Digital Dentistry is Here !

Digital Dentistry is here for many different types of dental prosthesis. In this case we were able to convert an optical scan of the models of a denture-type prosthesis into 3D Digital images.  From there we modified the position of the teeth to enhance both the esthetic and functional components before milling out individual acrylic temporary prosthesis which fit precisely in the patient's mouth.  The prosthesis in this case will actually be held in place by dental implants in both the upper and lower arches.

By doing the refinement work digitally, we can eliminate extra appointments time required to perfect the result of all types of prosthesis.

The images below came from an actual case which we will deliver to our patient next week.  If you have the need for these types of implant retained prosthesis please contact our office for further information on treatment options.

Implant Dentistry in the Digital World

Digital Dentistry is a reality when it comes to dental implant treatments. Precise implant size, implant position, and the corresponding final restorations can all be preplanned using sophisticated computer softwares.  Advanced planning also allows us to fabricate actual surgical guides which direct the exact locations for implant placement:  The jaw is evaluated in multiple dimensions.  Digital Technology allows us to take the guess work out of implant dentistry, and helps make the treatment outcome more predictable and safe.

The image below illustrates an actual patient case in our office.  By starting with a 3D Cone Beam scan we were able to determine what kind of restorations can be done, and where to place the implants without risks to the nerves and arteries in the patient's jaw.

Dental Implants Can Address both Functional and Esthetic Problems

This is a follow up of my blog entry dated December 19th, 2013 .  In that entry I discussed why lower dentures hurt and what can be done to address the problem. These images illustrate a complete case from preliminary assessment to the final prosthesis in the patient's mouth.  I was able to execute this treatment by handling both the surgical procedures and the restorative procedures in my office.

1.  CT scan to assess bone condition and location of the nerves:

2.  Treatment planning using computerized software and the actual CT Scan.

3.  Placement of the planned dental implants in the exact locations as displayed by the stone and model with replica of the soft tissue and the implants.

4.  Final delivery of upper full denture and lower fixed zirconia/porcelain hybrid prosthesis.

By keeping the lower prosthesis away from the nerves, the patient regained her chewing function which used to be debilitating from the pain induced by the removable lower denture.  Note the difference in esthetic between the lower zirconia/porcelain and the upper denture acrylic.

Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

Dental Implants Require Proper Bone Width and Height

When a tooth is missing in the jaw for an extended period of time, the bone at that location resorbs in both width and height.  Proper treatment planning is crucial in determining if ideal bone volume is in place before an implant could be placed with predictable long lasting result. In the case below resorption of the bone in three dimensions is observed, and the ideal treatment protocol requires an additional bone grafting procedure to build up the ridge before the implant can be placed.  When required, bone grafting extends the treatment time for dental implant treatments.  Nonetheless the long term treatment predictability merits the extra time and effort in treating everything right from the beginning.

Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry.  For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

When are Dental Implants Recommended?

Dental implants are recommended only when the root of the tooth can no longer sustain itself in the jaw bone.  There are two general scenarios for the problem: 1.  The root has lost too much bone around it.  Bone loss can be caused by gum disease or excess bite trauma to a particular tooth.  Bone loss can happen in both vital teeth and root canal treated teeth.   If the bone loss is beyond the minimum volume for a sustainable implant, then bone grafting may be necessary before the implant can be placed.

2.  When the root is cracked from bite trauma.

a)  A vital tooth can crack from bite trauma, and the crack can extend deep into the root.  In this situation, root canal treatment and crown are not viable options because of the extent of the crack or fracture.

b)  Root canal treated teeth are essentially dead roots.   These roots are very brittle.  Even with a crown placed on the root canal treated tooth, that root can manifest a vertical crack line running along the length of the root.  In this case, bone loss begins to occur where the crack line exists, and the root is no longer salvageable.  Evidence of cracks in root canal treated teeth can be seen as an absess in the gum tissue surrounding the root.  Keeping these roots in the jaw for extended periods of time will result in more extensive bone loss, and the destruction can be seen on xrays of the surrounding bone area of the root.

The decision to extract and replace a particular root with a dental implant has to be substantiated by clinical evidence and radiographic evidence.

The following sample cases illustrate situations where the natural tooth root cannot be saved, and a dental implant would be an option to replace the tooth.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry.  For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.