From a Flipper to a New Front Tooth

One of the most frustrating things for a patient (and challenging for us as dentists) is dealing with the loss of a front tooth.

In many of those cases, our patients have to wear the dreaded flipper for several months or more. No one likes a flipper – they can break easily, you can’t chew hard foods, they don’t look natural, and you can easily lose it.

Below is our patient Kim whom we helped to ditch her flipper:

before and after photo front tooth implant

Due to a fractured tooth root and an infection, she lost her left front tooth. After months with a flipper, this is what we achieved! Photos and dentistry Dr. Nicholas Calcaterra.

Our patient had to wear her flipper for several months while waiting for the infection to resolve and for the dental implant to become stable. On more than one occasion, she misplaced it, and then had to walk around without a front tooth!

A Look at Kim’s Flipper

front tooth dental flipper for missing tooth.

Kim’s flipper – along with the tooth model from which it was made.

This is Kim’s flipper. You can see it is a single tooth attached to denture acrylic. It is fragile and can break easily. She did NOT like wearing it.

Ditching the Flipper with Dental Implants

So how did we help Kim? As we mentioned before, we saved her smile with a dental implant. See these photos for a closeup:

before/after dental implant photo

Restoring a missing a front tooth on Kim with a dental implant and crown. Photos and dentistry Dr. Nicholas Calcaterra.

As you can see above, we gave Kim her smile back using a dental implant. She is now able to talk, smile, and chew normally.

It took significant time and expertise to match the new crown to her existing smile. We think the results speak for themselves.

And what, you may ask, did Kim do with her flipper after she left our office with her new tooth? We don’t know… but the rumor on the street is that somehow a hammer was involved…

Are you missing a front tooth? Walking around with a flipper but hate it? Call us at (203) 799 -2929 or see this page if you want to come in to see how we can help.

Screw-Retained versus Cemented Implant Crowns

In our office, we restore tons of dental implants. So naturally, we keep abreast of the latest techniques in creating teeth that look, feel, and function like real ones.

And because we like to post so much implant information and photos on this site, we get lots of patients who ask us great questions. Recently, we’ve had a lot of inquiries on cemented versus screw-retained crowns. So we decided to do a post on it!

Screw Retained Implant Crown Photos

Below is a photo of one of many cases we’ve completed recently:

High quality photos of screw retained implant crowns

Photos of screw retained implant crowns. She went from bare implants to two new teeth in 45 minutes. Dentistry and photos Dr. Nicholas Calcaterra.

In the above case, you can see the screw heads peeking through the crowns in the second photo. We then placed a small filling over each screw head. She received two teeth in less than hour. By using this design, we did not need to use cement. But why did we choose screw-retained crowns?

Reasons for Screw-Retained Implant Crowns

dental implant no cement next to it

Excess cement around this implant can lead to failure.

In the past, many dental implant crowns were cemented on. This can lead to two potential issues:

  1. Retrievability: when a crown is cemented on, it cannot be removed without destroying it. So if there is ever an issue down the road, there is no easy way to address it without cutting off the crown.
  2. Implant Failures: research is showing that excess cement remaining on an implant after cementation can lead to implant failure. It can be difficult to find and locate all the excess cement that might remain.

When a crown is held on by a screw, it can be removed within 5 minutes if there is ever a problem. And since there is no cement used, there is no potential for failure due to excess cement.

So why not Use Screw-Retained Crowns all the Time?

That’s a great question! In many cases, the screw hole can affect the esthetics. This usually is not an issue for back teeth like molars. But when it comes to a front tooth crown, we have to take every single detail into account.

front tooth dental implant has to be cemented

In restoring this front tooth dental implant, we had to use cement. Photo and dentistry Dr. Nicholas Calcaterra.

In the above case, the screw hole would have affected the esthetics. And given that it is a front tooth – we want and need perfection. So in these types of cases we typically use cemented-on crowns.

Are you interested in implants? Do you have an implant but not a crown yet? Call us at (203) 799 – 2929 if you would like to know your options.

Reference on the the dangers of excess cement: The positive relationship between excess cement and perio-implant disease: A prospective clinical endoscopic study. Wilson TG Jr., Journal of Periodontology, 2009  80(9) : 1388 – 92).

Why Teeth with Root Canals Often Need Crowns

When we do a root canal on a back tooth, we nearly always recommend a crown. Many of our patients will naturally ask us why? Frequently, the last thing a patient wants to do after they have recently had a root canal is to then sit in the chair for a crown! We certainly wouldn’t want to either. So why?

A picture is worth a thousand words, and we think this photo of one of our patients tells a descriptive story:

broken or cracked or split tooth high quality photo

This premolar on one of our patients literally split in two! After the root canal, we had recommended a crown, but he declined. The patient lost the tooth and needed an implant. Photo and subsequent dentistry by Dr. Nicholas Calcaterra.

As described in the photo above, this tooth cracked into two pieces with a fracture going deep beneath the gum tissue. If he had a crown, this would not have occured. He lost the tooth and needed a dental implant.

Brittleness + Great Forces = Tooth Failure

When a tooth has had a root canal, it becomes brittle. It loses the ability to flex slightly under loads. In addition, there is less natural tooth structure remaining, typically because of a past history of dental decay. When you put that all together, you have a very weak tooth.

The jaw muscles, specifically the masseter, are generally considered to be the strongest muscles in the human body. In one test, the masseter was able to generate a force of 975 pounds!

When you apply a force of several hundred pounds to a weak and brittle tooth, the following will likely happen:

Fractured tooth high quality photo and picture

Fractured lower left molar. In this case, the tooth could be saved, but not without heroic efforts. Photo and subsequent dentistry by Dr. Nicholas Calcaterra

This lower molar fractured after root canal treatment. In this case, the tooth was able to be saved by doing a special procedure called crown lengthening and then placing a crown.

How Crowns Protect Teeth

dental crown photo showing a reflection in the mirror

This crown will slide over the tooth, protecting it.

A dental crown, often called a “cap”, is a custom fabricated combination of either porcelain or metal that covers the entire surface of the tooth above the gumline. When you chew, the powerful forces that hit the crown are then directed down the long axis of the tooth.

In addition, the chewing forces cannot exert a splitting force onto the tooth, because the entire tooth is covered. As a result, catastrophic fractures like the ones seen above are avoided.

The photo to the right shows a crown for one of our patients. It will fit completely over the tooth. Not only will it prevent fractures but it will make the tooth look much more natural and esthetic.

Below are before and after photos of we preserved two badly broken down teeth with crowns:

Before and After photos of all ceramic and porcelain dental crowns

The above teeth had large silver fillings and both fractured. We were able to protect them with beautiful all ceramic crowns! Photos and dentistry by Dr. Nicholas Calcaterra

We hope that the narrative and the photos show you that teeth can break. And when they do break, the results can be catastrophic! So if/when you need a root canals on a back tooth, you should strongly consider getting a crown if your dentist recommends it.

A Bridge Over Troubled Water

Standard tooth model with perfect teeth

Very few of our patients have teeth like hers!

Many of our patients have perfect teeth without a single filling. Many others do not.

While we are tempted to only post photos of our patients with beautiful teeth, that would not represent what many people face today. So why do that? We’re out to help our patients achieve the smile and confidence they want, not create fake, airbrushed Vanity Fair models.

Our patient John was the furthest thing from a smiling model on the cover of a magazine. He came to us because he was impressed with our ability to help all types of patients. Let’s take a look:

Lower dental bridge with canines and incisors before and after photos

John was finally able to smile again with a new bridge! Photos and dentistry by Dr. Nicholas Calcaterra.

John had a bad experience at the Aspen Dental in Orange, CT. As you look at his photos, you can see he has multiple missing teeth, large silver colored fillings, and generalized stain. His biggest concern was the gap between his lower front teeth. He was unable to smile and could no longer eat the foods he used to enjoy. We listened.

We presented John with all his options. As a current smoker, dental implants would have been less predictable. We ultimately decided upon a dental bridge to replace this missing lower teeth. Given his past dental problems, this was going to be a bridge over troubled waters.

On cementation of the bridge, John was a changed man. He was able to smile again and enjoy all of his favorite foods. John’s experience was a testament to the fact that anyone can benefit from modern, twenty-first century dentistry.

The Best Dental Bridge Photo Ever!

cool dental bridge photo showing teeth and pontics

John’s bridge before we permanently cemented it into this mouth. Photo Dr. Nicholas Calcaterra.

Patients often ask us what a bridge actually looks like. Well there it is! For John, given his past history of dental problems, we used a durable style that has a thin layer of metal underneath. But no one can see the metal.

John’s experience was so positive that we are happy to say that there are no more troubled waters. Just a happy patient comfortable with his smile.

Do you have a less than ideal smile? We won’t judge you – we’ll listen to you and work with you to identify the best solution. Contact us anytime.