Prosthodontics is one of nine dental specialties recognized by the American Dental Association. Prosthodontists are experts in the restoration of natural teeth or the replacement of missing teeth and adjacent oral and facial tissues with artificial substitutes.
Prosthodontic treatment may include the use of removable partial or full dentures, caps, crowns, bridges, implant anchored restorations, or combinations of the above. For more information, visit our website at http://www.sandiegoprosthodontics.com
After completing 4 years of dental school, prosthodontists receive an additional 2-3 years of intense specialized training in an American Dental Association (ADA) accredited graduate program based either at a hospital or a university. This advanced training includes reviews of the literature, lectures, and treatment of patients. Prosthodontists are also trained in the hands-on technical aspects of laboratory fabrication of complex dental prosthetics and complex restoration of dental and facial esthetics. Prosthodontists have a comprehensive knowledge of dental materials and techniques, insuring both function and esthetics when it comes to your treatment.
At SAN DIEGO PROSTHODONTICS, we have a fully equipped dental laboratory staffed with two full-time dental technicians.
Think of the prosthodontist as the ‘quarterback’ of your dental restorative team. Prosthodontists take a whole-mouth approach to your dental care. They supervise your treatment from your initial consultations to your follow-up care after treatment. It is your prosthodontist who interacts with other dentists, specialists and technicians to coordinate your dental treatment plan.
Whether your care requires single crowns, fillings, veneers, dental bridges, dentures or complex implant restorations, you can be assured that you are receiving state-of-the-art dentistry from your prosthodontist, who is dedicated to the highest standards of care in restoration and replacement of teeth.
Monday, February 20, 2012
Tuesday, January 17, 2012
Dental Implants are a Team Effort at SAN DIEGO PROSTHODONTICS, Office of Harold J. Gulbransen, DDS
Today, dental implants offer patients with permanent tooth loss an excellent alternative to partial or complete dentures. Dental implants can help patients regain natural smiles, increase their comfort and minimize jawbone deterioration that can occur when natural teeth are lost.
Dental implants combine the best of science and technology, often involving the expertise of several different dental disciplines. Successful implant placement involves a coordinated team approach composed of prosthodontic dental specialist Dr. Harold Gulbransen, the oral surgeon or periodontist who surgically places the implants, and the lab technician.
The team of dental specialists work together to draw up a treatment plan that best meets each individual patient's needs. After an initial comprehensive examination, Dr. Gulbransen consults with other team members to determine if implants are the right solution and what, if any underlying dental issues need to be addressed to insure the success of the implants. Communication among team members ensures that every step of the process goes smoothly and the best possible results are achieved. The teamwork continues long after implant placement. Follow-up examinations with Dr. Gulbransen and other team members are very important.
Dr. Gulbransen, as the prosthodontist, is the 'quarterback' of your dental restorative team. Prosthodontists take a whole-mouth approach to your dental care. They supervise your treatmant from your initial consultations to your follow-up care after treatmant. Dr. Gulbransen will interact with other dentists, specialists and technicians to coordinate your dental treatment plan.
While implants have a very high success rate, implants are not always the best solutions for every dental problem. Prosthodontists are also trained in the hands-on technical aspects of laboratory fabrication of complex dental prosthetics and complex restoration of dental and facial esthetics. Harold J. Gulbransen, DDS, has a comprehensive knowledge of dental materials and techniques, insuring both function and esthetics when it comes to your treatment.
Whether your care requires single crowns, fillings, veneers, dental bridges, dentures or complex implant restorations, you can be assured that you are receiving state-of-the-art dentistry from Dr. Harold Gulbransen and his staff, who are didicated to the highest standards of care in restoration and replacement of teeth.
Dental implants combine the best of science and technology, often involving the expertise of several different dental disciplines. Successful implant placement involves a coordinated team approach composed of prosthodontic dental specialist Dr. Harold Gulbransen, the oral surgeon or periodontist who surgically places the implants, and the lab technician.
The team of dental specialists work together to draw up a treatment plan that best meets each individual patient's needs. After an initial comprehensive examination, Dr. Gulbransen consults with other team members to determine if implants are the right solution and what, if any underlying dental issues need to be addressed to insure the success of the implants. Communication among team members ensures that every step of the process goes smoothly and the best possible results are achieved. The teamwork continues long after implant placement. Follow-up examinations with Dr. Gulbransen and other team members are very important.
Dr. Gulbransen, as the prosthodontist, is the 'quarterback' of your dental restorative team. Prosthodontists take a whole-mouth approach to your dental care. They supervise your treatmant from your initial consultations to your follow-up care after treatmant. Dr. Gulbransen will interact with other dentists, specialists and technicians to coordinate your dental treatment plan.
While implants have a very high success rate, implants are not always the best solutions for every dental problem. Prosthodontists are also trained in the hands-on technical aspects of laboratory fabrication of complex dental prosthetics and complex restoration of dental and facial esthetics. Harold J. Gulbransen, DDS, has a comprehensive knowledge of dental materials and techniques, insuring both function and esthetics when it comes to your treatment.
Whether your care requires single crowns, fillings, veneers, dental bridges, dentures or complex implant restorations, you can be assured that you are receiving state-of-the-art dentistry from Dr. Harold Gulbransen and his staff, who are didicated to the highest standards of care in restoration and replacement of teeth.
Monday, July 18, 2011
Sterilization and Disinfection Procedures in our Dental Office
SAN DIEGO PROSTHODONTICS is proud to offer the latest in modern sterilization and disinfection techniques. Vigorous safeguards, exacting cleaning procedures and controlled professional standards are designed to protect the health and welfare of both patients and practitioners.
Some of our patients have questions regarding the protocol followed during disinfection and sterilization of instruments, hand pieces and treatment rooms. You will find our office follows the "universal precautions" as outlined by the American Dental Association and Center of Disease Control.
All instruments are thoroughly pre-cleaned ultrasonically before they are put into a steam autoclave. The steam autoclave uses heated, pressure and vaporized water to sterilize instruments in a closed chamber. Each instrument is then hand dried.
Dental assistants are responsible for cleaning and disinfecting surfaces in each operatory. We use disinfection procedures on surfaces and equipment that cannot be removed for cleaning and sterilization, such as counter tops, drawer handles, x-ray unit heads and light handles. A sterile disinfectant cleaning solution, Birex, is used to wipe down all counters, suction hoses, and hand piece connectors before and after each patient. You will also notice that we use disposable barriers on surfaces such as light handles that are touched during treatment.
The use of a closed dental unit water system which operates independently from municipal water supplies prevents mineral deposits from adhering to our instruments and in our water lines. Our dental units are not connected to municipal water supplies. This prevents contamination of the inside of the water lines used in each treatment operatory. We use distilled water in all of our operatories.
We want you to be assured that we are committed to providing you with a safe and healthy environment when you visit our office for dental treatment. The health and safety of our patients is our number one priority.
Some of our patients have questions regarding the protocol followed during disinfection and sterilization of instruments, hand pieces and treatment rooms. You will find our office follows the "universal precautions" as outlined by the American Dental Association and Center of Disease Control.
All instruments are thoroughly pre-cleaned ultrasonically before they are put into a steam autoclave. The steam autoclave uses heated, pressure and vaporized water to sterilize instruments in a closed chamber. Each instrument is then hand dried.
Dental assistants are responsible for cleaning and disinfecting surfaces in each operatory. We use disinfection procedures on surfaces and equipment that cannot be removed for cleaning and sterilization, such as counter tops, drawer handles, x-ray unit heads and light handles. A sterile disinfectant cleaning solution, Birex, is used to wipe down all counters, suction hoses, and hand piece connectors before and after each patient. You will also notice that we use disposable barriers on surfaces such as light handles that are touched during treatment.
The use of a closed dental unit water system which operates independently from municipal water supplies prevents mineral deposits from adhering to our instruments and in our water lines. Our dental units are not connected to municipal water supplies. This prevents contamination of the inside of the water lines used in each treatment operatory. We use distilled water in all of our operatories.
We want you to be assured that we are committed to providing you with a safe and healthy environment when you visit our office for dental treatment. The health and safety of our patients is our number one priority.
Thursday, June 2, 2011
E.Max Crowns—All Ceramic Dental Crowns Providing Beauty Without Compromising Strength and Durability
Dr. Harold Gulbransen at SAN DIEGO PROSTHODONTICS is proud to offer the latest techniques in Crown and Bridge Dentistry.
Significant new developments in all-ceramic materials have led to the introduction of the e.max dental crown. Previously, dental crowns made from the most natural appearing materials weren’t as durable as those made of less esthetic materials like gold or other precious metals.
However, e.max crowns are fabricated with the newest in cosmetic porcelain, a lithium disilicate glass ceramic material that is natural in appearance yet strong enough to withstand the pressures and demands of the human mouth. Researchers at the Department of Biomaterials and Biomimetics at the New York University College of Dentistry (NYU) found that the lithium disilicate ceramic material used in e.max crowns was far less likely to chip or fracture when compared to veneered zirconia-based crowns.
E.max dental crowns are designed using efficient pressed ceramic technology. They represent the ultimate in metal-free esthetics and durability. Unlike traditional crowns, there are no copings or metal substrates. This means that e.max crowns are more natural in appearance and do not have the telltale “black line” of the crown’s metal substructure at the gumline like traditional crowns do. In effect, the patient benefits from the best of both worlds—the beauty of all-ceramic crowns without compromising strength or durability.
Significant new developments in all-ceramic materials have led to the introduction of the e.max dental crown. Previously, dental crowns made from the most natural appearing materials weren’t as durable as those made of less esthetic materials like gold or other precious metals.
However, e.max crowns are fabricated with the newest in cosmetic porcelain, a lithium disilicate glass ceramic material that is natural in appearance yet strong enough to withstand the pressures and demands of the human mouth. Researchers at the Department of Biomaterials and Biomimetics at the New York University College of Dentistry (NYU) found that the lithium disilicate ceramic material used in e.max crowns was far less likely to chip or fracture when compared to veneered zirconia-based crowns.
E.max dental crowns are designed using efficient pressed ceramic technology. They represent the ultimate in metal-free esthetics and durability. Unlike traditional crowns, there are no copings or metal substrates. This means that e.max crowns are more natural in appearance and do not have the telltale “black line” of the crown’s metal substructure at the gumline like traditional crowns do. In effect, the patient benefits from the best of both worlds—the beauty of all-ceramic crowns without compromising strength or durability.
Friday, May 13, 2011
What are the Advantages of an Immediate Denture?
An immediate denture is a complete or partial denture that is inserted on the same day as teeth are extracted, immediately following removal of natural teeth. There are several advantages that immediate dentures provide for patients. First and foremost, immediate dentures provide an important psychological advantage because patients never have to appear in public without teeth. The immediate or temporary dentures are fabricated before the patient’s natural teeth are removed, so they are ready to be inserted at the time of the extractions.
Immediate dentures reduce post operative discomfort after extraction of teeth because they cover and protect the surgical site. In effect, the temporary or immediate dentures act as a Band-Aid and protect the extraction sites, reducing pain.
Studies have also shown that patients who wear an immediate denture have broader, fuller gums after healing which ultimately provides better support for all subsequent denture prostheses.
It is important to note that an immediate denture is an approximation of what the mouth will look like post-surgery. As a result, an immediate denture does not fit as precisely as the final denture will fit. Dr. Gulbransen will use a soft liner material to line the immediate denture after surgery to provide better fit and retention.
This will require a few adjustment visits. As the gums heal following the extractions, they will continue to shrink. Changes can continue for several months. Once the gum and bone healing is completed, the patient is ready to have the final dentures made, generally 4 – 6 months after tooth extractions.
Immediate dentures reduce post operative discomfort after extraction of teeth because they cover and protect the surgical site. In effect, the temporary or immediate dentures act as a Band-Aid and protect the extraction sites, reducing pain.
Studies have also shown that patients who wear an immediate denture have broader, fuller gums after healing which ultimately provides better support for all subsequent denture prostheses.
It is important to note that an immediate denture is an approximation of what the mouth will look like post-surgery. As a result, an immediate denture does not fit as precisely as the final denture will fit. Dr. Gulbransen will use a soft liner material to line the immediate denture after surgery to provide better fit and retention.
This will require a few adjustment visits. As the gums heal following the extractions, they will continue to shrink. Changes can continue for several months. Once the gum and bone healing is completed, the patient is ready to have the final dentures made, generally 4 – 6 months after tooth extractions.
Friday, April 22, 2011
What is an Immediate or Temporary Denture?
An immediate denture is a complete or partial denture that is inserted on the same day as teeth are extracted, immediately following removal of natural teeth. An immediate denture is actually made prior to extracting natural teeth. When a patient is due to have some teeth extracted, prior to surgery, an appointment is made with Dr. Gulbransen.
At this initial appointment, impressions are made with the teeth to be extracted still present. A model is made from this impression and mounted on an articulator, a mechanical device that replicates the upper and lower jaw relationships. Then, in our in-house dental laboratory, the teeth to be extracted are ground off the stone model and the resulting altered model is used to fabricate the immediate denture. This entire process takes place within our in-house dental laboratory, insuring quality control as well as timely delivery.
It is important to note that an immediate denture is an approximation of what the mouth will look like post-surgery. As a result, an immediate denture does not fit as precisely as the final denture will fit. Dr. Gulbransen will use a soft liner material to line the immediate denture after surgery to provide better fit and retention.
This will require a few adjustment visits. As the gums heal following the extractions, they will continue to shrink. Changes can continue for several months. Once the gum and bone healing is completed, the patient is ready to have the final dentures made.
At this initial appointment, impressions are made with the teeth to be extracted still present. A model is made from this impression and mounted on an articulator, a mechanical device that replicates the upper and lower jaw relationships. Then, in our in-house dental laboratory, the teeth to be extracted are ground off the stone model and the resulting altered model is used to fabricate the immediate denture. This entire process takes place within our in-house dental laboratory, insuring quality control as well as timely delivery.
It is important to note that an immediate denture is an approximation of what the mouth will look like post-surgery. As a result, an immediate denture does not fit as precisely as the final denture will fit. Dr. Gulbransen will use a soft liner material to line the immediate denture after surgery to provide better fit and retention.
This will require a few adjustment visits. As the gums heal following the extractions, they will continue to shrink. Changes can continue for several months. Once the gum and bone healing is completed, the patient is ready to have the final dentures made.
Wednesday, March 30, 2011
Precaution Against Denture Adhesives Containing Zinc
In February 2011, the U.S. Food and Drug Administration (FDA) sent a letter to all denture adhesive manufacturers, recommending removal of zinc from denture adhesive products and/or making significant label changes to warn consumers of potential dangers. This was in response to a number of scientific studies that suggest that zinc contained in some denture adhesives may contribute to zinc toxicity and neurologic disease.
Zinc is a mineral which is necessary to maintain your health. It is required to help regulate growth and metabolism in tissues where new cell development occurs, such as in the bone marrow and the intestinal lining. However, an excess amount of zinc, known as hyperzincemia, can contribute to copper deficiency, zinc toxicity and neurological damage. In the August 2008 publication of Neurology, researchers at the University of Texas Southwestern Medical Center in Dallas, linked use of large amounts of zinc containing denture adhesives to symptoms of neuropathy and zinc toxicity. It should be noted that patients in this study used a minimum of two tubes of denture adhesive weekly. Other researchers in the Department of Neurology at Vanderbilt University report in Neurotoxicology November 2009, patients experiencing progressive neurological symptoms following chronic overuse of zinc-containing denture adhesives.
The two primary manufacturers of zinc-containing denture adhesives in the U. S. are GlaxoSmithKline, which makes Super Poligrip, and Proctor & Gamble, which makes Fixodent. A small amount of zinc is used in these products to provide denture hold. Last year, GlaxoSmithKline agreed to reformulate Super Poligrip to remove zinc.
In 2009 the American College of Prosthodontists (ACP) formed a task force to establish evidence-based guidelines for the care and maintenance of complete dentures. At the conclusion of their study, they published a guideline for denture care in the Journal of Prosthodontics (Vol 20, Supplement1, February 2011)
Even with well-fitting dentures, they found that denture adhesives, when properly used, can improve the retention and stability of dentures and help seal out accumulation of food particles under the denture. However, the authors of the article caution against improper use of zinc-containing denture adhesives due to adverse systemic effects. So as a precautionary measure, they advise patients not to use zinc-containing denture adhesives.
The ACP further states that denture adhesives should be completely removed from the denture and the oral cavity on a daily basis. If increasing amounts of adhesives are required to achieve the same level of denture retention, patients should see their dentist or prosthodontist to evaluate the fit and stability of the dentures. Annual checkups with the dentist or prosthodontist are advised for denture wearers to achieve optimal fit and function of the dentures
References:
Denture cream: an unusual source of excess zinc, leading to hypocupremia and neurologic disease. Nations SP, Boyer PJ, Love LA et al. Neurology.2008; 71:639-643
Myelopolyneuropathy and pancytopenia due to copper deficiency and high zinc levels of unknown origin II: the denture cream is a primary source of excessive zinc. Hedera P, Peltier A, Fink JK, el al. Neurotoxicology 2009; 30:996-999
Evidence-Based Guidelines for the Care and Maintenance of Complete Dentures: A Publication of the American College of Prosthodontists. Felton D, Cooper L, et al. Journal of Prosthodontics Vol 20, Supplement 1, February 2011
Zinc is a mineral which is necessary to maintain your health. It is required to help regulate growth and metabolism in tissues where new cell development occurs, such as in the bone marrow and the intestinal lining. However, an excess amount of zinc, known as hyperzincemia, can contribute to copper deficiency, zinc toxicity and neurological damage. In the August 2008 publication of Neurology, researchers at the University of Texas Southwestern Medical Center in Dallas, linked use of large amounts of zinc containing denture adhesives to symptoms of neuropathy and zinc toxicity. It should be noted that patients in this study used a minimum of two tubes of denture adhesive weekly. Other researchers in the Department of Neurology at Vanderbilt University report in Neurotoxicology November 2009, patients experiencing progressive neurological symptoms following chronic overuse of zinc-containing denture adhesives.
The two primary manufacturers of zinc-containing denture adhesives in the U. S. are GlaxoSmithKline, which makes Super Poligrip, and Proctor & Gamble, which makes Fixodent. A small amount of zinc is used in these products to provide denture hold. Last year, GlaxoSmithKline agreed to reformulate Super Poligrip to remove zinc.
In 2009 the American College of Prosthodontists (ACP) formed a task force to establish evidence-based guidelines for the care and maintenance of complete dentures. At the conclusion of their study, they published a guideline for denture care in the Journal of Prosthodontics (Vol 20, Supplement1, February 2011)
Even with well-fitting dentures, they found that denture adhesives, when properly used, can improve the retention and stability of dentures and help seal out accumulation of food particles under the denture. However, the authors of the article caution against improper use of zinc-containing denture adhesives due to adverse systemic effects. So as a precautionary measure, they advise patients not to use zinc-containing denture adhesives.
The ACP further states that denture adhesives should be completely removed from the denture and the oral cavity on a daily basis. If increasing amounts of adhesives are required to achieve the same level of denture retention, patients should see their dentist or prosthodontist to evaluate the fit and stability of the dentures. Annual checkups with the dentist or prosthodontist are advised for denture wearers to achieve optimal fit and function of the dentures
References:
Denture cream: an unusual source of excess zinc, leading to hypocupremia and neurologic disease. Nations SP, Boyer PJ, Love LA et al. Neurology.2008; 71:639-643
Myelopolyneuropathy and pancytopenia due to copper deficiency and high zinc levels of unknown origin II: the denture cream is a primary source of excessive zinc. Hedera P, Peltier A, Fink JK, el al. Neurotoxicology 2009; 30:996-999
Evidence-Based Guidelines for the Care and Maintenance of Complete Dentures: A Publication of the American College of Prosthodontists. Felton D, Cooper L, et al. Journal of Prosthodontics Vol 20, Supplement 1, February 2011
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