Dr. Jose-Luis Ramirez is the founder and director of the Los Angeles Institute of clinical dentistry. We discuss using porcelain veneers to treat severe wear cases. Treating these patients is not only aesthetic, but it is also treating pain, headaches, and other secondary issues. Cutting a tooth for a crown weakens the tooth structure and will not prolong the life of the tooth because the patient is still grinding. While veneers are not the only way, it does help to bring a positive aesthetic that plays out in their lives. There is a lack of guidance from anterior teeth and can help improve the mechanics of the bite. Zircona crowns force margins below the gum. Occlusion is a mechanical system. The 3 golden rules: 1. All our teeth need to hit at the same time with the mandible centered. People do not always realize they shift. Anterior and canine guidance is imperative. Overjet is necessary. The jaw needs to open and close without rubbing. Getting the bite seems to be one of the most difficult parts. While there are different approaches, the principles are the same.
We need good quality photos and casts. Futar is a great product for a quick set. Silginat is hydrophilic and works well in the mouth. Calibration and wax-ups can help us guide best practices. Once wax-ups are done and the plan is in place, begin prepping with minimal structure loss by using a supragingival approach. This is a case where digital is not the best approach. A scanner is amazingly accurate, it is the printing process that has error because it cannot currently reproduce the margins with the level of accuracy you can get with impressions. You risk sacrificing tooth structure to improve your scan. Why is being minimally invasive important? When we do a regular crown, we cut as much as 75% of the tooth structure. The risk of coming in contact with the pulp risks the chance of a root canal. It is also better for periodontal health and is ultimately faster. The science behind the method supports the approach and is ultimately healthier for the patient. Every time you go below the gum, there is inflammation.
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The Nifty Thrifty Dentists
Dr. Glenn Vo and Dr. Vinh Nguyen are the original "Odd Couple" of Dentistry - they are neither partners in practice or in bed. Just the dynamic duo behind one of the most entertaining Dental Podcasts in the World. Let's face it. Being a Dental Professional is hard. Heck, life in general is hard. Leave reality for a moment and join us in this podcast whirlwind of interesting guests, funny jokes, and thought provoking banter.