Treatments

This is the branch that prevents and treats abnormal teeth position (known as malocclusion).

Orthodontic treatment aims to determine a proper intermaxillary ratio, correct alignment of the teeth and efficient chewing function, improving the aesthetics of the face and smile, and also correcting any breathing and chewing or speech disorders.

The pre-adolescent phase (from 5 to 12 years old) is approached by the ‘Interceptive‘ therapy, which identifies those skeletal defects, that can be corrected relatively easily with fixed or mobile devices, but that if underestimated or not treated, can make more complex or not possible future orthodontic corrections.

Interceptive treatments or orthodontic treatments with invisible aligners (Invisalign-Spark) are selected and applied depending on the case and patient’s needs.

Clear aligners are a customized series of transparent trays made of a special material able to straightens teeth: you must wear them 22 hours per day, changing every aligner every 10 days, and as you replace each aligner, you moving teeth – little by little, week by week, gradually moving towards the projected final position.

As they are removable you can brush and floss your teeth exactly as you normally would, allowing you to keep your teeth and gums healthy while you straighten and perfect your smile. There are no brackets or wires, so the aligners are barely perceivable on your teeth. In fact, it barely has to impact your day-to-day life at all. It is Comfortable, clear and removable.

Invisalign is successfully used in adult and adolescent patients who are looking for a comfortable way to correct their smile.

If you are curious in the first visit we can simulate the smile with the teeth aligned.

ACCELEDENT

Lately, together with Invisalign treatments, you can use AcceleDent^® Optima™, an advanced accelerated orthodontic device. Simple and easy-to-use, AcceleDent Optima is clinically shown to speed up tooth movement by as much as 50% while reducing orthodontic discomfort. Its  patented SoftPulse Technology® applies precisely calibrated vibrations called micropulses that transmit through the roots of your teeth to the surrounding bone. This gentle vibration helps increase the cellular activity and speeds the rate in which your teeth can move.

There is astonishing power in an attractive smile. When you are unhappy about the appearance of your teeth, there is a tendency to smile less frequently and less confidently. Your smile may bring embarrassment and awkward moments, even leading you to avoid certain social situations.
A treatment is defined aesthetic when is harmoniously integrated with the dental arches and the face of the patient: it must restore morphology and function in accordance with the primary objective of health and naturalness.

Every solution is obviously customized: the treatment you require, I will help you find the most conservative and effective solution for your functional and aesthetic needs.
There are several ways to improve a smile: I can change the colour, the shape, the position and the lenght of the teeth, replace a broken edge.. sometimes a simple addition of composite is enough to change the axis of the tooth and how light hits the tooth surface to immediately have a different perception.

We can get results with:

• Direct composite restorations
• Ceramic veneers and/or crowns
• Orthodontic therapy
• Whitening- Bleaching

Also called pedodontics: it deals with the prevention, diagnosis and treatment of deciduous teeth diseases.

The most important aspect is to build a positive relationship between child and care provider, based on trust and confidence that will last a lifetime. At the age of 3-4 years, it’s recommended to have an initial dental checkup to verify hygiene, gum, early stages of tooth decay and explain a program of preventive home care (brushing, diet and fluorides) and evaluate any malocclusions.

Later on, young patients should have their teeth checked annually, to assess that there are no cavities and that the teeth are well cleaned, avoiding possible problems to the permanent teeth.
It is very important that primary teeth are kept in place until they are lost naturally, because they maintain good nutrition, are involved in speech development and help the permanent teeth by saving space for them.

Useful Tips

• Avoid eating frequently of sweets (candy, but also savory snacks) especially soft drinks or sweetened teas that can “abrade” teeth
• Do not brush teeth immediately after consuming these acidic drinks, which make the surface more “attackable” by the direct action of the bristles of the toothbrush, but rinse with water and brush after at least 20 minutes
• Do not often give bottles with chamomile or other sugary drinks before going to bed without rinsing, as during the sleep the production of saliva is reduced and sugar is more easily deposited on teeth increasing the risk of caries
• grinding and clenching of the teeth, called bruxism, in children is a physiologi- cal fact due to an incorrect match between the upper and the lower Normally, bruxism does not cause significant problems to the child and should end with the growth.

Restoring the function and aesthetics of damaged teeth by congenital injuries, tooth decay or trauma, or malpositioned teeth.

Trying to “preserve” as much residual healthy tooth structure as possible, in order to postpone more complex endodontic and/or conventional prosthetic procedures.

In my office we use only resin composites, of tooth color, non-toxic, durable and esthetic. I never use amalgam of silver, whose toxicity is being discussed but we believe. The office specializes in the replacement of metal fillings by tooth colored restorations.

Restorations can be “direct” if they are performed on the chair – or “indirect” (onlays, overlays), when the damage is more extensive and it is necessary to build in the laboratory the missing part of the tooth, in resin or ceramic.

In any case the quality of the restorations and their duration are directly related to a proper and adequate isolation from the saliva of the patient by means of a sheet of latex called ” dam “.

Pain, in the case of teeth, is not a reliable warning sign: most of the time they are asymptomatic! The only solution is a periodic visit to the dentist!

Treats the space inside the tooth that contains the dental pulp, the nerve.

Healthy pulp can be altered in various situations: deep decay, severe periodontal problems, severe tooth wear (deep abrasion), occlusal trauma (functional overload of the tooth), repeated dental procedures on the tooth, faulty crowns, or a crack or chip in the tooth.
In addition, trauma to a tooth may cause pulp damage even if the tooth has no visible chips or cracks.  When you reach this stage of pain, you need to perform endodontic therapy, or root canal treatment or more improperly devitalization.

It is also possible to perform this treatment when the dental element must be involved in a prosthetic rehabilitation, also if nowdays, thanks to the new ceramic materials, we loss less dental structure, preserving the nerve.

The most common symptoms of pulp disease are cold and hot pain or chewing pain, sometimes leadind to an abscess. Swelling and gingival fistulas may also appear.

Proper canal treatment can change the prognosis of extremely compromised teeth, avoiding extraction and prosthetic replacement.

It is important to stress that implants are not free from problems; therefore,   whenever possible, our philosophy is to maintain the natural teeth as long as possible and to postpone implant placement, especially in young patients.

Your sleep impacts every aspect of your health and daily life. Sleeping well helps you look, feel and perform your best. But a sleep problem can be harmful to your health and well-being.

‘Snoring‘ can be a nuisance to your partner, but it can be an alarming bell for the diagnosis of a harmful respiratory disorder called obstructive sleep apnea syndrome (OSAS), a syndrome characterized by recurrent episodes of pharyngeal obstruction during sleep, underestimated due to lack of information.

These repeated breathing pauses can occur during the night hundreds of times, reducing oxygen levels and causing brief awakenings and health risks.
In fact, it can cause excessive daytime sleepiness, fatigue, morning headaches, increased car and work accidents, reduced cognitive ability with reduced quality of life. It is also an important risk factor for cardiovascular diseases, such as hypertension or heart attack, and cerebrovascular accidents.

Recent studies have shown that for mild and moderate cases, other than simple snoring, mandibular advancement dental appliances (MAD), are a good therapy. The oral sleep appliance is worn in the mouth only while you sleep and fits like a sports mouth guard or an orthodontic retainer. Oral appliances support your jaw in a forward position to help maintain an open upper airway.
However, losing weight, avoiding alcohol and smoking, and sleeping on your side also can help reduce snoring.

Functional and aesthetic replacement of one or more missing teeth using implants is nowdays a widely used treatment option.

The implant is a titanium screw to be inserted in an already edentulous bone crest or just after a tooth extraction, to mimic the function of the roots.

Generally, the implant can be load with a crown after 2-6 months, depending on whether or not bone regeneration procedures have been used. Even if, more and more often, the clinical conditions allow us to use an “immediate post-extraction implant with an immediate not functional loading” and place the crown immediately on the implant as soon as it is inserted, even if in the very first two months the tooth is lower and we suggest not to chew on it.

Local anesthesia is all that is needed to deal with the procedure.

It is generally followed by systemic antibiotic and anti-inflammatory therapy for a few days.

A healthy state of the mouth, without any infection (decays or periodontitis) is essential for the success of implant treatment, which is not without failures: the implant can also become “sick” like the tooth (PERIMPLANTITIS).

Periodic check-ups at the dentist and scrupulous home and professional oral hygiene are necessary to ensure a good prognosis in the long term.

Those are all the therapies necessary to replace missing or severely compromised teeth: it can be fixed (crowns, also called “capsules” and bridges) or removable (total prostheses or “dentures”, skeletons).

Nowadays, cosmetic dentures also mean those cosmetic treatments that change the shape or color of teeth, with full crowns or ceramic veneers to improve the smile.

FIXED PROSTHESIS: Integral ceramics, bridges, veneers

A fixed prosthesis is defined as a restoration or replacement which can not be removed from the oral cavity. They can be “crowns” or “bridges” supported by natural teeth or implants and their aesthetic and comfort are similar to natural teeth: a person looking at it should not notice that the tooth is not natural!

Thanks to the great evolution of materials (metal-free prostheses) and biomedical technologies (computer technology Cad/Cam), today it is possible to obtain resistant artefacts with a real aesthetic and biological integration of prosthetic restorations, making them hardly distinguishable from natural teeth (e.g. the light color of the core of these crowns eliminate the imperfections of the black border around the gum).

When teeth are severely compromised because a large amount of tooth tissue has been lost due to old fillings, penetrating decays, enamel abrasions, fractures or root canal treatments, it may be necessary to completely cover the element with a “crown” to restore functional solidity.

It is important to restore missing teeth:

• keep adjacent and antagonistic teeth in the correct position (otherwise they would shift)
• maintain stable chewing
• do not impair the patient’s appearance and self-esteem

Veneers are thin sheets that cover the outer surface of the teeth, the one in contact with the lips. They require minimal sacrifice of tooth tissue and never jeopardize the vitality of the tooth. Sometimes they are even totally non-invasive in the sense that they do not even require the use of a drill.

Ceramic veneers ensure the achievement of excellent aesthetics because they have excellent biocompatibility, wear resistance, no absorption of fluids and color stability over time.

Main indications are:

• reshape a chipped tooth or one with an unattractive shape
• fill in the diastemas, the empty spaces between the teeth
• lengthen worn teeth (obviously evaluating the masticatory biomechanics)
• whiten teeth that are particularly yellow or with previous restorations now visible
• restore clarity to enamel altered by smoking, food, drink, or self-induced vomiting

There are minimal contraindications, such as the presence of spoiled habits (grinding), a head-to-head bite (jaw and jaw aligned when viewed from the side), lack of enamel on the tooth surface, or excessive discoloration of the tooth.

MOBILE PROTESTS: partial or total type.

Also in case of removable prosthesis it can be useful to insert some implants to increase the stability, especially in the mandible where the tongue can move the prosthesis.

Periodontology deals with the treatment and prevention of periodontal disease, or “periodontitis” (formerly known as “pyorrhea”), which is the inflammation of everything around the roots of the teeth (gum, alveolar-dental ligament, bone and cementum).

This inflammation is almost always due to poor or incorrect dental hygiene, also if factors that may contribute to it include diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use. Once it becomes chronic, the teeth tend to move outwards and may begin to wobble; if we do not intervene urgently and with appropriate methods, their loose will be inevitable.

Healthy periodontal tissues are mandatory before starting with complex therapies that will last over time. If there is not a good control of bacterial plaque and gingival inflammation dental therapies are inevitably doomed to failure.
The diagnosis involves measuring with calibrated instruments any pockets on each tooth, then performing a radiographic status to map the bone around the roots of the teeth.

Symptoms are: bleeding gums, swelling gums, which become increasingly sensitive to the contact of the toothbrush and food; halitosis; the apparent elongation of the teeth (caused by the retraction of the gums and bone resorption).

Periodontal therapy is mainly aimed eliminating the etiological (causal) agents of the disease through scaling and root planning at the beginning and then with support over time (not surgical therapy). Then other local irritants must be eliminated such as over-contoured fillings, home oral hygiene must be improved and try to risky lifestyle habit changed, such as smoking.

Only after a careful reevaluation it will be possible to understand if any periodontal surgery will be necessary to stabilize the pockets that remained critical.

For me prevention is a pillar: the goal is to eliminate any pain that person is feeling, restore oral health, and correct any esthetic imperfections that may be present, but, after that, oral health must be maintained over the long term to preserve the appearance and health of your smile!

We provide customized maintenance therapy plans based on your individual periodontal and cavity risk and your at-home hygiene capability.

Besides, once a year, we take some x-rays to check also those areas you can’t see to the naked eye.

However, the patient plays an active role in the care of his or her own teeth: necessary measures in everyday life in one’s home oral hygiene are already a form of prevention (electric brush for 2 minutes, specific tooth paste or mouth rionse, folss…).