CT Scan and Dental Implant : High Standard of Care or Basic Requirement?

October 1, 2010 alexnguyen

In my practice, this "High Standard of Care" is a "Basic Requirement". Dental Implants have become the preferred standard of care when it comes to replacing missing teeth in the mouth. The advancement of technology has enabled dentists to accurately analyze the structure of the jaw and pre-plan for the implant work.

By using specialized software with images from a CT Scan of your dentition, I can analyze some important requirements which cannot be determined accurately with simple xrays alone:

1. Bone density

2. Bone thickness

3. Bone height

4. Proximity to nerve canals and the Sinus

5. Proximity to/ angulation of adjacent tooth root

With the above analysis, I can choose the right implant size before going into the surgery. The advanced treatment planning and analysis help prevent unexpected complications such as damage to vital nerves or impingement on the Sinus.

Here are some images of an analysis of a CT Scan for Dental Implants treatment:

One should never compromise a life-long restoration by choosing an implant treatment that has not been carefully planned out. This is particularly crucial in the esthetic zone such as your front teeth where lack of planning can produce an unfavorable esthetic result.

Thank you for viewing my post, and please let me know if you have any question.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

What Should Implant Crowns Look Like?

September 13, 2010 alexnguyen

I saw a patient last week for a consultation regarding implants to replace some missing teeth. As these teeth would be displayed in her smile, she was really concerned with whether the final crowns would look like real teeth. According to her. she has been putting off implant treatment because she has heard so many horror stories about complications and the "fake" look of implant crowns. My patient's concern is completely legitimate. Implant treatments carried out with improper planning and coordination between the implant placements and the final crowns can result in unattractive results. To avoid unfavorable outcomes, ask your dentists to show you their before and after cases of actual patients. Moreover, as a patient you should have a clear understanding of the necessary steps involved from beginning to end.

Beautiful crowns which mimic real teeth require a multi-dimensional construction of bone, gum, and teeth. When it comes to the esthetic of the anterior teeth, just remember one simple rule: Crowns, Bridges, Veneers, should all look like your real teeth.

Here is a case of front teeth that I have completed for one of my patients. Can you tell which one is a conventional crown, and which one is an implant crown? In reality, no one would ever look at your teeth at this close a magnification. Nonetheless, I would always choose to address all details in order for the restorations to come to life in your smile.

All Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

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Our Philosophy of Practice When It Comes to Cosmetic Dentistry

August 31, 2010 alexnguyen

[youtube=http://www.youtube.com/watch?v=BrC7GuJKO44&feature=player_embedded] ........................................................................................

A Dental Implant Case

December 4, 2008 alexnguyen

Today I had the opportunity to explain to a new patient about the proper treatment protocol for a tooth that she is losing. Here is a great lesson about what to do when you are about to lose a tooth. The patient was told by her previous dentist: "Your tooth has a infection. Let's put you on antibiotic. Then...you come back for us to extract the tooth and to do some bone graft. Then...TWO WEEKS LATER ... we can prep the adjacent teeth for a bridge to replace that same missing tooth."

I have never heard of any bone grafting material that can fully stabilize an extraction site in TWO WEEKS. A typical bone grafting site requires any where from 4 to 6 months of healing time.

In addition, the tooth behind this failing tooth is also compromised. Using it to anchor a bridge also will not provide the patient a predictable long term result.

In a case like this where an active infection is present due to a failed root canal treatment with compromised root structure we must be even more careful with our treatment plan. A Gum Specialist (periodontist) or an Oral Surgeon would be best to handle the surgical aspect of this tooth. The proper treatment sequence would follow something like this:

1. Antibiotic Regiment to suppress the infection

2. Extraction of the failed tooth with proper bone grafting done at the same time

3. Wait for proper healing. Typically 4-6 months

4. Placement of the dental implant to replace the missing root

5. Wait for proper healing. Typically another 4-6 months.

6. Placement of a new crown on top of the dental implant.

As a patient, you need to be educated enough about a complex procedure before agreeing to the recommended treatment. Dental Implant treatments require proper coordination between a surgeon and a restorative dentist in order to achieve a successful outcome. This patient had made a very wise decision to seek multiple consultations with different dentists before choosing her own treatment choice.

Let's take a look at the tooth:

√ The furthest left arrow points to the compromised root which was proposed to be the anchor for a new bridge.

√ The middle arrow points to the fractured root of the tooth in question.

√ The right arrow points to the infection and bone loss around the infection.

failedrct30

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