LET'S TALK ABOUT CROWNS-VENEERS--PORCELAIN VENEERS--ZIRCONIA--IMPLANTS

[Lazlo]

So a lot of us who have had jaw surgery experience damage of our teeth from root canals, dying teeth etc.

I want to know what are the experience who have gotten veneers. I am concerned about gum health and teeth. I would clearly look better if my teeth were different. I want my smile line re-countered and I want eventually to have more orthagnathic work done, like SARPE on my upper and lower jaws and then another jaw surgery. I envision my teeth will be in really bad shape afterwards. I will need new teeth.

Any of you have experience with different sorts of implants/veneers/crowns/etc. I'm especially concerned that there is staining against the gumline or in between the teeth and how natural they can look.

I really don't want this, but I just feel like it's better than having these already stained teeth that aren't the shape I want etc..

What do you guys think? Especially wanting to hear from people who have implants/veneers/crowns etc. .

[jusken]

I've done quite a bit of research and consulting on implants, so here's my take.

Implants should be done as a last resort to teeth that are compromised.  They work well for individual teeth that need to be replaced, but you should know most doctors follow a 'rule of 3's' or something along those lines on implants - meaning you have to have 3mm of space between them and an adjacent tooth, but double that for two implants.  This means implants can rarely be done side by side, and instead you have to go for a bridge (which are aesthetically worse - it's usually fairly obvious and slightly fake looking). Bridges cause extra bone loss because the bone resorbs when you don't have a root nearby.  Add to that the price and implants are a highly conditional option.  There are some advantages to implants over natural teeth, but you should aim to keep your natural teeth at all costs. 

I don't really have too much of an opinion on veneers, but the cost and process doesn't appeal to me.

Hopefully we can one day regrow bones and teeth instead of these things.  I hope the whole medical field gets totally disrupted, but some of you already know I have this opinion!

[Dogmatix]

I've done quite a bit of research and consulting on implants, so here's my take.

Implants should be done as a last resort to teeth that are compromised.  They work well for individual teeth that need to be replaced, but you should know most doctors follow a 'rule of 3's' or something along those lines on implants - meaning you have to have 3mm of space between them and an adjacent tooth, but double that for two implants.  This means implants can rarely be done side by side, and instead you have to go for a bridge (which are aesthetically worse - it's usually fairly obvious and slightly fake looking). Bridges cause extra bone loss because the bone resorbs when you don't have a root nearby.  Add to that the price and implants are a highly conditional option.  There are some advantages to implants over natural teeth, but you should aim to keep your natural teeth at all costs. 

I don't really have too much of an opinion on veneers, but the cost and process doesn't appeal to me.

Hopefully we can one day regrow bones and teeth instead of these things.  I hope the whole medical field gets totally disrupted, but some of you already know I have this opinion!

Do you know if regenerative bone/gum grafting is good if you have receding bone and gum? I've heard some people saying it can even do more damage.

[jusken]

Do you know if regenerative bone/gum grafting is good if you have receding bone and gum? I've heard some people saying it can even do more damage.

Yeah, I've had two consults on bone grafts.  They are okay for building width on the alveolar bone (this mostly applies to old people who have been missing teeth for a while), but work terribly for height or the alveolar ridge.  Most gum recession that people here are dealing with is due to loss of alveolar ridge height, which in turn causing the aesthetic 'pointy' gum line to recede a bit and causes black triangles.

You can try to find a world 'expert' who might do something more advanced, but my guess is it won't work too well no matter how much they try to sell you on it.  If you read the current papers on this, it has a very poor graft take rate and almost no one would even consider doing it for aesthetic reasons only.  Instead, we have to look to the future of regeneration tech to help with these problems...

[Lazlo]

Yeah, I've had two consults on bone grafts.  They are okay for building width on the alveolar bone (this mostly applies to old people who have been missing teeth for a while), but work terribly for height or the alveolar ridge.  Most gum recession that people here are dealing with is due to loss of alveolar ridge height, which in turn causing the aesthetic 'pointy' gum line to recede a bit and causes black triangles.

You can try to find a world 'expert' who might do something more advanced, but my guess is it won't work too well no matter how much they try to sell you on it.  If you read the current papers on this, it has a very poor graft take rate and almost no one would even consider doing it for aesthetic reasons only.  Instead, we have to look to the future of regeneration tech to help with these problems...

thanks for your replies. Yeah you're totally right. Keep your real teeth an wait for new technologies to change things. That sets my mind against all these veneers and implants. Just gonna wait.... Of course if my teeth get damaged I will have no option but to do implants/veneers.

[Dogmatix]

Yeah, I've had two consults on bone grafts.  They are okay for building width on the alveolar bone (this mostly applies to old people who have been missing teeth for a while), but work terribly for height or the alveolar ridge.  Most gum recession that people here are dealing with is due to loss of alveolar ridge height, which in turn causing the aesthetic 'pointy' gum line to recede a bit and causes black triangles.

You can try to find a world 'expert' who might do something more advanced, but my guess is it won't work too well no matter how much they try to sell you on it.  If you read the current papers on this, it has a very poor graft take rate and almost no one would even consider doing it for aesthetic reasons only.  Instead, we have to look to the future of regeneration tech to help with these problems...

You can see pretty clear what I'm talking about here.
https://imgur.com/aiLc7ce
Yes, as you say, it's mostly about height and not width. Biggest reason I'm looking into this is actually not aesthetic, but that I'm concerned about the teeth. They seem quite lose, and I also have a strange itching feeling which sometimes drive me crazy. I've had a professional cleaning done, so it's not about plaque or similar, but more like some nerve is exposed by irritated gum, or exposed root. If bone graft is not good, could gum graft be good?

I found this slide share on it.
https://www.slideshare.net/drjaffarraza/036-mucogingival-surgery

On some of the places they offer treatment for it, it sounds very good. But then I've also watched videos of how the actual procedure is done, and also seen the results. Firstly it seems very invasive how they open up and expose everything, almost like doing even more damage. And when done, the result looks similar to before in many cases.

https://www.institutomaxilofacial.com/en/tratamiento/dental-aesthetics-periodontal-treatment/

[jusken]

You can see pretty clear what I'm talking about here.
https://imgur.com/aiLc7ce
Yes, as you say, it's mostly about height and not width. Biggest reason I'm looking into this is actually not aesthetic, but that I'm concerned about the teeth. They seem quite lose, and I also have a strange itching feeling which sometimes drive me crazy. I've had a professional cleaning done, so it's not about plaque or similar, but more like some nerve is exposed by irritated gum, or exposed root. If bone graft is not good, could gum graft be good?

I found this slide share on it.
https://www.slideshare.net/drjaffarraza/036-mucogingival-surgery

On some of the places they offer treatment for it, it sounds very good. But then I've also watched videos of how the actual procedure is done, and also seen the results. Firstly it seems very invasive how they open up and expose everything, almost like doing even more damage. And when done, the result looks similar to before in many cases.

https://www.institutomaxilofacial.com/en/tratamiento/dental-aesthetics-periodontal-treatment/

It can be very difficult to deal with loose teeth depending on the problem.  If you have very bad tooth root resorption, then the bone and gum around them also recedes.  This was precisely why I went in for consults, I thought I could get a stronger foundation on the short roots (and of course in the back of my mind address the aesthetic concerns as a side effect of that).  If you have enough root length, then just adding a bone graft to the surrounding area might help.  If you think your teeth could be compromised at some point in the future, I'd strongly suggest going in a for a consult to evaluate your options at the very least.

Thankfully my gum recession isn't THAT bad all things considering, so not having any real options is okay for the time being.

[Lazlo]

Yeah, I'm like in a state where some teeth have a bit of slight mobility, there's clearly some gum recession, but i think as long as I get regular cleanings and don't clench too much I may be fine.
The problem would arise if I get a revision jaw surgery. I don't think my current teeth would make it through the braces etc.

There is clearly research being done, but it is in the pre-clinical stages. I would say 2040 is more likely fo r when clinical applications will be available.

https://link.springer.com/chapter/10.1007/978-981-10-1560-1_12

[jusken]

Yeah, I'm like in a state where some teeth have a bit of slight mobility, there's clearly some gum recession, but i think as long as I get regular cleanings and don't clench too much I may be fine.
The problem would arise if I get a revision jaw surgery. I don't think my current teeth would make it through the braces etc.

There is clearly research being done, but it is in the pre-clinical stages. I would say 2040 is more likely fo r when clinical applications will be available.

https://link.springer.com/chapter/10.1007/978-981-10-1560-1_12

I'm probably in a similar boat to you then... I have one crown length of root left on my upper incisors, so fairly short.  I had 10-ish years of braces though with my roots being quite short near the final couple years.  I'm surprised my teeth seem to be holding together at all!  I'm not going to necessarily encourage you to do another round of that, but it's amazing how resilient teeth can be.

2040 you say? Seems like an okay guess, I just have to make it to 50 then haha...    Anyone younger is pretty lucky in that regard.

[Lazlo]

It's so hard to make predictions. For example, here's an article that's not even about full tooth regeneration, it's just about f**king a gel to heal cavities. And here this dude ends the article by saying it will be "SEVERAL YEARS" before it enters clinical trials for humans.

Why the f**k would that be the case? If it works, this should be f**king streamlined for humans in a couple years.

"Several years" is the most vague answer ever, it basically means, a long time for now.

Anyone who has problems with their teeth KNOWS that its one of the areas of your body that is the most annoying to have a problem, you can never not feel it!!!!

And yet, we f**king moronic humans have done essentially nothing to really help regenerate teeth.

If your bite isn't aligned, and you have f**king huge black triangles, and your teeth are sensitive and feel s**tty, you're f**ked. Cause essentially nothing can help.

The idea of implants suck because they're not alive, you won't feel in your teeth and that will affect everything from how you enjoy foods to how you feel when you're kissing.

And yet we have to wait a f**king life time, till this s**t is developed. It doesn't make sense to me.
The only reaason my teeth are f**ked is because I had bicuspid extractions and teeth moved at what was clearly too advanced an age. The gums might rebound from this when you're in your teens but after forget it.

f**k this c*nt of a doctor.

[Lazlo]

blah blah blah several years: https://www.leafscience.org/regenerate-teeth-using-gsk3-antagonists/

and at the same time f**king Ray Kurzweil is saying we'll have nanobots swarming through our bodies by the 2030s.

So which one is f**king correct? We need tooth regeneration before I get nanobots. I can't see my heart, fix my teeth first!

[jusken]

blah blah blah several years: https://www.leafscience.org/regenerate-teeth-using-gsk3-antagonists/

and at the same time f**king Ray Kurzweil is saying we'll have nanobots swarming through our bodies by the 2030s.

So which one is f**king correct? We need tooth regeneration before I get nanobots. I can't see my heart, fix my teeth first!

Yeah, Ray is old and mostly does AI and computer related predictions.  I wouldn't expect many bio predictions out of him anyway.

Most news articles are highly sensationalized these days.  What I enjoy far more is listening to really interesting talks, where more science is demonstrated.  If you have time sometime check out this talk:

https://www.youtube.com/watch?v=RjD1aLm4Thg

I know I've mentioned his name several times recently, but it's mainly because I REALLY liked this talk.  If we take machine learning and apply it to some of the concepts demonstrated here, triggering regeneration anywhere in the body might be possible some day...

[Lazlo]

thanks jusken that was an interesting talk.

i mean the possibility of programming nature would be amazing. but we're at the stage of the transistor tube with that technology as the speaker says.

the idea that we will go to a doctor and she will just change our algorithm and thus some biological function won't be in our lifetime, or a few lifetimes.

even a fault tolerant quantum computer is decades away. so while something like a quantum computer is better for modeling nature and biological systems, again, all of this is decades away.

i was hoping the solutions might come from hydrogels and such things but I realize now it's foolish to actually wait for something like this cause you'd just keep waiting and things may not improve.

what actual improvement has happened in dentistry since we were children? Nothing. I mean, like really actually nothing --nothing that changes the quality of the solutions they offer.

Dental implants always have the possibility of getting infected. Plus they are dead teeth.

Maybe hyper-fast classical computers will be able do the trick but I mean hey, if it ever happens its not like I'll need this site to hear about it, it will be in the news everywhere. And if it's not something my dentist will know about who the f**k cares. Maybe things will happen faster in China. I just wish my tongue had space. I wish distraction osteogensis was the answer.

But I asked someone who was described as a world leader is DO and he totally flaked out and then admitted he had done lower jaw widening with DO once or twice in his career (they guy looked late 60s).

What a f**king disaster.

[micjawsurgery]

nice timing, i'm getting an implant next week to replace an abscessed baby tooth i pulled earlly april. tried to save it for a couple months but it came back and i ended up getting it pulled.

the plan is titanium implant and zirconia abutment and crown. aesthetics not really important  to me since its the posterior premolar, can hardly see it, so i may ask him about other options instead of zirconia. just want to stop further bone loss and my bite shrinking

i'm getting it done in korea along with genioplasty so i think i will be using osstem implant. it  seems like straumann has the best research data behind it, but unfortunately the surgeon is used to working with korean brands.

i will have a long consultation about this regardless, i know he's ethical so i don't mind that. he offers free revision if something goes wrong. i  also really like his genioplasty results.

[Lazlo]

nice timing, i'm getting an implant next week to replace an abscessed baby tooth i pulled earlly april. tried to save it for a couple months but it came back and i ended up getting it pulled.

the plan is titanium implant and zirconia abutment and crown. aesthetics not really important  to me since its the posterior premolar, can hardly see it, so i may ask him about other options instead of zirconia. just want to stop further bone loss and my bite shrinking

i'm getting it done in korea along with genioplasty so i think i will be using osstem implant. it  seems like straumann has the best research data behind it, but unfortunately the surgeon is used to working with korean brands.

i will have a long consultation about this regardless, i know he's ethical so i don't mind that. he offers free revision if something goes wrong. i  also really like his genioplasty results.

he got a website?