golden proportion...

here the patient has come to fix badly discoloured teeth

full-ceramic crowns are fixed only on 4 front teeth.
and motivated to come for regular check up ..but came on fifth year .........................because of her baby's teeth problems.
all photographs are placed from pre post treatment and follow up on fifth year.

she was supposed to come every year for oral prophylaxis...but some time people are too busy ...dont take preventive measures ... still she keep very good oral hygiene ... so no gum issues spotted.




before treatment 2009

 

                                                                                            

after treatment 2009

5th year [20/01/2014]

'GOLDEN PROPORTION'

photos are taken before oral prophylaxis...to show the gum margins ...

thank you .

Dr.Shoukath Ali.

Sharjah.UAE.

I BRUSH 3 TIMES still teeth DECAY !!!

 Doctor I brush 3 times still my teeth are decayed!

Why is it?
What can I do?

Generally we- dentist ask a question back – when did you start brushing ?!



Brushing habits will be developed seriously only after the age of 10
(unless until your parents are very strict about brushing habits)



Some are blessed with strongly mineralized teeth ,
while majority will be having teeth with deep pits where yummy chocolates can be stored more than 24 hours.
All the bacteria will enjoy it and excrete some form of acids .

these acids dissolve tooth making narrow pit into a cavity.



Depends on your mouth atmosphere including nature of food ,your immunity and intra oral temperature, saliva  – this will increase in to a big hole from few months to few years .



Look at the mirror ,the first big biting tooth ( first molar) inside your mouth-
 has erupted at the age of 6 !



if you have little one at the age of 6 -7 years ,do open their mouth and  take a look, you will be surprised to see how much food –sticky food and plaque are there on the surface.



This is the time we call mixed dentition period-

And this is the time you will be having milk teeth and permanent teeth together, then some will be shedding some will be erupting  and that continuous 10 – 12+ years.
And this is the time we should give more attention to developing decays.



Ok, that’s history
What is to be done now ?– can I never be out of dental clinic in my life ?



Dear friend,

Its not the dentist alone solve the problem,
we do our part and trusting your co –operation we send you home ,

like you take your car to service – maintenance and check-ups…

find out your comfortable dentist and do the necessary treatments and regular follow-ups….you will not be left at the middle of the road with breakdown car if your where following specifications of maintenance .



Tale piece; Still no body is accident proof - 
Lets do our job and hope for the best !!


Thank you
dentist24x7@gmail.com  
dentist24x7.blogspot.com

 

Dr.Shoukath Ali.
Dental Surgeon, Sharjah- UAE.

WHO IS THE REAL SMILE DESIGNER YOU OR YOUR TECHNICIAN? [ a topic for dentists]

Let us give all the credit to our lab - technicians and take all the responsibility our self.

Or the other way We DENTISTS are the ACTUAL SMILE DESIGNERS – and no way we can blame the technician –

or our loyal customers will not get convinced the errors of the third person since they are only rely on us .

Here we should know what is EXPECTED and what is ESTABLISHED.

From early diagnostic wax up …

to temporary crown and bridges especially if a plan for changing Occlusal Vertical Dimension [increased OVD in this patient]…..

unfinished /un glazed final work….

chair side modification of the work if it is not as we EXPECTED…..[this is the most important part –since it can fluctuate our Blood Pressure !]

and finally temporisation of the prosthesis- are few of them…

it was a challenging case due to lack of time – and no room for any errors – big responsibility-

even after proper planning   so many surprises due to the irresponsible laboratory persons -and how this has managed will be briefing here .

pre treatment photographs

temporary -acrylic crowns +crown & bridges       

[ in case of altering Occlusal Vertical Dimension...this is very important- not concentrating on the appearance since it may have to change many times -but no compromise in function ]...

keeping anterior edge to edge bite -posterior bite is raised . 

 Zirconium for anteriors and metal trial for posteriors- 

after all guidelines this is what came from  the lab! 

[ i usually ask for unglazed -un finished -BISQUE TRIAL]

each steps were discussed -photos given and properly guided -still surprises can happen .

that is the reason for this post.

this stage: it  is better not to show to the patient- and they should not feel we are correcting some mistakes that has happen....this is important because they should not  lose confidence !

               after correction of the anteriors - patient and her daughter were called for their                       VIEWS & OPINION.

[even though both of them like the smile - my judgement like most of you think was to reduce still 0.5 mm vertical hight and shape alteration according to that height]

this time it looks better - but still needed bit improvement-

to reach to golden proportion ! 

all golden proportion achieved KEEPING  the EDGE TO EDGE BITE at anteriors [ not to increase vertical crown height ] and same time OVD is reached to the EXPECTED level. 

finally I could finish it only 4 days back

[ my actual  plan for finishing was 2 weeks before her flight.ie;last month.]

– and today she came to the clinic with husband and daughter to say thanks….

I too believe the END IS WHAT THAT COUNTS….

And she flew to Canada tonight with happy smiling face …..

thank you 

Dr.Shoukath Ali.

Sharjah.UAE.

SHADE SELECTION - IN DENTISTRY ! [ A topic for Dentists ]

3 dimensions of colour  HUE, CHROMA& VALUE                                                [ + fourth dimension CHARECTERISATION ]

 

HUE  : - distinguish- different colours !

 when coming to dentistry it is represented A,B,C or D

[ great Indian dentist of aesthetic dentistry Dr.Sandesh mayekar has told  –we all must learn  this ‘ABCD ‘ like a young  learn to distinguish  BLUE from GREEN  & RED-]
So  to the finish line – now onwards we start to practice first lesson – when looking at teeth –without shade guides we will learn to say A or B/C/D- and that is HUE !

 CHROMA: when my wife prepare tea/coffee – first, I must take little water in a transparent glass pour milk to it drop by drop

 When first drop falls……. water turn white – [low chroma ] every drop addition increase ‘SATURATION’ of milk and increase CHROMA.[high chroma= highly saturated].( eg; gingival third  of teeth crown- high chroma & opacity )[ remember it is from dentin ]

VALUE : ‘brightness’-is the most important colour variable in dental shade selection &

the most  difficult thing to learn and use !

Forget about definition , I will tell you a secret

[ since I can’t teach this definition to my technician- I tell him just open photo I sent  by mail– and make it BLACK & WHITE ! – that is the easy way to SEE the VALUE  ]( high value middle third & low value incisal third where more translucency  present.)

Yes ! I bet u can’t forget it… it is lightness or darkness of HUE !

high value= brighter= more white -value 10 =white

low value =darker =more gray - value 0=black ,

 

To increase value

1.use lighter porcelain/ composite  [low chroma ]
2.increse reflectivity of surface.

 Conclusion:  

select HUE first, select CHROMA for that chosen hue –then verify VALUE
[vita 3D master is just opposite if anyone use it please read instruction manual ]

 

TIPS that HELPED me .

1. Learn HUE –ABCD (70% A, 20% D only  10% B or C as per science –but ,sorry I don’t trust these percentages ! )
2. Take photo graphs ..and make it B&W –look value difference on different parts of teeth.(tell lab to do the same)
3. Tell lab you want glossy or mat finish- depending upon case.
4. Common question: which shade guide to use .

Easy answer is which your lab use!(or make them use the one you prefer).

Characterization: someone asked about this  , it is more interesting and helpful tip which will make us ‘special dentist’- I love to write a lot about it – please give me some time because I am preparing for my implant test.

 

Now we have even the fifth dimension

They put like this
[1. Chromaticity-ie;hue and chroma-
2.value;luminosity
3.intensity
4.opalescence
5 th dimension Characterisation]

--Other optical property like translucency, fluorescence , contrast and glare – I think everyone are familiar  , so not going deep to that area

Thank you all for patient reading up to here- I tried to put maximum effort to present this most confusing part in simple way – and if anyone can contribute to this I think it will be a great help to our colleagues.

Dr.Shoukath Ali. Rolla-Sharjah-UAE.

SHADE SELECTION - CHARECTERISATION- [ A TOPIC FOR DENTIST]

Characterisation

{ Fourth Dimension of colour selection- CHARECTERISATION }

Here what I am putting together is my view points – if someone see this different from the updated –proven science of dentistry ,you are welcome and I will be thank full for correction.

 

 

When coming to characterisation –mamelons are the main area I concentrate more – that is not on the surface enamel but deep under the dentin- if you realize this –no one can realize your art work !

5 points we have to keep in mind when we do characterisation are

1.mamelons
2.white BANDS [horizontal on the labial surface and vertical on the inter proximal.]
3.margins [incisal MARGINS presents with a white line]
4.stains [one or more small amber /brown STAIN.]
5.cracks.[ either white /brown -confined to depth of enamel.]

 First dentin characterisation followed by enamel –white spots craze lines etc. comes here.

                                Contouring is the next step
                    Glazing and finishing is the last but one step-

 if you reach up to here  perfectly the last step that is the FEE COLLECTION will go smoothly-

Do not look into the JUST opposing tooth and try to reproduce a mirror image –[ if you are –doing an aesthetic dental treatment ! ]

 – on the other hand - in aesthetic dentistry there are no so called ‘symmetry’, but you have to consider opposing adjacent teeth + gum and nature of lip to tone of skin…. and when you look further pupil of the eye….. And colour of hair too come to the scene ]

 Thank you all.

                                 Dr. Shoukath Ali. Sharjah.UAE.

crown size and lengthening - FERRULE [ A TOPIC FOR DENTISTS]

an image -hope that will help to solve the problems - about the ferrule !

since there are lots of confusion in this subject - I thought to put the topic ferrule by a simple diagram .

thank you all

Published with Blogger-droid v2.0.6

GUM PROBLEMS SHAKE & SHED ALL YOUR TEETH !!!

GUM PROBLEMS SHAKE & SHED ALL YOUR TEETH !!!

bleeding gums
Its an Easily open pathway for hundreds and millions of bacteria and other micro organisms to
enter your blood stream .

If your heart is perfect every time when this polluted blood passes through heart, it may tolerate –
but what about if it is old / tired &  ill or fixed with a prosthetic heart valve ,
continuous Contaminated blood flow may weaken and damage it and worsen  the situation.


Advanced studies are showing low birth weight babies in pregnancy has some kind of relationship with gum problems ,
in stroke and heart attack  occurance of  very high number or count of same type of the micro organisms present in gum diseasesare also pointing relationship of these micro organisms and dangerous high risk conditions .


Oral health is gateway to general health

Tips: Regular dental visit –clean your teeth (oral prophylaxis) once in six months to once  in  a year - solve the problem !
( diabetic patients and those who already have gum problems may need to increase the dental visit -as per your dentists advice)

GUM DISEASE & BAD MOUTH -EASY Rx !!!

gum problems
Normally mild and moderate gum diseases do not give any severe form of pain .
some cases patients present with bad smell or may be bleeding gums when brushing.
But majority of the extractions done around the world are caused by gum diseases.(Especially among diabetics)
Here you can see a young boy 17 years from Sharjah ,UAE
has came to me to get treatment for his 9 years old sister for tooth ache.

During his sisters root canal treatment I could clarify his doubts about bad smell from his mouth and swollen bleeding gum conditions which is always bothering him (but since it was painless he was not sure dental treatment is required or not )

here you can see the change with improved oral hygiene and oral health .

if this patient was left untreated what would have been the consequences.

( he would have reached may be in my clinic or some where else in few years with loose / mobile teeth, with poor prognosis-leading to multiple teeth extactions- that is how we treat periodontal diseases with grade III mobility )

now he has to undergo normal oral prophylaxis once in a year and regular followup every 6 months .

Dr.SHOUKATH ALI

BUDGET-SMILE CREATION !!!

Mr.x from Bangladesh was rushing to my office-coz he is very busy don’t have time to wait till I finish all pre scheduled appointments.

He is hardly 15 days away from his annual vacation- besides regular purchases this vacation is very special and important in his life as his marriage is about to happen during this chutty days.

You may be wondering why I am going around the bush.

Let me come to it-

Interesting part is he don’t has time ( TIME! ) and  he has no enough $ /- for his problems to be solved !

As many of you (my colleagues) might have faced similar situation one or another occasion –in your dental practice, I too was bit confused.

I felt from my deep heart for this man – I called few of my appointment patients to borrow their scheduled time and started this case- needless to say within 13 days ALHAMDU LILLAH finished 3 root canals few restorations and oral prophylaxis here is the case !

thank u

special note : this case could have been treated  by diffrent  methods _
and I would have been able to give you a Hollywood smile photoghraphs -
if i have given enough time and  if it was affordable to some one like a BANGLADESHI  small to medium business man !!

Dr.SHOUKATH ALI