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Aug 2015
30th
30th of August 2015

Dental implants- all ceramic crowns

As you will be aware, dental implants are the best way to replace missing teeth. Whether you are missing one, several or all of your teeth, dental implants can help. In the past, dental implant crowns (the actual tooth replacement) was a combination of a titanium abutment (screwed into the implant) and a porcelain fused to metal crown. This was fine and provided a perfectly good, robust result. However, for front teeth especially, the aesthetics of such restorations were possibly not great. Today, we are able to provide crowns with all ceramic fittings. This is usually with a zirconium abutment and an E max crown. We can now also use a screw retained all ceramic crown, which was previously not possible. Therefore there is no metal above the gum line; greater aesthetics and no chance of a black line at the gum level. If you would like the most aesthetic dental implant restoration for your missing tooth/ teeth, contact us- we will have the solution.


Aug 2015
22nd
22nd of August 2015

Dental Implants Replacing Missing Teeth

Are you missing teeth? One tooth? Several teeth? All missing teeth? If so we can help. Dr Nissit Patel has over ten years experience of placing and restoring dental implants using only the best systems available. Dental implants are the best way to replace missing teeth and finding the right dentist to provide the treatment is vital. If you would like to discuss dental implant treatment with Dr Nissit Patel please do not hesitate to contact us. Tel 0207 7311162 e info@progressivedentistry.co.uk

Tagged with:   Dental implants

Aug 2015
7th
7th of August 2015

Dental Implants - All on 4

Dental implants are widely recognised as the best alternative to natural teeth. Implants can be used for single, multiple or all missing teeth. In this article, we would like to discuss the treatment called All on 4, which is designed to replace all missing teeth. The concept is simple. If you are missing all of your teeth on the upper, lower or both jaws then 4 dental implants on the upper and lower jaws can act as the anchors to replace the missing teeth.

There is a great deal of planning involved and the treatment must be carefully thought through and planned to provide a natural, harmonious result which is functional and aesthetic. This will involve comprehensive analysis of the upper and / or lower jaws with CT scans to assess the bone quality, volume and relevant anatomical landmarks. The dental implants will be planned in accordance with your own anatomy. In most cases, we will aim to avoid bone grafting, sinus grafting or any other additional surgical procedure. This way, the treatment is as minimally invasive as possible. 

At Progressive Dentistry, we are able to provide All on 4 dental implant treatment with Dr Nissit Patel as the lead clinician. If you are interested in dental implants then please do not hesitate to contact us.


Jun 2015
9th
9th of June 2015

Short Term Orthodontic Treatment To Correct Upper Teeth

Our case of the month for June is a short term orthodontic treatment (STO) to correct the upper teeth. STO has become extremely popular as a cosmetic dental option due to the non-invasive approach and the speed of treatment. In the past, traditional cosmetic dental treatments involved cutting down the teeth for veneers or crowns. Orthodontic treatment would often take 18-24 months, However, although there is a still a place for these treatments, there are alternative options. Please take a look at our before and after photos:
 


Jun 2015
7th
7th of June 2015

The Process of Cosmetic Bonding

Our case study today is on cosmetic bonding. For those of you who are unaware of the process of cosmetic bonding, here is a recap:

1. It is a completely NON-invasive treatment for chipped, fractured, spaced and uneven teeth.

2. It is additive i.e we bond to the natural tooth surface.

3. There is no need for any drilling of the underlying tooth. 

4. There is no need for any needles or injections.

5. It is far more affordable than traditional treatments such as porcelain veneers.

6. It is easy to maintain.

7. It is reversible. 

Just take a look at our photographs:
 


May 2015
19th
19th of May 2015

Tooth Wear - Grinding Or Bruxism

Our case of the month for May is one involving tooth wear. Tooth wear is a very common problem caused buy a number of factors and usually a combination of them all. The most common cause is night time grinding or bruxism. This can be hugely damaging to teeth. Did you know that on average our teeth make contact for only about 10-20 minutes of the day. During night grinding, the average contact time is 4 hours! It does not take a rocket scientist to figure out this is far too much contact which will lead to loss of tooth enamel. Just take a look at our case:
 


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.


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:
 


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: