Dr. Konig's Blog

Center for Cosmetic & Comprehensive Dentistry

Archive for August, 2010

Dental Implant Overdentures and Cosmetic Dentistry

Monday, August 30th, 2010

Gum Disease and Unesthetic Smileline

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All the Snoring Devices Available

Thursday, August 26th, 2010

It seems whereever one turns today there will be some advertisement on the internet, television, or mail regarding the cure all for snoring.  There is even an Apple App  called the “Snore Keeper” to let you know how many times you snore at night.

The real question becomes are these patients snoring or do they have sleep apnea.  These advertisements are very misleading from a health perspective as there is a huge difference between the two. Simple snoring means that there is no breathing cessation.  Most often there is a correlation between snoring and sleep apnea. 

Invidividuals who purchase anti-snoring devices in the drugstore or on television ads, have no way to know if they still have sleep apnea. People actually die from sleep apnea. The same token applies for dentists who make snoring devices and are not testing for sleep apnea prior to treating patients.  This is analagous to giving a patient blood pressure medication without taking their blood pressure.

Snoring and sleep apnea are serious health problems and should be under medical supervision.  In our office, we provide amubulatory monitors for patients to sleep with at home, if these reveal signs of sleep apnea, they are referred to sleep labs for a complete PSG (sleep study).  If they are candidates for a Houston dental sleep appliance, after fabrication, patients are given the ambulatory monitors at 1 week, 1 month, and 3 months to ascertain that the sleep apnea is controlled.  A final PSG in the sleep lab is usually a good idea.  

If you have any questions about houston snoring or houston dental sleep apnea, please feel free to contact our office, Ronald W. Konig DDS, FAGD, LVIF, 713-668-2289

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The Various TMJ and Bite Philosophies

Thursday, August 26th, 2010

There are many individuals and organizations that write about TMJ treatment and their philospophies in dental journals.  Many adhere to what they have taught for years and not accepting new findings and technology.  In essence, there are many brilliant pioneers are wonderful men who have devoted a lifetime to dentistry and helping patients with TMJ pain. 

Dr. Peter Dawson “romances” the mandible, others recapture the disc, others such as Dr. Robert Jankelson developed neuromuscular techniques to set the jaw where the muscles  are most comfortable.  I strongly encourage those treating TMJ to be knowledgable in all philosophies.

What is the right philosophy? Personally, through the years,  I have studied both schools of thought and have found that Neuromuscular Dentistry has been much more predictable and has allowed me to help patients with TMJ pain that I could not help before.  This is not intended to discredit Dawson or other Institutions. In the past, their philosphies did help me treat some patients, however, not even close to the extent that Houston Neuromuscular Dentistry has provided.   The technology and science behind neuromuscular dentistry has provided new insights and techniques to help with many of the complex TMJ cases.Dr. Jankelson’s neuromuscular protocol is based on science and has continued to evolve through the years as new technology was developed.

Having an open mind and being able to accept change as science evolves and provides new avenues to help patients, is essential to continuing to provide the best care in dentistry and medicine as well. 

If you have any questions about Houston TMJ pain, or Houston Sleep Apnea Dentistry, please do not hesitate to contact our office, Ronald W. Konig DDS, FAGD, LVIF, 713-668-2289

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Dental Implants and Missing Teeth

Wednesday, August 25th, 2010

Implant dentistry can be one of the most predictable ways to replace missing teeth.  Patients are fortunate that there is more than one option when it comes to implant cases.  Even with single tooth replacement, the type of dental implant used and the position the implant is placed affects the outcome and final result. This is even more critical in the anterior or smile area.

Implant dentistry and implant cosmetic dentistry is not a commodity.  Prior to beginning any implant, careful planning and analysis needs to be completed. This most often includes the use of 3D Cone and Beam films.  These films are very easy to take and allow us to see where the bone is and to be able to place the implant where necessary. One implant system cannot fill the needs for all patients.

A simple  example of common implant problem that I see is when a single molar tooth has been removed and implant placed.  The restored tooth often looks short and packs food around the implant.  This situation can be avoided by using bone level implants and the use of computer generated custom abutments.  In other words, using custom made implant parts as opposed to stock parts (which are basically like one size fits all) is a huge benefit for the patient.  Interestingly, there is not much difference in the fees for these services.

For more complex cases such as the use of All-on-4 implant dentures,  the cosmetic dentistry aspect of this needs to be planned, the facial profile considered, and the position of the implant placement carefully planned on the 3D scans.  It is critical to know where the prosthesis will be placed so that the dental implants will be under it and not coming out the sides. In our office, we also include our lab technician in the planning to ensure that our plans allow him to complete the prosthesis in the manner desired.  Failure to coordinate all aspects of this treatment will lead to complications, that sadly, most of the time can be avoided.

All in all, dental implants can be successfully and predictably placed and restored when a “blueprint” is designed and implemented prior to actual treatment.

If you have any questions about Houston Dental Implants or Houston Cosmetic Dentistry, please feel free to call our office as we welcome your calls.  Ronald W. Konig DDS, FAGD, LVIF  713-668-2289

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TMJ Pain can be Multifactorial

Tuesday, August 24th, 2010

Most Temporomandibular (TMJ) disorder patients present with more than one symptom.  Some of the more common symptoms are headaches, clicking popping, neck and shoulder pain, ear congestion, and facial pain.  Many articles and research studies have been conducted studying the various TMJ problems and how it affects these patients.

What seems to be lacking is treatment not looking at the whole picture, by this I mean the whole body. Posture is a critical component of this picture.  We have treated many patients who have poor posture due to their TMJ problems.  TMJ pain and/TMJ disorders can cause forward head posture .  Not only this, many of these same patients will also exhibit shoulder drop. There are other factors such as having functional or true short leg that will also add to the complexity of TMJ treatment.

When we treat Houston TMJ patients, the examination also includes a postural analysis. Additionally, the computers  (neuromuscular dentistry) we use to gather information about each patients TMJ problems allow us to assess how much of the problem includes the postural components.  When there is a postural component, we often work closely with a physical therapist so that we can help treat the “whole patient”, allowing these patients to have more stalile long term results and comfort.

If you have any questions about Houston neuromuscular dentistry or Houston TMJ treatment, please feel free to call our office as we welcome the opporunity to assist you. Ronald W. Konig DDS, FAGD, LVIF, 713-668-2289.

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All-on-4 Dental Implants

Monday, August 23rd, 2010

 

This technique is an excellent option for those patients who desire to have fixed dental implant dentures as opposed to having to remove dentures. The All-on-4 provides trained Houston  implant dentists an efficient and fixed restoration only using four implants to support an immediately loaded full arch fixed denture. This means that the day the implants are placed you will have a fixed prosthesis in place.  This is where the term teeth in a day was born.

The term “Teeth in a Day” is not exactly what is says. To  be able to perform this procedure, proper and thorough  planning is necessary prior to the implant placement and  “teeth in  day” placement.  It is truly  an excellent option when properly used.

This technique is really beneficial to patients who have a lot of bone loss and to place dental implants would require exetnsive bone grafting, sinus lifts, and a longer time frame to acheive desired results.

In our office, when we utilize this procedure, we have a complete team together: dental implant surgeon, restorative dentist, and our lab technician.  Our team planning and care makes this All-on-4 work very successfully. Additionally, the  Houston cosmetic dentistry aspect is very important. There are many styles and types of teeth that can be used. No two patients are alike and the smile design is, in my opinion, an integral part of the success of the case.

If you have any questions about Houston Implant Dentistry or Houston Cosmetic Dentistry, please feel free to call our office, Ronald W. Konig DDS, FAGD, LVIF, 713-668-2289.

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Dramatic Cosmetic Dentistry Changes: Stain Removal

Thursday, August 19th, 2010

 

 

 

Our patient presented on referral from his general dentist for a chief concern of decay, dental tooth stains,  and calicification stains  from orthodontic brackets.  This young gentleman was leaving for college in 2 days and really wanted cosmetic dentistry completed before he left. There are several treatments that could have been utilized in his situation including Houston porcelain veneers.  They elected  the more conservative approach which was to utilize dental bonding after removing the stains.  The size and shape of the natural tooth was maintained. Anesthesia was only necessary on for one tooth.  The bonding does not cover the whole tooth, only the stained areas.   It is carefully layered and blended in with the natural tooth.  The after photo was taken immediately after treatment, notice the dramatic difference in the appearance of his teeth.

Several different shades of bonding were used to create a natural and translucent effect.  Houston cosmetic dentistry offers many alternatives and ways to enhance smiles.  Most patients have options and should be aware of these different choices that advanced dental technology and cosmetic dentistry available.

If you have any questions regarding houston dental bonding or cosmetic dentistry, please feel free to call our office as we welcome the opportunity to assist  you. Ronald W. Konig DDS, FAGD, LVIF, 713-668-2289

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Dental Implants: The Time is Now

Wednesday, August 18th, 2010

Dental Implants continue to make huge strides into the dental areana.  With the new technology available today, implants no longer have to be placed where the bone is, rather we can plan to place implants where they need to be.

In a recent article that I wrote which was published in the Dental Tribune and Implant Tribune,  this phenomenon is addressed.  Dental implants should be planned for cosmetic dentistry and function as well.   Our office utilizes custom computerized abutments for implants. By custom designing the part that goes into the implant, I am able to improve the cosmetics and health of the implants as well as stop the food impaction that many patients complain about with stock implant design.

Even more important for our patients, is how we manage the gum tissue and preserve the gum height.  The photo shows a patient who broke his left front tooth off at the gumline.  He was not interested in closing the space, only replacing the broken tooth. Placing a fixed bridge would have involved grinding down the adjacent teeth and most likely having to do veneers on more teeth so as to handle the excess gap between the front teeth. 

For this case, the tooth was extracted and an immediate implant placed as well as an immediate temporary crown. Ninety days later, a custom computerized abutment was made and an all ceramic crown to match the adjacent teeth.  Note how nice the gum tissue health and esthetics appears.

If you have any question about Houston dental implants or Houston cosmetic dentistry, please call our office, Ronald W. Konig DDS, FAGD, LVIF, 713-668-2289. We welcome your inquiries.

 

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Cosmetic Dentistry: Bonding vs. Porcelain Veneers

Tuesday, August 17th, 2010

For those patient who are considering cosmetic dentistry, which a wonderful and exciting treatment as it changes lives and confidence,  many times there should be options based on what your desires are.

A look at the photos above, shows a patient with spaces between her teeth (gaps between teeth).  Our converstaion revealed that she was very happy with the color of her teeth and would be happy if the spaces were closed.  This case could be completed with Houston porcelain veneers or Houston Dental Bonding.

By using advancd bonding and shading technqiues, bonding was by far more conservative as no tooth preparation (non-prep veneers)was needed at all, hence the choice of porcelain veneers was not the best choice in this case.  Please do not take this incorrectly as porcelain veneers when artistically done, are an excellent option in many cases.

If you have any questions regarding Cosmetic Denstitry or Houston TMJ treatment, please feel free to contact our office, Ronald W. Konig DDS, FADG, LVIF 713-668-2289

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Sleep Apnea and Dental Sleep Appliances

Monday, August 16th, 2010

Our practice sees many sleep apnea patients who cannot wear or use a CPAP machine. It is truly wonderful to be able to offer alternatives to sleep apnea patients (alternatives to CPAP machines)  who are miserable trying to sleep with these machines or whose spouses are miserable with not being able to sleep.

 Many patients have asked us if it really matters if they snore. The important thing to distinguish here is are they “just snoring” or do the have sleep apnea, the cessation of breathing during sleep.  In my experience, most patients do not realize that they have sleep apnea or deny it to their spouses.  

It is extremely important that dentists do not just place appliances and think that because the snoring is reduced or stopped that the patients are fine.  Dental Sleep Appliances absolutely must be properly adjusted and this includes the use of home monitors or a sleep lab to ascertain that sleep apnea is controlled.

Obstructive sleep apnea (OSA), has been proven to contribute to  a multitude of medical problems. A recent study in May 2009, by Neomi Shah, Henry Klar Yaggi, John Concato, and Vahid Monsenin basically found that OSA increases the risk of myocardial infarction, coronary revascularization procedures, or cardiovascular death and this increased risk is independent of other risk factors including hypertension. This study was well done as it included a large sample of men and women and covered a wide range of sleep apnea severity. 

The good news is that Houston dental sleep appliances are a safe and effective way to help these patients who simply can not tolerate the CPAP machines.

If you have any questions regarding sleep apnea and the use dental sleep appliances, please feel free to call our office as welcome your questions.  Ronald W. Konig DDS, FAGD, LVIF  713-668-2289

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