A Critical Differential Diagnosis for Dentists
Dental professionals often encounter patients with orofacial symptoms that extend beyond the oral cavity. One such presentation—difficulty swallowing (dysphagia) combined with swelling under the jaw—can signal a serious infection that demands prompt recognition and intervention. While dental caries or periodontal abscesses may initially come to...
Understanding the Discovery: A Cyst Near an Impacted Tooth
When radiographic imaging reveals a cystic lesion adjacent to an impacted tooth—particularly in the mandibular third molar region—it prompts careful evaluation. Such findings are not uncommon in dental practice, offering an opportunity to diagnose and manage potential odontogenic cysts early. While the presence of a cyst may initial...
Understanding Post-Extraction Numbness: A Common but Manageable Concern
Numbness in the lower lip after a tooth extraction is a sensation many patients experience, though it’s often temporary. This discomfort can be unsettling, but understanding the underlying cause—specifically which nerve may be affected—can ease concerns and guide recovery. At Doctor+Dentist Dental , we prioritize pa...
Dental extractions are routine procedures, but occasional complications—such as persistent bleeding—can arise, even in skilled hands. While this may seem concerning, understanding the underlying factors can empower both clinicians and patients to manage outcomes effectively. At Doctor+Dentist Dental , we prioritize precision and patient-centered care, ensuring every extraction is followed by...
The Clinical Presentation of an Impacted Third Molar
When a patient arrives at Dental Implant & Doctor+Dentist Dental complaining of localized pain, swelling, and tenderness in the posterior mandible or maxilla—particularly near the third molar region—clinicians must consider pericoronitis as the most likely diagnosis. This condition arises when an impacted wisdom tooth (third molar) ...
Post-extraction swelling and trismus (limited mouth opening) are common, but they can sometimes signal underlying complications that require prompt attention. While these symptoms may resolve on their own, certain conditions—such as dry socket (alveolar osteitis), infection, or hematoma formation —can prolong discomfort and impact recovery. Understanding these possibilities allows patients t...
A Painful but Manageable Complication: Understanding Dry Socket After Extraction
Tooth extraction is a common dental procedure, but sometimes patients experience unexpected discomfort—even when the socket appears empty. While this can be alarming, it’s often a sign of dry socket (alveolar osteitis) , a well-documented post-extraction complication. The good news? With proper care and guida...
The Smoking-Periodontal Disease Connection
Smoking remains one of the most preventable yet devastating risk factors for periodontal disease, yet many smokers underestimate its impact on oral health. Advanced periodontal disease—characterized by gingival inflammation, bone loss, and tooth mobility—can progress rapidly in smokers, even in those who maintain rigorous oral hygiene. The relation...
What Does Furcation Involvement Indicate?
Furcation involvement refers to the progression of periodontal disease into the furcation area of multirooted teeth—most commonly molars. This region, where the roots diverge, is particularly vulnerable to bacterial invasion, bone loss, and structural compromise. While this diagnosis may initially raise concerns, modern periodontal therapy offers effe...
A Common yet Critical Sign: When Gingival Pus Signals Underlying Issues
Pus discharge from the gingiva is a clinical finding that demands immediate attention, as it often indicates an active inflammatory or infectious process. While it may seem alarming, this symptom is a positive sign —it means your body is actively fighting infection, and with the right intervention, your oral health can ...
A Common yet Critical Sign: When Gingival Pus Signals Underlying Issues
Pus discharge from the gingiva is a clinical finding that demands immediate attention, as it often indicates an active inflammatory or infectious process. While it may seem alarming, this symptom is a positive sign —it means your body is actively fighting infection, and with the right intervention, your oral health can ...
Recognizing the Signs: Mobility and Bone Loss in Periodontal Health
Periodontal disease is a progressive condition that affects the supporting structures of the teeth, including the gums, periodontal ligament, and alveolar bone. When a patient presents with mobility in several teeth alongside bone loss , it signals an advanced stage of periodontal breakdown. While this may initially seem co...
A Two-Way Street: Diabetes and Periodontal Health
Diabetes and periodontal disease share a complex, bidirectional relationship—one that can significantly impact a patient’s overall well-being. When diabetes remains uncontrolled, the elevated blood glucose levels create an ideal environment for bacterial proliferation in the oral cavity, accelerating the progression of periodontitis. Convers...
Gingival recession is a common yet concerning dental condition where the gum tissue pulls away from the tooth, exposing the root surface. While this may initially seem alarming, early detection and intervention at clinics like Doctor+Dentist Dental or Doctor+Dentist Dental can transform it into an opportunity for improved oral health and aesthetic enhancement. Let’s explore the potential cau...
A Common yet Critical Presentation: Halitosis and Gum Inflammation
When a patient presents with persistent halitosis (bad breath) and gingival swelling, the clinical picture often points toward periodontal disease —a spectrum of conditions affecting the supporting structures of the teeth. While these symptoms may seem routine, they represent an opportunity to intervene early and prevent pro...
Understanding the Clinical Presentation
When a patient presents with deep periodontal pockets (typically ≥ 5 mm) and radiographic evidence of alveolar bone loss, the clinical picture strongly suggests chronic periodontitis —a progressive inflammatory condition affecting the supporting structures of the teeth. This diagnosis is not merely a cause for concern but an opportunity to intervene...
A Common but Treatable Sign: The Likely Culprit Behind Bleeding Gums
When a patient reports bleeding gums during brushing, the most probable diagnosis is gingivitis —the early, reversible stage of periodontal disease. This condition arises from plaque buildup, which triggers an inflammatory response in the gingival tissues. While it may seem alarming, gingivitis is highly responsive to prop...
Understanding Internal Resorption: A Diagnostic Challenge with a Positive Outlook
Internal resorption is a rare but clinically significant pathological condition where the dental pulp undergoes progressive destruction from within, leading to replacement by cellular or fibrous tissue. While its exact etiology remains multifactorial—often linked to trauma, pulpitis, or genetic predispositions...
Why Immediate Action Matters for Cracked Teeth with Pulp Exposure
A cracked tooth exposing the dental pulp is a clinical scenario that demands prompt and strategic intervention. While the prospect of pulp exposure may initially seem daunting, modern endodontics offers highly effective solutions that preserve natural dentition and restore function. The key lies in a structured diagnostic and tr...
A Rare but Manageable Challenge in Endodontics
Root canal treatment (RCT) is a highly successful and predictable procedure, with success rates exceeding 95% when performed by skilled endodontists at reputable clinics like Dental Implant & Root Canal Specialists . However, even in the most precise hands, complications can arise—one of the most concerning being instrument separation (file...
Early detection of caries through radiographs is a game-changer in preventive dentistry, allowing clinicians to intervene before irreversible damage occurs. When radiographs reveal caries extending into the dentin but not yet reaching the pulp, the treatment options are both effective and conservative—prioritizing tooth preservation while minimizing patient discomfort. This scenario presents an ...
Early detection of caries through radiographs is a game-changer in preventive dentistry, allowing clinicians to intervene before irreversible damage occurs. When radiographs reveal caries extending into the dentin but not yet reaching the pulp, the treatment options are both effective and conservative—prioritizing tooth preservation while minimizing patient discomfort. This scenario presents an ...
Early detection of caries through radiographs is a game-changer in preventive dentistry, allowing clinicians to intervene before irreversible damage occurs. When radiographs reveal caries extending into the dentin but not yet reaching the pulp, the treatment options are both effective and conservative—prioritizing tooth preservation while minimizing patient discomfort. This scenario presents an ...
Early detection of caries through radiographs is a game-changer in preventive dentistry, allowing clinicians to intervene before irreversible damage occurs. When radiographs reveal caries extending into the dentin but not yet reaching the pulp, the treatment options are both effective and conservative—prioritizing tooth preservation while minimizing patient discomfort. This scenario presents an ...
Early detection of caries through radiographs is a game-changer in preventive dentistry, allowing clinicians to intervene before irreversible damage occurs. When radiographs reveal caries extending into the dentin but not yet reaching the pulp, the treatment options are both effective and conservative—prioritizing tooth preservation while minimizing patient discomfort. This scenario presents an ...
Early detection of caries through radiographs is a game-changer in preventive dentistry, allowing clinicians to intervene before irreversible damage occurs. When radiographs reveal caries extending into the dentin but not yet reaching the pulp, the treatment options are both effective and conservative—prioritizing tooth preservation while minimizing patient discomfort. This scenario presents an ...
Early detection of caries through radiographs is a game-changer in preventive dentistry, allowing clinicians to intervene before irreversible damage occurs. When radiographs reveal caries extending into the dentin but not yet reaching the pulp, the treatment options are both effective and conservative—prioritizing tooth preservation while minimizing patient discomfort. This scenario presents an ...
Early detection of caries through radiographs is a game-changer in preventive dentistry, allowing clinicians to intervene before irreversible damage occurs. When radiographs reveal caries extending into the dentin but not yet reaching the pulp, the treatment options are both effective and conservative—prioritizing tooth preservation while minimizing patient discomfort. This scenario presents an ...
Early detection of caries through radiographs is a game-changer in preventive dentistry, allowing clinicians to intervene before irreversible damage occurs. When radiographs reveal caries extending into the dentin but not yet reaching the pulp, the treatment options are both effective and conservative—prioritizing tooth preservation while minimizing patient discomfort. This scenario presents an ...
Early detection of caries through radiographs is a game-changer in preventive dentistry, allowing clinicians to intervene before irreversible damage occurs. When radiographs reveal caries extending into the dentin but not yet reaching the pulp, the treatment options are both effective and conservative—prioritizing tooth preservation while minimizing patient discomfort. This scenario presents an ...
When Pain Worsens After Dark: A Common but Critical Signal
A patient presenting with severe toothache that intensifies at night is a classic red flag in dentistry—one that demands careful evaluation. While nighttime pain can stem from various dental conditions, its intensity and timing often point toward pulpitis, irreversible pulpitis, or an advanced periapical abscess . These conditions, ...
Understanding the Challenge: Why Proximity to the Pulp Matters
A deep cavity approaching the pulp chamber presents a critical juncture in endodontic decision-making. While this scenario may initially evoke concern, modern dentistry offers precise, minimally invasive solutions to preserve natural teeth and restore function. The pulp’s proximity doesn’t signal failure—it signals an opportun...
Early detection of dental issues is a game-changer in maintaining oral health, and your experience—sharp pain when consuming sweets without spontaneous discomfort—offers valuable clues. This symptom often points to a specific stage of caries progression, where decay is active but not yet severe. Let’s explore what this means and how proactive care can turn this into a positive step toward st...
Understanding Early Childhood Caries in Primary Teeth
When a child presents with multiple carious lesions in primary teeth, it often signals Early Childhood Caries (ECC) , a severe form of tooth decay that disproportionately affects young children. While this condition may initially seem concerning, early intervention at clinics like Dental Care Specialists or Doctor+Dentist Dental can tr...
A Common yet Critical Presentation: Food Impaction and Mild Discomfort
When a patient presents with food impaction between teeth and reports mild discomfort, it may seem like a routine issue—until radiographs reveal an interproximal radiolucency . This finding shifts the clinical focus from a simple mechanical obstruction to a potential early-stage periodontal or periapical pathology . Wh...
Understanding the Presentation: A Common yet Critical Sign
A 22-year-old patient presenting with localized cold sensitivity in a molar—paired with a small occlusal cavity—offers a classic yet nuanced diagnostic challenge. Cold sensitivity, or dentalgia evans (evoked pain), often signals underlying pathology that, if addressed early, can prevent progression to more complex conditions. This...
Public health dentistry is the backbone of oral health equity, ensuring that every individual—regardless of socioeconomic status—has access to preventive care, education, and early intervention. In an era where dental disparities persist, this specialized field bridges gaps by integrating clinical expertise with community-driven strategies. From reducing cavities in children to combating perio...
Modern dentistry has evolved beyond traditional approaches, prioritizing patient comfort, faster recovery, and long-term oral health. Minimally invasive dentistry (MID) represents this evolution—a philosophy that emphasizes preserving natural tooth structure while delivering effective treatments. Unlike conventional methods that may require extensive drilling or tissue removal, MID focuses on ...
Why Doctor+Dentist Dental Health Programs Matter
School dental health programs are a cornerstone of preventive dentistry, ensuring that children and adolescents develop lifelong habits for optimal oral hygiene. These initiatives, often integrated into school curricula, target early intervention—reducing the prevalence of dental caries, periodontal disease, and other oral health disparities be...
Dental caries, commonly known as tooth decay, remains one of the most prevalent oral health challenges worldwide. While it may seem like a minor issue, untreated caries can lead to pain, infection, and even tooth loss—affecting both oral and overall well-being. The good news? Understanding the risk factors empowers patients to take proactive steps toward prevention. At Doctor+Dentist Dental , ...
Oral health education is the foundation of preventive dentistry, equipping individuals with the knowledge and skills to maintain a healthy mouth throughout their lifetime. It goes beyond basic brushing—it’s about understanding the intricate relationship between oral health and systemic well-being, fostering lifelong habits that prevent cavities, gum disease, and even chronic conditions like di...
Understanding the DMFT Index: A Simple Yet Powerful Metric
The Decayed, Missing, and Filled Teeth (DMFT) index is a standardized clinical tool used globally to assess the burden of dental caries (tooth decay) in populations. Developed in the mid-20th century, this index remains one of the most reliable ways for dental professionals—including those at Doctor+Dentist Dental or Doctor+Denti...
Saliva is far more than just a clear fluid in your mouth—it’s a dynamic, multifunctional shield that plays a crucial role in maintaining oral health. While many patients focus on brushing, flossing, and fluoride treatments, the often-overlooked saliva’s protective functions can significantly reduce the risk of dental caries (tooth decay). At Dental Implant & Doctor+Dentist Dental , we em...
Dental sealants are a simple yet highly effective preventive treatment designed to shield teeth—particularly molars—from decay. Often recommended by dental professionals at clinics like Doctor+Dentist Dental or Doctor+Dentist Dental , sealants act as a protective barrier, reducing the risk of cavities by up to 80% in children and adolescents (American Dental Association, 2023). For adult...
Fluoride therapy is a well-researched dental treatment designed to enhance enamel strength, prevent cavities, and even reverse early signs of tooth decay. For patients seeking long-term oral health, this minimally invasive procedure offers a proactive solution—especially for those at higher risk of caries or living in low-fluoride water zones. Whether you’re a parent looking to protect your ch...
A Modern Leap: How Doctor+Dentist Dental Diagnostics
Digital radiography has become a cornerstone of modern dentistry, replacing traditional film-based X-rays with advanced imaging technology. This evolution offers unparalleled clarity, efficiency, and safety—key advantages for both dental professionals and patients. Unlike conventional radiography, which relied on chemical processing and phy...
Periapical lesions are common findings in dental radiography, offering critical insights into underlying periapical pathology. Recognizing their radiographic characteristics allows dental professionals—especially those at clinics like Doctor+Dentist Dental or Doctor+Dentist Dental Care —to deliver timely, evidence-based treatment plans. By mastering these features, you can enhance diagnost...
Early detection of dental caries is a cornerstone of preventive dentistry, allowing for timely intervention and preservation of tooth structure. Radiographic imaging remains one of the most reliable tools for identifying caries beneath enamel, especially in occlusal surfaces, proximal contacts, and root surfaces. At Dental Implant & Cosmetic Dentistry , we emphasize the importance of advanced di...
Why the ALARA Principle Matters in Dental Radiography
Radiographic imaging is an indispensable tool in modern dentistry, enabling precise diagnosis, treatment planning, and long-term monitoring of oral health. However, exposure to ionizing radiation—even in small doses—raises concerns about cumulative effects over time. This is where the ALARA principle (As Low As Reasonably Achievable) c...
Radiation plays a vital role in modern dentistry, particularly in diagnostics like cone-beam computed tomography (CBCT) and intraoral radiography . However, ensuring safety is paramount to minimize exposure while maximizing clinical benefits. At Dental Implant Centers and Doctor+Dentist Dental Clinics , adherence to radiation safety principles not only protects patients but also empowers d...
A Revolutionary Imaging Tool for Modern Dentistry
Cone Beam Computed Tomography (CBCT) has transformed dental diagnostics, offering unparalleled precision in treatment planning for implants, orthodontics, and complex restorations. Unlike traditional X-rays, CBCT provides 3D volumetric imaging with minimal radiation exposure, making it a cornerstone in contemporary dental practice. Clinics lik...
Why Panoramic Radiography is a Game-Changer in Dentistry
Panoramic radiography, often called an orthopantomogram (OPG) , is a specialized imaging technique that captures a complete view of the upper and lower jaws, teeth, temporomandibular joints (TMJ), and surrounding structures in a single image. Unlike traditional intraoral X-rays, which focus on individual teeth, panoramic radiographs pro...
A Vital Tool in Modern Dental Diagnostics
Periapical radiographs are an indispensable component of comprehensive dental care, offering precise insights into the health of teeth and surrounding structures. These specialized X-rays provide detailed images of the entire tooth—from the crown to the root tip—and the adjacent bone, enabling dentists to detect issues that might otherwise go unnoti...
Modern dentistry relies on advanced imaging to diagnose, plan treatments, and monitor oral health with precision. Dental radiographs—commonly known as X-rays—are indispensable tools that allow dental professionals to detect issues invisible to the naked eye. At Doctor+Dentist Dental , we emphasize the importance of these imaging techniques in providing personalized, high-quality care. Whethe...
Tooth extraction is a common dental procedure, often performed to address impacted teeth, severe decay, or periodontal disease. While most patients experience smooth recoveries, nerve-related complications—though rare—can occur. Understanding the signs of nerve injury after extraction empowers you to seek timely care and ensures a positive healing journey. At Dental Implant & Doctor+Dentist D...
Why Understanding the Inferior Alveolar Nerve Block Matters for Your Dental Health
The inferior alveolar nerve block (IANB) is one of the most reliable and widely used local anesthetic techniques in dentistry. Whether you're preparing for a root canal, wisdom teeth extraction, or dental implant placement at Doctor+Dentist Dental , this procedure ensures minimal discomfort while maximizing pre...
Surgical asepsis is the cornerstone of modern dental implantology, ensuring patient safety and procedural success. By adhering to strict sterile techniques, dental professionals at clinics like Doctor+Dentist Dental and Doctor+Dentist Dental can minimize infection risks while delivering exceptional care. This blog explores the key principles of surgical asepsis, emphasizing their critical role...
Surgical asepsis is the cornerstone of modern dental implantology, ensuring patient safety and procedural success. By adhering to strict sterile techniques, dental professionals at clinics like Doctor+Dentist Dental and Doctor+Dentist Dental can minimize infection risks while delivering exceptional care. This blog explores the key principles of surgical asepsis, emphasizing their critical role...
Understanding Alveoloplasty: A Precision Procedure for Optimal Dental Foundations
Alveoloplasty is a specialized surgical procedure designed to reshape and contour the alveolar ridge—the bony structure of the jaw that supports teeth. Often performed before dental implants, orthognathic surgery, or denture placement, this technique ensures a smooth, stable, and well-defined ridge, enhancing bo...
Third molars, commonly known as wisdom teeth, often emerge in late adolescence or early adulthood. However, their eruption can sometimes lead to impaction , a condition where the tooth fails to fully emerge due to lack of space, improper alignment, or obstruction. While impactions may raise concerns, advancements in dental care—particularly at clinics like Doctor+Dentist Dental —have made ...
Understanding Impacted Teeth: When Wisdom Teeth Stay Hidden
An impacted tooth is one that fails to fully erupt (emerge) through the gum line due to lack of space, improper alignment, or obstruction by adjacent teeth. While commonly associated with third molars (wisdom teeth) , any tooth—including canines, premolars, or even primary teeth—can become impacted. This condition is more than ju...
What Is Dry Socket?
Dry socket, medically known as alveolar osteitis , is a rare but uncomfortable complication that can occur after tooth extraction. It happens when the blood clot that normally forms in the socket fails to develop properly or dissolves prematurely, exposing the underlying bone and nerves. While it may sound alarming, modern dental care—especially at clinics like Doctor+D...
Tooth extraction is a common dental procedure that can restore oral health, alleviate pain, and even pave the way for transformative treatments like dental implants. While the thought of losing a tooth may seem daunting, modern dentistry ensures the process is safe, efficient, and often life-changing. At Doctor+Dentist Dental , we prioritize patient comfort and long-term oral wellness, which is ...
Early orthodontic intervention can transform smiles and set the stage for a lifetime of healthy, aligned teeth. One of the most effective approaches is interceptive orthodontics , a proactive strategy that addresses dental and skeletal issues before they become severe. Unlike traditional orthodontics, which focuses on correcting fully developed problems, interceptive orthodontics targets emergin...
What Is an Overbite?
An overbite, clinically known as Class II malocclusion , occurs when the upper front teeth protrude beyond the lower front teeth when the mouth is closed. While mild cases may be cosmetic, severe overbites can impact chewing efficiency, speech clarity, and long-term oral health. Fortunately, advancements in orthodontics—particularly at clinics like Dental Implant & Ort...
What Is an Overjet?
An overjet is a common dental condition where the upper front teeth protrude beyond the lower front teeth. While it may seem like a minor cosmetic concern, an overjet can impact oral function, speech, and long-term dental health. Fortunately, modern orthodontics—especially at clinics like Dental Implant & Orthodontics —offers precise solutions to correct this alignment...
Why Space Maintainers Are Essential for Growing Smiles
A space maintainer is a custom-fitted dental appliance designed to preserve the natural space in a child’s mouth after a primary (baby) tooth is lost prematurely. When a tooth is lost too early—due to decay, trauma, or congenital absence—the adjacent teeth may drift into the empty space, creating alignment issues that can affect both ...
Why Cephalometric Analysis Matters in Modern Dentistry
Cephalometric analysis is a cornerstone of orthodontic treatment planning and dental implantology, offering precise insights into craniofacial morphology. This radiographic technique allows clinicians to assess skeletal relationships, dental alignment, and growth patterns with unparalleled accuracy. For dental professionals at clinics like ...
Clear aligners have revolutionized orthodontics, offering a nearly invisible alternative to traditional braces for achieving a beautifully aligned smile. Unlike fixed appliances, these removable, custom-made trays provide both aesthetic appeal and functional benefits, making them a preferred choice for many patients at clinics like Doctor+Dentist Dental and BrightDoctor+Dentist Dental .
How ...
Crowded teeth are a common dental concern that affects people of all ages, from children to adults. While they may seem like a purely cosmetic issue, dental crowding can impact oral health, bite function, and even overall well-being. Fortunately, modern dentistry—especially at clinics like Doctor+Dentist Dental and Doctor+Dentist Dental Care —offers effective solutions to straighten teeth ...
The Foundational Work of Edward Angle: A Cornerstone of Orthodontics
Edward Angle, often regarded as the "father of modern orthodontics," revolutionized the field in the late 19th and early 20th centuries. His classification system for malocclusion remains one of the most influential frameworks in orthodontics today. Angle’s work provided a structured approach to diagnosing and treating denta...
What Is Malocclusion?
Malocclusion refers to misalignment of the teeth when the jaws close, creating irregularities in bite patterns. While many associate it with crooked teeth, malocclusion encompasses a broader range of dental discrepancies—from overbites and underbites to crossbites and open bites—that can impact both aesthetics and function. Fortunately, advancements in orthodontics, pa...
Why Complete Dentures Remain a Transformative Solution in Modern Dentistry
Complete dentures have evolved significantly over the decades, offering patients a reliable and aesthetically pleasing solution for edentulism. With advancements in materials and digital technology, modern dentures from clinics like Dental Implant & Prosthodontics Center or Doctor+Dentist Dental now provide superior ...
The Foundation of Modern Dental Implants
Osseointegration is the biological process that allows dental implants to fuse seamlessly with the surrounding bone, creating a stable and durable foundation for prosthetic teeth. Unlike traditional dentures, which rely on adhesives or natural tooth structure, implants achieve unmatched stability through direct bone integration. This revolutionary concep...
Dental implants have revolutionized restorative dentistry, offering patients a durable, natural-looking alternative to missing teeth. Unlike traditional bridges or dentures, implants provide a permanent foundation that integrates with your jawbone, restoring both function and aesthetics. If you’ve ever wondered how dental implants work or why they’re the gold standard in tooth replacement, thi...
Dental crowns are a transformative solution for restoring damaged or weakened teeth, offering both functionality and aesthetic appeal. Whether you’re recovering from trauma, addressing decay, or enhancing your smile, the right crown can provide long-lasting results. Modern dentistry offers a variety of crown materials, each with unique benefits tailored to your oral health needs. Let’s explore...
Understanding Occlusion: The Foundation of Prosthodontic Success
Occlusion—the precise relationship between the upper and lower teeth when the jaws are closed—plays a pivotal role in prosthodontics. It ensures not just proper chewing function but also long-term stability, comfort, and aesthetics for dental prostheses. Whether restoring missing teeth with crowns, bridges, or full dentures, c...
Removable partial dentures (RPDs) are a transformative solution for patients with missing teeth, offering both functionality and confidence. These custom-made appliances restore chewing efficiency, speech clarity, and aesthetics while preserving remaining natural teeth. Understanding their components helps patients appreciate their precision and the advanced dental engineering behind them.
The F...
A Modern Solution for Missing Teeth
Partial dentures are a time-tested, biocompatible and functional restorative option for patients with one or more missing teeth , offering both aesthetic enhancement and oral health preservation . Unlike full dentures, which replace an entire arch, partial dentures are designed to integrate seamlessly with existing natural teeth, providing stabili...
A dental bridge is a highly effective, custom-crafted solution designed to replace one or more missing teeth while preserving the integrity of your oral structure. Whether due to decay, trauma, or periodontal disease, tooth loss can impact both aesthetics and function—but modern dentistry offers durable alternatives like bridges to restore your smile with natural-looking results.
How a Dental ...
A dental crown is a custom-made cap designed to cover and protect a damaged or weakened tooth, restoring its function, strength, and natural appearance. Whether you’ve experienced decay, trauma, or cosmetic concerns, crowns offer a durable solution that blends seamlessly with your smile. At Dental Implant & Smile Center , we prioritize advanced restorative dentistry to ensure your crown not on...
Why Working Length Matters in Endodontic Success
Endodontics is a precision-driven specialty where every millimeter counts. One of the most critical steps in root canal therapy (RCT) is determining the working length —the exact depth to which the root canal should be cleaned, shaped, and filled. Achieving the correct working length ensures thorough disinfection, prevents procedural errors, ...
A Brief Introduction to Gutta-Percha
Gutta-percha is a natural thermoplastic polymer derived from the latex of Palaquium trees, primarily found in Southeast Asia. In dentistry, it has become a cornerstone material for root canal therapy (RCT), offering unparalleled sealing properties and biocompatibility. Unlike synthetic alternatives, gutta-percha remains a preferred choice due to its proven...
The Role of Intracanal Medicaments in Modern Endodontics
Intracanal medicaments play a pivotal role in endodontic treatment by enhancing disinfection, reducing microbial load, and preparing the root canal system for definitive obturation. These agents are strategically placed within the canal space to combat persistent infections, control inflammation, and promote healing—ultimately improving...
Root canal treatment (RCT) is a highly effective, minimally invasive procedure designed to preserve natural teeth while eliminating infection and restoring function. Often misunderstood as painful, modern RCT—when performed by skilled professionals like those at Doctor+Dentist Dental or Doctor+Dentist Dental —is actually a precise, comfortable experience that relieves suffering and saves s...
Root canal treatment (RCT) is a highly effective, minimally invasive procedure designed to preserve natural teeth while eliminating infection and restoring function. Often misunderstood as painful, modern RCT—when performed by skilled professionals like those at Doctor+Dentist Dental or Doctor+Dentist Dental —is actually a precise, comfortable experience that relieves suffering and saves s...
Root canal treatment (RCT) is a highly effective, minimally invasive procedure designed to preserve natural teeth while eliminating infection and restoring function. Often misunderstood as painful, modern RCT—when performed by skilled professionals like those at Doctor+Dentist Dental or Doctor+Dentist Dental —is actually a precise, comfortable experience that relieves suffering and saves s...
Root canal treatment (RCT) is a highly effective endodontic procedure designed to preserve natural teeth while relieving pain and preventing further dental complications. Often misunderstood as a painful experience, modern RCT—when performed by skilled professionals like those at Dental Implant & Cosmetic Dentistry —is actually a precise, minimally invasive solution that can restore both fun...
What Is Root Canal Therapy?
Root canal therapy is a highly effective dental procedure designed to save a severely infected or damaged tooth while preserving its natural structure. Often misunderstood as painful, modern techniques—combined with advanced anesthesia and gentle instrumentation—make the process far more comfortable than its reputation suggests. This life-saving treatment not onl...
A Revolutionary Approach to Preserve Your Natural Gums and Bone
Guided tissue regeneration (GTR) is a cutting-edge dental technique that helps restore lost gum and bone tissue around teeth, particularly in cases of periodontal disease or trauma. Unlike traditional treatments that focus solely on symptom relief, GTR actively promotes natural healing by creating an ideal environment for cells to ...
Understanding the Community Periodontal Index (CPI)
The Community Periodontal Index (CPI) is a standardized, simplified screening tool designed to assess periodontal health at the population level. Developed by the World Health Organization (WHO) , it serves as a practical method for dental professionals—particularly in public health settings—to evaluate gum disease severity efficiently...
What Is Furcation Involvement?
Furcation involvement refers to the progression of periodontal disease into the furcation area of multirooted teeth, particularly molars. This critical region—where the roots diverge—can become compromised when periodontal pockets deepen, leading to bone loss and potential tooth instability. While this condition may sound concerning, early detection and adva...
Gingival recession is a common yet often overlooked dental condition where the gum tissue surrounding the teeth pulls back, exposing more of the tooth’s root. While it may seem like a minor issue, untreated recession can lead to sensitivity, root decay, and even tooth loss—making early awareness and proactive care essential. Fortunately, modern dentistry offers effective solutions to protect a...
What Is Scaling and Root Planing?
Scaling and root planing (SRP) is a meticulously performed dental procedure designed to combat periodontal disease by removing bacterial plaque and calculus from both the visible tooth surfaces and the hidden root areas. Unlike routine cleanings, SRP targets subgingival (below-the-gum) deposits that conventional scaling cannot reach. This non-surgical therapy i...
Doctor+Dentist Dental Plaque Biofilm: More Than Just Sticky Bacteria
Dental plaque biofilm is a structured community of microorganisms that naturally colonizes tooth surfaces, gingival crevices, and even dental implants. Far from being a mere nuisance, this microbial ecosystem plays a critical role in oral health—though its balance can shift dramatically when disrupted. Composed primarily of ...
Periodontal disease, often called gum disease, is a progressive condition that affects the tissues supporting your teeth. While it may seem daunting, early detection and proactive care can prevent severe complications. At Dental Implant & Periodontics Center , we believe in empowering patients with knowledge so they can take control of their oral health. Let’s explore the stages of periodontal...
What Are Periodontal Pockets?
Periodontal pockets are small spaces that form between the gum tissue and the teeth when the gums pull away from the tooth surface. While this may sound concerning, they are a natural part of gum health—especially as we age. When these pockets remain shallow (typically 1–3 mm), they pose minimal risk and are easily managed with proper oral hygiene. However, whe...
What Is Periodontitis?
Periodontitis is a chronic inflammatory disease that affects the supporting structures of the teeth—primarily the gums, periodontal ligament, and alveolar bone. Unlike gingivitis (early-stage gum inflammation), periodontitis involves irreversible tissue destruction, leading to pocket formation, bone loss, and potential tooth loss if untreated. However, with early detect...
Early detection of oral squamous cell carcinoma (OSCC) is critical for improving patient outcomes, and recognizing its clinical features empowers dental professionals to provide proactive care. At Dental Excellence Clinic , we emphasize education and early intervention to ensure our patients receive the best possible treatment. Let’s explore the defining characteristics of OSCC and how advance...
Oral cancer remains a significant concern in dental health, but awareness and proactive measures can significantly reduce its impact. At Doctor+Dentist Dental , we believe in empowering patients with knowledge so they can take control of their oral well-being. While oral cancer can be challenging, early detection and lifestyle adjustments offer hope for a healthier future. Let’s explore the ke...
Understanding Odontomas: Doctor+Dentist Dental Tumor
An odontoma is a benign, slow-growing odontogenic tumor that arises from the dental papilla and enamel organ during tooth development. Unlike malignant growths, odontomas are harmless and do not spread to other parts of the body. They are classified as hamartomas —meaning they are composed of tissues normally found in the area but arrange...
A Rare but Critical Oral Condition
Erythroplakia is a distinctive, potentially precancerous lesion of the oral mucosa that demands attention from both patients and dental professionals. Unlike more common conditions like leukoplakia, erythroplakia presents as smooth, red, velvety patches that lack the typical keratinized surface. While its rarity—affecting approximately 0.5% to 1.5% of the g...
A Rare but Critical Oral Condition
Erythroplakia is a distinctive, potentially precancerous lesion of the oral mucosa that demands attention from both patients and dental professionals. Unlike more common conditions like leukoplakia, erythroplakia presents as smooth, red, velvety patches that lack the typical keratinized surface. While its rarity—affecting approximately 0.5% to 1.5% of the g...
What Is Leukoplakia?
Leukoplakia is a benign (non-cancerous) oral lesion characterized by thickened, white patches that develop on the mucous membranes of the mouth. These patches are typically painless but can raise concerns due to their potential to progress into oral squamous cell carcinoma (OSCC) in rare cases. While most cases remain stable, early detection and monitoring are crucial for m...
What Is a Periapical Abscess?
A periapical abscess is a localized, pus-filled infection that develops at the tip of a tooth’s root, near the periapical area (the surrounding alveolar bone). This condition arises when bacteria invade the pulp chamber , leading to inflammation and eventual necrosis of the dental pulp. While often associated with severe pain, modern dentistry—particularly ...
Dental caries, commonly known as tooth decay, is a progressive condition that begins subtly but can significantly impact oral health if left unchecked. However, with early detection and proactive care, it’s entirely preventable! At Doctor+Dentist Dental , we believe in empowering patients with knowledge so they can take control of their smiles. Let’s explore the stages of caries progression...
What Is Dental Caries?
Dental caries, commonly known as tooth decay or cavities, is a chronic oral disease characterized by the demineralization of tooth enamel due to acid-producing bacteria. While often perceived as a minor issue, untreated caries can progress into severe pain, infections, and even tooth loss—highlighting the importance of early intervention. Fortunately, modern dentistry, ...
Enamel hypoplasia is a fascinating yet complex dental condition where the enamel layer of teeth fails to develop fully, leading to structural defects. While it may sound concerning, advancements in dental science—especially at clinics like Dental Implant Center and Doctor+Dentist Dental —offer proactive ways to manage and even prevent its progression. Let’s explore the underlying causes,...
Enamel is the body’s hardest and most mineralized tissue, serving as the protective outer layer of teeth. Its unique composition not only shields against daily wear but also plays a crucial role in maintaining oral health. Understanding what makes enamel so resilient can empower patients to better care for their smiles—especially when considering long-term dental solutions like implants or res...
Why Cementum Matters in Modern Dentistry
Cementum, the mineralized tissue covering the root of a tooth, plays a critical role in periodontal health and implant stability. Its composition—whether acellular extrinsic or cellular intrinsic —directly influences treatment planning, especially in endodontics and implantology. While both types serve essential functions, their structural and re...
Understanding the Dental Papilla: A Crucial Component of Tooth Formation
The dental papilla is a specialized mesenchymal tissue that plays an indispensable role in tooth development, particularly in the formation of the dental pulp and root structure. Often overlooked in general discussions about dentistry, this tiny yet powerful structure is the foundation for healthy, functional teeth. Its pr...
The Foundation of Root Formation
Hertwig’s epithelial root sheath (HERS) is a dynamic structure critical to the development of dental roots during odontogenesis. This specialized epithelial extension plays a pivotal role in shaping the root’s morphology, guiding dentin formation, and ensuring proper attachment of periodontal tissues. Without HERS, root formation would be incomplete, leading...
Understanding the Enamel Organ: Nature’s Blueprint for Strong Teeth
The enamel organ is a transient structure in tooth development that plays a critical role in forming the hard, protective outer layer of our teeth—enamel. This specialized tissue, derived from the ectodermal layer of the dental lamina , orchestrates the intricate process of amelogenesis, ensuring teeth are resilient again...
The Role of Odontoblasts in Tooth Formation and Repair
Odontoblasts are specialized cells found in the dental pulp of teeth, playing a critical role in forming and maintaining tooth structure. These cells are responsible for producing dentin , the hard, calcified tissue that lies beneath the enamel and provides structural support. Without odontoblasts, teeth would lack the resilience needed t...
The Foundation of Your Smile: Understanding Ameloblasts
Your teeth are a marvel of nature—hard, durable, and designed to last a lifetime. But what gives them their incredible strength? The answer lies in ameloblasts , the specialized cells responsible for producing enamel , the hardest substance in the human body. These cells play a critical role in dental development, and their proper fu...
The dental lamina is a critical embryonic structure that plays a pivotal role in the development of your teeth. Often overlooked in general discussions, its proper formation ensures healthy tooth buds and, ultimately, a strong, functional dentition. Understanding its function can help dental professionals like those at Doctor+Dentist Dental or Doctor+Dentist Dental provide better preventive ca...
Tooth development is a fascinating biological process that begins before birth and continues into early adulthood. Each stage is meticulously orchestrated, ensuring the formation of strong, functional teeth that last a lifetime. For dental professionals at clinics like Dental Implant Center of California and Doctor+Dentist Dental Group , understanding these stages is crucial for early interven...
Why the Eruption Sequence Matters for Long-Term Oral Health
The eruption of permanent teeth is a natural and exciting milestone in a child’s development, marking the transition from primary (baby) dentition to adult dentition. This process ensures proper jaw alignment, speech development, and optimal chewing function—all critical for lifelong oral health. While some variations exist, unders...
Maintaining optimal oral health isn’t just about teeth—it’s about the entire periodontium , the supporting structure that keeps your smile strong and functional. Understanding its components allows you to appreciate how dental professionals at clinics like Dental Implant Center or Doctor+Dentist Dental work to preserve your gum health and overall oral well-being.
Why the Periodontium...
Understanding Sharpey’s Fibers in Dental Implants
Sharpey’s fibers are a fascinating yet often overlooked component of periodontal biology that play a crucial role in the long-term success of dental implants. These collagen fibers anchor soft tissues—such as the gingiva and periodontal ligament—to hard structures like bone and teeth. In dental implantology, their presence (or absence) c...
Cementum is a critical yet often overlooked component of your dental anatomy. This specialized tissue plays a pivotal role in tooth stability, periodontal health, and long-term oral function. For dental professionals at clinics like Dental Implant Center or Doctor+Dentist Dental , understanding cementum’s functions is essential for diagnosing, treating, and preventing periodontal diseases wh...
Understanding the Dental Pulp: The Core of Your Smile
The dental pulp is often overlooked, yet it is the lifeblood of your teeth, playing a crucial role in maintaining oral health and overall well-being. Located at the center of each tooth, this soft tissue contains nerves, blood vessels, and connective tissue that work together to nourish and protect your teeth. Without it, teeth would be life...
The Foundations of Your Smile: How Enamel and Dentin Work Together
Your teeth are marvels of biological engineering, composed of multiple layers that protect and support your oral function. Among these, enamel and dentin are the two most critical components, each playing a distinct yet complementary role in maintaining dental integrity. While enamel is the hard, protective outer layer, dent...
Enamel, the outermost layer of your teeth, is often called the body’s hardest substance—even stronger than bone. While many overlook its importance, this mineralized tissue plays a critical role in protecting your teeth from daily wear, decay, and structural damage. Understanding its function can empower you to maintain optimal oral health and preserve your smile for years to come.
Why Ename...
Your teeth are marvels of nature—engineered to last a lifetime with proper care. Beneath their polished surface lies a complex structure composed of multiple layers, each playing a vital role in protecting your oral health. At Doctor+Dentist Dental , we believe knowledge empowers better dental decisions. Let’s explore the intricate anatomy of a tooth, where science meets strength.
The Fund...
Why Knowing the Difference Matters for Long-Term Oral Health
Understanding the stages of dental development is essential for parents, caregivers, and dental professionals alike. The transition from primary (baby) teeth to permanent dentition is a critical phase that sets the foundation for lifelong oral health. At Dental Harmony , we emphasize early education to ensure children grow up with h...
Understanding the structure of your permanent dentition isn’t just about curiosity—it’s about empowering yourself to maintain a healthy, functional smile for life. Your teeth are meticulously designed for specific roles, each contributing to efficient chewing, clear speech, and overall well-being. At Doctor+Dentist Dental , we believe knowledge is the first step toward proactive dental car...
The field of dentistry is evolving at an unprecedented pace, driven by technological advancements, artificial intelligence (AI), and a growing emphasis on preventive and personalized care. From AI-powered diagnostics to 3D-printed dental restorations, the future of dentistry promises to revolutionize patient experiences, treatment accuracy, and overall oral health outcomes. Let’s explore how the...
Modern dentistry has revolutionized patient care by prioritizing preservation over extraction and comfort over invasiveness . Minimally invasive dental treatments (MIDT) represent a paradigm shift—offering effective solutions with reduced trauma, faster recovery, and long-term benefits for oral health. Whether you’re avoiding discomfort or seeking a less disruptive approach to dental conce...
Artificial intelligence (AI) is transforming healthcare across disciplines, and dentistry is no exception. From diagnostic precision to personalized treatment planning, AI-driven tools are enhancing efficiency, accuracy, and patient outcomes in dental clinics like Dental Implant Center and Doctor+Dentist Dental . By leveraging machine learning and predictive analytics, AI empowers dentists to ...
Dentistry has evolved dramatically over the past decade, blending artistry with precision science to deliver unparalleled patient care. From AI-driven diagnostics to minimally invasive procedures, modern dental innovations are not just enhancing treatments—they’re making them faster, more comfortable, and highly personalized. Whether you’re considering a routine checkup or a complex restorat...
Stress is an inevitable part of life, but did you know it can silently impact your oral health? While you may associate stress with anxiety or fatigue, its effects extend to your teeth, gums, and even your jaw. Understanding this connection empowers you to take proactive steps toward maintaining a healthy smile—especially if you’re considering dental implants or long-term oral care. Let’s ex...
Diabetes and oral health share a bidirectional relationship—poorly managed diabetes can compromise your smile, while gum disease may worsen blood sugar control. Understanding this link empowers you to take proactive steps toward both metabolic and dental wellness. At Doctor+Dentist Dental , we believe that a healthy mouth is a gateway to overall well-being, and managing diabetes effectively ca...
Proper hydration isn’t just essential for overall well-being—it plays a crucial role in maintaining optimal oral health. While many patients focus on brushing and flossing, the role of water in preventing dental issues like dry mouth, tooth decay, and even gum disease is often overlooked. At Dental Implant & Cosmetic Dentistry , we emphasize hydration as a simple yet powerful way to support ...
Mouthguards are more than just protective gear for athletes—they’re a critical preventive measure in dentistry to safeguard your teeth from trauma, wear, and long-term damage. Whether you’re an athlete, a nighttime grinder, or someone prone to bruxism, a well-fitted mouthguard can preserve your dental investment while improving oral health. Below, we explore how these devices work their ...
Dry mouth, or xerostomia, is a common yet often overlooked condition that can significantly impact oral comfort and long-term dental health. While it may feel like a minor inconvenience, untreated dry mouth can lead to increased risk of cavities, gum disease, and even oral infections. Fortunately, effective treatments exist—many of which can be seamlessly integrated into daily routines. Let’s ...
Dry mouth, or xerostomia , is a common yet often overlooked condition that can impact oral health and overall well-being. While it may seem like a minor inconvenience, persistent dryness can lead to complications like dental caries, periodontal disease, and even oral infections —but don’t worry, there are ways to manage and even prevent it! Understanding the root causes empowers you to tak...
What Is Dry Mouth (Xerostomia)?
Dry mouth, clinically known as xerostomia , occurs when the salivary glands—primarily the parotid, submandibular, and sublingual glands —produce insufficient saliva to maintain oral moisture. Saliva isn’t just water; it contains enzymes (amylase), antimicrobial peptides (histatins), and bicarbonate that neutralize acids, lubricate tissues, and protect...
Alcohol is a social staple, but its impact on oral health often goes unnoticed—until it doesn’t. While enjoying a glass of wine or a cocktail can be part of a relaxing evening, excessive alcohol consumption poses significant risks to your teeth, gums, and overall dental well-being. The good news? Understanding these effects empowers you to make informed choices that protect your smile. Let’s...
The Hidden Threats of Smoking to Your Oral Cavity
Smoking remains one of the most preventable yet devastating habits for oral health, yet many underestimate its impact beyond lung disease. While the risks to respiratory and cardiovascular systems are widely known, the effects on teeth, gums, and overall oral well-being are equally concerning. Fortunately, understanding these mechanisms empowers...
Dental care has evolved dramatically over the past decade, thanks to groundbreaking advancements in technology. Today, patients at clinics like Doctor+Dentist Dental or Doctor+Dentist Dental experience treatments that are not only more precise but also less invasive, faster, and more comfortable. From digital imaging to AI-assisted diagnostics, technology enhances every stage of dental treatme...
A New Era of Accessible Dental Care
Teledentistry is transforming how patients receive dental consultations, diagnoses, and even treatments—bridging gaps in access while maintaining high standards of care. By leveraging digital communication tools, teledentistry enables dentists to provide expert advice remotely, reducing barriers like travel time, appointment waitlists, and geographic limita...
A Revolution in Digital Dentistry: How Intraoral Scanning Transforms Patient Care
Intraoral scanning has become a cornerstone of contemporary dental practice, replacing traditional impression materials with a seamless, patient-friendly alternative. This technology enables precise digital recordings of oral structures, enhancing diagnostic accuracy, treatment planning, and restorative outcomes. ...
A Game-Changer in Dental Technology
3D printing, also known as additive manufacturing, has transformed dentistry by enabling the creation of highly accurate, patient-specific dental restorations with unprecedented efficiency. Unlike traditional methods that rely on molds, wax carvings, or subtractive techniques, 3D printing allows for rapid prototyping, customization, and cost-effective product...
A Modern Evolution in Dental Care
Laser dentistry represents one of the most transformative advancements in modern dentistry, offering patients a less invasive, more precise, and often pain-free alternative to traditional dental procedures. Unlike conventional tools that rely on drills or scalpels, dental lasers—such as diode, CO₂, or Er:YAG lasers—emit concentrated light energy to trea...
Modern dentistry continues to evolve with groundbreaking technologies that enhance patient care, improve outcomes, and streamline workflows. Among these innovations, Computer-Aided Design (CAD) and Computer-Aided Manufacturing (CAM) have become indispensable tools in restorative and implant dentistry. By integrating digital precision with advanced materials, CAD/CAM technology empowers dental pr...
A New Era in Dental Care: How Digital Dentistry Transforms Patient Experience
Digital dentistry represents a paradigm shift in oral healthcare, blending advanced technology with traditional dentistry to deliver precision, efficiency, and personalized treatment . Unlike conventional methods that rely on physical molds, X-rays, and manual measurements, digital dentistry leverages computer-aide...
Dental X-rays are a cornerstone of modern dentistry, offering invaluable insights that go far beyond what the naked eye can detect. At Dental Implant Center or Doctor+Dentist Dental , these diagnostic tools empower dentists to provide precise, proactive care—ensuring early detection of issues before they escalate. Whether you're considering dental implants or routine check-ups, understanding...
Dental X-rays are an essential tool in modern dentistry, enabling clinicians to detect issues that aren’t visible to the naked eye. Whether you're preparing for a dental implant procedure or a routine checkup, understanding how dental X-rays work can help you feel more confident about your oral health journey.
Doctor+Dentist Dental X-Rays Are a Game-Changer in Dentistry
Dental X-rays provide...
Modern dentistry relies on a sophisticated array of tools designed to enhance accuracy, comfort, and outcomes for patients. From advanced imaging to ergonomic instruments, these tools empower dentists to provide high-quality care while minimizing discomfort. Below, we explore the most commonly used tools in dental clinics, highlighting their clinical significance and how they contribute to optimal...
Why Early Oral Hygiene Habits Matter
Establishing good tooth-brushing habits in childhood sets the foundation for a lifetime of oral health. According to a 2023 study published in Journal of Dental Research , children who develop consistent brushing routines by age 6 demonstrate significantly lower rates of dental caries (tooth decay) and gingival inflammation by adolescence. Poor oral hygien...
Thumb sucking is a natural reflex for infants, offering comfort and security. While it’s common in early childhood, its long-term effects on dental alignment can raise concerns. Understanding the science behind thumb sucking—both its temporary benefits and potential impacts—helps parents make informed decisions. With the right guidance from Dental Implant & Cosmetic Dentistry or Doctor+De...
Doctor+Dentist Dental Habits Matter for a Lifetime of Healthy Smiles
A child’s primary teeth may seem temporary, but they play a crucial role in speech development, nutrition, and guiding permanent teeth into place. Poor oral habits during childhood can lead to cavities, enamel erosion, or even early tooth loss—all of which can impact long-term dental health. The good news? Many harmful hab...
Why Space Maintainers Are Essential for Growing Smiles
Early childhood dental development is a delicate balance—missing teeth, early loss, or improper spacing can disrupt the natural alignment of permanent teeth. This is where space maintainers come into play, acting as temporary yet transformative solutions to ensure your child’s smile stays on track. These orthodontic devices are design...
What Is Fluoride Varnish?
Fluoride varnish is a highly concentrated, fast-acting dental treatment designed to strengthen tooth enamel and prevent cavities. Unlike traditional fluoride gels or rinses, varnish is applied directly to the teeth in a thick, paint-like consistency, allowing for prolonged contact with the enamel. This innovative approach ensures maximum fluoride absorption while minim...
Protecting your child’s dental health starts early—before their first tooth even emerges! Cavities, or dental caries, remain one of the most common chronic diseases in children, but proactive measures can significantly reduce their risk. By fostering good oral hygiene habits and making informed dietary choices, parents can help their little ones develop lifelong oral health resilience.
The S...
Early childhood caries (ECC), often called baby bottle tooth decay or nursing caries, is a severe form of tooth decay that affects infants and young children. While it may seem daunting, understanding its causes empowers parents and caregivers to take proactive steps toward protecting tiny smiles. With the right knowledge and preventive care, we can ensure strong, healthy teeth for the little ones...
The Foundation of a Healthy Smile Starts Early
Baby teeth, also known as primary dentition, may seem temporary, but they play a vital role in a child’s overall oral and systemic health. Often underestimated, these 20 teeth—10 in the upper arch and 10 in the lower—serve as placeholders for permanent teeth while also contributing to speech development, nutrition, and facial structure. Negle...
Early dental care sets the foundation for a lifetime of healthy smiles. While some parents may delay their child’s first dental visit, research shows that proactive oral health habits can prevent future complications. The American Academy of Pediatric Dentistry (AAPD) recommends that children visit a dentist by their first birthday or within six months after the first tooth erupts—whichever co...
A crossbite is a dental alignment issue where some or all of your upper teeth bite inside the lower teeth when your jaw closes. While it may seem like a minor concern, untreated crossbites can lead to functional and aesthetic challenges—making early detection and treatment essential for long-term oral health.
Why Crossbite Matters: More Than Just Misalignment
A crossbite isn’t just about...
What Is an Underbite?
An underbite, clinically known as prognathism or mandibular prognathia , occurs when the lower jaw (mandible) extends beyond the upper jaw (maxilla), causing the lower teeth to protrude forward. This misalignment isn’t just a cosmetic concern—it can impact chewing efficiency, speech clarity, and long-term oral health. Fortunately, advancements in orthodontics and d...
What Is an Overbite?
An overbite, clinically known as Class II malocclusion , occurs when the upper front teeth protrude beyond the lower front teeth when the mouth is closed. While mild cases may be cosmetic, more severe overbites can impact chewing efficiency, speech clarity, and long-term oral health. Fortunately, advancements in orthodontics—especially at clinics like Dental Implant & ...
What Is Malocclusion?
Malocclusion refers to misalignment of the teeth and jaws, where the upper and lower dental arches fail to meet in a harmonious occlusion. This condition affects bite function, aesthetics, and long-term oral health. While many associate malocclusion with crooked teeth, it can also involve overbites, underbites, crossbites, or excessive spacing—all of which may require or...
Achieving a beautifully aligned smile is a rewarding journey, and understanding the timeline for orthodontic treatment can help you stay motivated and excited about the results. While the duration varies based on individual needs, modern advancements in orthodontics—such as precision brackets, accelerated techniques, and clear aligners—have made the process more efficient than ever. Whether yo...
The Evolution of Braces: From Traditional to Cutting-Edge Orthodontics
Orthodontic treatment has come a long way, offering patients more options than ever before to achieve a beautifully aligned smile. Gone are the days of bulky, uncomfortable metal brackets—today’s braces are sleek, efficient, and tailored to individual needs. Whether you're a teenager, an adult, or someone seeking subtle ...
The Evolution of Braces: From Traditional to Cutting-Edge Orthodontics
Orthodontic treatment has come a long way, offering patients more options than ever before to achieve a beautifully aligned smile. Gone are the days of bulky, uncomfortable metal brackets—today’s braces are sleek, efficient, and tailored to individual needs. Whether you're a teenager, an adult, or someone seeking subtle ...
Orthodontics is a specialized branch of dentistry focused on diagnosing, preventing, and correcting misaligned teeth and jaws. Beyond aesthetics, it plays a crucial role in improving oral health, function, and long-term dental stability. Whether you're considering braces for yourself or exploring options for a loved one, understanding orthodontics can empower you to make informed decisions for a h...
Dental veneers have revolutionized cosmetic dentistry, offering a minimally invasive yet highly effective solution for enhancing smiles. Whether you seek to correct discoloration, misalignment, or minor structural imperfections, veneers provide a durable, natural-looking alternative to more extensive treatments. Below, we explore their benefits, types, and why they remain a top choice for patients...
Understanding the Role of Tooth Extraction in Modern Dentistry
Tooth extraction is a common dental procedure that, while often perceived as a last resort, can be a positive step toward long-term oral health . When a tooth is beyond saving due to severe decay, trauma, or overcrowding, extraction creates space for proper alignment or prevents systemic complications. Modern dentistry, particular...
Dental implants have revolutionized restorative dentistry, offering a permanent and natural-looking solution for missing teeth. Unlike traditional dentures or bridges, implants provide unmatched stability, functionality, and longevity—restoring not just your smile but your confidence. If you’ve ever wondered how this advanced dental treatment works, you’re in the right place. Let’s explore...
Dental implants have revolutionized restorative dentistry, offering a permanent and natural-looking solution for missing teeth. Unlike traditional dentures or bridges, implants provide unmatched stability, functionality, and longevity—restoring not just your smile but your confidence. If you’ve ever wondered how this advanced dental treatment works, you’re in the right place. Let’s explore...
A dental bridge is a highly effective, custom-crafted solution designed to replace one or more missing teeth while preserving the integrity of your oral structure. Whether due to decay, trauma, or periodontal disease, tooth loss can impact your ability to chew, speak clearly, and maintain facial aesthetics. Fortunately, modern dentistry offers the dental bridge—a time-tested restoration that bri...
A dental crown is a custom-made restoration designed to encase and protect a damaged or weakened tooth, restoring its strength, function, and natural appearance. Whether you’ve experienced decay, trauma, or cosmetic concerns, crowns offer a durable and aesthetically pleasing solution—helping you smile with renewed confidence.
Doctor+Dentist Dental Crowns Needed?
Dental crowns serve multipl...
Dental fillings are a cornerstone of restorative dentistry, offering a way to repair cavities, restore function, and preserve natural teeth. Over the years, advancements in dental materials have transformed fillings from basic silver amalgam to highly aesthetic, biocompatible composites. Today’s materials prioritize durability, minimal tooth reduction, and seamless integration with natural teeth...
Oral cancer remains a significant concern in dentistry, but knowledge is your strongest defense. By understanding the risk factors, you can take proactive steps to protect your oral health and maintain a confident, healthy smile. At Doctor+Dentist Dental , we believe in empowering patients with evidence-based insights to make informed decisions about their well-being.
Who Is at Risk? Key Facto...
Oral cancer remains a significant concern in dentistry, but knowledge is your strongest defense. By understanding the risk factors, you can take proactive steps to protect your oral health and maintain a confident, healthy smile. At Doctor+Dentist Dental , we believe in empowering patients with evidence-based insights to make informed decisions about their well-being.
Who Is at Risk? Key Facto...
Oral cancer remains a critical yet often overlooked health concern, affecting thousands annually. Yet, with early detection and proactive care, many cases can be managed successfully—especially when supported by advanced dental solutions like those offered at Doctor+Dentist Dental or Doctor+Dentist Dental . This condition, though serious, underscores the importance of regular dental checkups...
Oral ulcers, often called canker sores or aphthous ulcers, are small, painful sores that can appear inside the mouth. While they may seem like a minor inconvenience, they can significantly impact your comfort, eating habits, and overall oral health. At Dental Implant & Cosmetic Dentistry , we believe in empowering patients with knowledge so they can take proactive steps toward prevention and rel...
A Painful but Treatable Condition: What an Abscessed Tooth Really Means
An abscessed tooth is a localized, pus-filled infection that develops at the root of a tooth or in the surrounding gum tissue. While it may sound alarming, modern dentistry—especially at clinics like Doctor+Dentist Dental and Doctor+Dentist Dental —offers advanced treatments to resolve it effectively. This condition...
A radiant smile is often the first impression we leave on others, and healthy, white teeth play a crucial role in enhancing that appeal. However, tooth discoloration—whether intrinsic (from within the tooth) or extrinsic (on the surface)—can affect confidence and oral aesthetics. The good news? Understanding the underlying causes empowers us to take proactive steps toward maintaining a dazzlin...
Tooth sensitivity can be a nuisance, but with the right knowledge and care, you can restore comfort and confidence in your smile. Whether it’s a sharp twinge from cold coffee or a mild discomfort when brushing, understanding the underlying causes empowers you to take proactive steps toward relief. Modern dentistry, especially at clinics like Dental Implant & Cosmetic Dentistry , offers advance...
Halitosis, commonly known as bad breath, is a concern that affects many individuals, yet it’s often overlooked in dental discussions. While it may seem like a minor inconvenience, persistent halitosis can impact self-confidence and social interactions. Fortunately, understanding its root causes—many of which are linked to oral health—can empower patients to take proactive steps toward freshe...
What Is Periodontitis?
Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth—primarily the gums, periodontal ligament, and alveolar bone. Unlike gingivitis, which is reversible, periodontitis is an advanced stage where irreversible damage occurs if left untreated. It’s caused by harmful bacteria in dental plaque, which triggers an immune response t...
Gingivitis is the earliest stage of periodontal disease, affecting millions worldwide. While often overlooked, early detection and prevention can safeguard your oral health and overall well-being. At Dental Implant & Periodontal Center , we emphasize education as the first step toward healthier gums. Let’s explore what gingivitis is, its causes, and how proactive care can keep your smile vibra...
A radiant smile isn’t just about aesthetics—it’s a reflection of robust dental health. While brushing and flossing remain cornerstones of oral care, the foods we consume play a pivotal role in fortifying enamel, preventing cavities, and reducing the risk of periodontal disease. Research from Dental Associates of New York (2023) highlights that dietary choices can influence salivary pH, min...
Maintaining optimal oral health isn’t just about brushing and flossing—it’s also about what you eat. While a balanced diet fuels your body, certain foods can compromise your dental structure, accelerate decay, or even threaten long-term oral health. Understanding these dietary pitfalls allows you to make informed choices that preserve your smile while enjoying delicious meals. With the right...
Cavities remain one of the most common chronic diseases worldwide, affecting nearly 2.4 billion people annually (WHO, 2023). However, with the right preventive strategies, you can significantly reduce your risk—even reverse early decay with proper care. Below, we explore evidence-based methods to safeguard your enamel and maintain optimal oral health.
The Science Behind Cavity Formation
Ca...
Dental sealants are a simple yet highly effective preventive treatment designed to protect your teeth from decay, particularly in the deep grooves and pits of molars and premolars. Often recommended by pediatric and family dentists like Doctor+Dentist Dental , sealants act as a protective barrier, reducing the risk of cavities by up to 80% over three years (American Dental Association, 2023). ...
Fluoride is one of the most researched and proven dental health allies, yet many patients still wonder about its role in oral care. This naturally occurring mineral strengthens tooth enamel, reduces cavities, and supports long-term dental health—making it a cornerstone of preventive dentistry. Whether through toothpaste, mouthwash, or professional treatments at clinics like Doctor+Dentist Denta...
The Hidden Power of Flossing: More Than Just Clean Teeth
Flossing is often overlooked in daily oral hygiene routines, yet it remains one of the most effective tools for maintaining periodontal health and preventing systemic diseases. While brushing removes plaque from tooth surfaces, flossing reaches the interproximal spaces—areas where a toothbrush cannot effectively clean. Neglecting this s...
Proper brushing is the cornerstone of preventive dentistry, yet many patients underestimate its impact on long-term oral health. A consistent, technique-driven approach can significantly reduce plaque accumulation, minimize gingival inflammation, and lower the risk of periodontal disease—all while preserving the integrity of dental restorations like implants. Research confirms that effective bru...
Maintaining a consistent oral hygiene routine is one of the most impactful ways to preserve your smile and overall health. While brushing may seem like a simple habit, the frequency and technique can significantly influence dental health outcomes. Research from Dental Implant Centers of America (2023) highlights that proper brushing reduces plaque buildup by up to 40%, directly lowering the risk...
A Daily Ritual That Protects More Than Just Your Teeth
Brushing your teeth isn’t just about fresh breath—it’s a proactive investment in oral health that extends far beyond the mouth. Neglecting this simple habit can lead to plaque buildup, gingivitis, and even systemic conditions like cardiovascular disease. However, when done correctly, brushing becomes a powerful tool to prevent decay, ...
The Foundation of Your Oral Health: Understanding the Gingiva
The gingiva, commonly known as the gums, is the vibrant pink tissue that surrounds and supports your teeth, forming a protective barrier against bacteria and food debris. Often overlooked, this critical component of your oral cavity plays a pivotal role in maintaining overall dental health. Healthy gingiva not only enhances your smil...
The Foundation of Your Dental Structure
Your teeth may seem like standalone structures, but they rely on a complex network of tissues to stay firmly anchored in your jaw. Among these, the periodontal ligament (PDL) plays a critical role in maintaining stability, sensation, and overall oral health. Often overlooked in discussions about dental anatomy, the PDL is a delicate yet resilient connec...
Understanding Cementum: A Vital Component of Your Teeth
Cementum is a specialized calcified tissue that plays a crucial role in anchoring your teeth securely within the alveolar bone. Often overshadowed by enamel and dentin, cementum is essential for maintaining periodontal health and supporting dental implants. Unlike enamel, which is purely protective, cementum is dynamic—continuously formi...
The Vital Core of Your Teeth: What Is Dental Pulp?
Dental pulp is the innermost layer of a tooth, containing a network of nerves, blood vessels, and connective tissue. Often called the "heart" of the tooth, it plays a crucial role in tooth development, sensitivity, and overall oral health. While some may associate pulp with discomfort—such as during a root canal—modern dentistry has transfo...
The Role of Dentin in Your Oral Health
Dentin is the vital, resilient layer beneath your tooth enamel—a structural powerhouse that supports your smile’s strength and longevity. Often overshadowed by enamel, dentin plays a crucial role in protecting your pulp (the inner core containing nerves and blood vessels) while contributing to your teeth’s overall durability. Without it, your teeth w...
The Science Behind Enamel: Your Teeth’s Hardest Tissue
Enamel is the outermost layer of your teeth, a biomineralized tissue composed primarily of hydroxyapatite crystals embedded in an organic matrix. Unlike bone, which can regenerate, enamel is non-living and non-renewable —once damaged, it cannot repair itself. This makes its protection critical for maintaining oral health and preve...
The Essential Structure of a Healthy Smile
A tooth is a marvel of biological engineering, designed to last a lifetime with proper care. While many overlook its complexity, each tooth comprises distinct layers, each playing a critical role in function, protection, and overall dental health. Understanding these components—from the outermost enamel to the innermost pulp—empowers patients to ma...
The Primary Function of Molars: More Than Just Chewing
Molars are the unsung heroes of your mouth—large, multi-cusped teeth designed for grinding, crushing, and breaking down food into manageable, swallowable pieces. Unlike incisors or canines, which focus on cutting or tearing, molars (including premolars and third molars, or wisdom teeth) specialize in mechanical digestion , a critical fi...
Premolars—often overlooked in favor of their more flashy cousins, the incisors and canines—play a critical yet underappreciated role in maintaining optimal oral function and health. These transitional teeth between molars and canines are designed for efficient chewing, grinding, and breaking down food , ensuring your digestive system receives the proper preparation for nutrient absorption....
Why Canines Matter in Your Dental Anatomy
Canines are often overlooked in discussions about dental health, yet they play a critical structural and functional role in your oral anatomy. These sharp, conical teeth—located at the corners of your upper and lower dental arches—are not just aesthetic features; they are essential for biting, tearing, and maintaining proper jaw alignment . Thei...
Why Incisors Are More Than Just "Front Teeth"
Incisors—the eight sharp, chisel-shaped teeth at the front of your mouth—are often overlooked despite their critical functions. While they may seem like simple cutting tools, they play a pivotal role in mastication, speech articulation, and facial aesthetics . Their precise alignment and structural integrity directly influence your overall ora...
Your teeth are more than just tools for chewing—they’re essential for speech, aesthetics, and overall oral health. Each type of tooth has a unique structure and function, working together to ensure optimal dental function. At Dental Implant Center , we believe education empowers better oral care. Let’s explore the four primary types of teeth, their roles, and why maintaining them is a corn...
Understanding Primary Dentition: The Foundation of Oral Health
Children’s teeth, known as primary (deciduous) dentition , play a crucial role in speech development, chewing, and establishing proper alignment for permanent teeth. Unlike adults, who typically have 32 teeth , children begin life with a complete set of 20 primary teeth —10 in the upper arch and 10 in the lower. These teet...
The Short Answer: A Healthy Adult Smile Has 32 Teeth
Most adults have a full set of 32 permanent teeth , including four wisdom teeth (third molars). This complete dentition is the natural result of two distinct phases of dental development: the primary (baby) teeth and the permanent teeth that replace them. If wisdom teeth are removed, the count may drop to 28 , but this is still considered...
The Power of Nutrition in Maintaining a Radiant Smile
Your diet plays a far more significant role in oral health than many realize. While brushing and flossing remain essential, the foods you consume can either nourish your teeth and gums or contribute to decay and inflammation. Understanding this connection empowers you to make choices that support long-term dental wellness, especially if you...
The Power of Nutrition in Maintaining a Radiant Smile
Your diet plays a far more significant role in oral health than many realize. While brushing and flossing remain essential, the foods you consume can either nourish your teeth and gums or contribute to decay and inflammation. Understanding this connection empowers you to make choices that support long-term dental wellness, especially if you...
Dental plaque is a natural yet dynamic biofilm that forms on teeth, playing a crucial role in maintaining oral health when managed properly. Often misunderstood as merely a nuisance, plaque is actually a complex ecosystem of bacteria that can be harnessed for good—when paired with the right dental care. At Dental Implant Center , we believe in empowering patients with knowledge so they can tak...
Dental plaque is a natural yet dynamic biofilm that forms on teeth, playing a crucial role in maintaining oral health when managed properly. Often misunderstood as merely a nuisance, plaque is actually a complex ecosystem of bacteria that can be harnessed for good—when paired with the right dental care. At Dental Implant Center , we believe in empowering patients with knowledge so they can tak...
Tooth decay, or dental caries, is a common yet preventable condition that affects people of all ages. While it may seem like a minor issue, untreated decay can lead to pain, infections, and even tooth loss—affecting your confidence and overall oral health. The good news? With the right knowledge and proactive care, you can protect your smile for life. Let’s explore what causes tooth decay and ...
Maintaining a consistent dental care routine is one of the best ways to preserve your smile and overall well-being. While many people follow the traditional "twice a year" rule, modern dentistry—especially in advanced clinics like Dental Implant Center —recommends personalized schedules based on individual risk factors. Regular check-ups not only prevent cavities and gum disease but also hel...
A Gateway to Systemic Health: How Your Mouth Connects to Your Body
Your mouth isn’t just the entry point for food—it’s a critical gateway to your overall health. Poor oral hygiene isn’t just about bad breath or stained teeth; it can contribute to systemic conditions like cardiovascular disease, diabetes, and even respiratory infections. Research from Dental Implant Centers of America (...
Dentistry is a dynamic field dedicated to oral health, blending science, artistry, and patient care. From preventive checkups to advanced restorative treatments, dental professionals specialize in diverse areas to ensure every smile remains strong and radiant. Whether you’re curious about the latest advancements or considering a career in dentistry, understanding these branches can help you appr...
The Foundation of Dentistry: More Than Just Teeth
Dentistry is a specialized branch of medicine focused on diagnosing, preventing, and treating conditions affecting the oral and maxillofacial region. While many associate it with cavities and fillings, modern dentistry encompasses a broad spectrum of treatments—from cosmetic enhancements to advanced restorative procedures. At its core, dentist...
Dental health is a journey—one that requires informed decisions, personalized care, and a trusted partner in your oral wellness. Whether you’re exploring dental implants , managing periodontal concerns , or curious about the latest advancements in cosmetic dentistry , having the right information empowers you to make confident choices. But how do you know when to ask for more details? He...
Dental emergencies never wait for business hours, but knowing how to respond can turn a stressful situation into a manageable one—even when your local Dental Implant Clinic is closed. Whether it’s a sudden toothache, a broken crown, or trauma to your smile, staying calm and informed ensures you take the right steps until professional care is available. With advancements in emergency dentistr...
Dental pain can disrupt daily life, but nature offers several soothing remedies that complement professional care. While these solutions provide temporary relief, they should never replace regular visits to a trusted dental clinic like Dental Implant & Cosmetic Dentistry or Doctor+Dentist Dental . When used mindfully, these natural approaches can ease discomfort while supporting oral health.
...
Finding the right dentist who works with your insurance can feel overwhelming, but with the right approach, you’ll discover a provider who aligns with your oral health needs—without breaking the bank. Many patients overlook this step, only to face unexpected out-of-pocket costs later. However, proactive planning ensures you access high-quality care while maximizing your benefits. Below, we’l...
Transforming Confidence Through a Smile Makeover
A smile makeover is a comprehensive dental treatment plan designed to enhance the aesthetics, function, and overall health of a patient’s smile. Unlike isolated procedures, it combines multiple restorative and cosmetic techniques to achieve harmonious results. Whether addressing discoloration, misalignment, or structural deficiencies, a well-ex...
The Foundation of a Healthy Smile Starts with Nutrition
A child’s dental health is deeply influenced by their diet, shaping everything from enamel strength to the risk of cavities and gum disease. While sugar is often the primary concern, the broader nutritional landscape—including proteins, vitamins, and minerals—plays a crucial role in fostering strong, resilient teeth. By making inform...
Dental plaque is a natural, soft biofilm composed of bacteria, saliva, and food debris that constantly forms on teeth. While it’s an inevitable part of oral health, excessive plaque buildup can lead to gum inflammation, cavities, and even periodontal disease if left unchecked. The good news? With proper care and professional intervention, you can effectively manage and prevent plaque-related iss...
Getting a dental filling is a common and effective way to restore tooth structure and prevent further decay. With proper aftercare, your filling can last for years, preserving both function and aesthetics. Here’s how to ensure your filling remains strong and your smile stays healthy.
Understanding Your Filling: Why Aftercare Matters
A dental filling replaces decayed tooth material with bioco...
The Unsung Heroes of Oral Health: Why Dental Hygienists Matter
A dental hygienist is a licensed oral healthcare professional who plays a critical role in maintaining and improving patients’ oral health. While many associate dentistry with restorative treatments like fillings or implants, dental hygienists focus on preventive care—keeping smiles healthy, fresh, and free from disease. Their e...
Dental insurance is a game-changer for maintaining oral health without financial stress. Many people wonder whether routine checkups, fillings, or even advanced procedures like dental implants can be covered. The answer is yes—but it depends on your plan, provider, and treatment needs. Understanding how insurance works for dental care can help you make informed decisions while keeping your smile...
Regular dental cleanings are a cornerstone of preventive dentistry, helping maintain oral health and preventing long-term issues like periodontal disease and tooth decay. If you’re visiting a reputable clinic like Doctor+Dentist Dental or Doctor+Dentist Dental , you can expect a thorough yet comfortable experience designed to keep your smile bright and your gums healthy.
Why Professional C...
Your smile isn’t just about aesthetics—it’s a gateway to your overall well-being. While many associate dental health with cavities or gum disease, emerging research confirms a deeper connection between oral health and systemic conditions. Neglecting your teeth and gums may silently contribute to chronic illnesses, but proactive care can transform your health for the better. Let’s explore h...
Your first dental visit can feel like stepping into a new world—one where precision meets care, and every procedure is designed to keep your smile healthy and vibrant. Whether you’re visiting Doctor+Dentist Dental or Doctor+Dentist Dental , proper preparation ensures a smooth experience, allowing your dentist to assess your oral health with confidence. Research shows that patients who arri...
The Evolution of Orthodontics: Why Traditional Braces Aren’t the Only Option
For decades, traditional metal braces have been the gold standard for correcting misaligned teeth. However, advancements in dental technology have introduced discreet, faster, and more comfortable alternatives that cater to patients seeking efficiency without sacrificing effectiveness. While traditional braces rema...
Understanding Orthodontic Needs: When to Seek Professional Guidance
Orthodontic treatment, such as braces, is a transformative journey toward achieving optimal dental alignment and function. While many associate braces with cosmetic improvements, their benefits extend far beyond aesthetics—enhancing oral health, bite function, and long-term dental stability. Recognizing the early signs that y...
The Role of Wisdom Teeth in Dental Alignment
Wisdom teeth, or third molars, are the last set of molars to emerge—typically between ages 17 and 25. While they were once essential for grinding tough foods in early human diets, modern dentistry recognizes their potential to disrupt dental alignment. Unlike their ancestors, today’s wisdom teeth often lack sufficient space in the jaw, leading to...
Selecting the best toothpaste for children is a foundational step in establishing lifelong dental hygiene habits. With countless options available, parents must prioritize fluoride content, safety, and flavor preferences to ensure both effectiveness and compliance. The right choice not only prevents cavities but also sets the stage for strong, healthy teeth as they grow.
Key Considerations When ...
Understanding Bruxism: More Than Just a Habit
Bruxism—the involuntary grinding or clenching of teeth—affects millions globally, often occurring during sleep (sleep bruxism) or while awake (awake bruxism). While occasional grinding may seem harmless, chronic bruxism can lead to temporomandibular joint (TMJ) dysfunction , dental wear , fractured teeth , and even headaches or jaw pain ...
Why Prevention Is the Cornerstone of Dental Wellness
Regular oral check-ups are far more than routine visits—they are proactive investments in your overall health. While some may view dental appointments as merely addressing pain or visible issues, modern dentistry emphasizes early detection and prevention. A study published in The Journal of Periodontology (2023) found that patients who un...
Maintaining excellent dental health doesn’t require a fortune—it just needs the right knowledge and proactive habits. With rising costs of dental care, many people delay visits to Dental Implant Clinics or routine check-ups, but preventive care remains the most cost-effective approach. By adopting simple yet effective strategies, you can preserve your oral health without breaking the bank.
...
Understanding the Average Lifespan of Dental Fillings
Dental fillings are a cornerstone of restorative dentistry, providing durable solutions for cavities and tooth decay. While their longevity varies based on material, placement technique, and oral hygiene habits, modern dental fillings—especially those from reputable clinics like Doctor+Dentist Dental or Doctor+Dentist Dental —can las...
Modern dentistry has made procedures far more comfortable than ever before, thanks to advanced anesthesia techniques. Whether you're undergoing a routine filling or a complex dental implant placement, the right type of anesthesia ensures a pain-free experience while keeping you relaxed and at ease. At Dental Implant Center or Doctor+Dentist Dental , patients benefit from personalized anesthesi...
Modern dentistry has made procedures far more comfortable than ever before, thanks to advanced anesthesia techniques. Whether you're undergoing a routine filling or a complex dental implant placement, the right type of anesthesia ensures a pain-free experience while keeping you relaxed and at ease. At Dental Implant Center or Doctor+Dentist Dental , patients benefit from personalized anesthesi...
Dental health is a cornerstone of overall well-being, yet many myths persist that can lead to poor oral care habits. At Doctor+Dentist Dental , we believe in empowering patients with accurate, science-backed knowledge to achieve optimal oral health. Let’s explore some of the most widespread misconceptions—and the truth behind them—so you can make informed decisions for a healthier, happier...
Toothaches can disrupt daily life, but knowing how to manage them effectively can restore comfort and even prevent minor issues from escalating. Whether caused by dental caries, periodontal inflammation, or trauma, prompt relief allows you to focus on long-term oral health—especially if you’re considering restorative treatments like dental implants. Below, we explore evidence-based methods to ...
A dental abscess is a painful but treatable infection that forms at the root of a tooth or in the gums, often caused by untreated decay, gum disease, or trauma. While it may feel alarming, early intervention from a Dental clinic can resolve the issue effectively, restoring your oral health and comfort. With advancements in endodontics and modern dental care, abscesses are no longer a cause for l...
The Short Answer: 32 Teeth in Total
Most healthy adults have 32 permanent teeth , including four third molars (wisdom teeth). However, some individuals may have fewer due to congenital absence or extraction. This full set includes:
8 incisors (front teeth for cutting)
4 canines (for tearing)
8 premolars (for crushing)
12 molars (including wisdom teeth, for grinding)
This arra...
Dental technology continues to evolve at a rapid pace, transforming patient experiences and clinical outcomes. From AI-driven diagnostics to minimally invasive procedures, modern dentistry is more efficient, accurate, and patient-friendly than ever. These innovations not only enhance treatment precision but also reduce recovery times and improve long-term oral health. Whether you're a patient seek...
Selecting the right dentist is a crucial step toward maintaining optimal oral health, especially when considering advanced treatments like dental implants. A reputable dentist ensures not only high-quality care but also a comfortable, stress-free experience. With countless options available, how can you identify the best dental professional for your needs? Here’s a detailed guide to help you mak...
The Short Answer: Yes, But Strategically!
Eating before a dental appointment is generally safe—unless you’re undergoing sedation or a procedure requiring local anesthesia. For routine cleanings, fillings, or checkups, enjoying a light meal beforehand can actually help you feel more comfortable and energized. However, the timing, type of food, and your specific procedure matter. Let’s brea...
The Short Answer: Yes—But With a Twist!
While water flossers (also called oral irrigators) are highly effective at removing plaque and debris from hard-to-reach areas, they don’t replace traditional flossing entirely. Think of them as complementary tools in your oral hygiene routine rather than a standalone solution. The American Dental Association (ADA) and studies from the last five years...
The Short Answer: Yes—But With a Twist!
While water flossers (also called oral irrigators) are highly effective at removing plaque and debris from hard-to-reach areas, they don’t replace traditional flossing entirely. Think of them as complementary tools in your oral hygiene routine rather than a standalone solution. The American Dental Association (ADA) and studies from the last five years...
Diabetes is a chronic condition that affects blood sugar levels, but its influence extends far beyond metabolism—it significantly impacts oral health. Understanding this connection empowers patients to maintain a healthy smile while managing their diabetes effectively. At Dental Implant Center , we emphasize proactive care to mitigate risks and preserve oral well-being. With proper awareness a...
Tooth sensitivity can be a frustrating experience, but the good news is that many cases are reversible with the right approach. Whether caused by enamel erosion, gum recession, or dental procedures, understanding the underlying causes and treatment options can restore comfort and confidence in your smile.
Understanding Tooth Sensitivity: Causes and Clinical Insights
Tooth sensitivity occurs wh...
Gum recession is a common yet often overlooked dental concern that can compromise oral health and aesthetics. Fortunately, modern dentistry offers advanced solutions to halt progression and restore gum tissue. Whether through non-surgical therapies or regenerative procedures, Dental Implant Clinics and specialized practices like Doctor+Dentist Dental provide tailored treatments to reverse rece...
Gum recession is a common yet often overlooked dental concern that can compromise oral health and aesthetics. Fortunately, modern dentistry offers advanced solutions to halt progression and restore gum tissue. Whether through non-surgical therapies or regenerative procedures, Dental Implant Clinics and specialized practices like Doctor+Dentist Dental provide tailored treatments to reverse rece...
A Smarter Approach to Oral Health
Preventive dentistry isn’t just about avoiding cavities—it’s a proactive strategy that transforms dental care from reactive to transformative. By focusing on early intervention, education, and personalized risk assessment, preventive measures at clinics like Dental Implant & Cosmetic Dentistry or Doctor+Dentist Dental help patients maintain optimal or...
Dental insurance plays a crucial role in maintaining long-term oral health by making preventive and restorative care more accessible. With the right plan, you can afford essential treatments like dental implants , periodontal therapy , or orthodontic alignment without financial stress. However, not all dental insurance plans are created equal—each offers different levels of coverage, benef...
Doctor+Dentist Dental Visits Matter for Growing Smiles
Early dental care isn’t just about preventing cavities—it’s about building a foundation for lifelong oral health. The American Academy of Pediatric Dentistry (AAPD) emphasizes that children should see a dentist by their first birthday or within six months of their first tooth erupting. This proactive approach allows dental professiona...
Dental emergencies can strike unexpectedly, but knowing the right steps can turn a stressful situation into a manageable one—even before you reach a trusted dental clinic like Doctor+Dentist Dental or Doctor+Dentist Dental . Whether it’s a sudden toothache, a knocked-out tooth, or oral trauma, prompt action preserves your smile and oral health. Research from a 2023 study in Journal of End...
After dental procedures—whether it’s a filling, crown placement, or dental implant surgery—proper nutrition plays a crucial role in healing and minimizing discomfort. While dental work itself is a precise and minimally invasive process, the foods you consume can either accelerate recovery or introduce unnecessary complications. Understanding the right dietary approach ensures a smoother, mor...
Understanding Doctor+Dentist Dental Procedures
When facing dental concerns, two common treatments often come up: tooth extraction and root canal therapy . While both address severe dental issues, they serve distinct purposes and involve different approaches. At Dental Implant & Smile Center , we prioritize preserving natural teeth whenever possible—root canals are a prime example of thi...
Recognizing the Ideal Time for Orthodontic Intervention
Orthodontic treatment isn’t just for teenagers—it’s a lifelong investment in dental health, function, and confidence. Whether you’re an adult, a parent considering treatment for your child, or someone noticing subtle misalignments, understanding the right time for orthodontics can transform your smile and oral well-being. Modern or...
Dental health is a cornerstone of overall well-being, yet many patients hesitate to invest in necessary treatments due to financial concerns. The good news? Financing dental work is not only possible but increasingly accessible, thanks to flexible payment plans, insurance options, and specialized dental financing programs. Whether you’re considering a routine filling, cosmetic enhancement, or a ...
Dental health is a cornerstone of overall well-being, yet many patients hesitate to invest in necessary treatments due to financial concerns. The good news? Financing dental work is not only possible but increasingly accessible, thanks to flexible payment plans, insurance options, and specialized dental financing programs. Whether you’re considering a routine filling, cosmetic enhancement, or a ...
Dental procedures play a crucial role in maintaining oral health, restoring function, and enhancing aesthetics. While advancements in dentistry have made treatments safer than ever, it’s important to acknowledge that every medical intervention carries potential risks—even in the hands of skilled professionals like those at Doctor+Dentist Dental or Doctor+Dentist Dental . By understanding t...
Maintaining optimal oral health isn’t just about brushing and flossing—regular dental cleanings play a crucial role in preventing long-term dental issues. But how do you determine when it’s time for a professional cleaning? Recognizing the signs early can help you avoid discomfort, costly treatments, and even systemic health risks. Let’s explore the key indicators that suggest it’s time ...
Sensitive teeth can be a frustrating experience—whether it’s a sharp pain from hot coffee, cold air, or sweet treats. Many turn to toothpaste designed for sensitivity relief, but does it actually work? The answer is yes, but with the right approach. Modern desensitizing toothpastes, backed by clinical research, can effectively reduce dentin hypersensitivity over time. Let’s explore how these...
Dental crowns are a transformative solution for restoring damaged or weakened teeth, offering both functionality and aesthetics. But how long can you expect them to last? The answer depends on several factors—from material choice to oral hygiene habits. With proper care, crowns can last decades , providing long-term durability and confidence in your smile.
Factors That Influence Crown Longev...
Dental crowns are a transformative solution for restoring damaged or weakened teeth, offering both functionality and aesthetics. But how long can you expect them to last? The answer depends on several factors—from material choice to oral hygiene habits. With proper care, crowns can last decades , providing long-term durability and confidence in your smile.
Factors That Influence Crown Longev...
Dental implants have revolutionized restorative dentistry, offering a permanent solution for missing teeth with success rates exceeding 95% over 10 years, according to a 2023 study in The International Journal of Oral and Maxillofacial Implants . If you’ve recently undergone this transformative procedure at a reputable clinic like Dental Implants & Oral Surgery Center or Doctor+Dentist De...
Yes, with Careful Planning and Expert Guidance
Pregnancy brings joy and excitement, but it also introduces unique considerations for oral health. The good news is that dental treatments can be safely performed during pregnancy— when necessary and under the supervision of a qualified dentist . Modern dental practices prioritize maternal and fetal safety, ensuring that expectant mothers rec...
Maintaining optimal oral health goes beyond regular brushing and flossing—it also involves strategic dental imaging. Dental X-rays are a cornerstone of preventive dentistry, allowing dentists to detect early signs of decay, gum disease, and other hidden issues. But how often should you schedule them? The answer depends on your oral health status, risk factors, and the recommendations of your den...
Maintaining optimal oral health goes beyond regular brushing and flossing—it also involves strategic dental imaging. Dental X-rays are a cornerstone of preventive dentistry, allowing dentists to detect early signs of decay, gum disease, and other hidden issues. But how often should you schedule them? The answer depends on your oral health status, risk factors, and the recommendations of your den...
Doctor+Dentist Dental Sealants Are a Game-Changer for Kids’ Oral Health
Dental sealants have revolutionized pediatric dentistry by providing a simple yet highly effective preventive measure against tooth decay. These thin, protective coatings are applied to the chewing surfaces of molars—particularly the deep grooves and fissures where plaque and food particles easily accumulate. For childr...
The Great Debate: Electric vs. Manual Toothbrushes
The choice between electric and manual toothbrushes has long been a topic of discussion among dental professionals and patients alike. While manual toothbrushes have been a trusted staple for generations, electric toothbrushes have gained significant traction due to their advanced technology and proven efficacy. The key difference lies in their...
Ensuring your child’s dental health from an early age sets the foundation for strong, functional teeth and a confident smile. With proper care, you can prevent common issues like enamel erosion, cavities, and gum disease—while fostering lifelong oral hygiene habits. Research from Pediatric Dentistry (2023) highlights that early dental interventions reduce the risk of dental caries by up to 4...
What Is Periodontal Disease?
Periodontal disease—often called gum disease—is a chronic inflammatory condition affecting the tissues supporting your teeth. While it may sound intimidating, early detection and proactive care at clinics like Doctor+Dentist Dental or Doctor+Dentist Dental can prevent progression and preserve your oral health. This condition ranges from mild gingivitis (infl...
Maintaining a clean toothbrush is a cornerstone of effective oral care, yet many patients underestimate its impact on dental health. A worn-out or contaminated toothbrush can compromise plaque removal, increase the risk of gingival inflammation, and even introduce harmful bacteria into the oral cavity. Fortunately, following evidence-based guidelines ensures your toothbrush remains a powerful ally...
Early detection of oral cancer is a game-changer in dental health, offering better treatment outcomes and improved quality of life. At Dental Implant & Smile Center , we empower patients with knowledge so they can take proactive steps toward maintaining a healthy mouth. Oral cancer, though less discussed than other cancers, affects thousands annually—yet many cases are curable when identified ...
Selecting the right family dentist is a foundational step toward maintaining optimal oral health for every member of your household. A skilled dentist doesn’t just address immediate concerns—they foster preventive care, educate patients, and build trust for lifelong dental wellness. Whether you’re seeking routine cleanings, restorative treatments, or cosmetic enhancements, the right choice e...
Early dental care sets the foundation for a lifetime of healthy smiles. While some parents may wonder if their child is "too young" for a dental appointment, the American Academy of Pediatric Dentistry (AAPD) and the American Dental Association (ADA) strongly recommend that children visit a dentist by their first birthday or within six months after the first tooth erupts —which...
Maintaining fresh breath isn’t just about masking odors—it’s a cornerstone of overall oral health, particularly for patients with dental implants or those seeking to preserve natural dentition. Poor breath (halitosis) often stems from bacterial overgrowth, poor oral hygiene, or systemic factors like dry mouth (xerostomia). Fortunately, a strategic approach can transform your breath care into...
Dental fillings are a cornerstone of restorative dentistry, offering durable and aesthetically pleasing solutions to treat cavities and repair damaged teeth. Advances in dental materials have expanded the options available, allowing patients to choose treatments that align with their oral health needs and preferences. Whether you’re seeking a quick fix or a long-term solution, understanding the ...
Tooth pain can disrupt daily life, but with the right knowledge, you can find relief while waiting for professional dental care. Whether caused by sensitivity, infection, or trauma, managing discomfort at home—with guidance from trusted sources like Dental Implant Center —can make the process smoother. Below, we explore clinically supported strategies to ease discomfort while emphasizing the...
The Mechanics of Braces: A Precision Orthodontic Process
Braces are more than just metal wires—they’re a sophisticated orthodontic system designed to gradually shift teeth into their ideal positions. At the core of their function is orthodontic force application , which relies on the principle of bone remodeling . When gentle, controlled pressure is applied to teeth, the periodontal lig...
Dental implants have revolutionized restorative dentistry, offering a permanent solution for missing teeth that mimics natural dentition in both function and aesthetics. If you’ve ever wondered whether investing in dental implants is truly worth it, this guide will explore their benefits, long-term value, and why they stand out as one of the most advanced treatments available today.
The Short ...
Maintaining optimal oral hygiene isn’t just about fresh breath—it’s the foundation for long-term dental health, preventing periodontal disease, and even supporting systemic wellness. With advancements in dental science, we now understand how daily habits can significantly reduce risks like gingivitis and periodontitis , while preserving natural teeth and supporting restorative treatments...
Dental anxiety is a common yet manageable challenge that can prevent many from receiving essential oral care. The good news? With the right strategies, you can transform nervousness into confidence, ensuring your dental visits become a positive experience. Modern dentistry, especially at clinics like Dental Implant & Cosmetic Dentistry , prioritizes patient comfort, offering gentle techniques an...
Gum disease, clinically known as periodontitis , is a chronic inflammatory condition affecting the tissues supporting your teeth. While often overlooked, early intervention can prevent progression and preserve your oral and overall health. With proper care, you can maintain strong gums and a confident smile for life.
What Is Gum Disease?
Gum disease develops when harmful bacteria in plaque...
Smoking is a well-documented risk factor for systemic and oral health complications, yet many smokers remain unaware of its profound impact on dental well-being. While quitting smoking is the most effective way to reverse these effects, understanding the mechanisms behind them empowers patients to make informed decisions about their oral care. Below, we explore how smoking compromises dental healt...
What Are Wisdom Teeth?
Wisdom teeth, or third molars , are the last set of molars to emerge in the back of your mouth—typically between ages 17 and 25. These teeth are remnants of our ancestral diet, which required more chewing power. However, modern jaws have evolved to be smaller, often leaving little room for these late bloomers.
A 2023 study published in Journal of Oral and Maxillofac...
The Hidden Connection Between Nutrition and Oral Health
Your daily meals aren’t just fueling your body—they’re also shaping the health of your teeth and gums. While brushing and flossing remain essential, what you eat plays a crucial role in preventing cavities, gum disease, and even bone loss around dental implants. A well-balanced diet can strengthen enamel, reduce inflammation, and eve...
A Healthy Smile Starts with Prevention
Maintaining optimal oral health isn’t just about avoiding cavities—it’s about safeguarding your overall well-being. Regular dental cleanings at trusted clinics like Doctor+Dentist Dental or Doctor+Dentist Dental play a pivotal role in preventing periodontal disease, tooth decay, and even systemic health issues. According to a 2023 study published...
Stress is like an invisible guest that shows up unannounced—sometimes it’s a quick visit, other times it lingers for weeks. But did you know this uninvited guest might also be whispering to your teeth? While you might not immediately think of stress as a dental health villain, research from institutions like the American Dental Association (ADA) and studies from Harvard Medical School reve...
Stress isn’t just a mental burden—it can sneak into your oral health too! While you might not think of your teeth when you’re feeling overwhelmed, the connection between stress and dental well-being is real. The good news? Understanding this link can help you protect your smile—no matter how hectic life gets. From bustling cities like New York to serene retreats in Bali, everyone deserves ...
Short Answer
Ignoring a cavity can lead to severe pain, infections, tooth loss, and even systemic health issues. Early treatment by a dentist, like Dr. Andreas Tjandra at Doctor Dentist Clinic in West Jakarta, can prevent complications and save your smile.
Long Answer
A cavity is more than just a small hole in your tooth—it’s a warning sign of decay that, if left untreated, can spiral into ...
Short Answer
Ignoring a cavity can lead to severe dental problems, including tooth loss, infections, and even systemic health issues. Untreated cavities worsen over time, causing pain, sensitivity, and damage to surrounding teeth. Early treatment prevents complications and preserves oral health.
Long Answer
A cavity is a small hole in your tooth caused by decay, often due to poo...
Fluoride is a natural mineral that plays a crucial role in maintaining strong, cavity-free teeth. Whether you’re drinking fluoridated water or using fluoride toothpaste, this mineral helps protect your enamel and prevent tooth decay. But why is fluoride so important for dental health? Let’s break it down.
Short Answer
Fluoride strengthens tooth enamel, making it more resistant to acid attack...
Dental work like crowns and bridges can restore your smile and improve functionality, but they require proper care to last. Whether you’ve recently had a crown or bridge placed or want to maintain existing ones, knowing how to care for them is essential.
Short Answer
To care for dental crowns and bridges:
Brush and floss daily to prevent decay around the restoration.
Avoid hard or sticky f...
Gum disease, also known as periodontal disease, is a common but preventable condition that affects the tissues supporting your teeth. Left untreated, it can lead to tooth loss and other serious health issues. The good news is that with proper care, you can keep your gums healthy and prevent gum disease from developing.
Short Answer
To prevent gum disease, maintain good oral hygiene by brushing t...
Losing a tooth can affect your confidence, speech, and ability to chew properly. Fortunately, modern dentistry offers several effective solutions for replacing missing teeth. Whether you’ve lost a tooth due to decay, injury, or gum disease, understanding your options can help you make an informed decision.
Short Answer
The main options for replacing missing teeth include:- Dental implants (per...
If you're looking for a brighter smile, you're not alone. Teeth whitening is a popular cosmetic procedure, but it's essential to do it safely to avoid damaging your enamel or gums. The short answer is: use whitening toothpaste, baking soda, or professional treatments under dental supervision. For a deeper dive, let's explore safe and effective methods.
The long answer involves understanding the c...
Bad breath, or halitosis, can be embarrassing and frustrating. Whether it’s occasional or persistent, addressing the root cause is key to fresh breath. Here’s what you can do—quickly and in detail.
Short Answer
To combat bad breath, brush and floss daily, clean your tongue, stay hydrated, avoid strong-smelling foods, and visit your dentist regularly. If the issue persists, consult a doctor...
Short Answer:Yes, dental X-rays are generally safe when performed with modern equipment and proper precautions. The radiation exposure is minimal, and the benefits of early detection of dental issues far outweigh the risks.
Long Answer:Dental X-rays, also known as radiographs, are a crucial diagnostic tool in dentistry. They help dentists detect hidden dental problems like cavities, bone infectio...
Short Answer
During a dental check-up, you can expect a thorough examination of your teeth, gums, and mouth. The dentist will check for cavities, gum disease, and signs of oral cancer. They may also perform a professional cleaning, take X-rays if needed, and discuss oral hygiene tips. The visit typically lasts 30-60 minutes and is painless for most people.
Long Answer
A dental check-up is a rou...
Short Answer
A dentist focuses on general oral health, including cleanings, fillings, and tooth extractions, while an orthodontist specializes in correcting misaligned teeth and jaws using braces, aligners, and other treatments.
Long Answer
While both dentists and orthodontists are dental professionals, their roles and expertise differ significantly. Understanding these differences can help you...
Maintaining good oral hygiene is essential for a healthy smile and overall well-being. Proper brushing and flossing are the cornerstones of dental care, yet many people overlook the correct techniques. Whether you're a dental novice or a seasoned brusher, understanding the right methods can prevent cavities, gum disease, and bad breath.
Short Answer
The proper way to brush and floss teeth involv...
Short Answer
You should visit the dentist every 6 months for a routine check-up and cleaning. However, if you have specific dental concerns—such as gum disease, frequent cavities, or other oral health issues—your dentist may recommend more frequent visits.
Long Answer
Maintaining good oral hygiene goes beyond brushing and flossing daily. Regular dental visits are crucial for preventing prob...
Cavities, also known as dental caries, are one of the most common dental issues worldwide. They occur when bacteria in your mouth produce acids that erode tooth enamel, leading to decay. Recognizing the early signs of a cavity can help you seek timely treatment and prevent further damage. In this post, we willll explore the key indicators of a cavity, so you can take action before it worsens.
1. ...
Few treats are as universally loved as chocolate. Whether it is a creamy milk chocolate bar, a rich dark chocolate truffle, or a sweet white chocolate dessert, indulging in chocolate is a simple pleasure for many. But if you've ever wondered, "Is chocolate bad for my teeth?", you are not alone.
The answer isn't as straightforward as "yes" or "no." Chocolate can have both positive and negative eff...
A healthy mouth is more than just a bright smile—it’s a gateway to overall well-being. Poor oral hygiene can lead to gum disease, tooth decay, and even serious systemic health issues. On the other hand, maintaining good oral health boosts confidence, improves digestion, and reduces the risk of chronic diseases.
In this post, we’ll explore seven compelling reasons why keeping your mouth heal...
The All-on-4® implant technique is revolutionizing dental restoration, providing patients with a viable solution for full-arch tooth replacement. Ideal for those facing significant bone loss or decay, this innovative method utilizes just four strategically placed implants to support a complete set of teeth. In this blog post, we will explore the intricacies of All-on-4 implants, their benefits, t...
Abstract
Dental implants have revolutionized the field of prosthodontics, offering patients a more comfortable, functional, and durable alternative to traditional dentures and bridges. This paper examines the advantages of dental implants, including superior comfort, improved function, and biocompatibility, based on current research. We discuss how implants provide enhanced stability and confiden...
Abstract
Tooth loss represents a significant health concern that leads to profound functional and aesthetic challenges. One of the most critical consequences of tooth loss is the subsequent resorption of the underlying jawbone, a process accelerated by traditional dental solutions such as dentures and bridges. In contrast, dental implants have proven effective in preserving bone structure by stim...
Let's be real for a second—losing a tooth sucks. Whether you're dealing with it because you're getting older, you had an unfortunate accident, or your teeth just decided to betray you through disease, the impact goes way beyond just having a gap in your smile. It messes with your confidence, makes eating certain foods a nightmare, and honestly? It can make you feel like you've aged ten years ove...
Abstract
Osseointegration represents the biological cornerstone of contemporary dental implant therapy and is fundamental to achieving predictable long-term clinical success. First described by Brånemark, osseointegration is defined as a direct structural and functional connection between living bone and the surface of a load-bearing implant, without the interposition of fibrous tissue [1,2]. Th...
As we usher in the warmth and magic of Christmas and the excitement of the New Year, it's a time for reflection, celebration, and, of course, indulging in some of our favorite seasonal treats. While these festivities bring us joy and togetherness, they can also challenge our dental health. Between the candy canes, rich desserts, and festive meals, it’s easy for our teeth to take a backseat i...
As we usher in the warmth and magic of Christmas and the excitement of the New Year, it's a time for reflection, celebration, and, of course, indulging in some of our favorite seasonal treats. While these festivities bring us joy and togetherness, they can also challenge our dental health. Between the candy canes, rich desserts, and festive meals, it’s easy for our teeth to take a backseat i...
While the Bible does not mention "dentistry" as a modern profession, it contains several verses that describe teeth as symbols of beauty, health, and even spiritual discipline.
Here are the most relevant verses for dental professionals and patients:
1. Teeth as a Sign of Beauty and Health
In the Old Testament, having a full set of healthy, white teeth was a hallmark of physical perfection.
...
1. Overview of the Dental Implant Procedure
1.1. What Is a Dental Implant?
A dental implant is a modern solution for replacing missing or severely damaged teeth. It consists of a small titanium post, which serves as a replacement for the root of a missing tooth. This post is surgically placed into the jawbone, where it integrates over time through a process known as osseointegration. Once this p...
Abstract
Dental implants have become one of the most common and reliable solutions for replacing missing teeth. However, the success and longevity of dental implants are closely linked to the patient's commitment to maintaining optimal oral hygiene. Implants, unlike natural teeth, require specific care to avoid complications such as peri-implantitis and implant failure. This paper explores the cr...
Treatment arrangement and ground
The patient was first referred to the school of hygiene to treat the gum inflammation and improve his oral care. The treatment was planned in two main stages. In the first stage, the goal was to use growth to reduce the overjet, get the molars and canines into a normal Class I relationship, and create more room for the missing front tooth. This was done using a Tw...
Abstract
Children with an overjet of more than 6 mm have a threefold higher risk of upper incisor injuries than children with a typical overjet. This might be compounded by the avulsion of the permanent incisor and the loss of tooth space. Functional appliances are often utilized to address Class II skeletal patterns and increasing overjet in growing individuals. In the following example,...
After explaining the study's specifics, all patients provided written and informed consent. A medical questionnaire was used to collect a detailed history of the subjects, and a clinical oral examination was undertaken. Routine laboratory examinations were performed and documented for all individuals.
Maxillary and mandibular full dentures were made for all patients 6 to 8 weeks prior to implant ...
Introduction
Ineffective oral function, loss of structural balance, poor aesthetics, and psychological repercussions are all consequences of replacing lost teeth or teeth brought on by dental caries, chronic periodontitis, trauma, or anodontia. For these individuals to regain their natural shape, function, comfort, appearance, speech, and general health, restoration is necessary. For millennia, a...
Extensive research is necessary to determine the true reasons for extraction on nondental and nonmedical grounds in adults' permanent dentition (apart from third molars); this includes determining when such requests are fulfilled by extracting the tooth and the arguments for and against performing the extraction. Multiple well defined categories for non-dental and non-medical reaso...
The same is true of the few and poorly defined categories pertaining to the extraction indications in the included and examined research. For instance, there were either no descriptions of categories or a wide range of categories utilized in the three research that were analyzed. Two studies put impacted teeth, pericoronitis, and unidentified causes under the "other reasons" category, whereas one ...
Discussion
According to the review's findings, the primary reasons why oral (and maxillofacial) surgeons and dentists undertake dental extractions are periodontitis and cavities. Orthodontics, periapical illness, trauma, and other causes are also common indications. In general, this is consistent with earlier research, including that which did not fit the current review's inclusion requirements. ...
SBP (mmHg)
DBP (mmHg)
PR (bpm)
RPP (bpm × mmHg)
Normotensive patients (N = 410)
On arrival at the office
133.0 ± 18.4
76.4 ± 12.5
79.2 ± 13...
SBP (>160 mmHg)
RPP (>12,000 bpm × mmHg)
Normotensive group (N = 410)
On arrival at the office
41 (10.0%)
111 (27.1%)
Prior to sedation
...
Normotensive group
Hypertensive group
p
value
Number (male: female)
410 (127: 283)
106 (37: 69)
0.170
Age (year mean ± SD)
...
Kimura, M., Takasugi, Y., Hanano, S. et al. Efficacy of intravenous sedation and oral nifedipine in dental implant patients with preoperative hypertension - a retrospective study of 516 cases. Int J Implant Dent 1, 6 (2015). https://doi.org/10.1186/s40729-015-0004-4
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Received: 08 October 2014
Accepted: 14 January 2015
Published: 18 March 2015
DOI: https://doi.org/10.1186/s407...
Motoshi Kimura, Yoshihiro Takasugi, Shigeyoshi Hanano, Katsuyuki Terabe and Yuko Kimura declare that they have no competing interests.
YT and MK designed the study; MK, SH, and KT performed the surgeries; YT performed the intravenous sedation. YT, MK, and YK collected and analyzed the data; MK wrote the manuscript. YT revised the manuscript. All authors read and approved the final manuscript.
Hanano Dental Clinic, 4-2-3 Yamanoue, Hirakata, Osaka, 573-0047, Japan
Motoshi Kimura & Shigeyoshi Hanano
Department of Anesthesiology, Kinki University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
Yoshihiro Takasugi
Terabe Dental Clinic, 4-249 Sakae-cho, Tsu, Mie, 514-0004, Japan
Katsuyuki Terabe
First Department of Internal Medicine, Osaka Medical College...
Abraham-Inpijn L, Borgmeijer-Hoelen A, Gortzak RAT. Changes in blood pressure, heart rate, and electrocardiogram during dental treatment with use of local anesthesia. J Am Dent Assoc. 1988;116:531–6.
Brand HS, Gortzak RA, Palmer-Bouva CC, Abraham RE, Abraham-Inpijn L. Cardiovascular and neuroendocrine responses during acute stress induced by different types of dental treatment. Int Dent J. 1995...
Little JW. The impact on dentistry of recent advances in the management of hypertension. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:591–9.
Aubertin MA. The hypertensive patient in dental practice: updated recommendations for classification, prevention, monitoring, and dental management. Gen Dent. 2004;52:544–52.
Vaughan CJ, Delanty N. Hypertensive emergencies. Lancet. 2000;356...
Systolic blood pressure
Diastolic blood pressure
Pulse rate
Rate pressure product
Electrocardiogram
Percutaneous oxygen saturation
Analysis of variance
Immediate-release
In this study, we showed that the stable hemodynamic was obtained by performing intravenous sedation and oral administration of nifedipine for patients with hypertension. It is important not only to understand the systemic management of the patient but also to obtain stabled hemodynamic by performing intravenous sedation and oral administration of nifedipine for patients with hypertension in order...
Implant surgery is performed in patients with a wide age range, including elderly patients with hypertension. Dentists or oral surgeons often encounter hypertensive patients who are undiagnosed or noncompliant. Among Japanese over the age of 30, 60% of men and 44.6% of women suffer from high blood pressure, and 33.8% of men and 25.6% of women with a history of hypertension have not been managed me...
For patients with stage 2 hypertension before operation, it is difficult to maintain the recommended blood pressure during surgery using only intravenous sedation, and it is necessary to decrease blood pressure by antihypertensive drugs. In this study, the blood pressure of patients with sustained hypertension was reduced to stage I hypertension about 30 min after administration of oral nifedipin...
In 44 (8.5%) of the 516 implant surgery cases, oral nifedipine had to be administered, since preoperative SBP was higher than 160 mmHg in these patients. Within 30 min of administration of nifedipine, SBP of hypertensive patients decreased to a similar range as that of hypertensive patients who did not need administration of oral nifedipine. Intravenous sedation after nifedipine administration t...
In patients with oral nifedipine in the hypertensive group, the PR value slightly increased prior to initiation of intravenous sedation (p = 0.224) and then significantly decreased until completion of the operation (p 160 mmHg during and at completion of operation showed maximum SBP of 180 mmHg in the normotensive group, 190 mmHg on the hypertensive group without preoperative oral nifedip...
Patient demographics and clinical characteristics are summarized in Table 1. There were significant differences in age (p
This study protocol was approved by the ethics committee of Japanese Dental Society of Anesthesiology (No. 2015–4).
Following confirmation of a sufficient anesthetic effect, intravenous sedation with continuous infusion of propofol 1 to 2 mg/kg/h and midazolam 20 to 40 μg/kg bolus together with inhalation of oxygen 3 L/min via nasal cannula was initiated. After confirming Verrill sign, implant surgery was initiated. During operation, the propofol dose was adjusted to maintain the optimum conscious sedative ...
A retrospective review of the clinical records was conducted for 336 patients who received dental implant-related surgeries combined with intravenous sedation between January 2008 and February 2012 at our outpatient dental offices. Among the patients, 125 patients received multiple surgeries during the observation period: 4 patients underwent surgery five times, 7 patients four times, 29 patients ...
Osseointegrated dental implants were introduced in Japan in 1983, and the procedures are now performed very frequently. Dental implants are placed in a wide age range of patients, including elderly patients with hypertension. Patients with very high blood pressure are at great risk for acute medical problems when undergoing stressful dental procedures, such as oral surgery, periodontal surgery, an...
To examine the effects of intravenous sedation and oral nifedipine on blood pressure and pulse rate in patients with perioperative high blood pressure undergoing implant surgery, the clinical records of dental implant patients managed by intravenous sedation at our outpatient dental offices were retrospectively evaluated.
A total of 516 clinical charts were evaluated. The subjects were divided in...
Fig. 7. The epithesis allows both prompt inspection of the resection site and makes daily care easier
Fig. 7. The epithesis allows both prompt inspection of the resection site and makes daily care easier
Fig. 6. Frontal view of the patient after superior overdenture and nasal prosthesis delivery
Fig. 6. Frontal view of the patient after superior overdenture and nasal prosthesis delivery
Fig. 5. The intraoral bar crossing the palatal defect arising the nasal understructure
Fig. 5. The intraoral bar crossing the palatal defect arising the nasal understructure
Fig. 4. A front view of the bar with the intraoral portion and the metal extension for epithesis attachment
Fig. 4. A front view of the bar with the intraoral portion and the metal extension for epithesis attachment
Fig. 3. Postoperative panorex showing the symmetric distribution of the fixtures
Fig. 3. Postoperative panorex showing the symmetric distribution of the fixtures
Fig. 2. The healing abutments positioned onto fixtures and the oronasal communication
Fig. 2. The healing abutments positioned onto fixtures and the oronasal communication
Fig. 1. Intraoperative view of the zygoma implants placed in the residual maxilla
Fig. 1. Intraoperative view of the zygoma implants placed in the residual maxilla
Trevisiol, L., Procacci, P., D’Agostino, A. et al. Rehabilitation of a complex midfacial defect by means of a zygoma-implant-supported prosthesis and nasal epithesis: a novel technique.
Int J Implant Dent 2, 7 (2016). https://doi.org/10.1186/s40729-016-0043-5
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Received: 22 July 2015
Accepted: 23 March 2016
Published: 01 April 2016
DOI: https://doi.org/1...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Francesca Ferrari, Pasquale Procacci, Lorenzo Trevisiol, Pier Francesco Nocini, Daniele De Santis and Antonio D’Agostino declare that they have no competing interests.
FF was involved in revising the manuscript critically. PP was involved in drafting the manuscript. LT is another surgeon that belongs to surgery equipment. PFN, head professor and surgeon, operated the patient. DDeS was involved ...
Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134, Verona, Italy
Lorenzo Trevisiol, Pasquale Procacci, Antonio D’Agostino, Francesca Ferrari, Daniele De Santis & Pier Francesco Nocini
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Karakoca S, Aydin C, Handan Y, Bal BT. Retrospective study of treatment outcomes with implant- retained extraoral prostheses: survival rates and prosthetic complications. J Prosthet Dent. 2010;103:118–26.
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Parel SM, Branemark PI, Ohrnell LO, Svensson B. Remote implant anchorage for the rehabilitation of maxillary defects. J Prosthet Dent. 2001;86:377–81.
Bowden JR, Flood TR, Downie IP. Zygomaticus implants for retention of nasal prostheses after rhinectomy. Br J Oral Maxillofac Surg. 2006;44:54–6.
D’Agostino A, Procacci P, Ferrari F, Trevisiol L, Nocini PF. Zygoma implant-supported prostheti...
Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
Implant-supported prosthesis is a valid method to restore resected oral and head cancer patients and offers a good chance to social reintegration. The aesthetic result and facial camouflage are more achievable by means of dentures and epithesis than with several reconstructive interventions. Furthermore, due to the high risk of recurrences, it is sometime mandatory to keep the defect inspectionabl...
Rethinking globally of the possible indications to the adoption of this technique and its advantages compared to reconstructive microsurgery, the use of zygoma-implant-supported prosthesis may be suitable for patients whose systemic conditions are poor. The duration of surgery and of the postoperative recovery would be remarkably shortened avoiding the complications related to the harvesting of a ...
As far as prosthetic design is concerned, it is mandatory to avoid or, if not possible, limit as much as possible distal cantilever: given the absence of the premaxilla, an anterior cantilever is already present. Implant splintage is recommended [1, 8], and the bar design must respect technical data (implant-to-implant distance, cross-arch stabilization avoiding to cover oronasal communication and...
Patients with advanced orofacial cancer may require extensive surgical resection; the wider and more evident is the amputated region, the more this condition is generating inability for patients [6]. Visible head site mutilation and functional impairment in speech prevent social reintegration, and abnormal self-perception leads patients to depression [6].
Even if modern surgery offers many techni...
Cortical steroids were administered for the first two postoperative days. A postoperative 10-day cycle of antibiotic therapy (amoxicillin 1000 mg TID) was administered. Analgesics were administered as required. Sutures were removed 15 days after surgery. A soft diet was recommended for the first 2 weeks.
Three months afterwards, healing abutments were connected (Fig. 2) [4].
Approximately 4...
The patient, a male 46 years old at the time of our visit, underwent surgical resection of nasal pyramid and premaxilla including the whole upper jaw teeth sparing nasal bones. When the patient came to our clinic, apart from the defect resulting from the resection, he presented with a retraction scar crossing the upper lip from the floor of the nasal defect through the filtrum. The surgical resec...
The use of zygoma implants in the rehabilitation of patients who underwent surgical resection for oral cancer has been widely described [1–3]. There are several possibilities that can be considered when evaluating the possibility of surgical reconstruction after the first cancer resection, such as microvascular free flaps or rotation flaps, but it is sometimes necessary to monitor the healing pr...
Several authors have described zygoma implants as a reliable surgical option to rehabilitate severe maxillary defects in case of extreme atrophy or oncological resections. The aim of this study is to report a new technical approach to the rehabilitation of a complex oronasal defect by means of a zygoma-implant-supported full-arch dental prosthesis combined with a nasal epithesis.
The patient pres...
Fig. 5. Total score for physical and psychological disabilities before (gray) and after (hatched) sinus augmentation according to indications
Fig. 5. Total score for physical and psychological disabilities before (gray) and after (hatched) sinus augmentation according to indications
Fig. 4. Total score for functional limitations before (gray) and after (hatched) sinus augmentation according to indications
Fig. 4. Total score for functional limitations before (gray) and after (hatched) sinus augmentation according to indications
Fig. 3. Total score for complaints due to surgical procedure pre-operative, post-operative, and recently
Fig. 3. Total score for complaints due to surgical procedure pre-operative, post-operative, and recently
Fig. 2. Cumulative survival rate according to Kaplan–Meier and sinus augmentation procedure
Fig. 2. Cumulative survival rate according to Kaplan–Meier and sinus augmentation procedure
Fig. 1. Flow chart of patients included in the study
Fig. 1. Flow chart of patients included in the study
Item
Mean ± SD pre-operative
Mean ± SD post-operative
Mean ± SD in the last time
Have you felt pain in your mouth?
...
Item
Mean ± SD before sinus lift
Mean ± SD after sinus lift
p value
Have you felt tense because of problems with your teeth, mouth or dentures?
...
Item
Mean ± SD before sinus lift
Mean ± SD after sinus lift
p value
Have you had difficulty chewing any foods?
...
Schiegnitz, E., Kämmerer, P.W., Sagheb, K. et al. Impact of maxillary sinus augmentation on oral health-related quality of life. Int J Implant Dent 3, 10 (2017). https://doi.org/10.1186/s40729-017-0072-8
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Received: 20 November 2016
Accepted: 12 March 2017
Published: 28 March 2017
DOI: https://doi.org/10.1186/s40729-017-0072-8
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Augustusplatz 2, 55131, Mainz, Germany
E. Schiegnitz, K. Sagheb, A. Pabst, B. Al-Nawas & M. O. Klein
Department of Oral and Maxillofacial Surgery, Plastic Surgery, University of Rostock, Rostock, Germany
P. W. Kämmerer
Department of Prosthodontics, University of ...
Stellingsma K, Bouma J, Stegenga B, Meijer HJ, Raghoebar GM. Satisfaction and psychosocial aspects of patients with an extremely resorbed mandible treated with implant-retained overdentures. A prospective, comparative study. Clin Oral Implants Res. 2003;14(2):166–72.
Heydecke G, Locker D, Awad MA, Lund JP, Feine JS. Oral and general health-related quality of life with conventional and implant d...
Locker D. Self-esteem and socioeconomic disparities in self-perceived oral health. J Public Health Dent. 2009 Winter;69(1):1-8.
Allen PF, McMillan AS, Walshaw D. A patient-based assessment of implant-stabilized and conventional complete dentures. J Prosthet Dent. 2001;85(2):141–7.
Ohrn K, Jonsson B. A comparison of two questionnaires measuring oral health-related quality of life before and aft...
Al-Nawas B, Schiegnitz E. Augmentation procedures using bone substitute materials or autogenous bone—a systematic review and meta-analysis. Eur J Oral Implantol. 2014 Summer;7 Suppl 2:S219-34.
Derks J, Hakansson J, Wennstrom JL, Tomasi C, Larsson M, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: early and late implant loss. J Dent Res. 2015;94(3 Suppl):44S–51S...
Within the limitations of this study, the results demonstrated a high long-term survival for sinus augmentation procedures and significant improvement of OHRQoL after this procedure. Therefore, sinus augmentation procedures are highly valuable treatment options in implant dentistry.
In order to measure OHRQoL in the present study, a specific and shortened questionnaire based on the validated and reliable OHIP score was developed to consider representative impairments of maxillary sinus augmentation like sinusitis and to relieve the clinical application. In a cross sectional study, Allen et McMillan proofed that a shortened OHIP-14 version showed a similar ability to assess OH...
The clinical and radiological outcomes of sinus augmentation procedures have been published in several studies [1, 3, 6, 7]. However, little data on the physical and psychological impact of this procedure on the patient is available yet. The present study evaluated pre-operative and post-treatment OHRQoL self-assessment scores of patients treated with dental implants after sinus augmentation proce...
Concerning functional limitations, all posed questions showed significant better values for OHRQoL after sinus augmentation procedure than before the treatment (p
After an average time in situ of 41.2 ± 27 months (3.4 years; range 0–96 months), 40 of the 863 implants were lost. These results indicated an in situ rate of 95.4%. One-year and five-year survival rate according to Kaplan–Meier were 95.4 and 94.4%. In patients receiving an external sinus lift an in situ rate of 95.1% and in patients with an internal sinus lift an in situ rate of 96.4%...
The Kaplan–Meier survival function was applied for the description of survival rates. To examine the statistical difference between survival rates, a log-rank test was used. Implant-related data were calculated. For statistical comparison of the paired questions and the total scores, a Wilcoxon test was applied. The intention of this study was descriptive, exploratory without a primary hypothesi...
This retrospective study addresses the oral health-related quality of life after maxillary sinus augmentation. Therefore, all patients that received an implantation after maxillary sinus augmentation in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between July 2002 and December 2007 were included in this study. There were no specific exclusion c...
In conclusion, little information is available about patient’s perception of sinus augmentation procedures. The aim of the present study was to assess whether sinus augmentation procedures together with implant placement and prosthetic rehabilitation improve quality of life in dental patients using a modified German OHIP and to examine the survival rates after this procedure.
Rehabilitation of completely and partial edentulous patients with dental implants has proved to be a safe and predictable procedure [1–3]. However, reduced bone height and the proximity of the maxillary sinus are challenging limitations for dental implant placement in the posterior maxilla [3]. Besides the use of short and tilted implants [4], one of the most frequently used surgical techniques ...
The aim of this study was to measure the oral health-related quality of life (OHRQoL) after maxillary sinus augmentation to determine the physical and psychological impact of this procedure for the patient.
Three hundred sixteen patients treated with an external or internal maxillary sinus augmentation and a total of 863 implants in the Department of Oral and Maxillofacial Surgery, Johannes Guten...
Fig. 5. Survival rate of dental implants after autologous bone augmentation
Fig. 5. Survival rate of dental implants after autologous bone augmentation
Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Double asterisk, N refers to the total number of the surgical approaches in the maxilla (N = 225)
Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Dou...
Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites
Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites
Fig. 2. Survival rate of autologous bone grafts
Fig. 2. Survival rate of autologous bone grafts
Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)
Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)
Postoperative complications
%/procedures (N)
At donor sitea
Wound infection
2.6% (8/300)
At recipient site...
Donor site
Bone grafts (N)/patients (N)
Lateral zygomatic buttress
113/112
Mandibular ramus (retromolar)
...
Patient characteristics
N (%)
Gendera
Male
250 (89.6%)
Female
29 (10.4%)
...
Sakkas, A., Wilde, F., Heufelder, M. et al. Autogenous bone grafts in oral implantology—is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures.
Int J Implant Dent 3, 23 (2017). https://doi.org/10.1186/s40729-017-0084-4
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Received: 27 February 2017
Accepted: 22 May 2017
Published: 01 June 2017
DOI: https://doi...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
Andreas Sakkas, Frank Wilde, Marcus Heufelder & Alexander Schramm
Institute of Anatomy, Medical Faculty of Leipzig University, Leipzig, Germany
Karsten Winter
Department of Oral and Plastic Maxillofacial Surgery, University Hospit...
The authors thank the patients for their kindness to participate as study cases and the whole medical team at the Bundeswehrkrankenhaus Ulm.
AS participated in its design and coordination, carried out the data selection, and drafted the manuscript, and is the corresponding author. FW participated in its design and coordination and helped in drafting the manuscript. MH participated in its design a...
Semper W, Kraft S, Mehrhof J, Nelson K. Impact of abutment rotation and angulation on marginal fit: theoretical considerations. Int J Oral Maxillofac Implants. 2010;25:752–8.
Wiltfang J, Jätschmann N, Hedderich J, Neukam FW, Schlegel KA, Gierloff M. Effect of deproteinized bovine bone matrix coverage on the resorption of iliac cortico-spongeous bone grafts—a prospective study of two cohorts....
Chiapasco M, Zaniboni M. Clinical outcomes of GBR procedures to correct peri-implant dehiscences and fenestrations: a systematic review. Clin Oral Implants Res. 2009;20:113–23.
Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augmentation with interpositional blocks of anorganic bovine bone vs. 7-mm-long implants in posterior mandibles: 1-year results of a randomized clinical...
Verdugo F, Castillo A, Moragues MD, Pontón J. Bone microbial contamination influences autogenous grafting in sinus augmentation. J Periodontol. 2009;80:1355–64.
Wiltfang J, Schultze-Mosgau S, Merten HA, Kessler P, Ludwig A, Engelke W. Endoscopic and ultrasonographic evaluation of the maxillary sinus after combined sinus floor augmentation and implant insertion. Oral Surg Oral Med Oral Pathol O...
von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. Clin Oral Implants Res. 2006;17:359–66.
Levin L, Nitzan D, Schwartz-Arad D. Success of dental implants placed in intraoral block bone grafts. J Periodontol. 2007;78:18–21.
Andersson L. Patient self-evaluation of...
Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants. 2007;22:49–70.
Margonar R, dos Santos PL, Queiroz TP, Marcantonio E. Rehabilitation of atrophic maxilla using the combination of autogenous and allogeneic bone grafts followed by protocol-type prosthesis. J Craniofac Surg. 2010;2...
Schwartz-Arad D, Dori S. Intraoral autogenous onlay block bone grafting for implant dentistry. Refuat Hapeh Vehashinayim. 2002;19:35–9. 77.
Misch CM. Ridge augmentation using mandibular ramus bone grafts for the placement of dental implants: presentation of a technique. Pract Periodontics Aesthet Dent. 1996;8:127–35.
Altiparmak N, Soydan SS, Uckan S. The effect of conventional surgery and pi...
Jensen AT, Jensen SS, Worsaae N. Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study. Oral Maxillofac Surg. 2016;20(2):115–22 [Epub ahead of print].
Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmentation using autografts and barrier membranes: clinical study with 40 partially edentulous patients. J Oral Maxill...
The results of the clinical study proves the reliability and low comorbidity of autologous bone grafts in preprosthetic alveolar ridge reconstructions prior to implant insertion. The high graft success rate (95.6%) and the low early implant failure rate (0.38%) in a surveillance of all patients treated in three following years with this technique showing no exclusion and no dropout of any case for...
Data on risk factors based on the original examination and documentation are difficult to assess the adverse effects of variable factors on the surgical prognosis because of the multifactorial genesis of surgical complications [73]. Factors such as gender, age, or smoking habit could be associated with postoperative complications after two-stage dentoalveolar reconstruction with autologous bone gr...
The results of the present study have to take into account the absence of a control group with patients undergoing bone augmentation procedures with bone substitutes (allogen, alloplastic, exogen). Without a comparative group of grafting surgeries using alternative bone material, only limited statements can be made.
However, the excellent surgical outcome of autologous surgical methods providing ...
The use of autologous bone in this study has shown excellent graft survival and success rate (95.6%). This is equal to the results from the studies on implants inserted in reconstructed sites [6, 8, 24]. The early implant survival rate of 99.7% found in the present material is very high comparable to that in the previous systematic reviews after staged horizontal ridge augmentation [9, 10, 22, 62,...
Of the sinus floor elevations performed in this study, 84.8% were defined absolutely successful. Only two of our 72 patients having sinus lift operations could not finally be treated with dental implants. These results are comparable to other studies considering the sinus graft to be a safe treatment modality with few complications [6, 8, 51,52,53]. Raghoebar et al. reported incidences of sinus co...
Postoperative morbidity after mandibular bone harvesting procedures was reported to be mainly related to temporary or permanent neural disturbances involving the inferior alveolar nerve and its branches [19]. In this study, only the incidence of the temporary hypoesthesia of the mandibular and lingual nerve after harvesting from the retromolar area could be detected. It was 10.4 and 2.8%, respecti...
Systematic reviews have failed to find evidence that one particular grafting technique is superior to others [10]. Intraoral bone grafts from the mandibular symphysis, mandibular ramus, and maxillary tuberosity provide a good treatment modality for ridge augmentation, and the amount of bone available for harvesting is sufficient for defects up to the width of three teeth [42]. Harvesting of retrom...
Several grafting procedures have been described to create sufficient volume of bone for implant placement [8, 9]. Autologous bone grafts can be harvested by an intraoral approach (mandibular ramus, mandibular symphysis, zygomatic buttress) or from distant sites (iliac crest, calvaria, and etc.) [17, 36, 37]. However, bone harvesting potentially causes donor site morbidity which is a major issue fo...
The average healing period until implant placement after bone harvesting was 4.53 months. Initially, 546 implants in 279 patients were planned. After the healing period, it was possible to place 525 implants in 436 successfully augmented areas in 259 patients. Three hundred implants were inserted in the maxilla and 225 in the mandible. The remaining 21 implants planned for 20 patients could not b...
Regarding intraoperative complications, all sinus membrane perforations were covered with a resorbable collagen membrane (Bio-Gide®, Geistlich Biomaterials, Baden-Baden, Germany) which applied as sealant to overlap the site of perforation prior to insertion of the graft material. These patients were advised to avoid physical stress, blowing their noses, or sneezing for a period of 3 weeks, and n...
No permanent damage to any trigeminal nerves was evident in any of our entire cohort. All cases of postoperative hypoesthesia of the mental, lingual, or infraorbital nerve were just a temporary nature. At the time of implant surgery, none of these patients reported any persisting neural disturbances (Fig. 4).
In eleven patients, hypoesthesia of the mental area was mentioned, and three of them al...
Thirty-eight patients underwent a total of 116 augmentation procedures harvesting from the iliac crest. In 20 patients, a bone graft augmentation of the maxilla and the mandible in combination with bilateral sinus floor augmentations was performed. Eighteen patients had augmentations only in the maxilla, involving bone grafting and sinus lift elevations. Totally, 76 sinus lifts with bone material ...
In six patients, a partial graft resorption was detected at the time of implantation and an additional simultaneous augmentation with bone chips harvested with the Safescraper device (C.G.M. S.p.A., Divisione Medicale META, Italy) was then necessary in order to ensure the osseointegration of the implants. Two out of these six cases had grafts from the crista zygomatico-alveolaris, two from the ram...
A total of 112 sinus floor elevations were performed. In all of the cases, implants were inserted in a two-stage procedure. The donor site for harvesting the bone for the sinus elevations was in 76 procedures in the iliac crest area, and in 36 procedures, the bone was harvested with a bone scraper device from the lateral sinus wall at the site of sinus lifting.
The distribution and number of tran...
Two hundred seventy-nine patients—250 men and 29 women—underwent 456 augmentation procedures involving autologous bone grafts prior to implant placement. The patients ranged in age from 18.5 to 71.5 years (average 43.1 years) at the moment of augmentation surgery.
Of those patients, 162 (58.1%) were younger than 40 years of age and 117 (41.9%) were older than 40 years of age. Caries or pe...
Early and late implant loss was documented in this study, defining the clinical success of osseointegration. Early implant failures were assessed before the acquisition of osseointegration, i.e., before the placement of prosthodontic restorations. Early implant failure could occur from the time of placement, during the healing phase and before abutment connection. The implant inserted after re-aug...
Medical history of patient
Age of patient at the time of bone harvesting and augmentation
History of periodontal disease
Smoking habits
Donor site
Jaw area and dental situation of the recipient site
Intraoperative complications
Postoperative complications after augmentation
Management of complications
Bone graft stability and clinical resorption prior to implant placement
Complications a...
In addition to the bone already gained with the bone scraper device from the sinus wall during the antrostomy, bone was harvested with the same device from the maxillary buccal buttress, if more volume was needed. By taking this approach, the collection of enough bone for the augmentation of at least two implantation sites was feasible with a mean surgical time of 5 to 10 min for harvesting. In c...
Grafting from the iliac crest was always performed under general anesthesia in a two-team approach. The iliac crest was exposed and autogenous grafts from the anterosuperior inner edge of the iliac wing were harvested with an oscillating saw and/or a chisel, keeping a safe distance of around 2 cm from the anterosuperior iliac spine. After harvesting the bone grafts, the corticocancellous bone blo...
A standardized two-stage surgical protocol was used, and all sites were treated in a similar fashion. In the first intervention, a bone block harvested from the donor site was fixed with osteosynthesis titanium screws to the recipient site as an onlay graft to achieve a horizontal and/or vertical enlargement of the alveolar ridge. Placement of the bone graft was always guided by an augmentation te...
For this retrospective cohort study, we reviewed the records of all patients without exclusion criteria who were referred to the department of oral and plastic maxillofacial surgery at the military hospital of Ulm, Germany, between January 2009 and December 2011 for alveolar ridge augmentations prior to implant insertions using autologous bone grafts harvested from different donor sites and unilat...
In our military outpatient center exclusively, autologous bone transplantations harvested from different donor sites were used intraorally (crista zygomatico-alveolaris, ramus mandible, symphysis mandible, anterior sinus wall) and extraorally (iliac crest) to reconstruct severe horizontal and/or vertical alveolar ridge atrophy prior to implant placement. The aim of this study was to assess the cli...
Although the iliac crest is most often used in jaw reconstruction, a significant bone resorption has been mentioned [12]. This disadvantage, and the fact that dental implants do not always require a large amount of bone, has increased the use of autologous block bone grafts from intraoral sources [13]. Bone grafts from intraoral donor sites offer several benefits like surgical accessibility, proxi...
Oral implantation has a significant role in the rehabilitation of patients. Bone reconstruction techniques have been advanced in order to optimize the esthetic and functional outcome. However, the restoration of the oral function of atrophic alveolar crests still remains a challenge in oral implantology. Bone augmentation procedures are often indicated to allow implant placement in an optimal thre...
This review demonstrates the predictability of autologous bone material in alveolar ridge reconstructions prior to implant insertion, independent from donor and recipient site including even autologous bone chips for sinus elevation. Due to the low harvesting morbidity of autologous bone grafts, the clinical results of our study indicate that autologous bone grafts still remain the “gold standar...
This study assessed the clinical outcomes of graft success rate and early implant survival rate after preprosthetic alveolar ridge reconstruction with autologous bone grafts.
A consecutive retrospective study was conducted on all patients who were treated at the military outpatient clinic of the Department of Oral and Plastic Maxillofacial Surgery at the military hospital in Ulm (Germany) in the ...
Fig. 17. The appearance of the case shown in Fig. 16 with the polythene “washer” removed at 2 weeks post-surgery, providing access to the zygomatic oncology implants
Fig. 17. The appearance of the case shown in Fig. 16 with the polythene “washer” removed at 2 weeks post-surgery, providing access to the zygomatic oncology implants
Fig. 16. Another ZIP flap case demonstrating the use of a perforated polythene “washer” to keep the flap from overgrowing the implant abutments during the healing phase
Fig. 16. Another ZIP flap case demonstrating the use of a perforated polythene “washer” to keep the flap from overgrowing the implant abutments during the healing phase
Fig. 15. Facial appearance 18 months following treatment
Fig. 15. Facial appearance 18 months following treatment
Fig. 14. Intra-oral view of perforated flap 3 weeks following radiotherapy
Fig. 14. Intra-oral view of perforated flap 3 weeks following radiotherapy
Fig. 13. Panoramic dental radiograph showing the position of the zygomatic implants and the seating of the initial fixed prosthesis
Fig. 13. Panoramic dental radiograph showing the position of the zygomatic implants and the seating of the initial fixed prosthesis
Fig. 12. Provisional acrylic fixed dental prosthesis fitted at 4 weeks post-surgery
Fig. 12. Provisional acrylic fixed dental prosthesis fitted at 4 weeks post-surgery
Fig. 11. Intra-oral view of the soft tissue flap at 3 weeks post-operatively with overgrowth of flap over the zygomatic oncology implants
Fig. 11. Intra-oral view of the soft tissue flap at 3 weeks post-operatively with overgrowth of flap over the zygomatic oncology implants
Fig. 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments
Fig. 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments
Fig. 9. Inter-occlusal registration using the pre-fabricated maxillary denture prosthesis relined with silicone putty over the implant abutment protection caps
Fig. 9. Inter-occlusal registration using the pre-fabricated maxillary denture prosthesis relined with silicone putty over the implant abutment protection caps
Fig. 8. Abutment level impression utilising light-cured acrylic tray material
Fig. 8. Abutment level impression utilising light-cured acrylic tray material
Fig. 7. Conventional zygomatic implant insertion on the non-defect side of the maxilla following extraction of the remaining teeth and an alveoloplasty
Fig. 7. Conventional zygomatic implant insertion on the non-defect side of the maxilla following extraction of the remaining teeth and an alveoloplasty
Fig. 6. Zygomatic oncology implants sited in the residual zygomatic bone on the defect side of the maxilla
Fig. 6. Zygomatic oncology implants sited in the residual zygomatic bone on the defect side of the maxilla
Fig. 5. Left-sided maxillary resection (Brown class 2b)
Fig. 5. Left-sided maxillary resection (Brown class 2b)
Fig. 4. Panoramic dental radiograph showing dental status at presentation
Fig. 4. Panoramic dental radiograph showing dental status at presentation
Fig. 3. Staging CT scan confirming maxillary destruction but preservation of the orbital floor
Fig. 3. Staging CT scan confirming maxillary destruction but preservation of the orbital floor
Fig. 2. Staging MRI scan showing destructive lesion left maxilla
Fig. 2. Staging MRI scan showing destructive lesion left maxilla
Fig. 1. Clinical view of left-sided maxillary tumour at presentation
Fig. 1. Clinical view of left-sided maxillary tumour at presentation
Domain
Score
Activity
100 (“I am as active as I have ever been”)
Anxiety
100 (“...
Butterworth, C.J., Rogers, S.N. The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy.
Int J Implant Dent 3, 37 (2017). https://doi.org/10.1186/s40729-017-0100-8
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Received: 14 May 2017
Accepted: 23 July 2017
Published: 29 July 2017
DOI: https...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Consent has been obtained from the patient for the use and publication of all images.
Chris Butterworth and Simon Rogers declare that they have no competing interests.
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Department of Oral & Maxillofacial Surgery, University Hospital Aintree, Lower Lane, Liverpool, L9 7AL, UK
C. J. Butterworth & S. N. Rogers
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CB devised the treatment concept and undertook all implant surgeries and prostho...
Okay DJ, Genden E, Buchbinder D, Urken M. Prosthodontic guidelines for surgical reconstruction of the maxilla: a classification system of defects. J Prosthet Dent. 2001;86(4):352–63.
Rohner D, Bucher P, Hammer B. Prefabricated fibular flaps for reconstruction of defects of the maxillofacial skeleton: planning, technique, and long-term experience. Int J Oral Maxillofac Implants. 2013;28(5):e221...
The ZIP flap technique represents an innovative approach to the management of patients presenting with low-level malignant maxillary tumours. It provides effective closure of the resulting maxillary defect restoring speech and swallowing functions and also establishing a high-quality fixed dental rehabilitation in a rapid timescale, thus facilitating a more timely return to function and restored f...
Whilst technically, it would be possible to construct and fit the prosthesis on the same day or even a week later, the need for microvascular flap monitoring in the immediate post-operative period, together with the significant recovery period required by the patient following surgery has lead the authors to delay the fitting of the prosthesis at the 4 to 6-week period post-operatively. In terms o...
In contrast, the use of a soft tissue flap such as the RFFF or antero-lateral thigh flap can often be safely employed in elderly patients with peripheral vascular disease without unduly lengthening the operation too significantly with two-team operating. In addition, the predictability of these flaps with their excellent pedicle lengths is ideal for closure of the resulting oro-nasal surgical defe...
In low-level maxillectomy (Brown class II), the need for bony reconstruction is questionable depending on the horizontal component. With the preservation of the orbital floor, zygomatic prominence and some bony support for the nose, facial appearance, in the experience of the authors and, as demonstrated by this case, is not significantly worsened despite low-level removal of the maxilla. The key ...
In order to address some of the issues highlighted in this early case, the technique was modified slightly to try and prevent flap overgrowth and prosthesis fracture in the early stages. In order to prevent flap overgrowth over the zygomatic oncology implant abutments, the use of a polythene washer was instituted on subsequent cases treated in the unit. Once the flap was perforated, a 2-mm thick p...
The implant positions were then accurately registered by utilising light-cured resin tray material (Individo® Lux, Voco Gmbh, Germany) and abutment level impression copings. The resin material was applied in sections around the impression copings and cured incrementally to ensure a rigid splinting of the impression copings (Fig. 8). Abutment protection caps were then placed over all four abutment...
A 66-year-old male patient presented with an enlarging mass in the left maxilla (Fig. 1). The mass had been present for a few weeks. An incisional biopsy revealed squamous cell carcinoma. Staging scans were undertaken (Fig. 2) which demonstrated a T4N0M0 maxillary alveolus tumour in close proximity to the left orbital floor with obliteration of the maxillary antrum and destruction of the lateral m...
The surgical management and prosthodontic rehabilitation of the maxillectomy patient is complex with a variety of options available to the head and neck cancer team ranging from simple prosthodontic obturation [1] to reconstruction using pre-fabricated or digitally planned composite flaps [2] with or without the placement of osseointegrated implants [3]. The primary aims of treatment include effec...
This aim of this report is to describe the development and evolution of a new surgical technique for the immediate surgical reconstruction and rapid post-operative prosthodontic rehabilitation with a fixed dental prosthesis following low-level maxillectomy for malignant disease.
The technique involves the use of a zygomatic oncology implant perforated micro-vascular soft tissue flap (ZIP flap) fo...
Fig. 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Fig. 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Fig. 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Fig. 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Patient
Implant-localization (region)
Implant loss (+/−)
Buccal width of keratinized peri-implant gingiva (mm)
Buccal thickness of keratinized peri-implant gi...
Patient
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Age (years)
Implant localization (region)
Implant diameter (mm)
...
Lorenz, J., Lerner, H., Sader, R.A. et al. Investigation of peri-implant tissue conditions and peri-implant tissue stability in implants placed with simultaneous augmentation procedure: a 3-year retrospective follow-up analysis of a newly developed bone level implant system.
Int J Implant Dent 3, 41 (2017). https://doi.org/10.1186/s40729-017-0104-4
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and the approval of the ethics committee required for the study was obtained from the Ethics Committee of the Medical Center of the Goethe University Frankfurt. The procedures to be performed were explained in detail, and the patients signed the consent form.
Jonas Lorenz, Henriette Lerner, Robert Sader, an...
Department for Oral, FORM-Lab, Cranio-Maxillofacial, and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
Jonas Lorenz, Robert A. Sader & Shahram Ghanaati
HL-Dentclinic, Baden-Baden, Germany
Henriette Lerner
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Lerner H, Lorenz J, Sader R, Ghanaati S. Two-year retrospective study of periimplant health and periimplant bone stability after immediate implant placement of a newly developed bone level implant system—a first report. EDI Journal (European Association of Dental Implantologists, Teamwork Media); 2017; ahead of print.
Ghanaati S, Lorenz J, Obreja K, Choukroun J, Landes C, Sader R. Nanocrystalli...
Gurgel BC, Montenegro SC, Dantas PM, Pascoal AL, Lima KC, Calderon PD. Frequency of peri-implant diseases and associated factors. Clin Oral Implants Res. 2016; doi: 10.1111/clr.12944
Qian J, Wennerberg A, Albrektsson T. Reasons for marginal bone loss around oral implants. Clin Implant Dent Relat Res. 2012;14(6):792–807.
Berglundh T, Lindhe J, Ericsson I, Marinello C, Liljenberg B, Thomsen P....
β-tricalcium phosphate
Bleeding on probing
Fixed prosthetics
Guided bone regeneration
Hydroxyapatite
Multinucleated giant cells
Pink Esthetic Score
Removable prosthetics
In the present study, the implant and peri-implant hard- and soft-tissue stability was analyzed in a bone level implant system placed simultaneously with a GBR procedure 3 years after prosthetic loading. Peri-implant hard- and soft-tissue parameters such as width and thickness of peri-implant keratinized gingiva, probing depth, BOP, PES, peri-implant bone loss, and the presence of peri-implant os...
Comparing the present results to the aforementioned study with the same implant system on immediately placed implants, it seems that the GBR augmentation procedure has no influence on the long-term stability of the implants. In both studies with different placement modalities and protocols, comparable clinical and radiological results were achieved. This leads to the assumption that the investigat...
The tissue reaction, however, did not only differ in bone substitute materials of different origin but also in bone substitute materials of the same origin. In an in vivo trial, two xenogeneic bone substitute materials processed with different techniques were implanted subcutaneously in CD-1 mice for up to 60 days. Both bone substitute materials showed good integration within the peri-implant tis...
In the present retrospective study, C-Tech bone level implants placed simultaneously with a GBR procedure around the implant shoulder were investigated clinically and radiologically after at least 3 years of loading to assess peri-implant tissue conditions and document peri-implant tissue stability.
A total of 47 implants were placed in the upper (23 implants) and lower jaw (24 implants) of 20 p...
Investigation of the esthetic appearance via PES revealed a mean point score of 10.1 (ranging from 7 to 13) from a maximum of 14. The highest values and therefore acceptance were found in the alveolar process deficiency and the soft-tissue level, which can be interpreted as a benefit of the augmentation procedure around the implant shoulder.
Peri-implant bone loss calculated using the average bon...
Altogether, 47 implants were placed in the upper and lower jaws of a total of 20 patients. In all implants, lateral augmentation in a GBR process was performed simultaneously with implant placement due to reduced horizontal or vertical height of the alveolar crest. A total of 23 implants were placed in the upper jaw and 24 implants in the lower jaw. The implant diameter varied between 3.5 mm (32 ...
Investigation parameters:
Implant being in situ
Width and thickness of peri-implant keratinized gingiva
Pink Esthetic Score (PES)
Probing depth
BOP
Peri-implant bone loss
Presence of peri-implant osteolysis
In the present retrospective study, bone level implants (C-Tech Esthetic Line implants) were investigated clinically and radiologically. The bone level implant system has a Morse-locking conical implant-abutment connection with platform switching and an indexing hex that allows subcrestal implant placement and aims to prevent peri-implant bone loss. The surface of the implant system is manufacture...
In the present retrospective study, 47 dental implants (C-Tech Esthetic Line implants) from 20 patients (11 female, 9 male) with a mean age of 58.5 years (45–75 years) were analyzed clinically and radiologically. Implant placement and follow-up investigation was performed at the HL Dentclinic in Baden-Baden, Germany. The study was approved by the ethics commission of the medical department of ...
The aim of the present retrospective investigation was to assess clinically and radiologically peri-implant tissue conditions and document peri-implant tissue stability in C-Tech implants when placed simultaneously with a GBR augmentation procedure after at least 3 years of loading.
The ability of bone substitute materials to form a sufficient and stable implantation bed has been proven in numerous clinical trials; however, it is still to a certain degree unclear if the different tissue reactions have an impact on the establishment of a peri-implant infection, especially when these biomaterials are used for augmentations around the implant shoulder. Due to the two-stage desig...
The prevalence of peri-implantitis has grown in the past few years and has become a major issue in implant dentistry. Long-term stable and healthy soft- and hard-tissue conditions should be achieved in combination with esthetically and functionally satisfying results. However, the rising number of placed implants in the past decades has come with an increase in the prevalence of peri-implantitis [...
Guided bone regeneration (GBR) has been proven to be a reliable therapy to regenerate missing bone in cases of atrophy of the alveolar crest. The aim of the present retrospective analysis was to assess peri-implant tissue conditions and document peri-implant tissue stability in C-Tech implants when placed simultaneously with a GBR augmentation procedure.
A total of 47 implants, which were placed ...
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs accompanied by moderate grade inflammatory cell infiltration (HE staining, bar: 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs a...
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Antibody
Sorce
Clone
Staining
Keratin 13
DAKO
DE-K13
...
Noguchi, M., Tsuno, H., Ishizaka, R. et al. Primary peri-implant oral intra-epithelial neoplasia/carcinoma in situ: a case report considering risk factors for carcinogenesis.
Int J Implant Dent 3, 47 (2017). https://doi.org/10.1186/s40729-017-0109-z
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Received: 15 March 2017
Accepted: 25 October 2017
Published: 16 November 2017
DOI: https://doi.org/10.1186...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.
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Correspondence to
Makoto Noguchi.
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama city, Toyama, 9300194, Japan
Makoto Noguchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue & Kei Tomihara
Department of Diagnosis Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, Univers...
Vasilescu F, Ceauşu M, Tänsen C, et al. P53, p63 and ki-67 assessment in HPV-induced cervical neoplasia. RJME. 2009;50:357–61.
Ndiaye C, Mena M, Alemany L, et al. HPV DNA, E6/E7 mRNA, and p16INK4a detection in head and neck cancers: a systematic review and meta-analysis. Lancet Oncol. 2014;15:1319–31.
Nagy K, Sonkodi I, Szöke I, et al. The microflora associated with human oral carcinoma. ...
Sah JP, Johnson NW, Batsakis JG. Oral cancer. London: Informa Healthcare; 2011. p. 3–32.
Japan Society for Oral Tumors. General rules for clinical and pathological studies on oral cancer. 1st ed. Tokyo: Kanehara-shuppan Co; 2010. p. 44–7.
Laprise C, Shahl HP, Madathil SA, et al. Periodontal diseases and risk of oral cancer in Southern India: results from the HeNCe Life Study. Int J Cancer. 2...
Deoxyribonucleic acid
Human papilloma virus
Oral intra-epithelial neoplasia/carcinoma in situ
Squamous cell carcinoma
In our case, the persistence of peri-implant mucositis or peri-implantitis around the dental implant was implicated as being a plausible risk factor for carcinogenesis. Regular follow-up to ensure the maintenance of oral hygiene after dental implant therapy has again been shown to be important for preventing peri-implantitis, a plausible risk factor for carcinogenesis.
The latest evidence implies that the human papilloma virus (HPV) may be responsible for carcinogenesis in the oral cavity [12, 13]; however, its role is debatable. The interaction of the HPV’s E6 and E7 oncoproteins with cell cycle proteins disturbs the cell cycle mechanism and subsequent alteration in the expression of proteins such as p53, p63, and Ki-67 [14]. In our case, the immunohistochemi...
OIN/CIS can sometimes be difficult to distinguish pathologically from epithelial dysplasia on hematoxylin- and eosin-staining sections; this has proved challenging for oral pathologists [9]. Recently, it has been reported that combined immunohistochemistry for k13 and k17 was useful for the differential diagnosis [9, 10]. K13 is a marker for cellular differentiation toward prickle cells in normal ...
A 65-year-old woman was referred to our clinic with a tumor in the right lower gingiva. Her medical history included breast cancer without metastatic lesion, diabetes mellitus, hyperlipidemia, and hypertension. She had taken orally aspirin, amlodipine, pravastatin, and bepotastine for 2 years. She drank alcohol socially, but she had no history of tobacco smoking habit.
About 10 years prior to h...
Oral cancer ranks sixth among the malignancies in terms of worldwide prevalence, with more than 90% being pathologically squamous cell carcinoma (SCC) [1]. Oral SCC generally develops via multistep carcinogenesis. The squamous epithelium goes into irreversible change, including epithelial dysplasia and oral intra-epithelial neoplasia/carcinoma in-situ (OIN/CIS) [2], finally resulting in the develo...
In this case, prolonged peri-implant mucositis or peri-implantitis may have been a plausible risk factor for carcinogenesis.
Major risk factors for oral squamous cell carcinoma (SCC) are tobacco smoking, a betel quid chewing habit, and heavy alcohol consumption. However, around 15% of oral SCCs cannot be explained by these risk factors. Although oral SCC associated with dental implants is quite rare, there has been a recent gradual accumulation of reports about it. Here, we report a case of primary peri-implant oral int...
Fig. 5. Survival rate of dental implants after autologous bone augmentation
Fig. 5. Survival rate of dental implants after autologous bone augmentation
Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Double asterisk, N refers to the total number of the surgical approaches in the maxilla (N = 225)
Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Dou...
Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites
Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites
Fig. 2. Survival rate of autologous bone grafts
Fig. 2. Survival rate of autologous bone grafts
Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)
Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)
Postoperative complications
%/procedures (N)
At donor sitea
Wound infection
2.6% (8/300)
At recipient site...
Donor site
Bone grafts (N)/patients (N)
Lateral zygomatic buttress
113/112
Mandibular ramus (retromolar)
...
Patient characteristics
N (%)
Gendera
Male
250 (89.6%)
Female
29 (10.4%)
...
Sakkas, A., Wilde, F., Heufelder, M. et al. Autogenous bone grafts in oral implantology—is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures.
Int J Implant Dent 3, 23 (2017). https://doi.org/10.1186/s40729-017-0084-4
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Received: 27 February 2017
Accepted: 22 May 2017
Published: 01 June 2017
DOI: https://doi...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
Andreas Sakkas, Frank Wilde, Marcus Heufelder & Alexander Schramm
Institute of Anatomy, Medical Faculty of Leipzig University, Leipzig, Germany
Karsten Winter
Department of Oral and Plastic Maxillofacial Surgery, University Hospit...
The authors thank the patients for their kindness to participate as study cases and the whole medical team at the Bundeswehrkrankenhaus Ulm.
AS participated in its design and coordination, carried out the data selection, and drafted the manuscript, and is the corresponding author. FW participated in its design and coordination and helped in drafting the manuscript. MH participated in its design a...
Semper W, Kraft S, Mehrhof J, Nelson K. Impact of abutment rotation and angulation on marginal fit: theoretical considerations. Int J Oral Maxillofac Implants. 2010;25:752–8.
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Chiapasco M, Zaniboni M. Clinical outcomes of GBR procedures to correct peri-implant dehiscences and fenestrations: a systematic review. Clin Oral Implants Res. 2009;20:113–23.
Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augmentation with interpositional blocks of anorganic bovine bone vs. 7-mm-long implants in posterior mandibles: 1-year results of a randomized clinical...
Verdugo F, Castillo A, Moragues MD, Pontón J. Bone microbial contamination influences autogenous grafting in sinus augmentation. J Periodontol. 2009;80:1355–64.
Wiltfang J, Schultze-Mosgau S, Merten HA, Kessler P, Ludwig A, Engelke W. Endoscopic and ultrasonographic evaluation of the maxillary sinus after combined sinus floor augmentation and implant insertion. Oral Surg Oral Med Oral Pathol O...
von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. Clin Oral Implants Res. 2006;17:359–66.
Levin L, Nitzan D, Schwartz-Arad D. Success of dental implants placed in intraoral block bone grafts. J Periodontol. 2007;78:18–21.
Andersson L. Patient self-evaluation of...
Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants. 2007;22:49–70.
Margonar R, dos Santos PL, Queiroz TP, Marcantonio E. Rehabilitation of atrophic maxilla using the combination of autogenous and allogeneic bone grafts followed by protocol-type prosthesis. J Craniofac Surg. 2010;2...
Schwartz-Arad D, Dori S. Intraoral autogenous onlay block bone grafting for implant dentistry. Refuat Hapeh Vehashinayim. 2002;19:35–9. 77.
Misch CM. Ridge augmentation using mandibular ramus bone grafts for the placement of dental implants: presentation of a technique. Pract Periodontics Aesthet Dent. 1996;8:127–35.
Altiparmak N, Soydan SS, Uckan S. The effect of conventional surgery and pi...
Jensen AT, Jensen SS, Worsaae N. Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study. Oral Maxillofac Surg. 2016;20(2):115–22 [Epub ahead of print].
Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmentation using autografts and barrier membranes: clinical study with 40 partially edentulous patients. J Oral Maxill...
The results of the clinical study proves the reliability and low comorbidity of autologous bone grafts in preprosthetic alveolar ridge reconstructions prior to implant insertion. The high graft success rate (95.6%) and the low early implant failure rate (0.38%) in a surveillance of all patients treated in three following years with this technique showing no exclusion and no dropout of any case for...
Data on risk factors based on the original examination and documentation are difficult to assess the adverse effects of variable factors on the surgical prognosis because of the multifactorial genesis of surgical complications [73]. Factors such as gender, age, or smoking habit could be associated with postoperative complications after two-stage dentoalveolar reconstruction with autologous bone gr...
The results of the present study have to take into account the absence of a control group with patients undergoing bone augmentation procedures with bone substitutes (allogen, alloplastic, exogen). Without a comparative group of grafting surgeries using alternative bone material, only limited statements can be made.
However, the excellent surgical outcome of autologous surgical methods providing ...
The use of autologous bone in this study has shown excellent graft survival and success rate (95.6%). This is equal to the results from the studies on implants inserted in reconstructed sites [6, 8, 24]. The early implant survival rate of 99.7% found in the present material is very high comparable to that in the previous systematic reviews after staged horizontal ridge augmentation [9, 10, 22, 62,...
Of the sinus floor elevations performed in this study, 84.8% were defined absolutely successful. Only two of our 72 patients having sinus lift operations could not finally be treated with dental implants. These results are comparable to other studies considering the sinus graft to be a safe treatment modality with few complications [6, 8, 51,52,53]. Raghoebar et al. reported incidences of sinus co...
Postoperative morbidity after mandibular bone harvesting procedures was reported to be mainly related to temporary or permanent neural disturbances involving the inferior alveolar nerve and its branches [19]. In this study, only the incidence of the temporary hypoesthesia of the mandibular and lingual nerve after harvesting from the retromolar area could be detected. It was 10.4 and 2.8%, respecti...
Systematic reviews have failed to find evidence that one particular grafting technique is superior to others [10]. Intraoral bone grafts from the mandibular symphysis, mandibular ramus, and maxillary tuberosity provide a good treatment modality for ridge augmentation, and the amount of bone available for harvesting is sufficient for defects up to the width of three teeth [42]. Harvesting of retrom...
Several grafting procedures have been described to create sufficient volume of bone for implant placement [8, 9]. Autologous bone grafts can be harvested by an intraoral approach (mandibular ramus, mandibular symphysis, zygomatic buttress) or from distant sites (iliac crest, calvaria, and etc.) [17, 36, 37]. However, bone harvesting potentially causes donor site morbidity which is a major issue fo...
The surgical outcome after augmentation and implantation procedures is presented in Fig. 5.
The average healing period until implant placement after bone harvesting was 4.53 months. Initially, 546 implants in 279 patients were planned. After the healing period, it was possible to place 525 implants in 436 successfully augmented areas in 259 patients. Three hundred implants were inserted in the maxilla and 225 in the mandible. The remaining 21 implants planned for 20 patients could not b...
Regarding intraoperative complications, all sinus membrane perforations were covered with a resorbable collagen membrane (Bio-Gide®, Geistlich Biomaterials, Baden-Baden, Germany) which applied as sealant to overlap the site of perforation prior to insertion of the graft material. These patients were advised to avoid physical stress, blowing their noses, or sneezing for a period of 3 weeks, and n...
No permanent damage to any trigeminal nerves was evident in any of our entire cohort. All cases of postoperative hypoesthesia of the mental, lingual, or infraorbital nerve were just a temporary nature. At the time of implant surgery, none of these patients reported any persisting neural disturbances (Fig. 4).
In eleven patients, hypoesthesia of the mental area was mentioned, and three of them al...
Thirty-eight patients underwent a total of 116 augmentation procedures harvesting from the iliac crest. In 20 patients, a bone graft augmentation of the maxilla and the mandible in combination with bilateral sinus floor augmentations was performed. Eighteen patients had augmentations only in the maxilla, involving bone grafting and sinus lift elevations. Totally, 76 sinus lifts with bone material ...
A total of 104 retromolar bone graft procedures in 86 patients were conducted. Twenty-two harvesting procedures were performed for augmentation of the maxilla and 82 for the mandible. Seven retromolar bone grafts (93.2%) in seven single-tooth gap dental regions by seven patients had been lost. Therefore, seven implants could not be inserted in augmented alveolar sites after graft failure. Three of...
In six patients, a partial graft resorption was detected at the time of implantation and an additional simultaneous augmentation with bone chips harvested with the Safescraper device (C.G.M. S.p.A., Divisione Medicale META, Italy) was then necessary in order to ensure the osseointegration of the implants. Two out of these six cases had grafts from the crista zygomatico-alveolaris, two from the ram...
A total of 112 sinus floor elevations were performed. In all of the cases, implants were inserted in a two-stage procedure. The donor site for harvesting the bone for the sinus elevations was in 76 procedures in the iliac crest area, and in 36 procedures, the bone was harvested with a bone scraper device from the lateral sinus wall at the site of sinus lifting.
The distribution and number of tran...
Two hundred seventy-nine patients—250 men and 29 women—underwent 456 augmentation procedures involving autologous bone grafts prior to implant placement. The patients ranged in age from 18.5 to 71.5 years (average 43.1 years) at the moment of augmentation surgery.
Of those patients, 162 (58.1%) were younger than 40 years of age and 117 (41.9%) were older than 40 years of age. Caries or pe...
Early and late implant loss was documented in this study, defining the clinical success of osseointegration. Early implant failures were assessed before the acquisition of osseointegration, i.e., before the placement of prosthodontic restorations. Early implant failure could occur from the time of placement, during the healing phase and before abutment connection. The implant inserted after re-aug...
Medical history of patient
Age of patient at the time of bone harvesting and augmentation
History of periodontal disease
Smoking habits
Donor site
Jaw area and dental situation of the recipient site
Intraoperative complications
Postoperative complications after augmentation
Management of complications
Bone graft stability and clinical resorption prior to implant placement
Complications a...
In addition to the bone already gained with the bone scraper device from the sinus wall during the antrostomy, bone was harvested with the same device from the maxillary buccal buttress, if more volume was needed. By taking this approach, the collection of enough bone for the augmentation of at least two implantation sites was feasible with a mean surgical time of 5 to 10 min for harvesting. In c...
Grafting from the iliac crest was always performed under general anesthesia in a two-team approach. The iliac crest was exposed and autogenous grafts from the anterosuperior inner edge of the iliac wing were harvested with an oscillating saw and/or a chisel, keeping a safe distance of around 2 cm from the anterosuperior iliac spine. After harvesting the bone grafts, the corticocancellous bone blo...
A standardized two-stage surgical protocol was used, and all sites were treated in a similar fashion. In the first intervention, a bone block harvested from the donor site was fixed with osteosynthesis titanium screws to the recipient site as an onlay graft to achieve a horizontal and/or vertical enlargement of the alveolar ridge. Placement of the bone graft was always guided by an augmentation te...
For this retrospective cohort study, we reviewed the records of all patients without exclusion criteria who were referred to the department of oral and plastic maxillofacial surgery at the military hospital of Ulm, Germany, between January 2009 and December 2011 for alveolar ridge augmentations prior to implant insertions using autologous bone grafts harvested from different donor sites and unilat...
In our military outpatient center exclusively, autologous bone transplantations harvested from different donor sites were used intraorally (crista zygomatico-alveolaris, ramus mandible, symphysis mandible, anterior sinus wall) and extraorally (iliac crest) to reconstruct severe horizontal and/or vertical alveolar ridge atrophy prior to implant placement. The aim of this study was to assess the cli...
Although the iliac crest is most often used in jaw reconstruction, a significant bone resorption has been mentioned [12]. This disadvantage, and the fact that dental implants do not always require a large amount of bone, has increased the use of autologous block bone grafts from intraoral sources [13]. Bone grafts from intraoral donor sites offer several benefits like surgical accessibility, proxi...
Oral implantation has a significant role in the rehabilitation of patients. Bone reconstruction techniques have been advanced in order to optimize the esthetic and functional outcome. However, the restoration of the oral function of atrophic alveolar crests still remains a challenge in oral implantology. Bone augmentation procedures are often indicated to allow implant placement in an optimal thre...
This review demonstrates the predictability of autologous bone material in alveolar ridge reconstructions prior to implant insertion, independent from donor and recipient site including even autologous bone chips for sinus elevation. Due to the low harvesting morbidity of autologous bone grafts, the clinical results of our study indicate that autologous bone grafts still remain the “gold standar...
This study assessed the clinical outcomes of graft success rate and early implant survival rate after preprosthetic alveolar ridge reconstruction with autologous bone grafts.
A consecutive retrospective study was conducted on all patients who were treated at the military outpatient clinic of the Department of Oral and Plastic Maxillofacial Surgery at the military hospital in Ulm (Germany) in the ...
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs accompanied by moderate grade inflammatory cell infiltration (HE staining, bar: 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs a...
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Antibody
Sorce
Clone
Staining
Keratin 13
DAKO
DE-K13
...
Noguchi, M., Tsuno, H., Ishizaka, R. et al. Primary peri-implant oral intra-epithelial neoplasia/carcinoma in situ: a case report considering risk factors for carcinogenesis.
Int J Implant Dent 3, 47 (2017). https://doi.org/10.1186/s40729-017-0109-z
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Received: 15 March 2017
Accepted: 25 October 2017
Published: 16 November 2017
DOI: https://doi.org/10.1186...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Makoto Noguchi.
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama city, Toyama, 9300194, Japan
Makoto Noguchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue & Kei Tomihara
Department of Diagnosis Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, Univers...
Vasilescu F, Ceauşu M, Tänsen C, et al. P53, p63 and ki-67 assessment in HPV-induced cervical neoplasia. RJME. 2009;50:357–61.
Ndiaye C, Mena M, Alemany L, et al. HPV DNA, E6/E7 mRNA, and p16INK4a detection in head and neck cancers: a systematic review and meta-analysis. Lancet Oncol. 2014;15:1319–31.
Nagy K, Sonkodi I, Szöke I, et al. The microflora associated with human oral carcinoma. ...
Sah JP, Johnson NW, Batsakis JG. Oral cancer. London: Informa Healthcare; 2011. p. 3–32.
Japan Society for Oral Tumors. General rules for clinical and pathological studies on oral cancer. 1st ed. Tokyo: Kanehara-shuppan Co; 2010. p. 44–7.
Laprise C, Shahl HP, Madathil SA, et al. Periodontal diseases and risk of oral cancer in Southern India: results from the HeNCe Life Study. Int J Cancer. 2...
Deoxyribonucleic acid
Human papilloma virus
Oral intra-epithelial neoplasia/carcinoma in situ
Squamous cell carcinoma
In our case, the persistence of peri-implant mucositis or peri-implantitis around the dental implant was implicated as being a plausible risk factor for carcinogenesis. Regular follow-up to ensure the maintenance of oral hygiene after dental implant therapy has again been shown to be important for preventing peri-implantitis, a plausible risk factor for carcinogenesis.
The latest evidence implies that the human papilloma virus (HPV) may be responsible for carcinogenesis in the oral cavity [12, 13]; however, its role is debatable. The interaction of the HPV’s E6 and E7 oncoproteins with cell cycle proteins disturbs the cell cycle mechanism and subsequent alteration in the expression of proteins such as p53, p63, and Ki-67 [14]. In our case, the immunohistochemi...
OIN/CIS can sometimes be difficult to distinguish pathologically from epithelial dysplasia on hematoxylin- and eosin-staining sections; this has proved challenging for oral pathologists [9]. Recently, it has been reported that combined immunohistochemistry for k13 and k17 was useful for the differential diagnosis [9, 10]. K13 is a marker for cellular differentiation toward prickle cells in normal ...
A 65-year-old woman was referred to our clinic with a tumor in the right lower gingiva. Her medical history included breast cancer without metastatic lesion, diabetes mellitus, hyperlipidemia, and hypertension. She had taken orally aspirin, amlodipine, pravastatin, and bepotastine for 2 years. She drank alcohol socially, but she had no history of tobacco smoking habit.
About 10 years prior to h...
Oral cancer ranks sixth among the malignancies in terms of worldwide prevalence, with more than 90% being pathologically squamous cell carcinoma (SCC) [1]. Oral SCC generally develops via multistep carcinogenesis. The squamous epithelium goes into irreversible change, including epithelial dysplasia and oral intra-epithelial neoplasia/carcinoma in-situ (OIN/CIS) [2], finally resulting in the develo...
In this case, prolonged peri-implant mucositis or peri-implantitis may have been a plausible risk factor for carcinogenesis.
Major risk factors for oral squamous cell carcinoma (SCC) are tobacco smoking, a betel quid chewing habit, and heavy alcohol consumption. However, around 15% of oral SCCs cannot be explained by these risk factors. Although oral SCC associated with dental implants is quite rare, there has been a recent gradual accumulation of reports about it. Here, we report a case of primary peri-implant oral int...
Fig. 1. Treatment strategies for OAF closure
Fig. 1. Treatment strategies for OAF closure
Author year
No. of participants
Method
Autogenous soft tissue flaps
Lin et al. 1991
16
...
Parvini, P., Obreja, K., Sader, R. et al. Surgical options in oroantral fistula management: a narrative review.
Int J Implant Dent 4, 40 (2018). https://doi.org/10.1186/s40729-018-0152-4
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Received: 14 August 2018
Accepted: 02 November 2018
Published: 27 December 2018
DOI: https://doi.org/10.1186/s40729-018-0152-4
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Not applicable.
Not applicable.
Puria Parvini, Karina Obreja, Robert Sader, Jürgen Becker, Frank Schwarz, and Loutfi Salti declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Karina Obreja.
Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University, Frankfurt, Germany
Puria Parvini, Karina Obreja, Frank Schwarz & Loutfi Salti
Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
Robert Sader
Department of Oral Surgery, Universitätsklinikum Düsseldorf,...
Not applicable
No funding to declare.
All data generated or analyzed during this study are included in this published article.
Waldrop TC, Semba SE. Closure of oroantral communication using guided tissue regeneration and an absorbable gelatin membrane. J Periodontol. 1993;64:1061–6.
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Ogunsalu C. A new surgical management for oro-antral communication: the resorbable guided tissue regeneration membrane—bone substitute sandwich technique. West Indian Med J. 2005;54:261–3.
Goldman EH, Stratigos GT, Arthur AL. Treatment of oroantral fistula...
Joshi A, Kostakis GC. An investigation of post-operative morbidity following iliac crest graft harvesting. Br Dent J. 2004;196:167–71.
Misch CM. Harvesting of ramus bone in conjunction with third molar removal for onlay grafting before placement of dental implants. J Oral Maxillofac Surg. 1999;57:1376–9.
Nkenke E, Radespiel-Tröger M, Wiltfang J, Schultze-Mosgau S, Winkler G, Neukam FW. Morb...
El-Hakim IE, El-Fakharany AM. The use of the pedicled buccal fat pad (BFP) and palatal rotating flaps in closure of oroantral communication and palatal defects. J Laryngol Otol. 1999;113:834–8.
Singh J, Prasad K, Lalitha RM, Ranganath K. Buccal pad of fat and its applications in oral and maxillofacial surgery: a review of published literature (February) 2004 to (July) 2009. Oral Surg Oral Med O...
Awang MN. Closure of oroantral fistula. Int J Oral Maxillofac Surg. 1988;17:110–5.
Hynes W. Fistula in the hard palate following cleft surgery. Br J Plast Surg. 1957:377–84.
Genden EM, Lee BB, Urken ML. The palatal island flap for reconstruction of palatal and retromolar trigone defects revisited. Arch Otolaryngol Head Neck Surg. 2001;127(7):837–41.
Salins PC, Kishore SK. Anteriorly based...
Yilmaz T, Suslu AE, Gursel B. Treatment of oroantral fistula: experience with 27 cases. Am J Otolaryngol. 2003;24:221–3.
Borgonovo AE, Berardinelli FV, Favale M, Maiorana C. Surgical options in oroantral fistula treatment. Open Dent J. 2012;6:94–8.
Güven O. A clinical study on oroantral fistulae. J Craniomaxillofac Surg. 1998;26:267–71.
Amaratunga NADES. Oro-antral fistulae- a study of c...
Buccal fat pad
Bone graft transplantation
Connective tissue grafts
Free mucosal graft
Guided tissue regeneration
Oroantral fistula
Platelet-rich fibrin
By reviewing the literature, we can conclude that in selecting the surgical approach to close an oroantral fistula, different parameters have to be taken into account, including location and size of fistula as well as its relationship to the adjacent teeth, height of the alveolar ridge, persistence, sinus inflammation and the general health of the patient.
A small oroantral fistula of less than 5...
Logan and Coates described a procedure that provided closure of OAF in immunocompromised patients [74].
The oroantral fistula was de-epithelialized under local anesthesia, and the patient wore an acrylic surgical splint continuously for an 8-week period. The acrylic surgical splint covered the fistula and the edentulous area including the hard palate. The investigators reported complete healing o...
Use of guided tissue regeneration has been documented by Waldrop and Semba [71]. This method uses an absorbable gelatin membrane, allogenic bone graft material, and a nonresorbable expanded polytetrafluoroethylene (ePTFE) membrane. After flap reflection, an absorbable gelatin membrane is placed over the OAF with its edges on the bony margins of the perforation, which serve as a barrier for the bon...
The use of a bioabsorbable root analog made of β-tricalcium phosphate for closure of oroantral fistulas was proposed by Thoma et al. [68]. The root replicas were fabricated chair side, using a mold of the extracted tooth [10]. The investigators reported that the healing was uneventful. However, fragmentary roots or overly large defects prevent replica fabrication or accurate fitting of the analog...
Polymethylmethacrylate has been introduced as an alternative technique for closing OAFs [64]. After 24 h of immersion in a sterilizing solution, the polymethylmethacrylate plate is placed over the defect. Mucoperiosteal flaps are then replaced without attempting to cover the acrylic plate. The polymethylmethacrylate plate is removed as soon as the edges become exposed. One of the common disadvant...
Various synthetic materials have been used for OAF closures. Use of gold foil and gold plate for the closure of OAFs was reported for the first time by Goldman and Salman, respectively [59, 60]. It is a simplified technique for the closure of oroantral fistulas. The technique consists of elevating the mucoperiosteum to expose the bony margins of the fistula. Then, the opening is covered with an ov...
Multiple techniques have been described for the closure of OAFs using lyophilized fibrin glue of human origin [53]. In this technique, the fibrin glue is prepared and injected into the socket, together with the collagen sheet. Stajčić et al. stressed the importance of inserting the syringe above the floor of the antrum to protect the clot from airflow [53]. The technique is simple with few posto...
An autogenous bone graft and platelet-rich fibrin (PRF) membrane as a treatment strategy for closure of OAF has also been proposed [50]. PRF is a product of centrifuged blood. The biochemical components of PRF are well-known as factors acting synergistically in the healing process. This includes platelet-derived growth factor (PDGF), whose components are the reason why PRF has anti-inflammatory pr...
Recently, auricular cartilage graft has been used for the closure of OAFs. A full-thickness flap is raised at the defect site [47]. A semicircular incision is then made posteriorly over the conchal cartilage. The conchal cartilage with overlying perichondrium is exposed with a blunt dissection. The harvested auricular graft is then adapted on the defect site and sutured with the surrounding tissue...
A retromolar bone graft is a viable procedure for OAF closure. However, harvesting of a retromolar bone can occasionally be combined with removal of the third molar, which may affect acceptance of the procedure by patients [44]. When compared to chin bone grafts, the significant disadvantage of the retromolar donor area is the confined amount of bone available [45]. The incision is made medial to ...
The tongue is an excellent donor site for soft tissue defects of the oral cavity, due to its pliability, position, and abundant vascularity. Tongue flaps can be created from the ventral, dorsal, or lateral part of the tongue [36]. The surgical design of the flap is dictated by the location of the defect. A lateral tongue flap has been described as a suitable method for the closure of large OAF [37...
Free mucosal grafts (FMG) or connective tissue grafts (CTG) are suitable for the closure of small to moderate size defects in the premolar area as well as small to medium size-persistent defects. In contrast to the techniques described so far, the harvested grafts are not directly vascularized. The flap initially receives its nutrients within the first three postoperative days by diffusion alone, ...
The palatal straight advancement flap is of limited use due to the inelastic nature of the palatal tissue, which reduces its lateral mobility. For the same reason, it is suitable for the closure of minor palatal or alveolar defects [17].
The palatal hinged flap has been used successfully to close small fistula of the hard palate, i.e., those less than 2 cm in diameter in a one-stage operation [1...
Môczáir [14] described closing alveolar fistulas by the buccal sliding flap, shifting the flap one tooth distally. This technique produces only a negligible change in the depth of the buccal vestibule. A drawback of this approach is that it requires a large amount of dentogingival detachment in order to facilitate the shift, which may result in gingival recession and periodontal disease.
The fi...
A narrative literature review of articles and case reports for oroantral fistula has been conducted in the PubMed databases of published English literature. Articles published until April 2018 were reviewed. In addition to 262 articles on the closure of oroantral, 4 articles on the closure of antrooral fistula in humans, and 5 articles in animals, citations were referenced to identify further rele...
Radiologically, in the computed tomography (CT) or cone beam computed tomography (CBCT), the oroantral fistula might show as sinus floor discontinuity, opacification of the sinus, or communication between the oral cavity and the sinus. In addition, focal alveolar atrophy and associated periodontal disease may be observed [6]. In chronic OAF, there is generalized mucosal thickening. Recent studies ...
An oroantral fistula (OAF) can be defined as an epithelialized pathological unnatural communication between the oral cavity and the maxillary sinus [1]. The term oroantral fistula is used to indicate a canal lined by epithelium that may be filled with granulation tissue or polyposis of the sinus membrane [2]. They can arise as late sequelae from perforation and last at least 48–72 h. An oroantr...
Fig. 3. Treatability refers to OPG/CBCT and to residents in oral surgery and orthodontics
Fig. 3. Treatability refers to OPG/CBCT and to residents in oral surgery and orthodontics
Fig. 2. Accuracy of diagnostic answers given by residents in orthodontics (R right, F false, NS not sufficient)
Fig. 2. Accuracy of diagnostic answers given by residents in orthodontics (R right, F false, NS not sufficient)
Fig. 1. Accuracy of diagnostic answers from residents in oral surgery (R right, F false, NS not sufficient)
Fig. 1. Accuracy of diagnostic answers from residents in oral surgery (R right, F false, NS not sufficient)
Variable
p value
Odds ratio (95% CI)
Specialisation: oral surgery vs orthodontics
4 year
0.045*
...
Question pertaining to
OPG (%)
CBCT (%)
p value
Odds ratio (95% CI)
Contact to nerve
...
Question pertaining to
OS (%)
ORTH (%)
p value
Odds ratio (95% CI)
Contact to nerve
...
Case
Age (years)
Sex
Pathology
Time between OPG and CBCT
1
...
Resident
Age (years)
Sex
Specialisation
Experience as a dentist (years)
1
...
Radic, J., Patcas, R., Stadlinger, B. et al. Do we need CBCTs for sufficient diagnostics?-dentist-related factors.
Int J Implant Dent 4, 37 (2018). https://doi.org/10.1186/s40729-018-0147-1
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Received: 06 July 2018
Accepted: 08 October 2018
Published: 16 November 2018
DOI: https://doi.org/10.1186/s40729-018-0147-1
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
The study was approved by the cantonal ethics committee of the canton of Zurich (KEK 2016-00070).
Not applicable
Josipa Radic, Raphael Patcas, Bernd Stadlinger, Daniel Wiedemeier, Martin Rücker and Barbara Giacomelli-Hiestand declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Barbara Giacomelli-Hiestand.
Clinic of Cranio-Maxillofacial and Oral Surgery, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
Josipa Radic, Bernd Stadlinger, Martin Rücker & Barbara Giacomelli-Hiestand
Clinic for Orthodontics and Paediatric Dentistry, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
Raphael Patcas
Statistical S...
Ren H, Chen J, Deng F, Zheng L, Liu X, Dong Y. Comparison of cone-beam computed tomography and periapical radiography for detecting simulated apical root resorption. Angle Orthod. 2013;83(2):189–95. https://doi.org/10.2319/050512-372.1 published Online First: Epub Date]|.
Tantanapornkul W, Okouchi K, Fujiwara Y, Yamashiro M, Maruoka Y, Ohbayashi N, et al. A comparative study of cone-beam comput...
Hasani A, Ahmadi Moshtaghin F, Roohi P, Rakhshan V. Diagnostic value of cone beam computed tomography and panoramic radiography in predicting mandibular nerve exposure during third molar surgery. Int J Oral Maxillofac Surg. 2017;46(2):230–5. https://doi.org/10.1016/j.ijom.2016.10.003 published Online First: Epub Date]|.
Alqerban A, Jacobs R, Fieuws S, Willems G. Comparison of two cone beam comp...
Mason C, Papadakou P, Roberts GJ. The radiographic localization of impacted maxillary canines: a comparison of methods. Eur J Orthod. 2001;23(1):25–34.
Maverna R, Gracco A. Different diagnostic tools for the localization of impacted maxillary canines: clinical considerations. Prog Orthod. 2007;8(1):28–44.
Neves FS, Passos CP, Oliveira-Santos C, Cangussu MC, Campos PS, Nascimento RJ, et al. C...
Three-dimensional
Cone beam computed tomography
Digital Imaging and Communications in Medicine
Orthopantomography
Odds ratio
Resident in orthodontics
Resident in oral surgery
This study analysed (i) whether pathologies are accurately diagnosed in three different imaging modalities (OPG, CBCT, 3D model). Diagnostic accuracy was decent with OPG and was improved with CBCT. Next, the study assessed (ii) whether each case was classified as treatable on the basis of the present imaging modality. This result was influenced by the professional background, which influenced whet...
Certain limitations affect the generalizability of this study’s results. First, only nine cases were assessed with a limited range of pathologies (five retained teeth (canines and molars), two tooth resorptions, one odontoma and one supernumerary tooth). Moreover, the assessment was performed by a small amount of residents of the local university. The fact that all residents shared a similar aca...
In 81.6% of the cases, further imaging was requested after the OPG. Caution should be applied in the interpretation of this number, as the residents’ decision was theoretical and did not imply additional costs or radiation exposure. Nevertheless, it is striking that in the majority of the cases, further imaging was requested. One possible explanation might be the diagnostic difficulty of the cho...
Moreover, another valuable and novel observation is the divergence seen in the importance of printed 3D models. For residents in oral surgery, printed 3D models caused more uncertainties and led to a decrease of diagnostic accuracy (if assessed in sequential order after OPG and CBCT). In contrast, residents in orthodontics seemed to benefit of an additional assessment of printed 3D models, which r...
The aim of this study was twofold: (i) to analyse the diagnostic accuracy of pathologies in three different imaging modalities of the same case and (ii) to analyse the need for further imaging in order to enable treatment. Further, aspects like the impact of specialisation, gender and dental experience were analysed. In contrast to the plethora of scientific literature available dealing with CBCT ...
Overall, the majority of the questions were answered correctly, independently to the imaging modality. The percentages of correct answers given by OS were 66.3% for OPG, 83.4% for CBCT and 76.4% for 3D model; and differed slightly to those given by ORTH with 63.7% for OPG, 78.0% for CBCT and 78.7% for 3D model (Figs. 1 and 2). Both OS and ORTH alike answered to around 20% of the questions that th...
Statistical analysis and plots were performed using the statistical software R [12]. To evaluate the differences in the proportions of correct diagnostic answers between OS and ORTH and between different imaging modalities, Fisher’s exact tests were used and odds ratios (OR) including confidence intervals (CI) were computed for every question separately. Likewise, Fisher’s exact tests were app...
Each resident was shown the region of interest to which the questions related to
Allowed setup change of OPG: zoom
Allowed setup change of CBCT: brightness, contrast, zoom, scroll in all three levels (coronal, axial and sagittal
3D model: no restrictions
The OPGs of this study were taken either in-house (CRANEX D, Kw73, 10 mA) or extramural. All CBCTs were taken at the Centre of Dental Medici...
Fourteen residents were recruited for this survey [7 residents in oral surgery (OS) and 7 residents in orthodontics (ORTH), respectively; m = 6, f = 8]. Their characteristics are listed in Table 1. Every resident assessed individually nine separate patient cases, each containing a distinct dentoalveolar pathology, as defined in the study planning process (Table 2).
For each patient case...
Finally, the request for a CBCT should always be guided by the pursuit of improved diagnostic accuracy and the prospect of an enhanced treatment plan. Preferably, the indications for a CBCT should be based entirely on case-related factors. Yet, dentist-related factors might influence the request for a CBCT as well.
The aim of this study was therefore (i) to assess whether pathologies are accurate...
Along with the clinical examination, radiological imaging is essential for a complete diagnosis in dental medicine [1, 2]. Orthopantomography (OPG), a two-dimensional panoramic radiograph, is widely used across all dental disciplines including oral surgery and orthodontics [3,4,5] to address basic diagnostic queries. An OPG contains an abundance of information on the teeth, mandible, maxilla, incl...
The aim of this study was to assess the diagnostic accuracy of various dentoalveolar pathologies based on panoramic radiography (OPG), cone beam computed tomography (CBCT) and printed 3D models in consecutive order; and to evaluate the impact of specialisation of residents in oral surgery (OS) versus residents in orthodontics (ORTH).
Fourteen residents were recruited to evaluate nine selected cas...
Fig. 8. PPD on natural teeth. No significant differences appreciable
Fig. 8. PPD on natural teeth. No significant differences appreciable
Fig. 7. PPD on dental implants. No significant differences appreciable
Fig. 7. PPD on dental implants. No significant differences appreciable
between 1 month and 3 months, the test group values decrease during all the duration of the study
Fig. 6. BoP on natural teeth. While the control group shows a mild increase between 1 month and 3 months, the test group values decrease during all the duration of the study
Fig. 5. BoP on dental implants. It can be observed how the values keep decreasing after 1 month only in the test group
Fig. 5. BoP on dental implants. It can be observed how the values keep decreasing after 1 month only in the test group
Fig. 4. PI on natural teeth. After 1 month, the test group showed mild reduction while control a light improvement
Fig. 4. PI on natural teeth. After 1 month, the test group showed mild reduction while control a light improvement
Fig. 3. PI on dental implants. Test values keep reducing after 1 month while control maintains the same level
Fig. 3. PI on dental implants. Test values keep reducing after 1 month while control maintains the same level
Fig. 2. Patients’ population flow chart
Fig. 2. Patients’ population flow chart
Fig. 1. Electric toothbrush heads: on the left is the one designed for natural teeth, and on the right is the one designed for dental implants
Fig. 1. Electric toothbrush heads: on the left is the one designed for natural teeth, and on the right is the one designed for dental implants
Baseline
1 month
3 months
T0
T1
T2
BoP implants, t...
Allocca, G., Pudylyk, D., Signorino, F. et al. Effectiveness and compliance of an oscillating-rotating toothbrush in patients with dental implants: a randomized clinical trial.
Int J Implant Dent 4, 38 (2018). https://doi.org/10.1186/s40729-018-0150-6
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Received: 12 April 2018
Accepted: 24 October 2018
Published: 10 December 2018
DOI: https://doi.org/10.11...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Not applicable
This study was conducted in compliance with the principles of the Declaration of Helsinki, and the approval of the ethics committee required for the study was obtained from the Ethics Committee of the IRCCS Ospedale Maggiore Policlinico di Milano, Fondazione Ca’ Granda. The procedures to be performed were explained in detail, and the patients signed the consent form.
Not applica...
Center for Edentulism and Jaw Atrophies, Maxillofacial Surgery and Dentistry Unit, Fondazione IRCCS Cà Granda – Ospedale Maggiore Policlinico, University of Milan, Via Commenda 10, 20122, Milan, Italy
Giuseppe Allocca, Diana Pudylyk, Fabrizio Signorino & Carlo Maiorana
Oral Surgery, Maxillofacial Surgery and Dentistry Unit, Fondazione IRCCS Cà Granda – Ospedale Maggiore Policlinico, Un...
Not applicable
The authors declare no funds for the research.
Mean data of PI, BoP, and PPD collected from 80 periodontal charts are shown in Table 1.
Berglundh T, Lindhe J. Dimension of the periimplant mucosa. Biological width revisited. J Clin Periodontol. 1996;23(10):971–3 PubMed PMID: 8915028.
Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res. 1991;2(2):81–90 PubMed PMID: 1809403.
Berglundh T, Abrahamsson I, Welander M, Lang NP, Lindhe J. Morp...
Quirynen M, De Soete M, van Steenberghe D. Infectious risks for oral implants: a review of the literature. Clin Oral Implants Res. 2002;13(1):1–19 PubMed PMID: 12005139.
Roos-Jansåker AM, Renvert S, Egelberg J. Treatment of peri-implant infections: a literature review. J Clin Periodontol. 2003;30(6):467–85 PubMed PMID: 12795785.
Ho HP, Niederman R. Effectiveness of the Sonicare sonic toothb...
Pjetursson BE, Lang NP. Prosthetic treatment planning on the basis of scientific evidence. J Oral Rehabil. 2008;35(Suppl 1):72–9. https://doi.org/10.1111/j.1365-2842.2007.01824.x PubMed PMID: 18181936.
Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res. 2008...
Bleeding on probing
Plaque index
Pocket probing depth
The oscillating-rotating toothbrush can be used for the plaque and bleeding control around both natural teeth and dental implants. It has also been shown how the toothbrush head designed for dental implant can be effective in plaque removing of the peri-implant tissues.
At the end of the present study, electric toothbrush groups showed plaque and bleeding values lower (PI and BoP on teeth) or at least without significative differences (BoP on implants) than the control group. These data may suggest how the use of electric toothbrush, associated to the dedicate heads, can be an effective method for plaque and bleeding reduction.
This 3-month study aimed to demonstrate the efficacy of an electric toothbrush in reducing plaque and gingival inflammation around dental implants and natural teeth. To better understand the different data collected around two different anatomical structures, we decided to collect data separately. Analyzing our results, it is possible to observe how the mean values for probing, bleeding, and plaqu...
The difference between the BoP recorded on dental implant sites at baseline and the end of the study showed statistical significance for both the test and control groups (P
Seventy-eight patients successfully completed the study (45 women and 33 men aged from 31 to 76 years old) (Fig. 2). Two patients of test group did not show up both at the first and second controls. No patients were excluded or showed complications or adverse reaction. Results are shown in Table 1. The average number of implants per patients was 4.8 ± 3.4 in the control group and 4.4 ±...
Mean scores of all clinical indices for each subject were calculated separately for dental implants and natural teeth. The final data analysis was performed for those subjects who completed the study. The Student’s t test and the Mann-Whitney U test were used to evaluate whether any statistically significant differences were present between the two groups at each time point, and the Wilcoxon sig...
The study was conducted between September 2015 and June 2017 at Implantology Department of Policlinic Hospital, University of Milan, Milan. It was designed as a monocentric randomized clinical study according to the STROBE criteria. Eighty patients who underwent dental implant rehabilitation were selected for this study. At the screening visit, subjects were asked to read and sign a written inform...
Dental implants became one of the most accepted treatments for the rehabilitation of partial or complete edentulism [1]. However, inflammatory processes may still occur due to the presence of the implant itself [2]. It is well known that peri-mucositis and peri-implantitis are strictly related to the presence of plaque on the surface of the implant-prosthetic complex, which lead respectively to th...
The aim of this randomized clinical trial was to assess the efficacy of an oscillating-rotating toothbrush in reducing plaque and inflammation around dental implants.
Eighty patients presenting dental implants were enrolled in this study and assigned randomly to two different groups: 40 patients in the test group and 40 in the control one. Each patient in the test group received an oscillating-ro...
Figure 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Figure 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Patient
Implant-localization (region)
Implant loss (+/−)
Buccal width of keratinized peri-implant gingiva (mm)
Buccal thickness of keratinized peri-implant gingiva (mm)
Pink Esthetic Score (PES)
Probing depth (mm) at four sites (mb, db, mo, do)
Bleeding on Probing (+/−) at four sites (mb, db, mo, do)
Peri-implant bone loss (mm)
Presence of peri-implant osteolysis (+/−)
...
Patient
Gender (m/f)
Age (years)
Implant localization (region)
Implant diameter (mm)
Implant length (mm)
Augmentation material
Prosthetic rehabilitation
1
f
50
32
3.5
13
HA + β-TCP
r.p
34
4.3
11
HA + β-TCP
r.p
42
3.5
13
HA + β-TCP
r.p
44
4.3
11
HA + β-TCP
r.p
2
m
61
36
3.5
11
HA + β-TCP
...
Abbreviations
β-TCP:
β-tricalcium phosphate
BOP:
Bleeding on probing
F.P.:
Fixed prosthetics
GBR:
Guided bone regeneration
HA:
Hydroxyapatite
MNGCs:
Multinucleated giant cells
PES:
Pink Esthetic Score
R.P.:
Removable prosthetics
References
Gurgel BC, Montenegro SC, Dantas PM, Pascoal AL, Lima KC, Calderon PD. Frequency o...
Comparing the present results to the aforementioned study with the same implant system on immediately placed implants, it seems that the GBR augmentation procedure has no influence on the long-term stability of the implants. In both studies with different placement modalities and protocols, comparable clinical and radiological results were achieved. This leads to the assumption that the inve...
The tissue reaction, however, did not only differ in bone substitute materials of different origin but also in bone substitute materials of the same origin. In an in vivo trial, two xenogeneic bone substitute materials processed with different techniques were implanted subcutaneously in CD-1 mice for up to 60 days. Both bone substitute materials showed good integration within the peri-impla...
Discussion
In the present retrospective study, C-Tech bone level implants placed simultaneously with a GBR procedure around the implant shoulder were investigated clinically and radiologically after at least 3 years of loading to assess peri-implant tissue conditions and document peri-implant tissue stability.
A total of 47 implants were placed in the upper (23 implants) and lower jaw (24...
Results
Altogether, 47 implants were placed in the upper and lower jaws of a total of 20 patients. In all implants, lateral augmentation in a GBR process was performed simultaneously with implant placement due to reduced horizontal or vertical height of the alveolar crest. A total of 23 implants were placed in the upper jaw and 24 implants in the lower jaw. The implant diameter varied between 3...
C-Tech implant system
In the present retrospective study, bone level implants (C-Tech Esthetic Line implants) were investigated clinically and radiologically. The bone level implant system has a Morse-locking conical implant-abutment connection with platform switching and an indexing hex that allows subcrestal implant placement and aims to prevent peri-implant bone loss. The surface of the implan...
Methods
Patient population
In the present retrospective study, 47 dental implants (C-Tech Esthetic Line implants) from 20 patients (11 female, 9 male) with a mean age of 58.5 years (45–75 years) were analyzed clinically and radiologically. Implant placement and follow-up investigation was performed at the HL Dentclinic in Baden-Baden, Germany. The study was approved by the ethics commissio...
Regarding the stability of peri-implant hard and soft tissue, biological or anatomical factors are not the only elements that could be proven to have an impact. Technical factors such as the implant-abutment connection are also known to be key factors for long-term stable hard- and soft-tissue health [11]. Regarding the implant-abutment connection, which seems to be the key issue, located on the i...
However, in most patients, the local bone amount is reduced due to atrophy, inflammatory processes, or resectional defects. Therefore, in the past few years, different techniques have been described to enlarge the local bone amount in prospective implant sites [7]. Besides methods such as GBR or the sinus augmentation technique, different augmentation materials have been investigated and establish...
Background
The prevalence of peri-implantitis has grown in the past few years and has become a major issue in implant dentistry. Long-term stable and healthy soft- and hard-tissue conditions should be achieved in combination with esthetically and functionally satisfying results. However, the rising number of placed implants in the past decades has come with an increase in the prevalence of ...
Investigation of peri-implant tissue conditions and peri-implant tissue stability in implants placed with simultaneous augmentation procedure: a 3-year retrospective follow-up analysis of a newly developed bone level implant system
Abstract
Background
Guided bone regeneration (GBR) has been proven to be a reliable therapy to regenerate missing bone in cases of atrophy of the alveolar crest. T...
Figure 17. The appearance of the case shown in Fig. 16 with the polythene “washer” removed at 2 weeks post-surgery, providing access to the zygomatic oncology implants
Figure 15. Facial appearance 18 months following treatment
Figure 15. Facial appearance 18 months following treatment
Figure 14. Intra-oral view of perforated flap 3 weeks following radiotherapy
Figure 13. Panoramic dental radiograph showing the position of the zygomatic implants and the seating of the initial fixed prosthesis
Figure 12. Provisional acrylic fixed dental prosthesis fitted at 4 weeks post-surgery
Figure 11. Intra-oral view of the soft tissue flap at 3 weeks post-operatively with overgrowth of flap over the zygomatic oncology implants
Figure 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments
Figure 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments
Figure 9. Inter-occlusal registration using the pre-fabricated maxillary denture prosthesis relined with silicone putty over the implant abutment protection caps
Figure 8. Abutment level impression utilising light-cured acrylic tray material
Figure 7. Conventional zygomatic implant insertion on the non-defect side of the maxilla following extraction of the remaining teeth and an alveoloplasty
Figure 6. Zygomatic oncology implants sited in the residual zygomatic bone on the defect side of the maxilla
Figure 5. Left-sided maxillary resection (Brown class 2b)
Figure 4. Panoramic dental radiograph showing dental status at presentation
Figure 3. Staging CT scan confirming maxillary destruction but preservation of the orbital floor
Figure 2. Staging MRI scan showing destructive lesion left maxilla
Figure 1. Clinical view of left-sided maxillary tumour at presentation
Table 1 Patient-reported quality of life outcomes following ZIP flap procedure
From: The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy
Domain
Score
Activity
100 (“I am as active as I have ever been”)
Anxiety
100 (“I am not anxious about ...
References
Okay DJ, Genden E, Buchbinder D, Urken M. Prosthodontic guidelines for surgical reconstruction of the maxilla: a classification system of defects. J Prosthet Dent. 2001;86(4):352–63.
Rohner D, Bucher P, Hammer B. Prefabricated fibular flaps for reconstruction of defects of the maxillofacial skeleton: planning, technique, and long-term experience. Int J Oral Maxillofac Impl...
Conclusions
The ZIP flap technique represents an innovative approach to the management of patients presenting with low-level malignant maxillary tumours. It provides effective closure of the resulting maxillary defect restoring speech and swallowing functions and also establishing a high-quality fixed dental rehabilitation in a rapid timescale, thus facilitating a more timely return to function...
Immediate/early loading of zygomatic [8] and dental implants [9] have been well demonstrated already within the literature with very high implant survival rates. In the oncology setting, Boyes-Varley et al. [4] lost no zygomatic/oncology implants in their series of 20 patients restored with implant-retained obturators, 6 of whom received radiotherapy post-operatively. The case reported...
The use of soft tissue flaps to close a typical hemi-maxillectomy defect is an effective way of dealing with the oro-nasal communication, but in isolation, this technique works against dental rehabilitation as the bulk of the flap provides a very poor moveable foundation for a subsequent removable prosthesis. The move towards the use of composite reconstruction (especially the fibula flap) h...
Discussion
In order to reduce intra-operative time, the soft tissue free flap is harvested at the same time as the implant placement and prosthodontic procedures. On raising a skin island, it is appropriate to make it a little over-sized for the required defect to ensure that tension and possible dehiscence at the surgical margins during healing is reduced.
In low-level maxillectomy (Brown...
Procedural modifications to the ZIP flap technique
In order to address some of the issues highlighted in this early case, the technique was modified slightly to try and prevent flap overgrowth and prosthesis fracture in the early stages. In order to prevent flap overgrowth over the zygomatic oncology implant abutments, the use of a polythene washer was instituted on subsequent cases treated in th...
The radial forearm free flap (RFFF) was then disconnected from the arm and inset into the maxillary defect after creating a tunnel down into the left neck for the pedicle. The flap was carefully perforated over the zygomatic implant abutment protection caps using a short incision just through the skin layer followed by blunt dissection to allow the abutment and cap to perforate the flap ensuring a...
The ZIP flap technique
The patient underwent tracheostomy, a limited left-sided selective neck dissection for node sampling and vessels preparation. The maxillary tumour was excised in a standard manner via an intra-oral approach with preservation of the left orbital floor (Fig. 5). The resection extended to the maxillary alveolar midline in the incisor region with extension posteriorly just into...
Case presentation
A 66-year-old male patient presented with an enlarging mass in the left maxilla (Fig. 1). The mass had been present for a few weeks. An incisional biopsy revealed squamous cell carcinoma. Staging scans were undertaken (Fig. 2) which demonstrated a T4N0M0 maxillary alveolus tumour in close proximity to the left orbital floor with obliteration of the maxillary antrum and destruc...
Background
The surgical management and prosthodontic rehabilitation of the maxillectomy patient is complex with a variety of options available to the head and neck cancer team ranging from simple prosthodontic obturation [1] to reconstruction using pre-fabricated or digitally planned composite flaps [2] with or without the placement of osseointegrated implants [3]. The primary aims of treatment...
The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy
Abstract
This aim of this report is to describe the development and evolution of a new surgical technique for the immediate surgical reconstruction and rapid post-operative prosthodontic rehabilitation with a fixed dental prost...
Item
Mean ± SD pre-operative
Mean ± SD post-operative
Mean ± SD in the last time
Have you felt pain in your mouth?
0.9 ± 1.1
1.2 ± 1.0
0.3 ± 0.6
Have you had difficulties with your mouth opening?
0.2 ± 0.6
0.5 ± 0.9
0.1 ± 1.0
Have you had painful gums?
0.9 ± 1.0
1.0 ± 1.1
0.5 ± 0.8
Have you had a ...
Item
Mean ± SD before sinus lift
Mean ± SD after sinus lift
p value
Have you felt tense because of problems with your teeth, mouth or dentures?
1.8 ± 1.1
0.8 ± 1.0
Item
Mean ± SD before sinus lift
Mean ± SD after sinus lift
p value
Have you had difficulty chewing any foods?
1.6 ± 1.2
0.4 ± 0.7
Figure 5. Total score for physical and psychological disabilities before (gray) and after (hatched) sinus augmentation according to indications
Figure 4. Total score for functional limitations before (gray) and after (hatched) sinus augmentation according to indications
Figure 3. Total score for complaints due to surgical procedure pre-operative, post-operative, and recently
Figure 2. Cumulative survival rate according to Kaplan–Meier and sinus augmentation procedure
Figure 1. Flow chart of patients included in the study
Figure 1. Flow chart of patients included in the study
References
Al-Nawas B, Schiegnitz E. Augmentation procedures using bone substitute materials or autogenous bone—a systematic review and meta-analysis. Eur J Oral Implantol. 2014 Summer;7 Suppl 2:S219-34.
Derks J, Hakansson J, Wennstrom JL, Tomasi C, Larsson M, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: early and late implant loss. J Dent Res. 2015;94(...
The authors concluded that in clinical decision-making regarding donor site for bone graft harvesting, patients and clinicians should consider expected decrease in HRQoL if deciding to use extra-oral donor sites. Therefore, the authors recommended to prefer intra-oral donor sites whenever possible. In a recent study of Nickenig et al., OHIP-G 21 was evaluated in 8689 patients with variou...
In this prospective study, health-related quality of life questionnaire was given to 76 patients evaluating patient perception of recovery in the four areas pain, oral function, general activity, and other symptoms. The results showed that average and maximal pain peaked on post-operative day 1 and improved on post-operative days 4 and 5. Difficulty in mouth opening was greatest on pos...
Discussion
The clinical and radiological outcomes of sinus augmentation procedures have been published in several studies. However, little data on the physical and psychological impact of this procedure on the patient is available yet. The present study evaluated pre-operative and post-treatment OHRQoL self-assessment scores of patients treated with dental implants after sinus augmentation ...
In the subcategory physical and psychological disabilities, all questions had significant better values after the sinus lift (p
Results
Survival analysis
After an average time in situ of 41.2 ± 27 months (3.4 years; range 0–96 months), 40 of the 863 implants were lost. These results indicated an in situ rate of 95.4%. One-year and five-year survival rate according to Kaplan–Meier were 95.4 and 94.4%. In patients receiving an external sinus lift an in situ rate of 95.1% and in patients with an internal sinus...
Methods
Study design and subjects
This retrospective study addresses the oral health-related quality of life after maxillary sinus augmentation. Therefore, all patients that received an implantation after maxillary sinus augmentation in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between July 2002 and December 2007 were included in this stu...
Background
Rehabilitation of completely and partial edentulous patients with dental implants has proved to be a safe and predictable procedure. However, reduced bone height and the proximity of the maxillary sinus are challenging limitations for dental implant placement in the posterior maxilla. Besides the use of short and tilted implants, one of the most frequently used surgical techniques fo...
Abstract
Background
The aim of this study was to measure the oral health-related quality of life (OHRQoL) after maxillary sinus augmentation to determine the physical and psychological impact of this procedure for the patient.
Methods
Three hundred sixteen patients treated with an external or internal maxillary sinus augmentation and a total of 863 implants in the Department of Oral and Maxi...
Figure 9. a Mandibular implant-fixed prosthesis inserted into the mouth.
Figure 8. Periapical radiographs of the implants. a Postoperative, 1 year. b Postoperative, 16 years
Figure 7. a Intraoral photograph. b Gold Dolder bar and screws; marked wear of a prosthetic screw (arrow)
Figure 6. a Mandibular implant-supported overdenture inserted into the mouth. b Panoramic radiograph after insertion of the prosthesis
Figure 3. Photomicrographs of the biopsy specimen showing the intermingling of (a), (b), and (c). a Moderately differentiated epidermoid tumor cells with a duct-like structure (hematoxylin and eosin [H&E], original magnification × 100). b Intermediate cells (H&E, original magnification × 100). c Clear cells (H&E, original magnification × 100)
Figure 4. a Intraoperative photograph of resection of the alveolar ridge and bilateral upper neck dissection. b Transplantation of a lateral tongue flap to cover the alveolar ridge defect. c Surgical specimen
Figure 2. Panoramic radiograph showing notable alveolar bone resorption in the left mandibular premolar region and slight resorption in the right mandibular canine region (arrows)
Figure 1. Intraoral photograph showing diffuse tumor formation on the alveolar gingiva (arrows)
We inserted an implant-supported overdenture on a gold bar retainer splinting four implants. However, the patient was not satisfied with this prosthesis because of the mucosal pain and discomfort that developed over time. In such cases, prosthetic loading of atrophic mucosa is often not well tolerated. As such, we proposed replacement with an implant-fixed prosthesis. Initially, the patient ...
Conclusions
Prosthetic rehabilitation of edentulous patients after surgical management of oral cancer is difficult and therefore often avoided. However, adequate prosthetic rehabilitation is a pivotal factor for patients to regain oral function. In terms of the masticatory rehabilitation of these patients, the application of a removable prosthesis unsupported by implants may be difficult or...
However, she was not satisfied with the prosthesis; she experienced denture discomfort and developed a decubital ulcer in the tongue flap area, and she gradually ceased use of the denture. The patient was followed for more than 10 years on a regular basis to examine recurrence or metastasis of the gingival carcinoma. Mild erythema and swelling of the mandibular and implant-surrounding mucosa secon...
Case presentation
A 16-year-old female patient developed slight tenderness of the gingiva in the left mandibular premolar region, and her dentist referred her to our clinic in April 1992. Oral examination showed erythematous granular swellings that bled easily on the alveolar gingiva involving the area extending from the right second premolar to the left second molar (Fig. 1). The lesion showed...
Background
Surgical treatment of oral cancer may lead to significant disability, including facial deformity, loss of hard and soft tissue, and impaired function of speech, swallowing, and mastication. Bone resection because of surgical treatment of a large mandibular tumor can cause long-term defects. Rehabilitation with a removable prosthesis can be difficult or impossible due to the distorted...
Dental implant treatment in a young woman after marginal mandibulectomy for treatment of mandibular gingival carcinoma: a case report
Abstract
Dental implants play an important role in postoperative rehabilitation after surgical treatment of oral cancer through the provision of prosthetic tooth replacement. Two major implant prosthesis designs are available: fixed implant-supported prostheses ...
Figure 21. A dental class I occlusion was established only on the right side (lateral aspect)
Figure 20. The left side could not be restored to an ideal class I relationship from the original class II due to the pontic prosthesis
Figure 19. A full-mouth frontal aspect
Figure 18. OPT after prosthodontic finalization
Figure 17. Implants were used for implant-retained prostheses (abutment-cemented crowns), and a three-unit fixed partial denture pontic (crowns 25–27) was placed
Figure 16. After orthodontic treatment was completed, the prosthodontic phase took place
Figure 15. All implants received immediate healing screws
Figure 14. Implants placement after site preparation
Figure 13. Implant site preparation: OP5, IM2, OT4, and IM3 (correctly in sequence)
Figure 12. The total width flap was sutured
Figure 11. A mesiobuccal root surface exposure of element 16 required bone regeneration through Bio Oss and bone chip application
Figure 10. A triangular-shaped corticotomy was performed with inserts OT7 0.55 mm and OT7 special 0.35 mm to accelerate orthodontic tooth movements
Figure 9. A microsurgical corticotomy was mandatory to assist orthodontic tipping and intrusion of elements 16 and 17
Figure 8. Orthodontic bracket placement: left side view
Figure 7. Ortodontic bracket placement: right side view
Figure 6. Orthodontic bracket placement: frontal view
Figure 5. The panoramic radiography and cephalometric analysis revealed a partially edentulous mandible
Figure 4. The panoramic radiography and cephalometric analysis revealed a partially edentulous mandible
Figure 3. Some metal ceramic crowns in the upper left maxillary arch with a very poor esthetic appearance
Figure 2. Initial lateral intraoral aspect
Figure 1. Initial frontal intraoral aspect
A number of reports have indicated that orthodontic treatment can improve the periodontal situation in patients with pathologic migration by providing good function and improved esthetics after realignment.
It is generally recommended that orthodontic treatment should be preceded by periodontal therapy. In fact, orthodontic treatment when there is an inflammation/periodontal...
Discussion
The management of an anterior deep bite requires adequate treatment planning, especially if the clinical condition is associated with posterior DVO (vertical occlusion dimension) reduction due to multiple missing teeth. A multidisciplinary planning approach, including orthodontics, oral and periodontic surgery, and restorative dentistry, has an important role in t...
This was a preliminary stage before the first surgical corticotomy (performed with a piezo device).
A microsurgical corticotomy was mandatory to assist orthodontic tipping and intrusion of elements 16 and 17. This surgical procedure was performed by a piezo approach (Fig. 9).
A total width flap was elevated to make the cortical subapical and longitudinal bone cut possible. The ...
Case presentation
Diagnosis and etiology
A young female patient was referred to our dental clinic to resolve a malocclusion disorder due to missing teeth. She was unsatisfied with the functional aspect of her dentition. She had a second upper right molar very damaged by caries (17) (Figs. 1 and 2); it was also extruded due to missing antagonist teeth (I and II l...
A piezo surgery with corticotomies and implant placement as part of a multidisciplinary approach to treat malocclusion disorder in an adult patient: clinical report
Abstract
This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space and an anterior deep bite. The patient required orthodontics and surgic...
Pada dasarnya, membersihkan implant gigi sama seperti membersihkan gigi yamak Anda. Gampangnya, menyikat gigi, flossing, dan kumur-kumur pakai obat kumur setiap hari.
Tapi, karena gigi implant adalah gigi palsu buatan manusia, tetap ada yang butuh diperhatikan lebih daripada gigi jati. Partikel-partikel makanan dan bakteri bisa nyelip di derah sekeliling implant. Ini bisa marakken pembentukan pla...
Semua pasien yang baru masuk senden bisa punya kondisi kebersihan mulut yang buruk. Dalam kondisi semacam ini, layanan oral hygiene (kebersihan mulut) bisa diperlukan bila memang diperlukan, sekurang-kurangnya empat jam sekali, bisa lebih sering.
Indikasi untuk layanan oral hygiene meliputi pasien dengan karakteristik sebagai berikut:
Pasien yang mengalami demam tinggi atau hyper-pyrexia.
P...
Pasien mudah didiagnosis menderita gingivostomatitis primer dengan melihat gambaran klinis gejala umum yang pilah dan yang diikuti dengan:erupsi vesikel oralulkus oral simetris yang dangkalgingivitis marginal akutpasien tidak punya sejarah herpes kambuhanKarena infeksi virus HSV 1 mudah dikenali, maka tes laboratorium jarang digunakan. Tes laboratorium digunakan apabila infeksi virus HSV tidak ...
Cedera pada bagian mulut bisa dikarnakan oleh radiasi. Cedera karena radiasi dihasilkan dari efek ionisasi gelombang elektromagnetik atau partikel energi pada sel. Terapi radiasi umumnya digunakan untuk mengatasi kanker ganas pada kepala dan leher. Dalam proses menghilangkan jaringan yang sakit, jaringan oral yang normal di dalam atau dekat bidang yang sama juga dapat rusak tetapi biasanya pada t...