Combo Case

Implants are everywhere in people's mouths today...
here is a case where there are two implants in the back section of the mouth and I connect those two implants with a natural tooth that had a root canal and a post.
The natural tooth is somewhat questionable as to its longevity so i am hoping that by stabilizing it with the impants I will get extra years from it...
If in the future the natural tooth needs extraction then I will have a single tooth implant placed there...we shall see

4 little teeth/caps

Well when you are in dental school they sort of scare you away from doing crowns/caps on the lower front teeth..why...well they are very small and hard to prepare properly..the angle to work on them is tough even though they are right up front...and the teeth are small and any mis-prep and you hit the nerve...
but sometimes we have no choice..this gentleman had radiation and chemotherapy about two years ago and since that time his lower front teeth were continuously getting new areas of decay...
finally we decided to cap them all and hopefully prevent future decay...I had to make sure to get the crown margins below the gum level to prevent gum level decay and that made it even harder..but here he is and here are the crowns at the cementing visit..
the gums are a little puffy from irritation from the temp but i am optimistic that they will tighten up around these little caps!!
It helps when they come out looking this good..the patient loved them!

sometimes you get lucky...

A long time patient came in about two months ago...reported that she took a fall and may have injured her front teeth...clinical and xray exam showed nothing unusual.
About a week later the tooth took a turn for the worse..it was still asymptomatice but it had turned a dark grey...I explained this was due to the traumatic injury and would need to be treated ASAP with a root canal treatment to remove the damaged puly tissues.

Root canal treatment was successful but she still had a greyish tooth..and being that this is right up front and center it was no good!!!

A crown or laminate was ruled out as the whole tooth was basically intact and I felt that due to the unusual prominence of the tooth any artificial restoration, no matter how good, would be obvious...

So we decided to do an internal bleaching, often called a walking bleach...although this can sometimes have some unintended side effects...we decided to go ahead with it.

It basically involves placing a bleaching material in the tooth and letting the bleach penetrate the internal discolored aspect of the tooth...well the patient came in ten days after the first treatment and we had a huge success.

The patient and doctor were thrilled!
Please click on the photo to get a larger version!