General, Cosmetic, and Specialty Dentistry.

The advantage to seeing a prosthodontist lies in the manner in which they are trained. While a general dentist has a basic level of training in all aspects of dentistry, a prosthdontist’s advanced training after dental school focuses on how to comprehensively diagnosis oral health problems and create treatment plans that repair or replace missing teeth to their aesthetic and functional ideal. Prosthodontist’s use their training in dental implant surgical placement, implant prosthetics, dentures, and implant crowns to execute these treatment plans. A prosthodontist is often thought of as the “quarterback” of the treatment plan, working collaboratively with general dentists and other specialists to provide patient-specific solutions to dental and oral health problems.

Finally, prosthodontists are uniquely qualified to control all phases of dental implant therapy, working with patients from the initial planning, through surgical placement, and finally to fabricating long lasting, natural looking tooth replacements. Drs. Mangini and Mangini will be working with you through every step of your treatment to ensure a successful result.

Highlighted Service

CEREC Same Day Crowns - Image

CEREC Same Day Crowns

CEREC is an advanced dental restorative system that allows your dentist to restore decayed teeth, place crowns, remove defective amalgam fillings, or place cosmetic veneers in just one appointment. This allows you to have the highest quality, most lifelike dental restorations in just one visit to the dentist…in, out, and on with your busy life.

The process:

Exam and Preparation

First, we examine the tooth and determines the appropriate treatment. It could be a simple filling, or a full crown, depending on how much healthy tooth structure is remaining. Next, we administer an anesthetic and prepares your tooth for the restoration, removing decayed and weakened tooth tissue. This preparation is just like what we would do for many other restorative techniques.

Digital Impression

Then, we take a digital impression of the prepared tooth. Instead of filling a tray with impression “goop” that you must bite into and hold in your mouth until it hardens, a camera is used to take a digital picture of your tooth. This whole digital impression process takes only a minute or two.

No Temporaries

Next, the Dentist will design the custom restoration for your tooth: The CEREC 3D software takes the digital picture and converts it into a 3-dimensional virtual model on the computer screen. We then design the restoration using the CEREC 3D computer program. Within a few minutes, the restoration design data is sent to a separate milling machine in the office and a ceramic block that matches your tooth shade is placed in the milling machine. About 10–15 minutes later, your all-ceramic, tooth-colored restoration is complete. Your restoration will then be custom stained and glazed to perfectly match your teeth so that it seamlessly blends into you your smile. Finally, we test the restoration in your mouth to ensure proper fit and bite. The restoration is then bonded to the prepared tooth. Your tooth is restored with no “temporary” or return trip necessary. All of this is done in a single appointment! Ask us about CEREC today.

Specialty Dentistry

CEREC Same Day Crowns

CEREC is an advanced dental restorative system that allows your dentist to restore decayed teeth, place crowns, remove defective amalgam fillings, or place cosmetic veneers in just one appointment. This allows you to have the highest quality, most lifelike dental restorations in just one visit to the dentist…in, out, and on with your busy life.

The process:

Exam and Preparation

First, we examine the tooth and determines the appropriate treatment. It could be a simple filling, or a full crown, depending on how much healthy tooth structure is remaining. Next, we administer an anesthetic and prepares your tooth for the restoration, removing decayed and weakened tooth tissue. This preparation is just like what we would do for many other restorative techniques.

Digital Impression

Then, we take a digital impression of the prepared tooth. Instead of filling a tray with impression “goop” that you must bite into and hold in your mouth until it hardens, a camera is used to take a digital picture of your tooth. This whole digital impression process takes only a minute or two.

No Temporaries

Next, the Dentist will design the custom restoration for your tooth: The CEREC 3D software takes the digital picture and converts it into a 3-dimensional virtual model on the computer screen. We then design the restoration using the CEREC 3D computer program. Within a few minutes, the restoration design data is sent to a separate milling machine in the office and a ceramic block that matches your tooth shade is placed in the milling machine. About 10–15 minutes later, your all-ceramic, tooth-colored restoration is complete. Your restoration will then be custom stained and glazed to perfectly match your teeth so that it seamlessly blends into you your smile. Finally, we test the restoration in your mouth to ensure proper fit and bite. The restoration is then bonded to the prepared tooth. Your tooth is restored with no “temporary” or return trip necessary. All of this is done in a single appointment! Ask us about CEREC today.

Dental Implants

A dental implant is a prosthetic replacement for a missing tooth. Natural teeth consist of the crown and the root. The crown is the visible section that is covered with white enamel. Supporting the crown is the tooth root which extends into the jawbone. The root is the part of the tooth that is effectively replaced by an implant.

There are commonly three parts to what is described as an implant – the implant device itself (which is inserted directly into the bone); the abutment – the piece that connects the implant device to the third part – the overlying crown or denture.

Today’s implants are predominantly made of titanium, a metal that is bio-compatible and offers strength and durability as well as a unique property of fusing directly to bone – the process known asosseointegration. Other materials, such as zirconium, might be used to make implants in the future. But for now, these materials have not been perfected for general use.

While not always the case, often the placement of a dental implant requires a bone grafting procedure. The reason for this is that the primary purpose of much of the bone in our upper and lower jaws is to support our teeth. As a result, when a tooth is lost the body quickly begins to resorb the bone, unless it is immediately replaced with either another tooth, implant or in this case a “ridge preservation graft” (socket graft). Occasionally, it is possible to place an implant at the time of a tooth extraction. In these cases, the implant will act almost like a tent pole to hold the surrounding bone up and give it the functional requirements necessary to prevent it from undergoing atrophy. However, this is not always possible to due to local anatomy and/or the presence of infection. In these cases it is prudent to place a socket preservation graft. The socket graft is designed to fill the void left by the extracted tooth and hold the volume of this space while natural bone has the opportunity to proliferate and fill the space with high quality live bone. Depending on the size of the tooth that was extracted, the ridge graft requires between three to six months before an implant can be placed.

If you are self-conscious because you have missing teeth, wear dentures that are uncomfortable or don’t want to have good tooth structure removed to make a bridge, then a dental implant might be an option for you. Come see us at Atlas Dental to find out!

Advanced Tooth Replacement

Full Arch Dental Implant Solutions

There are a variety of implant prosthetics that can replace the teeth in an entire jaw. Some are removable, meaning you take them out to clean at night, and some are "permanent," meaning that they can only be removed by the dentist. They vary significantly in materials, function, patient comfort, and cost.

The following information reviews some of the options available for replacing missing teeth with full arch dental implant prosthetics.

Implant Overdenture

One option is to have two to four implants placed in your lower jaw and a denture made that snaps onto these implants. This is called an “overdenture.” This option allows your lower denture to be more stable while chewing than without implants, and will not allow the denture to come loose or float in your mouth. However, there will still be movement of your lower denture.

An additional overdenture option involves connecting the implants with a custom-made support bar. Your denture will be made with special internal retention attachments that attach onto the support bar, enabling the denture to snap firmly into place. The advantage of this option is that it is much more stable than overdentures made without a bar and allows very little denture movement, especially if you have maintained your natural teeth on your opposing jaw. Your denture is still removable for easy cleaning and maintenance.

Permanent Denture

Another option involves placing five or more implants in your jaw and attaching a permanent "denture." Your prosthesis is held in place by the implants and it does not rest on the gum tissue, which allows you to clean under the denture without removing it. This denture will replace all your missing teeth and will not be removed except at maintenance visits. Although cleaning under your denture without removing it is more time consuming and requires more dexterity, many patients who want a permanent tooth replacement prefer this option.

Pinhole Gum Rejuvenation

The Chao Pinhole® Surgical Technique (PST®), invented and patented by John Chao, D.D.S., is a scalpel-free, suture-free procedure for treating gum recession. This gum recession breakthrough treatment also known as Pinhole Gum Rejuvenation™ and Lunchtime Gum Lift™

How is Chao Pinhole® Surgical Technique (PST) performed?

During the Chao Pinhole® Surgical Technique, a needle is used to make a small hole in the patient’s existing gum tissue. Through this pinhole, special instruments are used to gently loosen the gum tissue. These tools help expand and slide the gumline to cover the exposed root structure. There are no grafts, no sutures, and no incisions needed with the Chao Pinhole® Surgical Technique. It simply involves the adjustment of the existing tissue.

What are the benefits of Chao Pinhole® Surgical Technique (PST)?

The benefits of the Chao Pinhole® Surgical Technique are many:

  • Less discomfort for the patient after treatment
  • Faster recovery for the patient than traditional grafting
  • No need for uncomfortable sutures
  • No need for scalpels or invasive surgical tools
  • No need to take donor tissue from the patient’s palate
  • Excellent, natural-looking, long-lasting results

Dentures

As prosthodontists, Drs. Mangini and Mangini are specialists in denture making. The dentures we create are comfortable, retentive, and most importantly, natural looking. Each denture is custom fabricated and we work with you to ensure that your smile is one to be proud of.

A denture or a complete denture as it is often called, is an appliance that is inserted in the mouth, replaces natural teeth and provides support for the cheeks and lips.

Most dentures are made of acrylic and can be fabricated two different ways.

  • A conventional denture is made after all teeth have been extracted and the tissues (gums) have healed.
  • A complete denture is fabricated in conjunction with dental implant placement to provide for teeth that “snap” into place
  • An upper denture has acrylic, usually flesh colored, that covers the palate (roof of the mouth).
  • A lower denture is shaped like a horseshoe to leave room for the tongue.

The teeth are made of plastic, porcelain or a combination thereof. Dentures can be fabricated to fit over endodontically treated teeth and a complete denture can be attached to dental implants to allow for a more secure fit of the appliance.

Cosmetic Dentistry

Invisalign Orthodonics

The invisible way to straighten your teeth without braces. To whether or not you are a candidate to be an Invisalign patient, please feel free to contact us to schedule an appointment.

What are the advantages to Invisalign

Clear

Invisalign is a series of clear plastic aligners (they look like clear retainers) that move your teeth. Invisalign uses advanced 3-D computer imaging technology to manipulate your “virtual” teeth into the desired position. Instead of wearing braces and wires, with Invisalign the plastic aligners place pressure on your teeth in a systematic way to cause movement. Since they are clear, no one knows you’re wearing them. Invisalign is virtually an invisible way to get the smile you want – no “train tracks”!

Clean

Invisalign aligners are removable. You wear them all day, but remove them to eat, and to clean your mouth. This means that you get to keep your teeth and gums clean and at their best while you are undergoing orthodontic treatment. As your dental care team, we love this feature of Invisalign, because along with straight teeth we love to see healthy teeth.

Comfortable

Invisalign aligners are very smooth and comfortable to wear. They exert the most pressure the first day you wear them, and most patients tolerate this easily. Since you change your aligners every 2 – 3 weeks, this means that the “pressure” days are only once in a while. The longer you wear them each day, the more comfortable they feel.

Porcelain Veneers

Porcelain veneers are thin shells of ceramic that bond directly to the front surfaces of the teeth. They are an ideal choice for improving your smile and have become increasingly popular due to their simplicity and versatility.

Placing custom veneers requires a high degree of technical skill as well as attention to cosmetic detail. We place veneers routinely, and design each case individually to match and enhance the characteristics of each patient’s smile.

When bonded to the teeth, the ultra-thin porcelain veneers are virtually undetectable and highly resistant to coffee, tea, or even cigarette stains. For strength and appearance, their resemblance to healthy, white tooth enamel is unsurpassed by other restorative options.

Inlays & Onlays

What are inlays and onlays?

Inlays and onlays can be made of porcelain, gold, or composite resin. These pieces are bonded to the damaged area of the tooth. An inlay, which is similar to a filling, is used inside the cusp tips of the tooth. An onlay is a more substantial reconstruction, similar to the inlay but extending out over one or more of the cusps of the tooth.

Traditionally, gold has been the material of choice for inlays and onlays. In recent years, however, porcelain has become increasingly popular due to its strength and color, which can potentially match the natural color of your teeth.

How are inlays and onlays applied?

Inlays and onlays require two appointments to complete the procedure. During the first visit, the filling being replaced or the damaged or decaying area of the tooth is removed, and the tooth is prepared for the inlay or onlay. To ensure proper fit and bite, an impression of the tooth is made by the dentist, and sent to a lab for fabrication. The dentist will then apply a temporary sealant on the tooth and schedule the next appointment.

At the second appointment, the temporary sealant is removed. Drs. Mangini, Mangini and Friedman will then make sure that the inlay or onlay fits correctly. If the fit is satisfactory, the inlay or onlay will be bonded to the tooth with a strong resin and polished to a smooth finish.

Considerations for inlays and onlays

Traditional fillings can reduce the strength of a natural tooth by up to 50 percent. As an alternative, inlays and onlays, which are bonded directly onto the tooth using special high-strength resins, can actually increase the strength of a tooth by up to 75 percent. As a result, they can last from 10 to 30 years. In some cases, where the damage to the tooth is not extensive enough to merit an entire crown, onlays can provide a very good alternative.

Teeth Whitening

It’s safe, quick, and inexpensive. Just let us know at any appointment if you would like to whiten your teeth. You can lighten only your upper teeth or both the upper and lower, depending on how much you show when you talk and smile.

In only a day or two your custom bleach splints will be ready for you to pick up. We provide you with a special bleaching agent that you put into the clear splints. With only a few hours of wear per day, our special bleaching agent bubbles stains right out of your enamel in a very short time without altering tooth structure or existing dental work in any way. When your teeth reach the desired brightness, only occasional treatment is needed to maintain your new smile. We’ll want to take “after” photos at your next appointment.

Dental bleaching can be used to correct tooth discoloration. Discolorations can be caused by staining, aging, or chemical damage to teeth. Using the latest in bleaching technology, we can offer a safe method for creating a beautiful “brilliant” smile. In cases of extreme tooth discoloration, crowns or veneers may be the only choice, but because of the low cost of bleaching treatments, bleaching is nearly always worth a solid try.

Bonding

Bonding is an alternative to veneers and can be used as a restorative procedure for teeth that are chipped, cracked, discolored or misarranged.

How does it work?

The tooth is prepared for the procedure by lightly etching the surface and applying a bonding liquid. Once the liquid sets, a plastic resin is applied and sculpted into the desired shape by the dentist. Once set, the resin is trimmed, smoothed and polished to a natural appearance.

Considerations

The bonding procedure can often be completed in a single office visit, and can improve the appearance of a tooth significantly. However, since the plastic resin used is not as strong as your natural tooth enamel, it is more likely to stain, chip or break than natural teeth. Bonding typically lasts three to five years before need of repair.

General Dentistry

Root Canals

A root canal is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need of dental implants or bridges.

At the center of your tooth is pulp. Pulp is a collection of blood vessels that helps to build the surrounding tooth. Infection of the pulp can be caused by trauma to the tooth, deep decay, cracks and chips, or repeated dental procedures. Symptoms of the infection can be identified as visible injury or swelling of the tooth, sensitivity to temperature or pain in the tooth and gums.

If you experience any of these symptoms, you may require non-surgical treatment to eliminate the diseased pulp. This injured pulp is removed and the root canal system is thoroughly cleaned and sealed. This therapy usually involves local anesthesia and may be completed in one or more visits depending on the treatment required. Success for this type of treatment occurs in about 90% of cases. If your tooth is not amenable to endodontic treatment or the chance of success is unfavorable, you will be informed at the time of consultation or when a complication becomes evident during or after treatment. We use local anesthesia to eliminate discomfort. In addition, we will provide nitrous oxide analgesia if indicated. You will be able to drive home after your treatment, and you probably will be comfortable returning to your normal routine.

Dental Crowns

Most dentistry looks like dentistry. Our goal is to provide dentistry that is natural and undetectable. We replace existing crowns and fillings with restorations that look and feel like your natural teeth.

Where damage to a person’s teeth is extreme, and beyond repair, we can use crowns to make the smile appear “as new”. This is an extremely reliable technique for repairing the most severe of dental problems, even permanently replacing missing teeth to offer a complete smile and a functional bite. Numerous materials can be used to make your crown, depending on your specific needs: all-ceramic, gold, or zirconia. We are renowned for the quality of our work and the fantastic changes we make for people using this technology. These treatments are used for a long-lasting correction of major dental problems. It is usual for these treatments to last for 20 to 30 years, which is as close to permanent as dental treatment can get.

Key Benefits:

  • Replaces missing teeth
  • Offers support to misshapen teeth or badly broken teeth
  • Looks completely natural
  • Fixes “smile” and functional chewing problems

Dental Bridge

ll of your teeth play an important role in speaking, chewing and in maintaining proper alignment of other teeth. Tooth loss doesn’t necessarily have to occur as you age, but if you do lose teeth they must be replaced to maintain proper function of your mouth. Fortunately, there are options for correcting tooth loss.

A bridge — a device used to replace missing teeth — attaches artificial teeth to adjacent natural teeth, called abutment teeth. Bridges are either permanently attached (fixed bridges), or they can be removable.

Fixed bridges are applied by either placing crowns on the abutment teeth or by bonding the artificial teeth directly to the abutment teeth. Removable bridges are attached to the teeth with metal clasps or by precision attachments.

If you’re missing one or more teeth, you may be aware of their importance to your appearance and dental health. Your teeth work together for many daily functions from eating to speaking. With missing teeth, it’s difficult to do these things. Missing teeth can and should be replaced. Fixed bridges are a great way to restore your dental health and appearance.

Tooth fillings & Restoration

We are a mercury-free practice. However, many people still have silver/mercury fillings in their mouths from years past. These fillings are not particularly pleasing to the eye, and we know that by unavoidable design, silver/mercury fillings ultimately result in a weaker tooth structure. Porcelain inlays and Tooth Colored Restorations (onlays) create fillings that are not only beautiful (or unnoticeable) but also add strength to weakened teeth. These restorations are esthetically pleasing and very strong thanks to new bonding technologies.

Advantages of tooth-colored restorations:

There are many advantages to tooth-colored restorations. Resin onlays are bonded to the teeth creating a tight, superior fit to the natural tooth. Such restorations can be used in instances where much of the tooth structure has been lost. The tooth remains intact and stronger.

Since the resin used in tooth-colored restorations contain fluoride this can help prevent decay. The resin wears like natural teeth and does not require placement at the gum line, which is healthier for your gums!

Tooth Extractions

You and Drs. Mangini, Mangini and Friedman may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.

To avoid these complications, in most cases, Drs. Mangini, Mangini and Friedman will discuss alternatives to extractions as well as replacement of the extracted tooth.

Teeth Cleaning

A dental prophylaxis is a cleaning treatment performed to thoroughly clean the teeth and gums. Prophylaxis is an important dental treatment for stopping the progression of gingivitis and periodontal disease.

Prophylaxis is an effective procedure in keeping the oral cavity in proper health and halting the progression of gum disease. The benefits include:

  • Plaque removal.
    Tartar (also referred to as calculus) and plaque buildup, both above and below the gum line, can result in serious periodontal problems. Unfortunately, even with a proper home brushing and flossing routine, it can be impossible to remove all debris, bacteria and deposits from gum pockets. The experienced eye of a dentist or hygienist using specialized dental equipment is necessary to catch potentially damaging buildup.
  • A healthier looking smile.
    Stained and yellowed teeth can dramatically decrease the esthetics of a smile. Prophylaxis is an effective treatment in ridding the teeth of these unsightly stains.
  • Fresher breath.
    Bad breath (or halitosis) is generally indicative of advancing periodontal disease. A combination of rotting food particles (possibly below the gum line) and potential gangrene stemming from gum infection, results in bad breath. The routine removal of plaque, calculus and bacteria at our facility can noticeably improve halitosis and reduce infection.

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