“Late in the evening on Monday night I was carrying a large heavy object up the basement steps. I lost my footing and fell forward striking the object face first. The results of this mishap left me with a broken front tooth. I was able to find the other half of my tooth and saved it. The next morning my wife called your office from a referral from one of her co-workers. The office staff made room for me in their schedule and saw me that day. As soon as I was greeted when I walked into the office, I felt welcomed and very comfortable. The receptionist was very polite and sympathetic to my new smile. During the assessment, I had let you know that I had recovered the other half of my tooth. You then advised me to get the broken tooth and soak it in saliva as soon as possible to keep the tooth from drying out. So, I left the office on Tuesday with the plan for the next visit to re-attach the broken tooth in two weeks. On Wednesday(less than 48 hrs after the incident) an appointment opened up. Amazingly, you were able to re-attach broken half by re-bonding. I am very happy and appreciative of not only having my old smile back, but to also have it done so quickly was impressive. Thanks again to you and your staff for an exceptional dental experience, I look forward to returning for a regular dental check up soon.” – G.L.
Our patient had just fractured his upper front right lateral and was very upset with a broken front tooth. Luckily, he saved the piece of his fracture tooth that was pretty much intact. Since the nerve was not involved, we decided to use a very conservative cosmetic technique to “re-bond” his fractured tooth back in place. Overnight we had our patient store his tooth in a small cup of his own saliva to rehydrate it. The following day when we saw him, we made sure the small piece of tooth fit like a puzzle piece with his remaining tooth.
We then treated this piece of tooth like a porcelain veneer and used thinned out composite that matched the shade of his tooth to bond his tooth back in place. Our patient was thrilled that within 40 minutes he had his smile back. This technique is the most conservative way to restore a fractured front tooth where the piece of tooth is intact. You cannot do this with multiple small pieces of tooth.
By saving his real tooth , this avoided a more expensive root canal, post and core buildup and a full porcelain crown. Whenever there is trauma to front teeth where the force is enough to fracture off a tooth, there always is the risk of a future root canal if the nerve was adversely affected. Our patient understands this and was very happy to have his smile back.
If you or someone you know breaks off a large piece of a front tooth in an accident, save that piece in a shot glass sized cup of that persons saliva to keep it moist and hydrated. Then contact a dentist familiar with this conservative treatment. You never know if your tooth (and smile) can be saved.
Our patient lost all of her lower teeth and had little of the lower jaw left. This made wearing a denture almost impossible. Our solution was to have five dental implants placed in the lower jaw. After they healed and integrated/fused to the jaw, a titanium bar was made with special “locator” attachments welded on the top of the bar. The bar was screwed into the five implants and secured.
We provided a full lower denture that was thinner and more streamlined than a conventional denture. On the undersurface of the denture, the three locator attachment spots snap onto the bar. Once the denture is snapped in, it does not move around, is not bulky and our patient can eat most anything without the denture shifting. The denture is taken out at night and the lower bar and denture are cleaned.
3-Unit Dental Implant Bridge
Here are photos of a 3-unit implant bridge that we completed for our patient to restore his lower left jaw. Our patient did not want a removable partial denture that would have to come out each night. The X-rays show two dental implants that support the 3 unit bridge. He was thrilled to have a solid bite again and is looking forward to eating any foods he wants. The dental implants also help to prevent the jawbone from wearing away.
Custom Implants with Porcelain Crowns
We inserted custom abutments and they seated seamlessly. Both porcelain crowns fit perfectly and needed no adjustments. The patient was thrilled with the results!
Implant Supported Bridge Replacing Lower Front Teeth
When Periodontal (gum) disease causes the loss of bone around the teeth in the lower jaw, the bottom front teeth are affected the most. The reason is that the front four lower teeth are slender and are not supported by a lot of bone. They are also in use with everything you eat and take a lot of biting force. When half of the bone is lost around these teeth, they start to get loose, which is accelerated by heavy biting forces. Once these four lower front teeth are lost, there are several ways to replace these teeth.
One way to restore this area is with a removable partial denture that comes out at night and is attached around the back teeth with metal clasps and acrylic. Another way to add teeth is to “bridge” the area with a fixed bridge of teeth. However with a fixed bridge, two or more teeth may need to be cut down to hold the bridge in place.
Usually the best choice to replace the missing teeth is to place two titanium implants and cement a 4-unit implant bridge such as above. Our patient chose to have a fixed solution that does not come out or involve cutting down good teeth. Plus, an added long term benefit is that the implants function like real tooth roots to stimulate the bone and prevent it from wearing away.
Our patient had lost her all lower left teeth behind her Canine (Eye Tooth). She did not want to have a partial denture that she would have to take out at night. She also did not want the metal bar that connects to the other lower teeth on the right side to keep the partial in. Our patient elected to have two dental implants placed and a fixed dental bridge cemented onto the custom abutments that attach to the implants in the jaw. This 3-unit bridge is strong, stable and does not come out. Our patient was thrilled with her implant bridge and was happy she decided to have this care done.
Lower Full Hybrid Dental Implant
Our patient had lost all his lower teeth due to gum disease. He did not want to wear a lower denture that moved around when he talked and ate. He also did not want to take his teeth out at night and put them in a cup. Our solution was an Implant Supported Fixed Hybrid Lower Denture that is stable and does not come out.
Our Periodontist Dr. John Nikas placed 5 lower dental implants, and Dr. Briglia made and placed the fixed lower denture. Our patient was very happy with his decision to go with the fixed lower denture. He now can eat whatever he wants without the fear of a loose or wobbly lower denture.
Removable Hybrid Implant
Our patient had no posterior upper back teeth that could hold a conventional partial denture in. To restore her upper back teeth, the two main options were to either extract the remaining teeth to make a regular full denture that comes out at night, or plan a fixed option. Our patient elected to have four dental implants placed in the upper jaw and to have titanium bars attached to the implants. On the titanium bar, locator adaptors were welded to the fixed bar.
The pictured upper partial denture that you see has no metal clasps that have to go around the front teeth. The undersurface of the removable partial denture has special locator attachments that snap into the fixed titanium bar. Once snapped in, the partial denture needs no denture adhesive, does not move at all, and allows our patient to eat anything she wants. The partial denture does come out at night for cleaning and storage until the next day. All full dentures and partial dentures should be removed and cleaned each night. Removable dentures and partials are meant to come out every night in order to keep the oral tissues and the roof of the mouth healthy.
Denture Implant Supported Teeth with Fixed Screwed in Bridge
Dental Implants with Locator Attachments to Support Removable Denture
Upper Front Implant Crown
This patient lost a front tooth which was replaced by a dental implant and porcelain crown. Can you guess which one it is? Our patient was thrilled with his new tooth and was happy he did not have to wear a removable partial denture, or to have teeth cut down to make a bridge.