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Aesthetic and conservative dentistry

As we all know, cavities, inflamed and aching teeth can render everyday life an ordeal. Aesthetic and conservative dentistry aims to conserve the teeth as long as possible and prevent them from further deterioration.

Below is a table for better perspicuity regarding the conservative and aesthetic treatments carried out at our clinic:

  1. dental scaling, dental hygiene
  2. teeth whitening (home and office, Walking Bleach teeth whitening)
  3. tooth filling
  4. root canal treatment (endodontic treatment)
  5. inlay and onlay preparation

1. Tartar removal and dental hygiene

Before and after tartar removal


Before and after tartar removal

In the course of dental scaling, the ultrasonic device removes the plaque deposited on the surface of the teeth, as well as discolorations and tartar, while washing the teeth by way of cooling. The rate of tartar formation varies by person, the patient is therefore recommended to repeat the treatment from time to time. Usually it is due every half a year and coincides with the dentist check-up due every half a year.

Devices used for dental scaling

NSK Prophy-Mate Neo

nskFollowing ultrasonic scaling the tooth surface is cleaned using a NSK Prophy-Mate Neo “sandblaster”. NSK Prophy-Mate Neo is a device for professional tooth cleaning. The polishing powder blown at high air pressure painlessly eliminates even the toughest discolorations and plaque without damaging the tooth surface. It is particularly recommended before teeth whitening.
Manufactured by NSK, Japan.

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2. Teeth whitening

At our clinic, three teeth whitening methods are used:

  1. home whitening
  2. in-office whitening
  3. internal whitening of a tooth (walking bleach)

All these procedures are gentle and cause no damage whatsoever to the teeth. Their operating mechanism is best likened to deep carpet cleaning. The teeth whitening substance placed on the teeth reaches the depth of the tooth enamel surface dissolving the deposits and resulting in a whiter colour.

Frequently asked questions as regards teeth whitening:

How safe is teeth whitening?
Professionally performed teeth whitening is not harmful for the teeth and the gums. It nonetheless involves risk factors and has its limits in terms of efficacy the patient should be appraised of before having a go at the treatment. Such circumstances, however, seldom rule out the possibility of teeth whitening. Consult your dentist on any risks involved.

How long does a teeth whitening session last?
It depends on the kind of treatment the patient opts for. The maximum duration of pola+ professional in-office whitening is 30 minutes. (At any rate, a session never exceeds 1 hour including preparations). Zoom, on the other hand, may take up to 1 or 2 hours. Home teeth whitening lasts an average of 60 to 90 minutes daily for a period of one week.

How long do my teeth maintain the bright tooth colour attained during teeth whitening?
This is subject, to a great extent, to the patient’s individual endowments, life style and nutritional and tooth care habits. Overall, however, it is safe to say that the whiteness of the teeth is ensured for up to 1 to 2 years, whether whitening is carried out in office or at home. If the habits having triggered the discoloration of your teeth in the first place persist, the same causes may set off the formation of various spots anew and the yellowish colour may return sooner than expected.

Can the outcome be predicted?
Unfortunately, the outcome cannot be predicted in all cases. Efficacy largely depends on the original tooth colour and individual habits (such as coffee and red wine consumption and smoking habits). Discuss with your dentist the whitening procedure best suited to your habits causing the discoloration of your teeth.

Does teeth whitening have any side effects?
If the dentist’s instructions are duly complied with and the rules are observed, most patients will experience no side effects.

Hot and cold tooth sensitivity to may arise temporarily, but quickly wears off after the treatment causing no permanent problems.

Post-treatment tooth sensitivity may be reduced by the application of gels, toothpastes and mouthwashes. Seek you dentist or dental hygienist’s advice on the matter. Our professionals will be happy to assist you in selecting the treatment best suited to your needs.

Another very common “side effect” is gingival irritation. This kind of irritation occurs if a small amount of whitening agent spills over onto the gums, resulting in a burning sensation, which, however, resolves in a short time.

Does the colour of fillings or crowns on top of the teeth change during teeth whitening?
Teeth whitening will only remove incidental stains having deposited on the surface of the fillings and will not change its original colour, as likewise it will not change the colour of the crowns either. The replacement of existing fillings and crowns may only be necessary, if the colour of the whitened teeth significantly differs from that of the filling/crown.

Can teeth whitening be performed during pregnancy?
Teeth whitening, whether in office, or home, is contraindicated for pregnant and nursing mothers.

Important notice before the commencement of teeth whitening.
Teeth whitening treatments can only be applied with healthy gums and teeth. During the health check-up our colleagues will assess if any preventive dental treatments are necessary prior to teeth whitening. Such treatments will usually involve oral hygiene treatments, fillings and root canal treatments.

 

Home whitening

Whitening is preceded by thorough dental scaling at all events. The dentist takes impressions of the teeth following which the patient receives customized whitening strips (splints) and teeth whitening gel packaged in syringes. You are advised to perform whitening following a thorough tooth brush for 6 to 8 days. Being reasonably priced, this is the most popular teeth whitening method. It has the downside, however, that the whitening strip needs to be placed on by the patient at home for 1-2 hours/day, leaving the patient with a “home assignment”.

Teeth whitening devices and substances

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Whitening substance: Opalescence

Manufactured by Ultra dent, USA.

Cavex VacuFormer is vacuum-operated deep-draw machine, by means of which different dental splints (such as whitening strips, occlusal guards/night guards and sports guards) can be prepared directly at our clinic saving our patients time and money.

Pola Office+ professional in-office teeth whitening

At our clinic teeth whitening involves, among others, the use of cutting-edge Australian PolaWhite products. The fastest teeth whitening agent worldwide, PolaWhite products efficiently yet safely whiten your teeth in a matter of less than 30 minutes. All PolaWhite products are developed with the utmost attention to the patient’s needs.

The main features of Pola Office +:

  • This short treatment includes 3 8-minute-long whitening sessions (excluding preparations).
  • The gel-like consistency of the substance ensures maximum bonding and whitening effect.
  • Although Pola Office+ requires no teeth whitening light, using one can further accelerate the process.
  • The natural PH value of Pola Office+ ensures an utmost sense of comfort both during and post treatment.
  • Pola Office+ contains potassium nitrate, which significantly alleviates any subsequent tooth sensitivity.

 

In-office whitening (Zoom Advanced Power)

rendeloi_fogfeheritesZoom Advanced Power is the cutting-edge office whitening system that is able to brighten several shades in a mere 1.5 hours. The special light source of the ZOOM White Speed whitening lamp is a quick and efficient solution to achieve the best results. In-office teeth whitening (chairside bleaching) is a procedure which can remove discolorations even in the inner tooth enamel. With the appropriate protection and isolation of the gum, the whitening substance is placed on the outer surface of the teeth. The whitening effect is enhanced with a special light which causes the whitening substance to release oxygen molecules capable of achieving a tooth colour 3 or 4 shades whiter.

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Benefits of the method:

  • outstanding results achieved in one sitting in as little as 1.5 hours.
  • Perfect solution for foreigners coming only for a week and looking to get a crown by the weekend.
  • Ideal for patients “in a hurry” immediately expecting maximum results.
  • Recommended for patients not very keen on home whitening.

However, it has the downside that it costs almost thrice as much as conventional home whitening splints. Transient and individually varying tooth sensitivity may arise that can be eliminated using ACP Relief gel.

ZOOM lamp is manufactured by Philips, USA.

Dental instruments used in whitening

ZOOM lamp is manufactured by Philips, USA.

Internal whitening of a tooth (walking bleach)

We have often encountered people smiling at us having one tooth of a greyer shade than the adjacent teeth. This discoloration takes years to develop and the patient usually says “I’m used to it”, “it never aches” and thinks there is nothing amiss with that tooth. In our view, however, this puts patients at a serious aesthetic disadvantage when establishing new relationships, adjusting to a new workplace or a new environment since it will escape nobody’s attention that something is wrong with a person’s teeth. In such cases, patients are advised to avail themselves of a dental check-up, and start off with an X-ray in the first place. It needs to be established whether the discoloured tooth has undergone a root canal treatment. If the tooth is not root canal treated, a vitality examination can determine if the tooth is necrotic. If so, the tooth immediately requires root canal treatment. If root canal treated, the tooth will demonstrate the quality of the root canal treatment in the X-ray image. It is generally inappropriately treated teeth that become discoloured, with infection or interstitial fluid flow remaining in the tooth’s root causing the tooth’s crown to gradually become discoloured with the remaining infection, fluid etc. “infiltrating” into it.

The success of internal whitening lies is an immaculate, hardwearing root canal sealant. If the root canal filling is adequate, the pulp chamber (nerve chamber) needs to be whitened from INSIDE and temporarily filled. This whitening procedure needs to be repeated as many times as required for the tooth to whiten up and attain a colour matching that of the adjacent teeth. Complete whitening (home or in office whitening) is also recommended at this point in order to enhance aesthetic results. Once white both internally and externally, the teeth are ready to receive a permanent aesthetic filling or a metal-free E.Max crown.

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3. Tooth filling

At our clinic, we exclusively use aesthetic (composite), tooth coloured fillings. This filling is also ideal for replacing old amalgam fillings. Durable, yet barely visible, it is also free from any disputed health side effects.

Filling materials

  • Estelite Asteria

An exclusive light-curing filling material that is both simple to install and has outstanding aesthetic properties. Its colour scale covers the entire dental colour range, with beautiful results guaranteed even with slant sections, with the treated tooth edges being invisible. It can achieve a translucency and shade matching that of the original teeth. It is marked by perfect and long-lasting light-retentiveness and a smooth surface. It is chiefly used for filling front teeth, direct veneers, the re-construction of crowns for chipped off teeth and tooth edge replacement.

Manufactured by Tokuyama Dental, Japan.

  • GC GRADIA DIRECT

A light-curing direct restorative composite filling offering an exceptionally natural look. In addition to its outstanding aesthetic properties, GC GRADIA DIRECT has all the characteristics that make for a long-lasting filling. It is easy to polish, in other words, a smooth and glossy surface can easily be achieved. It is resistant and flexible efficiently coping with bending and masticatory forces. Chiefly used for restoring and filling rear molars.

Manufactured by GC, Japan.

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4. Root canal treatment

The veins and nerves responsible for the vitality of the teeth are inside the teeth. Should these be damaged for one reason or another, the patient may experience a strong and permanent pain, but the damage may also go asymptomatic. The problem may even entail tooth loss. Root canal treatment can salvage the tooth and eliminate pain. During this intervention carried out in local anaesthesia the root canal is thoroughly cleaned, disinfected and sealed with a root canal filling.

Dental instruments and materials used in endodontics

Endodontic machine-driven files

Pro Taper Next

Manufacturer: Dentsply Maillefer, type: Protaper next, Switzerland

Endodontic hand files

Manufactured by Mani ,Japan

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Root canal filling materials

Manufactured by Dentsply, type: AH Plus Germany

Instruments and machines used in endodontics

X-Smart Plus endomotor (Dentsply)

x-smart_plus_endomotor

X-Smart Plus is an endomotor designed for root canal treatments facilitating the dentist’s work by substituting endodontic hand files by a machine-driven rotation file system. The machine’s revolutions per minute can be adjusted as required and has the great advantage that rotation is reversed (reciprocating motion) as soon as the file’s way is blocked, reducing the risk of the machine-driven endodontic file breaking off under the root canal.

Machine-driven endodontic files used for root canal widening are made of flexible nickel-titanium alloys also used in space research, allowing for the quick widening and thorough cleaning of the root canal. Thanks to its flexibility, the endodontic file is also excellently suited for curved canal paths. Machine-driven widening files are distributed in different sizes corresponding to the diameter of the root canal.

Manufactured by Dentsply; type: X-Smart Plus, Switzerland.

 

Raypex 6 apex locator

 

 

Raypex 6 apex locator is an electronic measurement device serving to determine the length of the root canal in an endodontic treatment. The device is fitted with two electrodes, one of which is connected to the oral mucosa and the other one to the file inserted in the root canal. Accurately determining the length of the root canal is essential in preparing a good root canal seal. When using this instrument fewer X-ray images are required during a root canal treatment, and less lead-time for the dentist to perform an accurate root canal treatment, which makes it particularly recommended for pregnant women, dentophobic patients.

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5. Inlays and onlays

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Gold inlays

Inlays and onlays are used for restoring root canal-treated teeth and larger cavities. The dentist prepares the location of the inlay in the tooth and takes an impression used by the dental technician as a mould to make the inlay, which is cemented into the tooth. Inlays can be made from E.Max pressed ceramic, Bell Glass (ceramic-reinforced synthetic resin), gold, etc. This kind of restoration is more durable than ordinary tooth fillings, which makes it ideal for restoring the masticatory function of molars.

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