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Specialized Dental Services

     

Root Canal Therapy (Endodontics) | Oral Surgery | Orthodontics (Tooth Straightening/Invisalign)OrthognathicsRelaxing Environment and Hypnotherapy TMJ Therapy | Night Guards | Occlusal Guards 

 

 

 Specialized Dental Services

Additional areas of our expert dental care.

Root Canal Therapy (Endodontics)

The pulp is in the center of the tooth from the root tip to the visible crown. It is the source of all sensations that come from a tooth. Pulpal therapy, also called root canal treatment (RCT), is the process by which a damaged pulp is treated to allow the tooth to exist normally for years to come.

Dr. Prus was trained to do RCT by Dr. Syngcuk Kim, Chairman of the Department of Endodontics at University.of Pennsylvania and one of the most respected and internationally known endodontists.  Dr. Prus is aware of the latest in technique advancement in this field.  At CDE we perform all our RCT with magnification and focused beam lighting. Microscopic endodontics (RCT with magnification) is the standard of care for all root canal treatment today.  A Zeiss microscope with 24X magnification is frequently employed because often there are pulp canals thinner than a human hair that cannot be seen by the human eye.  They must be located, cleaned out and disinfected for the treatment to be successful. If they are not, the infection will return.

Root canal treatment can involve many different procedures from direct pulp capping of a slightly damaged pulp, to total removal of the soft tissues of the pulp, leaving the hard structure of the tooth intact, ready to function in a normal and comfortable manner.

The most important aspect of RCT is the total removal of soft tissue material inside the pulp chamber all the way to the root tip and the complete disinfection of the chamber of existing bacteria and filled completely with a soft, pliable filling material called Gutta Percha. Root canals have a great variety of shapes and they can be difficult to thoroughly clean.  Extensive filing with special, slender rotary instruments and irrigation of the canal with special medicaments will provide a clean and bacteria-free chamber ready to be filled.

After RCT is finished a proper restoration must soon be placed to prevent reinfection from oral bacteria, or fracture of the weakened tooth.  Which restoration type is used depends on how much coronal tooth structure is left. It is preferred to cut the least amount of tooth structure for a restoration in order to leave the tooth stronger and more durable.

Oral Surgery

The Center for Dental Excellence will perform many routine extractions for its patients. If the need arises, either by patient request or by Dr. Prus’ directive, oral maxillo-facial surgeons are referred to in order to guarantee the most successful result.    

The single most important factor is the health and welfare of each patient. Patients trust us to make the best decisions in their behalf and we regard that trust with the highest level of professional care.

TMJ Therapy

Bite adjustments (occlusal adjustments)
CDE believe occlusal adjustment is an important preventive therapy in creating and maintaining a properly balanced bite.  Teeth out of position become loose, chip and wear faster. Teeth that are in functional balance wear less, chip less, are firmer, healthier and look more beautiful longer. Smiles look younger longer and are healthier when they function properly.

There are three main consequences of excess stress in the mouth.

1. Tooth deterioration: commonly seen two ways:
         o   Wear Facets: excessively worn, flat spots on chewing surfaces

         o   Abfractions: seen at the gum line as indentations of various shapes, or on the biting surfaces as little indented dimples in the enamel. They are very commonly found with excessive chewing or grinding forces but can come from multiple sources: chewing/grinding, excessive acidic dietary influences, gastric vapors, unidentified stress factors. Most patients recognize them through gum recession that they cause. They are often sensitive to touch (fingernail).  This sensitivity does NOT mean there is a cavity. It is advisable to place a bonded filling over the abfraction to reduce sensitivity and stop the deterioration from continuing.

 

2. Bone deterioration: when excessive stresses are placed on the teeth and if a patient has bacterial accumulations on their teeth below the gum line (plaque and calculus), the combined factors will accelerate bone deterioration and create tooth mobility.  Bone loss accelerates as the tooth becomes more loose.  Many teeth are lost due to this combination of events.

3. Jaw joint and supporting muscles also are frequently in spasm when stresses overwhelm the adaptive mechanisms of the jaw.

Use of a night guard can minimize, and, perhaps, prevent these deteriorations from occurring.

Night Guards
Due to personal stress issues or non-functional habits, many patients grind (movement) or clench (static pressure) their teeth causing excessive wear and deterioration of their teeth and supporting bone.
A night guard is a device that can be worn at any time, but most people prefer nighttime use, to spread out these excessive forces on the teeth.
It is better to wear out a night guard than your teeth. Excessive grinders may have to periodically replace them as they wear through.

Occlusal Guards
Mouth guards are also used extensively in all levels of sports to protect the athlete’s teeth.  Once rare in sports, they are now commonplace.  Professional athletes are routinely seen with them.  CDE believes all athletes should be fitted with precise occlusal guards.  Store bought guards offer less protection than those obtained from a dental office.
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Orthodontics (Inman Aligner Tooth Straightening/Invisalign)

Importance of straight teeth  Besides improving appearance, which is important in its own right, teeth in proper alignment function better.  When teeth function properly, not unlike any other interactive device, they will resist wear, look better, feel more comfortable, be easier to maintain and overall last longer.  Over a lifetime it can save you significant amounts of money.

The Center for Dental Excellence will perform minor tooth movement procedures in office (Inman Aligner) and refer patients to highly trained, advanced orthodontic specialists for more difficult cases such as full mouth orthodontic cases.
In all circumstances patients are taught that the position and arrangement of their teeth are critical to having a long lived and beautiful smile. Crooked teeth are more difficult to clean than straight teeth, therefore gum disease and tooth breakdown is more common.

Clear repositioning trays, such as Invisalign or ClearCorrect, guide the teeth into the correct functional position with sequential trays. Correct function is critical for durability in the mouth. When teeth are out of position, they tend to wear, chip and break more and become more mobile. It is also important to maintain correct alignment over years because teeth always have the capability to move out of position.  A clear tray aligner, similar to a thin night guard, can achieve that.  Many adults have had recurring teeth misalignment after childhood orthodontics and suffer from dysfunction of the jaw as a result of not maintaining proper position for several years after treatment.

It is very important that misalignment conditions are corrected and CDE will make certain that the best option is presented to each patient with the use of models, oral imaging and digital x-rays in order that they fully understand the problem and the solution.

Orthognathics (Jaw Corrective/Realignment Surgery)

Orthognathics (dental orthopedics) is an advanced application of dental care that is used when the bones of the mouth are out of position, irrelevant of tooth position. Repositioning of the bones by a highly trained oral maxillo-facial surgeon allows the other members of the dental treatment team to create the best possible result when the initial condition would have prevented it from happening.

In orthognathics the facial appearance of the person can be favorably altered, creating a more balance look to the face.

 

Examples of the conditions commonly corrected with orthognathics

 

  • Excessive display of gum tissues
  • Crooked upper or lower face
  • Protruding or heavily receded chin
  • Tilted or angled jaws
  • Severe misalignment between upper and lower jaws

 

It is very important to be able to recognize the potential need for orthognathics in any imbalance in the mouth. If it is appropriate for the patient, but bypassed, other treatment is less likely to be successful.

  

Hypnotherapy and a Personal and Relaxing Environment

 

Dr. Prus has received years of training in advanced applications of medical and dental hypnotherapy. In addition Dr. Prus has discovered the primal ingredient of most dental phobias and he will ensure each and every patient learns it and overcomes the consequences of it. A favorite patient for the staff and Dr. Prus at CDE is the phobic patient. They are enthusiastically welcomed because they will learn easily and effortlessly how they can truly control and overcome their dental fears.  For them, it is an exciting and rewarding experience as they realize they no longer need to rely on the escape mechanism of Nitrous Oxide (laughing gas). Empathy and TLC work wonders for all anxious patients and, along with specialized instructions for guided relaxation and anxiety control, they quickly become relaxed, happy and enthusiastic participants in the dental environment. They know their fears are behind them for good.


Dr. Prus and his staff at CDE appreciate and respect the effort the fearful and phobic has taken just to come into the office. That effort will not be invalidated by any attitude of the staff. They will support you and guide you through your apprehension so you may gain the confidence and self-assurance so many others have experienced before. All patients will enjoy the wonderful amenities in our office that will create a peaceful and relaxing experience that they will appreciate long after they have finished their care. If you suffer from dental fears or anxieties from any cause, the Center will help you start an entirely new chapter in your life.

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