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900 NW 13th St #301
Boca Raton, FL 33486
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Why do dental implant screws loosen and fracture after a prosthesis is placed?

May 3, 2013

 I feel that foreign matter plays a role in contamination of not only the implant fixture threads, but also the implant screw threads. This foreign matter is comprised of blood (body), calculus (body), wax (lab), porcelain powder (lab), metal filings(lab), and stone slurry (lab).  I also feel that the screw head may not seat properly in the screw access hole of the screw abutment, crown, and/or bridge prosthesis due to the same contaminants.

Screw loosening/fracture occurs:
1. When dentists and labs don’t recognize this debris as a contaminant.
2. The dentists and labs don’t use a new/unused screw for the final screw.
3. The proximal contacts of the crown and bridgework are too tight, putting excessive lateral pressure on the screw threads.
4. Calculus formation in the threads of loose screws will inhibit the dentist’s ability to remove the screw without fracture.
5. Screw metal surface quality may play an important role. You need to check with the implant manufacturers.

Presoaking the screw access hole with tarter/stain removing solution is my best advice for existing cases. Lab quality control starts with using advanced magnification such as a quality dental microscope.  GC

Reaching out to dental students across the nation via YouTube

May 2, 2013

Thank you very much for you fit check videos – I think if every dental student watched them and applied the level of detail that you do then the worldwide quality of dentistry would improve drastically!
Thanks for all of your videos – I think they are some of the most informative dental videos on YouTube.

Dental Video Eyewear – "Seeing is believing" – Real-Time patient co-diagnosis.

July 6, 2012

Patient education is presented in many different ways:

  1. Reading materials: brochures, pamphlets, etc.

  2. Demonstration models, props, etc.

  3. Computer graphic sample still images, books, before and after photos with still shot images shown on a computer screen.

  4. Image capturing device – intra-oral camera, extra-oral digital camera with still shot images shown on a computer screen.

  5. Patient Video Eyewear – direct live video line connected to patient via their own personal pair of video eyewear.

Out of all the techniques presented above, only video eyewear allows the patient to become a co-diagnostician.  In short, the patient sees exactly the condition of their entire mouth in real-time similar to a 3-D motion picture.  Other image capturing devices can only attempt one angle, one position, and one photo at any given time.  Video eye wear reveals an infinite number of viewing angles of the mouth directly to the patient.  Patients that use video eyewear seem to become more pro-active in learning about the various aspects of their dental condition.  Some patients will want to continue to use the video eyewear even during the actual dental procedures in order to actively learn about the process of having their own teeth restored.  Not to mention, finding the needle in the hay stack,  this method dominates all others simply because it acquires its image through the lens of a microscope.  This state-of the-art technology is a rare find in the state of Florida and is currently being used in our Boca Raton Dental office.  To learn more about our video eyewear technology or make an appointment, please go to the “Comfort and Technology” section located at the following link to our website: https://www.gcuomodds.com/comfort–technology.html    For scheduling all video eyewear intial exam appointments, please go to the “Contact Us” section located at: https://www.gcuomodds.com/contact-us.html

GC

Dental Lab Work – do dentists or labs perform the final "fit checking" of your case?

March 18, 2012

I published the following information for dentists to review on YouTube, along with a short video.  Ultimately it is the dentist’s responsibilty to perform the final “fit checking” of your lab work prior to placing it permanently in your mouth. 

“Everyone knows that dentistry is not an “exact science.”  That being said, where do you draw the line regarding the fit of your lab work.  Do you simply trust that your lab is operating at 100% quality control?  Whose level of quality control?  I highly recommend that you at least purchase a stereo zoom microscope that can be mounted to a countertop in your office.  “Fit checking” all of your cases under a microcope after they come back from your lab, will give you the opportunity to send the case back for further adjustments.  You could be faced with making these adjustments directly in the mouth wasting your time, your money, as well as the patient’s time.  For years I’ve struggled with inconsistencies related to lab work during seating appointments.  I had to finally “grab the bull by the horns” and you can too.  Simply purchase a microscope and watch my video on fit checking.  I will be happy to give you the microscope information that you will need to make the right purchase.”  GC

The quality of my dental work  reached an un-imaginable high level of care once I stopped using dental loupes and switched to using a dental microscope.  I send all of my patients’ lab work to dental labs that also use microscopes.  Finally, I perform the final “fit checking” procedure and then place the lab work permanently in my patient’s mouth.  GC

GERD, also known as gastroesophageal reflux disease: drug caution and alternative treatments.

February 18, 2012

Home remedies for GERD can be found at the “People’s Pharmacy” website.  Here is an important link for those who are suffering from this debilitating disease: http://www.peoplespharmacy.com/2009/08/02/persimmon-tea-eases-acid-reflux/

Many people do not know if they have GERD because the symptoms of heartburn are not noticed.  Also, many of the drugs for GERD interfer with normal body physiology (bone density).  Here is another important link to view: http://www.peoplespharmacy.com/2012/02/01/heartburn-drugs-and-hip-fractures/   GC

Common Causes of Chemical Erosion

January 28, 2012

1. GERD, also known as gastroesophageal reflux disease, is a chronic symptom of mucosal damage. It is caused by stomach acid (hydrochloric acid) coming up from the stomach into the esophagus and eventually reaching the oral cavity.
2. Bulimia, an eating disorder, is characterized by binge eating and then purging (vomiting).
3. Carbonated beverag…e swishers show tooth wear on the facial (front) side of teeth. The fizz (carbonic acid) causes the demineralization of enamel to eventually form islands of the underlying tooth structure known as dentin. Colas are the most destructive, as well as 5 and 7 hour energy drinks (phosphoric acid) and Gatorade (high fructose sugar).
4. Citrus fruit suckers have front teeth that look like a screwdriver blade. The enamel erodes on both the front and back side of front teeth.
5. Citrus fruit mullers have more wear on back teeth than front teeth.

Please note: 25-50% of GERD patients may not have any symptoms other than dental. GERD is a precursor to Barrett’s esophagitis which can lead to esophageal cancer!! GC

 

Willpower Science – Did you make a New Year's resolution and are you keeping it?

January 15, 2012

Happy and Healthy New Year to all!!  Our resolutions are easy to make, but sometimes disolve by the beginning of March.  This link will help keep your 2012 goals on track with less stress.  Dr. Kelly McGonigal teaches at Stanford University School of Medicine and specializes in mind-body connection.  Good luck this year with keeping a healthy body.  GC

 http://www.peoplespharmacy.com/radio-shows/

900 NW 13th Street, Suite 301, Boca Raton, FL 33486 USA
Dr. Gerard Cuomo Gerard Cuomo Microscope Enhanced Dentistry is passionate about dental service through their advanced technology to give their patients perfect smiles. (561) 391-6290 (561) 391-6299 dr@gcuomodds.com