Category: Restorative Dentistry

Dentures that don’t fit well anymore

Recently, television the air waves have been filled with commercials for denture adhesives to secure those loose fitting dentures and now those loose fitting partial dentures. So, what’s that all about. Well anyone with dentures know that even if they had a lot of suction when the dentist delivered them brand new to you, dentures over time loose that suction, “that tight feeling”. This is because dentures always move more than our teeth, no matter how good we make them, and because they move against our tissues, we loose boney support over time. The bone just melts away forming small and some time large gaps under the denture. This helps to break the seal (the suction) and produce a “looser” fit. Then more movement, more loss of boney support and so on. Those adhesives work for a time, but then again you have to put more and more in every day. The solution is to get a “reline” to your denture. So what’s a reline. We take a new impression of the voids inside your existing denture, send it to the lab and later that day, after the lab has put new denture material inside, we deliver the “new” denture back to you. A new fit and the suction is restored. In our practice, we use a very old time tested technique and an impression material that is “mucostatic”,...

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Crowns, why they break

Ever look at that new crown put in less than 5 years ago and see that half of it is missing? This is especially true in the back of the mouth (posterior) where the forces that you bite with can sometimes overcome the strength of the materials used. This is often true of the “full ceramic” crowns, and the new “Zirconia” crowns. In a study presented at the recent American Association of Dental Research it was reported that after just 2 years almost 40% of this type of crown failed usually splitting in half and necessitating complete replacement. It’s generally due to surface cracks that grow (that’s called crack propagation), connect and then the crown fails. The cracks are from the manufacturing of the crown by the lab or when we have to make adjustments before seating the crown in your mouth. In our practice we use a metal re-enforced crown called a PFM (porcelain fused to metal) which helps avoid these cracks and fractures. Any porcelain can crack and fail, but generally PFMs last longer in the back potions of the mouth. We tend to want to use the conservative method, the PFM, in our practice but always want to give options and respect the wishes of our...

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Why did this new filling break?

Why did this new “white filling” break is a question I hear more and more in my practice. A new patient comes in for an exam and has a “new” filling that has been done within the last 2 years, sometimes within the last year, and it has already failed. Normally I tell the patient that it most likely was the filling material the dentist used or the bonding agent that was used. Both are critical in achieving a restoration that does not fail too early. Research is telling of controlled clinical studies that show the new “nano” fills are failing within the first 2 years at rates we have not seen since the late 1980’s. In my practice, based on my knowledge of materials, my research I have done and continue to do at the UTHSCSA Dental School, and the published research, we use a composite first manufactured in the mid 1990’s and a bonding agent first used in 1990. Why? Because they work, have long term clinical trials that say they work and in our practice normally last more than the American Dental Association’s average of 3-5 years. We want them to last more than 10 years and that’s the reason we are conservative in what we use to restore teeth to their vibrant form and...

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