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Reconstructive Dentistry

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Restore Your Smile with Crowns & Bridges

Crowns & Bridges

A dental crown is a tooth-shaped “cap” that is cemented (glued) over a tooth to restore its shape, size and strength and/or improve its appearance. Crowns can be made of different materials, e.g. gold, porcelain or a combination of both. A dental crown has a life expectancy of approximately 10-20 years depending on “wear and tear”, one’s personal oral habits (e.g. clenching, grinding, chewing ice, nail biting etc.), and one’s oral hygiene care.

A dental crown may be needed to:

  • Protect a weak tooth from breaking or to hold together parts of a cracked tooth
  • Restore an already broken or severely worn tooth
  • Cover & support a tooth with a large filling
  • Hold a dental bridge in place
  • Cover misshaped or severely discoloured teeth
  • Cover misshaped or severely discoloured teeth

A dental bridge may be recommended to replace one or more missing teeth that adversely affect the appearance and functionality of your smile. Missing teeth can cause a change in one’s bite, as well as shifting of the teeth, temporomandibular joint disorder (TMD), speech impediments, an increased risk for periodontal (gum) disease, and a greater chance of tooth decay. A bridge can be made from the same materials as those used for a crown and typically provide a comparable life expectancy.

Crowns and bridges are wonderful solutions to fixing and/or replacing teeth, and the team at Dr. Phil Nasralla’s clinic will gladly explain your options while addressing your needs. Contact us by telephone at 250-339-2252 or send an email to schedule a consultation appointment.


 

Long Lasting Dental Implants in Courtenay and Comox

Dental implants have arrived! A dental implant is an artificial tooth root (titanium screw) and is used in dentistry to support restorations that replace 1 or more teeth in the form of crowns, bridges and dentures.

The earliest examples of dental implants (sea shells) have been found in Mayan jawbones dating circa 600 A.D. However, modern implant dentistry is credited to Dr. Branemark, a Swedish orthopedic surgeon who in the 1950's was conducting research on rabbits. One day he observed that titanium metal placed in the bone was not easily retrieved and consequently the bone had grown and adhered to the titanium surfaces (osseointegration). Dr. Branemark carried out further studies in both animal and human subjects and confirmed this phenomenon of osseointegration with regular consistency. In the past 40 years over 7 million Branemark type dental implants have been placed in patients around the world.

Diagram of our dental implants in Courtenay

Treatment planning for dental implants in Courtenay and Comox typically involves a CAT scan of the jaw (3D X-ray imaging), a review of one's medical history, digital photos, and impressions of the teeth. In addition, all financial arrangements and payments are made prior to surgical dates.

The procedure of placing an implant has become systematic, easier and very successful. What was once performed by specialists can now be accomplished by trained general dentists. Uncomplicated procedures are performed with local anesthetic in a relatively quick and clean, nonsurgical manner that is virtually pain-free.

The success rate of implants, when followed over a 10 year study was averaging 85-95%.

Contraindications for implants may include:

  • Smoking
  • Severe gum disease
  • Uncontrolled diabetes
  • Severe clenching & grinding
  • The use of bisphosphonate drugs (which delay bone healing and cause implant failures)

If you are interested in dental implants in Courtenay and Comox or would like a consultation appointment, 

contact us at 250-339-2252.


Virtually Painless Root Canals in the Courtenay Area

Root Canals (Endodontics)

Endodontics is the discipline of dentistry that treats the tooth’s pulp tissue (nerve, blood vessels, and lymphatic systems). The primary purpose of root canal therapy is to remove all pulpal tissues from within the tooth and root(s) and then seal and fill these structures (i.e. deep cleaning followed by a deep filling).

A root canal may be warranted in cases where a tooth has:

  • Deep decay that extends into the nerve
  • Experienced blunt force trauma (accidents)
  • Extreme pain from a dying nerve
  • Abscess or infection from a dead nerve
  • Sustained nerve damage from gum disease
  • To undergo reconstruction that may expose the nerve chamber

Dr. Phil Nasralla is highly trained and experienced in all realms of endodontics. He uses the best technology available, including dental microscopes for increased magnification and illumination in the tooth and roots. Unlike days of old, root canals are typically painless and done in 1 easy visit, with many patients reporting little or no discomfort the next day.

Root Canal Procedure

Dr. Nasralla examines and X-rays the tooth (decayed and infected in this illustration), then administers local anesthetic. Once it is numb, a rubber dam is placed over the tooth to isolate it and keep it clean and free of saliva during the procedure.

An opening is made in the crown (top) of the tooth and very fine, flexible instruments are used to clean out the pulp from the pulp chamber and root canals and to shape the space for fillings.

After the space is cleaned and shaped, the root canal spaces are filled with a biocompatible rubber-like material called “gutta percha”. The gutta percha is placed using an adhesive cement to ensure complete sealing of the roots.

A final X-ray is taken and a core buildup (final filling) is then placed in the top of the roots and the tooth. A crown may be necessary to restore the tooth to its full function and beauty.

Retreatment

We deal with the human body, and occasionally it does not heal as expected and a tooth can experience post-treatment infection. In these cases, the dentist must retreat the tooth with a second root canal therapy in the same manner as described above; but by removing all the gutta percha and re-cleaning the roots. Once thoroughly cleaned and shaped again, the system is resealed and filled as before. More often than not, the tooth responds favorably and the infection and symptoms disappear permanently.

Surgical Retreatment (Apicoectomy)

An apicoectomy, or root-end resection, is the removal of the root tip and the surrounding infected tissue of an abscessed tooth. This procedure may be indicated when inflammation and infection persists in the area around the root tip but cannot be addressed by retreatment through the tooth.


Diagram of the process for root canals in Courtenay

Step 1:After the tooth and gums are “numbed”, the gum is reflected (lifted) to uncover the underlying bone and the root end of the tooth. The root end is resected (removed) with all the surrounding infected tissue.

Root canal diagram 2

Step 2:A root-end filling is placed to seal the end of the root canal, and artificial bone is placed in the surrounding space. A few dissolvable sutures (stitches) are used to hold the gums in place until healing occurs.

Root canal diagram 3

Step 3:After several months, the bone and gums have healed (replacing all the artificial bone with natural bone) and all symptoms are gone.

If you suffer from toothaches, or think you need a root canal, contact Dr. Phil Nasralla to request a dental consultation.


 

Restore Your Bite & Your Appearance with a Full Mouth Restoration

Full mouth reconstruction, as the name suggests, is the dental procedure used to rebuild one's entire dentition to a more healthy, functional and youthful state. While smile makeovers will correct minor or moderate dental issues, full mouth reconstruction is warranted in cases that involve very complex bites, many missing teeth, or severely worn, damaged, or decayed teeth that affect one's quality of life. Pain may or may not always be a reported symptom of one's dental condition, but often it is associated with TMD or trauma from accidents and blunt force injuries and may necessitate full mouth reconstruction.

Correcting the aforementioned conditions with full mouth reconstruction may entail some or all of the following treatment modalities:

  • Dental implants & restorations to replace 1 or more missing teeth
  • Dental bridges to replace missing or broken teeth
  • TMD treatment to address TMJ pain and/or bite issues
  • Dental crowns, inlays & onlays to repair damaged or decayed teeth
  • Porcelain veneers and composite fillings for a metal-free, whiter & more beautiful smile

Comprehensive dental examinations are mandatory when planning treatment for any full mouth reconstruction purposes. And while different restorative treatment options may be possible, it is very important to customize the individual's planned treatment with their personal needs in a way that best achieves the desired outcome.

If you are a candidate for full mouth reconstruction, let Dr. Nasralla and his highly skilled team work with you in delivering the smile of your dreams. Please contact us to schedule a consultation appointment.

 


Laser Dentistry

In recent years modern dentistry has been revolutionized by the development and use of computers, digital X-rays and lasers. We proudly use all these technological wonders at our dental clinic; and though the public is cognizant of computers and digital X-rays, many remain unfamiliar with dental lasers and their applications.

The 2 most common uses of dental lasers are for early caries detection and for the reshaping of the gums and other soft tissues of the mouth.

In the past, dentists have traditionally depended on X-rays and visual and tactile (“stickiness of the pick” in the tooth) exams to diagnose tooth decay; and by those standards, the tooth had already undergone a lot of damage. By contrast, the use of a laser caries detection system (DIAGNOdent) allows Dr. Nasralla to accurately measure and quantify the depth of early caries before the damage is done. Prevention and early detection of any decay is always more cost-effective and conservative in its treatment than the alternative.

Unlike the diagnostic laser mentioned above, the soft tissue lasers are used to remove or reshape gums for different reasons:

  • Improve the look of “gummy” smiles
  • Remove excess gum tissue caused by certain medications or poor oral hygiene
  • Treat local areas of gum disease so that surgery may be avoided
  • Treatment of cold sores & cankers
  • Biopsy
  • Cauterizing & control of bleeding
  • Performing frenectomies (e.g. tongue-tie correction)

If you have questions or would like to discover other features and services we offer, please contact us to schedule an appointment.

 

 

 

 

 

 

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