Dental Crowns(2)

Nearly 5% of PFM fail after 10 years, he noted, while many ceramic and composites fail after one.

"When you put a restoration on a patient who is 30, it's going to fail," Dr. Christensen said. "You will replace it."

Then he asked who in the audience had had to cut off a full-zirconia crown. With many hands in the air, he quipped, "You still look tired!"

He dismissed most of the burrs designed for cutting zirconia.

"Our research shows you're better off with a $1 diamond," Dr. Christensen said. "A diamond from Microcopy called Neo is one that continues to prove itself." It comprises extremely sharp diamond pieces leftover from the ring-making process, he explained.

Varnish's 'dirty little secret'

Dr. Christensen also had a specific recommendation for a fluoride varnish.

"My wife and I tested 19 varnishes and found a dirty little secret," he said. "Most of them are made by VarnishAmerica, and they kept the best one for themselves."

While other varnishes tend to leave a brown, yellow, or snow white film on teeth, VarnishAmerica's 5% sodium fluoride varnish is clear, he noted.

Dr. Christensen then turned his attention to patient referrals, noting that with other medical professions referring patients to dentists, there is often a "serious lapse."

"There are two major things that they really screw people up on: heavy chemotherapy and heavy radiation treatment," he said. "Dentists should remove the teeth that won't stand a chance" following those cancer treatments.

Patients who undergo bisphosphonate treatment should also see a dentists prior to beginning treatment for the same reasons, he said.

When it comes to weathering the current economic storm, Dr. Christensen emphasized the need for broader patient education.

"For success, you and I need to educate patients," he said. "Let them know that they need that [treatment] more than a new dress or a new car."

When it comes to potential growth areas in dentistry, dental implants(China dental labor) top the list, according to Dr. Christensen. Aesthetic dentistry is still growing, but differently than in the past.

"It isn't putting 16 PFM veneers on 16-year-olds," he said. "Prior to the recession, there were 48 million crowns placed each year; right now, there are 38 million annually. That's a heck of a difference."

However, he added, this shift is having positive side effects, particularly since dentists are trending back toward conservative dentistry.

"That's a good thing," Dr. Christensen said. "We're getting back to our roots: maintaining the health of the tooth."

Metal Crowns

"One thing I'll look at is the white stuff [non-metals] in restorative dentistry," he said during the opening of the Christensen Bottom Line 2011. "Does it perform as well as the gold stuff? I'll tell you candidly that it doesn't."

The shift in materials favored for dental crowns received particular focus during the first part of his talk. Dr. Christensen shared conclusions that his nonprofit product-testing facility in Provo, UT, had reached about many of them.

He had strong words for what he termed "this white crown business." Of them, he said, "metal crowns of the past are far superior."

Nonetheless, dental practitioners continue to embrace the newer materials. According to data from Glidewell Laboratories, "Metal is dying," Dr. Christensen said. Metal has gone from 12% of all crowns placed from 1997 to 2010 to 5.6% in the year 2010. Porcelain-fused-to-metal (PFM) crowns went from 72% to 49% in the same period. Meanwhile, all-ceramic and dental attachments went from 16% to 49.5%.

“We're getting back to our roots.”
— Gordon Christensen, DDS, MSD, PhD
His skepticism was plain as he deconstructed the reasons all-ceramic restorations are being chosen.

"The strength of some types appears to be better than in the past," Dr. Christensen said. "But I have a whole drawer of broken dental crowns. I keep them there to keep me humble."

Diabetes and Dentistry

Diabetes is a disorder in which sugars from your diet are not transported into your cells where they are needed. Over time, the disease causes defects in the smaller blood

vessels. Classic diabetic problems are blindness, loss of circulation in extremities, and proclivity toward angina and heart disease. In dentistry we see

delayed wound healing, periodontal (gum and bone) disease that is less responsive to

aggressive therapy, and greater chance of infection after dental procedures. Most diabetics require gret attention

to their home care and more frequent visits to the hygienist. dental implant surgery has a lower

success rate in diabetics, which must be understood during the treatment planning phase.

Deprogrammer

A type of dental bite appliance dental lab in China for patients with muscle pain, or myositis. It

allows only the front tooth to touch, eliminates clenching and grinding for most patients, and relaxes muscles. It IS NOT for all day use; it is usually

prescribed for nighttime therapy. Many studies have shown that the majority of dangerous clenching, grinding, and bruxism occurs at

night in the deepest sleep stages,even in people who snoresnoring device with their

teeth apart in lighter sleep stages. Studies have also shown that when asleep, with inhibitory muscle reflexes decreased, people can and clench with four to five times the

muscle force that they could consciously develop. Hence myositis can develop in overworked muscles, with the net effect of a "charley horse" in your jaw muscles.The

deprogrammer helps to relieve these muscular symptoms.

Dentin

The part of the tooth directly underneath the dental enamel. It is softer, contains more water, and

has microscopic nerve endings. Dentin is much more susceptible to decay, abrasion from toothbrushing and bruxism, and is

responsible for many sensitivity reactions when it is exposed in the mouth.

Debridement

The act of cleansing an infected area. In dentistry most often used to denote a preliminary cleaning designed to remove gross accumulations of tartar so that

subsequent cleanings or dental root planings will be more comfortable and effective. Also used to denote a more

intensive cleaning for a patient who's tooth has not recieved regular care. usually used as dental

bridge Co-Cr/high precious

dental Crown

A covering placed on a tooth to replace missing structure and reinforce or strengthen it. The most common dental crown made today are from a cast metal (preferably a gold alloy) with esthetic porcelain baked to the outside. In non esthetic areas, or for patients with exremely strong masticatory musculature, gold crowns are still used and are still the most durable restorations known. Today, we also have all-porcelain crowns, with incredible esthetics (see Procera). Crowns are indicated for broken or cracked teeth, and any tooth in which the previous filling encompassed more than one-half of the width of the tooth. Crowns are also still used to solve some cosmetic problems when bonding or veneers would not be adequate. Crowns generally require two visits, and fine crafted provisional crowns are placed for the interim.

Crepitation

Grinding or gravelly sounds from within the dental jaw joint resulting from direct contact of bone against bone with no disc, or cushion, in between. May be with or without associated pain.dental crown/bridge or implant China dental lab dental lab China

Craniofacial Team

A multidisciplinary team of dental health care professionals who perform a joint evaluation and build a care plan for patients with craniofacial anomalies, such as cleft lip or palate. The Craniofacial Team at Miami Children's Hospital, for example, consists of plastic surgeons, orthodontists, reconstructive dentists, geneticists, otorhinolaryngologists(ENT's), pediatricians, pediatric anesthesiologists, pediatric neurosurgeons, audiologists, speach pathologists, feeding and swallowing therapists, psychologists, social workers, nurse practitioners, and parent advocates who meet twice monthly to assist these worthy patients. All of the physicians and dentists donate their time to the Center.dental crown/bridge or implant China dental lab dental lab China

Crepitation

Grinding or gravelly sounds from within the dental jaw joint resulting from direct contact of bone against bone with no disc, or cushion, in between. May be with or without associated pain.dental crown/bridge or implant China dental lab dental lab China

Crown

A covering placed on a tooth to replace missing structure and reinforce or strengthen it. The most common dental crown made today are from a cast metal (preferably a gold alloy) with esthetic porcelain baked to the outside. In non esthetic areas, or for patients with exremely strong masticatory musculature, gold crowns are still used and are still the most durable restorations known. Today, we also have all-porcelain crowns, with incredible esthetics (see Procera). Crowns are indicated for broken or cracked teeth, and any tooth in which the previous filling encompassed more than one-half of the width of the tooth. Crowns are also still used to solve some cosmetic problems when bonding or veneers would not be adequate. Crowns generally require two visits, and fine crafted provisional crowns are placed for the interim.

Cracked Tooth Syndrome

sometimes confusing collection of symptoms may develop. Usually characterized by pain to biting pressure or to the release of biting pressure, patients are often unable to

detect which is the problematic tooth, sometimes describing pain on the entire side of the face when chewing. Cold sensitivity often accompanies these symptoms.

Cracked teeth are predictably identified by good diagnostic dental techniques, and are treated by crowning the offending teeth to protect them and stop the

pain-producing flexure around the crack. Anywhere from fifteen to forty percent of cracked teeth will eventually require root canal therapy. A small percentage of profound

cracks are hopeless.dental crown/bridge or implant China dental lab dental lab China

Composite

The dental dental material traditionally used for bonded dental

restorations. Made from an admixture of various glass particles in a polymerized gel-like matrix. This material is generally applied to etched enamel and primed

dentin. It is then polymerized with a curing light, a visible blue light which activates a catalyst in the composite and causes it to harden almost instantly. Today's composite

bonding materials are extremely esthetic because of the way the glass particles reflect and refract light similarly to natural enamel. dental crown/bridge or implant

Compomer

A new dental material used for cementation of fixed crowns and bridges and also for some dental restorations. Combines the benefits of composite materials with those of glassionomers. We continue to look to these materials for

future restorative materials in dentistry.

Cold Sore

The common name for blisters cause by the Herpes Simplex virus, to which 98% of the world's population has been exposed by the age of two. This is a different but similar

virus to that which causes genital herpes. Cold sores often occur on the external lip (herpes labialis), and on the gum tissue near the dental. They last from

seven to ten days, and can be treated with antiviral medications when severe. dental crown/bridge or implant

Clenching

The habit of consciously or unconsciously squeezing the dental together with extraordinary muscle force.See Bruxism. dental crown/bridge or implant

Cleft Lip/Palate

A common craniofacial defect in which the upper lip and nose form incorrectly during embryonic development.In antiquity, this condition was referred to as "hare lip". Clefts

cause disfigurement and misalignment of the dental jaws. Fortunately, in this country, almost no children are allowed to grow with this condition untreated,

despite the fact that it occurs as commonly as 1 in 700 births. Dr. Groh is proud to be the co-founder of the esteemed Craniofacial Center at Miami Children's Hospital, which

specifically helps children with this problem.dental crown/bridge or implant

Cerebral Palsy

CP is a neurologic condition caused by oxygen deficiency at some time during the development of a

baby. A wide variation in the level of affliction is seen, although the condition is

characterized by poor control of motor movements and overcontracted muscles. The more severely

afflicted CP patients often have excessive saliva, excessive calculus, and thankfully very few

problems with cavities. We find more gum care necessary for these patients than might be

expected, as some of their medications also contribute to dental gum problems.

Cementation

The placement of a fixed dental crown

or bridge with a dental cement to assure retention.

Canker Sore

A fixed dental bridge

in which the false tooth, or dental pontic, is supported only

on one side. The supporting side, or dental abutment, must be especially strong

and well designed, and the bite must be scientifically arranged to minimize leverage forces.

Cantilever Bridge

A fixed dental bridge in which the false tooth, or dental pontic, is supported only on one side. The supporting side, or dental abutment, must be especially strong and well designed, and the bite must be scientifically arranged to minimize leverage forces.

Calculus

The scientific term for tartar, which is the accumulation of calcified substance that adheres to the teeth. Calculus is microscopically porous, and provides a multitude of hiding places for the bacteria that cause gum disease. It should be removed on a schedule chosen specifically for the individual needs of each patient. It is the major target of your " dental cleanings".

Bruxism

The habit of clenching and grinding the teeth using extremes of muscle power. Often some part of the mastication system is harmed, either the muscles, the jaw joint, or the teeth. Over thirty percent of the population does this to some degree, mostly at night in deep sleep stages. People are often unaware of the habit until either signs or symptoms appear. The habit often correlates with physical or emotional stress.like dental crown/bridge or implant

Bleaching

see Whitening. like Bleaching trays.
The different forms of dental bleaching
Whitening toothpastes: These are over-the-counter preparations that have a low concentration of carbamide peroxide. These toothpastes will work to brighten your teeth if you are a very good brusher, brush many times a day, and have a lot of patience. In the years since these toothpastes have been on the market, I have seen only one person who achieved real results using whitening toothpaste only. They are very useful, however in maintaining the whitening achieved by using trays and strips.
Bleach releasing disposable strips (Crest Whitestrips): These are strips of plastic dentures designed so that they will adhere to the teeth. They are applied and worn for several hours like the trays described above. The carbamide concentration in home bleaching strips is only 7% to 14% while professionally prescribed take-home bleaches come in either 22% or 32%. Thus it takes a lot longer to get the same results using over the counter bleaching strips than it does using professionally prescribed bleaching solutions in trays. The main advantages to the strips is that no impressions need to be taken to make trays, and the strips do not apply pressure to the teeth which may increase the sensitivity of the bleaching process. A number of my patients have tried them. Some have had good results. The major problems I have heard about with the strips is that they do not adhere very well to lower teeth, and they are too short to bleach all the upper teeth that show when the patient smiles.

Bonding

The name given to the process of placing esthetic white fillings. As different from amalgam fillings, these bonded fillings actually adhere to the tooth structure and make the tooth stronger.There is a slightly higher incidence of short term sensitivity than with silver fillings, but they are very esthetic, often indistinguishable from natural teeth.

Bone Graft

Surgical replacement of bone around tooth roots or in preparation for a dental implant. The predictability is generally good, but varies according to the particulars, and should be carefully discussed with your doctors.

Bridge

Replacing a missing tooth by placing at least two dental crowns on adjacent teeth and suspending a false tooth, or pontic, in between or cantilevered from one end. This restoration is cemented to your teeth and is not removable dentures. It is carefully crafted for esthetics, fit, comfort, and cleansibility. Depending on the size and situation, the bridge may take from two to six visits to complete.A quality provisional (temporary) bridge will be in place in-between appointments.

Autoimmune

Types of disease in which the dental body reacts against itself. Some types of arthritis fall into this category, as well as Sjogren's Syndrome.

Apicoectomy

A surgical dental root canal treatment used to seal the tip of a root when conventional root canal treatment has failed or is contraindicated. Usually a very straightforward dental treatment with quick recovery.

Apexification

A special type of root canal treatment used on young teeth to help them to continue to grow despite damage to the nerve tissue. Requires changing an internal medicament about every 90 days and can take six to eighteen months to finish. It is generally a painless treatment.Like implant dental and precious attachment dental restoration.

ANUG

Acute Necrotizing Ulcerative Gingivitis, commonly called trenchmouth. Rare today because of higher hygiene standards, but still seen. Causes irreversible loss of gum tissue.
Treatment of Trench Mouth (ANUG)
Treatment of Acute Necrotizing Ulcerative Gingivitis attempts to stop the infection, relieve the symptoms and restore the damaged gum tissue.
Medications. Dentists often prescribe antibiotics for ANUG treatment, in order to fight the bacterial growth and prevent infection from spreading. Over-the-counter or prescription pain relievers are also recommended, especially if the patient can not brush or floss teeth because of the pain of the gums.
Professional dental bleaching trays. A gentle cleaning of teeth and gums by the dentist is usually the first step in the treatment of trench mouth. The dentist will also remove any dead gum tissue. As soon as the pain is reduced the dentist will perform a more thorough cleaning procedure called tooth scaling and root planing. This procedure removes dental plaque and tartar from beneath the gumline and smooths any rough surfaces of the teeth roots.
Oral hygiene. Following a proper daily oral hygiene routine is essential for the treatment of trench mouth. Teeth should be brushed gently with a soft toothbrush at least twice a day after very meal and flossed at least once a day. If the gums feel very painful for brushing, an antiseptic mouthwash may be used for a few days for the home treatment of ANUG, until the pain subsides enough to allow brushing and flossing. Salt water rinses and hydrogen peroxide mouthwashes can also help soothe the pain of sore gums.
Gum surgery. If the damage to the gums is extensive, dental cleaning and oral hygiene may not be enough to restore the gum tissues. In this case, the ANUG treatment involves gum surgery (periodontal surgery) in order to restore the normal shape of the gums.
It is recommended that during ANUG treatment, any cause of irritation to the gums, such as smoking or eating spicy foods and drinking alcohol, should be avoided. Treatment of trench mouth with regular brushing and flossing, professional tooth cleaning and antibiotics is generally effective. In mild cases of Acute Necrotizing Ulcerative Gingivitis complete healing is expected in a couple of weeks.

Amalgam Filling

The traditional silver filling(high-precious crown/veneer). Actually a mixture of silver, mercury, copper, and tin. Long lasting, but expands and oxidizes over time. Can slow down the decay process. Not esthetic.

Alginate Impression

A quick setting impression material used to make study models and some dental appliances. Sets in about 90 seconds.

Air Abrasion

A resurgance of an old technique whereby cavities are prepared with a device similar to a sandblaster. Such a "particle beam" works best on new fillings; old fillings and dental restorations are very difficult and time consuming to remove with this technique. The main advantage is that for many people, small to medium sized new cavities may be prepared without "novocaine".The noise is also much less than from a conventional handpiece.

AHA Prophylaxis

Antibiotic premedication prescribed by the American Heart Association to protect patients with heart murmurs, mitral valve prolapse, rheumatic fever history, and other conditions from infections within the heart.In China dental lab, we have PFM crown, Implant and so on.

ADA

The American Dental Association

Abutment, Implant

The part of an implant restoration that brings the height of an implant from below to above the gumline. Allows the restoration to be attached to the implant.

Abscess

A pocket or sack of pus and gas produced by an infection. Painful when pressure builds up. This situation do not fit dentures restoration.

Abfraction

Wear, or notching, at the neck of a tooth at or below the gumline. Often sensitive, often accompanied by gum recession.Thought to be caused by excessive clenching or grinding. Requires bonding when too deep.If the patient have a Bruxism, it need a night solint.