Posts for category: Dental Procedures

By Fennell Baron & Associates
February 11, 2019
Category: Dental Procedures
Tags: dental treatment  
TreatingaYoungPermanentToothRequiresaDifferentApproach

Soon after the primary (baby) teeth begin to give way, the teeth a child will have the rest of their lives start erupting into the mouth. But while they’re permanent, they’re not as strong and developed as they will be in adulthood.

That’s why we treat young permanent teeth differently from older adult teeth. For example, a decayed adult tooth may need a root canal treatment; but this standard treatment would often be the wrong choice for a child’s tooth.

The reason why involves the pulp, the innermost layer of a tooth, which plays a critical role in early development. Young permanent teeth continue to grow in sync with the jaws and facial structure. Most of this growth is in the dentin, the layer between the enamel and pulp, which increases proportionally to the other layers as the tooth matures. The pulp generates this new dentin.

A root canal treatment completely removes the diseased tissue of the pulp. This isn’t a major issue for a mature tooth because it no longer needs to generate more dentin. But it can have long-term consequences for an immature tooth whose growth may become stunted and the roots not fully formed. The tooth may thus become brittle and darkened, and might eventually require removal.

Because of these potential consequences, a root canal treatment is a last resort for a young permanent tooth. But there are modified alternatives, depending on the degree of pulp exposure or infection. For example, if the pulp is intact, we may be able to remove as much soft decayed dentin as we can, place an antibacterial agent and then fill the tooth to seal it without disturbing the pulp. If the pulp is partially affected, we can remove that part and place substances that encourage dentin growth and repair.

Our main goal is to treat a young tooth with as little contact with the pulp as possible, so as not to diminish its capacity to generate new dentin. Avoiding a full root canal treatment if at all possible by using these and other techniques will help ensure the tooth continues to develop to full maturity.

If you would like more information on dental care for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Saving New Permanent Teeth after Injury.”

By Fennell Baron & Associates
February 06, 2019
Category: Dental Procedures
WemayNeedtoBuilduptheBoneinYourJawbeforeImplants

Dental implant technology has advanced at such an astounding rate in recent years that you can now walk into a dentist's office with a problem tooth and out the same day with a new one. Unfortunately, not all dental situations allow for this possibility.

For example, you might be considering an implant many years after losing a tooth. But there's a potential problem: there might not be enough supporting bone. While an implant might still be possible, inadequate bone complicates the matter.

Because implants are essentially tooth root replacements, they require a certain amount of bone for stability and the best attractive outcome. As a general rule, implants need to be surrounded by  at least 1.5-2.0 millimeters of healthy bone to support an implant. But you might not have enough if your tooth has been missing for awhile, regardless if you have or haven't worn dentures or other restorations.

That's because bone has a life cycle in which older cells die and newer ones form to take their place. As we chew or bite, the force generated travels up through the teeth to the bone to stimulate this new growth. Without a tooth the bone doesn't receive this stimulus, which can slow the growth rate. Over time the affected bone can lose its volume and density.

If we find you've experienced loss to the point your bone won't support an implant, that doesn't automatically mean this popular restoration is out of the picture. But it will require us first performing a procedure known as augmentation or bone grafting to help rejuvenate some of the lost bone.

With grafting, we place processed bone grafting material in the jaw through a minor surgical procedure to form a scaffold for new bone to grow upon. After several months this can result in several millimeters of new growth maintaining the width of the underlying bone, which in turn may be able to support an implant.

Bone grafting is quite common, often performed at the same time as tooth extraction if there's going to be a time lag before installing an implant. Even if performed later, though, it can successfully rejuvenate lost bone and make it possible for you to take advantage of durable, life-like implants.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants after Previous Tooth Loss.”

By Fennell Baron & Associates
February 01, 2019
Category: Dental Procedures
UsingSinusSurgerytoStimulateBoneGrowthforImplants

For a predictable outcome, a dental implant should be placed as soon as the bone and gum tissues following a tooth extraction have healed. But what happens if the tooth has been missing for months or years? You might then run the risk of not having enough bone to properly place an implant.

This can happen because of a disruption in the growth cycle of living bone tissue. As older bone cells dissolve (resorption), new bone develops to take its place. This is a dynamic process, as the amount and exact location of the new growth is in response to changes in the mouth, particularly from forces generated by the teeth as we chew. If, however, this stimulation transmitted to the bone no longer occurs because the tooth is missing, the bone will tend to dissolve over time.

In fact, within the first year after a tooth loss the associated bone can lose as much as a quarter of its normal width. This is why we typically place bone grafting material in an empty socket at the same time as we extract the tooth. This encourages bone growth during the healing period in anticipation of installing a dental implant or a fixed bridge. If, however, the bone has diminished to less than required for a dental implant, we must then use techniques to encourage new bone growth to support a future implant.

One such technique for restoring bone in the back of the upper jaw is to surgically access the area through the maxillary sinus (a membrane-lined air space within the bone structure of the face) positioned just over the jawbone to place grafting material. During surgery performed usually with local anesthesia, the surgeon accesses the sinus cavity, lifts the tissue membrane up from the sinus floor and applies the grafting material on top of the bone. Eventually, the new bone growth will replace the grafting material.

If successful, the new bone growth will be sufficient to support an implant. Thanks to this renewed growth, you’ll soon be able to enjoy better function and a transformed smile provided by your new implant.

If you would like more information on forming new bone for implants through sinus surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sinus Surgery.”

By Fennell Baron & Associates
January 27, 2019
Category: Dental Procedures
Tags: dental implants   dentures  
Implant-SupportedDenturesCouldBoostYourJawboneHealth

People have depended on dentures for generations—and they still do. That's because they work, both in restoring dental function and a smile marred by missing teeth.

But they have one major drawback related to bone health. That's because living bone has a life cycle: as older cells die, new ones form to take their place. The pressure generated when we chew stimulates this growth. But when this stimulus goes missing along with the teeth, the cell replacement rate slows and bone volume and density gradually diminishes.

Traditional dentures can't transmit this chewing pressure stimulus. And because they rest directly on the gum ridges, they can adversely affect the underlying bone and actually accelerate bone loss.

But implant technology potentially solves this bone loss problem with dentures by using implants rather than the gums to support them. It's a two-fold benefit: first, the implants relieve much of the irritation to the gums and bone caused by traditional dentures. Primarily, though, the implants themselves can slow or even stop continuing bone loss.

Most implants are made of titanium, not only because it's compatible with the body, but also because it has an affinity with bone. Over time bone cells grow on the titanium post imbedded in the jawbone. This process not only creates stability and durability, it can improve bone health.

In recent years dentists have incorporated implants with dentures to create two exciting treatment options. With one option, the dentist installs two or more implants in the jaw, to which a specially fitted removable denture can be attached. You would still have the ease of removing the denture for cleaning, while gaining greater stability and a reduced risk of bone loss.

The other option is a fixed denture (or bridge) attached permanently to implants. For this option, a patient's jawbone must be adequate and healthy enough to support at least four to six implants. A fixed denture is also often costlier and more complex than a removable denture, but it can feel more like real teeth. It also promotes better bone health too.

Although both options are more expensive than traditional dentures, they can pay dividends for long-term dental health. Implants could help you enjoy your new dentures and resulting smile for a long time to come.

If you would like more information on dental implant-supported restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Overdentures & Fixed Dentures.”

By Fennell Baron & Associates
January 22, 2019
Category: Dental Procedures
Tags: dental implants  
DentalImplantsBetterthanEverthankstoOngoingTechAdvances

While many people still consider dental implants the "new kids on the block" in dental restoration, they're now in their fourth decade of use. And since their inception implant technology has continued to improve and revolutionize how we replace missing teeth.

Implants are a different "species" compared to other restoration methods. To be precise, an implant is a tooth root replacement—usually a titanium metal post imbedded directly into the jaw bone. Titanium is not only a biocompatible metal, but bone cells naturally grow on its surface to create a strong and durable hold. It's this secure hold that's most responsible for implants' high long-term success rate.

But we should also credit some of this success to the steady stream of advances over the years in implant construction and supporting technologies. For one thing, we're now more accurate and precise with implant placement thanks to advances in computer tomography (CT) and cone beam CT (CBCT) scanning.

These digital processes merge a series of images taken by a special camera to form a three-dimensional model of the jaw. We can manipulate this model on a computer monitor to view it from different vantage points. It can help us locate and avoid anatomical structures like nerves and sinuses when determining where to place a future implant. CT and CBCT are especially useful when there's a concern about adequate available bone, a necessity for stable implants.

Technology has also improved how we create surgical guides, often used during implant surgery to obtain the most accurate results. Surgical guides are custom-made devices that fit over the teeth with the drilling locations for the implants marked on them. Recent advances in 3-D printing have made these guides even more accurate so that they fit more securely in the mouth. This greater stability increases their accuracy during the drilling sequence during surgery.

These and other advances are helping ensure every implant is a success story. The end result is both a functional restoration and a beautiful smile.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Technology Aids Dental Implant Therapy.”



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