Monthly Archives: August 2016

Restoration of a fractured upper central incisor tooth

This 14 year old patient chipped his front tooth on the metal restraint bar on a ride at Disney World. Today I repaired the tooth with a ceramic composite bonded restoration in 30 minutes.

before-fractured front tooth
after bonding
happy patient

A wonderful lady who I made happy today and a very rewarding and enjoyable case for me

I restored her smile with a Valplast upper partial denture. Nice case :-)))

valplast partial denture after
valplast partial denture
partial denture
comparison of a cast metal partial and a Valplast partial denture

I enjoy explaining and educating my patients

As Dean’s Faculty, Clinical Assistant Professor in The Advanced General Dentistry Department at The University of Maryland School of Dentistry, I am used to teaching and educating residents and senior dental students. I am always happy to answer questions and show patients exactly what I am doing and explain why.

X-ray of the patient’s upper left teeth on the monitor
Showing the patient her cavity and explaining what I am doing
After photo demonstrating her tooth restored with a ceramic composite restoration
Showing this patient his cavity
decay removed
restored with ceramic composite restoration
happy (and numb) patient

Monday morning dental implant case

This patient fractured his lower right first molar. We extracted the tooth and placed a 6mm wide 13 mm long Zimmer Biomet Encode titanium implant. This morning I delivered the  beautiful porcelain implant crown.

implant encode abutment
healing abutment
implant, notice internal hex
implant crown
implant crown with gold screw visible
implant crown
screw access channel filled
implant crown
second from the back
happy patient
happy patient
implant x-ray
digital x-ray
dental implant parts
crown and gold screw
computer design scans


Dental implant case of the afternoon

This patient lives in Ft. Lauderdale and flew up today for me to restore his lower front teeth with dental implant crowns. This was a challenging case because of how thin the bone was and the tight space, and close proximity of the implants.

x-ray of custom abutment try-in with gold screws
close up view, notice internal hex
custom titanium abutments
secured with gold screws
crowns cemented over custom abutments
looks so natural when he opens his mouth
happy patient :-)))


digital design scans

Replacing a 20 year old crown

This patient wanted me to replace her 20 year old crown. She had gum recession exposing her root and recurrent decay that had spread under her old crown. The dark area showed when she smiled. I cut off the old crown, removed the decay and made her a beautiful new porcelain crown to cover the exposed root. Here’s the before and after photos.

porcelain crown

Common conditions that can occur in the mouth, here’s 3 that I saw this week

These are 2 patients have swellings on the inner surface of the lower lip and cheek. The first is a 31 year old male, that has had it  for 1 month.  The second is a 27 year old female that has had it for 2 weeks. This is called a mucocele. It is caused when you bite or traumatize your lip and rupture or obstruct the small salivary gland duct. The saliva pools up and causes a small swelling. There are many small salivary glands on the inner surface of the lip and damaging the duct can cause the saliva to pool up causing a clear or bluish swelling. My treatment for this condition is to have the patient rinse with warm salt water 6 times a day for 1 week. If it is still present after 1 month have it surgically removed.


This next condition on this 55 year old female patient is called an aphthous ulcer, sometimes referred to as a canker sore. This is usually caused by  stress, not eating or sleeping enough and getting run down. I see this a lot in college kids who are stressed during finals and not sleeping enough or eating well. It can also be caused by an allergic reaction. The aphthous ulcer usually resolves on it’s own in 2 weeks and can reoccur. It can sometimes be painful, and if it’s really bothering the patient, I can prescribe a Chlorohexidine mouthwash or steroid cream.

aphthous ulcer
aphthous ulcer

These next patients have mandibular tori, also called torus mandibularis.  A torus (plural  tori) is a bony growth that occurs in the lower or upper jaw in 20% of the population. Tori are normal bone covered by normal tissue. These are usually caused by genetic factors and teeth grinding causing excess bone to be deposited. No treatment is required.

mandibular tori

mandibular tori 2

mandibular-tori                                                          mandibular-tori                                                          mandibulartori2                                                          tori                                                                       tori25                                                                       tori18                                                                        mandibulartori20                                                                      mandibulartori10                                                        mandibular-tori                                                     tori25                                                       tori26

This one in the middle of the palate is called a maxillary tori

This last patient has both maxillary and mandibular tori: maxillary-tori                                           mandibular-tori2

dental implant of the day

This patient’s upper left first molar tooth was fractured and very painful.  We extracted her tooth and placed a Biomet Zimmer Encode Implant. Today I finished restoring her molar with a beautiful dental implant.

dental implant
implant crown with screw access channel visible
filling placed in screw access channel
happy patient
initial x-ray, fractured molar
molar extracted and implant placed
implant crown


Importance of taking an x-ray prior to beginning dental treatment

This 19 year old was home from college for a few weeks and wanted me to do veneers to fill in the spaces between her upper front teeth and give her a pretty smile.  I took x-rays prior to starting treatment and noticed a large abscess at the root apex of this lateral incisor tooth. The tooth was asymptomatic and the patient said the tooth never hurt or felt sensitive. The tooth must has been traumatically injured when she was young.  It’s good we discovered this abscess and can take care of it before it destroys more bone and adjacent teeth.

veneer consultation appointment
periapical abscess

At the same time in a different dental operatory was this other patient who was here for her cleaning and check-up appointment. Notice the resorbed root on the maxillary lateral incisor. The root is about half as long as it should be. This was caused by her impacted canine tooth, stuck above this root, that was later brought down into place orthodontically.