SERVICES

PREVENTIVE DENTISTRY

An ounce of prevention is worth a pound of cure." This expression definitely holds true for dental health. Dental care at home and regular brushing, flossing, water picking and reducing frequency of sugar intake are the most important habits patients can establish to reduce dental decay. Here at Allison & Associates, we want to ensure our patients are well-educated in proper home care. Our office focuses on preventive dental care and offers the following related services:

Professional Cleanings:

Most patients refer to these as their "cleaning" appointments or "semi-annual cleanings." For patients with healthy teeth, gums and bone, this appointment involves removal of calculus/tartar above the gums and removal of extrinsic tooth stains. X-rays are taken every 12-18 months to evaluate areas between the teeth for cavities and to evaluate the inter-dental bone health. Oral cancer exams, periodontal exams, and general dentition exams are performed by both the hygienist and dentist. The teeth are polished with a glycerine air-polisher or prophy/cleaning paste.

Professional Cleanings

Gingivitis

Plaque and Calculus

Digital Dental X-rays - 2D and 3D:

Our dental office utilizes digital x-ray technology to reduce radiation exposure to our patients and reduce environmental waste. We take two dimensional images as well as three dimensional images. Both types of x-rays provide valuable and different information. 2D x-rays are generally taken every 12 months to evaluate areas in between the teeth for decay and bone loss, since these areas are difficult or impossible to see clinically. 3D X-rays are taken to evaluate overall jaw- bone health and tooth root/nerve health. The 3D images give dentists a 3D rendering of the tooth roots and jaw bones and many other facial structures. We can use these to analyze for placement of dental implants, root canal treatment, sinus pathology, and presence or absence of sufficient bone for orthodontic tooth movement. Depending on the 3D volume size, airway space and carotid artery calcifications may be seen.

3D Digital Dental X-rays

Sealants:

Apart from the usage of fluoride and good oral hygiene, pit and fissure sealants are an important component of preventing dental caries. Sealants are protective coatings placed in the grooves of non-carious and unstained permanent teeth. Usually these are placed after initial eruption into the mouth. Sealants have been proven to reduce decay in the grooves on the chewing surfaces of newly erupted teeth by 73% when compared to fluoride varnish application alone.

Sealants

Custom Nightguards:

These are also known as orthotic dental splints. For patients who clench or grind their teeth in the absence of sleep apnea, these appliances may be utilized to reduce tooth damage and alleviate muscle pain. The relationship of the chewing muscles (muscles of mastication), teeth, temporomandibular joint and the fifth cranial nerve is different for every patient. Therefore, one size and type of device does not fit every patient and patients may need more than one type of appliance depending on their current situation.

Occlusal Appliance for Tooth Wear

Posterior Wear

Temporomandibular Joint Disorder

Anterior Bite Plane

Anterior Wear Only

Healthy Occlusion

Athletic Mouthguards:

We make custom mouthguards for our patients participating in sports with risk of dental trauma. These appliances are only worn during practice and sporting events.

PERIODONTAL THERAPY

When the bone and gums surrounding the teeth become infected and bone loss occurs, more advanced dental treatment is required. The extent of periodontal disease is quantified with dental probing measurements, bite-wing x-rays and 3D CBCT images. Depending on the severity of dental disease, different treatments are available. Periodontal disease is a multi-factorial disease. Many patients with systemic health conditions suffer from gum infections and bone loss. It may be chronic and episodic in nature and often requires retreatment, especially if oral hygiene is not adequately maintained.

LANAP:

Laser assisted new attachment procedure or laser gum surgery is an FDA approved treatment for periodontal disease. A special Nd:YAG laser is utilized to treat the surrounding gum tissues, bone and teeth. There are no sutures or cutting required. This is an alternate form to traditional periodontal osseous surgery. Patients report easier healing and much less discomfort.

Pinhole Gingival Grafting:

The goal of this technique is to correct areas of recession of the teeth. Recession occurs in areas of thin bone or no bone covering the tooth roots and may occur due to aggressive brushing, grinding/bruxism, orthodontic treatment, habits like smokeless tobacco usage or gum disease. This procedure is an alternative treatment to traditional free connective tissue gum grafting. It is less invasive and healing is faster.

Gingival Recession

Connective Tissue Graft

Crown Lengthening:

Sometimes teeth break or get decay which advances to the interdental bone. In these instances, some bone is removed around the tooth so that enough tooth is present above the bone to properly support a crown or onlay. Additionally, this procedure may be performed on short front teeth for improved cosmetic appearance, usually in conjunction with veneers or crowns.

Crown Lengthening (Tooth Wear)

Crown Lengthening (Esthetic)

Laser Frenectomy and Gingivectomy:

To perform a frenectomy, a soft tissue laser is used to remove the internal tissue attachment to the upper or lower lip or from the tongue to the lower teeth/bone. The purpose of this procedure is to reduce the stress to the gum tissue which is being pulled away from the teeth. This procedure is recommended to prevent recession of gum tissue or excess spacing between teeth. A lingual frenectomy is performed when someone is tongue-tied.

Frenectomy

Gingivectomy

Deep Scaling:

When periodontal probing pocket depths exceed 3mm, there is bleeding with probing, and there is horizontal bone loss, deep cleanings are needed to properly remove bacteria and “barnacles” from tooth root surfaces. This is done usually with local anesthetic. The goal is to remove the bacteria and contaminants and aid the tissue in healing with daily proper home care. Health is determined by the absence of bleeding on probing.

Deep Scaling

Deep Scaling

COSMETIC/RESTORATIVE DENTISTRY

The last decade has seen tremendous advances in dentistry. Technology is improving and more procedures are available as single visit procedures which traditionally took at least 2 appointments or more. The ability to make our own crowns out of a plethora of materials has further enhanced our ability to match tooth colors and deliver same day smile makeovers.

CEREC Single Visit Crowns and Bridges:

CAD/CAM technology to allow same day treatment for dental crowns, onlays and bridges. An intraoral digital scanner is used, a Primescan or Omnicam, which takes multiple high definition images using a live video stream. A 3D rendering is made of the teeth and bite and a computer algorithm generates a restoration which fits the prepared tooth and bite. The restoration is then milled in-office, fired in a furnace, and cemented in place. It’s great to avoid missing work twice for one tooth and patients only have to get anesthesia once! Unlike many crowns that are sent to dental laboratories and then are shipped offshore to be made in foreign countries, our crowns are made 100 percent in the USA.

Single Visit CEREC CROWNS

CEREC SINGLE VISIT Bridges

Invisalign®:

Orthodontic tooth movement with individually customized clear aligners and tooth-colored attachments is an excellent treatment for minor tooth movement.

Tooth-colored Fillings:

These are also known as composite restorations. These may be used instead of traditional amalgam fillings in posterior teeth and are used on front teeth. They are bonded restorations and require precise placement without any moisture contamination.

Porcelain Veneers/Crowns:

These restorations match your teeth and contain no metal. They are made out of lithium disilicate, leucite glass ceramic, or feldspathic porcelain. These materials allow for excellent esthetic results for patients and dentists. Many restorations can be made the same day.

Single Crown (Impression)

Veneers (CAD/CAM)

Veneers (Impression)

Bridges:

These restorations are made to replace missing teeth due to tooth loss. They are an alternate option to implant and partial denture treatments. The teeth adjacent to the missing tooth are prepared for crowns/caps and an impression is taken. Some of these restorations may be made in office. Larger spanning bridges may require temporary fabrication and laboratory fabrication and 2 appointments. Bridges often cost less than dental implants and are a faster treatment. The negative aspects of bridge treatment are drilling on adjacent teeth, risk of tooth decay around bridge abutments

Bridge (Anterior- CAD/CAM)

Bridge (Anterior- Impression)

Dentures:

There are 2 types of dentures: full or complete dentures and partial dentures. Full dentures replace all the missing teeth in one arch. Full dentures may connect to dental implants for improved retention and bone maintenance. Partial dentures replace missing teeth and connect to the remaining teeth or implants in the arch. Partial dentures have metal clasps which may be designed to be hidden with special precision attachments.

Removable Complete Dentures

Post-Operative Instructions for Dentures

Removable Partial Dentures

Home Maintenance for Dentures

IMPLANTS

Dental implants are titanium root forms placed into the jawbone and ultimately may be connected to crowns, bridges, dentures, etc. Their primary role is to preserve jawbone. They are often the treatment of choice for single tooth replacement. They are usually the most expensive procedures as they require advanced training, multiple appointments, and many parts to complete the restorative process.

Anterior and Posterior Implants:

Dental implants may be placed in the position of anterior or posterior teeth. Different sizes are available. The final prosthetic outcome and the amount of available bone often determine size and type of implant to be placed. Our office places Ankylos Dental Implants from Dentsply Sirona. These implants have a long-standing history of excellent bone and tissue health which is a result of the platform switch design.

Extraction and Bone Grafting/Site Preservation:

When teeth are extracted, there is a bony defect. If implant placement is planned, bone grafting with cadaver bone and other biologic materials is performed to preserve the bone volume. Sometimes, the dental implant and bone graft are placed at the same time and allowed to heal concomitantly. Just think of it as good carpentry: who puts a 3-inch screw into a 2-inch thick board? Later, a crown, bridge or some other implant prosthesis may be placed.

Surgically Guided Implant Placement:

Digital impressions, photos and a 3D CBCT x-ray are taken. A crown, bridge or other prosthesis is designed based on a patients’ cosmetics, phonetics, and occlusion. The prosthesis data and the x-ray data are merged and the optimal implant placement is planned based on the available bone and end point restoration. A surgical guide is then generated which is specific only to that patient. This optimizes treatment outcomes and longevity.

LAPIP:

Laser Assisted Peri-Implantitis Protocol is treatment performed with an Nd:YAG laser around infected dental implants. It is a less-invasive treatment procedure for treatment of infected dental implants. It promotes reintegration of the dental implant and regrowth of bone of 3-8 implant threads. Treatment results vary due to prosthetic conditions present and oral hygiene practices.

MICROSCOPE DENTISTRY

In our practice, we utilize Zeiss PICO dental operating microscopes for most of our fine detail dental treatment procedures. The microscope improves the dentist’s view providing magnification, resolution and illumination which are not possible with the naked eye or other dental magnification loupes. Dr. Shannon Allison is the only general dentist in Moore County who practices with a microscope.

Root Canals:

Removal of infected nerve tissue from inside the tooth is a precise matter. Teeth are small enough objects as is. More light and more magnification allow the dentist to see more. This is so important when you are searching for pinpoint areas inside a tooth. Microscopes improve the success rates of endodontics therapy.

Root Canals

Endodontic Microsurgery:

Sometimes root canals get re-infected. A tooth nerve is a complex 3D network. Our goal in performing root canals is to mechanically remove the infected nerve tissue and use chemical irrigation to decontaminate the nerve canals. Then we place a bacteria tight seal with a bio-ceramic sealer to prevent re-infiltration along the instrumented canals. When reinfection happens, it is often due this complex network which may have multiple microscopic branches off the main canal. A surgical procedure to remove the lingering infection may need to be performed years later after root canal treatment. This is an apicoectomy. Using the microscope, the bad root tip is removed and the nerve is re-instrumented from the root tip end. A bio-ceramic filling material is placed in the amputated root end and allowed to heal.

Endodontics Microsurgery

Minimally Invasive Fillings

Utilization of a dental operating microscope allows us to minimize removal of excess tooth structure and allows better visualization of remaining decay to ensure total decay removal.