Unusual Symmetry

 

 

 

 

 

Patient presents with tooth decay and perio pain.

Treatment plan includes extraction of non-functional, bilateral bicuspids.

 

 

 

 

 



Rampant Decay

 

Above: What rampant decay looks like clinically.

Below: What rampant decay looks like radiographically.

 

 

 

 

Recommended treatment plan for this patient included dentures.



Wisdom Teeth Extractions

The 3rd molars in each quadrant are wisdom teeth.  In other words, the last tooth on the upper right, upper left, lower left and lower right.

This 3D model developed from iCat CT machine. Note the last teeth in the arch.  The top wisdom tooth is #16 and the bottom wisdom tooth is #17.  It is partially impacted under gums and bone.

Before extraction: Note how tooth #17 is only partially erupted. Left alone the gums around it can get sore because it is hard to keep  well cleaned.  This leads to cavities and gum disease.

After extraction: Tooth #17 has been removed.  In order to create enough space to pull the tooth, a little bone beside and behind the tooth had to be removed as well.  Note the white bone showing adjacent to the extraction socket.

KOR In-Office Teeth Bleaching

You can't do this with at-home bleaching trays.

Gums protected from extra-strength bleach (red) with liquid rubber dam (green).

The white tooth is a crown and can't be whitened. 

Denture Impression Comparison

Our denture lab has suggested the Accu-Gel impressions system.

Massad technique model.

Accu-Gel System 1 technique model.

Unilateral Condylar Hyperplasia

 

 

32-year-old black male, Asymptomatic

Note slight asymmetry

 

 

 

Unilateral (L) Condylar Hyperplasia

 

 

 

TMJ views showing Right and Left condyles

 

 

 

 

 

 

 

 



Dental Implant Surgery - Replace missing tooth #5.

 Cone beam CT technology to evaluate implant candidacy.

 

 Flapless, tissue punch technique. No bleeding.

 

 Selected implant.

 

 Osteotomy.

 

 Implant placement.

 

 Placement evaluation.

 

Healing cap placed.

 

Patient to return for crown after 4-6 months of healing.

 

 

 



 

Pathology: Odontogenic Cyst

 



Easy Treatment Plan

 

This was the easiest treatment plan of the week. 

Extraction, Dentures.



24/25 Gingivectomy

 

 

Simple surgery gives 15-year-old more confidence.

 

Before: Note pedunculated gingiva approximating teeth #24, 25.  

After: Excess tissue removed with electrosurgery.  No bleeding due to vessel cauterization.

Why do I need a Root Canal?

Patients often say to me, "I'm not in any pain, Doc.  Why do I need a root canal?"
While it's true that pain is one reason to need root canal therapy, it's not the only reason.

Look at this x-ray, for example, and notice the large circular shadow at the end of the tooth root (shown by the arrow).  This "lesion" indicates an unhealthy loss of bone around the tooth. 

This tooth is almost certainly dead and feels no pain.  But the infection that killed the tooth inside is now coming out the end of the tooth.

Untreated, our bodies will continue to lose bone (on purpose) to try to get rid of this tooth, the source of the infection.  The process is similar to a splinter getting red and sore until the splinter is pushed out.

Root canal treatment will clean and disinfect the inside of the tooth then seal it from future infections.  Once the infection is removed, our bodies will fill in bone around the tooth root once again.