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Extreme Acid Tooth Erosion Due to Lemon Sucking Habit

2011-06-29T21:58:00.000-04:00

Case Report

Patient: T.B.

Chief Concern: Severe enamel and tooth structure loss.

Diagnosis: Chemical erosion resulting from acid exposure due to long term habit of sucking on lemons. Lemon juice is saturated with Ascorbic acid and much like other acids can dissolve the calcified structure of teeth. Short duration exposure to acids (such as drinking soda or eating foods with vinegar) usually does not result in net loss of tooth structure because minerals in saliva will replace the minerals lost in contact with the acid. However repeated and long term exposure to acids will result in tooth erosion.

Treatment: Endodontic (Root Canal) therapy to treat exposed dental nerves followed by composite resin restorations.

Before:

After:

Dentistry by

Syamack Ganjavian, DDS

Composite Resin Veneers

2011-06-29T21:33:00.000-04:00

Treatment Report

Patient: L.B.

Chief Concerns: Old composite restorations on front teeth, spaces between teeth not resolved completely after Invisalign orthodontics, discolored teeth not whitened to satisfaction after bleaching treatments.

Treatment: Gradia Direct X composite resin veneers in XBW shade.
Length of Treatment: 2 hours.

Before:

After:

Dentistry by

Zahra Ashrafi, DDS

Single Dental Implant in the Esthetic Zone

2010-12-18T13:52:00.000-05:00

Treatment Report

Patient: M.D.

Chief Concern: Missing tooth in the front due to a severe abscess from failed root canal procedure.

Diagnosis: Missing tooth for more than 2 years. Loss of surrounding bone structure because of the abscess.

Treatment: Stage 1 surgery to augment the width of the bone structure with particulate graft. Stage 2 surgery 5 months later to place a root form dental implant and restoring the implant 6 months later with Zirconium abutment and a porcelain fused to Zirconium (PFZ) crown. Overall length of treatment was about 12 months. Patient was wearing a temporary single tooth denture in the meantime.

Before (with implant healing cap in place):

After (crown in place):

Dentistry by

Syamack Ganjavian, DDS

Extreme Makeover in 5 Hours!

2010-12-18T13:35:00.000-05:00

Treatment Report

Patient: C.M.

Chief Concern: Severely decayed and stained teeth in the smile zone.

Diagnosis: Rampant decay and severe staining due to decay and long time tobacco use.

Treatment: Decayed teeth structures were cleaned and composite resins placed for restorations. An abscessed tooth was also extracted at the same time in the back of the mouth. A slightly whiter shade of composite resin was placed to leave room for patient to whiten his teeth over time with home bleaching.

Before:

After:

Porcelain crowns are the optimal choice for dentition so severely damaged. Also they are more resistant to staining and retain their original shade and luster very well compared to composite fillings or natural tooth enamel, specially in smokers. In this case patient requested composite resins and was very pleased with instantaneous results in just 5 hours of treatment time and only 1 visit.

Dentistry by

Syamack Ganjavian, DDS

Conventional Orthodontics and Cosmetic Bonding

2010-12-18T13:00:00.002-05:00

Treatment Report

Patient: T.B.

Chief Concern: Crowding on lower teeth, Spacing on upper teeth.

Diagnosis: Constricted lower dental arch resulting severe crowding, Small upper teeth resulting in generalized spacing (tooth size discrepancy).

Treatment: Conventional orthodontics for 12 months along with dental whitening, followed by cosmetic bonding on upper teeth to address leftover spaces due to tooth size discrepancy.

Before:

Retracted Views:

After 12 Months of Orthodontic Treatment
and Cosmetic Bonding on Upper Front Teeth:

Retracted View:

Porcelain veneers would have been ideal in this case, however great results can also be achieved with cosmetic composite bonding. Further bleaching will be carried out at home on the upper teeth for even better final outcome.

Dentistry by: Syamack Ganjavian, DDS

Dental Implants in the Esthetic Zone continued

2010-12-18T12:35:00.000-05:00

Dental Implants for Hopeless Front Lower Teeth

Continuation of treatment six months later for bottom teeth.

Lower hopeless teeth extracted:

Implants with healing caps in place:

A brand new smile ! (retracted view)

A brand new man with a brand new smile !

Notice how we created an over lap on the lower implant teeth (on the right side in the picture) to satisfy patient's desire for a more natural smile, the same as it was on his natural teeth before they were removed.

Dental Implants in the Esthetic Zone

2010-05-09T10:06:00.003-04:00

Dental Implants for Hopeless Front Upper Teeth

Patient: X.F.

Chief Concerns: Loose front upper and lower teeth, previous history of gum disease, severe staining.

Treatment Plant: Remove periodontaly hopeless upper and lower teeth in phases, place bone graft to fill in the defect in the bone due to past gum (periodontal) disease and place dental implants first on the upper jaw and the on the lower jaw.

Treatment shown: Two implants were placed in place of the four front teeth extracted from the upper jaw about three months after extractions and bone replacement graft. Patient was wearing a removable transient partial denture in the mean time. Six months after placement of the implants, the heads of the implants were uncovered and healing caps placed (pictures 1 and 2). Treatment was completed by placing a four unit bridge on the two implants. Note the pink porcelain at the base of the teeth to compensate for the deficiency in the gums in order to achieve a cosmetic outcome.

Implants with healing caps in place:

Finished case twelve months from the start date:

Future treatment? Same treatment is scheduled for the four lower front teeth.

Dentistry by

Syamack Ganjavian, DDS

Spectra Caries Detection

2010-02-26T13:01:00.001-05:00

New Caries Detection Technology

Crescent Dental is now equipped with Spectra caries detection system. Spectra is a lightweight handpiece used as an aid for detecting caries, especially early stage enamel caries and hard-to-detect fissure caries.

How does it work?

The Spectra handpiece has a high resolution, high sensitivity CCD sensor and special LED lamps that emit high energy blue-violet light at a wavelength of 405nm. Light of this particular wavelength causes porphyrins from caries producing bacteria to flouresce. When used with the special Visix software areas of caries fluoresce in red whereas healthy enamel in contrast flouresces green enabling the dentist to identify carious lesions. The software also assigns a numerical value to the amount of red flourescence which corresponds with the amount of bacterial contamination. The higher the number the higher the bacterial contamination of enamel. The flourescence images can be stored in a patient's database, so that the progression or arrest of the early carious lesions can be tracked over time.

What do the flourescent images look like?

E.Max Porcelain Crowns, Bridge and Veneers

2010-02-06T16:22:00.001-05:00

Treatment Report

Patient: K.K.

Chief Concerns: Old composite fillings on front teeth that are discolored. numerous composite fillings done in the past at multiple occasions have rendered teeth uneven in shape.

Treatment: IPS E.Max porcelain crowns and veneers and a bridge.

Before:

Veneers on the model prior to cementation:

After:

Dentistry by

Zahra Ashrafi, DDS

Empress Porcelain Crowns and Veneers

2010-01-18T21:36:00.000-05:00

Treatment Report

Patient: C.K.

Chief Concerns: Old crowns of front teeth, not satisfied with their color and shape. Old metal partial denture on the bottom teeth with metal clasps showing in smile.

Treatment: Empress crowns and veneers on front upper teeth, in office whitening of lower front teeth, fabrication of a new cosmetic Valplast/Vitallium lower partial denture with no visible metal parts upon smiling.

Before:

After:

Dentistry by

Syamack Ganjavian, DDS

Lava Porcelain / Zirconia Crowns

2010-01-18T21:11:00.002-05:00

Treatment Report

Patient: A.B.

Chief Concerns: Severe decay throughout the mouth. Pain in several teeth.

Diagnosis: Rampant dental decay resulting in discoloration and fracture of most teeth. Multiple infected teeth requiring endodontic (root canal) therapy.

Treatment: Root canal therapy on total of 6 teeth. Composite restorations (white fillings) in the back teeth. Lava porcelain fused to zirconia crowns for the front teeth.

Length of treatment time: 2 months

Photos after completion of treatment:

* Patient preferred photos taken at the start of treatment not to be published.

Dentistry by

Syamack Ganjavian, DDS

Severe Enamel Wear Due to Acid and Mechanical Erosion

2010-01-17T18:08:00.002-05:00

Case Report

Patient: D.H.

Chief Concern: Continuous wear down of teeth

Diagnosis: Loss of tooth enamel and underlying dentin because of severe clenching and grinding habit. The wear down is also exacerbated by acid erosion (from stomach) due to under-treatment of GERD (Gastro-Esophageal Reflux Disorder).

Treatment: Fabrication of Night Guard appliance to protect teeth against the destructive effects of night time clenching and grinding to be worn at night during sleep. Fabrication of Fluoride trays to immerse teeth in Fluoride gel during the day to strengthen tooth enamel and combat acid erosion. Prescription for MI Paste (additional measure to strengthen tooth structure). Referral to GI specialist to possibly start patient of a proton pump inhibitor medication.

The ideal follow up treatment for this case would be restoration of the lost teeth structures with either porcelain veneers or full coverage crowns. However patient was happy about finding out the reason for his condition and preventing further erosion of his teeth and did not want to pursue any reconstructive dental work.

Dentistry by

Syamack Ganjavian, DDS

Lumineers Porcelain Veneers

2010-01-17T17:36:00.003-05:00

Treatment Report

Patient: A.C.

Chief Concern: Small teeth, worn out and yellowish color teeth.

Diagnosis: Excessive spacing between teeth, loss of dental enamel and tooth height due to excessive grinding, discolored teeth.

Treatment: Lumineers porcelain veneers to enhance smile by improving individual tooth shape, fill the spaces in between teeth and whiten teeth almost permanently (porcelain veneers are extremely resistant to staining and retain their original color very well).

Length of treatment: 3 weeks from start.

Before:

Lumineers Before Cementation:

After:

Dentistry by

Syamack Ganjavian, DDS

Invisalign Orthodontics

2010-01-17T16:33:00.007-05:00

Treatment Report

Patient: M.B.

Chief Concern: Cosmetic smile enhancement, did not want porcelain veneers

Diagnosis: Constricted dental arches, mild crowding, midline shift

Treatment: Invisalign orthodontics for 8 months along with dental bleaching using the Invisalign trays

Before:

After:

Dentistry by
Syamack Ganjavian, DDS