Tag Archive for: crowns

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How Dental Implants Work

There has been a lot of dental surgery going on around here. The information I collected at the AAID seminar has been put to good use!

If you are new to the entire dental implant procedure, the next few posts will be helpful for you to read. Every implant surgery is unique to the individual receiving it; every case is different. Dental implants require more than drilling a hole in your mouth and sticking an artificial tooth in that hole. (Ugh, that sounds like cruel torture stated so bluntly!) That is basically what dental implantation is; however, because we are not cavemen and have all kinds of brilliant technology and intelligent doctors* handling your oral ailments, you can be assured that such a surgery will be done with the utmost care and precision with long-term sustainability in mind.

Let’s say, in a “simple” case, a tooth has been extracted, lost, or missing for years. There is no tooth — or no healthy tooth — and the doctor determines that an implant is needed. After several careful measurements; x-rays; sizes; ways, shapes, and forms are recorded, the drilling begins. Don’t worry; you’d be under anesthesia. The place for the tooth in your jawbone or facial bones, depending on where the tooth is going, is drilled into and prepared for the implant base that will be twisted, screwed in, and anchored.

Side note: I have mentioned one-piece implants here before, but I will not bring that up just yet. Just imagine for a second that we’re using typical, two-piece implants.

After the base is screwed in nice and tight, the second piece is anchored onto it. This second piece is what the crown of the artificial tooth will fit onto. When the below-the-surface hardware has healed and integrated into the surrounding bone with no complications, the crown is installed. The crown, by now, has been formulated by the doctor after more measurements and math. In my holistic practice, it would be important for me to be sure this new tooth isn’t just some standard tooth that looks good alongside the others. This tooth must fit into the body’s naturally designed chewing system so that it does not interfere in any way with other teeth or the whole jaw. If it were to interfere, it could break, cause other teeth to wear down or break, or change how you chew in a way that might be detrimental to your jaw joints. I’ll go on about this later.

So finally, that crown is inserted and anchored into the implant site, allowed to heal, and there you have it: a brand-new tooth.

This is a problem-free version. Questions patients might have include:

What about if there is not enough bone to drill into?

What if multiple teeth in a row need to be adjusted?

How long does the entire process take?

Does it even look good afterwards?

I’m terrified of this procedure, but if I let my condition worsen, I will be infected and in pain the rest of my life. Which poison do I choose?

Oh, we’ll go over it all. Thanks for reading!

Dr. Boyajian, West Los Angeles

 

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Cosmetic Dentistry That Lasts

Cosmetic dentistry is the artsy part of dentistry — where we get to give your teeth makeovers. But cosmetic dentistry is more than just making your teeth look good on the outside. The beauty must go further than skin deep (er… enamel-deep…?). What if a crown or restoration conflicts with the way the opposing teeth bite against it? That seems like an obvious problem, but if you are not aware of how much a tiny adjustment can impact your entire jaw/head, then it is, in fact, an issue that must be approached with special care and consideration.

In most cases, though, it will be the restoration that shows signs of deterioration first. Cracking, chipping, even falling off altogether… and this may harm whatever natural tooth or tissues are bonded to this restoration. Pankey takes great care in training its dentists to take careful measures to ensure cosmetic improvements will also be functional and long-lasting. A little extra time and effort may go into forming a nicely fitted restoration, but the longterm benefits outweigh the initial installation process.

Perfectly colored or straight-looking teeth are only the tip of the iceberg!

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

CEREC Dentistry: Crowns

Using the CEREC unit, a crown is first made by the CAD/CAM (computer-assisted design/computer-assisted manufacture) digitally recording an image of the tooth. Calculations are processed, and the computer designs, then mills a crown perfectly suited to the shape of the tooth. The crown is then bonded on, and, voila! The patient’s visit is complete.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

CEREC Inlays + CEREC Partial Crowns

One of the greatest perks that comes with CEREC technology is the speed at which we can formulate restorations. In comparison to barely twenty years ago, forming a crown or veneer required a painful series of several dental visits. There were molds to be made, pictures to be photographed, temporary crowns to be endured, a perfectly fitted restoration to be slowly developed in a lab, and bonding to be done. CEREC accomplishes all of this in a single visit, in just a few hours!

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

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CEREC One-Visit Holistic Dentistry

CEREC is a state-of-the-art system that allows full restorations of one or more teeth to be made in a single visit to the dentist’s office. Whether it is a crown, inlay, onlay, filling, or veneer, the CAD/CAM technology the CEREC unit uses will design and produce a perfect restoration of the damaged tooth. The replacement material looks like, feels like, and is strong as a real tooth; biocompatibility and aesthetics are well-maintained; and further damage to the tooth is eliminated.

Do you have a need for a crown, or have large cavities? Have you had trouble with previous “restorations”? Do they look awful or keep on falling apart? Look into CEREC dentistry. There’s no better option!

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

Surfing Adventures

In Hawaii, our vacation home host works at a surfboard manufacturing shop. I was curious about the trade, so I took my son and daughter-in-law inside the shop to see if we could get a glimpse of the behind-the-scenes (rather, behind the rows and rows of colorful boards found in shops on every corner on the North Shore!) process of surfboard making. May as well since we were already there! Though many people surf in Los Angeles, I think it would be harder to just walk in the back door of a random surfboard place and “demand” a tour.

The white (often colored) boards we usually see are made out of polyurethane or polystyrene foam. Balsa and other light woods are also commonly used, only they are much more expensive than the foam boards. The shape and size of the board is sanded down to resemble what looks exactly like a surfboard carved out of fancy styrofoam or wood. Much care is taken in measuring the shapes, sizes, and weights of the boards. Then layers of fiberglass, cloth, paint (for designs), and resins are applied to form the complete product. We saw some beautiful boards, including a custom-made decorative one made out of several different hardwoods.

Being a dentist, I couldn’t help but compare the similarities in this process, and the restoration process used in CEREC system, which I have and definitely use. When a tooth needs restoration, the CEREC system records a digital image of the tooth’s structure, and within a matter of hours, carves out a perfect crown/filling out of a small block of ceramic inside a special machine (many demonstrations of this were held at the ADA Session). The faulty tooth is sanded down ever so slightly, and then, after some refining, fitting, and adjusting of the occlusion, the crown/filling is bonded or cemented right where it needs to be, fitting perfectly with the other teeth. It’s quite amazing.

Aloha!

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

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Cosmetic and Aesthetic Dental Services

Cosmetic dentistry is different from bioesthetic dentistry, even though some aspects of each are similar (improvement of looks, for example). Bioesthetics concentrates on foundational anatomy of your mouth, with good looks and comfort resulting from treatment, while cosmetics is primarily beautifying the outward appearance of your teeth. Here are the most commonly practiced procedures of cosmetic dentistry: teeth whitening, bonded white fillings (I do not use mercury in any of my dentistry, and we are a mercury-safe office), veneers, porcelain crowns, and dental implants. I will go over each of these in more detail soon.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

What Makes a Good Dental Restoration?

After we have completed the full exam, a lot of patients are ready to proceed with restorative work. There are a variety of restorations that we do in our practice. These include different types of tooth-colored fillings, bondings, veneers, crowns, bridges, implants and dentures.

The key to a successful restoration is ensuring that whatever is done fits in and supports the overall oral system. On the larger level, this requires proper understanding of function, speech, bite, hygiene and so on and on the more detailed level, precision and attention to detail is key.

Restorative procedures in my office typically last thirty minutes for a single filling to ninety minutes for a crown to three hours for restoring a larger section. The reason they are so time consuming is because I pay a lot of attention to detail in order to ensure the best chance of long-term use and comfort of the finished product.

For example, when I do a filling or crown preparation, I use multiple caries detection techniques. One is caries detector which is 95% accurate in identifying diseased remnants of the cavity. Another is the Diagnodent, a light sensor that detects the off gas put out by bacteria. The third method is the halogen light which raises the visibility of the caries. Combined use of these three tools allows for exceptional precision and success in removing the disease from the site being worked on. When this is done, I am ready to proceed with the actual restoration.

For fillings,  I use the latest generation of sealers and desensitizers which help to virtually eliminate sensitivity by blocking the tubules where the nerves reside and sealing them closed. Next I place the primer which is essentially a very thin filling below the filling. This is an important step because that is the first line of defense to protect against new cavities. After the primer we put in the solid filling material in stages in layers to ensure proper curing. Finally, we are ready for the tooth-colored top coat, which we customize to the natural teeth colorings surrounding and shape to accurately work with the natural bite process.

When the restoration is too large to be completed with a filling, I typically proceed with some type of crown restoration.  I use a Cerec machine to custom mill the restoration. I have chosen this method because it allows for the most conservative type of restoration and the most accurate fit, not to mention that, in most cases, you have your permanent crown the same day, eliminating the need for a second visit.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com