I Was Only Eating An Almond.

We all know the added health benefits to eating Almonds. Almonds contain the “good” fats, fiber, Vitamin E, Magnesium and protein. They assist in lowering blood sugar, lowering blood pressure and lowering cholesterol. They are just bad for teeth with large old silver restorations.

A patient came in today with a very saddened face. Her lower right molar tooth in question had no pain to touch or temperature sensitivity. As she stated, “something felt crunchy when I was chewing on an almond and soon after, I felt a sharp edge of my tooth with my tongue.”

The history of her tooth goes back over twenty years.  It had been previously filled twice with an amalgam filling. A radiograph check confirmed that the tooth was structurally remaining  in good condition. The nerve within the tooth was just fine.

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The side view
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Tongue side Fractured Off Cusp– towards the back aspect of the tooth.

This tooth had a tremendous amount of very healthy enamel.

In general, the functioning aspect of  Lower Posterior Teeth are the outer cusps, the “loading” cusps (buccal cusps). The inner “carrying” cusps (lingual) are non functional or non-loading cusps and are essentially bystanders in chewing. The opposite functionality could be said for an upper tooth.

I  felt that a Ceramic Onlay would be the perfect restoration. Ideally it would bring the tooth back to full function because the loading cusps were intact. There was no pain on chew, which would indicate a residual fracture line under the amalgam restoration. This would require a full coverage crown if it were the case. The nerve of the tooth was totally fine. No root canal procedure was indicated here.

An Onlay is sort of  a three quarter crown. After delivery of a simple local anesthetic, the process of creating an onlay requires that I clear away any pre-existing restoration, undermined, cracked, or weaken tooth structure resulting from the original insult. What remains should only be the sound tooth structure.

A ceramic restoration is created by my in-office milling machine (CEREC).  The CEREC created onlay restoration is super engineered to fit “into and onto” the prepped tooth with an accuracy of a 25 microns (0.025 of a millimeter).  That is a very small number. The seam in-between tooth enamel and restoration is tight, exact and imperceivable.

The restoration is then bonded into place with a resin cement and fine polished to perfection. The process in my office, start to finish, takes one hour.

The advantages are many:

An onlay is a very conservative restoration. I don’t need to aggressively shape the tooth as I would for a Full Coverage crown restoration. Less drilling means, less of a chance that you will need a root canal procedure.

The material is a Composite Hybrid of Ceramic and Resin (Cerasmart). It has a very long track record. It lasts many years.

A bonded restoration translates into a whole stronger tooth, subsequently less prone to fracturing in the future.

Esthetically, they are beautiful.

TIP: There is hope after all for you Almond Lovers with big beaten down silver restorations. You do not need to live in fear………….. I have been informed by numerous patients this to be true.
Apparently, Organic Almonds are softer and are less likely to break your teeth.

 

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Final Bonded Ceramic Restoration

Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

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