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Advanced Procedures

Crowns are full coverage restorations  to repair a severely broken tooth by covering all or most of the tooth after removing old fillings, fractured tooth structure, and all decay. While most teeth which have had root canal treatments do need crowns to strengthen and return it to normal form and function, not every tooth needing a crown also needs to have a root canal. The larger the hole made by a cavity that has to be treated, the more likely a crown will be needed. Even after a filling is put in a large cavity, a tooth is more likely to break. Keep in mind that the jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressures. Crowns cover the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a far more serious matter and much more difficult to treat. Crowns greatly reduce this risk, as well as making for a nice smile. 

It takes two appointments to restore a tooth with a crown. In the first any decay is removed from the tooth and if necessary filling material, core buildup, is bonded to the tooth, the tooth is then shaped to accept the crown. We then take an extremely accurate digital impression of the tooth with our iTero computer imaging system. No goopy impression material required! Your digital impession is immediately sent electronically to our lab where it is fabricated according to Dr. Marra's exact specifications for your tooth. Your crown is produced at the lab and returned to our office normally in a week or less. During this time a temporary crown is worn. In the second visit this temporary is removed and the permanent crown is adjusted as needed. Both the tooth and crown are cleaned and disinfected and then cemented in place. Crowns may be fabricated using high strength all ceramic materials, porcelain fused to noble metals, or full cast gold.  

There are different types of dentures, but they share a common function. They replace teeth that have been extracted due to excess decay or become loose or are lost due to lack of bone. When tooth  decay and/or bone loss is great enough , it's time for dentures. Relax. No one enjoys losing their natural teeth, but you can still eat and talk regularly.

The entire mouth is examined and a determination is made as to which teeth will have to be removed, and which will remain. The loose and unrestorable teeth are then extracted. Dentures are fitted to go over or around whatever teeth remain in the mouth, depending on the type. There is an adjustment period after dentures are placed in the mouth, and it can take some getting used to. But once accustomed to the dentures, normal functionality and appearance return and one just carries on as usual. Often implants can be used to further stabilize the dentures.

A dental implant is an option to replace a missing tooth. In this procedure, a small titanium screw, called an implant, is surgically placed into the bone and allowed to set or integrate. The bone grows around it, forming a tight connection, which additionally slows or stops the bone loss that occurs when the root of a natural tooth is missing. Once the implant is firmly integrated in the mouth, Dr. Marra will take digital impressions and other necessary records painlessly with no drilling or need for injection.Then we fabricate a tooth which will be secured onto the top of the implant.This permanent solution has advantages over bridge work because it does not stress the surrounding teeth for support.

Implants can also be used as support for an implant bridge. This is an alternative to partial dentures, and has several advantages. First, there is no adjustment period and the patient, once the work is done, only feels teeth, not metal supports intruding into the mouth. Second, this slows the bone loss occasioned by missing teeth. Third, there is no discomfort or difficulty in eating. And, best of all, of course, they don't have to be taken out all the time.

We also offer mini-dental implants. These implants are about half the diameter of traditional implants and are used mainly to stabilize lower dentures.

Call for a free implant consultation.

Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed to reach all the way to the nerve or pulp. (Regular cleanings and check-ups prevent and detect problems early.) Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy. Once this occurs the pulp becomes infected, and can even extend through the root tip and begin to eat away at the surrounding bone (called an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own or with antibiotics. It can even weaken the entire immune system. This is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and/or a bad taste in the mouth. Sometimes, however, no symptoms are apparent and the person is unaware of any problem until a check-up.

A root canal is then performed to clean out the infected tooth pulp, and disinfect the canals of the tooth. The only other treatment would be to extract the tooth. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has been damaged enough to require root canal therapy.

This is an option for filling the space created by a missing tooth. It is formed to look like the missing tooth, and it takes its place in the mouth. The sides of a bridge use the two surrounding teeth for support, hence the name. A bridge replaces the missing tooth, both functionally and cosmetically. Bridge work is as much an art as it is an exact science. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material. The choice of material depends on requirements for strength, wear, and/or esthetics.

It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated the teeth surrounding the gap begin to shift inward, creating a whole chain reaction of bad things. Teeth use their neighbors for support, and, with one missing, they start to "fall." As this worsens the bite changes in response to the pressure. This can eventually result in problems with the entire jaw, e.g., TMJ. The surrounding teeth deteriorate and it is just a matter of time before they, too, are lost. Gum disease becomes a serious problem, with the difficulty of treatment increasing as the neglect continues.

TMJ stands for temporal-mandibular joint. Temporal, as in temple area of the skull; mandibular as in mandible, or lower jaw; joint as in it's where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Aside from the two bones that meet there, cartilage buffers them and five muscles are involved in the area. If something goes wrong a good deal of trouble can result.

Problems in this area can cause:

  • Headaches and earaches;
  • Broken and excessively  worn teeth;
  • Trouble/soreness in opening and closing the mouth;
  • Clicking or popping of the jaw;
  • Pain in the jaw muscles and pain that radiates;
  • Soreness in the area, sometimes extending to the face.

Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite, filling gaps between teeth, etc. There is no one solution that is right for all cases. Sometimes a plastic mouthpiece is used to reduce clenching or grinding that is contributing to the problem. If untreated and taken to extremes, surgery may be required to repair a badly damaged joint and broken teeth.

1238 E. Chandler Blvd. #101
Phoenix, AZ 85048
Phone: (480) 460-0484
Text: (480)213-0808