Odontotherapy

Tooth decay is a disease of the tooth that needs treatment.
odontoterapia

Various teeth problems, from simple teeth decays to severe complications, can be eliminated with corresponding odontological treatments. The treatments presume the restoration of the structure and functionality of the affected tooth with the help of modern techniques and materials, which allow us to obtain lasting and perfectly aesthetic results.

The symptoms of tooth decays are:

  • Brown to black stains or dental cavities;
  • Bearable pains strictly caused by cold or sweet food or drink, pains that stop once the stimulus is removed;
  • Irritation of the interdental papilla (bleeding of the interdental gingival area), which could be a sign of interdental decay;
  • Floss shredding could happen because of an interdental decay.
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At Dental Progress you can benefit of:

  • The correct tooth decays treatment, for which are being used the best materials, the highest technology and the best system of adhesion that is manufactured by 3M firm, the worldwide leader in matter of adhesive;
  • Treatment for hypersensitive teeth;
  • Biomaterials that, under coronary fillings, help to preserve the vitality of the tooth;
  • Obturations of the radicular spaces realized with the support of a modern and secure technology;
  • Photopolymerizable physiognomic obturations;
  • New! – nanohybrid composite fillings with extraordinary aesthetics and high fracture resistance.

Fluoride treatments have proven to be very efficient, but they are useful only for the incipient stages of tooth decay lesions. The fluoride penetrates the dentinal tubules, fortifying the enamel and increasing its resistance towards acids found in the food and drink daily consumed.

In order to avoid the risk of fracturing the tooth surface, in case of extensive carious lesions, it is recommended to reconstruct the coronary contours with adhesive cementation of indirect tooth restorations.

  • Inlay: a ceramic prosthetic device, which has the shape of a filling, but it is made outside the oral cavity and it is going to be cemented on the tooth;
  • Onlay: an inlay of a bigger size which it is used when at least one of the surfaces of the tooth is missing;
  • Crown: it is a rigid “cap” (porcelain-fused-to-metal, all-ceramic, Zirconia) which will be adhesive cemented on the abutment offering a bigger stability and resistance in case of fracture.

Endodontics

A root canal treatment performed with loupes, with perfect isolation and with the latest rotary instrumentation technique, ensures a significant life extension of the tooth.
ENDODONTIE

With a lot of attention and precision, our doctors can perform obturations of the root canal that can significantly increase the lifetime of the tooth after the removal of the pulp. The procedure consists in several stages – the cleaning of the radicular canals, the mechanical preparation and confirmation of the root canal, sterilization, and, finally, the obturation that must extend along the entire size of the radicular canal and must have a homogeneous consistency.

The removal of the tooth pulp” is one of the procedures that require dexterity and experience. Plus, a safe intervention also demands special equipment with which a precise location of the apex and the adequate root canal preparation are realized. Dental Progress Clinic is one of the few dental clinics where doctors’ competence and the new electronic techniques guarantee good lasting results. The perfect isolation with diga, the latest rotary treatment and the tridimensional root canal obturation make out of the root canal treatment a success, even for curved canals which are very difficult to treat. The root canal treatment is a very important stage considering that a wrong root canal treatment could cause infections and even the loss of an improperly treated tooth.

New! – Treatment with titanium shape memory needle.

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What is endodontics?

The word “endodontics” comes from Greek and it is formed by the joining of “endo” (inside) and “dontia” (tooth), so the endodontics concerns the treatment of the inside of the tooth, more precisely, the affections of the dental pulp.

Endodontics is the dental specialty concerned with the prevention, diagnosis and treatment of the pulpal pathology.

When is an endodontic treatment required?

We need an endodontic treatment when the dental pulp becomes inflamed. The causes for the inflammation of the dental pulp are: dental trauma, inaccurate teeth fillings or severe teeth decays.  If the treatment is being postponed, the dental pulp becomes necrotic. As a result of necrosis, the present bacteria will move towards the apical region of the tooth causing apical reactions, leading in time to bone destruction of the respective tooth zone (dental granuloma or dental cyst).

Is the endodontic treatment painful?

All procedures will be performed under local anesthesia. This way the patient will be offered a full comfort during the endodontic treatment. For more severe apical infections, there might be the possibility for the anesthesia to take effect slower. The basic principle followed by the Dental Progress team is: ANY INTERVENTION ON TEETH OR ADJOINING TISSUE IS BEING PERFORMED WITHOUT ANY PAIN.

Are there any other procedures needed at the end of the endodontic treatment ?

At the end of the endodontic treatment the tooth must be restored with the aid of a radicular reconstruction (pivot) and of a coronary reconstruction (crown).

The periodic monitoring is being made at a 6 month distance and it consists in the examination of the specialist doctor and a retroalveolar x-ray.

Pediatric dentistry

Dental sealants for permanent teeth do not imply drilling or anesthesia and prevent tooth decay.
pedodontia

It is easy to have beautiful healthy teeth for a lifetime if we continuously take care of them starting from the early years. Therefore, a child must be taken regularly for dental examination, so the doctor may be able to preventively react against any possible affection (teeth decays, gum affections, dento-maxillary anomalies), to explain how to keep oral hygiene and also to explain its importance.

For children, just like for adults, the first impression can be very important. Dental Progress is the ideal place for a child’s first visit to a dentist precisely because here he will find a warm friendly and relaxing atmosphere, which will prove to be determinant for him. He will learn rules about hygiene and will receive advices but, at the same time, he will have fun.

The dentists from Dental Progress can help also the parents to take care of their children’s teeth by explaining them how to do it at different ages: when milk teeth appear and when they fall, starting when and how they should be brushed, how to prevent tooth decay at young ages, how a child should be prepared for his first visit at the dentist etc.

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Pediatric dentistry is the branch of dentistry dealing with the study of odontal pathology (simple decays, severe decays, trauma, dystrophies), of periodontal pathology and of oral mucosa for children and teenagers, as well of the preventive and curative treatment for these affections. The development of the teeth is a long term process which starts from the embryonic stage and it ends postpartum around the age of 15 when the forming of the M12 years apex completes (exclusively M3) -> the odontogenesis disruptions caused by genetics or the environment lead to dental development anomalies.

Teething age of primary teeth:

  • Temporary central incisor: 6-8 months;
  • Temporary lateral incisor: 8-12 months
  • Temporary canine teeth: 16-20 months
  • First temporary molar: 12-16 months
  • Second temporary molar: 20-24 months

Teething age of permanent teeth:

  • Upper central incisor
  • Lower central incisor
  • Upper lateral incisor
  • Lower lateral incisor
  • Lower and upper first molars
  • Lower and upper canines
  • Lower and upper second molars

What is sealing?

The sealing is the immunization procedure for tooth surfaces with accentuated contours (shortly after their eruption) for patients at high cariogenic risk, but with a poor oral care. The aim of sealing is to close the occlusal and oral contours of the erupted teeth in order to avoid the transformation of the areas of plaque stagnation into ecological niches.

If the sealing is being properly done it can be up to 80% efficient.

The teeth sealing is recommended for children starting with the age of 6, on the condition that the concerned teeth have not been affected by decay.

The teeth sealing procedure is not painful, does not require drilling or anesthesia, which makes it extremely tolerable for children.

Why is it indicated to seal the adult molars right away after their eruption?

Reaching the grooves with the tooth brush is pretty difficult and it requires skills, patience and insistence, wonderful qualities, but hard to find to a six year old child. The food remained on tooth grooves could lead afterwards to tooth decay lesions. The sealing of grooves will eliminate the possibility for tooth decay to settle.

What does dental sealant consist in?

Dental sealing is a completely noninvasive procedure that is absolutely painless, it takes from 10 to 15 minutes, usually it does not imply either anesthesia or drilling. It is a technique easy to use for children, being highly tolerated by them. In order to benefit of sealing the vital condition for tooth is not to have decay lesions. Sealing consists in loading the grooves with special materials (sealant). The specific feature of the sealant material is that transforms the retentive occlusal surfaces of the tooth into smooth, easy to clean zones. The prophylactic effect can be increased by adding fluoride into the sealant material. This way fluoride, which has a protective role for the enamel, will be continuously released.

When is sealing recommended?

Sealing is recommended when:

  • The patient is at high decay risk;
  • Tooth grooves have stains, but no decay at dentin underlying level has been highlighted on examination or x-ray;
  • Grooves morphological shown and valued as zones at high risk;
  • Children consume large amounts of sweets;
  • Children refuse fluoridation treatment.

The advantages of sealing:

  • Does not require drilling for the preparation of a cavity (noninvasive technique)
  • The check of an accurate covering and polymerization is very easy
  • It is a simple and harmless routine technique;
  • It can be renewed without causing any damage to the tooth, which remains intact;
  • It offers vital protection for the period when the tooth is at the highest risk of decay;
  • The excess of sealant or air bubbles are easy to see and remove;
  • The prophylactic effect can be increased by adding fluoride in sealant.

The disadvantages of sealing:

  • To perform an accurate sealing it is required a trained staff;
  • Sealing can be made only on the occlusal side of a tooth, so not all tooth surfaces can be sealed;
  • Because of the deterioration of adhesive soaking in time, the effect of sealing is temporary therefore sealing should be redone at a certain period of time;
  • It ensures only the role of mechanical barrier for retentive zones, eliminating the risk for decay lesions to settle.

Dental implants

The future of modern dentistry is represented by the treatment with the aid of dental implants
implant dentar

Dental implants represent the section of dentistry with the highest progress during the last years. The boundaries have been pushed as far as possible and few were the cases that could not have been solved with the help of dental implants.

The dental implant is a titanium component that represents the correspondent of the tooth root.

At Dental Progress Clinic we use dental implants of the highest quality, made of the purest grade 5 titanium, which are treated so that the human body perceives them as a tooth root, not as a foreign object. Therefore there is no situation when a patient’s body has rejected the dental implant, THE RATE OF INTEGRATION BEING 100%. We use the latest dental implants, their choice being based on a valuable experience with various systems. When we are asked: “For how long are dental implants guaranteed?” we like to answer that our treatment with dental implants it is done to last a lifetime! Of course, that if the patient strictly follows the directions given after the surgery of the dental implants placement, the daily oral hygiene and the periodical examinations!

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If recently the treatment with dental implants depended on the amount of bone of the targeted area, nowadays there are many procedures and innovative materials for bone regeneration which allow the use of dental implant treatment even in worse cases.

IN IMPLANTOLOGY THE SMALL DETAILES MAKE THE DIFFERENCE! And the small details are highly related to the doctor and his team, but also to the materials he uses. That is why we hear so many different opinions. Some patients are scared of dental implants because they have heard only bad things from other patients who describe the dental implant placement surgery as something unpleasant, while our patients, in most of the cases, say they have not felt any pain either during the surgery or after the passing of anesthesia.

Behind a successful surgery there is much training of the doctor and his team and many specialization courses. That is why we recommend you to carefully choose your implantologist doctor whereas a cavity filling incorrectly performed can be replaced the next day, while a dental implant incorrectly inserted can cause many inconveniences and its removal can be very difficult if the period of osseointegration has passed.

Dr. Cosmin Dima, the implantologist doctor of the Dental Progress Clinic has studied implantology both in the country and especially abroad and has an over 10 year extensive experience, placing over thousands of dental implants.

The partnership with professors with worldwide reputation (see Prof. Dr. Marcel Wainwright’s review) represents a big advantage, professors who offer us, when needed, competent opinions of a worldwide level.

The treatment with the aid of dental implants is a modern complex procedure and often an indispensable method to replace a lost tooth. The advantages of dental implants for patients have proven to be multiple and very important: dental implant prosthetics offer the highest level of comfort and resistance in time, the functionality is complete, the integrity of the old teeth is not affected, the aspect is a natural one and the oral hygiene is easy to maintain.

Practically the treatment with the aid of dental implants is the only physiological option when we want to fill a remaining space after a tooth extraction. The masticatory forces are transmitted through the dental implant to the alveolar bone so the alveolar bone is stimulated to regenerate through resorption and bone apposition, reaction encountered to natural teeth. For a classic prosthesis this bone regeneration is not realized because, unlike the dental implant which is positioned inside the bone, the dental bridge is suspended above the gum, being in contact only with the adjacent gum.

What is a dental implant?

A dental implant is a component made of titanium and other alloys which serves as pillar for the replacement of a missing tooth. The dental implant is surgically placed into the maxillary bone or mandible bone. The surgery is followed by a waiting period when a connection (osseointegration) between the implant and the bone is being established, so that the dental implant could support a crown, a fixed complete/partial denture or a removable denture. This artificial support will serve as tooth root on which the permanent dental crown will be made. Dental implants can replace a single tooth or several teeth. Dentures supported by implants have a similar aspect with the natural teeth aspect and the function of the missing tooth is taken by the prosthesis with implant support. The dental implant therapy is a restorative option with a long clinical history. Dental implants preserve the integrity of facial features and reduce the disadvantages of tooth loss.

Is this surgery painful?

The placement of dental implants is not painful, it is performed, in most of the cases, with local anesthesia. This is a very efficient type of anesthesia that offers the doctor the possibility to permanently communicate with the patient during the surgery of dental implant placement. There are cases when intravenous sedation is required, a technique usually used for patients with anxiety or for patients who suffer surgeries that last longer and that are more complex and more invasive. In dental implantology general anesthesia is rarely used, only for peculiar situations. The lasting of the surgery of dental implant placement varies from 45 minutes to several hours, depending on the number of implants and on the complexity of the case treated at that moment, and, after surgery, the patient can normally continue his daily routine.

The major advantages of dental implants:

  • The intact preservation of the adjoining teeth, that need no polishing for the realization of certain prostheses;
  • Besides the obvious benefit to replace the missing tooth, dental implant has also the advantage to stop the bone loss (the bone does not reabsorb/atrophy and it is functionally stimulated) and to prevent the change of facial features caused by bone loss. This is probably the biggest achievement comparing to traditional procedures (such as convetional dental bridges) that ignore this aspect;
  • They can last a lifetime if they are properly taken care of;
  • The aspect and the comfort related to dental implants are excellent;
  • Dental implants will provide you an impeccable smile and will make you feel very good, increasing your self-esteem.
  • In many cases, dental implants are the only solution for fixed prostheses;
  • Being made of titanium, dental implants are excellently received by the body.
  • Through psychological comfort offered, the dental implant increases the quality of life, the self-confidence;
  • A dental implant certainly is a future investment in the quality of life.

Precursory stages of dental implant placement

Detailed examination to evaluate both the health of oral cavity and general condition.

Radiological investigations consisting in panoramic dental X-ray and computed tomography (CT) of the concerned area, mandible or maxilla, investigations that offer precise details regarding the height, thickness and density of the bone and precise measurements based on which we can certainly establish the possibility for the dental implant placement.

At the Dental Progress Clinic, thanks to the doctors’ abilities, you will see dental implants as an investment in your health. You can be secure about the quality of execution and of all used materials and tools, either we refer to dental implants or implant supported denture or orthodontic implants or any other prosthesis.

Prosthodontics

The prostheses on dental implants can change the quality of the edentulous patients’ lives.
Protetica

Prosthodontics is the area of dentistry that focuses on the restoration and maintenance of oral functions, aspect and health of the patient as a method to rehabilitate natural teeth and/or to replace adjacent oral tissues with artificial substituents.

Fixed prosthodontics is the area of prosthodontics that deals with the restoration and/or replacement of the teeth with artificial components that cannot be removed.

Removable prosthodontics is the area of prosthodontics concerned with replacing the teeth and soft tissues for patients totally or partially edentulous with dentures that can be removed for cleaning.

Skeletal prosthodontics with attachments means a denture, fixed or removable, sustained by dental pillars with a specific system composed by 2 subunits (primary anchor and secondary anchor).

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Implant supported prosthesis is that area of prosthodontics dealing with restoration obtained by prosthesis on implants.

Severe tooth affections lead, in most cases, to their total or partial loss. The restoration of nonfunctional teeth and the replacement of the lost one are performed with the help of prosthetic treatments. The specialist dentist will determine the prosthetic treatment after a clinical and radiological examination (panoramic X-ray, computed tomography), intraoral and facial photos and, also, after the realization of dental impressions that are later placed on the articulator. In order to determine a treatment as accurate as possible, it is fundamental to obtain all the clinical, radiological and photographic information.

What is edentulism?

Edentulism is characterized by the absence of one tooth or of several teeth on one arch or even of all teeth of one or both arches (complete edentulism) and it is followed by the successive disruption of essential functions of the orofacial complex: mastication, speech, physiognomy and so on.

The consequences of the absence of one or several teeth on an arch:

  • The open space remaining after the loss of one or several teeth will decrease because of the neighboring teeth tendency to close the space;
  • The antagonist tooth inclines to vertically migrate (growing/rising) towards the edentate space (not accomplishing the functional role because of the absence of the correspondent tooth, the tooth on the opposite arch will migrate);

These changes of position of the remaining teeth will lead to:

  • Periodontal problems by way of the appearance of some retentive spaces which are hard to clean, accompanied by gum inflammation, that, uncontrolled, could affect the sustaining structure of the concerned teeth (periodontal disease);
  • Muscle tensions and, in time, temporomandibular joint dysfunctions;
  • Occlusal problems (mastication disorder with the appearance of abnormal contacts caused by dental migration)

What are dentures/prostheses?

Prostheses or”false teeth” are designed to replace missing teeth. They apply for patients with a few missing teeth and for those who have lost all their teeth (completely edentulous). Dentures also look and behave as natural teeth, proving to be an efficient option. A denture is a set of false teeth that are attached on an acrylic structure that can be reinforced with metal.

Types of denture:                                                                                     

By the way of fixation, dentures are divided in:

  1. Fixed (unidental – crowns or pluridental – bridges):
  • The crowns restore the morphology of a single broken tooth and they are fixed through cementation. Among unidental prostheses we can also include:
  • Vestibular ceramic veneers (aesthetic recontouring)
  • Palatal ceramic veneers and occlusal ceramic onlays (functional rebalancing)
  • Ceramic inlays (incrustations)
  • Bridges are prostheses that compensate the lack of one or several teeth, being cemented on the limitrophe teeth of an edentulism.

Fixed prostheses can be made of various materials:

  • All-ceramic
  • Zirconia supported ceramic
  • Metallic supported ceramic
  • Noble/half noble metals (unaesthetic)
  • Acrylic/ composite (temporary crowns)
  1. Movable (complete dentures): are extended works made for complete edentulism cases and they are sustained only by the bone structures of the oral cavity.
  2. Removable (they are recommended for partial edentulism, when dental bridges cannot be done)
  3. Implant supported prostheses

The role of prostheses is identical with the natural teeth role, namely they have to provide a normal mastication and a pleasant smile. In case of partial tooth loss, it is important that the resistance of the remaining natural teeth not to be through overstrain or leaning, so the prosthesis has to be done as fast and as good as possible. A quality prosthesis equally depends on the dentists, technicians and on the used materials.

Therefore the Dental Progress Clinic proves to be a good choice for the execution of the impeccable crowns and bridges of various materials (noble, half noble, ceramic), of different types of dentures (fixed or removable, classic or with special systems and so on), of prostheses on implants, of ceramic and composite veneers, of occlusal balancing treatment.

Surgery

Dental surgery is the area of dentistry that facilitates the success of the interventions for periodontal disease
Chirurgie

Whether we are talking about the rescue of a tooth or the preparation of prosthesis or any other procedure, at the Dental Progress Clinic the surgical treatment of disease (dental surgery) it is successfully performed thanks to the experienced doctors and to the advanced technology that they use.

In our clinic you are offered a wide range of medical services:

  1. The execution of difficult extractions (wisdom teeth, impacted teeth). A compromised tooth can be a focus of infection for the human body so the tooth extraction can be considered a needed procedure that aims to prevent the evolution of the infection.
  2. Apical resection. During this procedure the top of the tooth will be removed, preserving the healthy root of the tooth in order to be restored and maybe even included into a future prosthesis.
  3. Removal of periapical cyst
  4. Odontectomy
  5. Cystectomy
  6. Periodontal surgery
  7. Periodontal plastic surgery
  8. Frenectomy – implies the removal of the lingual frenulum when it negatively affects the lives of the patients;
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Oral and maxillofacial surgeries:

The oro-maxillo-facial surgery approaches surgical pathology aspects of the oral cavity, visceral cranium, face and cervical region.

There are many oral surgical interventions that can be performed in the dental offices, under the circumstances when there are provided all the necessary material conditions to perform a bleeding surgery and also to treat the possible accidents or complications. To the material conditions it is absolutely indispensable the association with the adequate medication and surgical training of the doctor in order to protect the patient from the occurrence of iatrogenic pathological changes, changes that in most of the cases are harder to treat than the initial reason of the surgery. Usually, into the dental offices there can be performed endodontic interventions and, only in exceptional situations, soft tissue interventions of the cervicofacial or of the maxilla area.

The oro-maxillo-facial surgeries are performed in specialized services, where there are the possibilities to provide a complex and surgical treatments and postoperative care.

Beside the adequate materials, there are a few fundamental conditions required to perform a surgery, namely:

the ensuring of a perfect visibility of the surgical field creating an access as convenient as possible

a cold lighting which do not warm the patient or the doctor and do not shadow the surgical area

the proper evacuation of the blood or secretions by using either the vacuum or the tampon, in order to avoid either to flood the surgical area or to disturb the patient’s breathing

In order to perform any surgical intervention it is required an assistant to remove the soft parts, to vacuum the secretions and to give the doctor the instruments. A good assistant should anticipate the medic’s requires so the surgery to evolve in the best conditions.

Maxillary sinuses

The maxillary bones are cavities found in the body of maxilla, above the molars and premolars. They are composed by two separate cavities, filled with air, placed on the left and right sides of the nasal cavity, and also by a very thin membrane that covers the whole sinus cavity and shelters the proper sinus. Dental extractions and also infections of the molar and premolar roots lead to bone loss and when it is thicker than 8 mm the dental implant placement is impossible.

Sinus lift surgery

Sinus lift surgery is a surgical intervention that aims to allow a further dental implant placement. The lifting of the sinus membrane is done through bone grafting and it is necessary only when the size and the position of the sinuses do not allow the placement of the implant.

The lifting of the sinus membrane is a frail procedure which requires a lot of attention and precision from the implantologist but which contributes at patient’s life quality improvement. Important from both functional and aesthetic points of view, the sinus lift surgery is a new innovator procedure which offers viable options for the patients who do not prefer removable dentures.

The maxillary sinus lifting can be done in 2 ways:

  1. Internal sinus lift
  2. External sinus lift

New! INTRALIFT system

The piezoelectric surgery or the ultrasonic surgery represents the most modern version of surgery in our days. The rotary systems are replaced by special loops that vibrate at ultrasonic frequencies, managing to cut the bone without warming or affecting it. This is a big advantage for the patient, the chances to swell or to have postoperative pains being lower.

This is what explains that, even after elaborate surgeries, our patients do not have even the smallest inconvenience.

At the Dental Progress Clinic, it is used probably the most advanced Satelec piezoelectric equipment in the world, manufactured by the Acteon company.

The surgical kit of this equipment can be used for BONE BLOCK HARVESTING, BONE SPLITTING or EXTERNAL SINUS LIFT, its big advantage being that it cuts only into the bone. Once it reaches the soft tissue, the device becomes harmless, the risk of accident being highly reduced.

The INTRALIFT kit of the same device is an ingenious system of the INTERNAL SINUS LIFT, maybe the less traumatic in the world because it lifts the maxillary sinus membrane with the aid of bubbles of air and water, the pressure on the membrane being equal and very soft. It is probably the only system with which the height of the bone can be increased by 1 to 13-15 mm in the same session.

A big plus of the Dental Progress Clinic is represented by the partnership with one of the inventors of this exceptional system, Professor Doctor Marcel Wainwright.

Prof. Dr. Wainwright with Dr. Dima and Dental Progress team have performed an INTERNAL SINUS LIFT, EXTERNAL SINUS LIFT, BONE REGENERATION and dental implant placement surgery that was recorded and live broadcasted.

Periodontics

At the Dental Progress Clinic the periodontal disease (periodontitis) can be treated! Depending on the gravity of the periodontal affection, the treatment can be either surgical or with medication.
paradontologie

The gum diseases (gingivitis and periodontitis) are frequent problems which can cause the loss of teeth. The early these problems are discovered and treated the bigger are the chances to avoid the complications. Therefore we recommend you to pay attention to bleeding or swollen gums and not to delay your appointment for dentist.

Gum inflammation or gingivitis appears when on teeth it is formed a plaque – an adherent biofilm of bacteria and food residues. If the plaque is not periodically removed, it collects at the edge of the gum, where teeth encounter the gum, gradually forming hardened deposits of calculus. The calculus irritates and swells the gum, giving the gum a swollen red aspect and making it bleed when you wash your teeth. Ignoring this problem you risk, at some point, to remain without teeth. Gums also bleed because of a bad nutrition, especially because of the lack of vitamin C. More separate periodontal disorders are called together “periodontal diseases”. Gum diseases are represented by bacterial infections of the tissue and bone that surround and sustain teeth. Gingivitis and periodontitis are the most frequent of these diseases. Gingivitis is the disease that affects only the gum (the tissue surrounding teeth). Gum diseases are progressive and spread under the gum-line insertion, affecting supporting tissues for gum and teeth, causing periodontitis.

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What is periodontitis?

The gum reaction is one of the clinical manifestations of periodontitis, a disease that appears after the age of 30 and progressively evolves in time with the appearance of bleeding while brushing teeth, gums with changes of color, enlarged papillae detached from the teeth, pain, feeling of itchy gum, moving teeth, gum recession, this is when dental hyperesthesia settles, with pains at the base of the tooth at the contact with something hot, cold or sweet. The disease gradually develops to deep structures, the gum starts to alarming recede away from the teeth then also stimulating the alveolar bone and, last but not least, periodontal pockets appear. In time it could lead to the partial or complete loss of teeth. Those who are most predisposed to periodontal diseases are smokers, elder persons, people with diabetes and also those with a poor oral hygiene. The immune system has a defensive role, but it cannot always compensate the microbial aggression from the periodontal pockets.

According to statistics, the incidence of periodontitis has increased in the past few years, reaching an alarming rate and becoming the “disease of the century” in dentistry. In conclusion about 70% of the overall population suffers of different types of periodontal affections, either gentle versions (simple gum bleeding, gingivitis) or severe versions (periodontitis with progressive avulsion of all teeth).

Favorable factors for the appearance of periodontitis:

  • Periodontitis is the disease affecting the periodontium, the supporting system of the tooth, meaning soft and hard tissues. The dental plaque, actually the bacteria that inhabit it, plays a decisive role in the aggravation of the infection once it appears. The presence of dental plaque, the primary factor of the etiology of periodontitis, is a natural biofilm, an ecological sticky deposit on the teeth surface, but also on other areas of the oral cavity: fixed dentures surfaces, filling surfaces, orthodontic braces surfaces, implant surfaces. It is a biofilm with a complex tridimensional structure, which is opaque, yellowish or grayish, in a continuous dynamics opposing the glossy surface of the enamel. The total number of bacteria from the sub-gingival plaque is twice bigger for the sickness estate than for the health estate. From a structural point of view, dental plaque is composed of bacteria that are attached on the organic substrate, bacteria with complex connections between them and also between them and the substrate, forming a stratified biofilm. Along with the bacteria there are also epithelial cells and leukocytes.
  • Poor oral hygiene
  • Gum inflammation
  • Untreated tooth decay
  • Incorrectly adapted fillings
  • Old prostheses
  • Malposition of teeth
  • Hormone imbalance
  • Endocrine disease and metabolic disorder
  • Smoking, coffee consumption, alcohol consumption

Stress, low immunity, biological conditions.

Stages of periodontal disease:

Gingivitis – the first stage of the disease, it advances very slow, being difficult to identify from the beginning. A proper hygiene of the oral cavity, an accurate brushing and the use of all additional teeth and oral cavity cleaning techniques could lead to healing, gum being perfectly reversible.

Superficial periodontitis – appears as a result of the untreated gingivitis. Gradually the gum separates from the teeth and deep grooves form, the teeth roots become visible and teeth start to move. A space forms between the gum and teeth and the inflammation spreads towards the bone and the fibers that sustain the tooth fixed into the bone.

Severe periodontitis – is a form of periodontitis encountered at young patients, usually until the age of 30, maybe 40. It is characterized by the fast destruction of the junctional epithelium and by the bone destruction.

Dental conditions related to periodontal diseases:

Different changes of teeth and of their structures support are often related to periodontal diseases including defective restorations, occlusal trauma, tooth mobility, abnormal contacts and local irritations. These changes are usually visible on the X-ray.

  1. Occlusal trauma – Traumatic occlusion determines degenerative changes caused by occlusal pressures that are bigger than the physiological allowance of the strength structure of the tooth. These lesions appear as a result of some malfunctions caused by the excessive occlusal force on the teeth or by the normal forces exerted on the periodontium which is compromised by the bone loss. Beside the clinical symptoms as the high tooth mobility, the use of dental surfaces, the uncommon reaction to percussion and also a history of bad habits, the radiological evidences can suggest an increase of the tooth mobility, including the enlargement of the periodontal ligament space, the extension of hard lamina, the bone loss and the growth of number and dimension for trabeculae. Other consequences caused by the traumatic occlusion include hypercementosis and root fractures. However the traumatic occlusion can be diagnosed only by clinical examination. The traumatic occlusion does not cause gingivitis or periodontitis, but affects the epithelial attachment.
  2. Tooth mobility – the extension of the periodontal ligament spaces implies the tooth mobility which can be the result of the occlusal trauma or of the lack of bone support as a consequence of a significant loss of bone. If the affected tooth has a single root, the alveolus can acquire an hourglass shape. If the root has several roots it can be noticed an extension of the periodontal ligament space to the apex and in the furcation area. These changes occur when the tooth is moving around the rotation axis around one of the root. The enlargement of the periodontal ligament is a result of the resorption of the root and of the alveolar bone (hard lamina). Plus, the radiological image of the hard lamina can be vague so it can show an increased density (osteoclerosis). In some cases, if the trauma is extended, the hard lamina cannot be observed. For multi-rooted teeth the height and density of the inter-radicular bone can be reduced, especially when the trauma has caused a movement of the tooth towards vestibular or tongue.
  3. Open contacts – when the mesial surfaces and the distal surfaces of the adjacent teeth are not in contact, the patient has open contacts. This is a harmful situation for the periodontium because of the high possibility for food to deposit in those areas. The remaining food can damage the soft tissue and also can induce a swollen reaction that leads to the starting of the periodontal disease. The areas with open contacts and the periodontal disease at a primary stage present a bigger bone loss than the areas with closed contacts. Similar problems can appear when there are height discrepancies between the marginal ridges of two adjacent teeth. These situations are examples that emphasize the importance of the correct teeth alignment in preventing periodontal diseases.
  4. Local irritation factors – the local irritation factors can cause or worsen the periodontal defects. The calculus deposits obstruct the efficient cleaning of the area which leads to the progress of the periodontal disease. Similarly the bad adapted prostheses could also lead to bacterial deposits followed by periodontal disease. In many cases X-rays reveal these situations. Sometimes the crowns have a deficient contour so they do not protect the gum. Gingivitis and periodontitis can be caused by tissue trauma. The extraction of the third molar is related with a larger deposit of plaque on the distal surface comparing to the rest of the molars’ surfaces.

 

Juvenile periodontitis

The juvenile periodontitis is a pretty rare, but aggressive form of the periodontal disease, encountered at children, teenagers and young adults. It can have a fast evolution, leading to teeth loss. It has 3 forms of manifestation. The accidental form is identified at children with a dental mobility of minimum 3 mm at one, two or three teeth. The accidental form is from afar the most current. Localized periodontitis affects four or more teeth, mainly the incisors and the first molars. For this form the bone loss is quantitatively related with the chronology of teeth eruption: the first erupted tooth is most affected by the bone loss. The generalized form affects almost all teeth, including the cuspids, the bicuspids and the second molars. It is not certain if the generalized form of the juvenile periodontitis is the advanced stage of the localized juvenile periodontitis. For the generalized forms it should be taken in consideration the possibility of Papillon-Lefevre syndrome diagnosis.

Chronic adult periodontitis

For chronic periodontitis the bone loss is so advanced that teeth present an excessive mobility and risk to detach because of the lack of support. Extended horizontal bone loss or extended vertical bone defects can be present. For moderate bone resorption the lesions encountered during surgery are more advanced than seen on the X-ray.

NEW!!! A modern method of surgery with extraordinary results, including for loose teeth.

The periodontal disease or “periodontitis”, the way most of patients know it, is still classified as an incurable disorder. At the Dental Progress Clinic periodontal disease can be treated! Depending on the gravity of the periodontal disease its treatment can be either surgical or with medication.

If the depth of the periodontal pockets is smaller than 4 mm, the periodontal disease generally can be treated with medicine by applying medical fluids on the pockets after a subgingival curettage in closed field has been performed previously.

When periodontal pockets are very deep the treatment based on medicine is not enough. This treatment needs to be supplemented with periodontal surgery which consist in lifting the gum off the bone for the affected teeth and in removing the granulation tissue and then in applying substances for regeneration, for cases of severe bone loss, being also supplemented with bone augmentation.

Dental Progress offers you:

  • Prophylactic treatments to prevent gum affections
  • Successful treatments for gingivitis and periodontitis
  • Occlusal balance for periodontal teeth
  • Periodontal flap surgeries
  • Subgingival curettage
  • New! Treatment for advanced periodontitis cases with flap surgeries and bone augmentation
  • New! Modern method of surgery with extraordinary results including for loose teeth

Cosmetic dentistry

Teeth up to 12 shades whiter, WITHOUT PAIN, in one hour – only with the revolutionary teeth whitening BRITE SMILE system
COSMETICA DENTARA

For splendid and healthy teeth and with a natural aspect, specialized dentist from Dental Progress can improve:

  • teeth color (indifferently of the factors that led to unwanted shades)
  • the arrangement of teeth (interproximal spaces, “crowded” teeth)
  • teeth size (heterogeneous aspect)
  • gum aspect (too visible gums or excessive gums)

These changes are done with the aid of modern and safe methods with spectacular results:

  • Various teeth whitening treatments – teeth whitening treatment (at home) – Opalescence
  • Teeth whitening procedure in office- extra boost
  • Teeth whitening Brite Smile procedure in office 10 to 12 shades – 1 hour
  • Various types of dental veneers (ceramic and composite)
  • Porcelain prosthetic restorations of the front teeth – tattoo, tooth jewelry and so on
  • All-ceramic crowns (without metallic support) – excellent aesthetics, they do not blacken the gum, no matter how old the prostheses are
  • New! – Zirconia supported ceramic crowns– extraordinary resistance in time.
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What is a crown?

A crown is a rigid “cap” (porcelain-fused-to-metal, all-ceramic, Zirconia) which will be adhesive cemented on the abutment offering it a bigger stability and resistance in case of fracture. It entirely restores the aesthetic and the functionality of the tooth.

What is a veneer?

A veneer is a modern component in the aesthetic dentistry and it is apllied on the visible surface of the tooth, especially on the front teeth for which there are special ceramic veneers. The result of the veneer treatment is fully satisfying, at its end obtaining a white bright smile, nicely lined teeth, a Hollywood smile (see clinical cases).

When are veneers NOT recommended?

Veneers are not recommended for teeth with extended decays lesions or for teeth with fillings on large surfaces because the enamel allows an ideal adherence on the ceramic surface of the tooth. When the enamel is replaced by composite (for filling situation) the adherence of the veneer on the tooth is diminished.

A Hollywood smile with the revolutionary Brite Smile system

Teeth whitening is a more and more requested treatment by patients lately. This is why the teeth whitening procedures have evolved so much, becoming more and more advanced. At the Dental Progress Clinic you can benefit of spectacular results of the most advanced teeth whitening system in the world – BRITE SMILE. The teeth whitening with the Brite Smile system can be spectacular, teeth can result up to 12 shades whiter, all WITHOUT PAIN, in just 1 hour.

What does Brite Smile treatment involve?

The Brite Smile system is a simple, painless procedure. The dentist will carefully apply the whitening gel on the patients’ teeth only after he completely isolates the patients’ gums with the aid of the accessories from the Brite Smile kit. This gel contains 15% hydrogen peroxide, percentage that represents a lower concentration than the other whitening products on the market nowadays, making it safer and more “gentle” for the gums and for the enamel. To activate the whitening gel the Brite Smile lamp is started and for 20 minutes the patient can relax in the dental chair provided with special protection for the back and for feet in order to increase the patient’s comfort during longer treatment sessions. The lamp is turned off after the first 20 minutes round, the dentist removes the gel of the dental surface, then applies another layer of gel and the lamp is turned on for another 20 minutes whitening round. The Brite Smile kit is provided with 3 whitening rounds of 20 minutes each so this revolutionary system offers the patient the possibility to get a real “Hollywood smile” in just one hour.

This technology is one of the top technologies used by the Dental Progress doctors and it is one of the most advanced technologies in the world, highly appreciated by the Hollywood stars, first of all, for the maximum comfort offered to the patient and, last but not least, for the extraordinary results obtained after the use of the system.

Orthodontics

Dental braces are the ideal solutions to straighten and align teeth regardless the patient’s age.

For everyone’s physical and mental comfort, the straightening and the right alignment of teeth worth the entire attention since baby teeth eruption.

For various reasons, it often happens for teeth to “straddle” wrongly, to be incorrectly aligned or to have an unaesthetic position. These types of problem are faster and easier to solve during childhood and adolescence, when the maxillary bones are still growing.

For the past few years more and more adults have decided to follow treatments for correcting teeth alignment being unsatisfied with the aspect of their teeth. The treatment last longer than for children and teenagers, but the results are extraordinary.

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Orthodontics is the specialty of dentistry dealing with the correction of dento-maxillary anomalies. Children, teenagers and adults need orthodontic treatments when they have dental alveolar anomalies.

There are several types of fixed braces: with metal brackets, with ceramic brackets or with sapphire brackets. There are also the “invisible” braces (lingual INCOGNITO, STB, EURAPIX sau Clear Alignar, Invisalign), that are placed on the inside of the teeth so they are invisible from outside.

The fixed braces are classified as fixed and removable, depending on the patient’s need. At the Dental Progress Clinic modern methods in orthodontics are used in order to offer the following types of braces:

Fixed braces:

Metal braces – this is the most often encountered type of braces and the new technologies have made its wear to be more comfortable nowadays than in the past.

Ceramic braces – are more and more preferred because they are less visible than the metal braces. Like metal braces, the ceramic braces are comfortable and very efficient in teeth alignment. Ceramic brackets are made of a transparent material so its visibility on teeth is reduced.

Sapphire braces – they are transparent, strong, resistant and less noticeable than the ceramic braces.

Lingual braces – the lingual orthodontic treatments through Incognito technique regard any type of teeth alignment problems (crowding), occlusion (bite) or dental spaces (caused by teeth loss because of different reasons). The brackets are made of gold, personalized for each patient. The biggest advantage is the aesthetic one, being “invisible” – a crucial advantage for patients with an active social and professional life. This technique is also extremely useful for patients with deep cover bite or with cross bite.

Fixed brace is the most used orthodontic device because of the treatment’s high percentage of success, aligning teeth with a bigger precision than the removable brace. Usually a fixed brace is worn about a year and a half, but this is not a rule. Only the orthodontist can determine the necessary period to wear braces.

Removable braces:

They are braces made of plastic that stimulate the bone growth and generate spaces between crowded teeth.

What can be improved by wearing braces?

  • misplaced midline – when the center of the front upper teeth does not match with the center of the lower front teeth
  • cross bite – when the upper teeth do not match on the front with the lower teeth, for a normal bite
  • crowded teeth – when there are too many teeth to fit on an arch
  • overbite – when upper front teeth reach too far down over the lower front teeth
  • gap teeth–interdental spaces or “edentulous breaches”, the result of teeth deficiency or because of the teeth that do not fill the entire arch
  • open bite – the formation of a space between the occlusal surfaces of the front teeth and/or of the lateral teeth, when the patient bites on the lower teeth

Radiology

The radiologic examination is vital to determine an accurate treatment plan
serviciu-radiologie

Dental radiographs were and still are indispensable for a complete and secure dental examination. What has changed in time is the radiologic equipment. Presently modern clinics have devices with special systems that emit a lower level of radiation which is not dangerous for the patient. Plus the patient is protected by a lead apron. Besides the fact that they are safer, these devices are able to offer images of a high quality that facilitate the determination of a correct diagnosis.

Each radiologic examination should generate an optimum radiograph for the possibility to determine a precise diagnosis, incorporating the following functions:

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The X-rays should record the complete areas of interest on the image. On the intraoral periapical radiograph the complete length of the root and also 2 mm of the periapical bone should be visible. When there are proves of a pathological situation the entire lesion area plus the bone surrounding it are visible on one of the radiographs. However sometimes this thing is difficult to realize on a periapical radiograph so both an occlusal projection and an extra-oral projection could be necessary. The bitewing view has to show at least once each proximal surface. Radiograph will have to have an as much reduced amount of distortions as possible. Most of the distortions are not caused by the curve of the structures that are examined or by the inaccurate position of the film, but by the wrong angulation of the fascicle of X-rays. Dental radiographs must have an optimum density and contrast, these being essential for their interpretation. When a radiograph is evaluated and its remaking is taken into consideration, the doctor must determine the original reason for making it.

The role of radiographs in the evaluation of periodontal diseases:

Radiographs play an essential role in the evaluation of the periodontal diseases. They provide exclusive information regarding the estate of the periodontium and the situation of the bone during the entire period of the disease evolution. The radiographs help the doctor to identify the destruction stage of the alveolar bone and, in many cases, they are valuable to evaluate specific points. It is important to emphasize that the clinical examination and the radiological one are complementary. The examination should include a bone sounding, a bleeding index, mobility diagrams and also an evaluation of the attached gingiva. The characteristics that are not enough radiologically highlighted are more obvious at the clinical examination and the characteristics noticed on the X-rays are harder to clinically identify and evaluate. Although a radiograph can prove an advanced stage of a periodontal lesion, other important changes of the periodontium are impossible to be seen on the X-ray. Therefore a complete diagnosis of the periodontal disease needs a clinical examination of the patient combined with the radiological examination.

The radiographs are useful especially to evaluate the following aspects:

  • The present bone quantity
  • The condition of the alveolar ridges
  • The bone loss for furcation area
  • The width of the periodontal space
  • The local elements that determine the starting or the advancing of the periodontal disease
  • Incorrect adapted restorations or over extended restorations
  • The root length and the morphology
  • The report between the root and the crown
  • The position of the maxillary sinus related with the periodontal affection
  • Decays
  • Anodontia
  • Supernumerary teeth
  • Periapical lesions
  • Radicular resorptions
  • Tumors
  • Cysts

Radiographs can offer an incomplete presentation of the periodontium estate, having three limits:

  1. The radiographs can offer a two-dimensional view of a tri-dimensional situation. Bone defects can be hidden because the radiologic image cannot reveal the tri-dimensional structure so the bone defects can overlap with the walls of the superior bone. Also because of the overlap of the tooth structure only the interproximal bone can be clearly seen. The subtle changes of the image of the root can indicate the oral and vestibular bone loss. Plus, the use of several images with different agulations, like a complete set of the mouth, allows the user to use the oral object to obtain tri-dimensional information.
  2. Usually the X-rays show a less severe bone destruction than the clinical examination presented. The early easy destructive bone lesions do not produce enough changes to be detected.
  3. Radiographs do not prove the relations between the hard tissue areas and the soft tissue areas so they cannot provide any information regarding the depth of the soft tissues.