability not to affect the natural teeth in any way.

-Replacing All Teeth. In the past, the only way to restore function was to fabricate a removable denture. With dental implants, dentists have the ability to restore natural function and esthetics.

Complementary Procedures To Dental Implants

There are times when other dental procedures are necessary to successfully complete the placement of dental implants. These include:

-Sinus Lift. When you have a large sinus area that impinges on available bone depth, the sinus lift is a common surgical procedure. Sinus lifts are needed to elevate the sinus membrane and thicken a part of the upper jaw with a bone graft. This helps give  a dental implant enough bone depth to place it properly in the area you need it. Dental implants need a good quantity of bone along with good, dense quality of bone to succeed. The upper jaw is known to have poorer quantity and quality bone structure as opposed to the lower jaw. The maxillary sinus also plays a role in increasing difficulty in this area. Sinus augmentation can remedy these issues by raising the sinus floor and placing bone grafts in the area to aid in dental implant placement.

-Bone Grafting. When the bone is not 100% adequate for dental implant placement, dentists are able to add to it by performing a dental bone graft. A bone graft is the placement of bone or bone-like materials in the jaw to to build it up. This gives an excellent platform for dental implants. Modification of the bone in this fashion has been shown to improve both appearance and long term success of dental implants. Typically, dentists try to place implants at least as deeply into bone as the crown or tooth will be above the bone. This is called a 1:1 crown to root ratio. This ratio serves as a guide for bone grafting in most situations.

Can A Dental Implant Fail?

It is quite rare for a dental implant to fail but when it does the dental implant must be removed. Then re evaluated as to why the failure occurred and to see if a new dental implant may be placed. Some of the common reasons for dental implant failure include:

-Failed Integration of Dental Implants - This occurs when the bone does not grow and fuse between the threads of the implant. This fusion of bone to dental implant is called osseointegration. If this does not occur, the dental implants will not function properly,will become uncomfortable, become loose, or come out completely. To reduce this risk, your dental surgeon will evaluate the quality and density of the jaw bone prior to surgery. This will help to only place dental implants in areas where there is a highly predictable success rate. If osseointegration does not take place, the dental implants can be removed, and surgery can be attempted again once the area has fully healed.

-Infection –  This is the most common complication of dental implant surgery. The surrounding bone and gums can get infected during the surgical procedure. This can happen due to non-sterile technique, a contaminated implant, poor healing ability(diabetic, smoker, osteoporosis medications), or pre-existing infection. The most likely time for this to occur would be during the surgical placement of the dental implant into the bone. Implant infection can occur after placement as well. Poor hygiene, too much force placed on the implant, or excess cement can cause the support tissue to breakdown. Implant infection is a condition referred to as peri-implantitis. Peri-implantitis is characterized by inflammation or swelling of the tissues surrounding the implant area. Peri-implantitis can also present as a secondary infection later on is a form of periodontal disease that can lead to inflammation, bone loss and implant failure if not treated quickly and properly. Although implant infections are usually caused by the presence of bacteria during or immediately after the oral surgery for the placement of the dental implants, an implant infection can occur months or years after surgery.

-Post Surgical Bleeding - Some bleeding following surgery is normal and should be expected for about 1-2 days. Biting gently on a gauze pad placed over the surgery area for 30 minutes should normally stop the bleeding. Excessive bleeding is not normal and you should notify your dentist immediately if you have concerns about your dental implants.

-Damage To Surrounding Tissues - Dental implant complications related with surgical errors affecting adjacent teeth, nerves or sinus are directly correlated with the experience and skills of the dentist or surgeon. An experienced and skilled implant dentist is able to identify potential problems by examining x-rays or CT scan (computer tomography), design the proper surgical plan for ideal location and angle, and execute it successfully without complications. Even with the most skilled implant dentist there is always a possibility of dental implant complications. The complications can be limited by choosing an implant dentist with the skills and experience necessary to handle any complications if they arise.

-Rejection – An extremely rare complication for dental implants but it has been noted in the research literature. The dental implants can sometimes be viewed as a foreign body.

-Unusable Dental Implants – An implant that has successfully integrated with bone, but the area or extreme angle of placement deem it unrestorable.

Dental Implants Conclusion

Dental implants have been the solution for many. They come with risks but with proper treatment planning from a well qualified dentist they can be a successful tooth replacement for a lifetime of smiles.

 

 

Porcelain crowns have long been the cosmetic dentist’s best friend. They  provide a long lasting, beautiful restoration that is very esthetic.   The cosmetic enhancement uses of porcelain crowns include, changing color of teeth, closing gaps between teeth, fixing teeth that are crooked or crowded, changing shape or size of teeth. Porcelain crowns

e.max porcelain crowns Marielaina Perrone DDS

e.max porcelain crowns look natural.

are also used to cover and protect damaged teeth, (tooth that had root canal treatment, broken, cracked, large fillings), and to act as a new tooth in the case of dental implants.

Full porcelain crowns, unlike porcelain fused to metal crowns, has translucency.  The porcelain’s translucency allows it to reflect light much like natural teeth. There are many different types of porcelain utilized in many different ways, however, the limiting  factor has always been strength against fracture. E.max porcelain crowns have combined optimum translucency and strength.

What are E.max Porcelain Crowns?

E.max porcelain crowns are a highly esthetic crown originally developed to be used on implants. Dental implant porcelain crowns require greater strength against fracture than crowns on natural teeth. E.max porcelain crowns (due to superior strength) can also be made thinner than other porcelain crowns, allowing for more natural translucency and beauty.  E.max porcelain crowns are made from a single block of lithium disilicate ceramic. This type of porcelain is considered a very high grade material which has been harvested for its toughness, durability and opaque qualities which make for a highly prized crown.

E.max porcelain crowns are considered to be a perfect match against the backdrop of your natural teeth. The transparent color, lifelike shape, along with its light reflection properties create the ideal restoration. There is no metal framework on e.max porcelain crowns which means there is never a chance of a grey line of metal showing through your gums. They are strong, long lasting and unlikely to crack or fracture as compared to many other types of crowns. They are considered to be at less risk of chipping compared to zirconia porcelain crowns.

The beauty of this technology is that e.max is not limited only to porcelain crowns. The same techniques and materials are available for porcelain veneers, porcelain inlays, porcelain onlays, and porcelain crowns over dental implants.

E.max lithium disilicate glass ceramic delivers the fit, form, function, and esthetics demanded by modern cosmetic dentistry but with the enhanced strength and light reflecting properties dentists demand as well. Since the e.max porcelain crown system was introduced almost 40 million restorations have been  and they have been proven effective for use.

 Any Disadvantages of e.max porcelain crowns?

-The main disadvantage of e.max porcelain crowns is with the cost. The lab equipment and highly specialized lab training to make this crown are the reasons why the quality comes with a higher price tag.

-The second disadvantage with e.max porcelain crowns is that it can not be used to make a porcelain bridge, and fusing of  more than 2 teeth is not recommended.

-The third main disadvantage is, as with most porcelain crowns, there tends to be a higher chance of sensitivity after the crown is cemented in place. The sensitivity may last days or weeks.

Conclusion

E.max porcelain crowns have proven to be a very useful cosmetic dentistry tool. Dentists and patients no longer need to compromise when it comes to the esthetic look of the final restorations. You no longer need to worry about crowns looking unnatural. E.max porcelain crowns will give you something to smile about!

Teeth whitening has become one of the most requested and performed procedures in dental offices across America and the world. According to the American

Academy of Cosmetic Dentistry, teeth whitening is the number one requested cosmetic dentistry procedure requested by patients to improve their smile. We have long known that the importance of feeling good about our smile increases our self esteem and confidence. It alters how others look at us and interact with us. So it is no surprise that people want a whiter smile. But did you know teeth whitening can occur using natural ingredients?

The first step is the maintenance of good dental hygiene. Our Health and beauty are one and the same. Start with clean, healthy teeth and gums.Removing plaque, and stains will help give your smile the sparkle you need and the  confidence to smile. Teeth covered in plaque, tartar and debris, and red, swollen puffy gums are never beautiful. Maintaining a regimen of brushing and flossing as well as regular visits to dentist and hygienist are the first step in any improvement to our smiles.

Foods To Eat for Teeth Whitening

-Crunchy, crispy fruits and vegetables have an abrasiveness that can help remove stains from the teeth and give the illusion they are whiter. Consider these like nature’s toothbrush. Apples, fresh green beans, cauliflower, carrots, celery and other crunchy fruits and vegetables help whiten by gently scrubbing the teeth. These abrasive vegetables and fruits have enough abrasiveness for teeth whitening without causing any harm to the enamel. A great snack for teeth whitening are crudités (sliced, fresh, raw veggies). Fibrous fruits and vegetables are low in calories, high in nutrients and massage gums and promote blood flow to help keep oral tissues healthy. They also help to increase salivary flow. Good salivary flow is an important key to help protect our oral health.

-Strawberries. This delicious fruit contains an enzyme called malic acid that helps with teeth whitening.

-Eating tart fruits such as oranges and pineapples. These may cause the mouth to produce more saliva, which washes

teeth clean naturally. Beware of using these very acidic directly on teeth, because too much acid can cause damage to the teeth.

-Cheese and other dairy products (like yogurt and milk). These products contain a type of lactic acid that helps prevent decay. Hard cheeses also scrub teeth similar to the crunchy fruits and vegetables to help with teeth whitening by removing stain build up.

-Ginger Root. This help is owed to the anti inflammatory and antibacterial ingredients of the fruit. Patients with periodontitis will receive some benefit by introducing ginger into their diet.

-Basil. This is known as a strong natural antibiotic. Basil can reduce the amount of harmful bacteria in the oral cavity. Basil also acts as a defense mechanism deterring the bacteria from multiplying.

-Sesame seeds. Nature’s scrubbing toothbrush. These will help in reduction of plaque deposits. Just take a few teaspoons of sesame seeds a few times per week, and you will begin to note a change in how clean your teeth are. You will probably see reduced plaque deposits.

Teeth Whitening with Crest Baking Soda

Teeth Whitening with Crest Baking Soda Toothpaste

-Baking Soda. Studies have found that toothpastes that contain baking soda do a better job of removing plaque than toothpastes without the ingredient. To try it, your best bet is brushing with a commercial paste (like Crest Baking soda teeth whitening toothpaste) that contains the mild abrasive. This will happen with teeth whitening due to removal of stains by the abrasive paste

Foods to Avoid for teeth whitening

I am sure most people can rattle off the worst offenders pretty quickly. Tea, coffee, red wine, and sodas. But there are a few foods that might surprise you. They include:

White wine. This can promote staining because it contains tannins and acids that can actually etch tooth surfaces. Alcoholic drinks are generally not acidic unless mixed with acidic beverages in cocktails. These can include drinks such as screwdrivers (vodka and orange juice) or cosmopolitans (vodka with cranberry and lime juice).

Sports drinks. These drinks tend to have a higher acidic content regardless of whether they are regular or sugar free.

teeth whitening - epic xylitol gum

xylitol gum – teeth whitening

Most people won’t give up staining foods. So they must maintain regular visits to the dentist as well as adding the next two to their diet on a regular basis.

Water works to reduce staining. Drink water with meals and rinse your mouth with water after eating. Just sip and give a final swish (and swallow) after a meal.

Sugar-free gum can also help clean teeth. This is helpful when you won’t be able to brush for a while. Xylitol (artificial sweetener) in some sugar-free gums also helps prevent decay by stimulating salivary flow.

 

Following some of the steps above will probably not get you the results of professional teeth whitening but they will help maintain a healthy, vibrant smile for many years to come. Teeth Whitening comes in many forms!

 

 

Teeth Whitening the Natural Way
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Porcelain crowns have been a staple in cosmetic dentistry for years. It gives the dentist and patient a much more aesthetic appearance as a final product. In the past crowns and bridges were traditionally made of porcelain fused to metal (PFM). With the development of modern porcelain, which are incredibly strong and reflect light similar to natural teeth, full porcelain crowns can be used in most areas in which porcelain fused to metal crowns were used. This is especially true in a cosmetic area of the mouth.

Porcelain crowns are very versatile and used in many ways. The cosmetic enhancement use of porcelain crowns include, changing color of teeth, closing gaps between teeth, fixing teeth that are crooked or crowded, changing shape or size of teeth. Porcelain crowns are also used to cover and protect damaged teeth, (tooth that has a root canal, broken, cracked, large fillings), and to act as a new tooth in the case of dental implants. Their versatility gives the dentist a greater flexibility in using them to fix potential issues for the patient.

cosmetic dentist emax crown

Emax Porcelain Crowns

The first step often times includes impressions for study models and photos. The patient and dentist can then discuss and plan what the end result should be. The treatment includes preparation of the tooth surface for the porcelain crowns. The outer enamel and sometimes a bit of  the dentin are removed. This allows room for the porcelain crowns to fit over the teeth and be in perfect cosmetic alignment with the others. Impressions are taken of the newly reshaped teeth and temporary crowns are made.  The porcelain crowns are custom made in the laboratory. The porcelain crowns are then cemented or bonded onto the teeth using an adhesive bonding material. The placement of the porcelain crown will normally take about 30 minutes (depends on amount of porcelain crowns being placed). Once completed,  the patient can eat normally and enjoy the benefits of a beautiful new porcelain crown that matches and blends perfectly with the patients existing teeth. Only you and the dentist should know anything was done.

Advantages of All Porcelain Crowns

-No PFM gray or black lines at the Gum Line of Teeth. You may have noticed a person with a dark line in the gum area along a PFM crown edge. With PFM crowns, the soft tissue around the tooth can recede over time. This allows a reveal of the metal framework underneath. This cannot happen with an all porcelain crowns because they are metal free.

-Perfect Fit. Porcelain crowns are created in state of the art facilities. Porcelain crowns will fit so well you will even forget they are present.

-Cosmetically Perfect Match. All porcelain crowns have the ability with modern porcelains to match your existing shade of tooth color as well as mimic the light reflecting properties of your natural teeth. Porcelain crowns will be undetectable to anyone but you and your dentist. Dental porcelain can be shaped custom colored and sculpted to closely copy the look of your own natural tooth enamel. All the while providing the desired strength and resilience.

Some disadvantages of an all porcelain crowns:

-Higher cost over traditional PFM crowns.

-Durability. While porcelain crowns are very durable, they do not have the flexibility of natural teeth, they can fracture. Avoiding certain foods may be necessary. For example, Biting into sandwich with a hard bread. Patients who grind and clench their teeth will need to be fitted with a mouth guard to protect the porcelain crown from unnecessary and excessive pressures.

-Porcelain crowns may need a bit more reduction of tooth structure than traditional PFM crowns.

-Sensitivity may happen for a short time, (hot, cold sensitivity), especially with bonded porcelain crowns.

Follow-up Maintenance of All Porcelain Crowns

The maintenance of porcelain crowns is actually very easy.  They require routine brushing with non-abrasive fluoride toothpaste and regular flossing as well as regular visits to the dentist. A follow-up appointment will be scheduled to evaluate the porcelain crowns about 2-4 weeks after they are placed in the mouth This allows the dentist to review the work with tissues all healed and see how your oral tissues are reacting to the crowns. Even if you think the crowns are successful, this appointment is an important part of your future oral health.
There are several types of all porcelain crowns generally used in dental offices today. They have all proven to give the best cosmetic dental results.
-Zirconia Crowns or Lava Crowns (made by 3M Espe). This type of all porcelain crowns are made out of a zirconium core with porcelain pressed or layered over the crown to follow the natural contours of teeth. These crowns offer good strength and durability. Due to great strength, the material can be used to make a bridge.
-Procera Crowns (made by Nobel Biocare). These are made of an Alumina core with porcelain pressed or layered over the crown to follow the natural contours of the teeth. These crowns offer great strength and durability and are esthetically quite beautiful. Often used in the back of the mouth, (premolars, molars), these are cemented in with traditional cement and have less post-placement sensitivity.
-Empress II Crowns (made by Ivoclar Vivadent).These highly cosmetic porcelain crowns are used in the front of the mouth. They are used mostly for cosmetics, are very beautiful, but can fracture.
-eMAX Crowns or IPS e.MAX Crowns (made by Ivoclar Vivadent). These porcelain crowns are entirely made out of porcelain without a underlying framework. The absence of this framework offers a great advantage over Zirconia crowns, Lava crowns and Procera crowns in that e.MAX crowns allow for more light transmission through the crown translating to a more superior cosmetic dental result. The strength of these porcelain crowns is such that they can be used in any area of the mouth, can be made thinner than most porcelains, and can be used for an implant without much worry of fracture.
Cosmetic Dentistry is the art and science of creating a beautiful smile. The all porcelain crowns are just one more tool that the dentist can use to give you that smile you’ve always dreamed of.
Procera Porcelain CrownsLava Crowns Ivoclar VivadentPorcelain Crowns 3M Espe