What is a Sinus Lift for Dental Implant?

November 2, 2010 alexnguyen

Sometimes there is not enough bone in the areas of the upper molars and bicuspids because the sinus floor has a tendency to expand into the space after the teeth have been lost. In order to properly anchor the right implant length for strength, we need to recreate adequate bone height. With today's innovation in instrumentation and technique, we can predictably condense bone grafting material and lift the floor of the sinus to create room for the implant. After the healing period, the bone solidifies around the implant and the result is much more predictable than to use a short or mini implant.

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

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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.

A Second Opinion on Dental Treatments - The Importance of the Quality and Type of Xray!

October 22, 2010 alexnguyen

This past week a patient came to see me for a second opinion on her dental implant treatment. She brought me a copy of the xray below, and asked me if I could advise her on whether or not she should do 1 or 2 implants to replace the teeth indicated by the green arrows. She wanted to find out which of the following treatment options is better:

Note: After this xray was taken, tooth (10) was extracted and a bone graft was done for this area by an oral surgeon. In other words, tooth (10) currently is missing.

Plan A: Extract the teeth labeled (8) and (9); place an implant at (8); do a bridge from position (8) to (11).

Plan B: Keep teeth (8) and (9) as is, and simply attach a new tooth to the implant crown (11) to replace missing tooth (10).

Unfortunately, I could not answer her questions because the copy of the xray given to her was not useable. Printed on regular white printer paper, the xray was dark and fuzzy. I could not clearly see the bone level at the location of these teeth. In fact, to identify the health of the existing teeth, other types of xrays would be necessary to have for our evaluation of the current condition. In this case, xrays called periapicals (often abbreviated PA) would then allow us to not only evaluate the bone but also the root structure and internal condition of these teeth. For example, if the integrity of teeth (8) and (9) is normal, and a successful bone graft was done for (10), then why would we want to remove 2 additional fully functional teeth?

We simply did not have enough information to determine an accurate evaluation based on this xray alone. Furthermore, when it comes to implant treatment, accurate studies of this patient's bite also would be necessary in order to complete a diagnosis and treatment plan.

When asking for copies of your xrays, please remember to ask your dentist to provide you with quality copies. This most basic diagnostic tool must be clear and readable.

What do Veneer and Crown Temporaries look like?

October 16, 2010 alexnguyen

The temporaries are made to protect the underlying tooth structure as the final porcelain restorations are being fabricated in the ceramist's laboratory. Veneer and crown temporaries should look good. Finely made temporaries should have perfect marginal adaptation to the underlying teeth. The surface should be well polished to resist staining, since the material is simply an acrylic form. In our office we spend a significant amount of time on the temporaries because they should not affect the lifestyles and career demands of our patients. In other words, at the very least, no one should notice at conversational distance that your teeth are in temporaries.

Furthermore, well made temporaries will also allow the gum tissue to remain in perfect health. This clinical result will allow the dentist to ensure a perfect bond between the porcelain and the teeth at the final cementation process. If the gum is inflamed from improper fabrication of the temporaries, the end result may be compromised due to possible contamination of fluid and blood from bleeding gum around temporaries.

The term "temporaries" is misleading in a sense that they are only meant for short-term use. In fact, all details considered in the final restorations must be taken in to consideration with the ... "temporaries".

Here is a photo of a sample case of one of our patients, taken on the day she returns for her final porcelain restorations. Note that the four front teeth are bonded with acrylic temporaries.

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

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Which Mouth Wash is good? Beware of advertisements when choosing consumer dental products !

October 8, 2010 alexnguyen

In a marketing driven country, consumer dental products are often pushed with claims to do wonders for your dental needs. Mouth rinses and toothpastes have been introduced with claims to help promote combinations of treatments. Here is a case where the FDA has contacted CVS to address inappropriate claims on the label of their CVS Complete Care Anticavity Mouth Wash. Apparently, we need to be cautious when choosing a product with the claim : “Helps prevent cavities, Kills germs that cause bad breath, Rebuilds enamel and strengthens teeth, and Promotes healthy gums.”

Which mouth wash and toothpaste are you using at home, and how did you make that choice?

Read the letter in the link below, and be careful when choosing your dental products.

Warning Letters CVS Pharmacy, Inc. 9/27/10.

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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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