CAPT Brian Guldbek Assumes Command of the 4th Dental Battalion

On Dec 8, 2013 CAPT Brian Guldbek assumed command of the 4th Dental Battalion, 4th Marine Logistics Group, Marine Force Reserve.  The primary mission of Marine Corps dentistry is to ensure the dental readiness and optimize the dental health of Marine forces.  In an operational environment, dental will provide emergency dental care and, when the mission allows, provide essential non-emergency care to include:  providing dental treatment as far forward as required to eliminate or reduce the effect of dental disease and injury on mission accomplishment, preventing oral disease, and promoting dental heath.  The field dental care system maintains the dental readiness of the deployed force by preventing and treating dental disease and injury.  To accomplish this, dental support is based on a task-organized, flexible structure that responds to rapidly changing conditions across the continuum of missions to provide the required level of dental care.  This task-organized support is based on the size of the unit supported, length of deployment, mission (MOOTW, low intensity conflict, war), and other dental support requirements.

 

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Not All Impressions Are Created Equal

Take a look at the following video of a dental impression for a three unit bridge sent to a prominent national dental lab by another dentist.

 Click on link below to start video…(takes a few seconds to start)

 Bad impression video3

bad impression 2

Still photo from video of bad impression

 

bad impression

Another still photo from video of bad impression

 

 

As I have said many times before, attention to detail is critical in dentistry. This  is never more true than with final impressions for a crown or bridge.

Brian Guldbek DDS  Impression

Single Tooth Impression By Brian R. Guldbek, D.D.S.

This is a photo of one of my  impressions for a single crown.   Notice that the flow material discussed in the video completely covers the entire arch. The cuff around the prep is fully distinguishable and continuous.

Taking extra steps to ensure we capture a perfect impression to assure success in the case. From previous blogs you know that I never take impressions the same day I prep the teeth. I spend time fabricating a provisional restoration at the prep appointment  which allows the tissue to heal so when we impress the preps the tissue is healthy, doesnt bleed and I am in control of the entire process. I always take full arch impressions and opposing full arch impressions to provide the lab all the information they need to guarantee success.

 

 

 

 

Good Crowns Vs Bad Crowns …..What to Look For

 

Dentistry is both a science and an art.  A good dentist must have the skills and attention to details in order to deliver a quality restoration. This is never more true than when it comes to crowns and bridges. Here are some guidelines as to what makes a good crown vs a bad crown.

 Qualities of a Good Crown:

  • Perfect fit at the margins and to the adjacent teeth
  • Proper emergence profile of the crown from the gum line
  • Excellent contact between the neighboring teeth
  • Excellent occlusion, i.e the fir of the crown to the opposing teeth
  • Excellent color to match natural teeth

Qualities of a Bad Crown:

  • Poor fit- this results in recurrent decay, sensitivity and ultimate failure of the crown
  • Over contoured crown- this results in inflammation of the gum tissue, gum disease and movement of the crown by muscle forces
  • No contact between the adjacent teeth-results in movement and tipping of the crown
  • Poor color and not natural looking

  Examples of Good Crowns

Good Crown

Excellent Esthetics

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Proper Shape and Contour

 

 

Proper Contact and Contour

Excellent Crown Interior

 

Examples of Bad Crowns

Bad Crown

Overcontoured Tooth

Bad Crown

Unnatural Contours and Occlusion

      

bad crown3

Poor Esthetics

   

 

 

 

 

 

Bad Crown

Poor Color and Contour

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Now you know what a good crown should look like and how it should fit to the tooth.   A good crown requires a high degree of skill and attention to details which creates the correct outcome.

 

 

My Upcoming Extraction…..

Part IV of My Dental Journey

Wednesday May 8 I will have my front tooth extracted and a bone graft placed by Dr. David McClenahan in Libertyville.  There will be an eight week healing period of the graft before the implant can be placed. The plan is to  temporarily bond the extracted crown of #9 by Dr. Mclenahan in the extraction site to serve as an ovate pontic to shape the bone and tissue during the healing process. I will have a flipper with a denture tooth made just in case the bonding does’nt hold for the full eight weeks. Cant be seeing patients with no front tooth!!

Keep you posted on how the appointment goes!

 

 

By: Brian R. Guldbek, D.D.S.

Provisonal Restorations Part 2

We discussed in Part 1 the difference between a temporary crown and a provisional restoration. In Part 2 we will go through the actual lab phase of how we fabricate a provional restoration.

Step 1

We take a pre-op impression of the tooth/teeth we are going to prpare for a crown. Here is a picture of the patient before treatment.

 bing preop

 Step 2

 In the lab we pour up a silicone model of the pre-op impression

Silicone Model

Silicone Model

 Step 3

A wax up of the broken or misaligned teeth on the preop model  is made to the size, shape and contour that we want to achieve. Then we make a putty matrix of the altered cast.

Wax up of Pre-op model

Wax up of Pre-op model

Putty Matrix

Putty Matrix

Step 4

A self cure composite is flowed into the putty matrix and the indexed silicone model is inserted and removed after material has set.

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Putty matrix with model and composite material

Provisional immediately after removal from matrix

Provisional immediately after removal from matrix

  

Step 5

After trimming , finishing and polishing the provisional restoration is ready to be delivered to the patient.

Provisional Restoration

Provisional Restoration

 

 

By: Brian R. Guldbek, D.D.S.

Where Does Your Dentist Get Their Crowns From?

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    Dental Work Made in China Might Contain Lead

    When Faye Lewis became concerned about her painful new bridgework, she had it checked out and received some disturbing news: Her bridge was manufactured in China and tainted with lead.

More dentists are using crowns and bridges made in China. According to the United State Customs Office, the number of dental products coming into the United States from China has doubled in the last year.

An investigation by ABC News affiliate WJLA-TV found that at least some of those dental products contain lead.

 

At Heritage Dental all of our Crowns and Bridges are fabricated at Bayview Dental Laboratory in Virgina.

Check them out at   Bayview Dental Lab

 

 

By: Brian R. Guldbek, D.D.S.

 

Interesting Dental Facts in the Animal World

*  The  mouth of a snail is no larger than the head of a pin, but it can have over 25,000 teeth!  

Snail-WA_edit02

  * The Elephant grinds down its molars and grows new ones. This happens six times in its lifetime!

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* The elephant’s molar is about 7″ square!!!

 

 

 

* The Blue Whale is the largest mammal on earth, but it eats only tiny shrimp because it has no teeth!

blue whale qed

 

By: Brian R. Guldbek, D.D.S.