Comprehensive Examination
The comprehensive examination is essential for all patients to have in order for your dentist to thotoughly understand your dental needs. Not only does this include an intra-oral examination with appropriate imaging as well as a thorough medical and dental history; an examination of the head and neck muscles, temporomandibular joint diagnosis, muscle examination, occlusal analysis, range of motion tests, vertical lead tests, doppler auscultation and dental records including mounted diagnostic models is included with the comprehensive examination.
Occlusal Splint Therapy / Occlusal Equilibration
Occlusal splint therapy / Occlusal equilibration…
Occlusion is the science of the way teeth fit together and function within the three dimensions of space. Sometimes our patients have head and neck discomfort or temporomandibular (jaw) joint discomfort (TMD) due to an interference or imbalance of either the 1. teeth 2. muscles, and / or 3. bones (TMJ’s and skeletal frame.) Occlusal splint therapy is one of the most exciting areas of learning for both our patients and their dentist. An occlusal splint is an acrylic appliance which is custom fabricated to perfectly fit over your teeth without hooks or clasps. The splint fits over either the upper or lower teeth and the biting surface is adjusted to discover the most ideal biting surface for the way that you function with your teeth, TMJ (jaw) joints and muscles. Both the patient and their dentist have the opportunity to learn together about your bite by adjusting the occlusion (science of the way your teeth fit together) on the splint in the most comfortable and stable arrangement that the patient prefers. Very often, as the patient is able to experience a more physiologic bite, the muscles of mastication become more relaxed, allowing the mandible to shift and function into a more ideal position. If the patient discovers that an ideal biting arrangement on the occlusal splint is more comfortable than when the splint is removed, occlusal equilibration may be indicated. Occlusal equilibration can be considered if the patient prefers their bite on the splint more than their bite once the splint is removed.
Cleaning and Prevention
Dentistry is founded on the principle of prevention. All patients are recommended for biannual cleanings and examinations. At Norman R. Chu, D. D. S. , and Kathleen L. Dreher, D. D. S. , M. P. H. , the dentists perform their own dental hygiene procedures, so that your dental cleanings are intimately performed by the doctors themselves rather than be delegated to a dental hygienist. In this way every surface of every tooth is literally examined by your doctors on a periodic basis. Cleaning and prevention includes: periodic recall examination; generalized debridement; deep (hand) scaling and root planing; prophylaxis; high polish to (1) micron aluminous oxide. Fluoride treatments and soft tissue intra-oral cancer exams are also performed at every periodic intra-oral recall.
All-Porcelain (bonded) restorations Porcelain fused to gold restorations Cast gold restorations
If you have a damaged or decayed tooth, our dentists can help you choose the best solution. All-Porcelain restorations are esthetic and a more esthetic long-lasting dental material than composite resin. All-porcelain restorations are natural in appearance because porcelain has glass-like translucency which allows light to pass through the material for esthetics. If a world class ceramist like Gilbert Young, C. D. T. is able to hand fabricate your customized all porcelain restorations these will be considered the most esthetic high end ceramic restorations available today. All-porcelain restorations are mostly indicated for anterior teeth which undergo less occlusal load in the mouth. In order for an all-porcelain restoration to have enough compressive strength it formerly needed to be fused to gold. For esthetics, the gold is covered by porcelain in order to look tooth colored. These restorations are called Porcelain fused to gold restorations and are mostly indicated for posterior molars and second bicuspid teeth. All - porcelain restorations used to be too fragile to use as restorations for teeth. Porcelain is like glass which can easily fracture. Until our professor at The University of Texas Health Science Center at San Antonio, Dr. Nassir Barghi, performed research to prove that porcelain could be bonded to tooth structure by using a special coupling agent for inorganic and organic compounds called Silane. Drs. Dreher and Chu use this technology on their all-porcelain bonded restorations to increase the longevity of their esthetic all- porcelain restorations.
With any artificial restoration there is a price to pay in healthy tooth structure. There is nothing like your natural tooth and to this day there is nothing that can replace natural tooth structure that is as good as the teeth you were born with. This is the reason Cast Gold restorations are still considered the standard against which all other restorative dental materials are measured. Of all dental restorative materials, gold can be cast to the thinnest thickness (0.2mm) and still be strong enough (ideal 1.0mm) to replace damaged tooth structure. This means less of your natural tooth will need to be reduced in order to make enough room for the required thickness of gold. In addition, it can be finished to a razor thin edge at the dental margin with the smallest micro gap (5-10 microns) between dental restoration and tooth preparation of all dental materials. It also happens to be almost identical to enamel in hardness, coefficients of expansion and contraction, and is malleable so that gold can be manipulated and worked into the contours of the natural tooth for the most functionally accurate and custom fit of any restorative dental material. Dr. Chu happens to work with Dr. Larry Cloetta for all of his cast gold restorations. Dr. Cloetta is the world authority on cast gold as a dental restorative material and we are thrilled to offer cast gold restorations fabricated by Dr. Cloetta.
Requirements of Porcelain versus Gold:
Porcelain requires 2.0 mm of occlusal reduction. Gold requires 1.0 mm of occlusal reduction.
Porcelain requires a 1.2 mm - 1.5 mm porcelain shoulder margin. Gold requires a 0.5 mm - 1.0 mm chamfer to knife - edged margin.
Porcelain is one of the most abrasive dental materials which can vaporize enamel and dentin once it is unglazed. Gold is almost identical to enamel in abrasiveness and hardness.
The fit of Porcelain restorations that are fabricated by hand have been measured to 22 micron marginal gap. Cast gold has been measured to a 5 micron marginal gap by Dr. Cloetta. Milled (in-office CAD CAM) porcelain restorations have a 100 micron marginal gap which the dental manufacturing companies consider acceptable!! The best marginal gap for Zirconia crowns is 57 microns in the current literature. There is a reason for choosing an appropriate dental material in 2019. The larger the gap between dental restoration and your natural tooth, the greater the chance for bacteria and micro-leakage to occur.
Dentures
Our dentists make every effort to preserve your natural teeth. However, extractions are necessary when decay has made the tooth unsalvageable or when you have an advanced periodontal disease.
Extractions
Our dentists make every effort to preserve your natural teeth. However, extractions are necessary when decay has made the tooth unsalvageable or when you have an advanced periodontal disease.
Fillings
Used to prevent the spread of tooth decay or correct any cosmetic damage, a filling is one of the ways our dentists preserve your health.
Implants
A dental implant mimics the form and function of a natural tooth, which consists of a root and a crown. The crown is the visible part of your tooth. It is used to chew food and is therefore the most susceptible to cavities.
Invisible Alignment
There are various ways to correct crooked or crowded teeth without the use of traditional braces.
Night and Snore Guards
Excessive jaw clenching and bruxism can accelerate tooth and jaw deterioration. Meanwhile, snoring can impact the quality of your own sleep and that of those around you.
Periodontal Maintenance
Among the causes for periodontal (gum) disease are genetic susceptibility, smoking, and other illnesses like diabetes. Periodontal maintenance involves removing plaque and tartar from above and below the gumline.
Whitening
Professional teeth whitening is faster, more effective, and longer lasting that treatments you find over the counter.
