DENTAL TREATMENTS

Endodontic treatment is the process of cleaning and disinfecting the nerves and blood vessels in the inner part of the tooth, called the pulp, and then filling it with a suitable filling material. Root canal treatment is the most common type of these procedures and is usually required when

• Deep decay: This is when decay has travelled beyond the enamel and dentin layer and reached the pulp tissue.
• Tooth trauma: Damage to the pulp as a result of a blow to the tooth.
• Infection or abscess: Inflammation or infection in the pulp area.
• Chronic pain: Irreversible damage to the nerve of the tooth.

The aim of endodontic treatment:

• To save the tooth and keep it in the mouth without the need for extraction.
• Eliminate infection and relieve pain.
• To preserve the functionality and aesthetics of the tooth.

Root canal treatment:

Stages of root canal treatment:

• The dentist evaluates the patient's complaints and the tooth by x-ray.
• The procedure is performed with regional or local anesthesia.
• Infected or damaged pulp tissue inside the tooth is removed.
• The root canals of the tooth are cleaned and shaped with special instruments.
• The canals are filled with a biocompatible material (usually gutta-percha).
• The tooth is restored with a filling or crown (veneer).

Advantages of root canal treatment:

• Preserves the natural structure of the tooth.
• It eliminates problems such as pain and infection.
• In most cases, it can be completed in one session (in some cases, more than one session may be required).

Surgical endodontics (apectectomy):

Surgical removal of infection at the root tip.

Application areas:

• Abscess that does not heal despite root canal treatment
• Cyst/granuloma at the root tip
• Broken root tip

Method of application:

• The gingiva is opened, and the root tip and surrounding tissue are cleaned.
• The root tip is cut, and retro filling is applied.
• Suture is placed and removed after 1 week.

Vital pulp treatments (pulp protection):

Protective methods are applied while the pulp is still alive.

Direct pulp coating:

If the pulp is opened while cleaning deep caries, a special drug (calcium hydroxide/MTA) is placed on it. It is intended to heal the pulp and keep it alive.

Partial pulpectomy:

Only the infected pulp part is removed; the healthy part is preserved. It is applied to children's deciduous teeth or young permanent teeth.

Revascularization (in young permanent teeth):

In young teeth that have not yet completed root development, it is the method that allows the root to be completed when the pulp dies.

• Root canals are disinfected.
• Root cells are encouraged to come into the root by bleeding from the root tip.
• The canal is sealed with calcium hydroxide or MTA.

Dentures are methods of replacing missing teeth and restoring oral functions (chewing, speaking) and aesthetics. Dentures can be fixed or removable, and different types are preferred according to the patient's needs, oral structure, and budget. The main types and characteristics of dentures dental treatments are as follows:

Fixed dentures:

Dentures that cannot be removed from the mouth and are fixed to natural teeth or implants. They usually provide a more natural feel and appearance.

Crowns:

• These are veneers placed over a single tooth.
• It is used to restore damaged, decayed, broken, or aesthetically problematic teeth.
• They are made of porcelain, zirconium, metal-supported porcelain, or full ceramic materials.
• Natural appearance, durability, and longevity are some of their advantages.

Dental bridges:

• Used to replace one or more missing teeth.
• Neighboring healthy teeth or implants are used as support.
• Traditional bridges are winged (Maryland) bridges and implant-supported bridges.
• An aesthetic and functional solution provides comfortable use because it is fixed.

Implant fixed dentures:

Crowns or bridges fixed to dental implants.

• With systems such as All-on-4 or All-on-6, fixed prostheses are placed in completely edentulous jaws.
• They have advantages such as maximum stability, the closest feeling to natural teeth, and prevention of bone loss.

Removable dentures:

Removable dentures are dentures that the patient can wear and remove. It is preferred when more teeth are missing or when there is not enough support for fixed prosthesis.

Full dentures:

• Used when all teeth are missing (complete edentulism).
• It is specially prepared according to the upper and lower jaw.
• It offers an economical, aesthetic solution.
• Less stable than fixed prostheses, an adjustment period may be required.

Partial dentures:

• Used in cases where several teeth are missing.
• Teeth are added on a metal or acrylic frame and fixed to the existing teeth with hooks or precision retainers.
• It protects natural teeth and is an economical option.
• Hooks can be aesthetically uncomfortable.

Implant-supported removable dentures:

• These are removable dentures that attach to implants.
• They provide more stability and are more comfortable than traditional complete dentures.
• Being removable provides ease of maintenance and offers a more stable feeling thanks to the implants.

Temporary dentures:

• Temporary solutions are used during the treatment process, for example, until implant placement or preparation of a permanent prosthesis.
• They are used to preserve aesthetics and function and to relieve the patient during the healing process.
• They are fast to apply and economical.

Overdentures:

• Removable dentures that attach to natural tooth roots or implants.
• It provides better retention, jawbone protection, and comfortable use.

Hybrid dentures:

It is a mixture of fixed and removable prostheses. Removable bridges on implants (snap-in prosthesis) are an example of this.

Advantages of prosthodontics:

• Provides natural tooth appearance, improves smile.
• Restores the ability to chew and speak.
• It can prevent bone loss caused by missing teeth (especially in implant-supported prostheses).
• The patient's self-confidence increases with aesthetic and functional improvement.

Denture treatment process:

• The dentist assesses the situation with X-rays and an oral examination.
• If necessary, caries treatment, tooth extraction, or implant placement is performed.
• Mouth impressions are taken to prepare the prosthesis.
• The denture is placed and the fit is checked.
• Regular maintenance and checks are important for the longevity of the dentures.

Surgical dental treatments include procedures that require surgical intervention in the mouth, teeth, and jaw area. These treatments include tooth extraction, implant applications, jaw surgery, and invasive procedures to solve other oral health problems. This treatment method is used for the following purposes:

• The tooth is too damaged to be saved.
• Impacted teeth threaten oral health.
• Jawbone or gum problems.
• Aesthetic or functional problems.

Tooth extraction (extraction)

It is the process of removing the tooth from the jawbone. Tooth extraction is performed in the following cases:

• Severely decayed or broken teeth.
• Impacted teeth (e.g. wisdom teeth).
• Making space for orthodontic treatment.
• Teeth that cannot be saved due to periodontal disease.

Types of tooth extraction:

• Simple extraction: Extraction of visible teeth under local anesthesia.
• Surgical extraction: Requires surgical intervention to remove impacted or broken teeth.
• Impacted tooth extraction (wisdom teeth): Surgical removal of teeth (usually wisdom teeth) that are fully or partially impacted in the jawbone.

Dental implant applications:

• It is the placement of titanium screws in the jawbone to replace missing teeth and fixing prosthetic teeth on it.
• It is used in cases of single missing teeth, multiple missing teeth, or complete edentulism (e.g., All-on-4, All-on-6).

Bone grafting and maxillofacial surgery:

These are procedures performed to increase bone volume in cases where the jawbone is insufficient.

• Bone grafting: Bone is added using synthetic, animal, or the patient's own bone.
• Sinus lifting: Bone is added by lifting the sinus floor in the posterior region of the upper jaw.

Periodontal surgery (Gum surgery):

Surgical procedures performed to treat gum diseases or for aesthetic purposes:

• Treatment of advanced gum disease (periodontitis).
• Graft applications for gingival recession.
• Aesthetic gum shaping (gingivectomy, gingivoplasty).

Cyst and tumor surgery:

Surgical removal of cysts or tumors in the mouth or jaw area:

• Tooth root cysts, odontogenic tumors.
• Pathological formations in the jawbone.

Maxillofacial surgery (orthognathic surgery)

Surgical procedures performed to correct serious disorders in the jaw structure:

• Jaw incompatibilities (for example, upper or lower jaw forward/backward).
• Chewing, speech or aesthetic problems.

Frenectomy:

Surgical cutting of the tongue or lip ligament (frenulum) if it is too short or thick:

• Difficulty speaking or sucking.
• Gum recession or gap formation between teeth.

Abscess drainage:

Surgical drainage of a tooth or gum abscess to prevent the spread of infection and relieve pain.

Orthodontic treatments are applied to correct the alignment of teeth and jaws and to solve aesthetic and functional problems.

Aims of orthodontic treatments:

• Aesthetic improvement: A more beautiful smile with proper alignment of the teeth.
• Functional improvement: solving chewing, speaking, and biting problems.
• Oral health: To reduce the risk of caries and gum disease by preventing cleaning difficulties caused by crowded teeth.
• Jaw Health: Reducing jaw joint (TMJ) problems.

Who can receive orthodontic treatment?

• Children: To guide jaw development during the deciduous or mixed dentition period (6-12 years).
• Adolescents: The most common treatment period when permanent teeth are completed (12-18 years).
• Adults: It can be applied at any age to solve aesthetic and functional problems.

Types of orthodontic treatment:

Fixed orthodontic treatments:

Fixed orthodontic treatments allow the teeth to be moved using appliances that cannot be removed from the mouth.

• Metal brackets: The teeth are aligned using metal brackets and wires that are bonded to the teeth.
• Ceramic (aesthetic) braces: A less visible treatment using tooth-colored or transparent brackets.
• Lingual braces: Treatment in which the brackets are placed on the inner surface of the teeth (on the tongue side).
• Damon system (self-ligating braces): It is a bracket system that connects the wires with a special clip mechanism.

Removable orthodontic treatments:

Removable appliances are devices that the patient can put on and take off and are usually used in milder cases or in children.

• Clear aligners (Invisalign and similar): Transparent, custom-made aligners are used to align the teeth.
• Removable appliances: Removable aligners or appliances, often used to guide jaw development in children or for minor tooth movement.

Jaw correction treatments (orthognathic treatments):

A combination of orthodontic treatment and surgery to correct severe malalignment of the jaw structure.

Mini screw and anchorage systems:

Small titanium screws are inserted into the jawbone to support tooth movement.

Functional appliances:

These are devices used in children to guide jaw growth.

Objectives of periodontal treatments:

• To eliminate gingivitis and infection.
• To reduce gum pockets and prevent tooth loss.
• To maintain jawbone and gum health.
• To improve aesthetic appearance (especially in cases of gum recession or enlargement).
• To ensure the long-term stability of the teeth.

Periodontal treatments are classified as surgical or non-surgical methods according to the severity of the disease and the needs of the patient.

Non-surgical periodontal treatments:

These treatments are usually applied in early-stage gum disease (gingivitis or mild periodontitis) and aim to improve gum health with non-invasive methods.

Scaling and root planing:

Plaque and tartar (calculus) accumulated on tooth surfaces and under the gum line are removed with special instruments. The root surface is leveled to make it more difficult for bacteria to take hold.

Professional oral hygiene practices:

Deep cleaning and oral care training by a dentist or hygienist.

Laser treatment:

It is the removal of bacteria in the gum pockets and removal of inflamed tissues with a laser.

Surgical periodontal treatments:

Surgical methods are applied in advanced periodontitis or in cases that do not respond to non-surgical treatments.

• Flap surgery (flap operation): The gums are lifted and the tooth roots and bone are cleaned, then the gums are sewn back into place.
• Bone grafting: Bone is added using synthetic, animal, or the patient's own bone to repair the jawbone lost due to periodontitis.
• Soft tissue grafting: Definition: The gum is repaired by grafting gum recession areas, usually with tissue taken from the palate.
• Gingivectomy and gingivoplasty: Removal of excess or misshapen gums (gingivectomy) or aesthetic reshaping (gingivoplasty).
• Crown lengthening: The gums and sometimes the bone are molded to increase the visible part of the tooth.

Supportive periodontal treatments:

• These are the treatments applied after periodontal treatments to prevent recurrence of the disease and to maintain oral health.
• Regular checkups and care:
• Checking and cleaning of gum pockets during dental visits.
• Oral hygiene education

Aesthetic dental treatments are dental procedures to improve the appearance of the teeth and smile. These treatments aim to achieve a more aesthetic smile by correcting the color, shape, size, or alignment of the teeth. It can also provide functional improvements. Aesthetic dental treatments vary according to the needs and expectations of the patient.

Aims of aesthetic dental treatments:

• Aesthetic improvement: a whiter, smoother, and more symmetrical smile.
• Increased self-confidence: Social and psychological improvement through smile aesthetics.
• Functional correction: solving chewing and speech problems.
• Dental health: Supporting tooth and gum health.

To whom is aesthetic dental treatment applied?

• Those with discoloration, deformity, or crowding in their teeth.
• Those with gummy smile or gum asymmetry.
• Those with broken, cracked or missing teeth.
• Individuals of all ages with aesthetic concerns.

Types of aesthetic dental treatment:

Teeth whitening (bleaching):

A procedure using chemicals (usually hydrogen peroxide or carbamide peroxide) to lighten the natural color of teeth.

• Office bleaching: Performed in the dentist's clinic with highly concentrated agents activated by laser or light (1-2 hours).
• Home whitening: It is applied at home with special trays and low-concentration whitening gels given by the dentist (usually 1-2 weeks).

Porcelain lamina:

Thin porcelain veneers (0.3-1 mm) are bonded to the front surface of the teeth.

Composite bonding (aesthetic filling):

It is the process of correcting the shape or color of teeth using tooth-coloured composite resin.

Zirconium or porcelain crowns:

Aesthetic crowns that cover the entire tooth are usually made of zirconium or porcelain.

Orthodontic treatments (aesthetically orientated)

Braces or clear aligners are used to correct the alignment of the teeth.

Gum aesthetics (gingivoplasty and gingivectomy):

A more aesthetic smile is created by correcting the shape or level of the gums.

Crown length increase:

The gums and sometimes bone are moulded to increase the visible part of the tooth.

Composite or porcelain inlay/onlay:

These are filling-like restorations specially prepared for the decayed or damaged part of the tooth.

Full ceramic restorations:

These are metal-free veneers or bridges made entirely of ceramic material.

Pediatric dentistry (pedodontics) is a branch of dentistry specialized in maintaining the oral and dental health of children aged 0-14 years, monitoring tooth and jaw development, and treating problems that arise. Pedodontic treatments use specialized techniques to protect children's dental health while at the same time preventing fear of the dentist and providing a positive experience.

Preventive treatments:

Preventive treatments are the most important methods to protect children's teeth from decay and other problems.

• Fluorine applications
• Fissure sealants
• Oral hygiene education

Restorative (filling) treatments:

These are the methods applied for the treatment of dental caries.

Pulpotomy and pulpectomy:

It is the removal of part of the nerve (pulpotomy) or the whole nerve (pulpectomy) in cases where the decay reaches the nerve in milk teeth.

Tooth extraction:

Extraction of milk teeth that are too damaged or infected to be saved.

Space maintainers:

Devices are used to replace prematurely lost primary teeth so that permanent teeth can erupt in the correct alignment.

Orthodontic treatments (early period):

Treatments are applied at an early age to correct jaw and tooth alignment.

Trauma treatments:

Treatment of tooth fractures, cracks, or tooth loss in children as a result of a fall or impact.

Treatment of bad habits:

Correction of habits such as thumb sucking, nail biting, tongue thrusting, or mouth breathing.