In today’s world, cosmetic dental treatment is quite a common procedure. The demand for dental treatment is high, and dental clinics are more than happy to supply this ever-growing demand.
But what are the dental treatment options? Which options address which issues? What are the steps of these treatment options? Lets take a quick look.
Possibly the simplest and least expensive way to enhance a smile is to bleach the teeth to make them shine bright.
As the bleeching can be damaging for flesh, lips and gums are covered with a protective material, leaving only the teeth exposed. A whitening gel is applied to teeth and zoom light is used to activate the gel for whitening effect. This procedure is repeated for few times to lighten the teeth and remove stains and discoloration.
This procedure only changes the colour of teeth and it has no effect on the shape.
Picture 1: Teeth whitening process
Dental bonding is a simple and low cost treatment to address discoloration and/or deformity (chipped, decayed, cracked or mishapen teeth can be repaired with bonding). A putty-like resin (which is a durable plastic material) with a matching color is used for bonding.
During the dental bonding, tooth is roughened to increase surface area for better bonding. Resin is carefully applied to the tooth with help of a conditioning liquid, and molded for the perfect shape. A bright light or laser then applied to harden the resin in place. If it’s required further trimming and shaping can be done by the dentist afterwards. Bonding can be applied to multiple teeth.
However, resin isn’t as stein resistant nor as long lasting as crowns, veneers or fillings.
Picture 2: Dental Bonding
Dental Veneers and Crowns
Although their treatment process is somewhat similar, veneers and crowns differ in their extend and purpose.
Veneers are thin shells that replaces the front surface of teeth. They are made of porcelain or zirconium and they can be produced in various colours and shapes depending on patients’ needs.
To perform the veneer treatment, around half a milimeter of upmost layer of front side of the teeth (the upmost layer of teeth is enamel, which is the hardest mineral substance of human body) is trimmed by the dentist, which is an amount nearly equal to the thickness of the veneer that will be placed afterwards. Next, dental impression will be taken for the veneers to be sent to the dental laboratory, where the custom-made veneers are produced for patients’ teeth. It will take a few days for laboratory to produce the veneers and patient will be given temporary teeth for this duration. Once the veneers are ready dentist will remove the temporary teeth and clear the treatment area to prevent any bacterial growth, and the veneers will be cemented on top of the trimmed tooth.
Picture 3: Laminate Veneer
Crowns treatment is similar to veneer treatment in many ways. Like in veneer treatment, teeth are trimmed for crown treatment as well which is then followed by the dental impression process. Just like veneers, crowns are also custom made for each patient, based on the impression, measurement, patient expectation (colour and shape). However, crowns replace the entire crown part of the tooth (basically the the part of the tooth that is above the gum line and covered with enamel). To be able to do this, teeth are trimmed down to the stub (entire enamel is trimmed down to the dentin). Furthermore, crowns have the option to be produced with a metal core. Crowns with metals core can be more suitable to be used in implant treatment due to being more durable compared to full porcelain and zirconium crowns. However they look less natural and under a strong light, their metal core can become somewhat visible.
Picture 4: Dental crown procedure
Veneer and crown treatment can address the colour and shape problems and can be used for full mouth makeover. In addition, crown treatment can address the small gaps caused by missing teeth with a bridgework, as long as gap isn’t too wide for the material to handle.
Dental Implant Treatment
Dental implants are titanium posts that are screwed into to jawbone to replace an extracted or missing tooth root. With the placement of an abutment on top of them, they act as sturdy bases to support individual crowns or bridgeworks that consist of multiple units of crowns. Crowns and bridges are connected to the implants with the help of a connector known as abutment. Implants can vary in size and surface type, and dentist would recommend the use of the right type of implant after examining patient’s jawbone and discussing about their needs.
A typical implant treatment consists of two stages. During the first stage, dentist cuts the gingiva on the treatment area and drills a channel in the jawbone to place the implant in. Gingiva is closed and stitched after that. This procedure is performed under local anesthesia, but depending on patients’ choice, a twilight sedation can be applied as well. While under twilight sedation, patients are still responsive enough to assist the treatment and follow dentists instructions, however they do not feel pain and they also do not remember the experience afterwards. Once implant is fitted and gingiva is stitched, patients can return to their daily lives. If required, they can be given temporary teeth as well.
Following the first stage, a 3 to 4 month healing time is required for bones to fuse around the implant, completing the ossification. A healthy ossification is required for implants to be able to steely support crowns and bridgework. If crowns are placed before the ossification is completed properly, implants can be wobbly and even fall off.
Once the ossification is completed, dentist opens the gingiva once again and places the crown/bridgework on top of the implant with the use of the abutment.
Picture 5: Dental implant procedure
In some cases, patients can have insufficient bone density or depth. In such cases, dentist can perform minor treatments, such as bone grafting and sinus lift to address this issue.
All on Four Implant Treatment
All on Four Implant Treatment All on four is an implant treatment technique that fixates a dental prothesis with use of 4 implants that are placed in specific angles into the jawbone. It is the most comfortable treatment option for patients with no teeth. This treatment can be also implemented with 6 implants if it is needed.
Picture 6: All on Four prothesis without gingiva
Picture 7: All on Four prothesis with gingiva
After losing all teeth, patients can experience bone loss, reducing the distance between the gums and nerve line for the lower jaw and sinus gaps for the upper. This would prevent dentists from performing a regular implant treatment as implants shouldn't reach to nerve lines and sinus gaps. While these issues can be addressed with bone grafting and sinus lift, all on four technique enables dentist and patient to by pass these additional procedures, reducing the time consumption, complexity and cost of the treatment. 4 (2 additional implants can be added if it is required for additional assistance) are placed into the jawbone in certain angles. 2 implants are fitted into the front area, where the bone is thickest, and 2 more is fitted into the back area. Front implants are fitted vertically, while back ones are fitted with 45 degrees. Following the implant fitting a temporary dental prothesis is placed on top of the implants. This way patient gets to have teeth right away. Permanent teeth can be placed at least 3 months after. What are the advantages of All on Four treatment?
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