Mobile Menu
Close

News - Nothing but the tooth

{ Search results for "" }

Showing 9 of 493
May 2015
3rd
3rd of May 2015

Cement Retained Dental Implant Crowns

When restoring dental implants, the choice is screw retained or cement retained. Cement retained crowns will often be used when the screw access hole is not positioned down the long axis of the implant. There may be angulation issues or aesthetic issues that arise from this. Cement retained crowns may also be preferred by the patient due to the unaesthetic appearance of the access cavity for screw retained crowns, which often looks grey and discoloured if the underlying crown has a metal sub structure. Patients now often regard premolar and molar teeth as being in the aesthetic zone and are highly dental aware. Quite rightly, they expect dental implant crowns to look like natural teeth.
 

What Abutment Is Best for Cement Retained Crowns?

In my experience, Atlantis abutments are far superior to any other system. Think about how you would prepare a tooth for a crown and amplify the precision ten fold. With the digital age we live in, technology should be used to enhance the outcomes for our patients. This is one system that certainly does that. There are also other scanning centres which produce excellent abutments. It is worth talking with your dental implant technician and using a few systems. Of course, there is a cost implication involved and Atlantis may not be suitable for all.
 

How To Fit The Cement Retained Crown

When fitting cement retained crowns it is imperative that excess cement does not exude the margins and act as a plaque trap. This is one the main causes of Peri-implantitis and is avoidable. 

There is an excellent technique which will help you to avoid any issues with excess cement: 

1. Once you have verified the margins, occlusion, contacts, embrasure space and aesthetics you are ready to cement the crown. 

2. Use your PVS bite registration material and insert within the crown creating a tag at the end to act as a handle. 

3. Remove this index. 

4. Mix the cement, which is usually a temporary cement (Tempbond NE) or a dedicated implant cement and place within the crown. Do not overfill. Make sure the abutment screw is covered. I use pre sterilised cotton wool. 

5. Insert the index into the crown to remove the excess. This will leave a very fine layer of cement. 

6. Place the crown and wait for setting. There should be no excess at the margins.

7. Perform the usual checks and take a PA radiograph to verify. There should be no exudate whatsoever. 

8. A useful tip for removing any fine smears of Tempbond on the crown is orange solvent. Spray some onto a ball of cotton wool and clean any fine residue. 

9. Review as required.
 

How To Remove Cement Retained Implant Crowns

There are times when implant crowns will need to be removed. For example, if the abutment screw loosens. This is why temporary cements are used. In my experience, cement retained crowns can be removed with minimal fuss. However, you must pre warn the patient that some force is required. I would over emphasise this fact. To avoid damage to the porcelain, use rubber coated crown removing pliers. GC have an excellent one. Grip the crown firmly and exert pressure in a bucco-lingual direction initially and then rotational. The crown should ease off within a few seconds.
 

How To Maintain Dental Implant Crowns

Dental implant crowns, screw or cement retained, require maintenance just as natural teeth. However, your hygienist must be trained in this field. Regular scalers, hand or ultrasonic, should not be used for fear of scratching the titanium. Satelec have introduced some excellent ultrasonic tips for implants. We have invested in these with great success. Specific implant hand scalers can also be used. We are also keen on adjunctive methods of cleaning such as Philips Airfloss.
 

Feedback

Article for dentists written by Dr Nissit Patel. 

I hope this article has been of use. It comes from many years of experience of placing implant crowns, cement and screw retained. I welcome any feedback that you may have, please e-mail me: nissit@progressivedentistry.co.uk 

My next article will focus on screw retained crowns.


Apr 2015
8th
8th of April 2015

Fixed Metal Brace Smile Makeover

Our case of the month for April is an unbelievable smile makeover using a fixed metal brace. Our patient wanted to be able to smile for her wedding photographs and we were given a time span of just 8 months! Now the level of tooth crowding was quite severe and we were unsure whether the treatment could be completed in time. However, we did not need to worry. The treatment was complete ahead of schedule. We used high tec metal brackets which have minimal friction and allow quick alignment of rotated, crooked, displaced teeth. Just take a look at the before and after photos:
 


Mar 2015
21st
21st of March 2015

Almost There! Shortlisted For Best Aesthetic Practice South & More Award News

We were recently shortlisted for the Best Aesthetic Practice South by the Aesthetic Dentistry awards, which was a fantastic achievement. The awards were held last night in central London. Unfortunately we did not win the title but to make the final was a real honour. Dr Veehar Malde also made the shortlist for the Best Case Full Mouth, which was a great achievement considering the level of expertise on show. His case was an amazing smile transformation and had a profound effect on the patient.

Dr Nissit Patel has also been shortlisted for the Best Dentist South awards by the Dental Awards, which is due to be held in April. Fingers crossed!


Mar 2015
13th
13th of March 2015

A Fantastic Smile Transformation Using ABC

Our case of the month for March 2015 is a fantastic smile transformation using ABC. What is ABC? Simple: 1. A is for ALIGNMENT. The teeth are straightened using one of our adult orthodontic techniques. 2. B is for BLEACHING. Whitening is carried out using a take home kit or our new Philips Zoom LED in chair whitening. 3. C is for COSMETIC BONDING. Any chipped, uneven, rough edges can be restored with our tooth like adhesive bonding techniques. ABC is the non invasive smile makeover. There is no need for drilling away of healthy tooth enamel, no need for injections and there is no pain. What could be better? Take a look for yourself:
 


Mar 2015
9th
9th of March 2015

Progressive Dentistry Achieves Third Award Nomination!

Following on from our two nominations at the Aesthetic Dentistry Awards for Best Aesthetic Practice South and Best Full Mouth case (Dr Veehar Malde), Progressive Dentistry have just learned about another nomination. Dr Nissit Patel has been shortlisted for Best Dentist South at the Dental Awards. The Dental awards are the longest running in the dental profession and to be shortlisted into the final for such a vast category is a huge achievement. The Aesthetic Dentistry Awards take place on the 20th March 2015 and the Dental Awards on 17th April 2015. We will keep you posted! In the meantime go to our awards page to see all the awards we have won to date.


Mar 2015
3rd
3rd of March 2015

Continual Professional Development - CPD

We strongly believe in continual professional development or CPD for short. The developments in dentistry are moving at a rapid rate and it is vital to keep up to date with the these advancements. On Friday, Dr Nissit Patel and Paula Ryan will be attending a core CPD meeting in Kensington. This will address important issues such as oral cancer, dental radiology, medical emergencies, decontamination and cross infection. As a practice, we are committed to being at the forefront of dental care. We undertake hundreds of hours of CPD per year, above and beyond the minimum requirements.


Feb 2015
25th
25th of February 2015

Dental Implant To Restore Missing Back Teeth

Our case of the month for February is a dental implant case to restore missing back teeth. Dental implants are used to replace missing teeth to restore function, aesthetics and prevent further problems of shrinkage and teeth movement. In our case of the month, our patient had lost some back teeth and there was a baby tooth remaining which was about to fall out. This severely impacted on her eating and everyday function. Dental implants were the best way to replace the missing teeth with a fixed and secure final end result. Here are some before photographs:
 


Feb 2015
23rd
23rd of February 2015

Advice After Fitting Your Dental Braces

After fitting your orthodontic appliance (brace), it is important to follow some simple but important instructions. We have also provided some useful information and advice regarding after care.
 

TOOTHBRUSHING AND ORAL HYGIENE

Oral hygiene is critical to the success of treatment. Please brush normally 2-3 times a day using a manual or electric toothbrush. It will be very difficult to floss your teeth but interdental brushes can still be used, which are very effective. The use of a mouthwash is advised on a regular basis, ideally containing fluoride. The latest developments in interdental hygiene include devices such as the Airfloss by Philips and Waterpik units. These are excellent adjunctive techniques and highly recommended for the hard to reach areas. They use a combination of pressure, air and water (or mouthwash) to flush debris away from the contact areas of the teeth.
 

PREVENTING TOOTH DECAY

Adhering to a sound oral hygiene regime coupled with the use of fluoride toothpaste and mouthwash will generally prevent any decay around the brace. However, you should also carefully monitor sugar intake throughout the day. High frequency of sugar throughout the day will increase the risk of tooth decay considerably especially when wearing braces. Now is the time to really cut down on those sugary snacks and drinks! We strongly advise using MI plus paste by GC. This is excellent at reversing early decay within the tooth enamel and will help to prevent decay or dimineralisation around the orthodontic brackets. Simply rub a small amount of the paste around the brace with your finger and tongue and discard the excess. Then leave overnight, do NOT rinse with water or mouthwash afterwards.
 

EATING 

It is important to adopt a soft diet for the first few weeks. This is especially important with lingual braces. Foods to avoid are:
 

  • Hard crunchy foods such as crusty bread
  • Sticky foods such as toffees
  • Chewy meats
  • Unpitted olives and stone fruits


If you have a tooth coloured brace, please avoid staining foods which could discolour the temporary elastics. These include:
 

  • Curries
  • Rich tomato based sauces with oil
  • Beetroot
  • Effervescent table drinks such as vitamin supplements and Berroca

 

LIP OR TONGUE IRRITATION

Braces can cause irritation to the tongue or lip after fitting. This will settle once you have become accustomed to the appliance. In the meantime, orthodontic wax or putty placed over the brackets can help to provide some temporary relief. We will provide this for you.
 

PAIN RELIEF

Due to the modern technology, there is much reduced pain compared to systems of the past. However, there may be some intermittent pain. Regular pain relief such as paracetamol, ibuprofen or a combination of both should be effective. If there is prolonged severe pain, please contact us. Of course, the most important aspect is that dental braces are temporary! Time will fly by and your teeth will be straight before you know it!


Feb 2015
13th
13th of February 2015

Dental Dam! Does Your Dentist Use One

What is dental dam? Dental dam is essentially a drape for your teeth. It provides total isolation for the tooth or teeth in question. Thus it will keep the lip, cheeks, tongue and saliva away from the working field. This is vital in modern day dentistry where most treatment relies on adhesive bonding of some form. A dry field is crucial.

Dental dam is also essential for root canal treatment. Powerful irrigants are used to clean the canal which contain sodium hypochoride and EDTA. It is not pleasant if these are accidentally swallowed! Dental dam will protect the oral cavity from these substances and prevent the ingress of oral fluids into the root canal thus increasing the success rate of the treatment. So if your dentist is not using dental dam, ask them why not. 

For modern day dentistry, it is essential.
 

Tagged with:   Rubber dam Rubber dam dentistry