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COSMETIC DENTISTRY

   
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Dental Implants

Cosmetic Dentistry

In modern dentistry, dental implant is one of the best treatment modality for replacement of missing teeth. Basically dental implant is titanium screw which serve as replacement for the the root portion of the missing tooth. Dental implant is available in various sizes (height and weight)
Selection of dental implant varies according to clinical situations.
It can be use to replace one or more missing teeth. In edentulous patients implant retained dentures can be used. Dental implant retained denture provide fixed teeth to edentulous patients.

Advantages to Dental Implant
  • Dental implant is better than conventional bridge as they eliminate the modification of adjacent sound natural teeth & they do not place additional load on adjacent natural teeth.
  • Long time missing teeth lead to shrinkage of surrounding jaw bone. Denture implants help to maintain shape & structure of jaw bone by bone stimulation.
  • Implant retained dentures are more comfortable than conventional dentures because there is no slipping problem. As dental implant are fixed into the jaw bone they function like natural teeth.
    Implant retained denture eliminate key worries of denture wearer & thus improve self confidence.
    Now a days various implant materials & techniques are available so anyone with missing teeth can go ahead for the implants. Also due to development in dental implant techniques one can go for immediate implant.

    Benefits of Implants Benefits of Implants

Conventional Implants
Cosmetic Dentistry

With today's advancements in dental implant techniques, materials and technologies, almost anyone with missing teeth can now have Dental Implantologist treatments done. Conventional implants techniques have had good long-standing success rates.

Also due to new developments in implant technologies and techniques, immediate implants and immediate loaded implants are now possible that can dramatically shorten treatment.

Conventional Dental Implants Procedure
Procedure for placement of implants involve several steps requires period of 2 to 6 months.

Assessment of patient & treatment planning
In first visit case assessment is alone in which patient is examined for systemic diseases. When patient wishes to proceed with implant treatment detail assessment of patient is done. This involves X-rays, OPG, CT scans & taking of impressions.

Placement of Dental implant
It is simple procedure. This is performed under local anesthesia in sterile conditions in a dental clinic. If required bone contouring can be done using artificial bone.

Osseointegration (Healing Process)

  • Dental implant is left in jaw bone for integration for period of 2-3 months.
  • Suture removal is done after 7-10 days of surgery.
  • Temporary bridge or simple dentures can be worn during the healing phase

The Restorative Phase
After complete healing when tissues gum is ready; special abutment is attached to the implant
  • If overdentures are opted, the metal bar/ball is placed and clip is used to securely retain the set of new over denture.
  • If crown or bridges are opted, abutment is placed which provides the support for new crown or bridge.

Maintenance
  • Patients are demonstrated brushing and flossing around implant.
  • Patient is recalled for check-up

Delayed Placement Mature Bone Site
Delayed Placement Mature Bone Site Delayed Placement Mature Bone Site
   
Delayed Placement Mature Bone Site Delayed Placement Mature Bone Site

Immediate Implants
Dental implants can now be placed after tooth extraction if bone condition and density are favourable.This technique is called as "Immediate Implant/Single day implants/Same day implant or One day implant."

Immediate implant placement in extraction socket


Immediate Implants Immediate Implants
   
Immediate Implants Immediate Implants

What is Immediate Loaded Implants (Teeth in an Hour)
In some patients, temporary or permanent prosthesis can be placed immediately during the same treatment visit. This is called as immediately loaded implants.
This forms the basis of "TOOTH IN AN HOUR" concept which is widely being used by Dentist Pune.
The immediate loading of dental implant shortens the treatment time.


Advantages of Immediate Loaded Implants :


Benefits of Immediate Loaded Implants

  • Shorter treatment period
  • Good aesthetic result
  • Immediate functioning teeth

Immediate loaded implants are dependent on the individual bone quality and conditions so they do not apply to all cases.

Decision to immediately load the implant is largely depend on clinical judgement of dental surgeon.
Following rules must be kept in mind:
  • Patient should be healthy
  • Patient should have good oral hygiene
  • Site selected for immediate loading should be free from infection and even adjacent tooth should be free from clinical/radiological sign of infection
  • Good bone quality and quantity is required
  • Patient should have stable occlusion

Implants supported Fixed Bridge Implant supported fixed bridge is best treatment modality if there are no posterior teeth or no healthy natural teeth available to support fixed bridge or when multiple natural teeth are missing.
It gives better stability and strength than removable partial denture.As bridges are tightly secured,patient can chew better.It helps to improve quality of life as well as self confidence.It helps to save adjacent teeth as it prevents bone loss and drifting of existing teeth into missing teeth space.It requires less maintainance than implant supported overdentures. Metal, ceramic, all-ceramic or zirconium teeth can be placed as per the patients choice.

Installing Implants with Fixed Bridge
1] Before the procedure

Installing Implants with Fixed Bridge Installing Implants with Fixed Bridge

2] At first implants are placed and left for 3-4 months to get integrated with the jaw bone.In case of immediate loaded implants a temporary bridge can be placed at the same time.

Implant Placement Implant Placement

3] Fixing bridge to the implants

Attaching the bridge to the implants Attaching the bridge to the implants

4] The new bridge handles all pressure like natural teeth.Patients wil have secure and stable solutions that allows them to eat whatever they want.

End result End result

Implants supported Overdentures
  • It is removable
  • Simple and relatively inexpensive.
  • Existing denture can be used.
  • As dentures are stabilized with implants it prevents slipping of dentures.So it renews the self confidence as well as improved quality life.

Fullarch Implants with Overdentures

procedure

1) Presurgical procedure:
Before the procedure, assessment of patient is done.

Before the procedure

2) Placements of implants
Firstly, placement of implants which serve as replacement to the roots portion of missing teeth is done.Usually two implants are placed but in some cases for added overdenture retention four implants may be placed. Patients can wear temporary denture which enable them to eat.

Implant Placement

3) Attachment of bridge to the implant
A bar of ball is then attached on the top of the implants and the over dentures installed over it. The ball or bar acts as a clip that enable the over denture to snap securely in place.

Attaching the bridge to the implants

4) Final Procedure
At the end the removable overdenture are securely clipped on top of implant with the ball / bar.

End result

FAQ's regarding implants: 1) Am I a good candidate for dental implant?
Any healthy individual who wants to replace missing teeth, those who are unsatisfied with current dentures, those who would like to eat better and with more comfort, smile more frequently, and feel more secure when they talk or laugh are candidate for dental implants. If treatment is properly planned, the surgery accomplished following accepted rules of practice, the prosthesis fabricated correctly and maintained properly by patient success rates are in excess of 98%. In majority of situations only one or two implants are required. Patients who have implants placed eat better also can eat more comfortably and they don’t need to use adhesives to retain their dentures.
They can talk and laugh without feeling self conscious and without fear of denture slippage.

2) Do dental implant require special maintenance?
No, Dental implant requires same care as real teeth such as brushing, flossing, regular dental check up.
  • Brush twice a day with soft brush.
  • Brush after eating leafy and sticky food.
  • Floss atleast once to twice a day use proxa brush or floss to remove plaque under and around the areas to maintain good oral hygiene.
  • Rinse with fluoride mouthwash before going to bed. Rinse vigoursly for atleast 1 minute. Do not swallow any of the rinse and don't eat or drink anything for 30 minute.
  • visit your dentist for routine dental check-up and cleanings.

special maintainence

Which Implant ?

Currently the market is flooded with companies marketing dental implants. Barring few and negligible differences almost all have same design and pattern. Choice for a particular product is purely based on user preference and being friendly to a particular product. Common systems available in the market include Nobel Biocare, Xive, Endopore, Alpha Bio etc

What to do in cases where bone volume does not support implants?
The success of a dental implant primarily depends on its ability to bear chewing forces which in turn is very much dependent upon how much bone is available in the site where the implant is placed. There are lots of things that affect the bone volume like gum diseases, trauma and age and it is not unusual to open up a site in the mouth for implant placement and find out that some of the critical supporting bone is missing. No problem.... Modern dentistry has gifted us new techniques to augment missing bone. We can increase both the height and width of bone by using bone substitutes called as Bone grafts. We can even use grafting techniques to prevent the loss of bone in circumstances where bone would normally be lost like the extraction of a tooth.

Types of Bone Grafts
There are a number of ways in which bone grafting can be done. The bone used for grafting may be collected when preparing an implant site and then reusing the same bone for grafting purposes. Use of such autogenous bone provides the best results.

But due to the limited quantity that can be procured and the requirement of a second surgical site, most often synthetic bone substitutes commercially available are used for the purpose. This bone is specially prepared from cadavers, corals or other sources but it is very effective and very safe.

The Sinus Lift
The human skull has several air filled cavities called "sinuses". They help to make the head lighter and add resonance to voice. However, they sometimes pose a problem in implant placement in the upper jaw specially in molar region by limiting the available bone volume. We cannot place a dental implant into the sinus because we would just be placing it into an air cavity and nothing would hold it into place. In such cases, bone grafts are placed on the floor of the sinus to increase the bone volume. The procedure is called "Sinus Lift". It has a very high success rate and is commonly done to augment bone for implant placement. We can then go back several months later and place our dental implants in solid bone. Sometimes, there is enough bone to place the implants at the same time that you raise the floor of the sinus.

Drawbacks of Bone Grafting Technique:
1. The bone grafting process adds significant time to the procedure.
2. The second problem is the increased cost to the patient.

Is the implant treatment very painful?
The implant treatment might appear very scary but infact it is associated with little or no pain or discomfort during the entire procedure.

Can anyone go for implant treatment?
Most of the patients can have dental implants irrespective of age. If you are healthy enough to undergo routine dental extractions then you are suitable candidate for implants.
In some cases loss or lack of sufficient bone to support implant may preclude implant treatment.
Smoking & Uncontrolled blood sugar level in diabetic person increase the number of problems associated with implants.

How long do implant last?
Statistics confirm a success rate of nearly 95% for individual implant & even higher for the bridges they support. Generally implant will normally serve its owner for life.

Is the implant treatment very painful?
Implant treatment might appear very scary but infact it is associated with very little or no pain or discomfort during entire procedure.
In general, the placement of single implant is no more traumatic than tooth extraction.

Which implant is better?
Now a days, implants of various marketing companies are available in market. Barring few & negligible differences almost all have same pattern & design.

Choice for a particular product is purely based on patient. Preference common systems available in market include Nobel Biocare, Endopore, Alpha Bio, Uniti etc.

What to do in cases where bone volume does not support implants?
The success of a dental implant primarily depends on it's ability to bear chewing forces which in turn is very much dependent upon how much bone is available in the site where the implant is placed. There are lots of things that affect the bone volume like gum diseases, trauma and age and it is not unusual to open up a site in the mouth for implant placement and find out that some of the critical supporting bone is missing. No problem.... Modern dentistry has gifted us new techniques to augment missing bone. We can increase both the height and width of bone by using bone substitutes called as Bone grafts. We can even use grafting techniques to prevent the loss of bone in circumstances where bone would normally be lost like the extraction of a tooth.

Types of Bone Grafts
There are a number of ways in which bone grafting can be done. The bone used for grafting may be collected when preparing an implant site and then reusing the same bone for grafting purposes. Use of such autogenous bone provides the best results.

But due to the limited quantity that can be procured and the requirement of a second surgical site, most often synthetic bone substitutes commercially available are used for the purpose. This bone is specially prepared from cadavers, corals or other sources but it is very effective and very safe.

The Sinus Lift
The human skull has several air filled cavities called "sinuses". They help to make the head lighter and add resonance to voice. However, they sometimes pose a problem in implant placement in the upper jaw specially in molar region by limiting the available bone volume. We cannot place a dental implant into the sinus because we would just be placing it into an air cavity and nothing would hold it into place. In such cases, bone grafts are placed on the floor of the sinus to increase the bone volume. The procedure is called "Sinus Lift". It has a very high success rate and is commonly done to augment bone for implant placement. We can then go back several months later and place our dental implants in solid bone. Sometimes, there is enough bone to place the implants at the same time that you raise the floor of the sinus.


Drawbacks of Bone Grafting Technique
  • The bone grafting process adds significant time to the procedure.
  • The second problem is the increased cost to the patient. Is the implant treatment very painful?

  • The implant treatment might appear very scary but infact it is associated with little or no pain or discomfort during the entire procedure.

Gum Diseases

Gum Diseases

Believe it or not, gum problems are the most common diseases affecting the human population.

Most of the people think that teeth are the only element of a beautiful smile. However, the fact is that the size, shape, integrity and health of gum tissue greatly influence the aesthetic appearance of even the most perfect teeth. Too much gum tissue can lead to teeth that look short and wide while too little gum tissue can lead to exposure of root surfaces of teeth that look way too long.

Periodontics is an area of expertise that deals with treatment of the gum and bone supporting the teeth.

In health, the gums firmly grip the neck of the tooth. If food is allowed to accumulate between the tooth and the gum margin, it forms plaque along with the microbes. The resultant irritation of the gum margins produces a condition called as GINGIVITIS characterized by redness, bleeding and swelling of the gums. If proper attention is paid at this stage the condition is perfectly reversible. However in untreated cases the condition further deteriorates leading to the destruction of the tooth-supporting tissues. The condition is then called PERIODONTITIS or PYORRHOEA. At this stage the teeth start shaking, they are unable to withstand chewing forces, pus forms in the gums and foul smell starts from the mouth.

Treatment
Treatment Treatment   Treatment

1. Non-surgical treatment involves scaling and polishing of teeth. The procedure aims to remove food particles, plaque and calculus accumulating around the tooth. The effectiveness of the procedure depends largely on the stage of the disease, the efficiency of instrumentation and the maintenance on the part of the patient.

No matter how good we are at brushing, we cannot achieve 100% efficiency in cleaning. So, small depositions continue to occur on a daily basis. For long term maintenance of teeth, it is therefore advisable to go in for a professional cleaning once in six months even if you do not have an evident gum problem.

2. The Surgical approach to treatment is usually recommended for resistant cases where complete removal of the irritants from root surface of the tooth is not possible by scaling alone due to the deep penetration of the deposits. The procedure also called as flap surgery or flap operation involves reflection of the gums by 1-1 1/2 mm and debriding the area under local anesthesia with direct visualization of the deposits. The procedure is completely painless and involves minimum post-operative pain or discomfort.

In certain cases however it is possible to regrow the lost bone by use of certain bone substitutes called Bone grafts. Such cases provide the ideal outcome of therapy by regenerating the lost tissues.

Gum Recession
Another commonly encountered problem with respect to gums is the recession of gum margins. The etiology of the condition is related to faulty tooth brushing technique or the use of hard-bristle brush. The significance of the condition to the patient lies in the fact that the exposed root surfaces left by the receding gums are sensitive to hot and cold and that the exposed root surfaces are prone to decay. Also, receded gums can make your teeth look unnaturally long robbing you of your beautiful smile.

Gum Recession Gum Recession


Treatment of gingival recession:
The treatment of gingival recession involves coverage of the exposed root surface. This is achieved either by

1.) pulling the gum margin coronally
2.) by covering the recessed area by a transplanted tissue. The tissue may be derived either from one's own body (palate) or some commercially available substitutes (alloderm) may be used. In the past this procedure required that a piece of tissue be harvested from the roof of your mouth to serve as the graft material. Unfortunately, not everyone has enough tissue available or wants to have tissue taken from this sensitive area. Now, however, you have a choice: AlloDerm. Every patient is different and patient results may vary. Only a trained clinician can determine the best treatment plan for you.

What is AlloDerm ?
AlloDerm is donated human tissue that has been processed to remove all cells,leaving behind a regenerative collagen matrix. The matrix is preserved with a patented freeze-drying process.

How safe is AlloDerm?
The donor tissue undergoes the same stringent screening criteria as any other implantable tissue or organ (heart, lungs &kidneys,etc.). AlloDerm is a processed tissue that comes from donors who are extensively screened and tested for presence of diseases including HIV and hepatitis Since its introduction in 1994,there have been more than 750,000 AlloDerm grafts placed with no incidence of disease transmission.

Why choose AlloDerm for my procedure?
1.AlloDerm allows you to receive the necessary grafting treatment without the concern and discomfort associated with palatal tissue harvesting.
2.Alloderm is available in unlimited quantities allowing treatment of all necessary areas in fewer visits than would be possible with palatal harvesting.
3.AlloDerm results are equivalent to those with palatal tissue

How does AlloDerm work?
AlloDerm repairs damaged tissue by providing a foundation for new tissue regeneration. The components preserved in AlloDerm contain the information that will help your own tissue to grow into the graft after placement. Soon after placement, blood flows from your tissue into the AlloDerm. Next, your own cells move into AlloDerm and begin the process of tissue regeneration. This is the way your body replaces cells during its regular maintenance cycle.

As the healing progresses, more of your cells move into the AlloDerm and transform it into tissue that looks and functions naturally.

What happens after the healing process?
Over time, AlloDerm allows regrowth of your own healthy gum tissue. Once recovery is complete, you won ’t be able to tell the AlloDerm was ever there.

Splinting- Managing mobile teeth Splinting refers to "the joining of two or more teeth into a rigid unit by means of fixed or removable restorations or devices.” The overall objective is to create an environment where tooth movement can be limited within physiologic limits with simultaneous restoration of function and patient comfort. The splint may be indicated because of individual tooth mobility or mobility of the entire dentition. Splinting may be a way to gain stability, reduce or eliminate the mobility, and relieve the pain and discomfort. Splints may be classified as provisional and definitive. The type of splint depends on the intended goal of therapy.

Splinting- Managing mobile teeth Splinting- Managing mobile teeth

Temporary splints may be worn for less than 6 months and may not be followed by additional splint therapy. They provide an insight into whether or not stabilization of the teeth provides any benefit before any irreversible definitive treatment is even initiated. These splints typically are fabricated using thin stainless steel wires, and tooth colored composite resin restorative materials. The splint can also be reinforced in several ways using one of the following materials: ligature wire, glass fiber, or a polyethylene fiber reinforced polymer( Ribbond Fiber). When anterior teeth require splinting, tooth colored restorative resin reinforced with polyethylene fiber is the material of choice. Such an interim restoration not only can improve esthetics, it can restore the occlusal scheme to be incorporated into any definitive prostheses. Only after the interim restoration has been worn by the patient can the design and occlusal form of the final prosthesis be evaluated and incorporated. in the definitive restoration. In patients with a history of bruxism and clenching, special occlusal splints are recommended to help stabilize teeth following selective occlusal adjustment.

Permanent splints maintain long term stability of the dentition. Definitive splints are placed only after stability has been achieved in order to increase functional stability, and improve esthetics on a long-term basis. Such treatment includes conventional fixed prostheses (Dental Bridges) because they provide definitive rigidity and are better able to control and direct occlusal forces than removable splints.

However, the mere presence of tooth mobility does not justify the need to splint teeth. Splinting is best viewed as a preventive treatment measure for teeth that have minimal or no bone loss, yet are clinically mobile. Therefore before treatment is started, the cause of any mobility must be identified. Extraction is an appropriate treatment for extremely mobile teeth.

Orthodontics

Orthodontics is the branch of dentistry that deals with straightening and correcting the tooth alignment and the dental specialist who does this is called an "Orthodontist".

Who Needs Orthodontic Treatment?
Today children as well as adults are choosing to have orthodontic treatment since age is no longer a factor that governs the feasibility of the treatment. But as you grow older the duration of the treatment is increased since it is easier to shift and align teeth during the growth phase of the jaws. Orthodontic treatment corrects
-malocclusion (bite or occlusion is off)
-tooth malalignment (crooked teeth)

Why Treat Malocclusion?

Orthodontics is not only used to improve your appearance. Malocclusion or malaligned teeth can have long term effects, such as:
interference with normal growth and development of the jaws
  • abnormal swallowing patterns
  • abnormal facial muscle function
  • impairment of chewing
  • speech defects
  • susceptibility to cavities due to the difficulty of removing plaque from crooked teeth vulnerability to accidents or fractured teeth (if your front teeth stick out, they may be more easily injured)

How Do Braces Work? Teeth can slowly be moved and shifted into proper position by applying pressure in certain directions. Bands, wires and elastics are placed on the teeth to move them in the right direction. This takes place slowly and carefully over an extended period of time. Shifting teeth back into a functional position can take months to years, but eventually you'll have a new and improved mouth! Retainers are often used after the braces, to hold the teeth in their new position until they are stable. It is important to wear the braces or an appliance for however long it takes. If you quit at any point during treatment, the teeth can shift back into their old position..

Types Of Braces Available - Dentist Dental Braces
Metal Braces


Metal Braces

Metal brackets are the ones that are most frequently used. They appear as small metal buttons that are glued to the front of each tooth. These tend to be less expensive than other types of brackets. Additionally, they can be made colorful with ligature rubber bands that come in a wide range of colors.

A major drawback of these braces is there color which makes its use very limited in cases of adult orthodontics.

Invisible Ceramic Braces

Invisible Braces

Most people want better looking teeth but they also don’t want people to know that they have braces or deal with the unattractiveness of having those things in your mouth for so long. You can give the appearance that you don’t have braces simply by asking for invisible braces. They are a little more expensive but they’ll get the job done, and you won’t look like a 13 year old. The invisible class of braces includes Ceramic braces and sapphire braces.

Ceramic (Tooth Colored) Braces

Ceramic (Tooth Colored) Braces

Ceramic brackets are made of composite materials. They are very strong and generally do not stain. Adults like to choose ceramic because they "blend in" with the teeth and are less noticeable than metal. The ligatures (tiny rubber bands) that hold the arch wire on to the ceramic brackets are often white or clear. This looks great at first, but the ligatures can stain. Unless you eat a lot of curry, smoke, or drink a lot of black coffee, this generally isn't a problem. Note that the ligatures are changed each time you get an adjustment -- usually, monthly. It's only the ligatures that stain, not the brackets themselves!

Clear Sapphire Inspire! Brand Braces

Clear Sapphire Inspire! Brand Braces

Inspire brand brackets, are made of pure monocrystalline sapphire and are very translucent. They are very strong and do not stain. If your teeth are already very white, then Inspire braces will look best on you and seem to "disappear" on your teeth. If your teeth are less than white, they may tend to stand out (in this case, the Ceramic brackets would be a better choice). The pros and cons for Sapphire brackets are the same as those for Ceramic brackets.

Disadvantages of "Invisible Braces"
  • More expensive than metal braces
  • Not suitable for all cases.

Lingual Braces

Lingual Braces

These are the ultimate in brace concealing technology. They are placed on the backs of your teeth so nobody will even see that you have them on, unless they get an up close and personal look at the inside of your mouth.



Usually, lingual brackets are made of metal.

Orthodontists need special training to be able to treat patients with lingual braces. Therefore, not every orthodontist provides them.

Drawbacks of lingual braces:

  • They tend to hurt your tongue and make it difficult to speak at first.
  • more expensive than traditional metal, because treatment is specialized.
  • Treatment may be longer than traditional braces.
  • Not every orthodontist does lingual treatment.
  • lingual treatment may not be applicable for all types of cases.

Some FAQs What are the early symptoms of orthodontic problems?
Although determining if treatment is necessary is difficult for you to assess, the following symptoms may help in prompting you to seek our orthodontic advice.

Ask your child to open their mouth, and let you look at their teeth. If you see any signs of crooked teeth, gaps between your child’s teeth or overlapping teeth, your child may need orthodontic treatment.

Ask your child to bite all the way down, but keeping their lips open so you can see their teeth. Do the front top teeth line up with the bottom?
Do the top teeth protrude out away from the bottom teeth?
Do the top front teeth cover more than 50% of the bottom teeth? Are the top teeth behind the bottom teeth?

Look at the alignment of your child’s jaw. Does the jaw shift off center when your child bites down?

What age should my child be seen by an orthodontist?
Orthodontists recommend that your child be evaluated by age seven. Early detection of some orthodontic problems is important in order to take early corrective action and avoid more difficult treatment later.

Will it hurt?
Teeth Orthodontic Treatments (Pune) has improved dramatically. As a rule, braces make your teeth sore for a few days, but it is not painful. This annoyance can be relieved with an over-the-counter pain reliever.

Pediatric Dentistry

Dental care for kids (Pediatric Dentistry for Children Pune) Pediatric Dentistry is a dental specialty that concentrates its attention on infants and children providing preventive and therapeutic oral health care. During the "growth" phase of a child, special approaches are needed to guide the dental growth and development in order to avoid future dental problems.

A common question that parents ask is “why spend on the maintenance of milk teeth when they are to be finally replaced by the permanent ones?”

Milk teeth are as important as the permanent ones because
  • Baby teeth are important in proper feeding and nutrition.
  • Milk teeth serve as space maintainers for the proper spacing and alignment of the permanent teeth.
  • Healthy milk teeth are crucial in helping the baby learn how to speak properly.
  • Healthy looking teeth are important in building self-confidence at an early age. Small children because of immaturity are quick to tease peers about ugly looking or decayed teeth.

Baby Bottle Tooth Decay (Nursing Bottle Caries)
The term describes a dental condition which involves the rapid decay of many or all the baby teeth of an infant or child. The teeth most likely to be damaged are the upper front teeth since they are the first teeth to erupt and thus have the longest exposure time to the sugars in the feeding bottle. The lower front teeth tend to be protected by the tongue as the child sucks on the nipple of the bottle or the breast.

Baby Bottle Tooth Decay is caused by long exposure of a child’s teeth to liquid containing sugars generally when the baby falls asleep with a bottle containing milk or juice or a pacifier dipped in honey. The liquid pools around the front teeth. During sleep, the bacteria living in every baby’s mouth, turns the milk sugar or other sugars to acid which causes the decay.

By the time the condition is noticed by the parents it may be too late and extractions of the decayed teeth may be necessary. As a result, your child may suffer from long term disorders which include speech impediments, possible psychological damage, crooked or crowded teeth, and poor oral health.

The condition can be easily prevented by
  • Clean your child’s teeth daily
  • Giving plain water after a bottle of juice, milk, or formula (or when awake, sip on it for long periods of time as a pacifier)
  • Start bottle weaning by at least a year
  • Make sure your child gets the fluoride needed to prevent decay
  • Have regular dental visits for your child beginning when their first tooth erupts

We hope that you realize this and give your child the best means possible to achieve optimal dental health.

Root Canal Treatment in milk teeth:

In cases where tooth decay extends deep into the nerve portion of the tooth it might be necessary to perform a root canal as described for the permanent tooth. Although the morphology of milk teeth makes the treatment difficult, it might still be considered as a better alternative to tooth extraction.

Space Maintainers:
A space maintainer is a removable or fixed appliance designed to maintain an existing space.
Space maintainers are usually fitted in children when they have lost baby teeth early. The gap left from losing this tooth needs to be held open for the permanent tooth to erupt in the correct position.


Fluoride application:

A child’s teeth are more prone to decay due to lack of proper dexterity of brushing. Application of fluoride varnishes at regular intervals strengthens the tooth structure by incorporating fluoride ions into the structure making them more prone to acid dissolution. Not only do the permanent but also milk teeth benefit from fluoride treatment.

For children under 3 years of age
  • The professional application of fluoride is particularly recommended because of the ease of application, patient acceptance and proven anti -decay benefits. For maximum benefits, reapplication should be made every 4 months.
  • Of the various home-use fluoride products (toothpastes, mouthwashes and gels) only fluoride toothpastes are recommended for young children, but caution must be exercised to minimize fluoride ingestion.

Oral habits in children (Dental Treatments for Children) Frequently children acquire certain habits that may either temporarily or permanently be harmful to teeth and tooth supporting structures. These habits are acquired as a result of repetition. In the initial stages there is a conscious effort to perform the act. Later the act becomes less conscious and if repeated often enough may enter the realms of unconsciousness.

Oral habits in children Treatment   Treatment

Some common oral habits seen in children include thumb sucking, mouth breathing, tongue thrusting, lip biting, grinding of teeth and nail biting

Treatment
Psychological approach:
It is generally said that children lacking parental care, love and affection resort to this habit. Thus the parents should provide the child with adequate love and affection. Also the child's attention be diverted to other things as games and toys. The dentist and the parents should together work to motivate the child to discontinue the habit.

Mechanical Aids:
They are basically reminding appliances that assist the child who is willing to quit the habit but is not able to do so as the habit has entered the subconscious level. They may be removable or fixed appliances.

Pit and Fissure sealants
The chewing surfaces of teeth are never flat. They have in fact certain depressions called Pit and Fissures which serve as potential traps for food and bacteria making the teeth susceptible for decay. Although other factors such as dietary habits, oral hygiene and amount of sugar intake do pay an important role but the pits and fissures have been suggested as " the single most important anatomic feature leading to the development of tooth decay". Therefore as a preventive measure certain pits and fissure sealants are placed.

The decay inhibiting properties of sealants are attributed to the physical obstruction of the pits and grooves. This prevents penetration of fermentable sugars and the bacteria cannot produce acid that causes tooth decay. The safety and effectiveness of pit and fissure sealants as a decay preventive measure has been confirmed by the American Dental Association .

However, good professional judgment should be used in the selection of teeth and patients. These are contraindicated in cases of already existing decay which require fillings. Finally, although sealant application is relatively simple, the meticulous technique requires patient cooperation and should be postponed for uncooperative patients until the procedure can be properly executed.

Root Canal

People are fearful about ROOT-CANAL DENTISTRY TREATMENT Prices (Pune). They think it is very painful procedures in root canal dentistry, but it's a Myth. By this procedure one can save decayed dying tooth. If natural tooth is saved there is no need of an artificial tooth.

Pulp is the inner most part of tooth. Pulp lies in the hollow cavity within the tooth. This hollow cavity is called Root-Canal. The pulp contains blood vessels and nerves. It provides nourishment to the tooth through the blood.

The root-canal gets infected if the pulp gets exposed. This may happen due to decay, tooth fracture, attrision (wear & tear of the tooth), abrasion, corrosions etc. At this stage the tooth is very painful and the pain may radiate to head and ear. If it is left untreated the infection may spread to the surrounding areas of bone and gums and eventually causes death of pulp. At this stage tooth is very painful & tender and sensitive to hot or/and cold so it cannot withstand chewing forces. If left untreated tooth abscess and pus may be formed and face is swollen and infection can spread to surrounding head and neck region.

So to prevent all above complications Root-canal treatment should be performed. In this treatment the entire infected damaged pulp material is thoroughly cleaned out. Access to the pulp is taken by drilling into tooth. After scrupulous cleaning of the root canals it is filled by Gutta-percha or other suitable biocompatible inert material.

Treatment Treatment  
Decayed Molar After RCT Filling  

Root-canal treatment is a highly successful treatment. The success rate is as high as 95-98%.

Only 2-3% of cases may require additional treatment. Complication of root-canal treatment involves reinfection of pulp which can be treated by root-canal treatment, in some cases if the tooth is highly damaged and infected it may need removal (Extraction).

So the tooth can be saved by root-canal surgery and patients chewing ability can be restored.

SO IF YOU HAVE DECAYED TOOTH OR PAINFUL TOOTH CONSULT YOUR DENTIST IMMMEDIATELY ABOUT ROOT-CANAL TREATMENT Endodontist in India .
Restoration of an RCT treated tooth- Post and Core
Placement of crown is mandatory after root-canal therapy. Since the tooth becomes brittle after root-canal therapy and due to decay lot of tooth structure needs to be removed, placement of is must.

In some teeth where there is extensive loss of tooth structure sometimes post & core treatment is necessary to restore the teeth structure. There are different types of post available such has metal post, fiber post, cast post etc. Reinforcement of the tooth can be successfully done by properly selecting case and post of core technique.

Sedation Dentistry

Are you nervous about your dental treatment?
You have need of dental care but too afraid to go visit dentist.
Does the thought of going to the dentist give you chills?

Ans: Now relax. There is really no reason to be nervous.
We understand not every one is comfortable receiving dental treatment therefore as a part of our personalized care we offer oral sedation for those patient who need that extra-help to relax.
Before dental appointment, patient will be instructed to swallow a small pill & be accompanised by a companion to a dental clinic.
Our team will make patient completely comfortable & will monitor patient closely when he or she is under sedation.
Patients feel little or no discomfort during or after treatment & often have little or no memory of the procedure.
If you are afraid of dental treatment but don’t want to ignore your oral health any longer talk to member of our team regarding oral conscious sedation.
We will provide you with the information necessary to smile with no fear.

Conscious Sedation & General Anesthesia Use of conscious sedation & General anesthesia in pediatric dentistry
Most of time it becomes difficult to treat unco-operative or apprehensive child patients, mentally or physically handicapped children.
Under these circumstances oral conscious sedation is best sedation.

What is Conscious Sedation & General anesthesia?
In conscious sedation, patient fall a sleep but not completely unconscious. Conscious sedation usually used for short dental procedure like one or two teeth removal or few fillings etc.
In general anesthesia, patient is completely unconscious & not aware of whatever happening to around him or her.
Under general anesthesia, one can perform extensive dental treatment like multiple fillings, multiple teeth removal, root canals, crowns etc.

What are the primary objectives of these procedure?
  • Most important objectives is psychological well being of a child. As traumatic dental experience during young age, make child aversive to dental treatment throughout his or her lifetime.
  • Another objective is to provide highest quality dental care to unco-operative children. One can not deny dental health just because the child is unco-operative. Every child has a right to obtain good oral health.

Are oral sedation procedures safe?
Before procedure, complete physical evalution of patient is done by dentist.
Once the patient is evaluated well then the chances for any complication are remote.
Medical research has shown high degree of success using these procedure.

Tooth Removal

The extraction of teeth is a minor surgical procedure. While the great majority of extractions can be safely and painlessly carried out in the dental office, some patients require hospitalization because of some medical problem.

With the advent of modern restorative techniques, a majority of teeth which were earlier advised for extractions, can now be easily saved. However, in certain situations extractions are the only solution, asl.
  • teeth that are decayed beyond restoration
  • in cases where the excessive bone support of the tooth is destroyed.
  • extra tooth
  • retained milk tooth
  • fractured tooth
  • malposed tooth which cannot be aligned by orthodontic treatment.
  • impacted and unerupted tooth
  • extraction of premolars for orthodontic treatment (Braces)

Impacted Wisdom tooth
Impacted Wisdom tooth

Wisdom teeth usually emerge from the gum (erupt) between the ages of 17 and 24. They are the last of the molar teeth. Some people never develop wisdom teeth, others have up to four - one in each corner of the mouth. Wisdom teeth often cause no problems. They are described as impacted when there is not enough space for them at the back of the mouth.

In such a case it might erupt towards the cheek or it might impinge on the second molar. Impacted wisdom teeth can cause pain, swelling, infection or damage to the teeth next to them. If the gum around the wisdom tooth is swollen the jaw may become stiff and sore. Infection at the back of the mouth can cause bad breath and a bad taste. The surgical removal (extraction) of one or more wisdom teeth can relieve these problems. People who have impacted wisdom teeth that are not causing problems do not need to have them removed.

Having wisdom teeth removed is often the only way to permanently relieve painful symptoms. Although antibiotics can provide temporary relief, the symptoms tend to flare up again in the future.

The removal of such impacted wisdom tooth has to be accomplished surgically. A flap is reflected to completely expose the tooth. Some amount of bone cutting may be required to facilitate easy removal. After the tooth is extracted the flaps are put in place and sutured. The procedure is performed under local anesthesia and is associated with minimal pain and discomfort. In some cases, where a wisdom tooth is causing pain because it is pressing into the surrounding gum, removal may not be necessary - an operation to cut back the gum may be all that is needed. However, this alternative is not suitable for everyone.
Tooth Replacement   Tooth Replacement

Modern dental advances provide a host of options for replacing missing tooth-from traditional dentures to crowns & bridges (metal ceramic and metal free ceramics) to the latest dental implants.

Why replace a missing tooth?
In a normal, healthy mouth, chewing function is well balanced since each upper tooth has proper contact and function with corresponding lower teeth.  Because of this natural proper balance, undue strain or irritation on the gum tissue and bone is non-existent.  Drifting or spreading of teeth does not occur and oral hygiene is easily maintained. But, this natural proper balance is quickly destroyed when a tooth is lost. 


This is what can happen :
  • The opposing molar may super-erupt.
  • The unprotected ridge is subject to trauma.
  • The neighbor teeth tilt and proper functional balance is destroyed.
  • The drifting teeth create food impact areas where decay starts –
  • or where Periodontal Disease can start.
  • Destruction to the bone will result as teeth drift and tip.

The loss of teeth is associated with diminished self-confidence and of course chewing difficulties. So, it is necessary to replace the missing teeth as early as possible with something that resembles your natural teeth to the maximum. With recent developments in dentistry, a number of options are now available to the patients to choose from.

Fixed Teeth
Patients willing to get replacements via fixed teeth may opt for crowns and bridges or for dental implants.

Dental Crowns And Bridges
Simply stated, a dental crown is a tooth cap placed to cover the tooth to restore its shape, its size and its strength. A bridge is a combination of crowns.

A dental crown may be advised to
  • protect a weak tooth (for instance, from decay) from breaking especially after an RCT
  • restore an already broken tooth or a tooth that has been severely worn down.
  • cover and support a tooth with a large filling when there isn’t a lot of tooth left
  • hold a dental bridge in place
  • cover misshaped or severely discolored teeth
  • over a dental implant

Dental bridges are meant to replace missing teeth by "bridging" the gap between two remaining teeth. This involves creation of a pontic, or false tooth's with a dental crown on either side. The crowns are fitted over the remaining teeth to hold the false tooth in place.

When there are only teeth on one side of the gap, cantilever bridges may be given. cantilever bridges consist of two side-by-side crowns and only one is connected to the pontic.

Fixed Bridge

A fixed bridge helps to
  • Replace missing tooth/teeth.
  • Helps balance a normal bite.
  • Helps prevent undesirable stress on the dental ridge.
  • Prevents over-eruption of the opposing teeth.
  • Prevents drift and tilt of adjacent teeth.
  • Prevents tooth decay in adjacent drifted teeth
  • Retards onset of gum diseases


To design a bridge, the dentist must reshape the teeth to make room for the crowns. The dentist then makes a mold of the teeth. This mold is then sent off to a laboratory, where the actual crowns and bridge are made.

These crowns and bridges require a bit of extra care in terms of oral hygiene. With such care, bridges can last up to several years. However, improper or infrequent brushing and flossing, irregular dental visits, and excessive sugar and starch intake can all bring untimely damage to the bridge.

Materials for Dental Crowns and Bridges
Materials for Dental Crowns and Bridges

All Resin : These are the least expensive crowns. Today these are generally used for temporary or provisional coverage. But like most inexpensive things they do not last as long as other types of crowns.

Metals
: These could include gold alloy and other base metal alloys. Metal dental crowns are by far the toughest. They can withstand daily wear and tear and they rarely break or chip. A gold crown has some very distinct characteristics that make it a good choice

1. Gold Fits better : A well-cast gold crown fits considerably better then other materials. Because it fits better, it lasts longer! The bacteria we all have in our mouths have less access to the micro-margins.

2. Gold Is Strong And Flexible
: Gold expands and contracts at the same rate as your natural tooth. This protects the gold crown from chipping, cracking or breaking; which can be a problem with other less versatile materials.

3. Gold Is Safe And Comfortable :
Gold doesn't just look good--it feels good--because gold is remarkably compatible with the inside of your mouth. With many other metals, the likelihood of sensitivity or an allergic reaction is a significant risk for the patient. But not with gold.

However not all crowns with the color of gold are the same - The best of the dental gold is an alloy of many metals, (gold, platinum, palladium, silver, copper and tin) and are usually about 76% gold or a little over 18 carat. Some gold crowns are made of an economy gold and are only gold in color and don't possess the casting characteristics so important for a good seal at the edges. These cheaper gold-content crowns are on the order of ten carat and do not have the tissue tolerance and compatibility of a higher gold-content alloy.

Indications :
  • Worn out teeth where creating additional space for porcelain is not possible.
  • Posterior teeth where esthetics are not the prime concern

The only real drawback is that they look like metal and not a naturally white tooth.

Metal-Porcelain : They combine the strength of the metal along with the esthetics of porcelain. These are probably the most used crowns nowadays. Of course the porcelain is slightly more prone to chipping, but they are still tough.

There are different types of porcelain fused to metal dental crowns :

Captek

There is a choice in the metal
1. Precious alloy (89-92% gold alloy, yellow gold color)
2. Semi-precious alloy (54-62% gold alloy, "white gold")
3. Non-precious (metal alloys, stainless steel color)

Precious alloys with high gold and platinum content are most preferable. One such crown that is commonly used today is called Captek.

Captek Bridges


Captek is an 88% gold alloy, which uses a unique fabrication system to provide the most extreme combination of strength and esthetics. It is formed using capillary casting technology which provides its exceptional characteristics. Due to porcelain's translucency, Captek crowns are truly the most beautiful metal-based crowns and are highly recommended for all areas of the mouth, front or back.

The advantages of using Captek are many;

Biocompatible: Captek’s advanced gold material reduces the accumulation of harmful bacteria at the gum line by 90% compared to natural tooth structure.Superior fit: Captek fit is superior to all other restorations, This is due to the fact that there is virtually no expansion or contraction, as there is no casting of the metal.

Esthetics: Captek™ (capillary technology) offers patients the beauty, health and longevity of gold crowns and bridgework Because it is a high gold alloy, Captek can impart a natural hue to porcelain veneered crowns and bridges. The light-dispersion effects of Captek crowns are designed to mimic those of healthy natural tooth structure. There is no oxidation, so it will not lead to black lines at the gum margins

It can easily be used for single crowns, implants, and bridges both anteriorly and posteriorly.

The only reason we have gone away from gold under our porcelain fused to metal crowns is the high cost of gold.


Semi-precious metal offers a balance between esthetics and strength at a lower cost than precious metals. It resists oxidation, it casts more accurately than non-precious metal, and it is a very commonly chosen option. But it cannot provide the warmth and beauty of gold-lined porcelain crowns.

Non-precious alloys are made of low-cost metals and have been in use for many decades. They are more difficult to cast (shape) than softer precious metals and therefore offer a less precise fit. Non-precious alloys also tend to oxidize over time) which darkens their color even more and can even stain and "tattoo" the gum.

All Ceramic Crowns and Bridges (Metal Free ceramic crowns)
These are the best looking crowns, and probably the best value for your money as far as esthetics are concerned. Contrary to what might appear, these materials are extremely strong and fracture tough. The material can well sustain the masticatory forces, providing durable crowns and bridges with beautiful esthetic results. They can be conveniently and reliably used in any part of the mouth. These are also the preferred material of choice in patients with metal allergies. Metal free restorations are produced with the latest CAD/CAM technology ensuring precision of fit. Some well known Metal free systems used are


Procera Procera® is a unique system from Nobel Biocare for the fabrication of esthetic and functional dental restorations.

Procera® offers you the optimal restorative system, including crowns, laminates, and bridges, for all indications and anywhere in the mouth. The combination of beauty and strength gives you a simple and predictable clinical procedure, excellent esthetic results and improved long-term performance.

'No PFM ‘gray lines’ ever With metal ceramic, soft tissue around the tooth can recede, over time, revealing the metal underneath as ugly gray lines. This simply can’t happen with Procera® because they are metal-free.

Bio-compatible Procera® all-ceramic solutions are completely tissue-friendly. Your crown, bridge or veneer (laminate) integrates beautifully with its surroundings, encouraging gum to grow back up to the tooth, as it would naturally. And because they are bio-compatible, there are no allergic reactions, no sensitivity to temperature and no impact on taste.

Perfect fit Procera® solutions are precision-engineered in state of the art production facilities. And they fit so well you will forget they are there.

Perfect match
Procera® uses a unique system to subtly match your real tooth’s color and translucency so they’re almost impossible to tell apart from real teeth.

Cercon is a high-tech ceramic, Zirconium Oxide, which has already been proven in many extreme situations such as heat shields in the Space Shuttle, brake disks for sports cars and the spherical heads of artificial hip joints. Using cercon has many advantages.

Improved Aesthetics
  • Due to the white zirconium oxide milled substructure
  • Optimal shade match to the existing natural teeth

Compatibility
  • Verified by the medical application of zirconium oxide for about 20 years
  • No allergic reactions reported in the published literature
  • Good insulating behavior of the ceramic against cold/warm influences
  • Thanks to a smooth ceramic surface that supports good oral hygiene
  • No interaction with other dental materials

Durability
  • Thanks to the exceptional strength of zirconium oxide
  • High stability requiring minimum framework dimensions

 
IPS Empress

IPS EMPRESS
IPS Empress is an all-ceramic crown system that gives you exceptional esthetics plus strength. A proven ceramic alternative to metallic restorations, IPS Empress offers patient satisfaction with aesthetic, natural looking restorations, by the exclusive use of ceramic materials.

Individually colored tooth restorations can be reproduced in exact shape and shade. The result is an individually fabricated restoration with an excellent fit and all the characteristics of a natural tooth. Even when working in limited space, optimum aesthetic results can be obtained.

The Empress system produces crowns, inlays/onlays and veneers, providing one of the strongest all-ceramic restorations available.

IPS E.MAX
The new all-ceramic system IPS e.max comprises highly aesthetic and high-strength materials for both the PRESS and the CAD/CAM technology. The system is versatile and economical.

Proven Strength
e.max® ZirCAD is your proven alternative to PFMs. Its high-strength offers long-term reliability for anterior and posterior single unit and multi-unit bridgework.

Empress Beauty
e.max® Ceram is a Nano-Fluor Apatite Glass Ceramic which mimics the optical effects of natural enamel, creating patient-pleasing esthetics.


IN ceram is a material from Vita (Germany). The VITA all-ceramic systems can be used for for crowns, bridges, veneers and implant suprastructures. The advantages of the VITA all-ceramic system are:

High bio compatibility
VITA all-ceramic is absolutely bio compatible. Your well-being will not be impaired by allergic or undesirable reactions, such as metal taste.

Aesthetics
Colour, shape and surface structure of your teeth are unique – just as you are. By selecting VITA all-ceramic, you will receive a high-quality restoration without any visible difference from the natural tooth structure.

Stability provides reliability
VITA In-Ceram provides reliability since this material has been used worldwide for more than 13 years and has proved its reliability in millions of cases. The long service life of VITA-In-Ceram restorations is mainly based on the high stability of the all-ceramic

Wol-Ceram is the first ceramic crown that allows you to prepare a conservative feather-edge or chamfer margin. Copings are made from Vita In-Ceram alumina material, which has been proven in clinical tests for over 12 years. The outstanding fit and strength are the result of the Electrophoretic ceramic process resulting in excellent marginal integrity. Wol-Ceram’s beautifully natural esthetics result from a dentin colored coping that prevents opaque show-through.

Dental Implants Missing teeth, single or multiple can be best replaced with dental implants. A dental implant is a small titanium screw that serves as the replacement for the root portion of a missing natural tooth. The screw is painlessly placed inside the jaw bone and left to heal. The healing period varies from patient to patient depending on bone quality and quantity. Once the implant fuses with the bone, an artificial tooth is attached to the implant.

Dental Implants may be used to replace one or more missing teeth. In case of completely edentulous patients, implants may be used to fix the dentures to the underlying bone. Needless to say, an implant offers several advantages over conventional treatment options. The benefits of implant treatment include improved appearance and self-esteem as well the enhanced ability to chew and enjoy your food, coupled with protection of your remaining teeth and jawbone.


The only disadvantage is that the dental implants are costly and the time involved in the entire treatment.

Replacements by Removable Teeth

Removable Teeth


Complete Dentures :
This is the most economic and most traditional method of tooth replacement. Dentures are removable objects that simulate the look and function of the tooth and its surrounding tissue. Most dentures are constructed with acrylic resins along with some composite materials. However patient can chose from a variety of options:

  • Traditional plastic denture
  • Traditional plastic denture with a metal framework to make the denture strong, lightand of course biocompatible.
  • Flexible denture(valplast)
  • Flexible denture(valplast) combined with metal framework

Dentures can also be fixed now by use of dental implants.
There are two major types of dentures. The full denture replaces an entire jaw’s dentition, while a partial denture only replaces multiple or single teeth where there are still healthy teeth present. A partial denture also serves as a spacer to prevent the living teeth from shifting position.

Most patients of full dentures are in their later years and have lost most of their teeth. Patients of partial dentures are usually people who have lost a tooth to gum disease or injury. All patients receiving dentures find that their chewing improves, their oral hygiene becomes easier, and their speech clears up. On the outside, a denture can drastically improve your smile.

Denture

Dentures are specifically made for each patient’s unique anatomy. Initially they will feel awkward, no matter how well they may fit you. The fact remains that it is not a living part of your mouth and it will feel foreign to you. However, after a short period of adjustment most people don’t even notice that they’re wearing the dentures anymore.

Regular checkups with your dentist are encouraged in order to track changing conditions in your mouth. Should your teeth shift or your bones change shape with time, you’ll need a new set. Dentures have been around for a long time and are a proven way to replace lost teeth. If you require dentures please contact a dentist for a consultation.

The Plastic Removable Partial Denture
This is the least expensive of all the removable partial dentures. These dentures are generally used for temporary or intermediary purpose until the final prosthesis is made. Still yet we find many people keep this type of appliance for many, many years, just like permanent ones because as long as they are properly maintained, they look outwardly as good as the more expensive permanent appliances. The one pictured above replaces 4 missing teeth, leaving spaces for 7 natural teeth. Two of the natural teeth are clasped with wrought wire clasps which are cured into the structure of the denture base.

The pink material of the denture base is hard plastic and the same material used to make complete dentures. The main single advantage to this type of RPD is the cost. Also the new teeth and new denture base can easily be added to an existing treatment RPD. These are frequently fabricated even if the remaining teeth have existing decay or periodontal disease and their prognosis is doubtful. If later in the course of treatment some of the existing natural teeth are extracted for any reason, new false teeth can be added quickly to the partial, maintaining the patient's appearance.

Another common and infact more important use of these appliances is as an "immediate partial denture". This means that the appliance can be made before the teeth are removed, and inserted immediately after the extraction of the planned teeth so that the patient is never without teeth. This is of special help when anterior teeth are to extracted and patient wants to return back to his/her normal routine immediately.

However in spite of these advantages they have a number of disadvantages too. They are basically plastic and due to their irregular shape, these partials tend to break frequently, especially those made for the lower arch. (Full dentures are more regular in shape and tend to be fairly strong as a result.) These appliances are less stable compared to cast partials. Also cases of allergy to this material have also been reported.

Partial Denture

Cast Metal Removable Partial Denture

Cast Metal Removable Partial Denture

These Removable Partial Dentures are cast metal frameworks made of chrome cobalt.These frameworks are cast to fit the teeth .These are cast very thin and are much less likely to break than the all plastic variety. For the same reason they are much less noticeable to the tongue.

The teeth have to be altered slightly beforehand in order that the partial denture can rest upon them without interfering with the way the patient bites the teeth together. Since they sit on the teeth, as well as being attached to them, they are extremely stable and retentive

The metal framework does not contact the gums. Thus, as the gums resorb, this type of partial does not sink with them and rarely requires relines.

Advantages
  • Rarely breaks. Can also be used for complete denture cases where breakage is a frequent problem.
  • It is made very thin, so less noticeable to tongue
  • More stable and retentive

However a major drawback is the visibility of metal clasps which might be objectionable to some patients.

Flexible Dentures (Valplast) The most recent advance in dental materials has been the application of flexible materials for the fabrication of dental appliances. This material generally replaces the metal, and the pink acrylic denture material used to build the framework for standard removable partial dentures Flexible partial dentures are the comfortable, beautiful, and affordable choice The flexibility, combined with strength and light weight, provides total comfort and great looks! It is nearly unbreakable, is colored pink like the gums, can be built quite thin, and can form not only the denture base, but the clasps as well.

The preparation is relatively simple because your natural teeth don't need to be altered in any way. The Valplast® partial is virtually invisible because there are no metal clasps and the material itself blends with the tissue in your mouth so that the only thing that shows is your beautiful smile.

Valplast® appliances are very durable and are designed to give long term performance under normal usage. Small accidents such as dropping the appliance in the sink or on the floor will not damage the Valplast®.


Flexible Dentures (Valplast)

VALPLAST KEY BENEFITS ARE :
  • Retention - flexes into a retentive position, below the undercut.
  • Comfort - thin, lightweight and flexible.
  • Esthetics-pink shades allow natural tissue tone to appear through material.
  • Strength - clinically unbreakable, more durable than acrylic and won't absorb stains or odors.
  • Ease - no tooth or tissue preparation is required so you can offer patients a conservative and pain-free solution.

VALPLAST INDICATIONS :
  • Allergies to conventional denture material
  • History of partial frame breakage
  • Alternative to implants or fixed products

THE COMBINATION OF CAST PARTIAL AND VALPLAST PARTIAL DENTURE

CAST PARTIAL AND VALPLAST PARTIAL DENTURE

A good alternative to the all-Valplast or a cast partial partial denture is one made with a combination cast metal framework with valplast clasps. This has the advantage of being tooth supported and also having gum colored plastic clasps like the Valplast partial.

This combination of metal framework and plastic clasp eliminates most of the difficulty of recurrent sore spots, since the framework resists movement and pressure from the clasps, while having the benefit of nearly invisible clasps.

TMJ Problems

TMJ (Temporo-mandibular joint) disorders are diseases of the joint that connect lower jaw to the skull. These TMJ problems can result from injury, aging, and poor dental behavior like frequent gum chewing, teeth grinding, and teeth clenching. Although the presence of one of these symptoms does not necessarily indicate the presence of a TMJ disorder, common symptoms of TMJ disorders include:

  • Clicking sound in the joint during jaw movement
  • Limited movement of the jaw
  • Earaches and headaches
  • Pain in the joint during hard chewing
  • Hearing problems
  • Pain in the face, jaw, neck, or shoulders
  • Loose teeth
  • Worn, chipped, or cracked teeth or fillings
  • Clenching or grinding
  • Facial pain
  • Difficulty in swallowing
  • Pain and sensitivity in teeth
  • Crowded teeth
  • Receding gums
  • Ringing or congestion in the ears

From a medical perspective, TMJ problems are classified into three main groups of disorders: muscle disorders, joint derangement disorders, and degenerative joint disorders.

  • Muscle disorders describes TMJ problems located in the muscles that control the TMJ. These disorders are often called myofacial disorders and are the most common of the TMJ disorders.
  • Joint derangement disorders are a group of TMJ problems that is caused by either: a dislocated jaw, a displaced disk, or an injured bone.
  • Degenerative joint disorders are a group of TMJ problems that is caused by degenerative changes in the joint like arthritis that destroy the cartilage that cover the TMJ and absorbs the shocks caused by such actions as chewing. Degenerative joint disorders stem from the wear and tear of the TMJ joints.

If you are suffering from any of these symptoms and are also experienced prolonged pain, it is highly recommended that you consult a doctor. Once, your doctor has confirmed the presence of a TMJ disorder, the next step is treatment. Depending on the type of disorder that you are suffering from and the extent of it, you will undergo specific treatment.

Dental Fillings

If there is presence of caries in your mouth & to prevent further spread of decay visit your dentist. The dentist will remove the decay & restored Tooth Caries Cavity Dentistry Treatment Pune with suitable permanent. Filling material in order to prevent further spread of decay & strengthen the affected tooth.
Now a days In modern dentistry more sufers esthetically pleasant filling materials are available.
In earlier days Silver ( Amalgam) filling or gold filling restoration were common but Amalgam fillings need more of tooth sliucture removal & are susceptible to discoloration compared to composite filling.

Silver Fillings

Silver Fillings

Earlier the trend was to have amalgam fillings (silver) or gold filling restorations. These fillings contain mercury which is poisonous to the body as well as the environment. Also the amalgam fillings are generally not as advantageous as composite fillings because they demand more of a tooth removal and are susceptible to corrosion.

Composite Fillings


Composite Fillings (Tooth-coloured)

Composite is tooth colored permanent resin filling material. When is an alternative to traditional metal dental filling (Amalgam or Gold Fillings.) Tooth filled with composite filling materials looks like natural tooth & composite fillings are more durable.
If you have cavities in teeth or broken fillings or teeth full of silver fillings ask your composite dental fillings.
Silver Fillings can be easily replaced with more natural looking composite fillings.
Composite fillings need removal of only infected decayed tooth structure, it also strengthen your tooth.

Technology

  • 5 dental operatory suites.
  • 5 dental x-ray units.
  • Orthopantomograph dental x-ray system.
  • International Standard dental sterilization equipment :
  • individually vacuum packed strile instruments are opened in the presence of every patient.
  • 2 Laser systems - Ezalase system
  • Whitening systems - Zoom bleaching
  • Endodontic equipment with microscope
  • 3D computerized implant treatment planning system

Patient Education

Know your teeth... The human have two sets of teeth. The teeth of the first set are called “Deciduous or Milk Teeth”, Milk teeth are twenty in number Milk Teeth set contain 2 incisors 1 canine & 2 molars in each half of each jaw.
The permanent teeth are Thirty two in number permanent teeth set contain 2 incisors, 1 canine, 2 permolars & 3 molars (1 wisdom molar) in each half of each jaw.

Benefits of Implants Benefits of Implants  
Milk Teeth Permanent Teeth   Structure of a tooth

Tooth Anatomy:
Tooth portion that project above the gum margin called as crown & portion that is embedded within bone beneath the gum is called as root.
Structurally, tooth is composed of outermost toughest calcified covering known as enamel, Inner to that sensitive calcified layer present known as dentine.
In centre tooth contain pulp. Pulp is made up of loose tissue containing blood vessels & nerves. It is life of tooth. All sensation whether of pain, hot or cold are all due to pulp damage.

Brushing Selecting the right toothbrush :
  • Toothbrushes vary in design, size, lengh, hardness & arrangement of bristles.
  • Selection of brush is totally depend on individual performance but following points must be kept in mind while selecting toothbrush.

1) Toothbrush should be able to reach & clean efficiently most of areas of mouth.

2) Arrangement of teeth in mouth ( Spacing or Crowding )

3) It should be easy to use.

There is controversy regarding hardness of toothbrush bristles people usually think, use of hard bristles cause enamel wear, but the fact is wearing of enamel depend on brushing method of individual & abrasiveness of the toothpaste.

Improper brushing can lead to painful recession (Downward shifting of gum) & triangular shaped defects in the neck areas of teeth.

To maintain the cleaning effectiveness,it is must to replace your toothbrush as soon as bristles begin to fray.
Generally with regular use brushes wear in about 3 to 4 months times.
But, if all bristles are flattened after one to two week of use it indicate that brushing is too aggressive or if the bristles remain. straight even after 6 to 7 months of use it indicate, brushing is very gentle than required.
The recommended brush for most people should have a short head with round ended, soft to medium nylon bristles arranged in 3 to 4 rows of tufts.

Manual vs Powered toothbrushes
Powered toothbrushes are recommended for;
  • Individual lacking fine motor skills.
  • Patients with orthodontic appliances.
  • Small children, hospitalized or handicapped patients, person who need to have their teeth cleaned by someone else.
  • Anybody who prefers can use powdered toothbrushes. Best results by using powered toothbrushes are obtained only when they are used in proper way. It can be valuable replacement for manual brush if used properly & regularly.However, when tooth brush cleaning ability is compared, it provides no superiority over manual tooth brushes.

Which toothpaste to use?
  • Toothpaste aid in cleaning & polishing.
  • Toothpaste contain abrasives such as aluminum oxides & silicon oxides, humectants, water detergent, flavoring & sweetening agents, therapeutic agents such as Fluoride coloring agents & preservatives.

Use of particular brand is totally depend on personal preference.

How many times should I brush?
Generally, everyone should brush twice a day. For children, brushing at night is helpful & needed.

Tooth brushing technique

  • Use a soft nylon toothbrush with round ended bristles.
  • Place the toothbrush with its bristles along the gumline at a 45 degree to long axis of the teeth. So the toothbrush is in contact with both tooth surface & gumline.
  • With gental movements to fro rolling motion, brush the outer tooth surfaces of 2 to 3 teeth without dislodging the tips of the bristles. Apply 20 strokes in same position around the arch brush three teeth at a time.


Toothbrushing technique

  • Similarly maintaining 45 degree angle brush using back, forth rolling motion along all the inner tooth surfaces.
  • Tilt brush vertically behind the front teeth. Make several up & down strokes using the front half of the brush.
  • Place the brush against the biting surface of the teeth. Gently do back & forth scrubbing motion. Brush the tongue from back to front to remove color producing bacteria or use tongue cleaner to clean tongue.


Toothbrushing technique

Continue around the arch, brushing around three teeth at a time, then use the same method to brush the inner surfaces of the teeth. To help reach the inner surfaces of the front teeth, insert the brush vertically.

Toothbrushing technique

Flossing
Flossing

To remove the plaque between your teeth, you need to do flossing at least once a day.

Flossing

Flossing Technique :
  • Floss should be long enough to hold securely; 14 to 18 inches is usually sufficient.
  • Stretch the floss tightly between the thumb & fore fingers.
  • Pull the floss tightly into a c shaped around the side of the tooth & slide it under the gumline.
  • Clean the surface of tooth by using an up & down motion.

Mouth Rinsing

Mouth Rinsing
Generally proper brushing & flossing will loosen food particles & tooth plaque bacteria. These loosen particles can be easily removed by vigorous rinsing with water.

Repeated rinsing also results in a rapid lowering of sugar level in saliva, therefore, it is recommended that after having sugar rich food, one should rinse his or her mouth vigorously two or three times with as much water as possible to held in the mouth.
(chlorhexidine mouth rinse?)

Bad breath (Hallitosis)
Bad breath also known as halitosis is caused primarily by volatile sulfure compoundas, specifically hydrogen sulfide & methyl / mercaption which result from degradation of sulfur containing proteins.

The foul smell may have oral cause or might caused by extra oral factors. Some of oral contributing factors are retention of odoriferous food partical on or in between teeth, in carities or on tongue, artificial dentures. Smokers breath & healing surgical or extraction wounds etc.
Tooth decay & gum diseases can cause foul smell because of accumulated food debris.
Extra-oral sources include respiratory tract infection such as bronchitis, pneumonia etc, or
Breath odour due to aromatic substances in blood stream. (Diabetic breath, alcoholic or uremic breath)

Oral Surgery

All the surgeries performed at Teeth Care Centre are under utmost attention from our highly skilled oral surgeons. We are also empanelled with some of the renowned hospitals to carry our complex oral surgeries and to offer our patients world class health care facilities with international standards of hygiene and sterilization. We use multidisciplinary approach consisting some of the diligent and highly qualified team of doctors from medical field as well to get maximum treatment outcome. We ensure that specialty care is available to our patients at the earliest.

We perform following surgeries at TCC:
  • Wisdom tooth removal
  • Apicoectomy
  • Cyst/ tumour removal
  • Corrective (cosmetic) jaw surgeries
  • Temporomandibular joint surgeries
  • Cleft lip and palate surgeries

Teeth Grinding

Is your teeth grinding sound bothersome for the people around you?
It shouldn’t be taken lightly because not only grinding and clenching cause severe physical discomfort, but this habit can also cause extreme damage to the teeth which can be painful and costly to remedy. People usually grind their teeth to relieve stress, anxiety or frustration. Improper alignment of teeth is also one of the cause.

Grinding and clenching the teeth can cause jaw pain and headaches, aside from damaging your teeth. It is a very significant cause of tooth loss and receding gums.

In order to treat the problem, it is advisable for the people to wear night guards during sleep to prevent tooth damage. Botox injection is also an excellent treatment for teeth grinding. Apart from this, reducing stress is also very important. Regular exercise and meditation is recommended for reducing the stress.