Archive for April, 2011
April 28, 2011 at 9:36 pm by Ian Kerr
Filed under Clinical Cases
No great message with these images; just that I love my job and I love working hard to save teeth for people who really want to keep them for as long as possible. I work with a fantastic team and really admire my patients for the efforts they will go to keep their teeth. These teeth have since been restored with cast restorations to keep them strong for many years to come.
Decayed infected teeth in need of treatment
Root filled teeth ready for their crowns
For a lot of people root fillings are the stuff of nightmares but this is just not true. The treatment should be pain free and is often completed in one visit. If you know you need a root filling but are putting it off because of anxiety about the treatment why not arrange to visit the surgery at no charge and chat with me about what the treatment will involve and see how we carry out the process. I am certain we will be able to help you, give us a call on 01580 752202.
April 26, 2011 at 9:31 pm by Ian Kerr
Filed under Clinical Cases
This case shows how we were able to get a patient out of pain and restore teeth that might easily have been extracted if we did not take the time to discuss all of the options first.
The two teeth in this case area clearly very damaged teeth. When ever we begin treatment in a case like this it is important that we review all treatment options and give our patients time to understand the choices available along with the likely outcomes, any risks associated with treatment and also the risks of doing nothing. With teeth like these that require new root fillings and crowns we need to look at the level of time and cost involved and the likelihood of long term success. There are never any guarantees in dentistry (or medicine) so we need to prepare patients for the possibility that work, no matter how well it is done, can fail and we need to look at the consequences of this failure. If the patient is going to be biologically worse off if the work fails then we need to make sure that they are fully aware of this before any work begins.
In this case the only alternative treatment option is to extract the teeth. Once the teeth are gone the patient is then faced with either a gap and loss of chewing function or replacement with dentures or implant retained crowns. We need to give unbiased informative information regarding these treatment options prior to beginning any work. At StoneRock this information is given as a written estimate and letter that gives the patient an opportunity to weigh up the various pros and cons and discuss options with their significant others. Decisions made under the glare of the dentists lamp or under the duress of tooth ache are rarely “informed choices” and would certainly not stand up as a defense in court for the dentist!
This work was undertaken using microscopes, rotary instruments and the SAF system. The work was completed in one visit. The teeth now need crowns placed to protect them from further fracture. This sort of work is quicker and cheaper than implant retained crowns and current evidence shows that root filled teeth supported with crowns are just as likely to be as successful at 10 years as implant retained crowns. The Saving Teeth campaign is attempting to encourage people to hang on to their teeth for longer and I fully support this campaign.
Before image with suboptimal root fillings
New root fillings in place
If you would like help deciding how best to proceed with dental treatment then please contact us on 01580 752202 and we will be happy to help.
April 12, 2011 at 10:30 pm by Ian Kerr
Filed under Clinical Cases
This case shows the results of a direct build up of some very damaged teeth two years after it was completed. The case shows the benefit of direct build ups as they can give an excellent aesthetic and functional result with no drilling of sound tooth tissue. The case was completed in one visit and did not involve any injections or impressions. The patient is delighted with the result but these photos also show that direct composites are by no means perfect and the “warts and all” view of some pitting to the lower incisor fillings and stain to the upper canine show the limitations of this technique as well. Fortunately for us dentists are results are not viewed under this level of close up scrutiny every day so, as the smile shot shows, our results can be clinically acceptable even if they are showing slight flaws under higher magnification. I favour this approach when ever possible because it leaves the patient with all of their remaining sound tooth tissue, and on this occasion created much needed space between the teeth so that if I did need to resort to full coverage crowns I could do them in a much less invasive way.
before closed
Before open
2 year review
2 year smile
In case like these I subscribe to a “dynamic lifetime therapy” approach that means I will be expecting to repair minor flaws and polish imperfections every couple of years and I do not view this as failure, just as my car has not failed if it needs to go for a service. The key points are that the patient is happy with their smile and their teeth are protected from further damage. As ever if you think that the case you have seen is similar to a problem that you are suffering with please do not hesitate to call the surgery on 01580 752202
April 12, 2011 at 10:18 pm by Ian Kerr
Filed under Clinical Cases
This case is an example of an endodontic retreatment, which means that we need to redo the root filling, prior to making a new crown. Although the root filling has been in place for several years and is not showing any obvious signs of infection there was decay present and this means there is a high risk that it will flare up during the decay removal and replacement of the crown. By redoing the root filling first we are providing more ideal foundations on which to place our new crown. This case was done using the new technology of the SAF system which really helps to clean and shape the canals whilst removing remnants of the old root filling. The tooth was symptomless 24 hours after treatment and is ready for its new crown and, hopefully, many more years service.
Old root filling and post
New root filling and solid core
If you are concerned about the health of any of your teeth then please do not hesitate to call the surgery on 01580 752202 and we will be happy to help.
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