Smiles of Regret. Who Do You Choose to Restore Your Teeth?

November 19, 2010 alexnguyen

Over the years I have had the opportunity to see cases of patients who came to me for initial consultation but ended up elsewhere for the completion of their dental work. Here are some cases where the patients returned to me a few years later to express their discontent and to complain about problems with their teeth. These are smiles of regret. Who do you choose to restore your teeth? Sometimes people will make their choices based on beautiful advertisements that they see. Sometimes the choice may be based on a price tag that may fit their budget at that particular moment. The key to remember is that an unsuccessful restorative case may eventually cost you more time and money to have the work redone.

CASE I: Excess cement materials left under the gum line and around every single restoration. This caused chronic inflammation of the gum and bone loss over time. The patient was also unhappy with the esthetic result.

CASE II: Restorations done without regards to the foundation of this patient's bite. After 3 years, there are gaps between teeth, crowns with open margins, crowns that are breaking away, and discomfort on chewing. There are even teeth left unrestored. The patient was also unhappy with the esthetic result.

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

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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.

Cosmetic or Form Follows Function? Follow Up of a Full Mouth Bite Rehabilitation Case

November 6, 2010 alexnguyen

Ta da ! ! ! This full mouth rehabilitation case restored this patient's smile with a combination of crowns, bridges, and veneers.

The important principles include:

1. The patient's personal preferences

2. The scientific foundation of the human dentition

3. The art of modern porcelain materials and technique

Before:

After:

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

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What is a Sinus Lift for Dental Implant?

November 2, 2010 alexnguyen

Sometimes there is not enough bone in the areas of the upper molars and bicuspids because the sinus floor has a tendency to expand into the space after the teeth have been lost. In order to properly anchor the right implant length for strength, we need to recreate adequate bone height. With today's innovation in instrumentation and technique, we can predictably condense bone grafting material and lift the floor of the sinus to create room for the implant. After the healing period, the bone solidifies around the implant and the result is much more predictable than to use a short or mini implant.

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

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What do Veneer and Crown Temporaries look like?

October 16, 2010 alexnguyen

The temporaries are made to protect the underlying tooth structure as the final porcelain restorations are being fabricated in the ceramist's laboratory. Veneer and crown temporaries should look good. Finely made temporaries should have perfect marginal adaptation to the underlying teeth. The surface should be well polished to resist staining, since the material is simply an acrylic form. In our office we spend a significant amount of time on the temporaries because they should not affect the lifestyles and career demands of our patients. In other words, at the very least, no one should notice at conversational distance that your teeth are in temporaries.

Furthermore, well made temporaries will also allow the gum tissue to remain in perfect health. This clinical result will allow the dentist to ensure a perfect bond between the porcelain and the teeth at the final cementation process. If the gum is inflamed from improper fabrication of the temporaries, the end result may be compromised due to possible contamination of fluid and blood from bleeding gum around temporaries.

The term "temporaries" is misleading in a sense that they are only meant for short-term use. In fact, all details considered in the final restorations must be taken in to consideration with the ... "temporaries".

Here is a photo of a sample case of one of our patients, taken on the day she returns for her final porcelain restorations. Note that the four front teeth are bonded with acrylic temporaries.

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

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CT Scan and Dental Implant : High Standard of Care or Basic Requirement?

October 1, 2010 alexnguyen

In my practice, this "High Standard of Care" is a "Basic Requirement". Dental Implants have become the preferred standard of care when it comes to replacing missing teeth in the mouth. The advancement of technology has enabled dentists to accurately analyze the structure of the jaw and pre-plan for the implant work.

By using specialized software with images from a CT Scan of your dentition, I can analyze some important requirements which cannot be determined accurately with simple xrays alone:

1. Bone density

2. Bone thickness

3. Bone height

4. Proximity to nerve canals and the Sinus

5. Proximity to/ angulation of adjacent tooth root

With the above analysis, I can choose the right implant size before going into the surgery. The advanced treatment planning and analysis help prevent unexpected complications such as damage to vital nerves or impingement on the Sinus.

Here are some images of an analysis of a CT Scan for Dental Implants treatment:

One should never compromise a life-long restoration by choosing an implant treatment that has not been carefully planned out. This is particularly crucial in the esthetic zone such as your front teeth where lack of planning can produce an unfavorable esthetic result.

Thank you for viewing my post, and please let me know if you have any question.

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