Exp. Dt. Berçem Kalender Arslan shares details about the field of restorative dentistry, which addresses both the function and aesthetics of teeth.

Assoc. Dr. Elif Öncü shares that the smile design process takes an average of one day and details the steps in this process, especially the mock-up (temporary trial) stage.

What are the Smile Design and Mock-up Stages?

Photography and Digital Measurement: The smile line and lip support are photographed and analyzed to assess facial proportions. Digital measurements are taken using intraoral scanners.

• Digital Modeling: The planned aesthetic form is modeled with software to match the facial features, and a physical model is prepared.
• Mock-up (Temporary Trial) Application: Silicone keys are prepared from the model and made suitable for the intraoral mock-up. Temporary restorations are used to rehearse the smile design in the mouth.

 

Assoc. Dr. Elif Öncü explains the details, advantages, and long-term success effects of cemented (bonded) and screw-retained prostheses, which are types of implant-supported prostheses.

What are Cemented (Bonded) Prostheses?

In classic prostheses that are directly bonded to the mouth, since the prosthesis cannot be removed, even if the bonding process is handled carefully, cement (adhesive) material remnants can escape into the gum tissue and reach the implant level. This cement buildup can damage the tissues surrounding the implant, negatively affecting implant success in the long term. What are Screw-Retained Prostheses?

In screw-retained prostheses, no bonding is done in the mouth. Screw-retained prostheses can be easily removed by accessing the screws through the screw holes in the mouth when necessary. Screw-in prostheses are very hygienic, especially in multi-unit prostheses, as they can be removed and professionally cleaned from time to time.

In summary: The biggest disadvantage of screw-in prostheses is that the intermediate parts used during the prosthesis process are somewhat expensive and cannot be applied in every case depending on the implant placement angles.

[Image caption: Screw-in prostheses are very hygienic because they can be removed and professionally cleaned from time to time, especially in multi-unit prostheses.]

Assoc. Dr. Elif Öncü shares important rules and tips to follow for a healthy recovery after implant surgery.

The First Days After Implant Surgery and Things to Watch Out For

Avoid Hot Foods: Avoid very hot food and drinks for the first 24 hours, and do not strain the surgical area.
Cold Compress: You can apply an ice compress externally to reduce swelling.
Rinsing and Straws: On the first day, avoid rinsing your mouth vigorously and do not use a straw.
Diet: For a few days, prefer soft foods and avoid chewing with the surgical area. It is important.

• Smoking: If you smoke, you should quit as it can negatively affect healing.
• Medication and Care: Follow your doctor’s prescribed medications and care recommendations regularly and correctly.

 

What are the Normal Situations?

After the operation, slight bleeding, tenderness lasting a few days, swelling and bruising in the cheek, temporary difficulty in fully opening the mouth, and discomfort while chewing may occur. These are not causes for concern and usually decrease in the first few days.

Assoc. Dr. Elif Öncü explains that implant treatments are among the most feared but, with the right techniques, are one of the most comfortable treatments.

Is There Pain During Implant Surgery?

Thanks to correct surgical techniques and modern anesthesia methods, there is no pain during implant surgery. Most patients state that they experience a much more comfortable process than they expected after implant surgery. What is Necessary for a Comfortable Process?

Controlled surgery, an atraumatic approach, and good planning greatly facilitate the healing process.

Prof. Dr. Alper Çağlar explains the properties, advantages, and when to choose Zirconia (Zirconium) and Lithium Disilicate materials, which are frequently used in prosthetic dentistry.

What is Zirconia (Zirconium Teeth) and What are its Properties?

Zirconia teeth are produced from a high-tech ceramic called zirconium dioxide, and its main characteristic is its high durability.

• Thanks to its high fracture resistance, it is ideal for molars where chewing forces are intense.
• It offers a long-lasting and reliable solution in long bridge prostheses covering more than one tooth and in patients with teeth grinding habits.

What is Lithium Disilicate and What are its Advantages?

Lithium disilicate material is considered the gold standard for treatments where aesthetics are paramount.

• Its most significant advantage is its superior translucency, which ideally mimics the way natural tooth enamel transmits and reflects light.
• It provides an extremely natural appearance that is almost indistinguishable, especially in the restoration of incisors located in the smile line.
• It has more than sufficient strength for single crowns and short bridges in the anterior region.

Exp. Dt. Berçem Kalender Arslan explains the possibility of recurrence of decay (secondary decay) in teeth that have been filled and the reasons for this.

Why Does a Filled Tooth Decay Again?

Yes, decay can occur again in a filled tooth. Because a filling treats the decay but does not completely protect the tooth against decay. Especially if plaque accumulates around the edges of the filling, new decay, which we call secondary decay, can develop over time.

What Factors Increase the Risk of Tooth Decay?

• Insufficient oral hygiene,
• Frequent consumption of sugary foods,
• Neglecting regular dental check-ups increases this risk.

Exp. Dt. Berçem Kalender Arslan explains that achieving ideal aesthetic and functional results in the anterior (front) region often requires a holistic treatment protocol that transcends the boundaries of a single specialty.

What are the Treatment Stages in Anterior Region Aesthetics?

Orthodontic Stage: In some cases, the process begins with orthodontic treatment, which aims to bring the teeth into the correct position and achieve a symmetrical distribution of gum spacing. This preparation allows us to adopt a “minimally invasive” approach that minimizes tissue loss during the restorative phase.

• Periodontal Procedures: Following alignment, periodontal procedures such as gingivectomy are performed to standardize gum levels and achieve “pink aesthetic” harmony.
• Restorative Phase: In the final stage, the optical properties and functional integrity of the teeth are restored using current adhesive systems and composite layering techniques.

 

Assoc. Dr. Elif Öncü explains in scientific detail how gum health is not limited to the oral cavity but directly affects brain health and the risk of Alzheimer’s disease.

How Do Gum Bacteria Reach the Brain?

In the chronic inflammation mechanism, especially in gum disease, tissue-destroying bacteria such as Porphyromonas gingivalis begin to multiply in the gums. These bacteria and their toxins reach the brain via the bloodstream, triggering microglial activation and increasing neuroinflammation specific to Alzheimer’s disease. Inflammatory Load and Neuronal Damage

Studies have shown that these bacteria can be detected in the brains of Alzheimer’s patients. The toxins of these bacteria can trigger the production of beta-amyloid in the brain, which is a typical symptom of Alzheimer’s. Furthermore, in advanced gum disease, pro-inflammatory markers such as C-reactive protein (CRP) and IL-6 can rise, accelerating brain aging and increasing neuronal damage.

Gum health is highly protective not only for oral health but also for brain health.

Assoc. Dr. Emre Cesur answers the frequently asked question, “How many hours a day should clear aligners be worn?” in clear aligner (wireless orthodontics) treatment, and shares the details of the ideal wearing time.

What is the Ideal Wearing Time Per Day?

Ideally, clear aligners should be worn for 21-22 hours, almost all day. The aligners should only be removed while eating and brushing your teeth.

Why Should Aligners Be Worn for So Long?

Tooth movement occurs with continuous and controlled force. If you remove the aligners frequently, this force is interrupted and the teeth begin to return to their old position; this causes the treatment to be prolonged. “Wouldn’t it be okay if I wore them for 15-16 hours a day?” The answer to that question is usually no because the system is not designed accordingly.

In short: If you want your clear aligner treatment to be successful, disciplined use is essential. The better you wear them, the faster and more consistent the results will be.

Assoc. Dr. Elif Öncü explains the processes to be followed for patients who have previously had implants but whose implants have fallen out or are at risk of falling out after a certain period (for example, after 2 months).

Why Doesn’t an Implant Heal or Fall Out?

First, we need to understand why the implant doesn’t heal, that is, why it doesn’t osseointegrate (fusion with the bone). There can be many reasons for this:

• Trauma during surgery,
• Insufficient attention to oral hygiene after surgery,
• Smoking,
• Biological problems in the fusion of bone and implant.

Can an Implant Be Placed Again in the Same Place?

If the source of the problem is bone deficiency or insufficient bone volume as a result of a three-dimensional evaluation (clinical, radiographic and tomography), we must first increase the bone volume. After strengthening the bone structure with various bone augmentation methods (autogenous or synthetic biomaterials), it is possible to place an implant again in the same area.

Assoc. Dr. Emre Cesur answers the question, “Can I not have orthodontics if I have gum disease?” and explains the details of the correct treatment sequence.

Is Orthodontics Possible in Active Gum Disease?

If there is active gum disease (bleeding, inflammation, bone loss continuing), orthodontic treatment is not started immediately. Periodontal treatment is done first, that is, gum health is brought under control. Because moving teeth in tissue that has lost its health can lead to further bone loss.

Orthodontics After Gum Treatment

However, if gum treatment is completed and the disease is under control, orthodontics can even be very beneficial for these patients. Proper tooth alignment facilitates cleaning, supports gum health in the long term, and can even provide tissue gain in appropriate cases.

Of course, it is healthiest to make this decision after an examination by a specialist periodontist and orthodontist. In short: Gum disease is not always an obstacle to orthodontics.

[Image caption: Proper tooth alignment facilitates cleaning, supports gum health in the long term, and can even provide tissue gain in appropriate cases.]

Assoc. Dr. Emre Cesur explains one of the most frequently asked questions after orthodontic treatment: He explains the truth behind the statement “My teeth have shifted again” and how to prevent it.

Why Can Teeth Shift Again?

Bad news: Yes, teeth can tend to return to their old positions after treatment. The main reasons for this are:

• Elastic Fibers: The fibers that connect the teeth to the bone are elastic and may try to pull the teeth back to their original position for a while after treatment.
• Bone Stabilization: During treatment, the bone around the teeth reshapes itself, and it takes time for this bone to become fully stable.
• Natural Change: Like all tissues in the body, teeth do not remain completely stable throughout life.

Why is the Retainer Phase Vital?

The good news is: You can protect your teeth with retention procedures after treatment. This phase is as important as the treatment itself. The new position of the teeth is secured using fixed braces (retainers) or removable appliances that the patient can put on and take off, allowing time for the surrounding tissues to adapt.

Exp. Dt. Berçem Kalender Arslan explains why healthy gums are so important before filling treatment and how they affect the success of composite fillings.

Why Does Gum Health Affect Fillings?

Yes, healthy gums are essential! Because it is almost impossible to perform composite fillings, especially when there is bleeding and inflammation in the mouth.

In such cases, moisture control cannot be achieved, and this seriously affects the success of the filling. Healthy gums provide a solid foundation for both accurate diagnosis and a long-lasting, aesthetically pleasing filling.

Assoc. Dr. Elif Öncü explains that thanks to developing digital technologies, dental implant treatment is now planned with much more precision, predictability, and comfort.