…passionate about teeth
Archive for February, 2011
February 17, 2011 at 10:06 pm by Ian Kerr
Filed under Clinical Cases
Amalgam fillings are a thorny issue in dentistry. They have been used to fill holes in teeth for over a 100 years and it has to be said that they do fill holes very well. The problem is (a side from all the health concerns) that that is all they do. Amalgam fillings do not offer any strengthening to the damaged tooth and in fact often weaken teeth making them prone to fracture. A great many patients now want their metal fillings out on either health grounds or aesthetic reasons and I often recommend it where I see the tooth beginning to weaken around them. If we are going to remove an amalgam filling then we need to know that the replacement is going to be at least as strong and is going to protect the tooth from further damage.
This simple case shows how well direct composite restorations can be used to treat very heavily filled teeth at the back of the mouth. Conventional dental wisdom states that heavily filled teeth such as these should be restored with a crown. Often this is the case but conventional full coverage crowns involve removal of large amounts of sound tooth tissue so come at a high “biological cost” to the tooth. They also come at a higher “financial cost” because they require two visits and a technician needs to be paid to make the crown as well.
Direct fibre reinforced composites can be used on occasions as a one visit procedure which involves much less drilling to sound tooth tissue and do not require the services of a dental technician making them significantly cheaper both financially and biologically. The composite option may not last as long as the crown but as we see here they can last very well and the crown is always an option for later on in life, if it is needed.
UR6 AF before cropped
Cavity after filling and decay removed
Filling at placement
3 year review of filling
If you are considering replacing fillings in this manner then please call us on 01580 752202 and we will be happy to discuss the various treatment options available to you.
February 17, 2011 at 9:49 pm by Ian Kerr
Filed under Clinical Cases
The previous article showed a 4 year review of an implant retained bridge. The results are excellent but the work involved is lengthy, surgically demanding and at the more expensive end of dentistry. On occasions implants are our only restorative option and they certainly offer excellent long term stability and predictability.
This case, however, is at the other end of the bridge spectrum and shows the excellent results we can achieve with directly placed fibre reinforced composite bridges. This case shows a missing lateral incisor being replaced with a direct bridge of this sort. The work is completed in one visit with no drilling to the adjacent teeth and costs a fraction of the implant alternative. It is not as strong as an implant retained crown or bridge but it is repairable in the mouth and can be redone several times over many years before it matches the cost of the implant options. Some times less is more.
Before shot showing gap and discoloured tooth
3 year review. Gap closed and discloured tooth restored
If you would like to know more about fibre reinforced bridges and how they could be used to restore your teeth then please do not hesitate to contact the surgery on 01580 752202 and we will be happy to help.
February 3, 2011 at 9:13 pm by Ian Kerr
Filed under Clinical Cases
This case shows how implant retained bridges can rescue a damaged dentition and can give excellent long lasting aesthetics.
The original two front teeth were lost at a young age and were replaced with a conventional tooth borne bridge. (The adjacent teeth are cut down for crowns and a fixed 4 unit bridge was cemented in place). These conventional bridges have been the mainstay of prosthetic dentistry for the past 40 years or so and provide excellent medium to long term results. The only problem is that when they fail they have a habit of taking at least one tooth with them and, in this unfortunate case, sometimes both support teeth.
As the remaining roots were too week to be restored in any predictable fashion they were removed and implants placed in the sockets. A three month healing period allowed the implants to integrate with the bone and once they were firm enough they were restored with a bridge. The case has been in place for 4 years and is looking (and feeling) very natural. If the gum health is well maintained then we would expect them to last for many more years to come.
If you would like to know how implants could be used to improve your dental health then please do not hesitate to call the surgery on 01580 752202 and we will be happy to help.