Tuesday, December 29, 2009

How to Straighten Your Teeth Without Braces

A young and attractive childcare teacher cum part-time model turned up at our clinic with an interesting problem.

Her main complaint was tilted right incisor. She could not put on braces as it would affect her modelling assignments.

Apart from a tilted incisor on the right side, she also has a retained baby tooth in the canine position

The tilted tooth affects her smile very significant.

An xray solves the mystery. The patient's permanent canine decided to lodge itself in the upper jaw bone directly above the right incisor. The "hidden dragon" pushed the root of the incisor backwards (palatally), tilting the crown of the same tooth forward (labially).
For those who are not familiar with xrays, we'ce traced the buried canine out for you.

The "hidden dragon" was surgically removed and the defect was filled with bone graft.

The patient was pain free from the second day after surgery. We proceeded to do a root canal on the tilted tooth.

Here's the tooth with fibre post and composite core built up.

Shade matching was a challenge. We didn't want to follow the colour of her other teeth too closely as she may want to do something about the unsightly spots soon.

She may also wish to extract her baby tooth and replace it with an implant.

And here is the temporary crown.

Stay tuned to see our e- max crown when it's ready.

Monday, December 21, 2009

Madam Soupless @ Fat Fish Thai Steamboat

“What? $5 for the soup? Steamboat is supposed to come with soup. How can you charge me for it? It’s not that I can’t afford to pay for the soup. It’s just that this is the most ridiculous thing I’ve heard.”

This was the argument I overheard at the next table. It was between an angry woman in her late 50s and the poor waiter trying hard to explain company policy. You might think that she was shocked by the bill when the waiter showed it to her. But no. She had not even started yet. The waiter was just informing her upfront that they would be charging $5 for the soup.

I was having steamboat dinner with my friend Tsun Han at Fat Fish Restaurant at the Admiral Country Club on a Saturday night. They serve steamboat which included a generous spread of seafood and sliced meat buffet style. Like one reviewer said, “the prawns were so fresh that they squirm”. The staff was also friendly and attentive. The ambience was pretty good without being packed with noisy crowds. Well, at least it wasn’t noisy until Madam Soupless turned up and complained about the $5 soup even before she started.

Let’s see. The restaurant charges $22.80++ per person which was cheap. Adding $5 to the total bill would mean an additional charge of only a little more than a $1 for 4 people. So would Madam Soupless be happier if she were charged $25 (2 people at her table) with no mention of soup cost?

The restaurant’s policy is just an example of itemised charges promoting “transparency”. If charging Madam Soupless $5 was enough to freak her out, I wonder what would happen if the restaurant gave her a bill which looks like this:

Food $18
Soup $5
Utensils $1
Gas $1

$100 + $7 GST is ridiculous? $107 no GST is good? Look who is being not just ridiculous but also stupid.

Monday, December 14, 2009

Implant (No) Surgery

Most implants are placed into bone which has already healed over the extraction socket. This requires surgery. The gums have to be cut, a flap retracted and bone has to be drilled. The retraction of a gum flap almost always results in some pain and swelling.

To make the surgery less invasive, some dentists do it flapless. In other words, they drill straight through the gums into the bone without cutting and reflecting a flap. After the flapless operation, the patient tends to feel less pain. However, flapless surgery is “blind”. The surgeon will not be able to see if there are any perforations beneath the gums. Where bone thickness is not ideal, flapless surgery may not be safe or even possible.

What about inserting an implant into an extraction socket immediately after the extraction? If possible, the advantages are obvious. First, the patient does not have to go through implant surgery at a later date. It is flapless and relatively atraumatic. It is usually a one-stage surgery where no further surgery is required to expose the implant. As implants take 2-3 months to integrate, placing it at the time of extraction shortens healing and restoration time.

What is not so obvious, is the technical difficulty of placing an implant into an irregularly-shaped socket. When you drill a hole into a clean wall, you can control the exact depth and width of the hole. When you drill into an existing hole, it’s very difficult to control the final shape and size of that hole. It is imperitive that the surgeon gets good primary stability and is able to place a wide, socket width healing abutment over the implant at the end of the surgery. The success of immediate insertion depends very much on the surgeon’s skill and experience. It also depends on the condition of the tooth.

Immediate placement is not recommended when.

1. There is pus and acute infection.
2. The tooth is very shaky with advanced gum disease.
3. Surgical removal of the broken tooth is necessary.

The conditions for immediate placement are very similar to the conditions for required for socket preservation with Alvelac bio-scaffold. As long as the socket is walled with bone on all sides, immediate implant insertion is possible. Forget about socket preservation. The immediate placement of the implant provides socket preservation, fewer surgeries and shorter healing time without additional costs.

Tuesday, December 8, 2009

About the denture.

Who are have a missing some of their teeth first choice is denture but is depending on the type of dentures are chosen for our clinic we have 4 types of dentures to sevice you like partial denture , chrome denture, flexible denture and Titanium denture. If you are looking for budgets denture, partial denture are affordable option for you.

But most of our patients concern about how long do we need get ready for a new denture for them. The answer is about 3 weeks to get ready for issue.

First of all, you need to call to make an appointment , consultation with the dentists. The 1st appointment consists of an oral examination and and a set of impressions of the upper and lower edentulous ridges. It takes 2 to 3 days to go for the 2nd visit.

The 2nd appointment consists of deciding how "long" to make the teeth, determining the plane of the tooth setup, and the bite of upper and lower teeth so that when you bite together, the upper and lower teeth line up correctly. This is called "wax-bite".

The 3rd appointment is called the "wax try-in". When the lab returns the loosely fitting tray from the 2nd appointment with the actual final plastic teeth lined up along the outer edge of the wax rim. The wax try-in looks just like a real denture, except that the base fits loosely on the gums, and the teeth are embedded in wax instead of plastic.

The 4th appointment is for the issue denture. So that when the patient walks out of the clinic with new dentures.

For a cost of denture our clinic starts from a few hundred dollars to a few thousand dollars you can call us for enquire.