During the first visit of the patient we examine carefully the oral cavity. We evaluate the condition of the hard and soft dental tissues, we do the required x-ray pictures and based on that information we form an individual treatment plan.
During regular "preventive" check-ups (usually 1x per year) we control the status of oral hygiene and the possible formation of new dental caries.
Dental hygiene is an integral part of correct oral care. Due to the fact that dental plaque forms continually and its proper removal is many times problematic, professional dental hygiena in often intervals is unavoidable.
Standard visit frequency is twice per year, however, in patients with periodontitis it can be even more often. Except of careful removal of dental plaque and calculus, polishing of surfaces of teeth and fillings and fluoridation, we pay great attention on instruction of proper home care-cleaning of teeth and interdental spaces.
Treatment of caries or dental trauma is the most common treatment procedure in the dental office. We prefer white "photocomposite" fillings, which preserve the biggest amount of hard dental tissues and offer perfect function and esthetics.
Advantages of photoconposite fillings:
-less stress on tooth structure during occlusal forces (mastication)
-esthetics: similar color with the tooth
-better compatibility with the tooth and the soft tissues than amalgam
-bonds chemically to the tooth structure=It can function in even smaller cavities without the need of removal of unnecessary dental tissue.
Disadvantages of photocomposite fillings:
-they generally last less than amalgam fillings, typically 7 to 10years
-technically more demanding procedure, for example is required completely dry operating field.
Root canal treatment comes into place, when dental caries irreversibly damages the pulp of the tooth. For successful treatment is necessary to find all the root canals, sufficiently mechanically clean them, disinfect them chemically and then hermetically close them with the filling material.
In some cases, the while procedure is performed within a single visit, however, in more complicated teeth (eg.more root canals or complicated root anatomy, teeth with a lesion or during the re-treatment of an old, insufficient root canal treatment) more than one visit is needed. To make sure, that treament is precise, we use materials and equipment of the newest technology.
If is needed to replace a missing part of a tooth, a whole tooth, a group of teeth or the whole dentition, then we can perform fixed prosthetic treatment with crowns, bridges or removable dentures, whose common aim is to replace the missing tissues in the best possible way.
CROWN:
Crown is a protective cap, which covers the tooth, whose own crown part is severely weakened (for example due to caries or trauma), where a normal filling is not possible anymore. The crown protects that tooth against fracture and renews its function and esthetics. Main condition of the treatment is healthy and rigid root of the tooth and sufficient hard dental tissue on which the crown is placed. Crowns are used on implants ad well.
Materials used:
Metal-ceramic (ceramic fused on metal core):
- Classical, verified type, very resistant, used mainly in the distal part of the mouth. Its only disadvantage is that, after some period of time, the edge of the gum might recess and, as a result, the dark, metal edge of the crown might be visible.
- Full Zircon crown (anatomical zircon)
High strength, satisfactory esthetics, also used mainly in the distal part of the dentition.
- Zircon-ceramic crowns (ceramic fused on zircon core)
Crown with high strength, which offers at the same time great esthetics, without the possible disadvantage of the metal-ceramic crown. It is, therefore, used in the distal and in the frontal part of mouth as well.
- Full ceramic crown (many layers of ceramic fused to each other):
offers the best imitation of the natural esthetic of the tooth but has the lower strength, so it is used mainly in the frontal teeth.
BRIDGE:
Bridge is an artifical denture, which aims to close the gap formed by the loss of one or more teeth. Contrary to removable dentures, bridge fully restores mastication function. In bridges there is no pressure on the gums, but on mucosa.
Materials used:
- Metal-ceramic
- Full zircon
- Zircon-ceramic
Advantages of bridges:
-Faster, easier, cheaper solution than implants or when implants are not possible
Disadvantages of bridges:
-need to prepare("grind") the neighboring teeth.
REMOVABLE DENTURES (PARTIAL OR TOTAL)
They are dentures, which replace missing teeth and are kept in place either by metal clasps or even by suction effect, in case of total dentures.
Dentures are made of acrylic base, which has on it artifical teeth.
Advantages of removable dentures:
-Cheaper, faster, easier solution technically
-do not demand perfect hygiene
Disadvantages of removable dentures:
-Removable, often unpleasant during eating
-retention is often problematic, especially in case of lower total dentures
Esthetic month rekonstruction is the renovation of appearance and function of damaged teeth. We can achieve that with composite fillings or ceramic veneers or even simply by bleeching (tooth whitening). With age also changes the color of the teeth, enamel becomes more yellowish or darker and on it appear dark spots or other esthetically unpleasant features.
Ceramic veneers:
Ceramic veneers is a very commonly used tool in esthetic stomatology. They are very thin pieces of ceramic, which are cemented on frontal, visible tooth surfaces. In that way, we manage to cover-among others-esthetically unpleasant filings, mechanical tooth damage, big gaps between teeth or discoloration of teeth. They are also suitable for patients with smaller orthodontic problems. We can apply veneers on one or more teeth at the same time.
Basic condition is healthy tooth. Decision about treatment with veneers should be made after careful dental examination and evaluation of the patient individually.
Veneers are made in the laboratory after minimal tooth preparation, is, therefore, considered as a very conservative treatment method.
Ceramic material brings many advantages. It has similar physical properties like real teeth and due to its smooth surface it prevents accumulation of bacteria that cause dental plaque and caries. Color is permanent and thus resistant to discoloration from specific foods or drinks. In case of damage, for example due to trauma, veneer is easily removed and replaced by new.
Tooth bleaching
Bleaching or 'whitening' can also improve a patient's smile. In our clinic we offer both home and office bleaching. Main condition is healthy teeth without caries or gum inflammation, for optimal result we recommend patients a so called 'white diet'.
Dental implants
Dental implant is a metal screw of a length 8-15mm, which is made of titanium. After careful examination of the patient and the bone condition, it is inserted surgically to jaw. After this surgical procedure, which usually lasts between 20 to 30 minutes, you can continue your normal daily activities.
After surgery follows a period of healing, typically 3 to 6 months. Healing time of the bone might last longer in case of special bone corrections. After the end of that period, we apply the so called 'healing abutment' on the implant, which is already healed inside the bone and we leave it in place for 2 weeks. The purpose of the healing abutment is to shape the gum around the implant. After that, we remove that abutment and we insert the final crown/bridge, which is made in the dental laboratory.
Advantages of implants:
- possibility to make a fixed bridge in areas where otherwise would be possible only a removable denture
- no need of preparation of adjacent, healthy teeth
- can aim on fixation of removable dentures
Disadvantages of implants:
- might be problematic integration to the gums in the so-called "aesthetic area"
- implant could be rejected by the organism. Fortunately, this might happen in only 2% of cases. In that case, we typically remove the implant and place a new. Smokers and diabetics have 8-12% higher risk. Therefore, the selection of patient for this surgical procedure should be very careful.
WHEN WE DO NOT RECOMMENDED IMPLANTS:
- Diabetes mellitus
If diabetes was developed in a later age (type 2), then you should follow special diet and use medications. We inform you about higher risk of complications, but implant is not contraindicated.
If diabetes was developed in a young age (type 1) and you inject insulin, then the risk is a lot higher.
- Anticoagulation treatment-blood thinners
Aspirin treatment is not a problem, however, Warfarin treatment might cause serious complications, so in that case, we usually do not indicate implants.
- Corticosteroid treatment
Corticoids, which are typically used for the treatment of skin and autoimmune diseases, can worsen a lot tissue healing. In case, when corticoid treatment is only short-term, then we can normally implant after some months.
- Age
Important is rather the lower limit-we do not implant patients younger than 18 years old, because the jaws are still growing.
- Smoking
Healing in smokers is typically slower. Occasional smokers do not run a big risk, however, in smokers of 15 or more cigarettes per day the prognosis of the implant is usually very poor.
- Condition of teeth and oral tissues and hygiene
IT IS NECESSARY TO TAKE CARE OF TEETH, IN CASE OF IMPLANTS THIS APPLIES 2x!!!
Before the insertion of the implant, the oral cavity should be properly treated. Patient should understand the fact that-in case he didn't lose his tooth/teeth due to trauma- then the reason was most likely insufficient oral care, which leads to caries or periodontal disease. Insufficient oral care is the most usual cause of implant failure.
Extraction of tooth is necessary, when conservative treatment is not possible or it is purposeless. T
The most common reasons are tooth mobility due to periodontitis, deep caries, trauma or orthodontic treatment. Treatment is painless, due to local anesthesia. Every patient is informed beforehand about the procedure and the postoperative care.
In case of bigger and more complicated procedures, we refer the patient to specialized surgical departments, for example in case of badly erupted wisdom teeth.
