永久性假牙 – 安裝程序(上)

由於此解決方案是使用牙齒植體來固定永久性假牙，因此您將再也不需要用到假牙膠黏劑和膠黏粉。

如果想要安裝新的永久性牙齒，第一個步驟便是由您的牙醫師針對您目前的牙齒情況進行檢查。接著，牙醫師便能和您一起找出最適合您的解決方案。

在診斷期間，牙科醫師可能會提供兩種牙齒植體置入方案供您選擇：

采用傳統程序，或是采用最先進的引導式程序。

如果您選擇了引導式程序，則牙醫師將會為您的顎骨進行電腦斷層 (CT) 掃描，或是將您的顎骨制作成模型，以便在牙科治療程序開始之前先進行完整的規劃。

牙醫師會使用拴孔手術為您完成牙齒植體的安裝。 此一微創外科技術不但能夠縮短傳統程序所需要的愈合時間，同時也免除了縫合需求，並能大幅減輕使用傳統方式置入牙齒植體所產生的腫脹及不適感。

傳統程序:
依照傳統程序，牙醫師會透過 X 光片來了解您的顎骨外觀。 牙醫師通常會在此時為您目前的牙齒及顎骨制作印模。

引導式程序:
如果您選擇了引導式程序，則牙醫師將會先建立您的顎骨對應圖，或是為您的顎部及牙齒進行電腦斷層 (CT) 掃描，以便在牙科治療程序開始之前先進行完整的規劃。 透過這樣的規劃程序，牙醫師將能建立一副導具，並利用此導具將牙齒植體安裝於最理想的位置。

同時間，實驗室也已經開始制作您的新牙；因此在您裝上牙齒植體的同時，您的新牙也已經制作完成，並能連同牙齒植體一並完成安裝。
(續)

參考資料: http://www.nobelsmile.com.hk/

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向牙醫查詢，而不應單倚賴以上提供的資料。

安裝在植體上的永久性假牙

如果您覺得假牙在您的嘴中總是讓您不自在，或是認為假牙膠黏劑十分麻煩，則我們的假牙替換物解決方案或許可以解決您的問題。

固定式假牙替換物解決方案是由牙齒﹑植體﹑牙橋(有時又稱為永久性假牙) 所組成，而這個牙橋是由 4 個以上的牙齒植體所支撐。 由於此解決方案是使用牙齒植體來固定永久性假牙，因此您再也不需要用到假牙膠黏劑。 由於牙齒植體的功能和真牙牙根一樣，因此使用永久性假牙時，感覺與使用真牙時幾乎沒有任何分別。

參考資料: www.nobelsmile.com.hk/

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向牙醫查詢，而不應單倚賴以上提供的資料。

Wanted: Whiter, Brighter Teeth (2)

The average price for a whitening treatment is about $150 for take-home whitening and $350 for in-office, Pace Brinker says. Since her practice adjusted the fees for treatment, she sees up to 12 to 14 patients per day on Mondays and Tuesdays just for whitening.

“Our case acceptance has exceeded our expectations with these adjusted fees,” Pace Brinker said.

AACD members said their practices generated about $19,100 on average from whitening last year.

The majority of AACD members polled said they provide in-office and take-home whitening treatments. Twenty-two percent said their patients have told them they use over-the-counter or commercially available whitening treatments.

Gender-wise, it seems that women are more concerned with a white smile. Roughly 65% of dental patients seeking whitening treatment last year were female, according to the poll.

"I think women are used to paying higher fees for services to make us look and feel better," Pace Brinker says.  "Currently men are more concerned about costs; however, as the market continues to be concerned with whiter teeth, I think you will see a trend from our male patients that is more equal to our female clients' philosophy.”

Reference information: www.aacd.com/

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Dentist for diagnosis and treatment.

Wanted: Whiter, Brighter Teeth (1)

AACD members say they expect the demand for teeth whitening to increase this year

MADISON, Wis. (4/21/10)—Teeth whitening seems to be on everyone’s wish list—and this momentum is likely to continue through 2011, according to a quick poll of member dentists at the American Academy of Cosmetic Dentistry (AACD).

AACD members performed an average of 77 whitening treatments last year, and 57% said they expect this number to rise.

“We are doing more whitening than ever before in our practice,” says Shannon Pace Brinker, certified dental assistant and clinical editor for CPS magazine. Pace Brinker performed more than 400 whitening treatments in the past year, and gives credit for the treatment acceptance due to the ability to offer a high quality whitening system with options to treat her patients based on bleaching strength, time, finances and patient compliance systems within her practice at Greenbrier Dental in Chesapeake, Virginia.

Pace Brinker says that her practice has reduced its whitening fees, which has not only brought in more patients seeking whitening—but it’s also opened their eyes to other cosmetic dental treatments.

“Our existing patients are saying ‘yes’ to other procedures after the whitening such as bonding, replacing amalgam fillings, and replacing porcelain restorations to match the whitening they have achieved,” she said.

While the number of patients seeking whitening treatments will likely increase this year, Pace Brinker expects that the fees for whitening will actually decrease, due to specials offered by dental practices through deal-a-day sites like Groupon and LivingSocial.

Reference information: www.aacd.com/

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Dentist for diagnosis and treatment.

Basic Concepts in Occlusion (4)

9. Bruxism and TMJ disorder

a.  pain often caused by stress-induced parafunctional habits (bruxism & clenching)

b. signs and symptoms

• dislocation: the condyle moves too far forward and get stuck
• pain from the joints on opening and chewing
• tender teeth, especially on percussion and grinding
• bi-lateral sore tongue and cheeks
• muscle tenderness, especially in the mornings
• clicking noise
• jaw locking
• difficulty in opening the mouth, i.e. trismus
• wear facets on occlusal surfaces

c.  treatment:

• pain relief (best with NSAID, e.g. Ibuprofen)
• rest, soft food, relaxation
• exercise
• hard bite guard (Occlusal Splint, Michigan Splint) or soft;
• mostly on the upper teeth

d. other painful joint conditions: accidental injury, arthritis (rheumatoid or osteo-arthritis)

10. Edentulous VS dentate

a.  edentulous àaim for balanced occlusion in the setup

b. dentate ­àfollow the existing or designed guidances

11. Practical tips for DSAs.

• use slightly over-sized trays, must cover all the teeth
• must have accurate study casts: properly washed impressions and keep them moist; cut off unsupported alginate heels; pour immediately; avoid bubbles (use vibration)
• make sure there are no blobs of plaster on the occlusal surfaces or over-extended edges at the back ends that stop the casts from accurate positioning
• set up the articulator correctly
• moisten the bottom of the grooved casts for better adhesion
• mount the casts on the articulator correctly, use minimum of thick low expansion plaster first, add more plaster to build up the mass after the initial stem has set.
• for better finish use wet finger before the final set, then use wet sandpaper afterwards
• mark the cast with patients’ names and date of production

Reference information: www.bjdental.com/

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Dentist for diagnosis and treatment.

Basic Concepts in Occlusion (3)

4. Patient examination

a.  medical, dental and social history

b. extra-oral examinations: facial profile, muscles, joints, speech

c.  intra-oral examinations: muscles, soft tissues, teeth, gum, occlusal relationships and contacts

d. radiographic examinations

e.  special tests: e.g. vitality tests, dietary analysis

f.   diagnostic study casts and occlusal analysis

5. Instruments needed for occlusion examinations

a.  articulating papers and holders, different colours

b. shimstock with mosquito forceps

c.  leaf gauge

d. alginate impressions of the upper and lower jaws

e.  face bow records

f.   occlusal records

6. Methods of reproducing the occlusal contacts and movements

a.  by hand

b. single hinge cast holder

c.  articulators

7. Articulators

·   Definition: a mechanical device which attempts to simulate the movements of the mandible.

·    Two designs: ARCON (ARticulated CONdyle, i.e.: the condylar part is attached to the lower member of the articulator) or NON-ARCON.

·         Types:

a.  Non adjustable articulator: predetermined values, e.g. Free-plane

b. Semi-adjustable articulator:

non-arcon type: Dentatus

arcon type: Denar Mark II, Whipmix

c.  Fully adjustable articulator:

e.g. Stuart articulator, Denar 5A

-used with pantographic tracings

8. Occlusal registration

·         occlusal records (the bite) of the relationship between the upper and lower teeth, taken at ICP or RCP.

·         material commonly used:

a.  air

b. hard wax (Moyco Beauty Wax)+ TempBond

c.  silicon bite registration material

d. fast setting self-cured acrylic (Duralay) either used with a “beading technique” at the chairside or as prefabricated transfer copings

Reference information: www.bjdental.com/

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Dentist for diagnosis and treatment.

Basic Concepts in Occlusion (2)

3. Commonly used terminology

a.  Occlusion (static): the contact between teeth of the opposing jaws at the end-point of the closure

b. Articulation (dynamic): the gliding contact during movements of the mandible

c.  Inter-cuspal Contact position (ICP): where the greatest number of contacts occur between the upper and lower jaws

d. Retruded Contact position (RCP): the most superior and posterior position of the mandible where the condyles cannot be retruded further.

e.  Freeway space: the space between the upper and lower teeth when the mandible is at rest.

f.   Occlusal Vertical Dimension (OVD): relationship between maxilla and mandible at ICP, i.e. face height

g.  Lateral excursion: sideways movements of the mandible with the teeth in contacts.

h. Anterior guidance: the palatal surface of the front teeth provide the guiding plane when the mandible slides forward (protrusion), separating the back teeth

i.    Canine guidance: the canine of the working side provide the guiding plane which separate the back teeth (disclusion) during lateral excursion, without any interference.

j.    Group function: teeth on the working side, with or without the canine, are in contact during lateral excursion. E.g.: premolars and molars, or, central and lateral incisors.

k. Premature contact: the first tooth contact when patient is closing onto the RCP.

l.    Interference: deflective contacts which prevent smooth movements to and fro from the ICP. It can be on the working side (the side to which the lower jaw is moving), non-Working side, or protrusive.

Reference information: www.bjdental.com/

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Dentist for diagnosis and treatment.