Dr. Ram Uttamchandani

Services

Cosmetic Dentistry What is Cosmetic Dentistry?
Cosmetic dentistry is dentistry aimed at creating a positive change to your teeth and to your smile. Most think of tooth whitening or veneers when cosmetic dentistry comes to mind, but a cosmetic dentist can provide much more. A skilled, experienced cosmetic dentist can help to improve your appearance, your smile, even your self-esteem, and confidence. Today, cosmetic dentistry has continued to evolve to where cosmetic dentists can address functional and esthetic patient concerns.

What are some benefits of cosmetic dentistry?
A great smile should improve your self-confidence, which can have a positive impact on the social and professional aspects of your life. Cosmetic dentistry is not just about pretty smiles though. New techniques and materials are available for back teeth as well as those seen when you smile. Now your mouth can look great, get healthy, and function better, all at the same time.

Is my new smile permanent?
With good home care and regular visits to your dentist, modern materials can last for many years, and possibly decades. Like most things, excellent maintenance will extend the life of your dental restorations.

Dental Implants The key benefit of dental implants over other tooth replacement systems is that an implant connects directly to the jaw bone. It's obviously not the same as the original connection, but functions just the same. When a tooth is lost, bone loss will eventually occur in that region because the root is no longer stimulating and stabilizing the bone. By using titanium--which biochemically joins to bone--to replace the root, you get a bond that more accurately replicates the one found in nature.

Single Tooth Implants/Implants for Missing Front Teeth –
Single-tooth implants can be used in people who are missing one or more teeth. An implant is surgically placed in an opening that is made by your dentist in the jawbone. After the implant integrates (attaches) to your bone, it acts as a new "root" for the crown that will be replacing your missing tooth. A crown (cap), which is made to look like a natural tooth, is attached to the implant and fills the space left in the mouth by the missing tooth.

What are the advantages of a single-tooth implant over a bridge?
A dental implant provides several advantages over other tooth replacement options. In addition to looking and functioning like a natural tooth, a dental implant replaces a single tooth without sacrificing the health of neighboring teeth. The other common treatment for the loss of a single tooth, a tooth-supported fixed bridge, requires that adjacent teeth be ground down to support the cemented bridge. Because a dental implant will replace your tooth root, the bone is better preserved. With a bridge, some of the bone that previously surrounded the tooth begins to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact. In the long term, a single implant can be more esthetic and easier to keep clean than a bridge. Gums can recede around a bridge, leaving a visible defect when the metal base or collar of the bridge becomes exposed. Resorbed bone beneath the bridge can lead to an unattractive smile.

What Happens When You Lose a Tooth?
When you lose a tooth, especially a back tooth, you may feel you don't need to replace it, since no one can see that it's missing and you have plenty of other teeth. However, there is more bone loss going on under the surface once a tooth is lost. Surrounding each tooth is an alveolar bone that supports the tooth and when the tooth is lost, that bone basically melts away. This is why people who have lost most of their teeth and are not wearing dentures appear to have a caved-in appearance to their mouths. Besides causing damage to the immediate area, tooth loss affects remaining teeth as well. Teeth create a structure for the face and their loss can shift the surrounding teeth, creating esthetic issues and bite problems. A lost tooth can also affect facial structures such as the jaw, muscles, jaw joints, and even the skin. If several teeth are lost, it's not uncommon to suffer from social consequences and poor nutrition.

Rebuilding Bone
When the supporting alveolar bone melts away, it's gone for good, but through grafting, a skilled dental professional can recreate bone to fuse with and support an implant. This is wonderful news, but it is still best to have a dental implant as soon as possible after the tooth is lost for the most predictable esthetic outcome.

Timeline
Replacing a tooth with an implant and a crown is not a one-day procedure. The implant needs time to properly adhere to the bone and create a healthy fusion before the crown can be attached and full bite force can be applied. In most cases, it will take a few months to complete the process. Due to the timeline, dental implants are actually a series of steps; each is very different and may require an individual specialist.

Implant Supported Dentures
An implant-supported denture is a type of overdenture that is supported by and attached to implants. A regular denture rests on the gums, and is not supported by implants. An implant-supported denture is used when a person doesn't have any teeth in the jaw, but has enough bone in the jaw to support implants. An implant-supported denture has special attachments that snap onto attachments on the implants. Your implant-supported denture will be more stable than a regular denture. You will find it easier to speak and you won't have to worry about the denture becoming loose or falling out of your mouth. You generally will be able to eat foods you could not eat before.

Dental Implants vs Fixed Bridge What Are Dental Implants?
Dental implants are actually a series of procedures used to recreate a missing tooth. The key part of a dental implant is the initial titanium implant which sits in the original tooth's bone pocket, or alveolus. The titanium works well with the bone and actually forms a bond with it over time, much like the original bond between the tooth and the jaw bone. This is essential as it prevents bone loss that would normally occur with any other type of tooth replacement. Dental implants are capped with a crown, which replicates the enamel or visible portion of a tooth, and in many cases the replacement tooth will work just as well, if not better, than the original tooth.

What Is a Fixed Dental Bridge?
A fixed dental bridge is a non-removable prosthesis attached to remaining natural teeth. The false tooth or teeth literally bridge the gap between natural teeth. For a long time, fixed bridges were the best alternative for people who had lost teeth, as they were quite successful and esthetically pleasing. Unfortunately, bridges can also present some problems because the natural teeth that lie on either side of the bridge are filed to accept the appliance. This step in the bridge-making procedure may make these teeth prone to bacterial plaque accumulations, decay, periodontal disease, and the possible need for future root canals.

Cost Breakdown: Implant vs. Bridge
At first glance, it appears that a bridge is the more economical route, with total fees for a typical implant starting at the top end of the cost for a fixed bridge and ending a couple thousand dollars higher. But when comparing cost versus value, the dental implant is more cost-effective and the better treatment option – if the patient is a candidate for implants.

Dental Porcelain Bridge Dental porcelain is remarkable in its ability to replicate both the form and function of original teeth. Whether you're looking at veneers, crowns, or a fixed bridge, the use of porcelain can provide the longevity, durability, and esthetic you desire. A porcelain fixed bridge is very useful when replacing a tooth or a couple of teeth that are no longer viable. The porcelain can be sculpted to replicate the look of natural tooth enamel and using this durable material gives your bridge a strong base to rely upon. Porcelain is so flexible in its design capabilities that it can be used not only to replace lost teeth, but also to improve the original appearance of those teeth and create a flawless replacement.

The Hows and Whys of a Porcelain Fixed Bridge
A porcelain fixed bridge replaces missing teeth by using the surrounding teeth as a foundation. This creates a literal "bridge" between the remaining teeth and the missing teeth. Dental porcelain is a great product because it can be shaped to replicate original teeth and fit comfortably within the established bite pattern. Porcelain is also very durable, will withstand most natural tooth functions, and can vividly mimic tooth enamel with its glass-like whiteness and translucence, which allows light to penetrate and scatter as it does with natural organic teeth.

Maintenance of a Porcelain Fixed Bridge
Maintaining a porcelain bridge is actually quite simple. Treat your bridge in the same manner as you would original teeth, with routine brushing with non-abrasive fluoride toothpaste and regular flossing. A follow-up appointment will be scheduled to evaluate your bridge shortly after it's placed, so the dentist can review his or her handiwork and see how your mouth is reacting to the treatment. Even if you think everything feels perfect, this appointment is vital to your future oral health.

Direct Bonding Procedures
Bonding is a popular treatment option because it provides a successful attachment between the filling material and the tooth's original enamel and dentin. It looks like the original tooth and functions like it as well. Direct composite bonding is used to recreate a smile in an additive manner, where little or no tooth reduction is needed. Direct bonding, in the hands of a skilled operator, is less costly than porcelain veneers and crowns and can be long-lasting with proper maintenance.

Enamel and Dentin
Teeth are a perfect combination of both strength and resilience and this is created through the fusion of enamel and dentin. Enamel is the outer shell of the tooth or the portion that is visible within the mouth. It is composed of densely packed calcium crystals which are very hard and resistant to wear. Enamel is composed of no living material and is effectively mimicked by dental porcelain. Dentin is the inner core of the tooth and is much more porous. Constructed of collagen tubes with calcium crystals, dentin is living tissue and transmits nerve sensation. Composite resins have properties similar to dentin and are a combination of a plastic resin and silica filler. This combination of materials allows for excellent tooth color replication and reliable adhesion.

Bonding to Repair Broken or Chipped Teeth
Tooth bonding is used in several different ways, but is probably most useful for repairing chipped teeth. Bonding materials (high-density, modern plastics called composite resin) and porcelain—are more natural in color and can be designed to perfectly match the surrounding teeth making it difficult to discern there ever was a broken tooth.

Laminates & Veneers
Completely reshape your teeth for a beautiful, white smile A porcelain laminate (often called a veneer) is a thin shell of porcelain that covers the front of each tooth. They bond directly to the front of the tooth, similar to the way artificial fingernails work. Each porcelain laminate is a work of art, carefully crafted in a laboratory to fit your individual smile. Often it is advantageous to whiten all teeth before treatment because the laminates allow color transfer from beneath. This further insures a whiter, brighter smile. Than a brilliant smile is the best business card

Smile Makeovers Utilizing Porcelain Veneers
Porcelain Veneers are a fantastic way to repair or enhance the appearance of front teeth. They can be used to whiten teeth, close spaces and create a great smile. Using veneers, we can even perform virtually "instant orthodontics" to straighten crooked teeth and give you the bright smile you always wanted. Many Hollywood actors have porcelain veneers, that are how many of them got the "Hollywood Smile". "Porcelain veneers can provide you with an incredibly natural, beautiful smile. They are virtually undetectable and can dramatically improve your appearance. They are durable and long-lasting when compared to other cosmetic treatments."

Porcelain Veneers can:
Close unsightly gaps between front teeth Improve teeth that are too small or large in proportion to rest of the mouth Repair broken, chipped or worn teeth Whiten dark, yellow, permanently stained or discolored teeth Straighten crooked teeth Repair rough or jagged edges on front teeth Improve gummy smiles Overall smile enhancement

Periodontal Surgery, Gum treatment Periodontal Plastic Surgery Periodontal plastic surgery is designed to restore form and function to the gum tissue, periodontal ligament, and the bone that supports your teeth or an individual tooth. The real long-term goal of any periodontal surgery is to increase the life expectancy of the teeth and their usefulness; it is not a cure for periodontal disease. Basically, periodontal surgery removes tissue that has been transformed by the disease and then reconstructs the gums and surrounding tissues to better support the teeth and to recreate a normal appearance.

Periodontal Disease
Periodontal disease is diagnosed when gingival or gum tissue attachment to the teeth is abnormal and bone changes may be evident through x-rays. The degree of periodontal disease will be estimated by examining "pockets" between the gum and tooth to see how much detachment exists and then will thoroughly examine the x-rays. Your dentist and you can discuss treatment procedures once a periodontal disease diagnosis has been made, beginning with conservative behavioral changes and extending to periodontal plastic surgery.

Treating Periodontal Disease
Periodontal disease does not always respond to conservative measures taken before and after diagnosis. While surgery may be necessary in the end, knowing what steps you can take to prevent disease from forming, and from progressing, is very important.

Behavioral Change
When periodontal disease is detected, you will first be recommendws for a few behavioral changes including an enhanced oral hygiene program, quitting smoking, and possibly some additional lifestyle changes.

Tartar Removal
A regular and thorough professional tartar or calcified plaque removal program will become an essential part of your oral hygiene routine. Typically this is a painless procedure but, in some extreme cases, pain medication may be required for a few days. Bite Therapy– Bite disorders can be treated after periodontal disease is diagnosed and treatment has begun. This may prevent future problems and will make your mouth an all-around more hospitable environment. Surgical Therapy– In cases of severe periodontal disease, surgery will be necessary to repair and regenerate the soft and hard tissues and replace any missing teeth. The goal of surgery is to eliminate pockets between the gum and tooth and attempt to encourage reattachment and normal function and esthetics to the patient.

Porcelain Crowns Dental porcelain can be sculpted to closely replicate the look of natural tooth enamel, while providing desirable strength and resilience. Porcelain crowns are an excellent choice when recreating the form and function of a damaged tooth, because a crown basically replaces the entire external portion of the tooth down to the gum level. Crowns are not limited to simply replacing the original tooth, but can be designed to create an even better esthetic appearance.

The Hows and Whys of Porcelain Crowns
Porcelain crowns replace the exterior portion of a tooth to re-establish its original function and to create a natural appearance. Crowns are the treatment of choice in situations where tooth decay has destroyed most of the original tooth, when a traumatic event has caused damage, or in cases of severe enamel erosion. They are also an option for people who grind and clench their teeth so much that the original structure of their teeth has been compromised. The great benefit to porcelain crowns is they can not only replicate the original tooth in function, but can be designed to look like the original--or even better. When patients select a porcelain veneer for cosmetic reasons, they're usually covering up the front portion of the tooth that has some esthetic flaw. A porcelain crown is thicker than a veneer and, in some situations, this thickness is needed. Crowns and veneers are situated and secured in the mouth in a similar fashion, using a light-sensitive resin placed between the original tooth and crown, and then hardening that resin with a special curing light. Partial crowns, often referred to as onlays, are a type of restoration or filling that covers one or more cusps. An inlay is similar to a filling but the work resides completely within the cusps on a tooth's chewing surface. These restorations are much more conservative than crowns, and can be imperceptible from your natural tooth.

Potential Crown Downsides
Porcelain crowns do require some laboratory time to be created and times vary according to the laboratory and its distance from your dentist, so expect to be fitted with a temporary, or provisional, crown for a while. Some patients may experience sensitivity to hot and cold temperatures after porcelain crowns are attached. It's best to consult with your dentist for more information about your individual case. While porcelain crowns are very durable, they do not have the flexibility of natural teeth, so avoiding certain foods may be necessary. Chronic tooth-grinders and jaw-clenchers will need to be fitted with a nighttime mouth guard to protect the porcelain from unnecessary and excessive pressure and use.

Maintenance of a Porcelain Crown
Maintaining porcelain crowns is actually quite simple. Much like your original teeth, they require routine brushing with non-abrasive fluoride toothpaste and regular flossing. A follow-up appointment will be scheduled to evaluate the crowns shortly after they're placed, so we can review the work and see how your mouth is reacting to the crowns. Even if you think the crowns are successful, this follow-up appointment is an important part of your future oral health.

Removable Dentures (Full and Partial) Partial Dentures
For many years, partial dentures have been used to replace groups of teeth or a few teeth scattered across the lower or upper jaw. There are a variety of removable partial dentures available to patients and each one comes with its own set of benefits and disadvantages. All partial dentures attach to remaining teeth and have a gum-colored portion meant to blend into the existing gum, with prosthetic teeth to replace the missing teeth.

Full Dentures
Full dentures are similar to partial dentures in that they are prosthetic teeth and gums used to replace missing teeth. The main difference between full and partial dentures is that full dentures are a total replacement system for either upper or lower teeth and, in some cases, both.

Over dentures
Over dentures are a newer alternative to dentures, combining traditional denture technology with modern advancements in dental implants. By establishing two implanted attachments to the lower jaw, an overdenture is able to sit securely in place to instantly increase retention, stability, and comfort. This is especially important in lower-jaw full-denture situations where traditional dentures tend to have less adhesion due to a limited foundation and the tongue muscle dislodging the prosthetic teeth. Another benefit of overdentures compared to traditional dentures is the limited amount of bone loss where the implants are placed, making the procedure more successful in the long run and helping to preserve facial structural integrity.

Implant Supported Dentures
An implant-supported denture is a type of overdenture that is supported by and attached to implants. A regular denture rests on the gums, and is not supported by implants. An implant-supported denture is used when a person doesn't have any teeth in the jaw, but has enough bone in the jaw to support implants. An implant-supported denture has special attachments that snap onto attachments on the implants. Your implant-supported denture will be more stable than a regular denture. You will find it easier to speak and you won't have to worry about the denture becoming loose or falling out of your mouth. You generally will be able to eat foods you could not eat before.

Root Canal Treatment
A root canal is the space within the root of a tooth. Root canals and their associated pulp chamber are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vessels and other cellular entities Endodontic therapy/Root Canal Treatment is a sequence of treatment for the pulp of a tooth which results in the elimination of infection and protection of the decontaminated tooth from future bacter ial invasion. This set of procedures is commonly referred to as a "root canal." Figure Legend - Root canal procedure: unhealthy or injured tooth, drilling and cleaning, filing with endofile, rubber filling and crown

Tooth Coloured Fillings
In the past, teeth were filled with a mixture—or amalgam—of different metals. Today that is changing as more natural-looking and metal-free fillings are becoming the preferred approach. Dentists are using more tooth-like materials (composite resins and porcelains) that are both safe and predictable. The most important feature, for many people, is that they look and react more like natural teeth. Here at Kunal Dental Clinic, Delhi; Dr. S. S. Rana and his team of dedicated dentists specialize in doing these tooth coloured fillings.

The Makeup of a Tooth
The external part of the tooth is called the enamel, which is arguably the hardest natural material produced by animals. It consists of very closely knit calcium crystals and contains no living tissue. Dental porcelains easily and efficiently imitate the enamel part of a tooth.The inner part of a tooth is the dentin, which is more porous and similar to bone. It consists of microscopic tubes of collagen with calcium crystal deposits. Dentin is living and very sensitive. Feeling in the dentin is transmitted through the pulp, or nerve tissues, in the very center of the tooth. To mimic the natural dentin in the teeth, today's dental composite resins are common in non-amalgam fillings. These composites are made of a plastic resin and silica filler.

Bonding
Metallic fillings or amalgams could not bond with the tooth; they merely rested on it and provided a degree of protection. Today, so much more is known about the interface between dentin and enamel and the bond created between these two natural products. This has led science to discover new ways of bonding fillings to teeth to create a stronger, more protected connection and also more comfortable fillings.

Rebuilding Teeth
Restoring teeth—or literally rebuilding them successfully—depends on a good bond between resin materials and both the enamel and dentin. Restorative dentistry recreates a tooth that not only looks natural but responds naturally too, allowing bite stress to pass through the tooth while receiving biting force.

Using Nature as a Guide
In the past, dentistry focused on creating "stronger" teeth by using very durable, rigid materials to replace decayed or damaged teeth. These rigid materials actually contributed to further decay by allowing additional decay and cracking to occur. Today, dentistry uses nature as a guide by constantly looking for materials that more closely mimic teeth in form and function. It is a combination of art and science that takes into account the action of the tooth being restored and its

Internal shape: A tooth, or portion of a tooth, is then recreated using materials that respond as a healthy tooth would.

Dentin Build-Up– This is simply the layering of resin to fill any voids and recreate the original tooth's shape. One problem with metal or amalgam fillings is that they need undercuts to hold them in place. The use of undercutting removes some of the healthy tooth and can lead to weakening and future cracks. Resin dentin build-ups don't have this problem.