Your questions

The whitening procedure is relatively simple compared with other dental services intended to improve appearance. We protect the patient’s lips and vestibular area (the area of the lips and soft tissues in front of the teeth), place a suction device to remove saliva, protect the gums around the teeth with a hard composite material that sets under blue light, and apply a coloured whitening gel to the teeth. Whitening takes from ten to twenty minutes (depending on the chemical composition, type of whitening…). After whitening, we rinse the gel off thoroughly, remove the protection, and advise the patient to avoid smoking and drinking coffee and black tea for at least three days. The method described is only one of the whitening methods, and unlike in the past it is no longer based on acidic whitening gels. Other, less aggressive substances are used. We also use a light-assisted whitening method.
The result of whitening is, of course, whiter enamel, but certain limits of tooth colour must be kept in mind. Whitening cannot achieve perfectly uniformly white teeth.
As for negative consequences, we can mention temporary tooth sensitivity to changes in temperature or acidity. Whitening does involve a change in the structure or organisation of enamel crystals on the tooth surface, which could be regarded as a form of micro-damage, although more in a theoretical sense. The decision to whiten teeth is entirely subjective and has no connection with improving dental health.
The duration of the effect depends on the patient’s habits (smoking, coffee consumption, hygiene…) and can be measured in years.
Whitening costs EUR 250.

For every problem and every dental status there are always several different solutions. As you wrote, your problem has already been temporarily solved with a partial removable denture, which unfortunately usually causes greater or lesser problems.
Implants are always a desirable solution, as they represent a stable, fixed, aesthetically satisfactory and durable rehabilitation of the problem.
Considering the described location of the missing teeth, I allow for the possibility that implant placement would be combined with sinus floor elevation surgery. In the upper jaw in the premolar and molar region, there is usually not sufficient bone thickness for implantation. We increase the bone thickness by adding artificial bone through the implant bed or via a lateral approach directly into the paranasal cavity. The need for this procedure is certainly not a rule; for a precise answer we would need a panoramic X-ray image.
Even with the placement of two implants we can achieve stability of the construction, but this could be discussed more easily after a clinical examination. The number of implants required depends on the static conditions in the oral cavity, the number of teeth still present and some other factors.
The operation takes approximately just under one hour. The osteointegration period (the time required for the implants to bond with the bone) depends on bone density and ranges from three to six months. During this entire time you wear one form or another of temporary prosthetic replacement.

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It is very difficult to answer the question without a detailed examination. You must be aware that you no longer have your own teeth and that you also need some time to get used to the denture. Adaptation can take several months. The anatomical conditions for good denture stability are usually not ideal. The denture rests on the remains of the bony ridge where the teeth once were. The ridge is usually highly resorbed, which means that its vertical component is greatly reduced. The denture therefore lacks an adequate foundation for normal function. To begin with, I recommend using denture adhesive gel. This will make the initial adaptation period easier. If the denture still does not function normally after the adaptation period, I recommend placement of at least two implants and fabrication of an implant-supported complete denture.

A denture with a cast metal base is much more rigid than an ordinary acrylic denture, which means that under load it does not yield to the forces acting on it. Specially shaped retention elements, namely clasps and rests, attach the denture to the abutment teeth in such a way that the latter are loaded along their vertical axis. The rigidity of the denture and the design of the retention elements ensure that loading during function does not cause mobility and loss of the patient's own teeth, which certainly cannot be said of an ordinary acrylic denture. Dental doctrine regards an acrylic denture only as a temporary removable prosthetic replacement. Because cast clasps have much better elastic properties than the spring wire used to form clasps on an acrylic denture, attachment of such a denture to the abutment teeth is much better. Because of the strong metal construction, the denture is resistant to fracture even with very small dimensions of its elements, so the final prosthesis can be much more delicate and bothers patients less during function. Since a larger proportion of the biting forces is transferred to the abutment teeth, the supporting mucosa and the underlying bone are loaded less, which means that the jawbone will resorb more slowly, provide a suitable anatomical foundation for the denture for a longer time and thus replace the patient's lost natural teeth more effectively.

The received doses in digital radiology are approximately ten times lower. The reason is the much greater sensitivity of the digital sensor to X-rays. Because of this higher sensitivity, the object being imaged (the tooth) can be exposed to a lower dose of radiation. The harmful effect on the irradiated organ is therefore considerably lower and the procedure less risky. Nevertheless, the rule should be followed that every X-ray must be professionally justified, because the doses received by patients and therapists during X-ray imaging accumulate throughout life.

The success of endodontic treatment depends on many factors. First and foremost, on the condition of the tooth or periodontal tissues at the time when therapy begins. In the case of treatment of inflammation of the dental pulp (i.e. a diagnosis of pulpitis), which the patient experiences as severe pain in a tooth that has appeared for the first time, the prognosis of treatment is fairly good. If the tooth was already affected some time ago and pain has reappeared, we assume that we are dealing with a tooth that has been non-vital for a longer period. In this case we treat what is known as gangrene of the dental pulp. Bacteria have already colonised the root canals and have probably also damaged the periodontal tissues in the area of the root apex. Treatment in this case is considerably more prolonged, and the prognosis substantially poorer.
As far as the quality of treatment by different dentists is concerned, I believe that everyone makes a great effort, while the treatment method is in any case determined by professional doctrine. Equipment for root canal treatment, however, differs considerably from one practice to another. Today we cannot imagine good root canal treatment without the ongoing use of an X-ray unit, an apex locator for determining root canal length, a rubber dam to protect the operative field and, finally, an operating microscope that enables us to locate microscopically small entrances to root canals. Using all of this requires a great deal of time. All of the above is of course associated with substantial costs, which in our experience the insurer will never cover.

Root canal treatment and gum bleeding on stimulation in the interdental space usually do not have a common cause. The gum bleeds because of constant irritation by bacterial plaque. The main question is why it bleeds more at this site than at other locations. Most often these are spaces that are more difficult to clean. The gum in the interdental spaces between premolars and molars usually bleeds more than between incisors, because cleaning at the front is easier and quicker. Given that the tooth has already undergone root canal treatment, there is probably some extensive restoration on the crown. The restoration may be damaged, deficient or porous. A small piece of hard dental tissue may have broken off. All these problems cause greater plaque accumulation in the interdental space and stronger irritation of the gum.
The affected interdental space needs to be cleaned more thoroughly and, if the bleeding does not stop despite this, the restoration on the existing dental crown should be replaced, repaired or modified.

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