Center for Cosmetic & Comprehensive Dentistry
January 27th, 2012
This is a frequent question that many of our TMJ patients come in with. They often come to our office with a “splint” that they cannot speak with and has not helped them as much as they had hoped or they are feeling better but do not want to live with the splint in their mouth.
Lets answer this question by dividing this into two types of TMJ problems:
1) Purely muscular TMJ pain
2) Joint problem TMJ such as popping or degenerative changes in the joint
If patients have purely muscular issues some times a bite adjustment using computer assisted equipment will suffice. If you are dealing with a joint problems, then a second phase of treatment is usually necessary. The second phase can include the of porcelain to build up some teeth, orthodontics, bite adjustments or a combination of these.
It is imperative to understand that TMJ splints should not be arbitrary. The final splint needs to position the teeth, joints, and muscles in the correct place for comfort and long term stabilization. This where neuromuscular dentistry differs from conventional treatment. Additionally, the goal of a neuromuscular appliance is to find the correct position for all three components then find the best way to get the teeth to this stable and comfortable position. You can also find more information about TMJ on WebMD.
In short, no, you do not have to wear a splint the rest of your life.
If you have any questions about TMJ treatment Houston, Texas or TMJ Houston, Texas please do not hesitate to contact our office, Ronald W. Konig DDS, FAGD, LVIF 713-668-2289
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January 21st, 2012
What is the Best Way to Close Spaces Between Teeth?
There are several excellent ways to use cosmetic dentistry to close spaces between teeth. Each case is different. Generally speaking, the three basic ways are:
1) Dental Bonding
2) Porcelain Veneers
3) Orthodontic Treatment (possibly with Invisalign)
| Before |
After |
 |
 |
| Bonding used to close gap between the teeth |
Dental Bonding works very nicely for small spaces and is very conservative. I often use this if the patient likes the color and size of their teeth and only wants the spaces closed. If a patient is not happy with the shade of their teeth and bleaching does not work well, then porcelain veneers may be a better choice. With veneers we can dramatically improve smiles and make beautiful changes. Sometimes orthodontics or braces can be an option, however, not all cases can work with this.
In overview, you are considering some form of cosmetic dentistry to close spaces, these are options that your dentist should discuss with you. The beauty of keeping up with dental technology is that I can offer choices for our patients.
If you have any questions about Cosmetic Dentistry Houston, Dental Bonding Houston, or Veneers Houston, please do not hesitate to contact our office, Ronald W. Konig DDS, FAGD, LVIF 713-668-2289
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January 16th, 2012
The answer is yes, a blow to your jaw cause can exacerbate TMJ problems and also damage the joint. Trauma to the jaw joint such as a strike or in a prolonged or sustained open position (third molar extractions, root canal treatment..etc) can cause TMJ pain. In this type of situation the damage is usually to the ligaments and capsule in the joint. The distension of these ligaments is what often causes the pain.
Ligaments also have unidirectional movement, meaning that they only move in one direction, so you can imagaine how a strike can traumatize this joint in this manner.
Many patients who come in for these issues are looking for something to give them quick relief. Unfortunately, it is like damaging your knee joint or elbow, the pain takes time to heal. The problem is that we need to eat,speak, and swallow.
The use of a temporary mouth appliance is often useful in allowing healing to occur faster along with the use of low frequency TENS (ULFTENS).
Please note every case is different and treated accordingly. In many cases taking a 3D Scan or CBCT scan of the joint is warranted to ascertain that there are no fractures.
If you have questions about TMJ treatment Houston, Texas or TMJ Pain Houston, Texas please call our office, Ronald W. Konig DDS, FAGD, LVIF 713-668-2289
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January 9th, 2012
The size of our jaws decreases with age, according to a Swedish University Study, which explains why why crowding of the front teeth occurs in adults.
This study which started in 1949, when the University took impressions of dental students when in their twentys and repeated at ten and forty years. They found that after 40 years there was less room for the teeth in the jaws. Their findings seem to find that the crowding was primarily on the lower front teeth and that this was from shrinkage of the jaw in length and width. Whereas it is only a few millimeters it is enough to cause changes and crowding.
In my opinion, this shrinkage along with microwear further contributes to the crowding issues. The good news is that cosmetic dentistry has many excellent ways to correct this crowding. This can be done with Invisalign or even porcelain veneers or dental bonding. Some of these cases can be called instant orthodontics.
If you have any questions about Cosmetic Dentistry Houston, Texas or Veneers Houston, Texas please feel free to contact our office, Ronald W. Konig DDS, FAGD, LVIF 713-668-2289
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January 4th, 2012
In the past, to mask out dark colored teeth, it was necessary to prep the teeth at least 1mm to have room to layer porcelains to block out the color with porcelain veneers. With the advent of stronger porcelains that are esthetic, in the hands of skilled cosmetic dentists and lab technicians, this is no longer true.
Discolored and crooked teeth
Veneers to Straighten and Whiten Teeth
The veneers in this case are about 3-4 tenths of a mm thick and are minimal prep veneers. In this case, our patient desired whiter teeth, a straighter smile, and for us to widen the smile. Note that the teeth are not too bulky as sometimes seen with Lumineers. We also artistically recontoured the spaces between the teeth to the patients desires.
In our office, cosmetic dentistry is not only about nice smiles but also about creating smiles for each individual based on what they desire. If you have any questions regarding Cosmetic Dentistry Houston, Texas or Porcelain Veneers Houston, Texas please feel free to call our office, Ronald W. Konig DDS,FAGD, LVIF 713-668-2289
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December 21st, 2011
There are many cases where porcelain veneers can be used for functional and esthetic purposes. In this case, the veneers are used to change the appearance of teeth that are in the wrong place in the smile. There are missing lateral incisors in the photo below and the cuspids were moved into the space of the lateral incisors giving the patient an unattractive smile. The cuspids are large teeth with curves whereas the lateral incisors are smaller teeth with a flat surface.
Missing lateral incisors: cuspids in their place
Porcelain Veneers used for Smilemaker
This case and veneers were designed to recreate proper proportions of the teeth to each other and create the illusions that there were no missing teeth. The gums were also laser recontoured in order to be able to properly place veneers in different positions. Note the drastic improvment in tooth proportion and how it appears that this gentleman has all his teeth.
This case is one of the many ways that we use veneers to artistically and functionally provide smilemakeovers. The use of veneers is much more conservative than using porcelain crowns. Specialized training, such as advanced LVI Global, has enabled us to continually improve complex cases.
If you have any questions about Cosmetic Dentistry Houston, Texas or Porcelain Veneers Houston,Texas please feel free to contact our office, Ronald W. Konig DDS, FAGD, LVIF 713-668-2289
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December 14th, 2011
Spaced, Crooked, and Discolored TeethPrepless Veneers and Laser Gumlift
Prepless Veneers
I wanted to share this case as it warrants attention to the use of porcelain veneers on young adults. Prepless veneers can produce nice esthetic results in the correct cases and are not indicated for all situations. They work best on small teeth or teeth that are tilted inwards and sometimes to close spaces.
One of the most common complaints that I hear and see about prepless veneers is that they are too bulky and look like chiclets. This occurs when they are used poorly selected cases and when there is not enough room to layer the porcelain shades. Some cases are better treated as minimal prep cases.
In this particular case, a laser gumlift was completed to even out the smileline. This is a painless procedure,however, is essential to the success of the case. These are also Emax ceramic which is has better esthetic properties than Lumineers. The teeth were also too small, which was another indication for prepless veneers. As you can see in the photos, a beautiful smile was created.
If you have any questions regarding Cosmetic Dentistry Houston, Texas or Porcelain Veneers Houston, Texas pleas feel free to call our office, Ronald W. Konig DDS, FAGD, LVIF 713-668-2289
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December 9th, 2011
One question that always arises regarding teeth that show in the smile is “How will a dental implant look with a crown on it?”
It is an excellent question! For dental implants to look cosmetically pleasing treatment planning from the extraction to implant placement and custom abutment design/crown needs to be considered beforehand. The photos show what is possible:
Custom Zirconium Abutment for a Dental ImplantPorcelain crown partially in place on dental implant
Porcelain Crown in Place
There are many different types and sizes of dental implants. In most esthetic cases the desired type would be bone level implant. This is placed level with the bone and not the gum tissue. The surgeon needs to try and preserve the architecture of the gums as well. A custom abutment (the piece that inserts into the implant) should be designed to mimic the natural tooth size and shape. Additionally, the use of a zirconium abutment eliminates the use of unsightly dark metals showing through the gums. Finally, a properly designed porcelain crown can be fabricated to fit over the zirconium abutment.
The photos show how this technique can provide beautiful results.
If you have any questions about Cosmetic Dentistry Houston or Dental Implants Houston , please call our office, Ronald W. Konig DDS, FAGD, LVIF 713-668-2289
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December 6th, 2011
Porcelain Veneers can be used for more than just improving ones smile. We have used new technologies to help many of our patients who have TMJ problems or broken teeth by using porcelain veneers as opposed to full porcelain crowns.
Broken, Worn, Crooked Teeth on TMJ Pain Patient
Porcelain Veneers and Crowns to Create Beautiful and Comfortable Smile
The advantage to our patients is that this allows us to be much more conservative than we were able to do in the past. The high tech porcelains that we are now using, such as Emax, not only can be fabricated to as thin as .3mm but also allow for exceptional estethics.
The case above shows a TMJ patient whose jaw and bite were corrected and then restored with a combination of porcelain crowns and porcelain veneers. Whereas each case is different, keeping up with technological changes and advancements allows us to continually improve the care for our patients.
If you have any questions about TMJ treatment Houston, Texas , Veneers Houston, Texas or Cosmetic Dentistry Houston, Texas please feel welcome to call our office, Ronald W. Konig DDS, FAGD, LVIF 713-668-2289
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November 30th, 2011
It is truly amazing how many patients we see for TMJ who have been to ENT’s, neurologists, and cardiologists as well. The reasons vary from earaches, dizziness, migraines, and severe neck pain. It is prudent to rule out medical issues when these symptoms are present. However, many of these patients are placed on medicine as no underlying cause can be found and still do not get results. These are the patients who wind up in our office.
TMJ is just now being slightly more diagnosed in the medical field which is evident by the increased number of referrals that our office is receiving from the physicians. By the same token, it is the responsibility of those treating TMJ or TMD to do a thorough evaluation and refer to MD’s when other issues may be present.
There are so many ways that TMJ mimics other medical problems and is beyond the scope of this blog to discuss. I do hope that this blog opens an awareness to those who are suffering from facial pain, migraines, headaches, and even ringing of the ears to seek help if needed.
If you have any questions about TMJ treatment or TMJ pain Houston, Texas please feel free to call our office, Ronald W. Konig DDS, FAGD, LVIF 713-668-2289
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