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Medical Forum / General / Dentistry / March 2007I'm going to need som edental treatment and would like some advise please.
Hi, I'm a Uk citizen over here in USA doing some travelling etc.. Basically I have a lower molar with a relatively large ceramic / white filling and I can feel that it has become loose. Before I started my trip I did have a dental check up and had this tooth repaired because the amalgam filling had cracked. My dentist at the time suggested I would need an onlay but on this occassion he would give me a ceramic filling, though he wasn't confident that it would hold up because of it's size. Any how, the filling has now worked loose, so I wondered what my options are. I've been having a look on the internet at the latest technology and various techniques available to Dentists and it all seems very impressive. The Cerec system sounds very good, though I wondered about the accuracy of such a system in terms of fit etc. The cerec 3 system presumably is the better out of the 3 models in the dentistry world, being the latest. I'm currently in Nashville for a week and see there are a few dentists offering such a service, and after that in San Francisco for another 3 weeks. I don't think my current filling is going to hold up to another 5 weeks and rather that go through the discomfort of not being able to eat properly during my holiday I'd better get it fixed. To give me a guide, how much does such a procedure cost. and also are their alternatives I could be looking at versus the cerec procedure. Thank you for your help. I have used CEREC for 7 years now. I have converted many dental offices to using it, (changed the opinion of the dentist owner). Cost for an average CEREC restoration is $750-$1000 USD depending on where you are and how much of the tooth is involved. Accuracy of the CEREC 2 was about 100 microns. The CEREC 3 is about 80 microns. The difference is only important in the laboratory. CEREC 3D is the same milling process as CEREC 3, but uses newer software. Accuracy of the CEREC 1 was around 150-200 microns --- I know of zero people using the CEREC 1 anywhere in the world at this time. I am actually looking for cheap one for display purposes only. If you have the restoration restored with CEREC technology, you are only in the dental chair one time for about 45-90 minutes (depends on the tooth). If you have it sent to a lab, you will have two appointments, minimum. I would not put gold on that tooth, although there are a bunch of Non-CEREC dentists on this forum who would prefer gold. CEREC would provide machine milled ceramic with margins as good as a dental technician can produce on his very best day--each time it mills a restoration. The material would have the same surface hardness as enamel and would expand and contract in response to temperature the same as tooth. It would be a "no-brainer" to me, but my view is skewed. I imagine finances would become a concern. Dr. Carlo Haskins is in Eastern Tenn. I can vouch for his honesty, concern and skill level. I visited his office when he first went "CEREC". I thought you were a subject of the UK, not a citizen?  Signature/ Amatus / > Hi, > I'm a Uk citizen over here in USA doing some travelling etc.. [quoted text clipped - 32 lines] > procedure. > Thank you for your help. > I have used CEREC for 7 years now. I have converted many dental offices to > using it, (changed the opinion of the dentist owner). > > Cost for an average CEREC restoration is $750-$1000 USD depending on where > you are and how much of the tooth is involved. It is also possible that the existing restoration can be treated as an inlay (*if* there is no fracture or decay!). Sandblast the 'filling' and bond it right back in the tooth. Good for emergency treatment (though definitive treatment by the right dentist could be a good idea before going back to the UK <G>). Steve On Feb 28, 8:36 pm, metsoman...@gmail.com wrote: > The Cerec system sounds very good, though I wondered about the > accuracy of such a system in terms of fit etc. The cerec 3 system > presumably is the better out of the 3 models in the dentistry world, > being the latest. I have good experiences with a Cerec onlay. Took 10 minutes to manufacture and fit. However, it didn't turn out quite as smooth or polished as a lab porcelain crown. The price for that Cerec was lower than the one quoted for a lab-made onlay. Since you're on-the-go I think Cerec would be a very good option for you. - Marco On Mar 1, 2:34 pm, grube...@gmail.com wrote: > On Feb 28, 8:36 pm, metsoman...@gmail.com wrote: > [quoted text clipped - 10 lines] > > - Marco if you want it on here start to finish then cerec is an option. If you are picky about how it looks then get something temporary here and get it fixed in the uk I challenge you to compare my average CEREC to your average lab fired restoration for esthetics. Signature/ Amatus / > On Mar 1, 2:34 pm, grube...@gmail.com wrote: >> On Feb 28, 8:36 pm, metsoman...@gmail.com wrote: [quoted text clipped - 15 lines] > are picky about how it looks then get something temporary here and get > it fixed in the uk > I challenge you to compare my average CEREC to your average lab fired > restoration for esthetics. I doubt very much your CEREC is any kind of average. Steve Hello, Thank you to all of you who responded with advise and information. I just returned from the dentist and happy with the final result. I was offered a couple of options, which included a crown and a temporary fix(another filling) allowing me to return back to UK to have my treatment back home under cover of my insurance. The crown would have taken a few days and will be beyond the length of my stay here in Nashville, which helped me decide to go for the option of having a filling. The dentist recommended I had a look at a zirconium core crown as an option when I return back to UK. I wondered if anybody would be so kind to explain about this type of crown the advantages etc over other types of crown and the disadvantages. Also if there are any UK dentists reading this forum, what I should ask for in UK, do they share the same name in the UK? I would like to add the dentist I visited also had the CEREC machine, but she felt because the filling that needed to be replaced was on my first molar, and I have a heavy bite, I should look at having a crown, she advised that whilst the CEREC onlay would be okay here she would advise against it. She advised that the cerec is very good for the forward teeth but for molars etc, she felt a crown would be better. Another question I have, is it possible to have a zirconium core onlay? thank you. I perform CEREC restorations on any tooth in the mouth with no problems. If you are a clencher, you need an NTI. Whatever material you restore the tooth with, you can break something if you are a forceful clencher. You need to plan where that break can occur. Zirconium is just a harder porcelain core than Procera and some of the others. It is usually machine milled, then covered with laboratory fired porcelain. Avid the full crown if you are a clencher, you will eventually break off the tooth at the gum-line if you have the tooth reduced in thickness. Signature/ Amatus / > Hello, > Thank you to all of you who responded with advise and information. [quoted text clipped - 30 lines] > > thank you. > Avoid the full crown if you are a clencher, you will eventually break off the > tooth at the gum-line if you have the tooth reduced in thickness. With all due respect, I have watched crowned teeth in service for over 27 years. The number that "eventually break off the tooth at the gum-line" are small in number and usually either a mediocre (at best) crown or on a tooth with a very limited chance of long term success. Yes, many more people should wear an NTI to protect their teeth and restorations. D The vast majority do hold up very well. But, if you have a heavy clencher, they start to break off one-by-one, unless they wear "nightly protection". The moderate clencher, will usually chip porcelain off the PFM and ditch out margins on FGC's, **abfractions** galore. The trick is figuring out who is going to switch from a non-clencher to a moderate clencher, and who is switching from moderate to severe. I have seen plenty of well cut PFM preparation teeth break off at the gingival crest in a heavy clencher. As the local economy continues to spiral down, we see more of it. Comerica just announced that they are leaving the area and taking a lot of jobs with them. That should trickle down and close another couple restaurants, gas stations, 7-11's, etc. Hopefully, most of the public will be watching the Stephen Grant/Tara Grant murder story on TV and not pay too much attention to losing more jobs in this area. Signature/ Amatus / > >> Avoid the full crown if you are a clencher, you will eventually break off [quoted text clipped - 10 lines] > > D Isn't that the sponsor of the Tiger's ball park? Comerica > just announced that they are leaving the area and taking a lot of jobs with > them. That should trickle down and close another couple restaurants, gas > stations, 7-11's, etc. Hopefully, most of the public will be watching the > Stephen Grant/Tara Grant murder story on TV and not pay too much attention > to losing more jobs in this area. Things have slowed down in this neck of the woods, but there haven't been the major closings that you describe. Housing has definitely leveled off (and other construction). A local surveying company was renting the walk-out basement part of my building for the last couple of years, and had to cut back to working out of the owners home. No new renters clamoring for the space yet...... D Yes, they sponsor the Ball-Park. Should be interesting to see if the name stays there or not. I doubt it will become the Chrysler Ball-Park. Our city actually just lowered the home valuations for tax purposes. No one can sell a house anywhere near market value, so the City is at least being realistic about tax rates. Unfortunately, our silly Governor thinks increasing taxes to businesses will increase jobs. :-( A service-tax is being pushed by her now. (Funny how she waited until 2 weeks after her inauguration speech to mention it.) Do any of the others on this NG live in States with service taxes on dentistry? Signature/ Amatus / > > Isn't that the sponsor of the Tiger's ball park? [quoted text clipped - 15 lines] > > D >Yes, they sponsor the Ball-Park. Should be interesting to see if the name >stays there or not. I doubt it will become the Chrysler Ball-Park. How about Cremona Ball-Park ? ;-]] >Our city actually just lowered the home valuations for tax purposes. No one >can sell a house anywhere near market value, so the City is at least being >realistic about tax rates. Unfortunately, our silly Governor thinks >increasing taxes to businesses will increase jobs. :-( A service-tax is >being pushed by her now. (Funny how she waited until 2 weeks after her >inauguration speech to mention it.) SOP for dems. Punish the successful. >Do any of the others on this NG live in >States with service taxes on dentistry? Someone mentioned it once, the public ran them out on a rail. >>Do any of the others on this NG live in >>States with service taxes on dentistry? > > Someone mentioned it once, the public ran them > out on a rail. Not here either. D >>> Do any of the others on this NG live in States with service taxes on >>> dentistry? [quoted text clipped - 5 lines] > > D Nah. I know service taxes were discussed; not even sure at which governmental level. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 She is threatening a 2-3% tax on all services. Add to that the cost of collecting the tax, filing forms, etc. I figure another 1% in overhead (conservatively). That means crowns go up by $30-40, RCT's too. Basically, we are going to push more people into not being able to afford dental care..... Not just dentistry, but auto service, hair-cuts, plumber, architect, etc. Net result, people are going to buy fewer services. Therefore, less money in the economy, leading to more businesses closing, and less income tax being paid, less property tax, less single business tax, etc. Net effect, economy gets worse, and the State ends up with even less money. Brilliant !! Signature/ Amatus / > >>>Do any of the others on this NG live in States with service taxes on [quoted text clipped - 6 lines] > > D >She is threatening a 2-3% tax on all services. Add to that the cost of >collecting the tax, filing forms, etc. I figure another 1% in overhead [quoted text clipped - 8 lines] > >Brilliant !! You cannot tax your way to prosperity, ever. Lower tax rates actually increase government revenue because the economy grows. The VAT (value added tax) is also another supremely stupid idea. >> Avoid the full crown if you are a clencher, you will eventually break off the >> tooth at the gum-line if you have the tooth reduced in thickness. [quoted text clipped - 9 lines] > >D Gotta agree here. But then again I don't subscribe to the 'ferrule' effect. > I perform CEREC restorations on any tooth in the mouth with no problems. If > you are a clencher, you need an NTI. Whatever material you restore the [quoted text clipped - 51 lines] > > > thank you. Amatus, I wish I knew you before I had the Porcleain crown 11 month ago. dose CEREC onlay depends on the technical of the dentist very much? Do you recommend to replace Porcleain crown with CEREC crown. I actually don't mean to have two visits, but I am worried about the abrasion to the opposite tooth. If it is on and working well, don't disturb it. when it fails (someday), think about options at that time. And, everything done in dentistry is dependent on operator knowledge and skill. Get an NTI. Signature/ Amatus / >> I perform CEREC restorations on any tooth in the mouth with no problems. >> If [quoted text clipped - 59 lines] > actually don't mean to have two visits, but I am worried about the > abrasion to the opposite tooth. > If it is on and working well, don't disturb it. when it fails (someday), > think about options at that time. [quoted text clipped - 72 lines] > > actually don't mean to have two visits, but I am worried about the > > abrasion to the opposite tooth. Although my crown is new but I think there is some problem. Initially I was painful when biting down. I thought that was normal after root canal and new crown since the teeth needed to get used to each other. And things was better for a few month. Then I felt painful on almost every back teeth. My dentist did some adjustments to lower the crown and some neighboring teeth. Now I felt painful on other teeth which were not lowered. And I also felt that teeth on the other side of the mouth fight each other more frequently. Is this because teeth on one side are too low? I am thinking of crown replacement already. NTI Signature/ Amatus / >> If it is on and working well, don't disturb it. when it fails (someday), >> think about options at that time. [quoted text clipped - 95 lines] > frequently. Is this because teeth on one side are too low? I am > thinking of crown replacement already. Hello, Thank you to all of you who responded with advise and information. I just returned from the dentist and happy with the final result. I was offered a couple of options, which included a crown and a temporary fix(another filling) allowing me to return back to UK to have my treatment back home under cover of my insurance. The crown would have taken a few days and will be beyond the length of my stay here in Nashville, which helped me decide to go for the option of having a filling. The dentist recommended I had a look at a zirconium core crown as an option when I return back to UK. I wondered if anybody would be so kind to explain about this type of crown the advantages etc over other types of crown and the disadvantages. Also if there are any UK dentists reading this forum, what I should ask for in UK, do they share the same name in the UK? I would like to add the dentist I visited also had the CEREC machine, but she felt because the filling that needed to be replaced was on my first molar, and I have a heavy bite, I should look at having a crown, she advised that whilst the CEREC onlay would be okay here she would advise against it. She advised that the cerec is very good for the forward teeth but for molars etc, she felt a crown would be better. Another question I have, is it possible to have a zirconium core onlay? thank you. |
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