Month: July 2015

Crack Tooth Syndrome: Crown as a Treatment

We talked about Crack Tooth Syndrome in the previous post.  Now we can talk about the type of treatment for the crack tooth syndrome.

The crack tooth syndrome begins with a tooth having the signs and symptoms of a crack tooth.  It can either be visually obvious or it requires xray image to determine the presence of a crack line.  The type of treatment depends on the location of the existing crack or defect and the patient’s symptoms.

The location of the existing crack or defect plays an important role in determining the type of treatment for crack tooth.  If the defect is away from the central nervous tissue within the tooth and the patient does not have any painful symptoms, a crown can often be the definitive treatment for treating the crack tooth and to restore the tooth back to its functional state.  I will illustrate this concept with a recent patient case.

This patient had an existing large amalgam filling done more than 10 years ago and now he bites into something hard and the filling cracked off.

Tooth with Large Filling

Tooth with a Large Dental Filling

 

Crack Tooth with No Nerve Exposure

Crack Tooth with No Nerve Exposure

Upon examination, patient does not have any unusualy painful symptoms.  The defect seems large so we have to take an xray image to determine if the nerve is involved.  The xray image reveals that there is a good distance (approximately more than 1 mm) between the defect and the central nerve pulp.  Since it doesn’t seem that the central nerve pulp is affected, the tooth does not need the root canal therapy.  The defect is large so the treatment of crown was offered to patient to restore the tooth.  Also the crown would help strengthen the tooth so to prevent the tooth from further fracture.

Even though the tooth seems to be infection free and patient does not have any symptoms, the tooth might become symptomatic if there are some unforeseen microscopic crack exists within the tooth which may lead to future infection.  This is the risk that associated with crack tooth.  Patient was warned of the need of additional root canal therapy if the tooth develops unforeseen infection problem after the treatment of crown is rendered.  The patient accepts the risk and agrees to proceed with the treatment of crown.

This is now the tooth looks like after the crown is put on.

Crown Fixing Crack Tooth

The patient is comfortable after the crown and to this date, the tooth is trouble free.

 

Written by Daniel Tee, DDS, MS

Genral Dental Office in Tempe AZ — White Tooth-Colored Fillings, Porcelain Crowns, Veneers, Inlays, Onlays

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona. Practicing General Dentist

Implant Restoration for Missing Front Tooth

I would like to demonstrate today how to restore the front tooth with the implant as the definitive treatment.  Of course, there are other alternatives to implant and the alternative options include bridge, partial denture, and flipper.  Each option has its own advanntages and disadvantages but implant is the standard treatment of choice if the medical and dental conditions of the patient fulfill the requirement for implant.

Missing Front ToothThis patient loses one of his front tooth because he has severe periodontal bone loss around that tooth and it becomes very loose.  The tooth was extracted and was allowed to heal for several months prior to implant is placed.  Meanwhile, the missing tooth gap is temporarily filled in with a dental flipper.  Dental flipper is essentially a plastic partial denture and its main function is a cosmetic one.

Once the bone is healed, dentist placed the implant into the bone.

 

 

 

Then the bone is allowed to undergo osteointegration with the implant.  Depending on the bone quality, upper front bone may take several month to fully heal around the implant.  The implant will become secure into the bone.  This is how the implant looks like within the bone:

Intraoral Implant Photo2

Xray Image showing Dental Implant in bone.

Xray Image showing Dental Implant in bone.

 

Once the bone is fully healed around the implant, the implant is ready to be restored.  The dentist with the help of dental laboratory will design the implant crown according to the patient’s dental condition.  Then the dental crown is fixated onto the implant.  This is how the final result looks like.

Front Tooth Restored with Dental Implant

 

Written by Daniel Tee, DDS, MS

General Dental Office in Tempe AZ — White Tooth-Colored Fillings, Porcelain Crowns, Veneers, Inlays, Onlays

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona. Practicing General Dentist

 

Porcelain Veneers Make Beauiful Smiles

Discolored and chipped front teeth can have a make-over with dental porcelain veneers.  Porcelain veneers are like a new jacket for teeth.  It is cemented onto the front part of the tooth and it can hide the discoloration and recreate a new contour for the tooth.  The following is the diagram showing how the veneers can be put on a tooth:

Porcelain veneer diagram

Many people may not like the appearance of their teeth.  For example, this patient said she would try to hide her front teeth whenever she smiles because she doesn’t like their appearance.  Her front two teeth has discoloration and the corner is chipped.

Veneer Preop

Photo shows chipped front two teeth.

 

My advice to her is to get the veneer treatment.  After the veneer treatment, her front teeth looks very natural and she said now she can really smile.

Porcelain veneer post-op photo

Dental Porcelain veneers on front two teeth

 

 

 

Written by Daniel Tee, DDS, MS

Cosmetic Dental Office in Tempe AZ — White Tooth-Colored Fillings, Porcelain Crowns, Veneers, Inlays, Onlays

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona. Practicing General Dentist

Cosmetic Anterior Crowns Can Dramatically Improve Your Smiles

Porcelain crowns can dramatically improve the appearance of your teeth and also provides structural protection for a broken tooth.  If the tooth has discoloration that cannot be removed by whitening and if the tooth has worn outer enamel, porcelain crown can be the option in addition to other dental prosthetics such as the veneers.

This patient has a chief complaint of disliking his yellowing lower front teeth.  Upon examination, he has a yellowish discoloration on his lower anterior teeth and also worn looking teeth.  Also the neck region of the teeth are worn due to slight gum recession.  Recession is due to his previous periodontal disease status.  However, he has no other pathologies and his current periodontal condition is satisfactory with healthy gum and bone support.

Zirconia-Cosmetic-Crowns-Preop

Whitening alone does not resolve all the problems.  Also the patient has a habit of bruxing his teeth so a veneer might not be a viable option because bruxism can damage the veneers.  So I suggest to the patient with the treatment of all porcelain crowns for his anterior teeth.  This is how the teeth looks like after the porcelain crowns are put on.

Zirconia Cosmetic Crowns Postop

The porcelain crowns are able to correct the uneven size and worn shape of his teeth and also provides a much more pleasing white color.

 

 

Written by Daniel Tee, DDS, MS

Cosmetic Dental Office in Tempe AZ — White Tooth-Colored Fillings, Porcelain Crowns, Veneers, Inlays, Onlays

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona. Practicing General Dentist