Clinical experience, misunderstood concepts and frequently asked questions. Notes from many years of practice.
Knowing what is normal afterwards saves needless worry. A meta-analysis of 13 clinical studies with a median nine-year follow-up reported debonding in 2 percent of veneers, fracture or chipping in 4 percent and severe marginal discolouration in 2 percent. Recovery, sensitivity and long-term care.
Root canal treatment removes infected pulp and seals the canals to save the tooth; in a 420-tooth cohort, 10-year survival was 81.5%, higher with a crown.
Guided surgery places the implant along a plan built from the CT scan, and the accuracy is quantified: a meta-analysis of 67 clinical studies measured deviation from plan at 1.11 mm at the entry point, 1.40 mm at the apex and 3.51 degrees in angulation. What the guide adds, and what it costs in flexibility.
Periodontitis is linked to cardiovascular disease, but modestly: across 30 cohort studies, people with gum disease had a relative risk of 1.20.
Screw loosening is the most common technical complication of implant single crowns, at a cumulative 8.8% over five years, while the implants survived 95.2% at ten. The part in question is the abutment screw.
Healing after a dental implant runs in two phases: the gum closes in about one to two weeks, and the bone bonds to the implant over three to six months.
In a systematic review of randomised trials, composite onlays reached 87% five-year survival (95% CI 81-93). Restorative work runs from a single filling to a full arch; the trade-off is how much tooth is kept.
The idea that tooth shape should mirror face shape is a design tradition, not a measured rule: across 160 subjects, tooth form matched face form in just 23.75 percent of cases, and expert agreement on classifying tooth form fell to around 30 percent. What actually guides the design.
The question everyone asks first has a pooled answer: a meta-analysis of 34 clinical trials covering 6,207 patients put the average duration of comprehensive fixed appliance treatment at 24.9 months (95% CI 24.6 to 25.1). What happens at each stage, and what moves that number.
