Restorative Dentistry & Endodontics

Specialities

Introduction

Endodontics is a dental specialty concerned with the study and treatment of the dental pulp. Endodontic study and practice encompasses the basic clinical sciences, including biology of the normal pulp, and etiology, diagnosis prevention, and treatment of diseases and injuries of the pulp and associated periradicular tissues.
Endodontists perform a variety of procedures including endodontic therapy (commonly known as “root canal therapy”), endodontic retreatment, surgery, treating cracked teeth, and treating dental trauma. Root canal therapy is one of the most common procedures. If the dental pulp becomes diseased or injured, endodontic treatment is required to save the tooth.

 

Dentures

Dentures make life easier every day. While you may miss your natural teeth, dentures make it possible for you to eat well, improve your appearance, fill gaps where natural teeth are missing and support your facial muscles so you maintain your appearance. Dentures require special care, however, and so does the rest of your mouth. Daily cleaning and regular dental visits are just as important now that you are a denture wearer as they were before you got your dentures.

Regular denture cleaning

Each day before you put your dentures in, use a brush with soft bristles to brush your remaining natural teeth, as well as your gums and your tongue. This will remove plaque that builds up overnight that can lead to gum disease. Pay special attention to any teeth that fit underneath the denture’s metal clasp, because bacteria trapped between the metal and your tooth can cause tooth decay.

Your dentures also need to be cleaned on a daily basis, after meals, and when you remove them for the night. Cleaning them will remove food particles and plaque, prevent them from becoming stained, and keep them tasting and smelling fresh when you put them in your mouth.

Your dentist will tell you the best kind of brushes and toothpaste or cleaning solutions to keep your dentures clean. Hand soap and mild dishwashing liquid are acceptable for use. Don’t use toothpastes that contain abrasive cleaners because they may scratch and weaken the denture.

 

Keeping dentures in good repair

Dentures are durable enough to stand up to chewing and biting, but fragile when they are out of your mouth. Dropping them or throwing them down on a sink or counter can break a tooth or part of the denture base. When your denture teeth are front teeth, avoid biting down directly on crunchy or hard foods, like hard pretzels, crusty bread, or even oversized sandwiches. They can all cause a denture to break because of the angle where your denture tooth meets the hard surface. Be careful when biting into whole apples with your dentures as well; cut them into wedges instead. If your denture cracks or breaks, or if your denture tooth is chipped or loose, call the dentist immediately. Dentures can usually be repaired quickly, even the same day, but do not continue to use a damaged denture without letting your dentist see it.

Dentures overnight

Take your dentures out at night and place them in a container of water or a solution designed to clean dentures while they soak. Dentures that dry out can become brittle and may also change shape. Ask your dentist for a container that will conceal your dentures while they soak, so your dentures won’t sit out in plain view, but make sure that the container is labeled or placed in a safe place, especially if you are visiting someone or have visitors at your home. Never place a denture in boiling water or the microwave oven. If your denture has metal clasps, ask your dentist whether soaking will tarnish them. If so, your dentist will recommend an alternative method of overnight storage.

Dentures and durability

While dentures are durable, they won’t last forever. With many years of use, dentures may lose their natural appearance and become worn, and will not function as well as they did when they were new. Stains will likely occur over time, and even the fit may become loose or uncomfortable as your mouth changes. Your dentist will be able to advise you on whether changes to your dentures are cosmetic or have an impact on your oral health and hygiene.

Mouth Reconstruction

Full Mouth Reconstruction is the process of restoring or rebuilding all or most of the teeth on both the upper and lower jaws. Some people opt for this simply for cosmetic purposes, but often its necessity stems from a true medical problem, such as:

  • Persistent jaw, muscle and headache pain caused by an irregular bite
  • Teeth severely worn down by long-term tooth grinding or acid erosion
  • Injured or fractured teeth
  • Missing teeth due to trauma or decay

In these situations, you should get a comprehensive exam to determine the extent of the damage and the discount treatment options that are available to you.

Your dentures also need to be cleaned on a daily basis, after meals, and when you remove them for the night. Cleaning them will remove food particles and plaque, prevent them from becoming stained, and keep them tasting and smelling fresh when you put them in your mouth.

We will suggest the best kind of brushes and toothpaste or cleaning solutions to keep your dentures clean. Hand soap and mild dishwashing liquid are acceptable for use. Don’t use toothpastes that contain abrasive cleaners because they may scratch and weaken the denture mouth reconstruction in muscat.

Common procedures

This drastic treatment often involves a combination of both cosmetic dentistry and restorative procedures.

Dentures overnight

  • Implants require two surgeries to permanently replace individual teeth. In the first surgery, we makes gum incisions and drills titanium rods into your jawbone where you are missing teeth. Any openings are sealed with stitches, and often a temporary bridge or denture is placed over the gaps. After several months, your bone will fuse with the metal rods, and then we can attach prosthetic teeth.
  • Bridges replace missing teeth by attaching crowns to the teeth on either side of the gap, connected by a false tooth in the center. Bridges can be made from ceramic, metal or plastic.
  • Crowns attach to damaged teeth to restore their shape and protect them from further harm. Parts of your original tooth may be removed to better accommodate the crown. The most common varieties are made of ceramic, metal or a mixture of the two. Some people find that they get a better discount with the inexpensive metal version.
  • Fillings protect your pearly whites that have cavities from further damage. The removed cavity creates space, which is filled with either a composite or a metal amalgam component.

Dental crowns

Dental crowns (“tooth caps”) are one of dentistry’s most versatile restorations. Beyond just offering a way to rebuild and strengthen damaged or compromised teeth, they also provide a way by which a tooth’s overall appearance (color, shape and even apparent alignment) can be vastly improved.

While reading our pages, you’ll learn about the different types of crowns (ceramic, porcelain-fused-to-metal, and all-metal/gold) and when each of these types might make the best choice. We also describe the steps a dentist follows when they make a crown for a patient, as well as how much you can expect your crown to cost and how long it may possibly last.

We also cover issues such as alternative restorations, how crowns differ from porcelain veneers and common crown-related problems, including what to do if you have one come off.

A crown is a type of dental restoration that, when cemented into place, fully cups over that portion of a tooth that lies at and above the gum line. Since it encases the entire visible aspect of a tooth, a dental crown, in effect, becomes the tooth’s new outer surface.
In comparison, dental fillings are restorations that fill in or patch just a portion of a tooth. Other terms that are used to refer to crowns are “dental caps” and “tooth caps.”

It’s not too hard to envision how a dental crown might be used to restore, or even improve, a tooth’s shape. When a crown is cemented into place, it becomes, in essence, the tooth’s new outer shell. And although they must stay within certain guidelines, it’s easy to seen. how placing a crown gives a dentist great control in defining the overall shape of a tooth.

Porcelain-Fused-to-Metal crowns

Porcelain-fused-to-metal crowns provide for a strong, durable, and esthetic treatment option. One of the key factors for the esthetic and functional success of this type of crown is ensuring the preparation of the underlying tooth structure provides adequate space for the appropriate thickness of the material selected. Additionally, the artistic skill of the laboratory technologist creating the crown will determine its esthetic appeal.
One consideration in the porcelain-fused-to-metal crown is that these crowns may tend to show the underlying metal or gold margin at the gum line as gums recede over time. Some patients opt for this type of crown, but replace the crown at a later date in order to maintain a higher esthetic benefit. Porcelain-fused-to-metal crowns with an all porcelain collar can eliminate this vulnerability.

All-Ceramic crowns (Procera, Cercon, and IPS Empress System)

The predominant material choice for all-ceramic crowns today is either zirconia, or aluminous materials. They provide a metal-free esthetic option with a number of benefits. By eliminating the need for the supportive metal core, an esthetic all-ceramic crown can be created with a reduced thickness of material. This makes them a more favorable treatment choice in areas with limited space. Additionally, the elimination of the metal core allows for light transmission through the porcelain for better optical, life-like properties and a higher level of esthetics. All-ceramic materials continue to evolve in strength and durability, but caution should still be exercised for areas of the mouth requiring heavy function. Continuing research is exploring the significant vulnerabilities of the porcelain systems in such areas.

Gold crowns

Although not as popular a treatment choice for esthetic reasons, gold crowns are still indicated in some instances. For example, patients with strong bites and those with parafunctional habits (such as grinding or clenching) might be better served with gold crown. The traditional restorative material can provide stronger support to the remaining healthy tooth structure. Gold crowns offer a level of durability that is appropriate for teeth located in the back of the mouth (such as the molars), where they will not be highly visible. Gold crowns tend to offer greater longevity and require less preparation than porcelain and porcelain-fused-to-metal crowns. When chewing, gold tends to be less abrasive to the opposing tooth than porcelain. This helps to prevent wearing of the teeth.

Dental Bridges

One or more missing teeth can adversely affect the appearance and functionality of your smile. Missing teeth can cause a change in occlusion (bite), shifting of the teeth, temporomandibular joint disorder (TMJ), speech impediments, an increased risk for periodontal disease and a greater chance of tooth decay.

Dental bridges, like implants and partial dentures, are used to replace missing teeth. There are several types of fixed dental bridges (cannot be removed), including conventional fixed bridges, cantilever bridges and resin-bonded bridges.

Typically, conventional and cantilever bridges require shaping of the teeth surrounding a missing tooth. Crowns are then placed on the shaped teeth and attached to an artificial tooth (called a pontic).A resin-bonded bridge requires less preparation of adjacent teeth. It is often used to replace front teeth, provided that the gums are healthy and the surrounding teeth do not have extensive dental fillings.

Your dentist will tell you the best kind of brushes and toothpaste or cleaning solutions to keep your dentures clean. Hand soap and mild dishwashing liquid are acceptable for use. Don’t use toothpastes that contain abrasive cleaners because they may scratch and weaken the denture.

The dental bridge procedure

During the first visit, we examine the health of your gums and other teeth to evaluate if you are a candidate for a dental bridge. You are given a local anesthetic so we can prepare the teeth required to support the bridge. If the support teeth are decayed or badly broken down, we may have to build them back up before they can be used as support teeth for a bridge.

Next, we take an impression of the prepared teeth with a putty-like material that is used to create a model of your teeth. Your bridge is fabricated based on this model by a skilled lab technician so that it precisely fits the prepared teeth. It is important that your restoration fit perfectly to avoid additional oral health problems such as tooth decay.

While your bridge is being fabricated, we fit you with a temporary bridge so the teeth and gums can be protected from damage until your permanent bridge is ready. To complete the dental bridge procedure, you must return to the dental office for a second visit to have the bridge fitted and cemented.

Dental Implants

Dental implants are artificial tooth roots used to support a restoration for a missing tooth or teeth, helping to stop or prevent jaw bone loss. The dental implant procedure is categorized as a form of prosthetic (artificial replacement) dentistry, but also is considered a form of cosmetic dentistry.

People who have lost teeth might feel too self-conscious to smile or talk. Additionally, biting irregularities caused by tooth loss can have a negative effect on eating habits, leading to secondary health problems like malnutrition.

By replacing missing tooth roots, dental implants provide people with the strength and stability required to eat all the foods they love, without struggling to chew. Additionally, dental implants stimulate and maintain jaw bone, preventing bone loss and helping to maintain facial features.

Dental implant placement procedure

 

Today’s dental implant restorations are virtually indistinguishable from other teeth. This appearance is aided in part by the structural and functional connection between the dental implant and the living bone. Implants are typically placed in a single sitting but require a period of osseointegration.

Osseointegration is the process by which the dental implant anchors to the jaw bone. Osseointegrated implants are the most commonly used and successful type of dental implant. An osseointegrated implant takes anywhere from three to six months to anchor and heal, at which point your dentist can complete the procedure by placing a crown restoration. If osseointegration does not occur, the implant will fail.

Dental implantation, which is performed to replace missing teeth, can be done any time after adolescence or when bone growth is complete. Certain medical conditions, such as active diabetes, cancer or periodontal disease, may require additional treatment before the implant procedure can be performed.

Detailed procedural steps are as follows:

Preparing the jaw for implantation:

A dental implant restoration is commonly composed of a titanium material screw and a crown. A small-diameter hole (pilot hole) is drilled at edentulous (where there is no tooth) jaw sites in order to guide the titanium screw that holds a dental implant in place. To avoid damaging vital jaw and face structures like the inferior alveolar nerve in the mandible (lower jaw), a dentist must use great skill and expertise when boring the pilot hole and sizing the jaw bone. In many instances dentists use surgical guides created based on the CT scans when placing the dental implants.

Placement of the implant:

After the initial pilot hole has been drilled into the appropriate jaw site, it is slowly widened to allow placement of the implant screw. Once in place, surrounding gum tissue is secured over the implant and a protective cover screw is placed on top to allow the site to heal and osseointegration to occur. After up to six months of healing, your dentist will uncover the implant and attach an abutment (which holds the crown or tooth-like replacement) to the implant. In some cases, the abutment may be attached during the initial procedure. When the abutment is in place, your dentist then will create a temporary crown. The temporary crown serves as a template around which the gum grows and shapes itself in a natural way. The process is completed when the temporary crown is replaced with a permanent crown.

Root Canal Treatment

A person’s teeth are meant to last a lifetime. If the teeth have been exposed to a disease or a trauma the dentist may recommend a Root Canal Treatment as an option to save the tooth. The best to save oneself from the trauma is early diagnosis. Most patients that come to us come when the issue is in its severity stage. This however is preventive with yearly dental checks.

At Wassan Dental, our Specialist Endodontists ensure high quality treatments to our patients. Advances in technology, the use of microscopes and other high-tech instruments, have meant that processes in the field of Endodontics have changed enormously over the recent years. Nowadays, Root canals have more than 92% success rate. In most cases it is completely painless and generally comfortable for the patient.

To explain further a root canal treatment is a routine dental procedure needed when the blood or nerve supply of the tooth (known as the pulp) is infected through decay or injury. You may not feel any pain in the early stages of the infection. In some cases, your tooth could darken in colour, which may mean that the nerve of the tooth has died (or is dying). The symptoms can range from a dull ache to severe pain and the tooth may be tender when you bite. This would need root canal treatment.

The aim of the treatment is to remove all infection from the root canal. The root is then cleaned and filled to prevent any further infection. With dental advances and local anesthetics, most people have little if any pain with a root canal. In fact, it’s probably more painful living with a decayed tooth. As a dead tooth is more brittle, it is usually necessary to restore the tooth with a crown to provide extra support and strength to the tooth after the root canal is completed.

Root canal treatment is a skilled and time-consuming procedure. Most of treatment will involve two or more visits to your dentist. Our doctors and staff are determined to ensure a warm and friendly Endodontic experience.
How is a root canal treatment done?

1. The dentist gives you a local anesthetic (freezing).
2. To protect your tooth from bacteria in your saliva during the treatment, the dentist places a rubber dam around the tooth being treated.
3. The dentist makes an opening in the tooth to reach the root canal system and the damaged pulp.
4. Using very fine dental instruments, the dentist removes the pulp by cleaning and enlarging the root canal system.
5. After the canal has been cleaned, the dentist fills and seals the canal.
6. The opening of the tooth is then sealed with either a temporary or permanent filling.