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JORDAN PYSZ / iFoundMyDoctor.com
Dawn has every reason to smile after having an infected molar restored. Through the placement of a dental implant, she has regained full and normal function with that tooth.
Among the thousands of river and ocean cruises canceled during the first several months of the COVID-19 pandemic was the trip that Dawn Bertler and her husband planned to take to St. Thomas and St. Martin in June 2020.
Four years later, that Caribbean voyage is finally back on.
“We’re scheduled to go in late July, and I think it will have been worth the wait because we’ll be sailing on Royal Caribbean’s new ship, Icon of the Seas,” Dawn relates. “We’re really excited because my husband and I really love cruising.
“We think it’s one of the most family-friendly vacations you can take, and we really love to do vacations with our kids. There’s 12 of us now, including grandchildren, and we’re all going on the cruise, so it should be a lot of fun.”
Dawn, 60, and her husband are due for some fun. Their home and business were damaged by Hurricane Ian in 2022, and while their audio/video installation company was running again days after the storm, the house remains under repair.
“All these months later, we’re still fighting with the insurance company over the house, so we’re renting a home, but we’re not as unfortunate as a lot of people,’’ says Dawn, who found herself in a different type of battle soon after the hurricane.
The foe was a tooth, a lower left molar in which an abscess formed in 2005. While clearing the abscess, Dawn’s dentist, Joseph Farag, DMD, of Port Charlotte Dental Care, performed a root canal. Nearly 20 years later, Dr. Farag found another problem.
“The root canal held up well for almost 20 years, but all of a sudden last summer, we found another infection brewing in there,” Dr. Farag reports. “I’m not sure how that happened after sitting quietly for nearly 20 years, but it does happen.
“The body’s immune system goes up and down and, in this case, the infection came back. Dawn wasn’t feeling any pain, but we noticed the infection on an x-ray and determined that the best way to address it was to remove the tooth and replace it with a dental implant.”
Dental implants are root-shaped, screw-like bodies that are surgically placed into the jawbone. New bone naturally grows around the implant to form the foundation for an abutment and replacement teeth.
The replacement teeth can be a crown cemented or screwed onto the abutment, a partial bridge affixed to one or more implants, a full lower denture, or a full upper denture that is fastened to a series of implants and does not include a plate that covers the palate.
Prior to receiving an implant, some patients require a bone graft designed to enhance the volume of alveolar bone, which surrounds and supports the tooth. Performed using autologous bone or a synthetic substitute, the graft gives the bone added strength to support an implant.
Bone grafts are not always necessary, but for patients who have been missing teeth for many years, they sometimes are necessary because bone deteriorates when there is no pressure from chewing to stimulate natural bone regeneration.
COURTESY GRAPHIC
Illustration, detailing bone grafting steps and structure of dental implant.
X-Guide Marks Spot
Though Dawn kept her bothersome tooth, the infection had already eaten away enough of the jawbone to require grafting, which Dr. Farag performed during the same visit as the extraction.
Following a bone graft, it takes a few months for new bone to grow to a point where it can support an implant. Dr. Farag waited three months before seating the implant, which was completed with the help of a digital 3D platform called X-Guide®.
“The X-Guide system is a tremendous tool that allows us to do all the planning for a dental implant virtually on a computer,” Dr Farag states. “It also helps us determine the precise size of the implant that’s needed and how to place it.
“It gives us all the angles that we need for proper alignment of the implant and even shows us how the implant will line up with the opposing jawbone and teeth that we’re keeping. For obvious reasons, it’s an invaluable tool.”
Once the implant is placed, patients typically need to wait about three months before receiving their replacement teeth.
Dawn’s new crown was made in Dr. Farag’s office using a technology known as CEREC®, which stands for Chairside Economical Restoration of Esthetic Ceramics.
CEREC produces digital dental impressions and ceramic restorations such as crowns, veneers, inlays and onlays in minutes using computer-aided design (CAD) and computer-aided manufacturing (CAM).
Without CEREC, restorations typically require two dental visits, once for preparation of the tooth and fitting of a temporary crown and again for the fitting of a permanent crown.
CEREC eliminates the need for a second visit by allowing for the production of a permanent crown in a fraction of the time required by an outside lab. It also allows for superior results.
The reason is that CEREC uses biocompatible and natural-looking ceramic materials, including lithium disilicate and zirconia.
In addition, the crowns are monolithic, meaning they are formed from a single block of material. That creates several advantages over standard crowns, which are typically made of porcelain fused to metal. For starters, monolithic crowns are stronger and more aesthetically pleasing because they have no metal collar.
“These new materials also mimic the enamel translucency of natural teeth because they allow light to transfer in and out of the tooth,” Dr. Farag notes. “Patients like that because it looks more like a real tooth, even up close.
“With the old porcelain-fused-to-metal crowns, your teeth might look good from far away. But if you get close, you start to notice that there’s something different about them. They don’t look as real or as good.
“These new crowns are milled through a dental milling unit in about 20 minutes. The technology also allows us to dial in the shade match of the teeth, so the crown has the same color as the rest of the patient’s teeth.”
“A Great Job”
Dawn says the outcome was worth the wait.
“It was a tremendous experience,” she enthuses. “Dr. Farag is very up to date with all the latest technology, so I experienced only minimal discomfort throughout the entire process. It was one of the best things I’ve ever done for myself.
-Dawn
“From beginning to end, Dr. Farag did a great job of explaining everything that was going to happen throughout the process, and now I have completely normal function with that tooth again and I am very pleased with the outcome.
“As for Dr. Farag, well, I just love him. He’s the best, and I’m so appreciative of him and his staff. They’re amazing people, and unless he closes his practice, Dr. Farag will always be my dentist.”
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