Dental Bridges Pros and Cons

Tooth under bridge snapped off at the gum line

A dental bridge is a common prothesis used to replace missing teeth. Typically the two teeth on the side of the space are crowned to anchor the false tooth or teeth in between them.
Bridges are effective to address both functional and esthetic needs until they have problems. If one side of the anchor teeth becomes detached from the bridge, the entire unit has to be removed and replaced. Decay and bite pressure can cause loosening of bridges.

This X-Ray shows a bridge that lasted over 12 years in the patient’s mouth until one side of the anchor teeth broke off at the gum line. Depending on how the tooth breaks, sometime it is impossible to replace with a new bridge.

A better alternative to bridges is to use dental implant to replace just the missing tooth if the space in between them is optimized. By treating teeth independently we can better manage the physical force of the bite on the teeth and the prosthesis.

Customized Smile Rejuvenation with Veneers and Crowns

Smile Rejuvenation to replace old restorations or unattractive natural teeth is a customized process.  Every single case begins with the diagnosis of the patient's current bite condition.  Then, a comprehensive treatment plan is presented which incorporates the balance between Function and Esthetics. The smile rejuvenation case below was achieved by taking into consideration the patient's personal preferences for things like tooth size, length, contour, colors, and detailed translucency characteristics.  We replaced her old restorations with newly designed and fabricated restorations with the latest techniques and materials.  This patient was very happy with the end result because it was exactly what she wanted.  She did not want a "Hollywood Smile", but rather a natural looking attractive smile.

It is important to note that every single case is a different scenario, and the patient's preexisting condition of the natural dentition can change the treatment options for his/her case.

Anterior Teeth Wear - Treat or Ignore?

Anterior teeth wear usually exhibits a classic pattern where the canines will get ground down first, followed by the front four teeth. It is a challenge to restore and maintain this kind of bite profile. If we go by the belief that enamel is sacred and that we should never grind away teeth to restore them with porcelain,  then allowing the teeth to destroy themselves to tiny short stumps goes against this belief.

If we restore early enough and the patient is diligent with night guard wear, then the treatment can be predictable and effective.

Anterior bite problems dictate length, shape, and position of the anterior teeth.  Hence, on occasion where dentists and patients may mistakenly violate the mechanical principle of the bite at the expense of esthetics, then one can expect the bite to fight off anything that is in its pathway.

By choosing not to treat an anterior bite case, the teeth will wear themselves away.  In the case below we can see the actual opening of the nerve canals on the front teeth.  Severe wear cases also leave us with very little tooth structure to work with.  Hence, anterior teeth wear should not be ignored.

Smile Make Over for Men

Some of the fun artistic cases for me involve changing the smiles for men.  In the case below we used a combination of gum contour, resin bonding on the canines, porcelain veneers on the lateral incisors, and porcelain crowns on the central incisors to change the patient's smile. We replicated details like the patient's natural shade transition and the surface characteristics to make the restorations look as natural as possible.  When we try to achieve a natural look, length, shape, contour, are also intentionally made slightly imperfect because in the natural dentition perfect symmetry among the teeth rarely exists.

Actual patient images of Alex Nguyen, DDS are copyrighted and digitally embedded to prevent unauthorized use.

Implant Dentistry in the Digital World

Digital Dentistry is a reality when it comes to dental implant treatments. Precise implant size, implant position, and the corresponding final restorations can all be preplanned using sophisticated computer softwares.  Advanced planning also allows us to fabricate actual surgical guides which direct the exact locations for implant placement:  The jaw is evaluated in multiple dimensions.  Digital Technology allows us to take the guess work out of implant dentistry, and helps make the treatment outcome more predictable and safe.

The image below illustrates an actual patient case in our office.  By starting with a 3D Cone Beam scan we were able to determine what kind of restorations can be done, and where to place the implants without risks to the nerves and arteries in the patient's jaw.