Tooth Extraction – What happens next?

May 9, 2017

Overeruption

What happens when you lose tooth?  Well, it’s not the end of the world, but your teeth all have a reason for being and there are consequences when one is lost.

Firstly the bone around the area is lost because there is no stimulation anymore.  In the above photograph you can see the gum has shrunk away.  This can be mild as above, or extreme as in the photograph below:

3bx

The bone progressively wastes away.  Once the bone is lost it is very hard to replace this missing tooth, as the bone needs to be rebuilt before a dental implant can be utilized.   Also the remaining teeth start to move and shift into the space as shown below:

Overeruption2

2cxMolar move

Drift X2

The extra load can lead to further cracks and splitting of the remaining teeth:

1Fracturetooth1

Eventually the straw on the camels back reaches breaking point and multiple tooth failures occur.  If this also results in bone loss the end result can be catastrophic:

DSC_0030

3nohealth

I am reminded of the old tale – for the want of a nail the shoe was lost, for the want of a shoe the horse was lost, for the want of a horse the battle was lost, for the want of a battle the kingdom was lost.


Porcelain Bridges – missing lateral incisors and cosmetic dentistry

February 17, 2013

What a difference a smile makes!  This patient was missing her lateral incisors – a common genetic occurence.  Her options were a denture, bridges, or implants.  I would prefer inplants but there was no room in the bone to fit them.  She had worn the denture since a teenager and hated it – why wouldn’t she.  That only left us with bridges.  A bridge is a false tooth that is attached to the exisitng teeth on either side or both sides.  Traditionally this meant cutting the tooth significantly.  Newer techniques give us more options.  These bridges have been made with Zirconia, a very hard and strong porcelain, with a wing wrapping around the back of the front teeth.  By use of a new spray on porcelain bond, we were able to bond the Zirconia wing onto the back of the front incisors without any prepping or danage to the existing teeth.  The porcelain bride cantilevers out over the space.  I have also closed the dark triangle between the front teeth with tooth coloured composite resin bonding as the patient found it unattractive.  I think we have ended up with a lovely result.

B1Hayes (2) B3Hayes (4) B2Hayes (3)

B4Hayes (6)

DSC_0004 DSC_0001 DSC_0006

 

 

 

 


Adult with baby teeth – bonding

November 10, 2010

This dental patient was missing her lateral incisors and the adult canines erupted into the space, with the baby teeth canines still in place.  You can see the baby teeth have worn down severely, and the adult eye teeth look bulky in this position.

The best way to treat this would be by extracting the baby teeth, moving the eye teeth to where they should be with orthodontics, and then placing implants in the spaces.  Unfortunatley this would be expensive and take many months to complete.

While our patient is saving for the best long term solution, we were able to provide a great compromise using dental composite resin.  This will prevent further wear and is completely reversable.  It was done in one appointment for the cost of less than 1 crown.

You can see the compromise is the position of the gum due to the adult eye tooth being so large.  That is why orthodontics and implants in the long term will be the best option for the missing insicor teeth.