Archive for December, 2011
December 22, 2011 at 8:19 pm by Ian Kerr
Filed under Clinical Cases
This case presented as tooth (upper lateral) giving pain and was scheduled for removal and replacement with an implant retained crown. As the images show it is possible for us to do alternative work to try and delay the loss of the tooth for a few more years so putting off any replacement treatment. Whenever we are planning the loss of a tooth we should always consider how long the replacement options are likely to last. Whilst we hope that all of the work we do will last for many years we can rarely say that any work is likely to be “life long”. It is very difficult to give accurate average figures for certain types of restorations (bridges, crowns, implants etc) and impossible, of course, to say how they are going to apply to each individual patient. With this in mind I always feel we should try to delay the final step of extraction for as long as possible- dentistry is one way street and we should head down this street as slowly as possible! In the example below the root filling and the coronal restoration (the bit above the gum that we see) could both be improved upon and so I felt it was worth trying to do this and then see how long the work lasts. The work as completed in one, 2hour, visit and I think this was time well spent. There are no guarantees with this sort of work but neither are there with the replacement options and once the tooth is out there is no going back. This work will eventually fail and the tooth will then need extraction but if this happens 5 or even 10 years down the road then the replacement options may well have improved and we have delayed the onset of the next round of treatment by this time.
Xray of tooth before treatment
Old filling removed
Pre endodontic build up
Finished root filling
Finished result from the incisal edge
Finished result
If you are worried about a tooth and would like to know if it can be restored then please give us a call on 01580 752202 and we will be happy to help
December 13, 2011 at 9:14 pm by Ian Kerr
Filed under Clinical Cases
This case was a joy from the start and whilst we still have some work to complete at the back of the mouth the smile is looking many years younger and all with no drilling and no injections.
This case was completed using simple home use night guard vital whitening which is the way we do almost all of our whitening cases. We tend to use 10% carbemide peroxide as this is the lowest effective concentration and the one that most of the original research from the 1980s was done on. The trays are worn at night typically for 14 nights and we complete with a simple 40 minutes in the surgery on the 15th day with a higher concentration, if patients feel they need it. The patient is then able to top up their results at home and do not need any further trips for “lazer” or “power” whitening sessions. This approach is not only the cheapest way of whitening your teeth it is also the most researched and has been in use the longest.
The tips of the teeth were built up with direct white fillings which was done in one visit, without the need for any local anaesthetic as we were not drilling in to the teeth at all. The builds up not only enhance the appearance of the teeth they also protect them from further wear and tear. It is inevitable that the build ups will eventually wear down but they can simply be rebuilt with no further impact on the underlying teeth.
If you would like to know more about the techniques discussed here and find out if they would be suitable for you then please do not hesitate to contact the surgery on 01580 752202 and we will be happy to help
December 6, 2011 at 11:35 pm by Ian Kerr
Filed under Clinical Cases
This case is a good example of simple dentistry done to save some teeth that otherwise might have needed to come out. I like this case because it demonstrates the use of fibre reinforced composites both as laboratory made crown (on the molar tooth) and as a direct restoration made in the mouth for the premolar. It also shows fibre posts made to fit the anatomical shape of the root so we can be a minimal as possible in our preparation of the root canal. The curved tip and proximity to the floor of the maxillary sinus made this a little bit more challenging than it might have been.
This is a very typical example of the work that I do and I love doing it because it saves the patient from the pain often associated with the sort of infection seen at the tip of the root; it gives great strength to the damaged teeth and great aesthetics whilst leaving as much sound tooth tissue as possible intact.
Biting surfac view of damaged teeth before treatment
Root filling in premolar tooth with anatomical post
Molar and premolar restorations in place (Dark amalgam filling in front tooth, needs replacing)
Biting surface views of restored teeth after treatment
At StoneRock we believe treatment should be planned in this order- Health, Function, Beauty. This sort of work covers all three and gives the patient strong, healthy teeth that look and feel nice. It is a privilege to get to do this sort of work. If you would like to find out more about what we do and how we might help you then please call us on 01580 752202 and we will be happy to help.