Loss of Vertical Dimension

Vertical dimension is the space between the upper and lower jaws. In a normal occlusion with a full dentition the space is ideal with the teeth and jaw working in harmony. Over time, especially in older patients this space can diminish if the natural teeth are worn down  from bruxism or lost due to decay or periodontal disease.

This loss of vertical dimension or bite collapse can result in damage to the jaw joints, severe pain or dysfunction in the jaw joints, frequent muscle tension headaches, tooth fractures and tooth loss, and aggravation of periodontal disease if present. Other resulting issues are shortening of the lower face height, an inverted smile (corners of the mouth sag), a toothless smile, frequent cracking or chapping at the corners of the mouth (angular cheilitis), and problems chewing.

Restoring the proper vertical dimension and associated cosmetic and functional problems can be obtained by proper treatment planning. In the case of a full dentition with worn teeth, the teeth can be crowned and returned to their natural size. For partial or fully edentulous patients implants can be utilized along with removable or hybrid appliances. Below are some before and after pictures depicting loss of vertical dimension and its correction.

by Dr. H. Kopel, DDS

 

 

Posterior Dentition

Dr. Karnakova with Dr. Zak Dental Care discusses the problem of Posterior Dentition. The lack of posterior teeth may have many negative consequences on the oral health. Posterior teeth support the vertical height of the face, and may lead to a posterior bite collapse if missing.

 

Sinus Lift Surgery

A key to implant success is the quantity and quality of the bone where the implant is to be placed. Missing upper back teeth are among the most difficult to restore.    When the back teeth in the upper jaw are missing the sinus cavity becomes larger as the natural bone deteriorates over time.  If you’ve lost bone in that area due to reasons such as periodontal disease or tooth loss, you may be left without enough bone to place implants.

A sinus lift, also called sinus augmentation or sinus elevation, is a bone –augmentation procedure for patients who have insufficient natural bone below the sinus so that one or more implants can be placed. Sinus lift surgery can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. Several techniques can be used to raise the sinus and allow for new bone to form. In one common technique, an incision is made to expose the bone. Then a small circle is cut into the bone. This bony piece is lifted into the sinus cavity, much like a trap door, and the space underneath is filled with bone graft material. This can regenerate lost bone and tissue. Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. After the implants are placed, an additional healing period is required. In some cases, the implant can be placed at the same time the sinus is augmented.

3D scan imaging often is incorporated into the sinus lift and implant process. This advanced imaging shows us the height and width of bone and the location of the maxillary sinus.3D imaging allows us to map out the details of existing structure and perform the sinus lift with the greatest amount of precision.

The procedure does not affect speech, intonation or cause sinus problems. Many patients experience minimal discomfort during this procedure. Undergoing sinus lift surgery has been shown to greatly increase your chances for successful implants that can last for years to come.

by Dr. Nadia Abazarnia, DDS

 

Lack of Posterior Dentition

It is not uncommon for people to have concerns about the health of their anterior teeth due to concerns of esthetics and a beautiful smile. Equally as important are posterior teeth, which play an important role in chewing, grinding, and crushing food. Anterior teeth are designed for biting and tearing, and are unable to handle the stress of chewing.

The lack of posterior teeth may have many negative consequences on the oral health of an individual. Posterior teeth support the vertical height of the face, and may lead to a posterior bite collapse if missing. The missing of posterior teeth can also lead to the drifting, flaring, or extrusion of remaining dentition. Speech impairment and temporal mandibular disorders can also be a consequence. In addition, unnecessary stress is placed on the remaining dentition, and can lead to fractures or breakage.

Ideally, the best treatment for replacing missing posterior teeth is an implant, which have the greatest long-term prognosis. Bridges or partial dentures may also be used to restore missing teeth. Each method of replacing missing dentition is based on a patient-by-patient case. Please consult with your dentist for available treatment options best suited for your needs.

by Dr. O. Karnakova, DDS

Braces vs. Invisalign

The Healthy Smile

by ADA (American Dental Association)

It’s never too late to perfect your smile.
Ask dental professionals about the health reasons for having a correct bite.

When you have your teeth that are in cross bite, your teeth that are misaligned, and there is a great chance to have food buildup in between your teeth, then plaque buildup which has a trickle-down effect because the more food buildup, the more plaque you get. Therefore, the more concern for periodontal disease.
Improper bite also means you can’t chew food properly, which can lead to gastrointestinal problems.

Orthodontic treatments that use either braces or Invisalign are just few of the many techniques used by dental professionals in straightening the teeth. They straighten teeth to give them an ideal position, improve their look, and promote proper function.  Traditional braces utilze metal wires to get the most ideal movement or position for the teeth.  Invisalign on the other hand, utilizes a set of clear plastic trays to achieve the position.

What is the great thing about orthodontic dental treatments that use braces or Invisalign is that they do more than just straighten the teeth. They also correct bite issues that often require special diagnosis and treatment.

Benefits of dental braces

Dental braces feature brackets that tend to run along a wire. An orthodontist or other trained dental professional is responsible for affixing the dental braces onto the teeth. The wire and brackets that form part of the braces are pressed against the patient’s teeth. This supports slight movements that can help in properly aligning and straightening the teeth.

Dental braces can correct even the most complicated issues in aligning the teeth. The braces are not only esthetically pleasing, but functional as well. These are beneficial in closing gaps and correcting crooked teeth.

Benefits of Invisalign

The use of Invisalign is an efficient method for tooth movements that are not too complicated. A set of clear, computer-generated trays is ideally worn 24 hours a day with change-outs every two weeks. There are certain trays that can last for six months to one year. However, these require some form of retention to prevent the teeth from shifting back. One of its best advantages is that the trays are relatively invisible. Hence the name Invisalign. Some people simply don’t want anyone to know they are wearing braces. They also provide help for people who wish to obtain straight teeth while still feeling comfortable in social situations. Wearing Invisalign offers comfort because it does not affect your speech.

Invisalign treatment can be expected to work more efficiently for esthetic purposes rather than for the purpose of improving the functionality of the teeth. This is why many people, especially those who have complex dental problems, still prefer dental braces.

Dental braces are better for complex cases

There are plenty of reasons why you might choose dental braces over Invisalign. Mainly composed either of colored metal or resin brackets, braces are attached onto the face of the teeth. Braces also come with a wire that runs through them and affixes them in place. One benefit of dental braces over Invisalign is that these are not removable.

Unlike an Invisalign treatment which is extremely useful for esthetic purposes and simple dental issues, braces are functional and work efficiently for fixing complex tooth issues. Braces can also be expected to work faster at closing gaps and aligning the teeth than Invisalign.

According to patients, braces work in moving misaligned teeth within a relatively short period. The use of these dental materials in aligning the teeth is also a huge help in fixing bites and creating an attractive and healthy smile. This plays a significant role in boosting the patient’s self-confidence. Dental braces are also useful in correcting malocclusion (crooked or crowded teeth) and bad bites.

If the patient’s bite is abnormal, then the application of braces can bring out his or her best smile. The immediate correction of this problem can improve the patient’s smile while also boosting his or her oral health. This is beneficial because being unable to correct an abnormal bite, or other dental issues that are treatable using braces, can lead to oral health problems. This proves the usefulness of dental braces in curing various dental problems.

Are braces better than Invisalign? Ultimately it’s going to come down to determining the specific need in each case and deciding which one will meet that need in the best way for your patient.

Dental Prosthesis Care

by Dr. O. Karnakova

Among many of the different care approaches for fixed tooth retained bridges and fixed implant bridges, brushing and flossing still remains the most effective and preferred method by dentists. Inadequate oral hygiene will eventually lead to gum disease and the formation of cavities. Ideally, brushing should be performed after every meal, or a minimum of two times daily for at least two minutes.

It is important to brush around the gumline, where plaque is most prone to accumulate. The toothbrush should be held at a forty-five degree angle, using a combination of gentle horizontal strokes and a vertical sweeping stroke towards the occlusal surface of the tooth. Flossing should be performed a minimum of two times daily and is essential at removing plaque where the toothbrush cannot. To floss around the tooth or implant, the floss should be wrapped in a "C" shape to hug the abutment. Gently slide the floss up and down in a vertical motion for a minimum of three to five times. On the downward motion, the floss should slide about two to three millimeters below the gumline. It is also important to floss underneath the bridge by use of a floss threader. Floss threaders feature a stiff plastic end and are effective at inserting the floss under the bridge. Simply use the stiff end to thread the floss under the bridge, and gently slide the floss back and forth parallel to the occlusal plane.

Partial dentures and full dentures can accumulate bacteria and plaque much like natural teeth. Patients should rinse their denture with water after every meal to remove any food particles. Brushing is recommended at least once per day and also prevents staining. It is best to use a brush specifically designed for cleaning dentures or a soft bristled toothbrush. Avoid using hard bristles that can potentially damage the appliance. Special denture cleaning solutions, gels, or pastes are recommended for cleaning the denture because they do not contain abrasive materials. Toothpaste should not be used because they contain abrasive particles that can damage the denture. Polident is a recommended tablet solution by dentist for cleaning or soaking your dentures at night. Please follow the labeled instructions for the length of time the denture should be soaked.

Patients with a removable or fixed prosthesis should visit their dentist for gum treatment every three to four months. The accumulation of plaque over time hardens into a substance called calculus or tartar that can cause many health concerns. Calculus can only be removed by a dental professional. Visiting the dentist regularly ensures that the gums and dental prosthesis are in good health and increases its life span. If a denture breaks or does not fit properly, please take it to your dentist. Do not attempt to adjust or repair the denture yourself as it can cause irreversible damage.