TREATMENT OPTIONS

The proper use of the term All-on-4 refers to the ability to use 4 implants to support a full arch of teeth without bone grafting.  The technique was originally designed for the upper jaw to avoid sinus grafting by distally tilting posterior implants. By avoiding grafting procedures, healing times are greatly reduced.  Distally tilted implants are also useful in the lower jaw to avoid the nerve canal and extend the teeth further posteriorly for better bio-mechanical support.

Many patients worldwide have been restored with a full arch of teeth in both upper and lower jaws using the All-on-4 technique.  Implants are placed more precisely using the digital technology that is employed at Three Village Prosthodontics.  We have also accomplished All-on-4 treatment with immediate loading.  Immediate loading refers to the fact that the implants and the teeth are placed in one visit.  All patients are not amenable to this one visit approach, but under the proper conditions, it is a predictable procedure that greatly reduces treatment time.

Bonding is an adhesive process that can be used to permanently attach porcelain veneers or composite materials to tooth structure.

A fixed bridge technique has been used with high success for many years. Teeth on both side of the missing space are prepared for a crown. Then a false tooth is joined to the crowns, and the entire bridge is cemented to the prepared teeth. The patient cannot remove the bridge, and special aids are available to keep it clean. In the appropriate circumstance, a fixed bridge can be a viable alternative to a dental implant.

Crowns cover or “cap” a tooth to restore the normal function and appearance of the tooth. Crowns may be made of all metal, porcelain fused to metal, or all-ceramic (porcelain). Crowns are indicated for teeth with very large fillings, teeth that have had a root canal treatment, fractured teeth, worn teeth and misshapen and/or discolored teeth.

Dental composites are a tooth-colored material commonly used as a filling material. It can be a way to build, reshape or change the color of teeth. This material can be used to conservatively alter the appearance of teeth as well as fill in places where cavities have been removed.

Cat Scan Technology has evolved to develop improved imaging of patients with significantly less radiation and discomfort.  Our in house I-CAT machine made by Imaging Sciences International delivers a scan of the jaw in 8.5 seconds while the patient sits upright.  This enables our office to use computer software to virtually place implants and produce surgical guides for guided implant placement.

Cosmetic dentistry consists of any dental work that improves the appearance of a person’s teeth, gums, or smile. Depending on the patient’s desires, cosmetic dentistry may range from simple teeth whitening to bonding to porcelain veneers to full mouth restoration.  The American Dental Association recognizes nine dental specialties. Prosthodontists are the only ADA-recognized dental specialists with formal training in creating beautiful smiles. 

Dentures are removable replacements for missing teeth. Complete dentures replace all teeth and removable partial dentures replace some teeth. By matching each individual’s unique smile and bite, dentures can improve facial appearance and self-confidence. Dentures may also improve speech problems caused by missing teeth and will improve chewing.

Digital X-rays use low levels of radiation and an electronic sensor to create a black and white picture of the teeth and surrounding bone. Digital imaging is a relatively new technology in dentistry and offers features that enhance the viewing of any problem areas. The images are displayed almost instantly on a computer screen and are stored in the computer allowing easy electronic transmission. Like traditional dental x-rays, digital x-rays are used inside the mouth to examine the teeth, the jaw-bone and dental restorations.

Dental x-rays, including digital x-rays, play an important role in the diagnosis of decay and failing crowns and fillings, the correct placement of dental implants, and the proper treatment of teeth requiring root canals. Digital x-rays are utilized to help with evaluation of the upper and lower jaws, the sinuses, and the temporomandibular joints. All dental x-rays, including digital x-rays, use very low levels of radiation and are very safe. Protective lead aprons can be used to cover various body parts when x-rays are taken.

Enamel shaping can correct uneven edges of the front teeth or round off sharp pointed tips of the teeth and make the smile more proportioned and even. This may be done in some situations to correct a person’s bite. 

Esthetic restorations can help you achieve a more natural-looking smile and improve your teeth’s natural beauty and strength. Prosthodontists can replace stained, chipped, missing or worn teeth with crowns, veneers, bridges, and implants using the most advanced esthetic restorations to bring back your beautiful smile.

Dental fillings replace lost tooth structure due to dental decay or fracture of the tooth. In advanced cases of lost tooth structure, porcelain or gold crowns and onlays may be required. In simple cases, the missing tooth structure can be replaced with dental fillings using composites.

Fluoride decreases dental decay. Since 1945, the U.S. Government has advocated the controlled addition of fluoride to public drinking water. In small amounts, ingested fluoride seems to strengthen the enamel while it is being formed in young children or pregnant women. Recommended levels of fluoride in water should range from 0.5mg – 1.0mg per liter of water with 0.7mg per liter as optimal. Applying fluoride to the teeth in the form of toothpaste or gels helps prevent tooth decay and can also decrease the sensitivity of exposed root surfaces

People with severe dental problems are candidates for a full mouth reconstruction. As the name implies, full mouth reconstruction refers to rebuilding all of the teeth in a patient’s mouth. Full mouth reconstructions combine esthetics with the science of restorative dentistry to improve the health, function, and beauty of the smile. Crowns (caps), dental bridges, dental veneers and/or dental implants may be used in a full mouth reconstruction. In some patients orthodontics may also be employed to help properly position the jaw and align the teeth.

UNDERSTANDING GUIDED IMPLANT PLACEMENT

Three Village Prosthodontics employs digital technology which allows us to perform state of the art implant treatment with comfort, speed and efficiency.  Guided implant placement is accomplished by combining CAT scan technology with next generation software enabling us to accurately place implants with the highest precision possible.  The procedure we offer is a two step process done entirely in our office.  The first step for the patient is to undergo a CAT scan.  In order to do this, we have installed an I-CAT machine from Imaging Sciences International which performs a scan in 8.5 seconds while the patient sits upright.  More importantly, our Cone Beam CT scanner delivers improved imaging using a small fraction of the radiation that a medical CAT scan delivers.

Step two employs software created by Nobel Biocare that converts the CT data into three dimensional skeletal forms allowing for virtual implant placement.  Virtual implant placement means that the dentist has the ability to create a computer generated surgical guide that provides unprecedented accuracy for implant placement.  This guide enables the dentist to enter the jaw only at the location where the implant will be placed.  This digital scanning approach is a vast improvement over the more commonly used and invasive procedure of surgically opening the entire jaw line.  The planning and preparation that is necessary for this technique requires the expertise of a Prosthodontist whose training provides the in-depth competency required to precisely identify final tooth position and placement prior to treatment.

Fully embracing this technology we acquired the necessary equipment in our office in 2006.  Since that time Three Village Prosthodontics has become one of the leading practices implementing virtual implant placement in the United States and one of a handful of practices in the Northeast that can perform this technique entirely in house.  We encourage our patients to consider this greatly improved technology whenever there is a need for tooth replacement.  This is clearly the procedure of choice for anyone requiring a solid foundation to replace missing teeth.

Dental implants are titanium cylinders  surgically placed in the jawbone where teeth are missing. Implants replace the roots of missing teeth and support single crowns, large bridges and dentures. State-of-the-art technology makes it possible for these implant-supported replacement teeth to look, feel and function like natural teeth. There are many types of dental implants and many ways to use dental implants to achieve your goals of a pleasing smile and good chewing function. 

An occlusal splint or orthotic device is a specially designed mouth guard for people who grind their teeth, have a history of TMJ pain and dysfunction or have completed a full mouth reconstruction. An occlusal splint is custom made using detailed study models on an instrument called an articulator that simulates the movement of the jaws. The occlusal splint is made from a processed acrylic resin and is designed to guide the jaw as it moves side to side and front to back. This precise custom orthotic device not only protects the teeth from harmful habits, but it supports the TMJ and the muscles that are used in chewing.

For patients missing several teeth, but not all of their teeth, a removable partial denture may be recommended. This type of denture uses the remaining teeth to hold or anchor the removable bridge in place. There are many different types and designs for removable partial dentures.

Typically, a removable partial denture is made of a metal framework with pink plastic to replace the gum tissue and plastic or resin denture teeth. The number of missing teeth and their location will affect the comfort and stability of the removable partial denture. The use of dental implants may increase the stability of a removable partial denture, or dental implants may be the best solution for replacing the missing teeth. 

When a tooth is overly sensitive to cold or sweets the exposed tooth can be sealed. Sealants can microscopically bond to the exposed tooth and also prevent the formation of caries.

Many patients are unhappy with the appearance of their teeth and want a “smile makeover”. Often patients want “perfect” bright white teeth, but this type of smile makeover usually looks artificial and unnatural. What patients are truly seeking is a satisfying and esthetic enhancement of their smile that also retains a natural healthy appearance of their gums.  A prosthodontist has completed advanced training in the restoration of teeth to their natural form, color and function, and the ADA recognizes prosthodontists as specialists in this field, including smile makeovers.

Many products are now available for patients to whiten their teeth. These products include commercially available strips; custom fabricated trays with a bleaching gel; or bleaching in a dental office using UV light or laser as the catalyst. There are limitations to these products.  Your prosthodontist can determine the best teeth brightening and whitening procedures for you.

Porcelain laminate veneers are used to modify the shape and color of teeth. Veneers are thin shells of porcelain that are etched and then bonded to the enamel of the teeth. A small amount of tooth structure must be removed to make room for the porcelain veneer and to avoid making the tooth look big and bulky. The tooth preparation is usually limited to the enamel and involves less tooth surfaces, unlike a crown or cap A prosthodontist uses porcelain veneers to improve the appearance of teeth and to even close spaces or gaps between teeth.

Radiography refers to the use of x-ray radiation to create images of structures of the body. Like medicine, digital radiography is gradually replacing the traditional dental radiographs using film. Either technique uses low levels of radiation to create a black and white picture of the various structures in and near the mouth. X-rays are used inside the mouth to examine the teeth, the jaw-bone and dental restorations. Dental x-rays play an important role in the diagnosis of decay and failing crowns and fillings, the correct placement of dental implants and the proper treatment of teeth requiring root canals.  X-rays are utilized to help with evaluation of the upper and lower jaws, the sinuses and the temporomandibular joints. All dental x-rays, including digital x-rays, use very low levels of radiation and are very safe. Protective lead aprons can be used to cover various body parts when x-rays are taken. Protective lead aprons can be used to cover various body parts such as the abdominal area or the thyroid gland during procedures requiring x-rays.