Tuesday, May 29, 2012

Dental Surgery Review: Partially Impacted Wisdom Teeth

Surgically removal of two lower partially impacted wisdom teeth. This procedure was done under local anesthesia in our office on May 16, 2012 for a young female patient.

 
Panorex xray shows partially impacted wisdom teeth (#17 and #32) on mandible.  Noted there is also a completed bony impacted on the maxillary left wisdom tooth (#16) as well.


Our patient was a young healthy female.  She came to our office with a complaint of pain on her lower right jaw and difficult in chewing.  A diagnosis of acute operculitis was made and she was treated immediately with incision and drainage procedure.  The patient was discharged with antibiotic and rescheduled for surgery in 1 week.


A picture of her lower right wisdom tooth (#32) a week after.  Noted that the inflammation was reduced.  Also noted for a carious lesion on the chewing surface and partially erupted condition. The tooth also had slight rotation counter-clockwise.


Lower left wisdom tooth was also partially impacted and rotated.  There was a carious lesion on the chewing surface as well.


After the wisdom tooth was anesthetized, a small incision was made to expose the crown of tooth.


Standing from behind the patient,  a dental forcep was used to extracted the wisdom tooth in standard fashion.


Extraction socket of the lower right impacted wisdom tooth was irrigated with normal saline.


Partially impacted right wisdom tooth showing calculus on the distal surface and carious lesion on the occlusal surface


The wisdom tooth on the left side was then extracted in similar fashion. Photo showing the extracted socket after normal saline irrigation.


Lower left partially impacted wisdom tooth extracted.  Note for the fused roots and the carious lesion on the distal surface in addition to the one on the occlusal surface.


Photos of the 2 extracted partially impacted wisdom teeth.  The patient tolerated procedure well and she was scheduled for a follow-up visit in one week.


Houston dentist
Minh Nguyen, D.D.S.

Monday, May 14, 2012

Case review: CEREC porcelain onlay restoration, May 9, 2012

 The 60 year old patient complained of a "broken tooth."  Examination showed a defective filling with recurrent carious lesion extending to all four surfaces (FDOL) of the tooth.  Because the extensive of the decay, the strength of the tooth was compromised and the onlay restoration was recommended.

Preop picture of tooth #28 , showing a defective amalgam (silver) filling and a cavity is forming in the area between the tooth






closeup view of the defective filling and the cavity on the tooth #28


Preparation of the onlay was done in the patient mouth.



The onlay data was being prepared by the CEREC program



Computer generated a drawing of the onlay 3-D shape



The onlay was ready to be fabricated by the CEREC milling chamber as the CEREC program calculated how much time required to mill out the onlay.



A view at the milling chamber, showing the square porcelain block which will be used to mill out the onlay



the precised porcelain onlay was milled out by the CEREC machine and is ready to try-in the mouth



The porcelain onlay was trying-in to make sure it has proper seating and fit



After the onlay was completely cemented in the mouth



A closeup look at the final CECEC restoration for tooth #28



Thank you for viewing the note.  I hope it is informative and educational.




Wishing a good health to all of us!!



Houston dentist
Minh Nguyen, D.D.S.