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Reconstructive Dentistry

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To become a patient of Dr Phil Nasralla's please fill out our New Patient Dental Questionnaire

Crowns and Bridges

A dental crown is a tooth-shaped "cap" that is cemented (glued) over a tooth to restore its shape, size, strength and/or improve its appearance.  Crowns can be made of different materials e.g. gold, porcelain or a combination of both.  A dental crown has a life expectancy of approximately 10-20 years depending on "wear and tear", one's personal oral habits (clenching, grinding, chewing ice, nail biting etc…), and one's oral hygiene care.
A dental crown may be needed to:

  • Protect a weak tooth from breaking or to hold together parts of a cracked tooth
  • Restore an already broken or severely worn tooth
  • Cover and support a tooth with a large filling
  • Hold a dental bridge in place (see below)
  • Cover misshaped or severely discoloured teeth
  • Cover a dental implant

A dental bridge may be recommended to replace one or more missing teeth. Without which could adversely affect the appearance and functionality of your smile.  Missing teeth can cause a change in one's bite, shifting of the teeth, temporomandibular joint disorder (TMD), speech impediments, an increased risk for periodontal (gum) disease and a greater chance of tooth decay.  A bridge can be made from the same materials and have a life expectancy like that of a crown.

Crowns and bridges are wonderful solutions to fixing and/or replacing teeth, and the team at Dr. Nasralla's clinic will gladly explain your options while addressing your needs. 


Dental Implants

A dental implant is an artificial tooth root and is used in dentistry to support restorations to replace one or more teeth in the form of crowns, bridges or dentures.

The earliest example of dental implants (sea shells) have been found in Mayan jawbones dating circa 600 A.D. However modern implant dentistry is credited to Dr.Branemark, a Swedish orthopedic surgeon who in the 1950's was conducting research on rabbits. One day he observed that titanium metal placed in the bone was not easily retrieved and consequently the bone had grown and adhered to the titanium surfaces (osseointegration). Dr. Branemark carried out further studies both in animal and human subjects and confirmed this phenomenon of osseointegration with regular consistency. In the past 40 years over 7 million Branemark type dental implants have been placed in people around the world.

Treatment planning for implants typically involves a CAT scan of the jaw (3-D x-ray imaging), review of one's medical history, digital photos and impressions of the teeth.

The procedure of placing an implant has become systematic, and very successful. What was once performed by specialists is now possible in the hands of trained general dentists. Uncomplicated procedures are performed with local anesthetic in a relatively quick and clean, nonsurgical manner that is virtually pain free.

The success rate of implants, when followed over a 10 year study was averaging 85-95%.

Contraindications for implants may include:

  • Smoking
  • Severe gum disease
  • Uncontrolled diabetes
  • Severe clenching and grinding
  • The use of Bisphosphonate drugs (which delay bone healing and cause implant failures)

If you are interested in implants please contact us to book a consultation appointment.



Endodontics (Root Canals) Therapy

Endodontics is the discipline of dentistry that treats the tooth's pulp tissue (nerve, blood vessels, and lymphatic systems). The primary purpose of root canal therapy is to remove all pulpal tissues from within the tooth and root(s) and then seal and fill these structures (i.e. deep cleaning followed by a deep filling).

A root canal may be warranted in cases where a tooth has:

  • deep decay into the nerve
  • experienced blunt force trauma (accidents)
  • extreme pain from a dying nerve
  • abscess/infection from a dead nerve
  • sustained nerve damage from gum disease
  • to undergo reconstruction that may expose the nerve chamber

Dr. Nasralla is highly trained and experienced in all realms of endodontics and uses the best technology available, including dental microscopes for increased magnification and illumination in the tooth and roots. Unlike days of old, root canals are typically painless and done in one easy visit with many patients reporting little or no discomfort the next day.


Root canal procedure

Dr. Nasralla examines and x-rays the tooth, then administers local anesthetic. Once it is numb, a rubber dam is placed over the tooth to isolate it and keep it clean and free of saliva during the procedure.




An opening is made in the crown (top) of the tooth and very fine, flexible instruments are used to clean out the pulp from the pulp chamber and root canals and to shape the space for fillings.



After the space is cleaned and shaped, the root canal spaces are filled with a biocompatible rubber-like material called "gutta percha". The gutta percha is placed with an adhesive cement to ensure complete sealing of the roots.
A final x-ray is taken and a core build-up (final filling) is then placed in the top of the roots and the tooth. A crown may be necessary to restore the tooth to its full function and beauty.


Root Canal Therapy retreatment

We deal with the human body, and occasionally it does not heal as expected and a tooth can experience post-treatment infection. In these cases, the dentist must retreat the tooth with a second root canal treatment in the same manner as described above; but by removing all the gutta percha and recleaning the roots. Once thoroughly cleaned and shaped again, the system is resealed and filled as before. More often than not, the tooth responds favorably and the infection and symptoms disappear permanently.

Surgical Retreatment (Apicoectomy)

An apicoectomy, or root-end resection, is the removal of the root tip and the surrounding infected tissue of an abscessed tooth. This procedure may be indicated when inflammation and infection persists in the area around the root tip but cannot be addressed by retreatment through the tooth.

Step 1: After the tooth and gums are "numbed", the gum is reflected (lifted) to uncover the underlying bone and the root end of the tooth. The root end is resected (removed) with all the surrounding infected tissue.

Step 2: A root-end filling is placed to seal the end of the root canal and artificial bone is placed in the surrounding space. A few dissolvable sutures (stitches) are placed to hold the gums in place until healing occurs.

Step 3: After several months, the bone and gums have healed (replacing all the artificial bone with natural bone) and all symptoms are gone.


Full Mouth Reconstruction

Full mouth reconstruction, as the name suggests, is the dental procedure to rebuild one's entire dentition to a more healthy, functional and youthful state. While smile makeovers will correct minor or moderate dental issues, full mouth reconstruction is warranted in cases of very complex bites, many missing teeth, severely worn, damaged, or decayed teeth that affect one's quality of life. Pain may or may not always be a reported symptom of one's dental condition, but very often is associated with TMD or trauma from accidents and blunt force injuries and may necessitate full mouth reconstruction.

Correcting the aforementioned conditions with full mouth reconstruction may entail some or all of the following treatment modalities:

  • Dental implants and restorations to replace one or more missing teeth
  • Dental bridges to replace missing or broken teeth
  • TMD treatment to address TMJ pain and/or bite issues
  • Dental crowns, inlays and onlays to repair damaged or decayed teeth
  • Porcelain veneers and composite fillings for a metal-free, whiter and more beautiful smile

Comprehensive dental examinations are mandatory for any full mouth reconstruction treatment planning purposes. And while different restorative treatment options may be possible, it is very important to customize the individual's planned treatment with their personal needs in a way that best achieves the desired outcome.

If you are a candidate for full mouth reconstruction, then let Dr. Nasralla and his highly skilled team work with you in delivering the smile of your dreams.


Laser Dentistry

In recent years, modern dentistry has been revolutionized by the development and use of computers, digital x-rays and lasers.  We proudly use all these technological wonders at our dental clinic; and though the public is cognizant of computers and digital x-rays, many remain unfamiliar with dental lasers and their applications.

The two most common uses of dental lasers are for early caries detection and for the reshaping of the gums and other soft tissues of the mouth.
In the past, dentists have traditionally depended on x-rays, visual and tactile ("stickiness of the pick" in the tooth) exams to diagnose tooth decay; and by those standards, the tooth had already undergone a lot of damage.  By contrast, the use of a laser caries detection system (Diagnodent) allows Dr. Nasralla to accurately measure and quantify the depth of early caries before the damage is done.  Prevention and early detection of any decay is always more cost-effective and conservative in its treatment than the alternative.

Unlike the diagnostic laser mentioned above, the soft tissue lasers are used to remove or reshape gums for different reasons:

  • Improve the look of "gummy" smiles
  • Remove excess gum tissue caused by certain medications or poor oral hygiene
  • Treat local areas of gum disease so that surgery may be avoided
  • Treatment of cold sores and cankers
  • Biopsy
  • Cauterizing and control bleeding
  • Performing frenectomies (e.g. tongue-tie correction)