Direct, Indirect and Cosmetic Dentistry

Direct restorations are those placed chairside in one appointment without need for laboratory assistance and typically include resin, glass-ionomer restorations, or variants thereof. They are generally indicated for small to medium size cavities and usually require replacement after 5-7 years.

Indirect restorations require laboratory support and multiple appointments. They include tooth or implant supported gold, ceramic, metal ceramic and or resin reinforced restorations in the form of crowns, bridges, inlays, onlays, posts and veneers.

 

They are generally indicated where teeth require definitive strengthening, replacement and or aesthetic improvement. The longevity of indirect restorations varies considerably depending on how well they are constructed and or maintained. Average lifespan varies from 8-15 years at which time some may demand repair or replacement.

Implant Dentistry

Implant dentistry refers to integration between bone and titanium implants (fixtures) by a process called ‘Osseointegration’. Since the first case was completed in 1965, there have been significant advances in the field, particularly over the past five to ten years. Implants can be used to retain crowns, bridges, dentures, maxillofacial prostheses, oral sleep apnoea devices as well as simplify certain orthodontic procedures. The main benefits of implant supported restorations over conventional approaches such as tooth supported bridges and dentures include preservation of hard and soft tissues, highly predictable outcomes, free standing with functional levels comparable to those of the natural dentition. Although there are a variety of brands and designs, we choose to support the NobelBiocare range of products.

Dental Trauma

Dental injuries present in many ways, dependent on cause of injury and patient age. By 14 years of age, every second child sustains some form of dental injury. Predisposing factors include insufficient lip closure, protruding upper incisors, boys being twice as vulnerable as girls, peak incidence between 2-4 and 10-12 years of age with the majority of cases involving a single anterior tooth. Management is a function of age, severity of injury sustained and overall medical status. Dental trauma represents a true dental emergency and often demands immediate attention. As prevention is better than cure, we strongly recommend the use of custom fitted mouthguards for those engaged in vulnerable team positions or contact sports.

 

In the event that a tooth is avulsed (knocked out);

  1. If clean, immediately replant in socket and hold in place with aluminium foil or gauze, avoiding tissue paper.

  2. If tooth is dirty, rinse in milk and replant. Otherwise, briefly rinse in water and replant. Don’t scrape or rub root surface and hold tooth by the crown only.

  3. If unable to replant, retain the tooth in the mouth if safe and possible to do so, store in milk or wrap in gladwrap.

  4. If tooth root appears broken, replant if clean, or store orally, in milk or wrap in gladwrap.

  5. SEEK IMMEDIATE DENTAL TREATMENT – TIME IS CRITICAL

 

Contact Dr Lego on 0437784859 or email tlego@dentaldifference.com.au

Endodontics

Dental restorations not only potentially weaken teeth but can also predispose towards pulpal (nerve) degeneration. Unfavourable loading, often in the form of sleep bruxism, can result in flexion, fatigue and microcracks resulting in abfraction lesions, cracked and broken teeth, secondary bacterial microleakage, decay and ultimate contamination of the nerve space referred to as an “endodontic complication”, demanding either root canal treatment or extraction. Affected teeth are typically painful, often sleep disturbed, heat sensitive and tender to touch. Endodontic complications occur in approximately 15% of heavily restored teeth, the timing of which is unpredictable.

 

Elective root canal therapy is sometimes recommended for teeth of strategic value where pulpal prognosis is guarded and the tooth concerned requires indirect restoration. Root canal treatment is not always successful nor risk free, demanding an initial period of observation prior to definitive restoration with an indirect restoration. Should complications arise, specialist referral and or extraction may be indicated. Trauma and acute pain cases will be attended to on the day.

Complete and Partial Dentures

Dentures are a removable replacement modality for missing teeth and are classified into two broad categories:​​

  • Complete - removable replacements for fully edentulous patients, complete dentures can be fabricated with a variety of designs and from a range of materials and techniques, including acrylic, gold, chrome-cobalt and titanium. Immediate dentures are those issued at the time of dental extraction. Dentures can be tissue, tooth and or implant supported, the latter commonly referred to as ‘overdentures’.

  • Partial - removable replacements for partially edentulous patients, partial dentures can also be fabricated with a variety of designs and from a range of materials and techniques, including acrylic, gold, chrome-cobalt and titanium. Immediate partial dentures are those issued at the time of dental extraction and commonly serve as a provisional replacement prior to either fixed partial prostheses or transition to a complete denture.

MAJOR DENTAL

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