Advantages and disadvantages of Zirconia Crowns
The new era of dental materials is flourishing and much has to do with the advantages and disadvantages of Zirconia Crowns. Zirconia is an extremely strong and hard materiel, close to 1200 Mpa, compared to a traditional full porcelain crown at 250mpa. We measure in MPA’s or mega pascals. It is white and relatively opaque. So it is a great replacement for the previous metal that was used as a base underneath PFM’s, or porcelain fused to metal crowns. PFMs, were the standard of esthetic dentistry for the last 60 years or so.
Advantages and disadvantages of Zirconia Crowns
We are all familiar with the white crowns, that were relatively opaque, sometimes you saw a little metal sticking out at the gum line, causing a dark area at the neck of the tooth. These teeth were also often opaque and not terribly natural. This was because the metal had to be hidden by an opaque white color, so as not to see greyish in the crown.One problem was that the porcelain can chip off of the outside of the crown revealing an ugly grey color.
Zirconia crowns have overcome these problems. The zirconia comes either in small blocks that can be milled in a CEREC machine, or, as one of the few dentists in Israel with a Sirona Inlab system in my office, I can mill large restorations out of a puck of zirconia. Zirconia in its raw form is chalky. We mill it dry, and it needs to be put into an oven for 12 hours to sinter, or become hard. But once hard it is strong, tough and very exact in terms of its fit. One of advantages and disadvantages of Zirconia Crowns is that they are brittle. So we must be careful when adjusting the so as not to cause microscopic cracks which can lead to failure. All in all it is an amazing material and the advantages and disadvantages of Zirconia Crowns are far outweighed by the advantages.
We recently added a Surgical microscope to our practice. This tool offers an astounding upgrade in the way we are able to treat you, in that the visibility and light in the treatment field had gone up dramatically.
Magnification in dentistry
For the last 30 years or so, dentists have started using glasses with magnification. This was then improved with little headlights that focused the light into the mouth. Those early lights were heavy and hot. With the advent of LEDs that became lighter, cooler and better. The truth is , magnification is a must in dentistry. I really do not understand how you can treat a patient without it. Especially for an experienced dentist. As you age, your vision gets poorer and without magnification your ability to provide good care suffers.
A surgical microscope is usually hung from the ceiling above the patient, it is fully adjustable, have powerful lighting and has different levels of magnification. Another great advantage is that it can be connected to a screen so that the dental assistants can see exactly what is going on in the mouth. The lighting is very very powerful and it also has a filter that allows us to block the UV light when working with composite fillings, which get hard when exposed to the light.
Uses of the Surgical Microscope
Firstly an a diagnostic tool, it allows us to see things that otherwise might not be visible. In the picture below you can see 2 teeth with multiple fractures. While some might be clear to the naked eye, others are not.
Another very powerful usage is in root canal therapy. It is often difficult to find the opening into the canals in a tooth. When we have the magnification and ability to focus exactly, we have almost no difficulty in find them. The picture below illustrates that.
16 year old with natural stains and pitting
Before. Note the pitting and staining. Front to teeth were covered with an old white filling.
Before placement age 16
A happy patient 5 years later.
Esthetic dentistry – veneers close his gaps. It is invisible.
Before veneer placement – large spaces between his teeth
Dental Clinical Microscope
We have recently started working with a Dental Clinical Microscope, one of the few general practitioners in the country to do so. A Dental Clinical Microscope allows us to control our magnification, light and the ability to see everything we are doing in a manner that nothing else can.
Here is how it works. A high quality Dental Clinical Microscope with adjustable magnification is placed over the patient’s mouth. We can change our magnification as well as use the powerful light to harden our composite fillings. The microscope comes with a UV filter so those white dental fillings will not cure if we don’t want them to. Another fascinating advantage of the UV filter is that when using it, blood becomes invisible. So when we are doing surgery, even if there is a little bleeding, it does not obscure our vision.
I must share with you that the difference in my ability to see is astounding and as a result, you obviously understand, the quality of the work is in another league. What is interesting is that contrary to what you would think, the more intense the light , is not always the best way to practice as there is more contrast without the brightest light. Another thing to take into account with a dental clinical microscope is the focal length of the lens. Since we need to be able to work at a certain distance from the mouth as well as keep the entire mouth in focus, we need a lens that can do that. Stability of the microscope is critical and mine, like the better ones, has a gyroscope system built in that will keep it stable and exactly in place.
Finally, the other great advantage of this is that we have a port on the dental clinical microscope that allows me to take high quality pictures or high definition video of any procedure that we do.
Dental implants have been in use successfully for the last few decades, and with great results. This article will be about failures in implant esthetics.
Poor implant esthetics are a concern, particularly when the implant is placed in the front area of the mouth or even in the posterior section if the patient has a wide smile line. If the implant is placed too high or to low, this can cause all sorts of problems. The most common problem is exposure of the grey metal at the neck of the tooth. This issue of implant esthetics is not an easy thing to overcome if the implant is poorly placed. One can see that poorly placed implant can cause dramatic esthetic problems. These implant have actually not been placed too far apically or coronally.
Another problem is poorly angled implants. This picture shows an implant that is jutting out of the mouth and will give us a very poor esthetic result.
Dr. Ari Greenspan is a Jerusalem dentist. Our office offers an unusually wide array of dental services at the highest level of quality. Dr. Greenspan, a Jerusalem dentist, studied in The University of Medicine and Dentistry of NJ in the USA.
What is unique about Jerusalem dentist Dr. Ari Greenspan?
- Dr. Greenspan was the first dentist in the country to use the revolutionary CEREC 3d technology to form crowns in an hour.
- A great emphasis is placed on continuing education. See here for a complete list of his constant striving for improving and keeping updated.
- Jerusalem dentist Dr. Greenspan, is one of a handful of Jerusalem dentist’s who have the permission of the ministry of health to do dentistry under general anesthesia in his office.
- Dr. Greenspan also is one of a handful of dentists that perform frenectomies for babies who have a tongue tie and have nursing difficulties.
- The office performs a large amount of esthetic dentistry including full porcelain crowns in Jerusalem as well as porcelain veneers.
- Naturally, we also do implantology placing dental implants as well as doing sinus lift surgery and bone grafting.
- We have an active dental hygiene program offering patients the ability to upkeep their mouth in a state of health.
- We offer childrens dentistry done by Dr. Joel Cohen Jerusalem dentist who is a graduate of Hadassah dental school and an expert in pediatric dentistry. Dr.Cohen has worked for the Ministry of health’s dental division
- We offer facial pain, TMJ and sleep apnea treat performed by Dr. Larry Lockerman, Jerusalem dentist who practices in the Boston facial pain clinic as well as in Jerusalem.
For more information on Jerusalem dentist Dr. Ari Greenspan at 02 679-8040