Welcome to our dental clinic

Our office is situated in the downtown area of Thessaloniki. We are specialized in complex and difficult cases of advanced periodontal disease in need of implant tooth rehabilitation. Esthetics is a prime objective in every approach. The team is comprised of specialized clinicians in different aspects of dentistry. Head of team is Dr. G. Makris.

  • The office works on appointment basis accepting however emergency problems in need of immediate care
  • The working schedule of the clinic is from 10:00 am to 9:00 pm.



What has changed in our office because of
Covid-19 pandemia

We have taken a series of preventive measures according to the Swiss Dental Association which can be summarized as follows:
  1. Medical exam of every individual before entering the office (temperature, oxygen saturation, medical history, questionnaire of recent activities)
  2. In the waiting room there will be just one patient per doctor and there will be no cross contacts.
  3. Continuous fresh air ventilation of the office.
  4. Measures of oral health prevention (hand washing, decrease of microbial load in the mouth, gloves and mask for all patients).
  5. Disinfection of the working area after every patient.
  6. Appropriate medical equipment for single use for all personnel of the office (masks, garments).
  7. All dental service is provided with 4 hand dentistry.


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All these measures prolong the treatment phase considerably compared with previous modality of work. Additionally the cost of the treatment is affected. We hope that you will understand all these procedures for the prevention of public health and you will justify time lengthening of your treatment.

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The philosophy of the team focuses
on the "holistic approach" of treatment.

This approach is based on the thorough diagnosis of all aspects of mouth function and plans the clinical steps to accomplish the original goal of the therapy.


Let’s give some examples:
  1. An absolute prerequisite to make a filling is the establishment of gum healthlightbox. The least amount of bleeding will hamper the gluing properties of the material and thus will produce micro-leakage and microbial infiltration. Thus before any operative approach the treatment of inflamed gums is an absolute step. This is the reason why the metal margins of crown restorations appear afterwhile ugly when someone smiles. Periodontal treatment will eliminate edema of the gums. These will produce resession: the gums will move away from the crown and thus the margins of the metal will appear. Additionally black holes will occur between the crowns of teeth and sensitivity in cold and warm will provoke discomfort when chewing.
  2. Absolute prerequisite for implantlightbox placement is the completion of periodontal treatment. Why? Periopathogen bacteria from periodontal pockets will attach to implant surface and this is a high risk factor for implant rejection.
  3. Absolute prerequisite for an esthetic restoration in the anterior teeth is the establishment of complete homogeneitylightbox of adjacent teeth in color, shape and appearance through lips.
  4. Absolute prerequisite for implant placement is the thorough examination of general health. The simplest drug (aspirin) to more complex (diphosphonates) can induce serious problems of healing procedures.

What should be this step procedure?

  1. First to teach the appropriate dental health. Why? The most serious dental diseases are caries (rotten tooth) and gum problems. Both conditions are infection diseases. Which means disease produced by bacteria. So if we do not learn how to remove microbial agglomerations away from our teeth on a daily basis this would be a serious risk to develope disease and thus will affect prognosis of our restorative works.
  2. Secondly we have to reduce the microbial load from our mouth. In which way? Well caries is broken down dental structure infiltrated with millions of bacteria. Bleeding gums are the result of acute inflammation caused by the invasion of bacteria inside the tissues.
    So this step includes the following procedures aiming to reduce microbial load.

    1. Cleaning of tooth caries (soft diseased material of tooth).
    2. Treatment of gum disease (removal of calculus and diseased tissue).
    3. Extraction of the destroyed and not maintanable teeth.
    4. Root canal treatment.
  3. Only after completion of the above we proceed to the final step: the restorative phase

Dental Implants

Dental Implants

What is a dental implant?

The implant corresponds to the tooth’s root. It has the shape of a screw and it is placed in the jaw’s bone. What shows in the mouth (the «tooth») is a porcelain crown which is supported by the implant.

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Where dental implants are used?

An implant can be used when one, more than one or all the teeth are missing.

A. One tooth missing
An implant replaces one tooth, usaually a front and rarely a posterior, in order the adjacent unimpaired teeth won’t be harmed.

B. More teeth missing
It is indicated in cases that posterior or front teeth are missing and the placement of a removable partial denture is not desirable. Placement of implants helps construct of a fixed bridge. Futhermore, implants are used in cases where the gap between teeth is extended making the construction of a bridge difficult or even impossible.

C. All the teeth are missing
Implants offer two options:

  • When a patient doesn’t want to wear a denture. With implants one can have teeth as if were hiw own.
  • When a denture is well tolerable by the patient but it has poor retention.
    Then, only two implants can improve dramatically retention and function of the denture.

Can the human organism reject dental implants?

No. Implants are manufactured by pure titanium, a material compatible with the human organism. Besides, titanium is being used for many years in orthopeadics without causing any problems.

Is it possible for an implant to fail? If so, what is the failure percentage?

Yes, in very few cases. The reasons are technical. Still, even in this case it can be replaced without a problem. The failure percentage depends on the doctor’s experience. In sepcialized and well-experienced dentists this percentage is less than 1%.

How long do implants last and how much they cost?

With proper care implants can last a lifetime. At first glance implants are far more expensive than a conventional bridge or a denture. In the long run one must have in mind that a bridge or a denture must be remanufacrured 2-3 times and then realizes that the overall cost of implants is much lower.

Is there an insurance and quarantine policy for your implants?

Our office has chosen to work with one system of implants the last 20 years. This is the Swiss Straummann and the reasons for this choice are the following:

  1. Dental international literature shows the lowest failure rate of all implant systems
  2. This implant system is one of the very few that invented the foundations of osseointegration, which is the biologic basis of implant therapy.
  3. Maintains spare parts for all implant types and provides continuous education
  4. The industrial production of implants is made in their own premises. There are no contractors in implant production.
  5. It was never purchased by other implant manufacturers or changed hands. This policy does not produce problems of patent ownership.
  6. They provide warranty which covers every replacement of the implant lost for any reason.
    Thus, our office provides warranty for the implant lost and the surgical procedure to replace the lost implant.


Is age a contraindication in the placement of implants?

No. The only exception are children. In that case, growth must be completed before the implant placement (after the age of 16-18).

Is the placement of implants a painful procedure? How many days must I be absent from my job?

Usually is less painful than a tooth extraction. In the case that many implants are being placed in the same operation, mild pain and swelling can be observed, but nothing that cannot be settled by a simple painkiller. In most cases the patient can return on his/her job immediately after the operation. When many implants are placed the intercession of a weekend allows the patient to return to his/her job without any annoyance.

How long will it take to have my new teeth?
During that time I will be edentulous?

After the first visit usually it takes 6-12 weeks for the therapy to be completed. As long as therapy lasts provisional restorations are made in order to achieve satisfactory mastication and esthetics.

Do I have to quit smoking during therapy?

As in many other cases, smoking can cause various problems.
So, decreasing or even quitting smoking is recommended at least the first week after the operation because smoking affects the process of healing.

Do implants need special care?

No. As natural teeth, daily brushing is sufficient as well as frequent visits to the dentist.

Why should we know and ask our doctor for our implant identity?

First, there are very few manufacturers among hundreds that produce primary applied research trying to explore the properties and behavior of their implant.
Second, the serious manufacturers provide insurance policies for their implant. They are replacing any implant lost for biological or mechanical reasons.
Thirdly, if we know the identity of the implant any other dentist can find spare parts replacing and repairing possible problems.
Finally, serious manufacturers maintain spare parts and replacement parts for damaged implants. Otherwise, with no possibility of repair the restoration is useless.


Cases

  • Single implants

    Are needed mostly in cases of missing teeth, or more rarely posterior teeth.
    These teeth can be lost due to:

    • accidents (fails or hits)
    • extensive caries
    • bad endo work
    • fractures
    • repeated abscesses
    • gum disease

    In these cases dental implants provide the best solution. Adjacent teeth can be preserved unimpaired and not be included in the bridge. Single implants can be restored with porcelain jackets, which provide function and esthetics.
    In the 1st case two of the teeth presented excessive mobility due to terminal gum disease. Teeth were removed. Two single implants were placed and porcelain jackets restored hers.

  • Case 2

    In the second case treatment was more complex.

    It demanded plastic surgery of gums and regeneration of underlying bone tissue.

    Subsequently a single implant was placed.
    Prosthesis followed and a small esthetic arrangement of the adjacent teeth was done.

  • Case 3

    Young woman with primary teeth (milk teeth) still in her mouth. The permanent teeth were
    congenitally missing.

    These «baby teeth» fell in the age of thirty. She has done orthodontic treatment for esthetic
    reasons and to provide space for the lost teeth.

    Now she does not want to cut down adjacent teeth in order to place a fixed bridge.
    Two individual implants with porcelain crowns solved the problem!

  • Case 4

    Patient who wears denture in the upper jaw.
    She wishes to have:

    In this case four to six implants are needed to replace the denture. The new teeth are now fixed and function as her own. They are esthetic and the palate is open, as it was in the past. Now she can enjoy her meals without her tongue touching the cold, metal surface of the denture all the time.

    • Fixed teeth
    • Open palate for comfort and better taste
    • Pretty teeth-smile
  • Case 5

    Individuals who wear partial dentures (Vitalium) and wish to replace it with fixed teeth. In this case the false teeth are the front of the upper jaw. The patient feels embarrassed when the vitalium moves around and she is afraid of smiling. She wishes to:

    Three implants were placed. A new fixed prosthesis combined with her natural teeth was placed. Now she is happy and she can function properlly. She laughs all the time and she feels good with herself.

    • Have fixed teeth
    • To get rid of the vitalium
    • Be pretty
  • This patient lost a number of teeth due to gum disease. He wishes to:

    The treatment plan in this case is more complex and takes more time. Requirements:

    • Treatment of gum disease
    • Provisional fixed bridge to evaluate factors such as
    • Prognosis of treated teeth
    • Esthetics
    • Mobility etc.
    • Get rid of the bad odor of the gum bleeding
    • Avoid eventually denture placement
    • Have pretty smile
    • Have fixed teeth

    Only when inflammation is under control, we proceed to the placement of implants. In this particular patient we placed three implants and a bridge was made in combination with his natural teeth. All of his demands were satisfied > Healthy mouth > Fixed and pretty teeth

  • Patient wearing full dentures, mostly in the lower jaw.

    The denture is very mobile, the cannot chew well and feel very uncomfortable and insecure in their social life. They wish for a good and secure retention of their denture.

    The best solution would be two implants on which the denture could be attached.

    The heads of the implants are connected with the inside part of the denture. The retention is perfect.

    The denture does not move at all and the patient can function normally in his social life.

  • Restoration

    Restoration of missing central incisor with single implant

  • Restoration

    Young individual that lost his front tooth after a bicycle accident. Implant placement can be immediate or in a couple of weeks depending on tissue trauma. In any case immediate aesthetic restoration is imperative and tooth replacement will be executed immediately. Usually the restoration is an adhesive bridge (Maryland type) attached on the adjacent teeth. The procedure is reversible and will be replaced by the fixed implant supported tooth.

Periimplant Diseases

Periimplant Diseases


or what can happen to your implant!!

What are the periimplant diseases?

These are inflammatory diseases that develop around the implant. They may affect only the soft tissue around the implant but they can also invade deeper structures of the implant support. This means bone destruction and denudation of implants from their support.These diseases are considered similar to periodontal ones but there is a distinct difference; Inflammation is evolving and spreading more rapidly causing extensive and more important destruction.

What are the symptoms and how often they occur?

The symptoms are: swelling of the mucosa, intensive bleeding, abscess and pain. Dental literature indicates a mean 10% of frequency in all implants, but unfortunately this percentage can affect only some individuals and thus many implants at the same time. This means that for these individuals implant loss will be a total loss!!!!

What is the cause of periimplant disease?

There are three main reasons. The first reason is the level of everyday oral health. This can be also related to the quality of prosthesis. How accessible is to good cleaning. The second reason is the existence of active periodontal disease in the adjacent teeth or even more in the previous dentition (even if the individual had lost all his teeth because of periodontal disease).Your doctor should treat your periodontal condition BEFORE placing the implant Otherwise bacteria from adjacent teeth can colonize implant surfaces and that is the beginning!! Third causative factor is the quality of your implant restoration. This comprises a lot of factors of the surgical procedure (how neat and precise), the type of implant, their position in the arch, the accessibility to oral health measures. Final causative factor is smoking. More than 10 cigarettes is considered a heavy smoker!!

Let’s see some examples of periimplant diseases that were referred to our office for treatment.

It is obvious even for an amateur when he sees the x-rays to understand several problems of these cases:

  1. The extensive number of implants placed without any treatment plan across the arch of the patient resulting in an implant superstructure not accessible for oral health measures. The extensive number of implants means also an “extensive” amount of money!!
  2. The advanced destruction of implant bone support( red line) is obvious compared to the normal level of bone (white line)

What is the scientific reason of these conditions?

These are infectious diseases which means adherence and concentration of bacteria around the neck of the implant that produce inflammatory reactions that are followed by tissue destruction. These bacteria originate from adjacent structures or from other parts of the oral cavity (tongue, cheeks, throat).

Is there a treatment for periodontal disease?

Yes there is!

It demands a holistic approach again which comprise.

  1. Treatment of the disease in the entire mouth including teeth (if survive).
  2. Oral hygiene instructions, applied to every individual (interdental brushes, superfloss, etc.)
  3. Modification of the prosthetic restoration, so that is more accessible to oral health measures.
  4. Surgical approach around the implants that were affected in order to accomplish mechanical and chemical decontamination.
  5. Application of surgical methods of regeneration using grafts and membranes.

What is the best way of prevention?

Evaluating the risk factors for every case!! It is advisable 2-3 times a year to provide a “thorough” cleaning of teeth and prosthetic superstructure.

Example Cases

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This lady presented to our office with a lot of pain and swelling in the upper jaw. She had placed implants five years ago and she had already lost one implant in the lower jaw two years ago. Her x-rays demonstrated huge bone destruction around the implants,arrows 1 2 3 photo 1lightbox. With the removal of her bridge photo 2lightbox one implant was explanted automatically No3. In the 3rd photolightbox we can see the swelling and the granulomatous hyperplastic tissue. The implants are mobile which means they have lost their osseointegration. One tooth which was maintained, had an extensive carious lesion and should now be removed. Thus after the removal of the 3 implants and the carious tooth, the only possible prosthetic solution is a full upper denture.

What was the cause of this case?

  1. The surgical technique appeared inadequate. Observe the proximity between the two implants, almost in touch!!!
  2. Selection of implants. She had 4 different implant systems in her mouth!
  3. There was no organized preventive recall system in the last 4-5 years.
  4. Inadequate prosthetic restoration. One can observe the quality of the abutments.
  5. Oral hygiene was really difficult to be maintained due to the inadequate prosthetic restoration.

Conclusion: The success of an implant supported prosthesis is a very delicate procedure demanding careful treatment attention to all biologic and biomechanical parameters. It is more than pity to sacrifice all that time, pain and money due to an insufficient medical work!!

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The perfect disaster!
This lady six years ago had an implant operation. Her doctor placed 14 (!!) implants for upper and lower jaw rehabilitation (please multiply the number of implants with the dentist’s fee per implant and you will find the sum of money that she paid). She came to our office complaining of multiple episodes of swelling pain antibiotics over and over again in the last years.
In the x-ray that she brought it is marked with a white line photolightbox where the bone level should have been and with red line where is situated now. A marked difference all over!

Many of the implants should be removed. What happened??

  1. Firstly, the number of implants is excessive! Good for the doctor, but bad for the lady!! Between the implants there is a minimum bone support, which means that a very light inflammation would provoke extensive destruction. So the number of implants does not matter really but the quality of the treatment is of major importance.
  2. It is obvious that there was no planning neither for the surgical place nor for the restoration treatment.
  3. She was never instructed in specific oral hygiene measures.
  4. She did not have any fixed recalls for professional cleaning.

Conclusion: It is sad to observe cases like this without surgical and prosthetic plan. It is obvious that this case presents matters of medical ethics, but also misjudgment of this individual in choosing the proper doctor.

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Two cases executed with the same mistaken concept: multiple implant placement in sites where one implant was sufficient. It is for this reason that bone loss around the implants is more advanced (red arrow) compared to that of the adjacent teeth!

Final conclusion: Doctor’s ignorance or profit expectations have detrimental effect on your implant work. It should be made clear that peri-implant destruction could be faster compared to the periodontal bone destruction around the teeth of the same patient. Thus, placement of implants could produce more problems than solving ones in case that proper planning is inadequate!!!

Sinus lift

Sinus lift

What does sinus lift mean?

It is a surgical procedure that is used in the upper posterior jaw in cases of terminal bone reduction and pneumatization of the sinus cavity. Then by using a small portion of the sinus cavity, which is filled with graft material new bone is regenerated and implants can be placed in a later time.

Is sinus lift more demanding and more time consuming?

Unfortunately yes! It takes 4-6 months waiting time. In addition has a higher cost because of the second surgical procedure plus a considerable quantity of graft material needed to fill in the space.

What is the prognosis of such an operation?

Statistics for implant success in these procedures are very high and equivalent to normal implant placement. However it should be noted that duration for the final restoration is longer, cost is a lot higher and side effects could be more prominent.

Are there side effects and whether alternative solutions exist?

Every surgical approach should be planned and executed through accurate diagnosis and proper treatment plan. There are 5-10% of side effects reported in the literature. For this reason, before the decision for such an operation, a search for other conservative approaches is advised. The alternative solutions are:
a. Very short implant (>6mm). In this case for biomechanical reasons an increased number of implants is recommended.
b. Placement of tilted implants that can bypass the sinus cavity
c. Closed sinus lift procedure which can increase the height of remaining bone through a more conservative approach.

Periodontology

Periodontology

Periodontology

What is the microbial (or dental) plaque?

This is an organized agglomerate of bacteria originating from the microbial flora of the mouth attached mainly on the surface of the teeth. The maturation of the plaque increases its infectious potential and so becomes aggressive to the tooth itself and the tissues around the teeth. In the mouth microbial plaque can be recognized as an off-white colored agglomerating where the tooth meets the gums. The only way to remove the plaque and thus to protect tooth and gums, is by the mechanical action of the tooth brush.

What is calculus?

This is the calcified hard structure initially found in areas where the saliva exits from the salivary glands (for example inferior surfaces of lower front teeth). Absolute prerequisite to have calculus is the presence of dental plaque. Then mineral ions infiltrate the organic matrix of plaque and form crystals and thus starts the mineralization process. Calculus is harmful because its surface is porous and microbial plaque can “hide” and mature inside protected cavities. So its presence is more harmful. At this time removal of calculus can be accomplished only by the specialized dentist.

What is gingivitis?

This is an infection of soft tissues around teeth that produce bleeding and local swelling. These symptoms ( blood on the pillow is frequent) can appear to recede and then again “flare up”. So it can be of a cyclic nature. However these main symptoms can be aggravated due to hormonal disturbances ( puberty- pregnancy- menopause etc) and to systemic diseases ( diabetes). Treatment of this infection can totally reverse disease to health.

What is the treatment of gingivitis?

Removal of microbial plaque and calculus, education in effective daily tooth brushing and removal of local factors that increase plaque accumulation ( bad fillings etc) are the main elements of treatment. This treatment can be accomplished under anesthesia in two or three visits in the office.

What is periodontitis?

When the infection from the soft tissues (gingivitis) propagate to the underneath supporting bone. This process produces destruction of bone and decreases tooth support. There is gum recession and finally this can result in tooth loss depending to different factors but mainly to the rapidity of this bone loss. This condition can be diagnosed as early, medium, advanced and aggressive. Treatment cannot reverse destroyed tissues but can succeed in arresting the disease and in some specific cases localized regeneration can be accomplished.

What are the symptoms of periodontitis?

Periodontitis does not produce pain as in the case of caries in the tooth. In early stages symptoms (swelling- bleeding- pain) come and go (cyclic nature). It is only in late stages that tooth mobility appears and teeth move in other positions. Abscesses can occur, taste is bad and oral breath is annoying.

What is the cause of periodontitis?

These are infections associated with very virulent and aggressive bacteria that usually develop in anaerobic conditions. There is also a predisposing family factor (genetics) and most of the times reduced interest in daily oral health.

What is the treatment?

Since we have an infection, treatment should be antimicrobial. This does not mean antibiotic therapy. Treatment should aim to “clean” thoroughly teeth underneath the gums. This is performed under local anesthesia in quadrants. Access to tooth cleaning can be done surgically ( open flaps) or conservatively (closed curettage) depending on the severity of the disease. Daily oral health should be thorough and applied intensively in order to preserve results of treatment.

Does periodontits produce pain?

Very seldom so, this can only happen in acute stages of the disease. Abscess formation with pus exudation can provoke pain. Usually there is a feeling of “etching” on gums. You want to “frot” the gums in order to remove this symptom.

Why does my mouth smell bad?

Periodontal diseases are infections of inflammatory nature. This means that there is an ongoing process of tissue destruction. Bi-products of this destruction are sulfur chemical unions that produce bad smell and cannot be hidden with mouthwashes.

What means a ”pocket” in periodontal disease?

In advanced periodontitis pocket formation occurs. Because of bone destruction and when the gums are not receding there is a gap between the margin of the gingiva and the level of the supporting bone. In other words there is a crypt underneath the gums that bacteria can agglomerate and be “protected” from the action of the toothbrush. When a critical volume of bacteria is reached then a ”burst” occurs- like a microabscess- producing a localized destruction. The bone, recedes and a new equilibrium is established until the next “burst”. Thus pocket formation is potentially very dangerous in tooth prognosis. One aspect of periodontal treatment is to eliminate pocket formation.

What does it mean ”surgical approach” to periodontal treatment?

When the depth of the pockets extends beyond 5mm measured from the margin of the gum then this pocket is a potential aggravating factor of the disease. It is estimated that the extent of the pocket surface in the case of periodontal disease equals the surface of the palm of the hand. The bacterial population of this area is enormous. Three objectives of the periodontal surgery are 1. elimination of pockets, 2. access to the hidden areas of the tooth in order to clean then from bacterial plaque and calculus, 3. establishment of a tissue contour that enables better oral health of the patient.

Is laser therapy better than the surgical one?

Laser is a high energy beam. Despite the fact that every laser instrument could be different, there is no scientific evidence that lasers are more effective in periodontal treatment. On the contrary there is evidence that some of them “burn” the tissues producing extensive esthetic damages.

Does the surgical approach is painful?

It depends on the surgeon! How aggressive is the technique and whether is needed to approach surgically the area, when there is a possibility of a conservative approach.

Is it possible to surgically intervene locally?

Of course! The case of surgical approach should be targeting only in areas that need such intervention. After conservative treatment this approach could be very localized where is truly needed. Sometimes periodontists overtreat patients!

Why we observe recession of gum in periodontal disease?

In some cases due to anatomic reasons (very thin gingiva) bone resorption is followed by tissue recession. This is more frequent in front teeth. So we can say that there are two cases of equal periodontal destruction. One can appear with recession and no pockets while the other with pockets and no recession.

Does treatment can restore recession?

Most of the times the answer is no. Sometimes localized recession defects can be treated by plastic surgery. It is important however to understand that even in these cases there is no proper regeneration of the lost tissues but rather an esthetic approach of “covering” this recession.

Do the spaces between teeth will close after treatment?

Unfortunately no! Spaces have been formed because the edema and inflammation have been gone. The gum in a physiologic manner seek to take its place near the underlying supporting bone. Gingiva now appear pink, firm and healthy. Spaces can be closed only by restoratives means (see bonding).

Does periodontal disease affect general health?

There is scientific evidence that supports a relationship between cardiovascular disease and periodontal disease. Periodontopathic microbes can induce formation of atherosis in the vessels. There is also general agreement that the same periodontopathic bacteria of the mouth can enter circulation and affect remote organs.

What can I do with tooth mobility?

The fist step is periodontal treatment. Reduction of inflammation will reduce tooth mobility. Empirically if tooth mobility does not affect our masticatory function means no intervention. If on the contrary we estimate that this is the case we can proceed in tooth splinting. Teeth are ”bonded” together to withstand better masticatory function. Additionally occlusal adjustment can be done to equilibrate masticatory contacts in all teeth. These are not invasive, reversible methods with a high success rate.

How we maintain the results of the treatment?

This is the main issue. Every individual is educated in oral health witch comprises effective tooth brushing with use of interdental brushes. Interdental cleaning is an absolute mean of oral health because tooth brush cannot have access in spaces between teeth. We try continuously to modify and educate our patients in daily propper oral health. Every patient then, depending on its effort will participate in a prevention programme every 3 to 6 months.

Does the treatment of my periodontal disease will solve once and for all my problem?

Unfortunately no. Treatment will arrest the progress of the disease. However every individual will have to understand the primordial importance of oral health ( brushing- interdental cleaning), to understand that smoking aggravates the disease and integrate in his life regular visits 2-3 times a year for professional cleaning.

Is my periodontal disease contagious for my family?

No, these infections are not transmitted. However it is not pleasant to live with a person that has a bad breath and sure enough this is not a good example for the children. Oral health is an important part of our body health.

Esthetic Dentistry

Esthetic Dentistry

Are there different approaches to esthetic dentistry?

In every office there is different approach in dental treatment. According to our principles esthetic dentistry cannot be performed without treatment of periodontal disease or caries removal.
The second philosophical approach is minimal intervention. Teeth that are prepared (cut) cannot be restored in their previous situation. It is a non reversible approach. It should be known that prepared teeth can develop sensitivity, pain, and this can lead to root canal treatment.
Therefore our approach to dental esthetics is a minimal intervention.
What are the procedures? A. Minor tooth movement, this is a targeted and of short duration orthodontic movement,
and B. Bold adhesive techniques.
That is bonding of teeth with tooth-like materials that absolutely match the color of the tooth. The procedure is like modeling the tooth in the desired shape and color with material behaving like tooth. This minimal approach cannot create Hollywood- type smiles. If this is the desire of the individual then more invasive techniques are needed.

Minor tooth movement. What is the invisalign technique?

This is an orthodontic technique based on the prevision of the final result we expect using CAD-CAM technology.

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This procedure enables the prefabrication of a series of splints that can move teeth in the desired position. Every splint moves the teeth for some millimeters and then after 2-3 weeks another one continues the movement. This treatment can last 6- 12 months depending on the aim of the study. We use this method for small movement in adult patients to accommodate their esthetic needs. The advantage of the method is that do not have to wear wires or brackets. The splints are transparent and cannot be distinguished in the mouth. They have to be worn as long as possible except eating time.


Cases

  • Full restoration of upper anterior teeth with all ceramic crowns. Periodontal treatment preceded the prosthetic work.

  • Esthetic bond composite restoration.

  • Esthetic bond composite restoration.

  • Old filling on the central incisor replaced by composite resine restoration.

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    Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s

  • Full restoration of upper anterior teeth with metal ceramic crowns. Periodontal treatment preceded the prosthetic work.

    Male 62 years old presenting aesthetic and functional problems in the front upper area. Caries and periodontal lesions were treated and a metaloceramic bridge was placed, because of the extensive destruction of tooth structure and need of strength in the fabrication of the framework.

  • Full restoration of upper anterior teeth with metal ceramic crowns in order to restore/treat attritions

    Male 48 years old with extensive tooth abrasions and old acrylic prosthesis in need of replacement and tooth protection. We have chosen a metaloceramic framework for better resistance and strength because of the powerful masticatory function of this individual. In these cases we recommend the fabrication of a mouth splint Porcelane fracture could happen because of parafunctional night habits of this individual.

  • Full restoration of upper anterior teeth with metal ceramic crowns.

    An attractive woman of 48 years old with obvious problems in the anterior area. For functional reasons we decided for a metaloceramic restoration. The result is excellent.

  • Esthetic bond composite restoration.

    A case with a purely aesthetic demand. Use of bonding technique could be very fast (1 appointment), very efficient and immensely creative. It is our beloved approach for aesthetics because it is an irreversible technique with exquisite results.

  • Esthetic bond composite restoration.

    A case with a purely aesthetic demand. Use of bonding technique could be very fast (1 appointment), very efficient and immensely creative. It is our beloved approach for aesthetics because it is an irreversible technique with exquisite results.

  • Esthetic bond composite restoration.

    A case with a purely aesthetic demand. Use of bonding technique could be very fast (1 appointment), very efficient and immensely creative. It is our beloved approach for aesthetics because it is an irreversible technique with exquisite results.


Crowns

What is the difference between a metal-ceramic crown (MC) and an all-ceramic crown (AC)?

The MC is a crown placed on a tooth with a metal frame covered with porcelain. An AC is a crown fabricated totally with porcelain. The esthetic outcome of both is excellent. The disadvantage of MC could be that sometimes due to gum recession the appearance of the metal frame on the edge of the crown is unaesthetic, thus there is an esthetic advantage of AC.

Do MCs and Fcs present the same strength?

Unfortunately MCs present fewer strength problems. AC crowns develop more often fractures thus they are not recommended to cover teeth with extended restorations or when these teeth bear excursive occlusal forces.

What is the difference between an AC crown and a laminate?

An AC demands complete grinding of tooth whereas a laminate demands minimal grinding of the facial aspect of the tooth.

What is the difference between bonding and laminate?

Bonding is a procedure that tooth-like substance is attached to the tooth modeling its appearance. The laminate needs very careful grinding of the facial aspect of tooth, impression, fabrication of the new facial structure of tooth. So the main differences are reversibility of tooth (no tooth grinding, possibility to reverse in previous situation), time (fewer visits), cost (no laboratory involvement), so lower cost for the patient.

Is it possible to remove bonding or laminates?

Bonding can be detached very easily without intervening the integrity of tooth. Laminate should be detached and replaced by a new one following all the procedure again (impression- fabrication- placement).


Tooth Bleaching

What is the tooth bleaching?

This is a procedure that aims to whiten the tooth. It is a chemical reaction that reduces or eliminates deep color staining of the tooth. The dentist can give information on the potential whitening (how many shades will drop), on the hazards and on time and effort needed.

What is the procedure?

This can be done by the following methods.

  1. In the dental practice. This is for immediate results using a whitening solution of high concentration, enhancing its effect by external light emission of special wave length. This procedure can last for 1 to 2 hours.
  2. At home. This is a procedure so that the individual can control its whitening effect. It is imperative to use custom made plastic splints inside of which the bleaching solution is placed. This one is of lower concentration (10-20 %) and the final result appears after 10 to 15 days. This method is the safest and more conservative.
  3. A combination of both procedures.

Does it hurt? Does it harm teeth?

It can produce tooth sensitivity, which is reversible following directions. It does not harm teeth but it should proceed slowly, having patience

What is the lasting effect?

This can last from 1 to 5 years depending on the nutrition habits and the coloration of food. Also it depends on smoking, frequency of coffee and wine drinking. Repetition of the procedure can be done in cases of relapse.

Is this a procedure for everybody?

Basically yes. It is not indicated for persons that have extensive caries, recession of gums and extensive denudation of teeth, pregnant women, different oral pathological conditions, children and people with allergies to whitening solutions.

Does bleaching change color of crowns and bridges?

Definitely no! This solution can act only on the enamel surface. In the end of the procedure it is also imperative to change all fillings (at least in the front teeth) since their color will not match the whitening result of the teeth. This should be considered when cost analysis is discussed.


  • Teeth whitening

    This is a case with an aesthetic demand of whitening her teeth. The technique is simple and can be accomplished in the office or at home using a stent and a whitening solution during the night. Refreshing of the procedure every year is recommended.

Dr. George Makris

Dr. George Makris

dr-makrisDr. George Makris is a periodontist graduated from the postgraduate programme of Periodontology at the University of Pennsylvania, probably one of the most prestigious postgraduate programmes in USA. Moreover he is graduate of the postgraduate programme of Periodontology of Paris University in France with two certificates in Oral Biology and Periodontology, His PhD degree was awarded from the University of Paris (with honors). Since 1992 he is As. Professor in the Department of Periodontology and Implant Biology of the University of Thessaloniki. He is author of a textbook “Biology of Dental Implants” which is part of the curiculum in the dental school of Thessaloniki.

He is a member of:



The Team

His team comprises dentists with postgraduate studies in Oral Rehabilitation, Implantology, Esthetic Dentistry, Oral Pathology and Oral Surgery. Moreover the team is working together for more than ten years. This has resulted in the development of a common philosophy in treating the most complex cases of mouth rehabilitation. The team has a continuous participation in postgraduate seminars and scientific meetings all over the world.

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Biology of Dental Implants

Read the Textbook (Greek)


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