Definitive dental diagnosis using 3D X-rays

Often time patients would present with a tooth that may feel unusual, uncomfortable, or slightly painful. However, traditional X-rays do not always show the exact problem due to the fact that bone morphology and root structures may overlap each other and create inaccurate images. Stitched together from precise individual slices of images, 3 Dimensional X-rays (Cone Beam Scans) provide very detailed images which can help clinicians see exactly what is going on with the questioned site.

The first X-ray below shows a tooth that may have something going on at the tip of the root, yet the information is limiting and non-diagnostic. The second X-ray below is an actual slice of a 3D Scan which shows definite lack of bone support on the front side of the tooth. The image also shows slow growing infection lesions that have been dissolving the bone around the roots of the tooth. The red arrows point to the problem area.

Based on the information from the 3D X-ray, this tooth cannot be saved because hanging on to it will allow further destruction of the jaw bone surrounding the tooth. Early detection of bone loss and infection can help make the treatments much more predictable, and 3D X-rays are now a very important part of our dental diagnostic tools.

 Traditional X-ray showing possible problem at the end of the root.

Traditional X-ray showing possible problem at the end of the root.

 A slice of a 3D X-ray showing definite bone loss and infection around the same tooth above.

A slice of a 3D X-ray showing definite bone loss and infection around the same tooth above.

Other uses of Zirconia in Dentistry

In a previous blog post I showed a case of veneers done by solid Zirconia. Besides crowns and veneers, Zirconia is also used to make bridges to replace missing teeth. Due to the high density of the material from the sintering process, Zirconia is a great material used to make full arches of implant retained bridges. In the hands of the right ceramist who knows how to custom stain the material, Zirconia in its final product stage can be lifelike with exceptional strength.

 Solid material stained to replicate details found in gum and teeth.  In the mouth this prosthesis looks indistinguishable as real teeth or man-made.

Solid material stained to replicate details found in gum and teeth. In the mouth this prosthesis looks indistinguishable as real teeth or man-made.

 This full arch Zirconia bridge is retained by multiple implants in the mouth to help replace missing lower teeth.

This full arch Zirconia bridge is retained by multiple implants in the mouth to help replace missing lower teeth.

Dental Care - An Ongoing Commitment

This week I received a beautiful flower arrangement from a patient.  It really marks over twenty five years that I have been taking care of her teeth.  Our professional relationship goes back to the days when I was still a dental student in the early 90's.  My patient is committed to the upkeep of her dental health, and I try hard to deliver my best dental care to her.

Indeed, dental care requires a commitment from both the patient and the dentist.  It really does not matter how well we perform the dentistry at the office.  If the patient is not committed to home care, then dental problems will continue to worsen.  Home care is not just about flossing and brushing.  For example:  in cases where the patient's bite and joints are considered at risk, staying committed to wearing the night guards will help minimize problems of excess wear and fractures of teeth and restorations in the mouth. 

When the patient and the dentist develop a mutual understanding of the patient's dental condition and what it takes to maintain optimum dental health, the result can be long lasting, manageable, and predictable.

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