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Dentistry After Root Canals Impact Tooth Longevity – Newton, Wellesley, MA

“Irynen a recent longitudinal, retrospective analysis, researchers found that what one does AFTER a root canal procedure directly influences the longevity of that tooth” says Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners.  “Teeth with endodontic therapy have been hollowed out and need internal and external protection to prevent fracturing.  This cannot be accomplished with fillings, according to this study” says Dr. Johnson.  “After 30 years of restorative dentistry, I can attest that the best means to improve longevity on a root canaled tooth is with a dental crown”.

Methods

Computerized analysis was performed for all patients who received posterior RCT from 2008 to 2016 in the graduate endodontic department. Data collected included dates of RCT, type of post-endodontic restoration, and time of extraction if extracted. Teeth that received crown after RCT were also divided into 2 groups: receiving crown before 4 months and after 4 months after RCT. Data were analyzed by using Kaplan-Meier log-rank test and Cox regression model (α = 0.05) by using SPPS Statistic 21.

Results

Type of restoration after RCT significantly affected the survival.  Those that received composite/amalgam buildup restorations were 2.29 times more likely to be extracted compared with those that received crown. Time of crown placementproject1 after RCT was also significantly correlated with survival rate. Teeth that received crown 4 months after RCT were almost 3 times more likely to get extracted compared with teeth that received crown within 4 months of RCT.

Thus, according to Boston’s best prosthodontist, “it’s best to protect the tooth as soon as possible to avoid problems”.

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Original article: http://www.ada.org Artwork: www.OswegoSmiles.com

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Using Computers in Implant Dentistry – Newton, Wellesley, MA

There is archeological evidence that humans have attempted to replace missing teeth with root form implants for thousands of years. Remains from ancient China (dating 4000 years ago) have carved bamboo pegs, tapped into the bone, to replace lost teeth, and 2000-year-old remains from ancient Egypt have similarly shaped pegs made of precious metals.

In 1952 the Swedish orthopaedic surgeon, Per-Ingvar Brånemark,project3 was interested in studying bone healing and regeneration. During his research time at Lund University he adopted the Cambridge designed "rabbit ear chamber" for use in the rabbit femur. Following the study, he attempted to retrieve these expensive chambers from the rabbits and found that he was unable to remove them. Brånemark observed that bone had grown into such close proximity with the titanium that it effectively adhered to the metal and the birth of current day implants was seen.

ryneDr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners, whom many consider a pioneer in using computer in implant dentistry, has developed a synergistic technique to remove many of the early pitfalls seen in implant placement and dental prosthetics.  He has been performing implant reconstructions since 1989 with the assistance of computers.  His current approach is outlined below:

1.    Initial examination and work up to simulate the final design of the dental prosthesis (think architectural plans when building a home). 2.    Create a three dimensional representation of this plan (either a denture or some other means to position teeth for the patient & doctor to evaluate form, aesthetics, phoneticsproject1 3.    Convert this into a X-ray scanning guide (to wear during the CT scan) or to scan the mouth with CAD/CAM appliance 4.    Merge the digital data into software that creates a 3-D image of the newly designed plan overlaid onto the existing bone contoursproject4 5.    Evaluate bone and other anatomical structures related to planned implant placement 6.    Determine implant angulation, length, diameter, position, etc 7.    Create a surgical placement jig 8.    Place implants using placement jig 9.    Place dental prosthesis (often at same visit as implant placement)

Dr. Johnson uses this approach on most of his dental implant cases and states, “I can’t imagine why more clinicians are not following this protocol as it has diminished our complications and often allows our patients to go home with a ‘tooth’ the same day implants are placed.  Why accept less?

For additional blogs by Dr. Johnson, click here To contact Dr. Johnson or the office, click here.

Original content:  www.wikipedia.com Artwork:  www.perfectdentalimplant.com, www.wikipedia, www.texasimplant.com

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Digital Dentistry Impacts Hollywood – Newton, Wellesley, MA

Digital models of humans can be uncannily accurate these days, but there's at least one area where they fall short: teeth. Unless you're willing to scan the inside of someone's mouth, you aren't going to get a very faithful representation of someone's pearly whites.ryneDr. Ryne Johnson, a prosthodontist and managing partner of Newton Wellesley Dental Partners has been considered a pioneer in the use of CAD/CAM technology in dental restorations. He notes that, “Disney Research and ETH Zurich have just developed a technique to digitally recreate teeth beyond the gum line using little more than source data and everyday imagery. The team used 86 3D scans to create a model for an "average" set of teeth, and wrote an algorithm that adapts that model based on what it sees in the contours of teeth in photos and videos.  Unlike the $40,000 CAD/CAM unit that’s used in my office, this new approach allows sufficient accuracy to be captured from regular digital photographs”.

The technology doesn't require any special capture equipment outside of the initial scans (the camera on your phone will do). Also, you don't have to purposefully bare your teeth: it can work with the incomplete information from a smile or grimace. A movie crew could generate models based on a brief, natural motion capture session.project1

This being Disney, the most obvious use is for digital actor models in animated movies and video games. You could see uncannily realistic characters whose details pass muster even in close-up shots. However, there are plenty of medical uses as well. The scientists see dentists using the tech to previsualize a patient's mouth before they sit in the operating chair, and it's easy to imagine this leading to more authentic-looking dentures. As silly as the notion of accurately rendered teeth may be, they could be important for your well-being.

Dr. Johnson feels that this new technology will help the film and media production companies but will not be incorporated into a dental office any time soon.  However, he reminds everyone that, “digital dentistry is here and should be a part of your dental reconstructive and implant work”.

For more blogs by Dr. Johnson, click here To contact Dr. Johnson or the office, click here

Original article:  www.engadget.com Artwork:  Chenglei Wu, Derek Bradley et. al.

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Ceramic Dental Implants – Newton, Wellesely, MA

Are dental implants made from ceramics ready to consider as a viable alternative to metal?

Since their introduction over 40 years ago, dental implants have become an established treatment modality that had revolutionized the concept of replacing missing teeth. Dr. Ryne Johnson, prosthodontist ryneand managing partner of Newton Wellesley Dental Partners has been considered a pioneer in computer-assisted implant dentistry.  His first implant case was in 1988.  According to Dr. Johnson, “The recent material of choice for manufacturing dental implants is commercially pure titanium, because of its excellent biocompatibilty and mechanical properties However, the gray colour of the titanium may be disadvantageous and give rise to esthetic problems, especially if the soft tissue situation is not optimal and the dark colour shines through the thin peri-implant mucosa.  The profession has been looking for options to address this concern.  Some implant companies are wrapping a pink material along the collar of the implant while others are developing ceramic implants.”

project1Zirconia ceramics (yttrium-stabilized tetragonal poly-crystals) seem to be a suitable material for dental implants because of their tooth-like colour, their excellent mechanical properties and their good biocompatibility. They have extensively been used as ball heads in total hip replacements with remarkable clinical outcomes. Recent animal studies have also shown successful bone healing of dental zirconia implants under both unloaded and loaded conditions.  Dr. Johnson has been using zirconia to fabricate his dental crowns for many years without outstanding success. As the conventional fabrication of zirconia rods usually results in realtively smooth surfaces, only few studies have investigated rough surface modifications of zirconia implants. This is a critical aspect, since it has been already demonstrated that surface roughness and topography also influence osseointegration of zirconia implants.

A recent study by Rita Depprich, et al, in Head and Face Medicine, looks at the comparison of titanium and zirconia implants on pigs and concludes that, “zirconia implants with modified surfaces display features of osseointegration similar to those of titanium implants. These results are promising for using zirconia implants for dental applications in the future”.

“It’s still early in the game” according to Dr. Johnson, “but it may be available in the next few years after clinical trials are complete.  Until then, titanium implants are sill the gold standard. ”

For more information on Dr. Johnson, click here To contact Dr. Johnson or the office, click here

Original article:  https://head-face-med.biomedcentral.com Artwork: www.southerdentalimplant.com

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