This technique is suitable for the repair of dental lesions small and medium-sized, since the structure of the tooth in addition to a certoi damage would be subjected to dangerous stress for its integrity.

Indirect technique

When the amount of the injured tooth is too big we prefer to restore it with a more complex technology that provides for the construction in the laboratory of inlay or an aesthetic Facet.

Most of these operational techniques involves the use of rubber dam, to avoid contamination of the oral liquids.

In cases of particularly large dental injuries you will need to perform true and proper prosthetic restorations: Crowns.


The Endodontics is the medical science in the field of Dentistry, which referred to the internal tissues of the tooth, diseases and related treatments. When these tissues or tissues surrounding the tooth root get sick or hurt due to caries or trauma, endodontic treatment makes it possible to save the tooth.

What is a root canal treatment or root canal or "root canal" of the tooth?

The endodontic treatment is an outpatient dental work that is necessary when the pulp (the soft tissue inside the tooth) is inflamed or infected for a damage caused by a deep caries, the outcome of interventions on the tooth, or by trauma (severe sudden or more light but repeated) that caused fracture or chipping or deep cracks.

The dental pulp, contained inside the teeth, popularly known as the nerve of the tooth, is in reality a highly specialized tissue consisting of arteries, veins, nerves, and connective tissue cells. In the age of development this fabric has the function of forming the supporting structure of the calcified tooth (dentin); in adults, for complete growth, the pulp - now thinned - remains confined in the pulp chamber and root canals, with residual functions of sensitivity to cold and moisture of the dentin.

A perturb the pulpal health may intervene various pathological situations, the most common of which is by far the dental caries (see below), namely the progressive decalcification and destruction of the hard tissues of the tooth to the action of microorganisms present in plaque bacterial. If the cavity is not treated promptly produced by decay it expands and deepens and extends until the pulp is achieved by bacteria with irreversible transformations due to infection. When you get to this stage, the conservative care that keeps the tooth while avoiding the extraction is endodontic therapy or root canal or even improperly called root canal treatment. In general the Endodontics aims to preserve teeth that have received significant damage to their structure which led to infection and necrosis of the pulp, with acute or chronic effects of surrounding tissue, more or less painful.

Modern Endodontics uses sophisticated tools for diagnosis and therapy, such as surgical stereo microscope, innovative biomaterials, instrumentation in special alloys.

What signs indicate the presence of a cavity?

Tooth decay can not give any early sign of his presence, or the symptoms are so mild that they do not induce concern. This is especially true in the early stages, but often even in the face to the complete destruction of the tooth the patient may not report any particular discomfort and show indeed surprised of what happened without pain. Only with regular monitoring by the dentist - that must be done even in the absence of pain - you can verify their presence until the very early stages and intervene early therapy and thus limited, minimizing damage and preventing sudden pains and care in emergency regime. Therefore the pain, in the case of teeth, is not a reliable warning signal and even a severity index of the damage: the solution is the periodic visit to the dentist.

The excessive sensitivity to cold is a symptom to consider, but it is not a unique index of the presence of a cavity. Can also be caused by the uncovering of the collars in level (the part of the teeth next to the gingiva) for periodontal disease, by abrasion from toothbrush used incorrectly, or for a particular acidity of the oral cavity (from excessive erosion intake of acidic foods such as citrus or vinegar, or even to pathological conditions such as gastroesophageal reflux). The grinding (bruxism), or cracks / fractures can lead to hypersensitivity to cold.

Besides the sign of pain in the cold or even to sweets or salty foods it is completely absent in the already treated teeth endodontically. the pulp is the sensitive part and if the pulp is necrotic, or has been removed to a previous root canal therapy, this symptom is lacking. Note in this regard that the caries attacks indifferently and with the same intensity both healthy teeth, is tooth previously cured or devitalized.

Excluding situations listed above, when the heat symptoms, cold, sweet, salty is accompanied by a more or less localized pain that lasts for a time later to the stimulus, this is a clear sign of the presence of a caries already at an advanced stage. The damage extends in rapid progression, and if not intercepted in time inevitably leads to painful phenomena of pulpitis (acute inflammation) and necrosis (cell death) of the pulp of the tooth itself. The care at this late stage is no longer the removal of the carious part and a filling more or less extended, but is requiring the processing endodontic (or root canal treatment, also called root canal treatment or channeling).

Endodontic treatment

What is it about?

The endodontic treatment (root canal or also called root canal treatment or channeling) consists in the removal of the pulp (dental nerve) inflamed and infected, present within the tooth and over the entire length of the roots, and in its replacement with permanent obturation in gutta-percha and cement root canal, after adequate cleaning and shaping of root canals.

What you get with the endodontic treatment?

The result is that the tooth will no longer be an infectious tank and, after adequate reconstruction of the crown, can continue to perform the same functions of an intact tooth. The percentage of success of a root canal proper care is, under normal conditions, very high. The percentage decreases in cases of endodontic retreatment, that is when you need to repeat the procedure for a previous failure (execution errors, anatomical complexity, objective difficulties)

How long?

Endodontic treatment is now also fast for molars, thanks to new techniques and modern equipment available. The operational steps are the following:

Local anesthesia to neutralize the pain even in cases with more sensitive pulp

temporary restoration of the dental crown when this is very destroyed, in order to eliminate all the cavities without giving up the walls of the tooth cavities (containment of liquid disinfectants and engagement of the insulating rubber sheet)

Isolation of the operating field by means of the rubber dam (necessary means for a good outcome of the root canal) consisting of a rubber latex sheet stretched by a headband and held in place by a hook placed around the tooth to be cured or to a tooth near

Opening the pulp chamber: access to the pulp through a cavity prepared by chewing the side of the tooth

Or retrieval of the root canal with the aid of optical magnification

Measurement of the working length of each channel that is present (by a reference on the crown to the root apex) by means of an X-ray and an electronic apex locator (the dose of radiation absorbed in the execution of a radiography for dental use is minimal)

Instrumentation of channels using endodontic instruments that remove the root canal pulp contaminated by bacteria and infectious substances, creating at the same time a form of walls suited to a complete filling

Washing with sodium hypochlorite, powerful disinfectant, to obtain an environment as clean and antiseptic as possible

Root filling using gutta-percha, plastic and moldable by heat, associated with a concrete canal

crown reconstruction

Radiographic testing of the end of care

Any fixed prosthesis (crown or bridge)

The Root canal care can hurt?

During treatment, endodontic pain is under control thanks to local anesthesia. A soreness, which can be subjectively more or less troublesome, may be present after the therapy, but is easily controlled with a common analgesic. Rarely, particularly in infected roots it can develop an abscess with pain and swelling due to the passage of bacteria in the bone surrounding the roots. The onset of these complications does not necessarily affect the success of the treatment in progress.

Source: Italian Endodontic Society


Gnathology is a branch of dentistry that humans (but, comparative research level, even in animals) studies the physiology, pathology and function of the jaw (chewing, swallowing, phonation, postural) and therefore, studying reports between the jaws, teeth, temporomandibular joints of right and left, the muscles that move the jaw and nervous system that controls those muscles, including language.


The term "occlusion" literally refers to the contacts between the teeth of the opposed arched both in a static position and dynamic. For "gnathology" means the study of all organs or organ systems that from a physiological or pathological side can be connected dental occlusion "

(Mario Molina, Fundamentals of Modern gnathology)

It is a wider definition, which opens wide on the correlations space with many other organs or systems. It can be defined as Gnathology postural (some authors have also called "Ortoposturodonzia"): here increases the importance of the lingual function, respiration, the cranio-sacral breathing, swallowing mediated the hyoid bone with muscles to it connected (directly connected with: mandible, temporal bone of the skull, sternum bone handlebar, clavicles, first thoracic ribs, shoulder blades, cervical vertebrae). From these areas of interest related to postural Gnathology it is easy to understand how the stomatognathic apparatus participates in the global posture of the human being.


The gnathological therapy is to restore normal relations between the mandibular condyle, articular disk, and glenoid fossa. Therefore is the mandibular position each to the skull that makes the difference between success and failure. In order artifacts serve mainly resin and metal (bite) that reposition the lower jaw while producing a muscular relaxation of the masticatory muscles and all other affected muscles. Once deleted, contractures proceed to the results of stabilization therapy, which may provide for the occlusal adjustment for affixing, by subtraction or modification using aids that can range from a simple selective grinding to eliminate interference (sometimes caused by ill-posed restorations) to restore the correct heights by onlays, crowns or missing teeth by implants, finally you can change positions by dental orthodontics.

Gnathological many existing schools, the therapeutic means can vary while fairly constant use of occlusal splints (retraction / relaxation or "bite planes", indented, orthotic, recapture meniscus protective etc.). If therapy is not successful it can then try a different method. Only in case of permanence of internal problems in the joints and as a last resort, after instrumental diagnosis (Nuclear Magnetic Resonance and more rarely Cone Beam CT scan, the temporomandibular joints), you can leave the gnathology to resort to more or less invasive surgery the degree of severity of the problem (washing intra-articular, endoscopic surgery, TMJ surgery classical)

Dr. Alcide Pirazzi Maffiola has long experience in this field having worked as an assistant with Dr. Mario Molina at the Stomatologico Institute in Milan for 10 years and is co-author of some of the most important texts on the subject.


Orthodontics is a dental specialty that deals with the correction of the position of the teeth and bones, as well as of the problems affecting the occlusion of teeth.

Orthodontic treatments are able to move a tooth located at an incorrect location, in a proper.

In addition, the orthodontic intervenes in the correction of the rotation and inclination of the teeth which, precisely because positioned abnormally, can be interested by the onset of caries and inflammation of the gums, in addition to causing problems temporomandibular articulation mandibolare.E 'a treatment that offers effective solutions at any age thanks to the fact that there are various alternative care.

In our clinic we offer you the opportunity to find the best solution to your dental problems.

The types of orthodontics are three:

  1. Orthodontics Fixed
  2. Mobile Orthodontics
  3. Cosmetic Orthodontics.

Orthodontics Fixed

The fixed orthodontics is one that can not be removed from the paziente.Comunemente is known as brackets, referring precisely to the attacks, normally metal, bonded to the teeth that support the arch that produces the tooth movement. In recent years there have been great developments in the field of orthodontics fixed that led to the emergence of a wide range of orthodontic appliances suited to different functions and different aesthetic needs of each fixed noi.L'ortodonzia is divided into:

  • Colourful Orthodontics. It is designed especially for small children for whom taking the set may cause problems interpersonally. It is orthodontics fixed metal whose attacks can be customized in favorite colors
  • Orthodontics Self-ligating. Per self-ligating orthodontic appliance is a system of direct attacks that lets you keep the arch in brackets. This type of orthodontic determines a reduction of the total time of treatment and facilitates cleaning since the accumulation of food residues is less. If you're concerned about aesthetics, you can count orthodontics self-ligating ceramic brackets with the color of your teeth so that smile no longer poses a problem.
  • Self-ligating orthodontic Ceramic. It is a system of self-ligating brackets, the latest technology and made of ceramic, with rounded edges and soft. With the self-ligating orthodontic eliminates ligatures to the arches facilitating cleaning and preventing you from accumulating food debris. Moreover, thanks to the shape of the brackets, the teeth reach the correct alignment very rapidly and, accordingly, the duration of treatment is significantly reduced. It is an optimal solution in terms of aesthetics and comfort. The brackets are made of translucent ceramic. The time of the treatment is reduced. The shape allows for better hygiene.

Mobile Orthodontics

The mobile orthodontics is still the teeth and can be removed without the help of the dentist. The use of mobile orthodontic appliances is particularly suitable for the correction of dental misalignments or to modify the growth of the teeth. They can be removed to eat and to be cleaned. In many cases the mobile orthodontic apparatuses are used as support to the fixed one, after an orthodontic treatment or fixing brackets.

Cosmetic Orthodontics

Orthodontics aesthetic will be most effective in the treatment, combined with an aesthetic solution that safeguards the self-confidence of the patient, passing virtually inosservata.É an ideal solution for adulti.Si divided into:

  • Orthodontics Fixed Ceramic. It involves the use of a fixed appliance whose brackets are made of ceramic material. Ceramics have the advantage, therefore, to match the tone of the teeth of those who use this type of orthodontic appliance: once placed on the teeth brackets are nearly invisible, providing a unique aesthetic result
  • Mobile Invisible Orthodontics. It is an alternative therapy to conventional orthodontic treatment. Through a transparent system splints you can gradually correct the position of the teeth leading them in a proper, without anyone being aware of it. The Invisible Orthodontics is effective and comfortable solution, able to guarantee maximum aesthetic result
  • Self-ligating orthodontic Ceramic. It is a system of self-ligating brackets, the latest technology and made of ceramic, with rounded edges and soft. It is an optimal solution in terms of aesthetics and comfort.


Periodontology is a branch of Dentistry that studies periodontal tissues (peri = around; odons = tooth) and related diseases. The periodontium consists of:

  1. gum
  2. alveolar bone
  3. cementum (tissue that covers the tooth root)
  4. periodontal ligament.

The periodontology is then occupies the whole of the soft tissues (periodontal ligament and the gingiva) and hard (cement and alveolar bone tissue) surrounding the tooth and alveolar arch which ensure its stability (in health conditions). Periodontics, also takes care of diseases affecting the periodontium. These are generically called periodontitis or periodontal disease, or periodontal disease (historical term still used today in the population). They are periodontitis and gingivitis.

Etiology of periodontal disease

Periodontal disease is an infectious multifactorial disease site-specific. Or:

  1. infectious: the necessary cause that can never fail are bacteria (plaque);
  2. multifactorial: it has multiple causes that together can reinforce and exacerbate the effects of infectious component;
  3. site-specific: each tooth and every area can be differently affected, serious, moderate, little or nothing; this is necessary for an accurate diagnosis tooth to tooth.

Periodontal disease can present as gingivitis or periodontitis. The first involves the rehabilitation, the "recovered fully," the supporting tissues, the second involves more after healing an irreversible lesion.

Incidence of periodontal disease

It is estimated that at least ten million Italians suffer from such illnesses after thirty years of age; with periodontal disease is lost "attack" (epithelial attachment, which in fact is not lost, but it moves apically, moving away from the tooth towards the root) and alveolar bone. These periodontal anatomical changes are consequences of the disease lead to two possible clinical manifestations:

  1. gingival recession (gum lowered that is highlighted with a longer tooth)
  2. pocket periodontal (gum in the correct position, but the bone and the attack have moved apically along the root, thus forming an empty space called periodontal pocket).

Periodontal disease aggressive child

Although this disease can occur in children and is mainly due to an organism: the actinomices actinomicetemcomitans. Other conditions are particularly unfavorable anatomical favor it that facilitate the loss of gum; poor hygiene and a resulting inflammation may aggravate the lesions usually heal after appropriate antibiotic treatment and the restoration of good practice of oral hygiene.

In our study Doctors Dentists and Dental Hygienists graduates they are particularly experienced in the diagnosis and treatment of these diseases, the assessment of which requires specific knowledge and skills.

Pediatric Dentistry

The pediatric dentistry is the field of dentistry that deals with the care of children's teeth.

Prevention is a key objective for the pediatric dentistry: for this reason a first follow-up visit is recommended for ages 3-4 years.

Pediatric dentistry and oral hygiene

Proper oral hygiene combined with healthy eating habits will help to save the dental health of the young patient since the deciduous teeth (milk) until the final dentition.

In this regard, the dentist will provide the child and parents the information relating to prevention rules and removal of bacterial plaque and the correct use of the toothbrush, engines and gradually, during control sessions, the teeth and gum health.

Pediatric dentistry and tooth decay: Prevention and Treatment

The sealing of permanent molars is a good defensive strategy against pediatric tooth decay and is feasible, if necessary, even on deciduous teeth.

The chewing surfaces of molars has deep grooves, in which the plaque is easily nestles making difficult and often insufficient everyday maneuvers of oral hygiene. Since the molars at increased risk of early carious lesions, the application of a special resin along the jaw grooves allows to protect the paintwork, making it impervious to bacterial plaque.

The protective effect of the sealing can last several years: a new application is required when the resin is consumed.

The treatment of caries as well as the different dental benefits targeted at young patients, may be carried out with the aid of the laser, in order to avoid the use of anesthesia or whiplash drill turbine.

In more complex cases (or to cope with a poor collaborative ability of the child), dental treatment can be performed using sedation with nitrous oxide and intravenous sedation or hypnosis.

Pediatric dentistry and orthodontics

Important is the role played by prevention in pediatric orthodontics.

An early screening of occlusive masticatory functions and allows the baby, already in the presence of deciduous teeth or milk is to detect any misalignments dental or skeletal abnormalities (maxillary and mandibular). Such alterations, intercepted during the growing period, can be corrected with the help of orthodontic appliances, avoiding the need for any extractions or orthognathic surgery.

Early orthodontic treatment, by identifying the most important malocclusion, allows you to avoid the long and traditional orthodontic treatment in puberty.

Fixed Prothesis

The dental prosthesis is an artifact used to replace the original dentition lost or compromised for functional and / or aesthetic reasons. It also defines the denture part of dentistry that deals with the design and construction of prostheses, subject to the following requirements:

  1. functionality
  2. resistance
  3. harmlessness
  4. aesthetics

Fixed Prosthesis

The fixed prosthesis is fixed to the elements pillar with the cementation and can not be removed from the patient. Based on the features, there are three types of fixed prosthesis:

  1. fixed prosthetic reconstruction: has the task of rebuilding the anatomical parts of the removed tooth and then preserve it from complete destruction (eg. crowns, inlays, die pin);
  2. prosthesis replacement: it replaces with particular elements natural teeth lost (eg. intermediate elements of bridge prostheses);
  3. prosthesis fixation: has the ability to block and properly distribute chewing forces (eg. splints fixation).

These items if you anchor the tooth root or residue are defined crowns, if built on the adjacent teeth (properly filed) with the aim to restore missing teeth are called decks, and when applied on the bone implants are defined implant prosthetics.

Are defined prosthesis also fixing the veneers, which consist of ceramic shells to be applied on the front teeth for aesthetic or functional purposes.

In recent years great importance has taken the computer-assisted production of fixed restorations with CAD / CAM technology.


The crowns are implants for single teeth of which at least the root is preserved. Are anchored or properly prepared tooth (stump) or via endodontic posts, the root (crown Richmond).

The crowns, as well as bridge elements, can be metal, ceramic metal, only ceramics. Currently they are presenting other materials useful for the fixed prosthesis.


What bridges the extract dental element it is replaced by a prosthesis that also includes the adjacent dental elements which are for this reduced to stumps and prosthesized also.

The missing element together with the pillar elements (abutments on which leans) form the bridge. It can be total understanding that the whole arch (prostheses circular bridge) or part comprising two or more elements.

The pillar elements must have a number equal to or greater than the number of pillar roots of missing items, if it does not exist you run a mixed prostheses.

For girder it means the structure is allocated to support the item or items missing.

Porcelain Veneers

Porcelain veneers are thin ceramic plates which are cemented on the visible surface of the front teeth. The teeth that receive a veneer are slightly filed down to the ceramic spacer. However, their preparation is extremely conservative and should be maintained at the level of the surface portion of the tooth, the enamel. The enamel allows optimal bonding of the veneers to the tooth.

Mobile Prothesis

The dental prosthesis is an artifact used to replace the original dentition lost or compromised for functional and / or aesthetic reasons. It also defines the denture part of dentistry that deals with the design and construction of prostheses, subject to the following requirements:

  • functionality
  • resistance
  • harmlessness
  • aesthetics

Mobile Prothesis

By the term "denture" refers to all the prostheses designed for the replacement of full arches or parts of it. furniture are defined as they can be easily removed from the patient during the day. 

Partial Prothesis

The partial prothesis are still using hooks or attacks on the remaining teeth. When the partial denture has a metal support structure is defined skeletal prostheses or skeletonized and if mixed with precision attacks on fixed cemented crowns to adjacent abutment teeth, is said combined prostheses. It can also establish a type implants skeletonized acetal resin or termopressata without metal hooks or simple wire hangers.

Total Prosthesis

The full denture is one of the afisiologici devices, as the chewing loads are fully downloaded to the mucosa and underlying bone, because the remaining teeth or roots are lacking (edentulous). Therefore has the task of fully restoring the chewing functions.

In the performance of this prosthesis must respect the profile of the face (facial profile).

It is best defined as "the total mobile" because it turns out to be a device that the patient can be removed and reinstalled at any time of the day.

It is a device able to replace entire edentulous arches now, it consists of a support structure in the acrylic resin. The teeth are the teeth of the trade is used in ceramics (little used) in acrylic or composite resin).

With products teeth currently we achieve excellent aesthetic results: fundamental is the technician's skills, especially for the front teeth, manages to give the prosthesis a natural look that is well suited to the patient's face and expressions.

If the edentulous saddle was little detected or in any case to increase the retention of the total denture is possible, if the amount of residual bone is sufficient, resorting to implant surgery. In such a case they would be inserted in the edentulous crest of the installations with anchoring function (typically for overdentures technique with a spherical retention, in the lower jaw are inserted from 2 to 4 systems in the area of ​​the canines).

Prothesis on Implants

When the root of missing an element is replaced by a dental implant (usually titanium) and on this is cemented or screwed onto the prosthetic element is spoken of prosthesis on implants.

With implants it is possible to replace individual teeth or bridges realize or more extended structures (Toronto bars, or similar) that can replace from one to all the elements of the entire dental arch.

Ea can also stabilize dentures specifically constructed or existing furniture with anchoring systems supported by implants.


Dental Whitening

Teeth whitening is one of the quickest ways to obtain an improvement of the same, but it should be carefully evaluated by a specialist.

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