What is a Hybrid Prosthesis in Implant Dentistry?

March 26, 2011 alexnguyen

Implant dentistry can really change people's lives. In cases where there have been significant amounts of bone and tissue loss, this type of restoration allows the patient to regain both the function and the look of a real dentition. Here is a rough outline of the process:

1. Before the treatment was executed, proper diagnostics were done with study models, X-rays, CT Scan, etc.

2. The implants were then placed, and allowed to integrate with the patient’s bone.

3. An accurate impression was done to capture the implant positions and was sent to the laboratory.

4. The lab then created a duplicate model of the patient’s arch (with the implants replicated exactly how they are in the mouth).

5. A Cad Cam scan was done to design a titanium framework for the prosthesis. See my blog entry dated Dec 4, 2010 about the Cad Cam technology for this same case.

6. The titanium bar is tried in the mouth on the actual implants to ensure accurate fit.

7. Teeth and gum colored materials are placed over the titanium bar.

8. The final prosthesis was placed precisely over the implants in the patient’s mouth. The entire prosthesis was held in placed by screws that fit into the implants. Openings at the screw access were filled with proper composite materials to blend in with the surrounding areas.

9. Proper contacts and functional guidance of the bite were checked and fine-tuned.

The patient once again has a full arch of teeth fixated to his/her arch to replace the missing teeth. This type of restoration takes away the pain and inefficient chewing problem for patients who maybe suffering from the lack of ability to simply … eat.

Case Photos:

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

The titanium bar on the stone model:

The prosthesis on the stone model. Note the access holes where the implants were positioned.

The final hybrid prosthesis in the mouth. Note all implant access holes were filled.

The patient's smile at completion of treatment.

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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.

Naturally Beautiful Smiles

March 5, 2011 alexnguyen

Occasionally I have the pleasure to invite some of my patients to do a photo shoot for ... fun ! Here are some samples of our latest collection of beautiful smiles. Whether it is a full mouth of restorative works or a few enhancements, I want the smiles to be simply beautiful and natural looking.

Thanks to Ivy, Alydia, and Saifon for allowing me to showcase your smiles.

My sincere appreciation to our stylist Jackie ( www.jolidejackie.com) and our photographer Paul (www.ferradasphotography.com).

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

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Can a Smile Makeover be Done in Two Visits?

February 14, 2011 alexnguyen

On December 19th, 2010 I posted a blog entry with a wonderful smile guide sent to me by a well-informed patient. Last Friday I delivered the porcelain restorations which completed his smile makeover process. I will still have to bring the patient back to fine tune and touch up some of the detail work. I could not have done the job in two simple visits like many advertisements claim to be able to do. The process cannot be done in two visits because a number of critical steps must be carried out:

- Diagnostic work-up of the case

- Laser contouring of the gum

- Equilibration of the bite

- Bonding of some of the teeth

- Preparation of the teeth for porcelain

- Working with the ceramist while the case is at the lab

- Tryin/delivery of the final restorations

Depending on what level of quality you are looking for, the process typically defines the end result.

Here is the feedback I received from the same patient today via email about his feelings regarding the end result of the case.

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From: S

Subject: teeth

Date: February 14, 2011 11:54:26 AM PST

To: Alex Nguyen

Hi Dr. Alex, just wanted to drop a quick note to express how happy I am with how my smile has turned out (the gums are much better and closer to normal now) The teeth are exactly what I wanted: shapes/edges are just as envisioned, and the whiteness and translucency couldn't be any more perfect. I noticed the very slight decalcification on the inciscor is exactly as I wanted. The bite feels solid and like my own teeth.

In short I can't stop myself from looking in the mirror and smiling :) Thanks for your hard work and attentional to detail. Looking forward to the fine-tuning and tweaking of the bicuspids and wrapping up the case.

See you soon

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Details in the Fabric - Fine Cosmetic Dentistry is All About the Details

January 24, 2011 alexnguyen

Whether you like the shape of your teeth to be more square or more rounded, the key to a life-like porcelain restoration is the details of translucency layering, internal color structure, and reflection of light on the surface texture. Visually, depth is perceived in the fabricated piece of porcelain when light penetrates the porcelain to the same degree that it will penetrate natural tooth structure. Like a painter's canvas, the smile is my fabric.

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

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What Brand or Type of Porcelain Should We Use for the Best Cosmetic Result?

January 15, 2011 alexnguyen

A recent new patient consultation this week has inspired me to write this blog entry... Sometimes I hear this question during my discussions with the patients. In reality, as a patient you should not have to worry about the "name" or "type" of porcelain. In fact, it is always the "technique" employed by the dentist that makes a difference in the outcome of a case.

In the photo below, three front teeth are marked with arrows. They look different from the rest of the restorations because our eyes can see dark areas on the teeth. In particular, the patient was most bothered by the tooth on the far right of the screen. This lateral incisor had an extremely dark tooth structure build-up underneath. When the same "type" of porcelain is used in a series of teeth, color differences of the underlying tooth structure will affect how the final restorations look.

In this case, proper technique can be used to mask out the dark underlying tooth structure in order to allow better color blend. This "technique" is a coordination between the dentist and the ceramist, and it is not a choice that the patient would have to make.

In order for your restorations to look natural, a number of factors must come into play. Those factors are not limited to just ... the porcelain.

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