Case Studies

Root Canal Treatment

Very often, it is seen that dental treatments are delayed in the absence of pain. People ignore even a huge cavity in their tooth for very long which leads to severe destruction. Having no pain does not mean that there is no issue or the issue will subside on its own.

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. We had a patient who waited a little too long to visit us after he had a cavity as he was not suffering from any pain. It was not possible to treat him with a simple root canal treatment as the tooth structure was damaged to a great extent. The decay or cavity had eaten up most of the surrounding tooth structure making it fragile, due to which the life of the tooth could have been compromised. We had to thus follow the root canal treatment with the rebuilding of all the lost tooth structure. Luckily, we have certain advanced procedures such as “Post and Core Treatment” with the help of which we could still rebuild the lost tooth structure even with all the delay. Hence, we could still save the patient’s tooth from being removed and he could chew and eat with no difficulty. Having said that, it is still advisable that you do not wait for too long to get tooth treated, as it may not always be able to possible to save it!!

  

Third Molar Removal

Ideally, we all have a 3rd molar in each of our four dental arches which are commonly known as the wisdom teeth. Unlike their name, they do not impart any wisdom in our minds. In fact, they serve no purpose in any of the functions that our teeth perform such as chewing, speaking etc. In many people, they erupt only partially or erupt in a different direction than normal resulting in various associated complications. It is very common to have patients come up with wisdom tooth pain or discomfort. The ideal treatment for all these third molar problems is surgical extraction, as it is anyway quite difficult to maintain those teeth and there is no point saving them.

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However, patients can be very apprehensive of getting a surgical extraction done because of all the misconceptions associated with it and usually end up settling for pain killers only. One such patient visited our clinic a while back whose wisdom tooth as well as the tooth in front of it was paining. The patient was extremely scared of dental treatment and was afraid to visit the dentist for a long time as she thought that she will have immense pain if she has to get her wisdom tooth removed. This led to negligence for a long time and she started having complaint of food getting stuck between the wisdom tooth and the tooth ahead of it. On examination, it was observed that the wisdom tooth was tilted and not upright. The X-ray evidently showed that the wisdom tooth was horizontally placed and it was pushing the tooth in front of it. It also showed a deep cavity in both the teeth which were paining. After a proper counselling at our clinic, she was assured that the dental procedure will not be as painful as she has imagined. She was also informed that the negligence has resulted in a cavity in the wisdom tooth and its spread to the adjacent tooth as well which is why the food was getting stuck there. Once the patient was fully convinced, the wisdom tooth was surgically removed with absolutely no pain or discomfort. The tooth adjacent to the wisdom tooth was treated by root canal treatment followed by placement of full ceramic cap. The patient was very satisfied with the entire treatment and she could eat and chew with no discomfort after that.

  

Dental Trauma

Growing children are quite susceptible to injuries while playing or indulging in any physical activities. Many a times, it may result in trauma to the teeth, especially the upper front ones. However, parents tend to ignore them thinking that these are just the milk teeth and are eventually going to fall off. While this may feel like the right thing to do at that time, it can lead to much bigger problems in later ages of the child.

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There is a possibility that the trauma to their milk tooth initiates an infection which may stay even after the tooth falls off and it may ultimately affect the permanent tooth as well. One such patient visited the clinic who had experienced trauma to her upper front milk tooth many years back. Patient had undergone a root canal treatment then. Even after that, the permanent tooth had shifted its position and also turned blackish in color. The patient came to our clinic with excruciating pain and wanted to get a permanent solution for her tooth. On examination, it was observed that the tooth was incompletely formed and it had an open end. Also, there was an infectious cyst beneath the affected tooth. After assessing the case properly, we decided to do a root canal treatment of the tooth and treat the underlying cyst without any additional surgical procedure. First, the RCT was completed using a special root canal filling machine which was used specifically for this case. The cyst healed automatically following the root canal procedure. Yet, we could not leave the space which was enclosed by the cyst empty. We took a small amount of the patient’s blood and used it to extract growth factors which we then placed in the empty space to induce growth of normal tissue within the empty space. All this was done through the tooth which was being root canal treated and no added surgery was performed. In the end, a medicament was used to close the open end of the affected tooth. After the complete treatment, the infectious cyst was completely healed; the tooth regained its original colour and position and went absolutely back to normal.

  

Ceramic Crown

Getting a root canal treatment done immediately relieves the tooth pain if any. It is important to do this treatment to remove all the associated infection with the tooth so that it does not spread to the surrounding teeth and other structures. The cavity if left untreated can be a hub for lodgement of food which can cause a lot of discomfort. You can also experience difficulty in chewing due to broken tooth structure which can eventually lead to improper digestion resulting in gastric problems.

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A complete root canal treatment along with a fitted cap will replicate the natural tooth and hence it will help in restoring the form and function of the tooth. The biggest advantage of the root canal treatment is that it is a conservative treatment which means you do not need to get the entire tooth extracted and therefore, need not worry about future expenditure over its replacement options. A similar case came to our clinic where the patient complained of food getting stuck. On examination, she had a very deep cavity. We treated it with the help of a root canal treatment followed by a ceramic crown. Placing a cap after a root canal treatment is very important as it makes sure that the treated tooth is protected from the oral environment minimising any further infection. It also aids in restoring the bite of the patient and helps in chewing as well. Choosing the correct type of cap can ensure that your treated tooth lasts longer. Ceramic crown has proven to be a very good crown option over a simple metal crown or porcelain fused to metal (PFM) crown. It looks very aesthetic as it is of the color of your tooth inside out. Its form is exactly like that of the natural tooth. It fits perfectly leaving no space to encourage any further infection. Durable, long lasting and superbly aesthetic – all these qualities make it one of the best crown options after an RCT.

  

Gum Cleaning Therapy

There are many misconceptions surrounding the scaling of teeth. People often come up to
us with concerns that getting scaling done will make their teeth loose and it will create gaps
between their teeth. We can assure you that there is no truth to this claim. Scaling is simply
the removal of plaque, debris, stains and calculus from your teeth which is formed as a
result of improper oral care and certain habits like smoking and tobacco consumption.

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The gap that you may feel is because of the elimination of the hard chunks of calculus deposits which had been covering your teeth since so long and the temporary feeling of loose teeth may be because your teeth have already lost its attachment because of the lack of oral
health care. All this will get back to normal in a couple of days if you continue taking goodcare and get a regular scaling done every 6 months. Ignoring your teeth and refraining from getting regular dental cleaning done will only cause more problems to your teeth. We had a
patient who suffered from foul odour from mouth and bleeding from gums. On examination, it was noticed that he had hard calculus deposits around all his teeth which caused his gums to get detached from the teeth and move downwards eventually leading to spacing and loosening of teeth. It caused inflammation in the gums causing bleeding and the
bad breath was due to the hard calculus and plaque deposits. Once we performed deep cleaning of all his teeth and explained him the oral hygiene measures, his gums gained back their original position within a matter of days. This healed the inflammation of gums, and both the bad breath and the bleeding gums were treated. So we may think that scaling is a simple and not so important treatment, but sometimes, getting your teeth clean is all that is needed to solve all your dental problems.

  

Ceramic Veneers

Pt Anita Dhuria visited our clinic with the complaint of spaces between her teeth. She had undergone multiple fillings for the same previously at a local dental clinic. However, the fillings got stained within a period of 6 months. She wasn’t satisfied with the results of her previous treatment and wanted to know if it could be redone. We suggested her that she could opt for a more permanent treatment if she wanted a better looking smile.

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The option that we advised her to go for were ‘Ceramic Veneers’. In this, the fillings on her front four teeth were replaced with ceramic veneers. This was done by making the top surface of her teeth slightly rough without any major grinding, using an exceptionally delicate and conservative technique. Approximately, only 0.3 – 0.5 mm of tooth surface needs to be ground or roughened for placing ceramic veneers as they are extremely thin. The thickness of a ceramic veneer can be compared to that of a screen guard which we place over a smartphone. Just like a screen guard, it is very thin and transparent and helps in protecting the underlying structure without compromising on the aesthetic bit. Hence, it also prevents further formation of cavities in the underlying tooth. We chose the perfect shade, shape and size of veneers for the patient to completely match her facial complexion and her personality. Ceramic veneers is a widely recommended treatment option for front teeth unless there is a major crowding present in the teeth of a patient. In such cases, it is first recommended to correct the teeth alignment with the help of aligners and then go for veneers. In the above case, only minor alignment correction was needed which could be achieved directly with the help of ceramic veneers. The treatment was completed in three sittings over a week period by the end of which the patient got a perfectly natural looking new smile. Not only her smile but also her whole self-confidence was at an all-time high after her treatment. Her speech was also absolutely crisp and clear. She was elated and very satisfied with the results.

  

Full Mouth Rehabilitation

Mr B K Khurana is a 64 year old patient who had visited the clinic with the complaint of “short teeth” which he felt were breaking apart. For a very long time, he had a habit of eating betel nut or what is commonly known as
“supari”. This resulted in severe wearing off of his teeth surfaces causing the tooth height to decrease and also affected his entire facial profile. He wanted to get rid of all these issues. He also wished to have the natural white shade of his teeth back. He mentioned that in his younger years, he was constantly complimented for his shiny whites and his smile which diminished over the time period due to his habit.

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He also wished to have the natural white shade of his teeth back. He mentioned that in his younger years, he was constantly complimented for his shiny whites and his smile which diminished over the time period due to his habit. He was willing to leave his habit once and for all and wanted us to give him his old dazzling smile back. We asked him to undergo “Full mouth rehabilitation” for his teeth where we rebuilt them to their original tooth structure. To achieve this, we first removed the tooth layer which was affected by wear and tear due to ‘supari chewing’ and restored them with the help of ceramic based caps. These caps were specially designed to make his teeth look naturally beautiful. We placed a total of 28 such caps in his entire mouth. Out of these, only two teeth required root canal treatment to be done. The whole procedure was completed very smoothly and in a hassle-free manner just within a span of 2-3 months. By the end of it, the happiness and satisfaction on his face had no bounds and he had got his young dazzling whites back. He was also able to resume eating his favourite delicacies. He experienced a complete shift of look and personality, and the compliments that he used to get previously started pouring in again. We were really happy to give him his young dashing smile and confidence back.

  

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