A dental implant is a "root" device, usually made of titanium, used in dentistry to support restorations that resemble a tooth or group of teeth to replace missing teeth. Virtually all dental implants placed today are root-form endosseous implants, i.e., they appear similar to an actual tooth root (and thus possess a "root-form") and are placed within the bone (endo- being the Greek prefix for "in" and osseous referring to "bone"). The bone of the jaw accepts and osseointegrates with the titanium post. Osseointegration refers to the fusion of the implant surface with the surrounding bone. Dental implants will fuse with bone, however they lack the periodontal ligament, so they will feel slightly different than natural teeth during chewing. Prior to the advent of root-form endosseous implants, most implants were either blade endosseous implants, in that the shape of the metal piece placed within the bone resembled a flat blade, or subperiosteal implants, in which a framework was constructed to lie upon and was attached with screws to the exposed bone of the jaws. Dental implants can be used to support a number of dental prostheses, including crowns, implant-supported bridges or dentures. They can also be used as anchorage for orthodontic tooth movement. The use of dental implants permits undirectional tooth movement without reciprocal action. The Maya civilization has been shown to have used the earliest known examples of endosseous implants (implants embedded into bone), dating back over 1,350 years before Per-Ingvar Brånemark started working with titanium.
Osseointegration derives from the Greek osteon, bone, and the Latin integrare, to make whole. The term refers to the direct structural and functional connection between living bone and the surface of a load-bearing artificial implant. Osseointegration has enhanced the science of medical bone and joint replacement techniques. Osseointegration is also defined as : "the formation of a direct interface between an implant and bone, without intervening soft tissue". Osseointegrated implant is a type of implant defined as "an endosteal implant containing pores into which osteoblasts and supporting connective tissue can migrate". Applied to oral implantology, this thus refers to bone grown right up to the implant surface without interposed soft tissue layer. No scar tissue, cartilage or ligament fibers are present between the bone and implant surface. The direct contact of bone and implant surface can be verified microscopically. Osseointegration may also be defined as : Osseous integration, the apparent direct attachment or connection of osseous tissue to an inert alloplastic material without intervening connective tissue. The process and resultant apparent direct connection of the endogenous material surface and the host bone tissues without intervening connective tissue. The interface between alloplastic material and bone. In 1952, Per-Ingvar Brånemark of Sweden conducted an experiment where he utilized a titanium implant chamber to study blood flow in rabbit bone.
The technique for total rehabilitation of the edentulous, All-on-4 is a surgical and prosthetic medical procedure invented in the nineties by the Portuguese dentist Paulo Maló. It consists of the rehabilitation of the edentulous maxilla and mandible with fixed prosthesis by placing four implants in the anterior maxilla, where bone density is higher, allowing the highest success rate. The four implants support a fixed prosthesis with 12 to 14 teeth and it is placed immediately on the day of surgery. Often, tooth loss is accompanied by loss of the jaw bone which poses the problem of reconstruction of the jaw bone. For the implementation to be successful it is necessary to transplant bone from other parts of the body, for example, the iliac crest or the skull and apply it in the area where it is planned to deploy tooth or teeth. Transplantation of bone graft technique takes between three and six months so that the implants can be placed. After implant placement, it is necessary to wait two to three months, after which time it is possible the placement of the fixed prosthesis. The total rehabilitation time lasts about twelve months. Many patients can not do the transplant of bone for general health reasons (diabetes and others). The rehabilitation of the teeth in this way (the transplantation of bone) due to health problems is impossible in 20% of patients. The process All-on-4™, will address these drawbacks because it consists in establishing a fully customized denture (bridge) based only on four titanium implants.
Dental surgery is any of a number of medical procedures that involve artificially modifying dentition, in other words surgery of the teeth and jaw bones. Some of the more common are: Endodontic (surgery involving the pulp or root of the tooth) Pulpotomy The opening of the pulp chamber of the tooth to allow an infection to drain; Usually a precursor to a root canal Pulpectomy - The removal of the pulp from the pulp chamber to temporarily relieve pain; Usually a precursor to a root canal. Apicoectomy - A root-end resection. Occasionally a root canal alone will not be enough to relieve pain and the end of the tooth, called the apex, will be removed by entering through the gingiva and surgically extracting the diseased material. Prosthodontics (dental prosthetics) Crowns (caps) — artificial coverings of the tooth made from a variety of biocompatible materials, including CMC/PMC (ceramic/porcelain metal composite), gold or a tin/aluminum mixture. The underlying tooth must be reshaped to accommodate these fixed restorations Veneers — artificial coverings similar to above, except that they only cover the forward (labial or buccal) surface of the tooth. Usually for aesthetic purposes only. Bridges — a fixed prothesis in which two or more crowns are connected together, which replace a missing tooth or teeth through a bridge. Typically used after an extraction.
Dr. Ken Hebel (B.Sc., D.D.S., M.Sc.) is a prosthetic dentist practicing in London, Ontario. He is most recognized within the dental community as the owner of the Hands On Training Institute, an educational program that trains dentists in implant dentistry through a mixture of theoretical work and practical experience. Dr. Ken Hebel received his dental degree in 1979 from the University of Western Ontario, specialized at the Eastman Dental Clinic and then proceeded to earn a Master of Science degree in Anatomy at the University of Rochester. He was one of the first dentists to embrace implant dentistry and has since become a leader in the field, well renowned for his work and his clinical advances in the field. He has received acknowledgement from dentists around the world for the training program and his experience in implant dentistry. He has been published in many dental journals and lectures on an international level on the topic of implant dentistry. Having given hundreds of lectures, Dr. Hebel is an authority in the industry and has partnered with companies such as Nobel Biocare in order to further educate dentists in the field. Dr. Hebel is the co-founder of both the Hands On Training Institute as well as the patient education software My Dental Hub. He also currently runs a private prosthodontics practice out of London, Ontario.
Primary implant stability refers to the stability of a dental implant immediately after implantation. Its value is derived from a mechanical engraving of the titanium screw implant in the patient's bone tissue. High initial stabilization may be an indication for immediate loading with prosthetic reconstruction. The value of primary implant stabilization decreases gradually with reconstruction of bone tissue around the implant in the first weeks after surgery, ceding to secondary stability. Its character is quite different from the initial stabilization, because it results from the ongoing process of osseointegration. When the healing process is complete, the initial mechanical stability is fully replaced by biological stability. The most dangerous moment for implantation success is the moment of the lowest initial stabilization, pending sufficient bone reconstruction supporting long-term maintenance of the implant. Usually this occurs during the 3–4 weeks after implantation. If primary stability was not high enough following implantation, the implant's mobility is high and can cause failure.
Bone grafting is a surgical procedure that replaces missing bone in order to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly. Bone generally has the ability to regenerate completely but requires a very small fracture space or some sort of scaffold to do so. Bone grafts may be autologous (bone harvested from the patient’s own body, often from the iliac crest), allograft (cadaveric bone usually obtained from a bone bank), or synthetic (often made of hydroxyapatite or other naturally occurring and biocompatible substances) with similar mechanical properties to bone. Most bone grafts are expected to be reabsorbed and replaced as the natural bone heals over a few months’ time. The principles involved in successful bone grafts include osteoconduction (guiding the reparative growth of the natural bone), osteoinduction (encouraging undifferentiated cells to become active osteoblasts), and osteogenesis (living bone cells in the graft material contribute to bone remodeling). Osteogenesis only occurs with autografts. Bone grafting is possible because bone tissue, unlike most other tissues, has the ability to regenerate completely if provided the space into which to grow. As native bone grows, it will generally replace the graft material completely, resulting in a fully integrated region of new bone. The biologic mechanisms that provide a rationale for bone grafting are osteoconduction, osteoinduction and osteogenesis.
A dental technologist is a member of the dental team who, upon prescription from a dental clinician, constructs custom made restorative and dental appliances. There are four major disciplines within dental technology. These are fixed prosthesis including crowns, bridges and implants; removable prosthesis, including dentures and removable partial dentures; maxillofacial prosthesis, including ocular prosthesis and craniofacial prosthesis; and orthodontics and auxiliaries, including orthodontic appliances and mouthguards. The dentist communicates with the dental technologist with prescriptions, drawings and measurements taken from the patient. The most important aspect of this is a dental impression in to which the technologist flows a gypsum dental stone to create a replica of the patients anatomy known as a dental model. A technologist can then use this model for the construction of custom appliances. A fixed dental restoration is an appliance designed to replace a tooth or teeth that may have been lost or damaged by injury, caries or other oral diseases. These restorations are distinguished from other restorations by the fact that once they have been placed by a dentist the patient can not remove them. Such Restorations include; crowns, bridges, veneers, fixed implant restorations, inlays and onlays. Removable restorations are dental appliances to replace one or more teeth that have been completely lost. These restorations ideally remain stable in normal function but can be removed by the patient for cleaning and at night.
WorkNC is a Computer aided manufacturing (CAM) software developed by Sescoi for 2, 2.5, 3, 3+2 and 5-axis machining. WorkNC is used by more than 25% of companies in countries such as Japan and is known for having always focused on automation and ease of use since its first release in 1988. WorkNC-CAD was introduced in 2002, making WorkNC a complete CAD/CAM product, one of the leaders in its field. The typical users of WorkNC belong to the following industries: automotive, aerospace and defense, engineering, medical & dental, tooling, mold and die manufacturing. WorkNC is supported from Sescoi offices in the USA, UK, France, Germany, Spain, Japan, India, China and Korea, and more than 50 distributors around the world. The first version of WorkNC CAM software was released by Sescoi in 1988. The driving forces behind the product were Bruno Marko, president of Sescoi, and Gerard Billard, R&D Innovation Manager. In the late eighties, CNC programming of complex components was a difficult and lengthy process. This was when Sescoi identified the need for 3-axis CAM software and pioneered the development of WorkNC, a new, reliable and automatic 3-axis CAM system. Over the years, Sescoi has stuck to the original philosophy behind WorkNC : to speed up toolpath calculations, ensure optimum reliability to facilitate machining directly into hard materials, and maximize automation and ease of use so that programming can be carried out on the shop floor. Automation is a theme which runs throughout the development history of the software.
The General Dental Council (GDC) is a United Kingdom organisation which regulates all dental professionals in the country. Established in 1956 by an amendment to the Dentists Act 1948, now updated in the Dentists Act 1984, it keeps an up-to-date register of all qualified dentists and other dental care professionals such as: dental hygienists, dental therapists, dental nurses, dental technicians and clinical dental technicians. It aims to protect the general public from unqualified dental professionals. Its headquarters are in the City of Westminster, London. The General Dental Council’s mission statement is: To protect patients To promote confidence in dental professionals To be at the forefront of health care regulation The GDC is tasked with ensuring that all dental professionals maintain up to date knowledge, controlling the quality of dental education in the country, ensuring a proper quality of care is given to the patients, and helping any patient who has questions or complaints. It is meant to act as a bridge of communication between the government, public and the dental professionals. The Council was originally set up in 1956 with 50 members but is now a smaller, restructured Council. On 1 October 2009, following a recruitment process managed by the Appointments Commission, the new Council took office. The Council has 24 members and a balance of 12 lay and 12 professional Qualified dentist Kevin O’Brien was elected Chair of the GDC on 21 September 2011.
In the United States, Canada, and Australia, there are nine recognized dental specialties in which some dentists choose to train and practice, in addition to or instead of general dentistry. To become a specialist requires training in a residency or advanced graduate training program. Once a residency is completed, the doctor is granted a certificate of specialty training. Many specialty programs have optional or required advanced degrees such as a master's degree, such as the Master of Science (MS or MSc), Master of Dental Surgery/Science (MDS/MDSc), Master of Dentistry (MDent), Master of Clinical Dentistry (MClinDent), Master of Philosophy (MPhil), Master of Medical Science (MMS or (MMSc); doctorate such as Doctor of Clinical Dentistry (DClinDent), Doctor of Medical Science/Sciences (DMSc), or PhD;or medical degree: Doctor of Medicine/Bachelor of Medicine, Bachelor of Surgery (MD/MBBS) specific to maxillofacial surgery and sometimes oral medicine). Dental public health - The study of dental epidemiology and social health policies. Endodontics - Root canal therapy and study of diseases of the dental pulp. Oral and maxillofacial pathology - The study, diagnosis, and sometimes the treatment of oral and maxillofacial related diseases. Oral and maxillofacial radiology - The study and radiologic interpretation of oral and maxillofacial diseases. Oral and maxillofacial surgery - Extractions, implants, and facial surgery. Orthodontics and dentofacial orthopedics - The straightening of teeth and modification of midface and mandibular growth.