Ceramic Crowns And Bridges Fixing Tips

What are Dental Crowns and Tooth Bridges?
Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily, crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.

How do Crowns Work?

A crown is used to entirely cover or “cap” a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function. Porcelain or ceramic crowns can be matched to the color of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive.

Losing a tooth to infection (decay) or trauma can be a painful experience. Imagine that you are in a dental chair and just got a new tooth or a bridge fitted. It is a joyous experience, almost like a new found lease of life, to be able to eat better and look better. However, even after a few days to a week, you realize that the new crown is just not settling down completely. There is a constant sensitivity that exists and is not allowing you to enjoy the new tooth.  

There are various reasons that the new crown can be sensitive, some of them including:

1. A high point: On the new crown, there could be small points that do not allow for a bite as earlier. This can lead to sensitivity and minor jaw discomfort. 
2. Improper fit with exposed dentin: This can happen at the neck area, where the crown is not fitting the tooth, leaving a small part of dentin exposed. This can lead to sensitivity once the crown is fixed in.
3. Other decayed teeth: If there is a decayed tooth adjacent to the crown, it could be confusing and sometimes difficult to pinpoint the exact area.

If it persists for more than a week, check with your dentist on the following:

1. Severity of decay: The extent of decay in the first place should be considered, especially if you have had crown as a result of extensive tooth decay. If it was involving a large portion of the dentin, the changes of having sensitivity are high, even after a crown placement.  In these cases, there could be silent abscess, which may never manifest as symptoms, but can cause a gnawing sensitivity issue with each bite.
2. Area of decay: Root caries and cervical caries are more prone to have sensitivity compared to the crown of the tooth. The enamel layer in these areas is thin and the chances of dentinal involvement is high. The rate at which the decay will reach the pulp and cause pain is also higher.
3. Type of dental treatment: If extensive metal work is done, the sensitivity might last longer than a week, which is the norm.
4. Triggering factors: Make a note of what triggers the sensitivity, hot, cold or sweets. 
5. Management: As mentioned, expect the sensitivity with your new crown to last for up to a week. In some cases, it may be longer, depending on, as noted above, the severity of the original decay, the area, triggers, etc. 

While some cases may be managed with a small trim of the crown, some may need the crown to be re-fitted, and some may even require re-treating the tooth completely.

How They Work

A dental implant is basically an artificial tooth root (typically made from titanium) that is anchored in place of a missing tooth. A temporary protective cover screw is placed on the implant while it fuses with the jawbone (a process called osseointegration). This process can take up to six months to complete, but creates an incredibly stable, durable prosthetic. After completed osseointegration, the protective cover is replaced by a temporary crown. This serves as a template around which the gum grows and shapes itself in a natural way. The process is completed when the temporary crown is replaced by a permanent crown.

(Read more about dental implants)

A dental bridge is in some ways less invasive and other ways more invasive than a dental implant. Unlike implants, bridges do not replace a tooth root. Rather, a bridge uses one or more surrounding teeth as a support on which to attach a crown that can fill the missing tooth space. The treatment process is not nearly as long as the implant process (which requires osseointegration); though in some ways it is more invasive because it requires the permanent alteration of adjacent teeth to support the bridge. As the name implies, a dental bridge literally bridges the gap between teeth resulting from a missing tooth. The restoration therefore must be anchored to one or more adjacent teeth, which must first be filed down in order to function as a support.

When a tooth is lost, the dental implant or dental crown would be the closest replacement both in terms of chewing efficiency and facial appearance.

Unlike a denture, the implant replaces not just the crown structure but also the root portion. This ensures that the tooth is replaced as it was prior to the loss. When clinically done properly and cared for appropriately, the dental implant can last for decades.

Why Is a Dental Crown Needed?
A dental crown may be needed in the following situations:

1. To protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth
2. To restore an already broken tooth or a tooth that has been severely worn down
3. To cover and support a tooth with a large filling when there isn't a lot of tooth left
4. To hold a dental bridge in place
5. To cover misshapened or severely discolored teeth
6. To make a cosmetic modification

And, if you have gone for dental implants, keep the following in-check to maintain a good oral health after you the implant is done- 

• Until the effect of the anesthetic wears off, do not eat or limit to drinking something cold. Avoid anything hot or spicy for the first day.
• Start using the mouthwash from the evening of surgery and continue through the entire week. It should be held in the surgical area for at least a minute, repeated 3 times daily, for the first week.
• The other teeth should be brushed from the evening of the surgery. The surgical area should not be touched for the first 3 to 4 days. After that, depending on the pain tolerance, gently brush this area with a soft toothbrush.
• Add a teaspoon of salt to a glass of warm water, keep it in the surgical site for a soothing effect. This can be repeated as many times as possible, after each meal or snack.
• Follow a soft diet and do not let the food go into the surgical site area.
• Do not disturb the surgical site with either tongue or finger.
• Smoking should be completely avoided until the wound completely heals. The negative pressure created during can dislodge the clot and lead to delayed healing and even complications like dry socket.
• Expect some swelling and/or bruising in the cheek and mouth area, which will increase for the first 2 to 3 days and then gradually subside. Swelling can be managed with ice packs or a cold towel that is applied for 10 minutes with half-hour breaks. From day 2 onwards, gentle heat can be used.
• Similarly, expect pain for the first couple of days which can be controlled with pain-killers. Take the first pain-killer before the anesthetic effect wears off.
• Continued pain and swelling after the first 4 to 5 days should prompt a visit to the dentist, as it might be an indication of underlying dental infection.
• If you have dentures over the surgical implant site, try using them to the least extent possible for the first week.
• Complete the entire antibiotics course after the surgery.

Appropriate post-operative care goes a long way in ensure the implant gets absorbed and lasts a lifetime. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

What is All-On-6?

Six implants placed in a completely teeth-less jaw, providing a secure and optimal support for a fixed bridge/denture. It is the most Comprehensive, Successful, Safe, Simpler, for completely missing teeth.

 

 

 Why All-On-6?

* Using Nobel Biocare (Sweden) / Alphadent (Netherlands) Implants with Life Time Warranty (Scientifically documented over a decade).

** Upto 14 fixed metal free Zirconium ceramic teeth per jaw.

*** If more than 35N torque achieved on placement of implants.

Phases of All-on-6 Dental Implant Procedure

The entire process of treatment includes two phases. However, after your first visit, your ugly, broken teeth will be gone, you will have your implants in place, and you will leave smiling with a beautiful temporary set of teeth.

 

Phase I:

– Diagnosis and planning with panoramic x-rays/ CBCT scans – Necessary health checks. – Tooth extraction (if required) and dental implant placement, followed by immediate provisional denture (fixed).

Phase II:

The temporary bridge is replaced with the final full mouth metal free Zirconium crown and Bridge.

Benefits of All-on-6 Immediate Function Dental Implants

• Suitable for almost all bone quantities.

• None or very small bone graft required.

• Simple and good predictability from a surgical perspective

• Well-balanced prosthetic support for an immediate function procedure

• Attractive prosthetic solution, Immediate Function & fixed prosthesis

• No healing time required prior to functioning

• Fast , fixed and cost effective.

All on 4 dental implant procedure for completely missing teeth with minimal bone

(Scientifically documented for 20 years, with 99% success rate)

 

What is All-On-4? 

Four implants placed in a completely teeth-less jaw, providing secure and optimal support for a fixed bridge/denture. The posterior two implants are specially designed and angulated to achieve, the most Comprehensive, Successful, Safe, Simpler, Graft-less, Minimum-Number-Implant-Solution for completely missing teeth.

Often, tooth loss is accompanied by loss of the jaw bone which poses the problem of reconstruction of the jaw bone. For the implantation to be successful, it is necessary to transplant bone from other parts of the body. It requires an additional surgery and many patients can not do the transplant of bone for general health reasons also (diabetes and others).

The All-on-4 solution, will address these drawbacks because it consists in establishing a fully customized denture (bridge) based only on four titanium implants. These implants act as “pillars” to the bridge that supports the prosthetic teeth. The invented process allows taking advantage of existing bone, even if scarce, avoiding having to use bone grafts.

The posterior implants are substantially angled at approximately 45 degrees to avoid compromising the sinus cavity in the upper jaw and the nerve canal in the lower jaw.

The All-on-4 solution owes its name to the very nature of the method, which consists of applying a dental prosthesis with at least twelve teeth (bridge) fixed in the jaw, based only on four titanium implants.

The specific implants or pillars used are protected by international patenting.

Benefits of all on 4 dental implant procedure

– High success rate : Mandible – 98.1%, Maxilla – 98.42% (Success Rate at Cosmodent Dental is 100% till today)

– High aesthetics and function.

– High hygiene maintenance capability.

– Simple surgical procedure, since only 4 implants are used.

– Walk-in Edentulous and walk out Dentulous in less than a day.

 

3RD DAY WITH NEW TEETH

All –on-4

1. Classic -Noble Bio care Implant+ Ceramic Crown

2. Premier- Noble Bio care Implant + Zirconia Crown

(KOS, BCS & BOI Basal Implants)
(say good bye to bone grafting, sinus lifts, and nerve repositioning)

For all queries regarding Dental Implants Call +918588097530  or email to dr.amanahuja@yahoo.com

Dental implants are changing the way people live. They are designed to provide a foundation for replacing teeth which look, feel and function like natural teeth. Moreover the facial contours are also preserved. With dental implants, the person who has lost teeth regains the ability to eat virtually anything.

There are different protocols/techniques for Dental implant treatment. Cosmodent Implant team believes only in scientifically proven protocols. The proven Branemark Protocol is a two stage dental implant treatment which requires 3 to 6 months with 2-3 sittings. Patients undergoing such treatment have to wait for a longer time before they can enjoy the benefits of better appearance, chewing, speech and their self confidence.

What is Permanent-fixed teeth-in-5days protocol?

Permanent-fixed teeth-in 5-days protocol is the in thing in dental implant treatment today. As the name says, every patient receives fixed permanent ceramic teeth in exactly 5 days from the day of implant placement. The most conservative (flapless) surgical technique combined with an in-house dental laboratory can deliver fixed teeth in 5 days.

With Permanent-fixed teeth-in-5-days protocol we can replace a single tooth, several teeth, or a full mouth of teeth, upper or lower, with remarkable comfort, predictability and aesthetics.

Permanent-fixed-teeth-in-5 days, How is it done?

The Permanent-fixed teeth-in-5 days protocol is performed in a single phase. It includes,

– Any tooth extraction, as indicated

– Implant placement, as planned

– Custom made CAD-CAM (designed ‘n’ milled) permanent prosthesis (teeth) fixed on Implants.

Day 1

On the first visit, the implant team clinically examines the patient, followed by necessary OPG taken for preliminary assessment. A 3D CBCT Scan (COSMODENT has an in-house OPG facility) if required, will be performed for precision planning. A virtual placement of implants will be demonstrated to the patient on the 3D CBCT SCAN, before finalizing the treatment plan. As a part of the treatment planning, the technique, cost factor and different fixed teeth options will be explained to the patient.

Day 2/3

The teeth are extracted and the basal implants are also placed during the same surgical visit. Impressions are taken for permanent ceramic teeth.

Day4/5

The permanent ceramic teeth are custom prepared and fixed within 5 days.

Thus the timeline for Permanent-fixed teeth-in-5 days is completed within one trip. At Cosmodent, we place 8 to 10 implants to restore the upper jaw and 6 to 8 implants for the lower jaw. The technique includes a combination of compression implants, basal implants and pterygoid implants. With this combination, every patient receives a full set of fixed teeth, without any bone graft procedure, sinus lift or nerve repositioning, that too with a lifetime warranty.

With these 8 to 10 basal implants, a full set of permanent ceramic teeth are fixed. A full set means the patient gets a total of 14 teeth on each arch, including the 2nd molars. The fabrication of permanent teeth takes approximately 4 to 5 days in our hi-tech dental lab. These permanent solutions are exclusively customized for you using CAD-CAM precision, along with the manual artistry and dexterity of skilled technicians. You have varied options to choose from such as metal ceramics, metal free Zirconium or titanium based crown and bridges.

Why is Permanent-fixed teeth-in-5 days protocol so successful at Cosmodent?

• Vast experience of the multispecialty implant team, close to 2 decades, with thousands of implants placed, a big percentage of which includes immediate loading implants.

• Constant collaborations with leaders in immediate loading implants, Ihde Dental Switzerland and their associates. COSMODENT has standardized the rehabilitation of edentulous jaws, using this wonderful technique which is based on basal implants and immediate loading implants.

• With an in-house X-Ray, OPG, every implant planning and placement is done with ultimate precision. Hi-tech CAD-CAM supported, dental laboratory with 20 versatile and artistic dental technicians, in team with 2 high profile Prosthodontists (tooth replacement specialists) make sure you get the most natural looking, functional teeth in just 5 days time.

• It means that implant treatments are done with high standards of sterilization and state-of-the-art equipments.

• Even though every practitioner claims painless/ stress less placement of implants, we believe that full mouth implant placement needs more attention as far as the stress factor is concerned. To overcome this issue, the implant centre is equipped with conscious sedation machines, general anesthesia facility and a senior anesthetist on call.

• The implant centre even has inpatient facilities, if you prefer round the clock attention and surely some savings on your accommodation.

Advantages of Permanent-fixed teeth-in-5 days protocol using KOS, BCS, BOI implants.

• The BCS implants can be placed immediately after extraction.

• KOS, BCS and BOI Implants are designed to be immediately loaded. That means permanent teeth (not removable dentures) can be fixed in 5 days.

• This implant system heals faster, when they are loaded immediately, so no waiting for 3-6 months, for Osseo integration.

• As these are single piece implants, so no screw loosening, less chance of peri implantitis.

• These implants can be placed flapless (except BOI, which needs a gum incision and suturing) so more patient comfort and faster healing assured.

• BCS and BOI (basal) implants are smooth surface implants. The advantages of smooth surface implants are-more resistant to infections-less maintenance needed-less bone resorption around implants-less risk of periimplantitis…(which is a major reason for implant failure )

• This protocol can be performed in controlled diabetic patients, smokers and patients with severe gum disease with equal success.

• In a single visit….both extraction and implant can be completed. So, a single surgical visit is required, compared to a two-staged implant protocol, thus avoiding multiple surgeries.

• These implants are from highly reputed IDHE DENTAL, a SWISS company which is known for its perfection.

• All patients can enjoy the benefits of permanent fixed bridges on implants within 5 days.

• This improvised technique is equally reliable as the traditional techniques.

• This protocol can often be used to replace a single tooth, several teeth, or a full mouth of teeth, upper or lower, with remarkable comfort, predictability and aesthetics.

• The Permanent-fixed teeth-in-5 days protocol is completed in a single trip.

Comparison of different implant treatment techniques at Cosmodent.

• Versatility of the implant team is very crucial in implant treatment planning and execution.

• No single implant procedure is ideal for every clinical situation. Many of the known implant practitioners perform only a single technique for every situation, because they are only familiar to that one technique. They not only promote that technique, they even put down other modalities. This is lack of expertise and knowledge.

• No technique is superior to any other technique. The fact is that, different techniques and approaches are required for different clinical situations, for the ultimate success of implant.

 

#	Permanent-fixedteeth-in-5days	All-on-4	All-on-6 / 8	Zygomatic implant
Relative risk of failure	Less risk, lifetime warranty	Less risk, lifetime warranty.	Less risk, lifetime warranty.	Mild risk of sinus infection, life time warranty
Cantilevers	No cantilevers required	Technique designed for cantilevers on either side	No cantilevers required	Technique designed for cantilevers on either side
Type of prosthesis	Metal Ceramic or Zirconium Ceramic Crown & Bridge	Acrylic (initial), Final prosthesis with Titanium Hybrid Denture or Procera Implant Bridge	Metal Ceramic or Zirconium Ceramic Crown & Bridge	Acrylic (initial), Final prosthesis with Titanium Hybrid Denture or Procera Implant Bridge
Type of implants	Single piece Implants. Combination of compression screw, Basal Implants and Pterygoid Implants are used.	Two piece implants	Single piece Implants /Two piece implant	Two piece implants
Screw loosening	No screw loosening, since single piece implants used	Screw loosening rarely a problem. But has an advantage of unscrewing the Prosthesis to clean and polish	Combination	Screw loosening rarely a problem. But has an advantage of unscrewing the prosthesis to clean and polish
Infections	Mild risk	Mild risk	Mild risk	Mild risk of Sinus infection
No of implants	6-8 for lower jaw. 8-10 for upper jaw.	4- 5 implants	6-8 implants	4-6 implants for upper jaw
No of teeth	12-14 teeth in each jaw. Teeth replaced till second molar	10 teeth (initial) 12-14 teeth (final)	12-14 teeth in each jaw. Teeth replaced till second molar	10 teeth (intial) 12-14 teeth (final)
No of trips	One trip, as permanent ceramic crown or bridge is placed in 5 days	Two trips. Final teeth fixed after 3-6 months of implant placement.	One/Two trips.	Two trips. Final teeth fixed after 3-6 months of implant placement.
Dental lab support	COSMODENT have CAD-CAM Dental Lab support	COSMODENT have CAD-CAM Dental Lab support	COSMODENTin house CAD-CAM Dental Lab support	COSMODENTin house CAD-CAM Dental Lab support

Classic- Simpladent- IHDE Implant+ Ceramic Crowns

Premier- Simpladent-IHDE Implant + Zirconia Crowns

Cosmetic dentistry primarily involves improving a person's smile and facial appearance. It could involve the teeth, gums, cheeks, lips, or the bite of the patient. Accordingly, a change can be produced in the color, position, size or shape of the teeth, alignment of the teeth, contouring of the smile, etc. The end result is always a better facial appearance and improved confidence level of the patient.

Some common examples of cosmetic dentistry include:

• Teeth whitening: There are very few people who are happy with the color of their teeth. Everybody wants whiter teeth and therefore go for options like bleaching. This can be done either in the dental office or done at home. A word of caution though - go for teeth whitening only after the consultation with a dentist.
• Veneers, crowns: Just as the color of the teeth, the shape of the teeth also leaves a lot to be desired for almost everybody. Veneers are applied on the teeth after removing a thin layer of tooth structure. Minor reshaping and contouring of the tooth can also be done, especially to improve appearance in the front teeth.
• Tooth contouring/shaping: The edges of the teeth can be smoothened by mere shaping or contouring. There is no extra material that is added to the tooth here. In some cases, a thin layer of resin may be bonded to the tooth if required.
• Bridges: In cases the adjacent teeth shape, size, or color mismatch, then bridges can be done to even out the difference and produce a more corrected appearance.
• Braces: Braces are a big hit as they help correct misaligned teeth. However, the next step with invisible braces and ceramic braces is another step towards moving away from the traditional metal braces, which itself was not cosmetically received.
• Onlays and Inlays: Improper tooth shapes can be corrected with parts of the teeth that either replace only a small decayed portion or the entire crown portion to produce a more pleasing effect.
• Implants: Though fixed bridges do a very good job at replacing lost teeth, implants go to the next level in terms of the aesthetic replacement.
• Gingivoplasty: In cases where the gums have black spots, are too short, or are too long, the gums can be shaped to provide a better teeth visibility. The gums can also be sculpted to produce a more appealing gum line that shows off the teeth to give a more harmonious smile.
• Bite correction: In addition to braces, in some cases, bite correction may be required to smoothen out a sharp cusp or reduce the prominence of the canine.

With a number of corrections possible, cosmetic dentistry is here to stay - just as the drive to look good.

Multiple tooth replacement:

Individuals missing several teeth can undergo multiple tooth replacements with implant supported bridges. All lost natural teeth can be replaced with dental implants. Individual crowns or implant supported of fixed bridges can restore full functionality of the teeth with just the appropriate fit. There are several treatment options available for multiple tooth implants such as removable partial dentures, implant supported bridges and multiple tooth supported fixed bridge.

The procedure

Like most dental implants, screws and cylinders are affixed into the jaw surgically. The procedure is performed under local anaesthesia. Over a period of time, the implants are allowed to bond together with the bone forming anchors. Temporary teeth replacements are provided during the interim integration period. The areas are then uncovered to allow the gums to heal. Most modern implant systems do not require the second step and one-stage implants can be executed. In such a case, an implant already has a piece of extension attached.

Multiple tooth replacements 

Treatment options available for multiple tooth replacements are performed with implant supported bridges. One of the most superior forms of treatments for multiple tooth replacements, this implant stops bone deterioration and are much more comfortable than any other methodology. The additional advantages of the implant supported bridges are maintenance of facial integrity and gum line is intact. Natural adjacent teeth are preserved and the implants feel and act just like original teeth. Biting, chewing and eating all substances are possible with implants. Dental implants are a permanent solution that is durable and does not require cleaning solutions or adhesives.