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A tooth that has been structurally damaged by decay or trauma sometimes needs to be crowned or “capped” so that it can look good and function properly again. A crown is a durable covering that is custom-made to fit over the entire tooth from the gum line up. Crown fabrication traditionally takes place in a dental laboratory. But these days, there's a much more convenient alternative: same-day crowns made in the dental office.

Advanced dental technology known as Computer-Aided Design/Computer-Aided Manufacturing, or CAD/CAM, makes it possible to fabricate laboratory-grade crowns and other dental restorations in minutes. It's an amazing innovation when you consider that traditionally, crowns take two or three visits and just as many weeks of waiting. Now you can have a restored tooth without the wait.

Best of all, studies have shown that CAD/CAM tooth restorations are just as successful as crowns made with traditional materials and techniques. And the amazingly lifelike appearance of a same-day crown means that no one will know your tooth has been restored.

How It Works

The process of crowning a tooth starts out the same way, whether it's a same-day crown or traditional crown: with “preparation” of the tooth. This involves removing any decay that's present, and shaping the tooth with a dental drill so that it will fit perfectly inside the crown. But the similarities end there.

If you were getting a traditional crown, the next step would be to take an impression (mold) of your teeth with a putty-like material, and use it to construct a model on which to create the crown. With a same-day crown, your teeth are simply given a light dusting of reflective powder and then a small scanning wand attached to a computer is used to take digital pictures inside your mouth. In seconds, the computer will generate a highly accurate 3D model of your teeth. But it gets even better.

With the help of the CAD/CAM software, your crown will be designed while you wait. The software can even be used to create a mirror-image twin of the same tooth on the other side of your mouth, for the most natural-looking result possible. Then a block of dental ceramic material is chosen in the shade that most closely matches your own teeth. The computer's digital design is transmitted to a milling machine that carves the crown from the ceramic block in about five minutes.

Once the crown's fit has been verified, and any necessary aesthetic enhancements have been made to the crown's surface (staining and glazing, for example), the crown will be bonded to your tooth. With a traditional crown, you would have to wear a temporary restoration for several weeks while the permanent crown was being fabricated at the lab. With a same-day crown, you walk out with the real thing.

Caring for Your Same-Day Crown

Crowned teeth require the same conscientious care as your natural teeth. Be sure to brush and floss between all of your teeth — restored and natural — every day to reduce the build-up of dental plaque. When you have crowns, it is even more important to maintain your regular schedule of professional cleanings at the dental office. Avoid using your teeth as tools (to open packages, for example). If you have a grinding habit, wearing a nightguard would be a good idea to protect your teeth and your investment. A well-cared-for same-day crown will last for years to come.

Value Of Quality Care 

Are all crowns created equal? And why are some crowns more expensive than others? Crown fabrication costs depend upon the materials used and the time needed to create them, among other factors. Dear Doctor magazine examines these variables... Read ArticleLaser Dentistry.They are inside your laptop computer and your DVD player, present on the factory floor and the supermarket checkout line. And now, lasers are finding increasing use in dentistry. Someday soon, you may have a routine dental procedure performed with the aid of a powerful, yet highly controllable beam of laser light, instead of a drill or a probe.

What are dentists currently using lasers for? These devices have been proven to help in the detection and treatment of oral diseases. They can be used for treating gum disease, detecting cancer, and pinpointing tooth decay in its early stages. They can precisely remove tissue, seal painful ulcerations like canker sores, and even treat small cavities. In the future, dental laser technology will undoubtedly find even more applications.

How Do Lasers Work?

Lasers take advantage of the quantum behavior of electrons, tiny particles inside atoms. By stimulating atoms with pulses of energy, and then using a method of optical amplification, they cause the atoms to produce a beam of coherent light. Essentially, that means that they emit light which has a great deal of energy, yet can be precisely controlled. It's the combination of high energy and precision that make lasers so useful.

Where Are Lasers Being Used?

At present, the use of lasers in dentistry falls into three general categories: disease detection, soft tissue treatments, and hard tissue treatments.

There are many ways lasers can aid in diagnosis. Laser light of specific wavelength, for example, can detect tiny pits and fissures in the biting surfaces of the tooth that a traditional dental tool can't find. This enables a defect that's too small to be treated at present to be carefully monitored. Lasers can also help locate dental calculus (tartar) beneath the surface of the gums, and can even aid in the detection of oral cancer in its early stages, accurately showing where healthy tissue ends and diseased tissue begins.

For the treatment of soft tissue problems, lasers have many advantages. They are minimally invasive tools that generally involve taking away less tissue than conventional methods. Used in gum surgery, for example, lasers can treat gum disease by killing harmful bacteria deep in pockets below the gum line, and removing the diseased tissue without harming the healthy tissue. They can also remove the thin layer of cells that inhibits reattachment of the gum and bone tissues to the tooth, while sealing off the adjacent blood vessels. This type of procedure generally results in less bleeding and pain. Lasers are also effective in treating ulcers and sores on the lips or gums.

Lasers are even finding increasing use for hard-tissue procedures, like the treatment of dental caries and cavities. Not only are they more exact in the amount of material they remove, but they eliminate the noise and vibration of the dental drill, which is uncomfortable for some patients.

 As lasers become more common in the dental office, these high-tech tools will be integrated into routine dental practice. This promising technology already offers some real benefits, and is sure to find increasing use in the near future. to the treatment of disease... Read ArticleItero.For years, whenever you needed a dental crown (cap), your dentist had to make molds of your teeth which required taking an impression of your teeth. A tray filled with a goopy, putty-like material was used so that a three-dimensional model of the prepared tooth could be created. Using this mold, a dental lab could custom-craft the new crown.

However, as we journey further into the technology-driven 21st century, this traditional methodology is being replaced with virtual models — made using small, handheld “wands” that employ a digital camera and some reflective dust.

Here's how it works

The initial phase of restoration, preparing the tooth surface, remains virtually the same. First, any dental decay must be removed, and the remaining tooth must be shaped so that a crown or filling can be fitted properly. This will allow the tooth to be restored to its original shape, look, and function. Next, the area is lightly dusted with a reflective material (not a goopy impression material) so that multiple images of your tooth's surface can be recorded with a small scanning wand. Later, the computer component is connected to the scanning wand and these separate images are combined into a computer-generated 3D image.

 This remarkable tool uses blue wavelength light to precisely capture the unique nooks and crannies of your tooth's surface and make a highly accurate 3D digital model. It makes it possible to instantaneously examine your tooth, and your bite. It's possible to identify any additional prep work required for new crowns, veneers and fillings right then and there; to implement any needed changes; and to rescan the tooth to create a new series of images and 3D model.

Once the image capture and prep work are satisfactory, your images are sent on to the lab for fabrication. This technique makes it possible to create a crown or a filling that can often be completed during a single office visit.

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How this technology benefits you

• Finally, you can say goodbye to the goop, gagging, discomfort, and anxiety you've experienced in the past with traditional dental impression materials!
• It enables the immediate assessment of whether or not your tooth has been properly prepared for restoration.
• This technology is ideal for fabricating restorations such as new crowns, veneers and fillings for teeth — often possible in one office visit.
• It takes less time than traditional dental impressions. 
• It's almost impossible to imagine the practice of dentistry without x-ray technology. Radiographs (x-ray pictures) allow dentists to diagnose and treat problems not yet visible to the naked eye, including early tooth decay, gum disease, abscesses and abnormal growths. There is no question that since x-rays first became available a century ago, this diagnostic tool has prevented untold suffering and saved countless teeth. Now, state-of-the-art digital x-rays have made the technology even safer and more beneficial.

  Digital x-ray technology uses a small electronic sensor placed in the mouth to capture an image, which can be called up instantly on a computer screen. When digital x-rays first became available about 20 years ago, they immediately offered a host of advantages over traditional x-ray films, which require chemical processing. Most importantly, they cut the amount of radiation exposure to the dental patient by as much as 90%. While faster x-ray films have been developed over the years that require less exposure, making that difference less dramatic, a digital x-ray still offers the lowest radiation dose possible.

  Advantages of Digital X-Rays

  Besides minimizing radiation exposure, digital x-rays offer numerous advantages to dentists and patients alike. These include:

  • No chemical processing & no waiting. Because there is no film to process with digital x-rays, there is no waiting for pictures to develop — and no toxic chemicals to dispose of. Your dentist can immediately show you the pictures on a computer screen for easy viewing.
  • A clearer picture. It's possible to get more information from digital x-rays because they are sharper and can be enhanced in a number of ways. The contrast can be increased or decreased, and areas of concern can be magnified. It's even possible to compare them on-screen to your previous x-rays, making even the minutest changes to your tooth structure easier to detect.
  • Easy sharing and storage. Digital x-rays provide a better visual aide for you, the patient, to understand your diagnosis and treatment options. They can be e-mailed to different locations; they are also far less likely to be misplaced.

  X-Rays and Your Safety

  While digital technology has minimized the health risks of x-rays, it has not entirely eliminated it. X-rays are a type of radiation used to penetrate the tissues of the body to create an image. In doing so, there is always a slight possibility of causing changes at the cellular level that might lead to future disease. Of course, there are sources of radiation present in the daily environment — the sun, for example — that can also cause disease. It's important to note that the chance of this happening is thought to be cumulative and not based on a single exposure. Still, x-rays are not considered risk-free regardless of how technology reduces your exposure. That's why dentists will only use them when the benefit of obtaining better diagnostic information outweighs the procedure's small risk. This is particularly true of computed tomography or CT scans, which can raise the level of exposure, yet yield a tremendous amount of information per scan. No matter which technology is being used, each case is considered individually, and your safety is always paramount. If you have questions about why an x-ray is being recommended for you, please feel free to ask.