Restoring the Tooth After Root Canal

After the root canal procedure your tooth may need to be restored. This gives your tooth natural shape and appearance. In the front teeth a composite filling material is used to restore the tooth. The molars and premolars need a crown. Before the crown is made your dentist will make a base or foundation to reinforce the tooth and support the crown. The base to reinforce the tooth is called a core. A post may be needed to hold the core in place. The post is a rod made of metal. Your dentist may take out a little root filling material from the root canals to make space for the post. The crown is prepared in a dental laboratory. Material used to make crown are porcelain, metal, or a combination of the two. The crown is cemented onto the base or foundation.

Root canal procedure can fail. Reasons for failure of root canal include

All the infection from a canal was not removed
All  the canals were not cleaned or desinfected
Tooth gets infected again if there is a leakage around an old filling or crown from which the bacteria can enter the tooth.
The procedure to do a repeat root canal treatment is the same but it is more complicated and time consuming than the first one because the restorative material has to be removed before the second root canal.

Most of the failed root canal treatments have infection that are difficult to eliminate.
You may need endodontic surgery, either in place of or after retreatment. If a second root canal is not possible endodontic surgery apicoectomy may be needed. During apicoectomy, the root tip, or apex, and the infected tissue are removed. Then filling is done to seal the end of the root. An apicoectomy is performed using an operating microscope. That's why apicoectomy is also called endodontic microsurgery. Apicoectomy may be needed if the tooth remains infected after retreatment. The success rate for apicoectomy is approximately 80% to 90%. If the tooth remains infected after apicoectomy also it will have to be extracted.

  Dr. Claudio A. Sorrentino

  www.dentalpalermo.com.ar

Information on Dental Implants

Dental implants are metal posts or frames which are placed in the jaw bone under the gums by surgery. After it is implanted surgically your dentist can put replacement teeth onto them.

How do Dental Implants Work
The implants after placement get fused with your jawbone. This then give a stable support for the artificial teeth or dentures and bridges. Dentures and bridges that do not slip or shift in your mouth is big advantage while eating and speaking. Another advantage of implants is that the healthy teeth adjacent to the implant don’t need to be prepared.

Where as standard bridges and dentures may not be as comfortable, and need to be fixed to teeth on either side of the missing tooth/teeth.

Prerequisite for an implant
Your gums should be healthy and there should be adequate bone to support the implant.
After implant you have to maintain good oral hygiene to keep these structures healthy.
Regular dental visits and cleaning as required will be needed for long-term success of dental implants. But remember that implants cost a lot more than the standard bridges and dentures. The two types of implants that are considered to be safe are endosteal implants and subperiosteal implants. When you consult your dentist for an implant he or she will advise regarding the appropriate implant for you.

Deciding if implants are right for you
Implants can not be placed in everyone who wants it. Your dentist after examining you will tell if you are suitable to get an implant.

Some considerations before you get an implant are
You should have healthy gums and enough bone in the jaw to allow an implant to be placed in.
If you have periodontal (gum) disease, infection or injury you may need antibiotics or other treatment for it before the implant is placed.
If there is a severe infection in your tooth root then after extraction the area will need time to heal before the implant can be placed.
At times uour jaw bone may need bone grafting or augmentation. In this procedure, before the implant is placed, your jaw bone is built up by bone grafting to increase the chance of implant success. Your dentist may do the bone grafting and place the implant at the same time. At times he or she may do the bone-graft procedure first and the place the implant after a few months (about 4 to 12 months). During this time you will be given dentures or bridge, so that you are not without teeth.
You should be ready to take good care of the implanted teeth and surrounding gums. You will have to maintain good oral hygiene by daily brushing and flossing and regular visits to the dentist for cleaning.

People who are not good candidates for implants include
Children whose jawbones are still growing
Pregnant women
Heavy smoker as smoking interferes with healing and can decrease the chance of implant success.
Excessive use of alcohol or substance abusers
Patients who have been administered high-dose irradiation to the head or neck
People with chronic diseases such as hypertension (high blood pressure), diabetes, connective-tissue diseases, hemophilia and certain immune deficiencies
Patients on medications that suppress the immune system such as steroids, immunosuppressant
People with severe bruxism (who severely grind or clench their teeth)
Your dentist after examining you will decide whether you can receive implants.

  Dr. Claudio A. Sorrentino

  www.dentalpalermo.com.ar

How Crowns and Bridges solve Dental Problems

Crowns and most of the bridges are fixed dental prosthetic devices that are cemented on the existing teeth or implants. These can be taken out by a dentist only.

How do Crowns Work?                 

A crown or "cap" covers the entire surface of a damaged tooth. It not only strengthens a damaged tooth, it improves its appearance, shape or alignment as well. It may be placed on an implant too to give a tooth-like shape and structure for function. Materials used to make a crown include porcelain, ceramic, gold and metal alloys, and acrylic. Crowns made of porcelain or ceramic match the color of your natural teeth. As the alloys are stronger than porcelain they are preferred for back teeth.

You may be recommended crown as a treatment option:

As a replacement of a large filling if there isn't enough tooth left
Prevent fracture in a weak tooth
Repair a fractured tooth
Connect a bridge
Cover up a dental implant, discolored or poorly shaped tooth, or tooth after root canal treatment

How do Bridges Work?

If you have one or more missing tooth a bridge may be advised. Missing teeth can cause:

 Remaining teeth to rotate or shift into the unfilled space of the tooth/teeth and cause bad bite.
Imbalance as a result of the missing teeth can lead to gum disease and temporomandibular joint (TMJ) disorders.
 

Bridges may be used to replace one or more missing teeth. They fill the space of the missing teeth. The bridge is attached or cemented to the existing natural teeth or implants around the unfilled space of the missing tooth/teeth. Several different material are used to make bridges. Your dentist may advice you the material based on the missing tooth (or teeth), its function, aesthetic considerations and cost. Bridges made of porcelain or ceramic match the color of your natural teeth.

How Long do Crowns and Bridges Last?

Crowns and bridges can last for the rest of your life. But they can become loose or fall out. To increase the longevity of your crown or bridge maintain good oral hygiene. The bridge can be damaged if the teeth or bone holding it in place are affected by dental disease. To maintain healthy teeth and gums brush with fluoride toothpaste (twice a day) and floss everyday and go for regular dental checkups and professional cleanings. Do not chew hard foods, ice or other hard objects to avoid damage to your new crown or bridge.

What is a crown?

Crown is a fixed dental prosthetic device that is cemented on the existing teeth or implants. A crown or "cap" covers the entire surface of a damaged tooth. It not only strengthens a damaged tooth, it improves its appearance, shape or alignment as well. It may be placed on an implant too to give a tooth-like shape and structure for function.

A crown may be recommended as a treatment option:

As a replacement of a large filling if there isn't enough tooth left
To prevent fracture in a weak tooth
To Repair a fractured tooth
To cover up a dental implant, discolored or poorly shaped tooth, or tooth after root canal treatment
There are two types of crown--- prefabricated or made in a laboratory.

Prefabricated crowns: These can be prepared from plastic or stainless steel. They are mostly used as a temporary restoration until a permanent crown is made. Rarely prefabricated crowns are used for permanent restoration.

Materials used to make crowns include metal [gold alloy, other alloys (palladium) or a base-metal alloy (nickel or chromium)], porcelain fused to metal (PFM), or ceramic. 

  Dr. Claudio A. Sorrentino

  www.dentalpalermo.com.ar