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Orthodontics
Check below for frequently asked questions about orthodontics.
The braces work through a system of forces. It is through the braces that the teeth are “pushed” or “pulled” to the ideal position. For these forces to be applied correctly, 3 fundamental parts are required.
1. Braces: are the metal parts that are glued to the tooth;
2. Wires: are placed inside the brackets;
3. Elastic bands: attach the wire to the brace.
There are other parts like tubes, springs, buttons. In general, they all act as tools for the correct application of forces. With this, the teeth are moved to the correct position.
In order for a tooth to be moved to the correct position, 2 processes take place: resorption and bone affixing. That is, on one side the bone is reabsorbed and on the other it is formed. A slow process, which depends on the organism of the individual. In addition, if the professional applies a very intense force in order to move the tooth more quickly, it can cause an uncontrolled bone resorption and this would result in serious problems, such as tooth loss, for example. That’s why it’s a slow treatment.
As appropriate as the brace glue is, there is always a limit to the resistance of this “glue”. Even using very high quality materials, brace detachment can happen due to the forces of chewing. This is very common when the patient chews a harder food.
This does not always happen, but it is common in the hours following maintenance for patients to complain with pain.
It occurs because the change of the thread ends up exerting a greater force in the teeth. As a result they become sensitive. This discomfort should not last longer than 3 days. If it persists, go talk to your dentist.
The main difference is in the fastening system of the wire with the bracket. In the conventional apparatus, we use small rubber rings.
In the self-connected device, there is a slot, a kind of socket with a locking system, which lodges the wire. It is a more modern fixed apparatus, an evolution of the conventional model.
The main advantages are greater stability and control, shorter treatment time, more spaced maintenance and greater hygiene. And in the case of adult people, the coloured elastics don’t always please.
The friction between the wire and the bracket in the self-plugged device is less intense. With this, this system slides more easily. Therefore, the drive occurs easier.
Unlike fixed appliances, which rely on braces, bandages and wires, invisible aligners correct the positioning of the teeth through transparent plates. They are acrylic plates, thin and removable.
Unlike fixed appliances, which rely on braces, bandages and wires, invisible aligners correct the positioning of the teeth through transparent plates. They are acrylic plates, thin and removable.
Certainly, the aesthetics is the greatest of them, since it is a transparent and very discreet device. Comfort is also an asset, since the patient can remove the device.
This also facilitates the cleaning of the teeth and the aligner itself. In addition, they are more comfortable and interfere less in the speech of users.
Yes! As in other orthodontic treatments, the follow-up is crucial so that the professional can follow the evolution of the treatment.
Protocol and Overdenture
Check below for frequently asked questions about Protocol and Overdenture.
Protocol is a treatment with dental implants indicated for people who have lost all or several teeth. This treatment is named because it follows the recommendation (protocol) of Branemark (Per-Ingvar Branemark), a Swedish orthopedist who discovered osteointegration – a mechanism that supports the use of dental implants.
The protocol allows a person to have a fixed prosthesis over a smaller number of implants (usually between 4 and 8). In this way, it is not necessary to make an implant for each missing tooth.
Certainly, the greatest benefit is related to the recovery of self-esteem, safety and chewing capacity. Patients treated with the Protocol report major positive changes in their lives.
Unlike a removable prosthesis, it doesn’t come out of your mouth. This results in safe chewing of more fibrous or sticky foods, to smile and talk. And it is not necessary to take it to sleep.
Another important benefit is the longevity of this treatment. When well executed by the professional and well sanitized by the patient, it lasts many years.
The Protocol has two main parts: implants (screws) and teeth. This second (of artificial teeth) can be held in different materials, but is usually in ceramic or acrylic.
Ceramics:
– suffer less erosion;
– retains less plaque, due to the nature of the material itself, which is not porous;
– longer lasting.
Acrylic:
– There is erosion on the acrylic teeth, which requires its replacement after a few years;
– It is a more porous material and therefore retains more bacterial plaque.
This generates many doubts and controversies because people associate the quantity of implants with the quality of the treatment (the more implants, the better the treatment). However, that is not the case. After much research, what is known is that the position and type of implant used are more important than the quantity itself.
As proof of this, it is the wide use of the All-on-Four technique, ie, the Protocol is performed with only 4 implants. Usually 4 to 5 implants are used for the jaw (lower bone, which is more compact) and 6 to 8 implants for the maxilla (upper bone, more porous).
So don’t worry so much about the quantity of implants, but about the quality. The success comes from the technique used and the quality of the implants.
Hygiene is essential for the treatment to last. In the case of the Protocol, a little more attention is needed, because there are several implants joined by a prosthesis. This facilitates the accumulation of bacteria and food debris.
To sanitise, the patient must use a uni–tuff brush, which has the shape of a spear and can penetrate the space between the gumline and the prosthesis, removing the dirt. In addition, there is the wire raiser, a needle-like device, only plastic. It helps to insert the floss into the spaces.
A widely used resource is the oral irrigators. They are appliances that pour a jet of water that remove the remains of food. They are easily found on the Internet, in pharmacies or even in dental clinics.
“Doctor, is it possible to take out the Protocol to clean it up?” That’s a common question. And the answer is YES and NO. Yes, if done by the professional in the office and Not because it is laborious and it would be impracticable to remove often (moreover, can harm the components).
The usual is the removal for a deeper cleaning (and even polishing off the prosthesis) every 6 months. In addition to giving an extra shine to the prosthesis, the dentist can check the health of the gumline and implants. There are reports of patients who tried to remove the prosthesis at home. This practice is very risky, so don’t even think about it!
Maintenance takes place through radiographic and clinical follow-up of the patient. When necessary, the professional will perform a professional cleaning of the implants. The screws that fix the prosthesis inside the implants can be damaged over time, and in maintenance appointments should be replaced.
Another important procedure in maintenance is the analysis of occlusion (bite) and occlusal adjustment, so that the patient always has an adequate distribution of forces during movements.
As in any treatment, periodic monitoring should be performed. In addition to diagnosing problems early, you can also have a coffee with your dentist!
This answer depends on the amount of bone available. Over the years, the alveolar bones (where the teeth were in the jaw and maxilla) of toothless patients undergo an intense resorption process.
This occurs in the vast majority of people and, in the most extreme cases, it is impossible to treat the patient with dental implants because of the lack of bone. In the lower part (jaw), the resorption process is less intense, which often allows the fixation of the implants.
In the upper part (maxilla), the extreme cases are more common and in some of them, the “conventional” treatment is not possible. If you have been using removable prosthesis for many years, do not postpone your treatment with implants. The more time passes, the more the bone is reabsorbed and the more complex the treatment becomes.
Overdenture is a type of treatment with dental implants, in which the professional fixed, from 2 to 4 implants for the installation of a removable prosthesis. It’s an intermediate treatment between Protocol and denture.
Unlike a removable prosthesis, the prosthesis is not trapped only by the negative pressure (vacuum) between the piece and the gumline – It consists of a system of attachment to the implants, through a bar or locators, for example. However, it is not as fixed as the Protocol.
When the patient has contraindications to perform a Protocol. This happens in the case of very old people, with little bone or health conditions that make a longer surgical procedure impossible.
The biggest difference is that the Overdenture is removable and the Protocol is not. On a day-to-day basis, the patient feels it move during speech and chewing.
In the case of the Protocol, there is no movement or weigh-bridge. Consequently, the masticatory efficacy of Overdenture is lower. Another difference between the 2 treatments is the price. As the preparation of the Protocol is more elaborate and requires more implants, the cost of Overdenture is lower.
As in the Protocol, maintenance takes place through radiographic and clinical follow-up of the patient. When necessary, the professional will perform a professional cleaning around the implants.
Another important procedure in maintenance is the analysis of occlusion (bite) and occlusal adjustment, so that the patient always has an adequate distribution of forces during mouth movements.
As there is some movement of the prosthesis on the bar or on certain components of the implants, it is common to wear the intermediate part, which is between the overdenture and the implants or the bar that is on them. The replacement of this part should be performed as well as the replacement of the prosthesis.
Aesthetic
Check below the frequently asked questions about aesthetics.
Before knowing how it works, it is necessary to understand how the teeth darken or stain over time.
There is extrinsic pigmentation, caused by external agents such as smoking, food or drink. The intrinsic pigmentation is caused by bleeding inside the tooth that causes stains.
These pigments penetrate into the Dentinal Tubules which are like small cannulas in the Dentina and this alters the coloration of the teeth. Whiteners are composed of peroxides, which react chemically with the dental structure and release gases inside the Dentinal Tubules. These gases carry the pigments out of the tooth structure and so the tooth becomes whiter.
No! This is an ancient history. Several studies have proven that the procedure is absolutely safe and does not alter the structural morphology of the teeth.
Yes! The action of the gases can dehydrate and expose the nerve endings inside the Dentinal Tubules and cause sensitivity. However, selecting the type of technique and gel concentration can prevent these adverse reactions.
In addition, the dentist may use medications during and after treatment to control or avoid sensitivity.
It is not possible to answer this question, but according to the patient’s habits and preventive care, it can last for many years. Factors such as bruxism (the habit of grinding teeth), dental clenching, nail biting or objects, directly affects the durability of the treatment.
The main difference is that to make a contact lens no wear to the tooth structure is performed. If some wear is done, however minor, it becomes called a facet.
It involves the use of various procedures that seek the aesthetic and functional balance of the face, so that the smile and the face are harmonious with each other.
Yes! The dentist is qualified to perform several procedures on the face.
The effects last between 4 and 6 months, being shorter the duration time in men who have a more intense facial musculature than women.
Prostheses
Check below for frequently asked questions about prostheses.
The removable prosthesis was, for many years, the main choice of treatment for toothless people. However, many people complain about this type of prosthesis.
The main complaints are:
– Movement during chewing: especially fibrous or sticky foods. When the patient performs the masticatory movements, the prosthesis moves and hinders the correct grinding of food.
– Burning mucous membranes: very common in the roof of the mouth, caused by the presence of fungi. Even the most careful patients can suffer from this disease, especially because of the porosity of the prosthesis that ends up housing fungi and bacteria on its surface.
– Pain when chewing: it is mainly due to the adaptation of the prosthesis to the mouth, pointed bone formations, incorrect occlusal adjustment (the way the teeth fit when the person chews) and limitations related to the amount of bone of the patient (the less bone this possesses, the greater is the possibility of movement and discomfort).
– Loss of taste and touch: this occurs because the prosthesis blocks the mucosa (gumline). This block prevents the taste buds located in the roof of the mouth from coming into contact with the food and noticing the taste of it. This also occurs in relation to the perception of food texture and temperature, so some patients who use removable prosthesis complain about the “lack of taste” of food.
– Pain in the joints of the mouth: also known as TMJ, the temporal-mandibular joint can be injured by the use of worn, poorly adapted or poorly made prostheses. The patients also report headache and tinnitus in the ear.
– Difficulty in grinding food: even well-adapted removable prostheses have important limitations in relation to masticatory function. So patients end up finding it difficult to grind foods such as leaves and fibrous meats.
– Difficulty in pronouncing a few words: how the prosthesis can affect the vibration of the Soft Palate (the back of the roof of the mouth) and the movement of the tongue, some words such as “Mississippi” or “sixteen” can be difficult to pronounce.
– Insecurity, shame and psychological implications: these are questions that are little explored during dental care, but have a fundamental importance, including for the choice of treatment. Many people feel ashamed to smile or to eat near others, afraid of going through some embarrassment. Others are not happy with the appearance of the smile because the teeth of the prosthesis are very different from how they were originally natural.
This is a difficult question to answer, because several factors can influence the durability and adaptation of prostheses. People who undergo bariatric surgery, for example, lose a lot of weight and need to repeat the prosthesis a few months after surgery. According to the ADA (American Dental Association), prostheses should be replaced every 4 years. Obviously, for financial reasons, not everyone can change their prosthetics in this time.
Yes! Plaque and food scraps stick to the teeth and to the resin of the prosthesis (as in an individual who has natural teeth). This accumulation of dirt causes bad breath, burning and can stain the prosthesis. Therefore, the best thing to do is to brush it (all its parts) after meals.
Yes! It is during the night that the mucous membranes “rest” after long hours of contact with the prostheses. This rest allows the tissue to regenerate and restore its vitality. In addition, this habit prevents the appearance of infections by fungi or bacteria.
Keeping it in a container with clean water is ideal.
Yes! This happens because the hooks end up overloading the teeth by exerting lateral forces. Normally, the roots of the natural teeth resist the vertical forces very well. When the prosthesis moves, the hook ends by pulling or pushing the tooth and this compromises the health of the roots and gumline.
Yes, and no! When it is not possible to indicate the implant, using teeth as a support for a fixed prosthesis is the best option. Otherwise, no! This happens because the remaining teeth need to be worn out (after all, the prosthesis will fit into these teeth) and the roots, which previously supported the forces of the respective tooth; now they will receive an extra charge (referring to the missing teeth and replacements in the prosthesis).
Periodontology
Check below the frequently asked questions about periodontology.
Why does my gums bleed? In normal situations, the gums should not bleed. This bleeding indicates that the gums are inflamed! As with any inflammation the blood vessels become dilated, the blood flows very easily. Just a little touch of the brush bristles and the gums start bleeding. The risk depends on the time of starting the bleeding and the amount of bleeding too. Generally speaking, gum bleeding requires immediate care and professional care.
Gingivitis is a relatively common oral disease, characterized mainly by gingival bleeding, swollen and reddish gums, with a smoother and brighter appearance than usual and with changes in contour. This happens because of poor oral hygiene. In the vast majority of cases this poor oral hygiene is due to the lack of personal care, but some situations such as prosthesis overbite, orthodontic appliances, contentions and dental crowding can favor this situation. The treatment consists in the removal of the causative agents, that is, professional cleaning of the teeth. In addition, the professional may indicate some treatment with medicines.
Periodontitis, or periodontal disease, is a more advanced stage of gingivitis. Also caused by poor oral hygiene, it has symptoms also similar to those of Gingivitis – gingival bleeding, swollen gums, reddish, smooth appearance and with contour change. Additionally, purulent secretion (pus) may occur in the gingival groove, tooth mobility, pain, tooth movement and persistent bad breath. Symptoms vary according to the level of the disease, which can range from mild to severe. In recent years, the studies indicated a direct relationship between Periodontal disease and cardiovascular complications. Periodontal Disease is one of the main causes of tooth loss, alongside Caries Disease and trauma, so it should be treated as soon as possible.
Normally, individuals suffering from periodontal disease need periodic follow-up, even after the disease control. These periodic controls are scheduled according to the risk identified by the professional. Treatment, in addition to scraping and cleaning, may include removal of the retention factors of plaque and even periodontal surgeries (in the gums). Scrapings can be above or below the gum level. In this second case, the professional can associate surgical procedures to ensure greater visibility during the procedure. It is important to emphasise that in this case (from the sub-gingival scraping) the professional always makes use of anaesthesia.
Each patient needs a specific number of sessions and different techniques, so talking about price can be precipitated, after all, each patient evolves in a way during treatment and some need more sessions than others.
No! Although there are solutions for cheek and medicines to control the bacterial infection causing Periodontal Disease, treatment is obligatorily dependent on professional procedures performed by the dentist. In relation to toothpastes, it is possible to find those specific or more suitable for the control of the disease. However, the prescription between one and the other depends on the professional.
It depends! In cases of severe mobility it is not always possible (there, the treatment with dental implants is indicated). On the other hand, for cases with less intensity mobility, the correct treatment and control can recover the vitality of the periodontal tissues (gum, root and bone) saving the tooth. In addition to being healthy, mobility decreases or even disappears.
The main one is the Clinical Exam. In it, the professional identifies the depth of the Gingival Groove (a space between the gum and the root). It is through this survey that the presence and severity of periodontal scholarships are verified. In addition, radiographs demonstrate bone characteristics, which are fundamental for the detection of the disease. In some cases, the professional may request culture of bacteria from the oral cavity to identify the main type of agent causing the disease. This helps in the choice of medicines.
Endodontics
Check below for frequently asked questions about endodontics.
The tooth canal is a space located inside the root, which contains nerves and blood vessels. It houses the vital part of the tooth.
When the bacteria that cause caries reach the deeper layers of the tooth, they eventually contaminate the inside of the canal. Therefore, the professional has to open the tooth, expose the channel and remove all its contents. After decontaminating the inside of the canal and smoothing its internal walls, the dentist fills the space with a specific material to prevent the appearance of new infections.
The presence of nerve endings inside the canal makes it extremely sensitive. Therefore, treatment requires anaesthesia. However, when the channel is contaminated by bacteria, the anaesthetic solution may have its effectiveness diminished. Therefore, the medicines and techniques used by the professional make all the difference. Certainly a proper clinical protocol and effective medicines, make the procedure safer and more comfortable for the patient.
In the past, yes! Especially in cases where teeth were contaminated. With the development of techniques, equipment and medicines, treatment time was drastically reduced. The new rotating devices made the instrumentation part of the channel much easier.
Probably because the channel already treated was recontaminated or because at the end of the treatment, some bacteria remained inside the canal. Therefore, every treated channel should be monitored after completion. In addition, the restoration of the tooth (either through composite resin or crown) should be performed with great care, in order to avoid infiltrations of microorganisms.
That is a very timely question to ask! Before the emergence and popularisation of Dental Implants, professionals needed to wear out the tooth to fit a fixed prosthesis. Often this wear out is very severe and reaches the inner layers (in some cases the pulp that is the content inside the channel). In such cases, the channel must be treated.
Each tooth has a certain number of channels, and the same tooth may have more or less channels from one individual to the other. That is, only after an evaluation consultation the professional can pass the price correctly.
Implants
Check below for frequently asked questions about implants.
To understand how dental implant treatment is, the first step is to know what a tooth looks like. The tooth has two main parts: root which is the inner part that holds the tooth in the bone below the gum and crown, the white and visible part of the tooth, which appears when we speak or smile. Dental implant is a treatment used for people who have lost one or more teeth. With it, the dentist performs a surgical procedure for the installation of a screw, which will replace the root of the missing tooth and will serve as a support for an artificial tooth, most often in ceramic or zirconia. This screw has an external and an internal thread, where the artificial tooth is fixed.
The implant is made of titanium, a very resistant and biocompatible metal. However, often our patients ask if “dental implant can cause rejection”. The fact is that there is no rejection of dental implant, since our body understands the implant as something natural.
The procedure can be divided into 2 steps:
Surgical stage
It consists in performing surgery for the fixation of the implant, and always begins in the surgical planning. This planning serves to define the type of surgical technique, pre and post-operative medications, type of material, to analyse the preoperative exams and of course, to know the professional responsible for the surgery.
In surgery, the dentist anaesthetises the region and then does a procedure on the gum and bone to create a space, where the implant will be fixed. This step is performed with specific equipment to monitor the patient and the procedure itself. After that, the professional fixes the implant in the bone, respecting its measurements and surgical planning. Finally, he sutures (sews) the gum in the region of the implant so that healing occurs in the best possible way and to protect the implant.
Thus ends the Surgical Stage! After comes the phase of Osteointegration (from 3 to 6 months on average), when the professional starts the 2nd stage – the Prosthetic Stage.
Prosthetic Stage
In this phase, the implant is already fully adhered and integrated to the bone and already has conditions to sustain the artificial tooth and all the strength of the patient’s bite.
The professional puts a pillar inside the implant and, on this pillar, screws an artificial crown (remember, crown is the white part of the tooth, the exposed one, that appears when we speak or smile). After that, he makes the adjustments so that the patient has an efficient and comfortable chewing. Finally, the dental implant is finished!
Once fixed to the bone, the implant takes on average 3 to 6 months to “heal”. The correct term for this procedure is Osteointegration, that is, joining the bone. This time can vary according to the type of bone (not all are equal, there are more or less porous bones, more or less vascularised), systemic health condition of the patient (diseases such as diabetes, for example, can delay this process), type of surgical technique, type of material used, medications of frequent use of the patient and several other factors that are analysed by the professional in the evaluation consultation.
As in other areas of health science, in Dentistry the success of a treatment depends on several factors. Therefore, telling precisely why a patient has lost the implant is difficult. However, the main reasons for the loss of dental implant are:
๏ Peri-Implantitis and poor oral hygiene: an infectious disease caused by bacteria that lodge around the implant and destroy bone. This disease, in turn, is caused by the accumulation of dirt (food debris) and consequently the accumulation of bacteria. Certainly, the lack of hygiene is one of the great villains of teeth and implants. Therefore, implants require strict hygiene care as well as natural teeth.
๏ Occlusal trauma: consists of excess force exerted on the tooth during chewing. This situation can cause bone resorption and this affects Osteointegration. This condition is often associated with the carelessness of the professional when adjusting the prosthesis or the patient’s deleterious habits, such as biting objects for example.
๏ Incorrect procedure: in these cases, the patient loses the implant because it was fixed in an incorrect position, often in regions with insufficient amount of bone.
๏ Medications used by patients: some medications interfere with the Osteointegration process. A typical example is the Biphosphonate family. This medicine is often used to treat osteoporosis, however, it can cause bone necrosis around the dental implant.
๏ Systemic diseases and procedures: some diseases may interfere with the Osteointegration process. For example, we can mention Osteoporosis, Radiotherapy, Diabetes, Periodontal Disease, coagulation disorders, drug use, alcoholism and smoking.
Perhaps that is the most frequent question and it is absolutely understandable. The cost of the materials used is standard, changing according to the manufacturer, composition, size and shape of the implant. However, in addition to these costs, there are those associated with clinical and professional practice. The fact is that in the recent past, about 15 years ago, implants were very expensive procedures, accessible to a small portion of the population.
In this sense the industry has collaborated. There are excellent implants produced in several countries. In addition, the number of professionals increased and naturally caused prices to fall. Regardless of the price (and even if it is critical to your choice), check the clinic facilities and the professional who will take care of you. Certainly, they are indispensable factors, when it comes to health.
Each individual has a specific threshold of pain, that is, even in the face of the same painful stimulus, 2 people can feel pain differently. If this is an issue that concerns you, calm down. There are efficient anaesthetic solutions that avoid the discomfort of pain during the procedure. However, as with all surgery, post-surgery can bring some discomfort. To overcome this situation, the professional should carefully choose the technique and materials, as well as medicate the patient (before, during and after the procedure) and give the post-operative guidelines. It may not seem like it, but simply lifting the headboard or using a larger pillow can prevent a sleepless night. If you trust the clinic and the professional you’ve chosen, everything will certainly be easier. This and other issues will be discussed very calmly at the right time.
Implantprime
Check out the frequently asked questions about Implantprime's implants below.
If you are looking for a referral clinic with good professionals, you
need to know Implantprime. Our work philosophy focuses on
the customer, from our welcoming to the execution of treatments.
In addition, patients rely on constant administrative support to help
them achieve the perfect smile. All cases are planned by the Clinical
Supervisor who works together with the team of
specialists to complete the treatment and each patient receives a schedule, to
follow the evolution of their case.
Technology: Implantprime is a technological clinic, because it has state-of-the-art equipment, sensor chairs, digital diagnostic equipment and various infrastructure resources to ensure the best quality in the execution of services;
Prime Evaluation: more than a common evaluation, in Implantprime the evaluation is always performed by a specialist who will investigate the patient’s entire health history and indicate the best treatment option. In this consultation, the Clinical Supervisor presents and explains in detail the treatment plan to the patient. According to satisfaction surveys carried out in the units, 9 out of 10 patients evaluated Implantprime as the best dental clinic they have ever known.
Digital Checkup: this is a set of free exams performed before the service in the Prime Evaluation. It’s like a hospital triage with digital devices.
Operating room: is a dental room with specific equipment for surgery. In addition, in the operating room, the cleaning and use protocols follow the standards adopted by hospitals. Safety and comfort always, even in the most delicate moments.
Comfort: a comfortable clinic, from the use of armchairs in the waiting room to the post-operative comfort room for patients undergoing surgery. The entire environment of the clinic is air conditioned. The flow of people within the units is studied to make the service more fluid. Even lighting is carefully planned to make the customer experience as enjoyable as possible.
Trained professionals: at Implantprime, each
professional works in their area of expertise. There are several specialists
who together discuss clinical cases always in search of the best treatment for
the patient.
Everyone! Implantprime is a multidisciplinary clinic, that is, it works with several specialties. However, the focus is on
the rehabilitation with dental implants of patients who have lost teeth over
time. In addition, orthodontic treatment is also part of Implantprime DNA.
No! We charge the right price to provide high quality services. Our
goal is to make each patient feel special, therefore Implantprime needs to be the best experience for each of them.
The Concierge is the person who
takes care of the patient’s life until he starts his
treatment. From the scheduling issues to the financial easing of the treatment
plan. It is a service available to all patients to make bureaucratic matters
less complicated.
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