Posts for: September, 2014
When a permanent tooth has been injured, our first priority should be to save it. A root canal treatment (where the interior pulp of the tooth is removed and the pulp chamber and root canals are filled and sealed) is usually the best approach for tooth preservation.
An immature permanent tooth, however, presents a different challenge. While the pulp is less essential to a mature tooth’s vitality, it serves a critical purpose in the tooth’s early development before early adulthood. The pulp produces layers of dentin necessary for the tooth’s root system development. Completely removing the pulp at this stage may retard root development and cause the tooth to eventually weaken, and become brittle and darkened.
For younger teeth, we should therefore use alternative techniques that preserve as much healthy pulp as possible. One of these alternatives is Indirect Pulp Therapy, used when the pulp hasn’t been exposed by the trauma. With this technique we remove as much damaged dentin as possible while preserving the harder dentin closer to the pulp. After applying an antibacterial agent to protect against infection, and then filling and sealing the tooth, the pulp can continue to produce dentin in a normal way.
If pulp exposure has occurred, some form of pulpotomy — the partial removal of any damaged or infected pulp — would be in order. Our goal here is to leave as much of the pulp as possible, and then apply substances that stimulate the remaining pulp to create dentin. The most common type of growth substances are calcium hydroxide or mineral trioxide aggregate (MTA).
If the pulp isn’t at all salvageable, we may then turn to a procedure known as apexification. After removing the pulp we insert MTA at the root end of the tooth, then fill and seal the remaining interior as in a regular root canal treatment. The MTA will help the surrounding bone to heal and continue to grow around the root to further support the tooth.
Recent research into pulp stem cells promises further advances in this area. The regenerative qualities of stem cells could eventually help us “engineer” root development. Until then, there are still effective ways to give a young, damaged tooth a fighting chance to survive.
If you would like more information on preserving injured teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Saving New Permanent Teeth After Injury.”
Martha Stewart has built a flourishing career by showcasing the things she’s designed and made — like floral arrangements, crafts, and even home renovations. Just recently, she was showing off her latest restoration project: a new dental bridge. In fact, she live-tweeted the procedure from her dentist’s office… and she even included pictures of the bridgework before it was placed on her teeth!
OK, it’s a departure from paper crafts and home-made pillows… but why not? We can’t help feeling that there’s just as much craftsmanship — even artistry — in dental bridgework as there is in many other custom-made items. If you learn a little more about what goes into making and placing bridgework, perhaps you’ll understand why we feel that way.
Bridgework is one good solution to the problem of missing teeth (another is dental implants). A fixed bridge is anchored to existing teeth on either side of the gap left by missing teeth, and it uses those healthy teeth to support one or more lifelike replacement teeth. How does it work?
Fabricated as a single unit, the bridge consists of one or more crowns (caps) on either end that will be bonded or cemented to the existing teeth, plus a number of prosthetic teeth in the middle. The solid attachment of the crowns to the healthy teeth keeps the bridge in place; they support the artificial teeth in between, and let them function properly in the bite.
Here’s where some of the artistry comes in: Every piece of bridgework is custom-made for each individual patient. It matches not only their dental anatomy, but also the shape and shade of their natural teeth. Most bridges are made in dental laboratories from models of an individual’s teeth — but some dental offices have their own mini-labs, capable of fabricating quality bridgework quickly and accurately. No matter where they are made, lifelike and perfect-fitting bridges reflect the craftsmanship of skilled lab technicians using high-tech equipment.
Once it is made, bridgework must be properly placed on your teeth. That’s another job that requires a combination of art and science — and it’s one we’re experts at. From creating accurate models of your mouth to making sure the new bridge works well with your bite, we take pride in the work we do… and it shows in your smile.
If you would like more information about dental bridges, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Fixed vs. Removable Bridges” and “Dental Implants vs. Bridgework.”