Charlie Connell | Dandy Lab https://www.meetdandy.com/author/charlie-connell/ Dandy is an all-in-one partner in digital dentistry. We are redefining the dental lab – so dentists can deliver the best clinical outcomes, delight patients and drive efficient growth for their practice. Fri, 23 Feb 2024 20:24:35 +0000 en-US hourly 1 https://wordpress.org/?v=6.9 https://www.meetdandy.com/wp-content/uploads/2022/10/cropped-Dandy_Favicon-2-32x32.png Charlie Connell | Dandy Lab https://www.meetdandy.com/author/charlie-connell/ 32 32 Zirconia restorations 101 for dentists https://www.meetdandy.com/learning-center/glossary/zirconia-restorations/ Fri, 23 Feb 2024 20:24:33 +0000 https://www.meetdandy.com/?p=17099 Zirconia crowns are a type of dental crown made from a strong and biocompatible material called zirconium oxide. They are becoming increasingly popular among dentists due to their advantages over other crown materials, such as porcelain and metal alloys. In this article, we will explore the topic of zirconia restorations and cover everything you need […]

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Zirconia crowns are a type of dental crown made from a strong and biocompatible material called zirconium oxide. They are becoming increasingly popular among dentists due to their advantages over other crown materials, such as porcelain and metal alloys. In this article, we will explore the topic of zirconia restorations and cover everything you need to know about them as a dentist. 

The history of Zirconia restorations

It’s been a little over 230 years since German chemist Martin Heinrich Klaproth discovered zirconium while analyzing the gemstone jacinth, and we have come a long way in understanding the element and finding uses for it. It wasn’t until the 1960s that zirconia started appearing in medical applications, with the metal being used in hip-joint replacements. During that same time, dentists experimented with zirconia, but the material lacked the proper strength and aesthetics. 

Then in the 1990s zirconia started becoming a more viable option for dentists with the development of Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP), a much stronger and more biocompatible form of zirconia. It was also at this time that CAD/CAM technology emerged, allowing for the precise milling required for zirconia crowns. 

In the early 2000s zirconia crowns started to gain popularity throughout dentistry, especially for the less visible teeth in the back of the mouth. Porcelain-fused-to-zirconia crowns (PFZ) combined the aesthetic value of porcelain with the strength of zirconia, making them suitable for front-of-the-mouth restorations. 

Continuous advancements in material science and technology have led to stronger and more translucent zirconia restorations, monocrystalline zirconia for greater strength and durability, and the amazing precision and efficiency that come with digitally designed and milled zirconia restorations. 

Today, zirconia crowns are a popular choice among dentists for their durability, biocompatibility, strength, and the minimal tooth reduction required during installation. 

What is zirconia material? 

Zirconia, also known as zirconium dioxide (ZrO2), is a ceramic material made of zirconium, a metallic element, and oxygen. It has been harnessed by dentistry for use in crowns, bridges, implants, and veneers due to its strength, aesthetics, and biocompatibility.

Dentists are able to make extensive use of zirconia in part thanks to the advancements in CAD/CAM technology. During the initial visit by the patient, the dentist is able to take digital impressions of the prepared tooth. Then the impressions are sent to the lab, where a tech uses CAD software to design the crown before sending the specs to a dental milling machine, which then precisely fabricates the crown from zirconia. 

Zirconia crown prep vs. other ceramic restorations 

The differences between zirconia crowns and other ceramic restorations start back in preparation. Let’s look at each step involved and compare zirconia crown preparations to other methods. 

Tooth removal

Zirconia: Requires minimal tooth removal due to its strength. It is suitable for situations where tooth structure preservation is a priority.

Other ceramics: The amount of removal varies depending on the material. Lithium disilicate (eMax) needs slightly more than zirconia due to its lower strength, while feldspar (porcelain) might require similar or even more removal.

Preparation technique

Zirconia: Similar to other ceramic crowns, involving enamel and dentin reduction to create space for the crown. It may involve chamfer or shoulder margins depending on the case.

Other ceramics: Similar techniques apply, but specific considerations might exist. Lithium disilicate may require specific bur designs due to its material properties and feldspar might require additional attention to margin integrity due to its potential for chipping.

Impression taking

All ceramics are similar, requiring highly accurate impressions (physical or digital) of the prepared tooth and surrounding area.

Lab work

Zirconia: Often utilizes CAD/CAM technology for precise milling from zirconia blanks. It can be monolithic (solid) or layered with porcelain.

Other ceramics: Lab procedures vary depending on the material. Lithium disilicate might involve pressing or milling techniques, while feldspar typically involves pressing.

Overall

Zirconia: Generally requires less tooth removal due to its strength. The lab process and construction benefits from advanced technology.

Other ceramics: Require slightly more tooth removal depending on the material. Lab procedures vary, with some potentially being less accurate than zirconia.

Zirconia crown cementation

After prepping the tooth and ensuring a perfect fit, the dentist secures the precisely designed zirconia crown onto it. They clean and condition the tooth, apply specific cement to both crown and tooth, carefully seat the crown, remove excess cement, and light-cure the bond. This crucial step, requiring special techniques for zirconia cementation, ensures a strong, aesthetically pleasing, and functionally optimal restoration.

Types of zirconia restorations

There are three main types of zirconia restoration, each offering its own advantages. Let’s take a look at each. 

Layered zirconia restorations

Layered zirconia restorations combine the best of both worlds: strength and aesthetics. A solid zirconia framework provides exceptional durability, especially for back teeth, while a thin layer of porcelain mimics the translucency and color of natural teeth, making them ideal for front teeth, creating what is known as a porcelain fused to zirconia crown (PFZ). This layering process requires skilled technicians and often involves digital design and milling for precise results. While potentially slightly more expensive than other ceramic options, layered zirconia restorations offer a strong, natural-looking, and biocompatible solution for long-lasting smile improvements.

Monolithic zirconia restorations

Monolithic zirconia restorations are exactly what they sound like—crowns crafted from only one material. Made entirely from solid zirconia, they boast exceptional strength and durability, making them ideal for back teeth that endure heavy chewing forces. By forgoing a delicate layer of porcelain, monolithic zirconia crowns minimize chipping concerns and simplify the process. While their natural zirconia color might not perfectly match front teeth, their impressive strength, biocompatibility, and minimal tooth removal requirements make them a popular choice for function and long-lasting restorations.

High translucent zirconia

High translucent or aesthetic zirconia crowns are the ultimate in modern tooth replacement innovation. They combine the exceptional strength of standard zirconia with a special formulation that lets more light through, achieving a level of translucency that closely mimics natural teeth. This makes them ideal for enhancing the aesthetics of front teeth, allowing natural light to play beautifully across the restoration. While not quite as strong as solid zirconia, they’re still highly durable and offer excellent biocompatibility, minimal tooth removal, and long-lasting, bright smiles.

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Reduction copings 101 for dentists https://www.meetdandy.com/learning-center/glossary/occusal-reduction/ Fri, 23 Feb 2024 20:24:15 +0000 https://www.meetdandy.com/?p=17100 A reduction coping is a temporary, thin shell, typically made of resin or metal, that a dental technician creates to guide the dentist in removing the correct amount of tooth structure when preparing a tooth for a zirconia crown or other restoration. Reduction copings help to ensure that the final restoration fits properly and has […]

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A reduction coping is a temporary, thin shell, typically made of resin or metal, that a dental technician creates to guide the dentist in removing the correct amount of tooth structure when preparing a tooth for a zirconia crown or other restoration.

Reduction copings help to ensure that the final restoration fits properly and has the correct thickness. They can also save time and money by eliminating the need for additional appointments or remakes. 

How to use a crown reduction coping

The workflow for using a crown reduction coping involves the following steps:

  • The dentist prepares the tooth, but leaves slightly more tooth structure than is necessary for the final restoration.
  • An impression of the prepared tooth is taken and sent to the dental lab.
  • The dental technician creates a replica of the prepared tooth.
  • The technician creates the reduction coping, which fits over the prepared tooth replica on the model.
  • The technician modifies the model removing the tooth structure through the opening in the coping, creating the exact space needed for the restoration.
  • The coping is sent back to the dentist with the completed restoration.
  • The dentist places the coping on the prepared tooth and removes any tooth structure that protrudes through the opening.
  • The dentist then cements the restoration onto the prepared tooth.

Reduction copings are a useful tool for dentists, but it’s possible to alleviate the need for them altogether with better crown preparation. Digital dentistry has revolutionized the process of dental restoration through the use of intraoral scanners which capture precise 3D images of the prepared tooth, eliminating the inaccuracies that can occur with physical impressions.

Detailed communication between the dentist and the lab technician can also help alleviate the need for reduction copings. Clear instructions regarding desired margins, crown material, and thickness can help guide accurate lab-fabricated restorations and potentially reduce the need for further tooth reduction.

Best practices for crown preparation 

Here are some best practices for zirconia crown preparation, aimed at achieving a successful and lasting outcome while minimizing the need for reduction copings:

Pre-operative evaluation

  • Thorough diagnosis and treatment planning: Clearly understand the reason for the crown, the patient’s expectations, and any potential complications.
  • Radiographic and clinical assessment: Evaluate tooth structure, root health, and surrounding tissues.
  • Discussion with the patient: Explain the procedure, risks, and benefits of different crown materials and preparation techniques.

Preparation technique

  • Conservative approach: Remove the minimum amount of tooth structure necessary for crown placement, considering material thickness and strength.
  • Clear and defined margins: Achieve smooth, well-defined margins for optimal adaptation of the crown and prevention of future leakage.
  • Smooth preparation surface: Avoid unevenness or scratches that could affect crown fit and aesthetics.
  • Proper reduction angles and chamfers: Follow material-specific guidelines for shoulder, chamfer, or feather-edge preparations to ensure crown retention and strength.
  • Adequate occlusal clearance: Provide enough space between the opposing teeth for a comfortable bite and proper function.
  • Minimize gingival manipulation: Handle gum tissue gently to avoid inflammation and potential complications.
  • Use of depth-limiting burs: Ensure precise tooth reduction within predetermined limits, reducing the risk of over-preparation.
  • Employ magnification loupes: Enhance visualization for improved control and accuracy.

Adjunctive procedures

  • Digital dentistry: Utilize intraoral scanners and CAD/CAM technology for precise impressions, virtual crown design, and potentially reduced tooth reduction.
  • Rubber dam isolation: Maintain a clean and dry operative field for optimal visibility and control.
  • Water cooling and air evacuation: Minimize heat generation and ensure clear visualization during tooth preparation.

Communication and collaboration

  • Clear communication with the dental lab technician: Provide detailed instructions regarding margins, crown material, thickness, and any specific requirements.
  • Consider using reduction copings: While striving for minimal reduction, reduction copings can still be valuable tools for complex cases or ensuring precise crown fit.

Post-operative care

  • Provide temporary crown: Protect the prepared tooth and maintain aesthetics while the permanent crown is being fabricated.
  • Educate the patient on proper hygiene: Explain how to care for the new crown and maintain oral health.
  • Schedule follow-up appointments: Monitor the crown fit, function, and overall oral health.

Tips to create adequate occlusal reduction

Creating adequate occlusal reduction involves achieving the right balance between preserving healthy tooth structure and ensuring enough space for the restoration. Here are some tips to help you achieve that balance:

Planning and preparation

  • Understand desired outcomes: Clearly define the restoration type, material, and aesthetic goals. This helps gauge the minimum reduction needed.
  • Preoperative assessment: Analyze radiographs, scans, and the tooth itself to estimate enamel and dentin thickness, pulp chamber location, and existing restorations.
  • Utilize depth gauges: Take pre-op measurements of existing occlusal clearance and desired restoration thickness to determine reduction target.
  • Mark reduction guidelines: Use temporary markers or depth cuts on the tooth surface to visualize the planned reduction.

Technique and precision

  • Start conservative: Begin with minimal reduction and gradually increase as needed. Remember, removing tooth structure is irreversible.
  • Use depth-limiting burs: These ensure precise and consistent reduction within predetermined limits, preventing over-preparation.
  • Follow material guidelines: Different materials have specific thickness requirements. Familiarize yourself with them for optimal restoration strength and durability.
  • Maintain smooth surfaces: Avoid unevenness or scratches that could disrupt crown fit and aesthetics.
  • Utilize magnification loupes: Enhanced visualization facilitates controlled and accurate reduction.

Considerations for different areas

  • Incisors: Focus on preserving aesthetics. Prioritize enamel reduction and minimize dentin exposure.
  • Canines: These require more occlusal clearance due to function. Balance preserving structure with providing enough space for the restoration.
  • Premolars and molars: Often require significant reduction due to larger cusps and increased chewing forces. Ensure adequate reduction of material thickness and proper occlusal function.

Additional tools and techniques

  • Digital dentistry: Intraoral scanners and CAD/CAM technology provide precise data for virtual crown design and accurate assessment of reduction needs.
  • Articulating paper and shims: Use them to visualize occlusal contacts and fine-tune reduction for even pressure distribution.
  • Bite registration: Capture dynamic jaw movements to guide crown design and ensure proper occlusion.

Remember, minimizing tooth removal while ensuring functional and aesthetic success is key. With careful planning, precise technique, and the right tools, you can create adequate occlusal reduction for a long-lasting and successful restoration.

Capturing occlusal clearance with digital dentistry

Here are some best practices for taking digital impressions with proper occlusal clearance:

Before you begin:

  • Inform the patient about the procedure and ensure they are comfortable and relaxed. Encourage them to avoid clenching or biting during the scan.
  • Choose a scanner with adequate resolution and depth of field to capture details of the prepared tooth and surrounding tissues.
  • Ensure the scanner is properly calibrated for optimal accuracy.
  • Evaluate the preparation margins, smoothness, and overall quality before scanning.
  • Measure existing occlusal clearance and mark reference points on the tooth to guide later assessment.

During the scan:

  • Cut down on excess light to remove the possibility of glare.
  • Dry the teeth and gums to reduce moisture in the mouth.
  • Use retraction cords and gently retract the gingival tissue for improved visualization and access during scanning. Retraction with dental lasers is not ideal but acceptable due to the risk of scarring and lack of mechanical traction.
  • Employ tongue and cheek retractors to maintain a clear field of view and prevent interference from soft tissues.
  • Capture the tooth from various angles, including occlusal, lingual, buccal, and interproximal views. Pay close attention to the preparation margins and interproximal spaces.
  • Occlusal clearance assessment: Utilize the depth gauge reference points and software tools to analyze and adjust the virtual model for proper occlusal clearance. This could involve using an articulator and articulating paper to physically verify and fine-tune the occlusal contacts in the digital model.

While digital impressions offer significant advantages, proper technique and attention to detail are crucial for capturing accurate occlusal clearance. Consider seeking training from experienced professionals to ensure optimal outcomes.

By following these best practices, you can confidently capture digital impressions with proper occlusal clearance for successful restorations. Most importantly, clearly communicate the desired occlusal clearance to the dental lab technician along with the digital impression.

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Why your patients should have you fit their sports mouth guard https://www.meetdandy.com/learning-center/articles/why-your-patients-should-have-you-fit-their-sports-mouth-guard/ Tue, 30 Jan 2024 18:00:18 +0000 https://www.meetdandy.com/?p=16962 Learn why you should add sports guards to your practice

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The number 1 reason most patients don’t get their sports mouth guards from their dentist is because they have no idea that their dentist fits mouth guards. From the dawn of time, young athletes have accompanied a parent to the sporting goods store to return home with a cumbersome mouth guard that they then attempt to fit over a boiling pot of water. There was no other option until recently.

Through remarkable advancements in sports mouth guard technology, dentists can scan, order, and fit guards for their patients. No matter the sport being played, a custom-fit mouthguard provided by a dentist makes the endeavor so much safer, particularly for younger athletes. 

Read on to see how you can incorporate sports mouth guards into your practice, how they are more beneficial to your patients, and what the digital dental workflow looks like for sports guards.

What are sports mouth guards?

Sports mouth guards, also known as simply sports guards, mouth protectors, or athletic mouth guards, are protective devices worn over the teeth during sports activities. They act as a cushion to absorb impact and shield your patient’s teeth, lips, and tongue from potential injuries. Wearing a custom sports guard protects athletes from more than just chipping or losing teeth; they can also prevent soft tissue injuries within the mouth as well as absorb shock to help prevent jaw injuries. The medical benefits are obvious, but the mental benefit of mouth guards for athletes can’t be overlooked as the layer of protection adds a little ease of mind during the heat of competition.

Athletes in all sports can benefit from wearing a sports mouth guard, not just those who play high-contact sports like hockey or football. One of the most prominent proponents of mouth guards has been Steph Curry of the Golden State Warriors. The All-Star guard chewing on his mouth guard is one of the more enduring images fans have of Curry, not unlike Michael Jordan sticking out his tongue during dunks. Curry’s mouthguard has even been the subject of controversy—he’s been ejected at least three times for tossing it in disgust. While we’re sure his dentist (and coach) would prefer if Curry kept the dental guard in his mouth—and please stop chewing on it—he’s popularizing the protective gear with younger athletes who want to be just like their idols. 

Boil and bite sports mouth guards

For years, boil and bite mouth guards have been the overwhelming standard in the industry as a popular and convenient option for protecting your teeth during sports activities. As the name suggests, they’re made from a thermoplastic material that softens when heated in hot water. This allows the athlete or a helper to mold the guard to their own dentition for a tight fit. These guards are available at most sporting goods stores, are one-size-fits-all (they need to be cut to fit smaller mouths), and are relatively cheap when compared to custom-fit mouth guards available at dental practices. 

While boil and bite mouth guards are affordable and convenient, they are not as precise as custom-fit sports guards nor are they as durable. They are a particularly poor option for people with braces or uneven teeth. These guards are certainly better than nothing, but the protection offered by a dentist-custom-fit mouth guard is far greater. 

Thermoformed sports guards

The integration of digital patient impression-making and thermoforming technology has entered into the realm of sports guards. This fusion has not only revolutionized the way dentists offer these protective mouthpieces but has also made them a more accessible and appealing option for athletes of all levels.

Digital impression-making systems, such as intraoral scanners, capture precise 3D models of a patient’s mouth. This eliminates the need for gooey impression materials, making the process far more pleasant and efficient for both the dentist and the patient.

Once the digital model is acquired, thermoforming technology comes into play. The model is used to create a custom mold, which is then heated and vacuum-formed around a high-quality material. This results in a perfectly fitting, comfortable, and highly protective sports guard tailor-made for the individual athlete’s mouth.

Thermoformed sports guard material

Laminated ethyl vinyl acetate, often shortened to EVA, is a versatile material made by combining ethylene and vinyl acetate monomers. Its properties can be tweaked by adjusting the ratio of these components, making it suitable for various applications. In the context of sports mouth guards, it plays a crucial role in offering protection and comfort. By layering the material it’s possible to create a guard that is durable, comfortable and safe. 

Why dentist-fitted sports mouth guards are superior to boil and bite mouth guards

Simply put, boil and bite mouth guards are useful for athletes, but in almost every regard a dentist-fitted sports guard is superior. The advances in technology combined with the benefits of having a guard produced under a dentist’s supervision simply leads to a superior product for the following reasons. 

  • The main benefit of boil-and-bite mouth guards—the ease with which they can be purchased and fit at home—is also their greatest flaw. The margin for error is enormous when the patient is fitting themselves, leading to a mouth guard that can be both ineffective and uncomfortable. It is far better to have a dental professional involved in the process. 
  • A dentist can make sure the patient is giving their true bite. People get self-conscious and tend to overthink it when biting into a boil-and-bite mouth guard. This can lead to an inaccurate mold. Under a dentist’s supervision, a patient can be coached to bite naturally, leading to far better results with the sports guard. 
  • If a patient has a misaligned bite, a dentist’s supervision can help ensure that the mouth guard accurately reflects this, something that a patient would likely not address with a boil and bite guard. 
  • Laminated ethyl vinyl acetate is a stronger material than the thin and brittle plastic used in many over-the-counter boil-and-bite mouth guards. 
  • Replacements are simple. With a digital scan already on the files, there is no need to rescan when it’s time for the patient to order a new mouth guard. Nor is there the hope that a patient will get the correct fit by undergoing the boil and bite process again. 
  • Store-bought mouth guards are not intended for athletes who are missing teeth or who have braces. A customized fit taken by a dental progressional will always be safer for the patient. 
  • Boil and bite mouth guards can have sharp corners, ride too high in the mouth, and pop out more easily during play. 

Discussing sports mouth guards with patients

When talking to your patients about sports mouth guards, and as covered above you need to introduce them to this service, the educational aspect is paramount. Talking points that put the two types of mouth guards into perspective are:

“When you are shopping for a fancy dress or a suit, do you measure yourself at home with a rope and a yardstick or do you go to a tailor?”

“Think of this as a piece of sports equipment, do you buy the cheapest or look for the best performer for the right value?”

The digital workflow for sports mouth guards with Dandy

The digital workflow for producing sports dental guards with Dandy couldn’t be simpler. All you need to do is scan the patient as you would for a night guard, select “sports guard” within the Dandy portal, select from an array of colors, and hit submit. That’s it. 

The process is even easier if you have recently scanned for a restorative and want to update the patient’s sports guard for the new landscape of their mouth. Simply add on a sports guard from the Dandy Chairside portal

If you are not currently working with Dandy but are looking to add digital dental offerings such as sports guards to your practice, contact us today and we can walk you through our full product guide.

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Composite veneers https://www.meetdandy.com/learning-center/glossary/composite-veneers/ Thu, 21 Dec 2023 18:37:21 +0000 https://www.meetdandy.com/?p=16677 Composite veneers are thin shells made of tooth-colored resin that are bonded to the front surface of a patient’s teeth to improve their appearance. They are a more affordable and less invasive alternative to porcelain veneers, and they can be used to correct a variety of cosmetic problems including staining, chips or cracks, and misaligned […]

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Composite veneers are thin shells made of tooth-colored resin that are bonded to the front surface of a patient’s teeth to improve their appearance. They are a more affordable and less invasive alternative to porcelain veneers, and they can be used to correct a variety of cosmetic problems including staining, chips or cracks, and misaligned teeth. 

Composite veneers materials

There are two main materials of composite veneers, each using a different type of resin.

  • Bisphenol A-glycidyl methacrylate (Bis-GMA): This is the most common type of resin used for composite veneers. It is a strong and durable material that can be bonded well to teeth. However, Bis-GMA can release small amounts of BPA, a chemical that has been linked to some health concerns.
  • Urethane dimethacrylate (UDMA): This is a newer type of resin that is less likely to release BPA (Bisphenol A) than Bis-GMA. It is also a strong and durable material, and it can be bonded well to teeth.

Other materials that may be used in composite veneers include:

  • Silica is a filler that helps to strengthen the composite resin and make it more resistant to wear.
  • Zirconium is another filler that is sometimes used in composite veneers. It is similar to silica, but it is stronger and more resistant to chipping.
  • Glass is sometimes used as a filler in composite veneers. It can help to make the veneers more translucent and give them a more natural appearance.

The specific materials used in composite veneers will vary depending on the manufacturer and the dentist’s preferences. However, all of the materials used in composite veneers are safe and effective.

Workflow for composite veneers

Applying composite veneers is a relatively simple, four-step process. 

  1. Consultation: During the consultation, the patient will discuss their goals for their smile with you. After an examination of the patient’s teeth and gums, it can be determined if they are a good candidate for composite veneers. You, the dentist will also determine which type of composite veneer is the most apt for the patient during the consultation.
  2. Veneer Preparation: On the day of the procedure, you will begin by preparing the patient’s teeth for the veneers by removing a thin layer of enamel to create space for the veneers and to ensure a good bond between the veneers and the teeth. 
  3. Application: Once the teeth are prepared, apply the composite resin to the front surface of the teeth. The resin will be sculpted to the desired shape and size, and it will be cured with a special light.
  4. Polishing: Once the resin is cured, polish the veneers to give them a natural shine. 

Direct composite veneers

Once known as “day savior fillings,” as they can be done in one patient visit, direct composite veneers have evolved into becoming reliable, durable and minimally invasive solutions for smile makeovers for the right patient. A study published by the National Library of Medicine showed that after two years direct composite ventures proved themselves to be one of the most promising treatment options for patients.

Direct composite veneers workflow

The workflow for direct composite veneers can be summarized in the following steps:

Preoperative evaluation and diagnosis

  1. Initial consultation: Gather patient’s history, expectations, and aesthetic concerns. Perform a thorough clinical examination to assess oral health, tooth alignment, and bite function.
  2. Diagnostic records: Take dental impressions (digital preferred), photographs, and radiographs to evaluate tooth structure, occlusion, and underlying bone support.
  3. Treatment planning: Discuss treatment options with the patient, considering factors such as patient preference, budget, and severity of aesthetic defects.

Tooth preparation and etching

  1. Anesthesia: Apply local anesthesia to the treatment area to numb the teeth and surrounding tissues.
  2. Rubber dam isolation: Place a rubber dam to isolate the treatment area, preventing saliva contamination and ensuring a dry field.
  3. Tooth preparation: Minimal enamel preparation is required to create a bonding surface for the composite resin. This involves using fine burs to remove a thin layer of enamel, typically 0.5-1.0 millimeter.
  4. Acid etching: Etch the enamel surface with phosphoric acid for 30 seconds to create microscopic pores, enhancing the adhesion of the composite resin to the tooth structure.

Bonding and layering composite resin

  1. Primer application: Apply a primer to the etched enamel surface to increase bonding strength.
  2. Adhesive application: Apply a thin layer of adhesive resin to both the tooth surface and the composite resin.
  3. Light curing: Polymerize the adhesive resin using a curing light to create a strong bond between the tooth and the composite resin.
  4. Composite resin layering: Build up the composite resin in incremental layers, starting with an opaque dentin shade to mask the underlying tooth color.
  5. Coloration and characterization: Use different shades and translucency levels of composite resin to create natural-looking tooth contours, mamelons, and incisal edges.
  6. Additional light curing: After each layer of composite resin is placed, it is carefully cured with a curing light to ensure proper polymerization and prevent premature bonding failure.

Finishing and polishing

  1. Initial shaping: Use fine diamond burs or carbide burs to shape the composite resin into the desired tooth anatomy.
  2. Finishing: Refine the surface texture of the composite resin using polishing discs and polishing strips to achieve a smooth and natural-looking finish.
  3. Occlusal adjustment: Evaluate and adjust the occlusion to ensure proper bite function and prevent premature tooth wear.
  4. Final polishing: Apply polishing paste with a polishing wheel to achieve a high-gloss finish that mimics the natural shine of enamel.

Postoperative care and follow-up

  1. Postoperative instructions: Provide the patient with postoperative care instructions, including dietary recommendations and oral hygiene guidelines.
  2. Follow-up appointments: Schedule follow-up appointments to monitor the healing process, evaluate the aesthetics and function of the veneers, and provide any necessary adjustments or maintenance.

Direct composite veneers indications

  • Mild to moderate tooth discoloration: Composite veneers can effectively mask tooth discoloration caused by tetracycline staining, fluorosis, or mild general staining.
  • Minor tooth misalignment: Direct composite veneers can be used to correct minor tooth misalignment, such as crowding, spacing, or mild rotations.
  • Chipped or fractured teeth: Composite veneers can restore the aesthetics and function of chipped or fractured teeth, especially in the anterior region.
  • Abraded or eroded teeth: Direct composite veneers can protect abraded or eroded teeth from further wear and enhance their appearance.
  • Diastemas: Composite veneers can effectively close diastemas, which are gaps between teeth.
  • Aesthetic contouring: Direct composite veneers can be used to improve the overall appearance of teeth by modifying their shape, size, and contour.

Direct composite veneers contraindications

  • Severe tooth discoloration: Direct composite veneers may not be able to adequately mask severe tooth discoloration caused by factors such as endodontic treatment or extensive metallic restorations.
  • Significant tooth misalignment: For moderate to severe tooth misalignment, orthodontic treatment is often a more appropriate option.
  • Major tooth wear or loss of tooth structure: Direct composite veneers may not be strong enough to restore teeth with significant wear or loss of tooth structure.
  • Poor oral hygiene: Patients with poor oral hygiene are at increased risk of composite veneer fracture or failure.
  • Bruxism: Patients with bruxism, or excessive grinding of teeth, may require protective nightguards to prevent damage to the composite veneers.
  • High bite forces: Direct composite veneers may not be suitable for patients with high bite forces, especially in the posterior region.
  • Unrealistic expectations: Patients should have realistic expectations about the aesthetic outcome of direct composite veneers.
  • Allergy to composite resin materials: Patients with a known allergy to composite resin materials should not undergo this procedure.

Indirect composite veneers

Indirect composite veneers are a type of cosmetic dental restoration that is used to improve the appearance of teeth. They are made from a composite resin material that is layered onto a model of the patient’s teeth. The veneers are then bonded to the teeth, providing a durable and natural-looking restoration.

Indirect composite veneers workflow

The workflow for indirect composite veneers typically involves the following steps:

Preoperative evaluation and diagnosis

  1. Initial consultation: Gather the patient’s history, expectations, and aesthetic concerns. Then perform a thorough clinical examination to assess oral health, tooth alignment, and bite function.
  2. Diagnostic records: Take dental impressions (digital preferred), photographs, and radiographs to evaluate tooth structure, occlusion, and underlying bone support.
  3. Treatment planning: Discuss treatment options with the patient, considering factors such as patient preference, budget, and severity of aesthetic defects.

Tooth preparation and impression

  1. Anesthesia: Apply local anesthesia to the treatment area to numb the teeth and surrounding tissues.
  2. Rubber dam isolation: Place a rubber dam to isolate the treatment area, preventing saliva contamination and ensuring a dry field.
  3. Tooth preparation: Minimal enamel preparation is required to create a bonding surface for the composite resin. This involves using fine burs to remove a thin layer of enamel, typically 0.5-1.0 millimeter.
  4. Impression: Take a high-quality impression of the prepared teeth.

Laboratory fabrication of the veneer

  1. Model creation: Pour the impression material into a stone cast to create a working model of the patient’s teeth.
  2. Wax-up: Wax is sculpted onto the model to create the desired shape and anatomy of the veneer.
  3. Investing: The wax-up is covered in an investment material and placed in a furnace to create a mold.
  4. Composite resin application: Composite resin is carefully layered into the mold, following the contours of the wax-up.
  5. Pressurization: The mold is pressurized to ensure proper compaction of the composite resin.
  6. Curing: The composite resin is cured under ultraviolet light to harden the material.
  7. Finishing and polishing: The veneer is finished and polished to achieve a natural-looking surface.

Veneer placement

  1. Try-in: The veneer is placed on the tooth to check for fit and aesthetics.
  2. Bonding: The tooth surface is etched with acid to create a micromechanical bond.
  3. Adhesive application: A bonding agent is applied to both the tooth and the veneer.
  4. Luting: The veneer is bonded to the tooth using a light-cured composite resin.
  5. Marginal adaption: Excess composite resin is removed, and the margins are polished to create a smooth transition between the veneer and the natural tooth.
  6. Occlusal adjustment: Evaluate and adjust the occlusion to ensure proper bite function and prevent premature tooth wear.
  7. Final polishing: Apply polishing paste with a polishing wheel to achieve a high-gloss finish that mimics the natural shine of enamel.

Postoperative care and follow-up

  1. Postoperative instructions: Provide the patient with postoperative care instructions, including dietary recommendations and oral hygiene guidelines.
  2. Follow-up appointments: Schedule follow-up appointments to monitor the healing process, evaluate the aesthetics and function of the veneers, and provide any necessary adjustments or maintenance.

Indirect composite veneers indications

  • Moderate to severe tooth discoloration: Indirect composite veneers can effectively mask moderate to severe tooth discoloration.
  • Significant tooth misalignment: Indirect composite veneers can be used to correct significant tooth misalignment, such as moderate to severe crowding, spacing, or rotations.
  • Major tooth wear or loss of tooth structure: Indirect composite veneers can restore teeth with significant wear or loss of tooth structure.
  • High bite forces: Indirect composite veneers are stronger than direct composite veneers and may be a better option for patients with high bite forces.

Indirect composite veneers contraindications

  • Poor oral hygiene: Patients with poor oral hygiene are at increased risk of composite veneer fracture or failure.
  • Bruxism: Patients with bruxism may require protective nightguards to prevent damage to the composite veneers.
  • Unrealistic expectations: Patients should have realistic expectations about the aesthetic outcome of indirect composite veneers.
  • Allergy to composite resin materials: Patients with a known allergy to composite resin materials should not undergo this procedure.

How long do composite veneers last? 

Composite veneers can typically last for five-to-seven years. However, several factors can affect their longevity, including:

  • Oral hygiene: Good oral hygiene is essential for prolonging the life of composite veneers. This includes brushing your teeth twice a day, flossing daily, and using a mouthwash.
  • Diet: A diet that is high in sugar and acid can damage composite veneers. Limit your intake of sugary drinks, candy, and acidic foods.
  • Grinding your teeth: If you grind your teeth, you may need to wear a nightguard to protect your veneers from damage.
  • Smoking: Smoking can stain and damage composite veneers. If you smoke, quitting is the best way to protect your veneers.

The material used in composite veneers can significantly impact their longevity. Composite veneers are made from a resin-based material that is bonded to the tooth surface. The type of resin used, as well as the quality of the bonding process, can affect how long the veneers last.

  • Microfill: Microfill composite resins have very fine particles, which makes them more durable and less likely to chip or crack. However, they are also more difficult to polish to a high shine. 
  • Macrofill: Macrofill composite resins have large particles, which makes them less durable and more likely to chip or crack. However, they are also the easiest to polish to a high shine. 
  • Hybrid: Hybrid composite resins are a mixture of microfill and macrofill particles. They are more durable than macrofill resins, but they are less durable than microfill resins. They are also easier to polish than microfill resins. 

Composite veneers vs. porcelain veneers longevity

Composite veneers have an average lifespan between five and seven years, whereas porcelain veneers have a lifespan between 10 and 15 years. If longevity is the main factor in consideration, porcelain veneers are generally a better choice for patients who want the most natural-looking, durable, and long-lasting veneers. However, composite veneers are a good option for patients who are on a budget or who want a less invasive procedure.

Comparison between direct composite and indirect composite workflows

There are many factors to be considered when choosing which type of composite veneers are right for a patient. Among them are price, aesthetics, and complexity of the procedure. The best workflow for you will depend on your individual needs and preferences. Indirect composite veneers require multiple steps more than the direct composite option, including the lab fabrication from an intraoral scan dental impression. The application of indirect composite veneers will often take at least two-to-three visits while direct composite veneers can be installed within a matter of a couple of hours during a single visit. The extended process is often worth it as indirect composite veneers are more aesthetically pleasing and more durable than direct composite veneers. 

What are composite veneers made out of? 

Composite veneers are made out of a tooth-colored resin material. This resin is composed of several different components, including:

  • Fillers: Fillers are the main component of composite resin. They are typically made of glass or ceramic particles and give the resin its strength and durability.
  • Monomer: Monomer is the liquid component of composite resin. It is responsible for bonding the fillers together and creating a hard, durable surface.
  • Initiator: Initiator is a chemical that is used to start the polymerization reaction. This reaction hardens the resin and makes it more durable.
  • Inhibitor: Inhibitor is a chemical that is used to slow down the polymerization reaction. This is important because it allows the dentist to sculpt the resin before it hardens.
  • Pigments: Pigments are added to the resin to give it a natural tooth-like color.

The specific composition of composite resin varies depending on the manufacturer. However, all composite resins contain these basic components.

What are porcelain veneers? 

Porcelain veneers are thin, custom-made shells of tooth-colored material designed to cover the front surface of teeth to change their appearance. They are made of a high-grade ceramic material that is strong, durable, and resistant to staining. Porcelain veneers are often considered to be the best option for cosmetic dental restorations because they can provide a natural-looking and long-lasting solution for a variety of dental problems.

Benefits of porcelain veneers

  • Natural-looking appearance: Porcelain veneers are very closely matched to the natural color and translucency of teeth, so they can give teeth a very natural-looking appearance.
  • Durability: Porcelain veneers are very strong and durable, and they can resist chipping and cracking.
  • Stain resistance: Porcelain veneers are resistant to staining, so they can help to keep teeth looking white and bright.
  • Versatility: Porcelain veneers can be used to correct a variety of dental problems, including:
    • Chipped or cracked teeth
    • Discolored teeth
    • Gaps between teeth
    • Crooked or misaligned teeth
    • Shortened teeth

Workflow for porcelain veneers

The procedure for installing porcelain veneers involves the following steps:

  1. Consultation: The first step is to have a consultation with the patient to discuss their goals for treatment and determine if porcelain veneers are the right option.
  2. Tooth preparation: The dentist will remove a small amount of enamel from the front of the teeth to make room for the veneers.
  3. Impressions: Impressions will be taken of the teeth to create custom-made veneers.
  4. Temporary veneers: While the permanent veneers are being made, the patient may be given temporary veneers to wear.
  5. Veneer placement: The permanent veneers will be bonded to the teeth using a special adhesive.
  6. Final touches: The dentist will trim and polish the veneers to ensure they look natural and fit perfectly.

Porcelain veneers vs. composite veneers

The best type of veneer for you will depend on the individual needs and goals of the patient. Porcelain veneers are the best choice if the patient prioritizes durability and the most natural look. However, if they are on a budget or want a less time-consuming procedure, then composite veneers may be the better option.

Here is a summary of the key differences between porcelain veneers and composite veneers:

  • Material: Porcelain veneers are made of a ceramic material, while composite veneers are made of a tooth-colored resin.
  • Appearance: Porcelain veneers are generally considered to be more natural-looking than composite veneers.
  • Durability: Porcelain veneers are more durable than composite veneers.
  • Stain resistance: Porcelain veneers are more stain resistant than composite veneers.
  • Cost: Porcelain veneers are more expensive than composite veneers.
  • Procedure: The procedure for getting porcelain veneers is more time-consuming than the procedure for getting composite veneers.
  • Reversibility: Porcelain veneers are less reversible than composite veneers as the latter bonds to the teeth but does not remove enamel.

Are composite veneers right for your practice? 

Composite veneers offer a couple of benefits over porcelain veneers. Porcelain veneers are more durable and natural-looking than composite veneers, but those benefits come with a cost—the process is far more time-consuming and expensive. You will most likely want to nudge patients who are looking to have a less invasive, more reversible, and less expensive procedure toward composite veneers.

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Hybrid dentures https://www.meetdandy.com/learning-center/glossary/hybrid-dentures/ Wed, 13 Dec 2023 22:25:50 +0000 https://www.meetdandy.com/?p=16683 Hybrid dentures are a type of dental prosthesis that combines the stability and support of dental implants with the affordability and removability of traditional dentures. They are a good option for patients who have lost all of their teeth in one or both arches and who are looking for a more secure and natural-looking alternative […]

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Hybrid dentures are a type of dental prosthesis that combines the stability and support of dental implants with the affordability and removability of traditional dentures. They are a good option for patients who have lost all of their teeth in one or both arches and who are looking for a more secure and natural-looking alternative to traditional dentures.

Sometimes hybrid dentures are referred to as “All-on-4,” a reference to the (usually) four implanted pillars the dentures sit upon. These four implants are strategically placed in the jawbone, with two in the front and two in the back. This placement allows the implants to support a full arch of teeth, even if there is not enough bone for traditional implants. The number of implants can vary from two to six, but “All-on-4” is a catchy moniker, so it has become commonplace. 

Pros and cons of hybrid dentures

Like all dental procedures, there are a lot of different factors to consider before choosing which one is right for the patient. Let’s go over all of the pros and cons associated with hybrid dentures. 

The pros of hybrid dentures

  • Improved stability and support: Hybrid dentures are anchored to dental implants, providing significantly greater stability compared to traditional dentures. This allows the patient to eat, speak, and laugh confidently without worrying about the dentures slipping or falling out.
  • Enhanced chewing function: The improved stability of hybrid dentures allows for more effective chewing, leading to improved digestion and a better overall eating experience.
  • Natural-looking appearance: High-quality hybrid dentures are crafted to closely resemble natural teeth, offering a more natural and aesthetically pleasing appearance than traditional dentures.
  • Improved oral health: Hybrid dentures can help prevent bone loss in the jaw, a common concern with traditional dentures. This is because the implants stimulate the jawbone, promoting its health and density.
  • Reduced risk of gum irritation: Unlike traditional dentures, which can irritate the gums due to friction, hybrid dentures distribute pressure more evenly, reducing the risk of irritation.
  • Easier cleaning: Hybrid dentures can be easily removed for cleaning, allowing for more thorough and effective cleaning compared to traditional dentures.

The cons of hybrid dentures

  • Higher cost: All-in hybrid dentures are significantly more expensive than traditional dentures due to the additional cost of dental implants and the more complex fabrication process.
  • Surgical procedure required: Placing dental implants involves surgery, which requires healing time and carries certain risks associated with any surgical procedure.
  • Longer treatment time: Compared to traditional dentures, the process of getting hybrid dentures typically takes longer due to the surgical procedure and the time required for the implants to heal.
  • Maintenance requirements: While hybrid dentures are easier to clean than traditional dentures, they still require regular brushing, flossing, and professional cleanings to maintain their appearance and function.
  • Not suitable for everyone: Certain medical conditions or bone health issues may make individuals ineligible for dental implants, thus disqualifying them for hybrid dentures.

The hybrid dentures workflow

The process of installing hybrid dentures typically involves multiple appointments spread over several months. Here’s a breakdown of each appointment and what to expect:

Appointment 1: Consultation and planning

  • Consultation: Being with a discussion of the patient’s dental history, expectations, and concerns.
  • Examination: Then you will examine the patient’s teeth and gums to assess their suitability for hybrid dentures.
  • X-rays and scans: These tools will help determine the amount of bone available for implant placement.
  • Planning: Based on the assessment, you will develop a personalized treatment plan, including the number and location of implants needed, the type of hybrid denture, and the estimated timeline.
  • Financial discussion: Please do discuss the costs involved and payment options before beginning work.

Appointment 2: Implant placement

  • Surgery: The dentist or oral surgeon will place the dental implants in the jawbone.
  • Healing time: Following implant placement, several months are required for the bone to heal and integrate with the implants.
  • Temporary restoration: In some cases, temporary dentures may be provided to wear during the healing period.

Appointment 3: Impression and bite registration

  • Impressions: After the healing period, the dentist will take impressions of the patient’s mouth and jaw to create a custom-made hybrid denture.
  • Bite registration: This will record the correct bite position for optimal chewing function and aesthetics.

Appointment 4: Denture fitting and adjustments

  • Initial fitting: The dentist will place the custom-made hybrid denture and check for fit, comfort, and function.
  • Adjustments: Minor adjustments may be needed to ensure a perfect fit and address any concerns.
  • Instructions and care: You will provide instructions on how the patient should care for hybrid dentures and schedule follow-up appointments.

The overall timeline for installing hybrid dentures can vary depending on individual needs and healing abilities. However, it typically takes four-nine months from the initial consultation to the final denture placement.

Materials used for hybrid dentures

Like with many dental procedures, there are a variety of different materials available for constructing hybrid dentures. Each different method has its own set of pros and cons.

Acrylic with titanium

Acrylic with titanium hybrid dentures are a popular choice for patients who are missing teeth and want a more stable and natural-looking alternative to traditional dentures. These dentures combine the affordability and ease of use of acrylic with the strength and durability of titanium. They are a particularly good choice for people with limited bone support and are easy to care for. However, they may not be as natural-looking as other options and may need to be replaced more often.

Composite

This form of hybrid dentures features a composite base made of a mixture of acrylic resin and fibers. Typically these fibers are made of materials such as glass, carbon, or aramid. The composite material can be custom-colored to match a patient’s existing teeth. Composite hybrid dentures are a good option for people who want a strong, durable, and natural-looking denture that is comfortable to wear. They are a good choice for patients with allergies to nickel and can be repaired easily. However, they are more expensive than traditional dentures and may not be as readily available.

PFM

Porcelain-fused-to-metal (PFM) hybrid dentures offer a unique blend of strength, durability, and aesthetics. Porcelain provides superior aesthetics compared to other materials, so PFM dentures are especially popular among patients hoping to have a natural-looking smile. The metal framework of PFM hybrid dentures gives them superior strength and durability. This is one of the more costly options.

Milled zirconia

Milled zirconia hybrid dentures, also known as monolithic zirconia dentures, are a cutting-edge solution for individuals seeking a strong, natural-looking, and long-lasting alternative to traditional dentures. These dentures are crafted from a single block of high-quality zirconia, a ceramic material known for its exceptional strength, biocompatibility, and aesthetic properties. The entire structure is milled using computer-aided design and manufacturing (CAD/CAM) technology, ensuring a precise fit and customized appearance.

How long do hybrid dentures last? 

The longevity of hybrid dentures is dependent on two key factors: the material they are created with and how well they are taken care of. Different materials are more durable than others, which can shorten their lifespan. For example, acrylic hybrid dentures typically last from five-seven years, while PFM or milled zirconia hybrid dentures can last 10-15 years or even longer. 

Regardless of the material used in the hybrid denture implants, maintaining proper care and maintenance, including regular brushing, flossing, and professional cleanings will significantly extend the lifespan of the dentures. Avoiding hard foods and chewing habits that damage the dentures will also go a long way to maintaining a long life out of the hybrid dentures. It also can’t be understated how important craftsmanship and a properly aligned bite are to the long-term success of hybrid dentures. 

What is the survival rate for All-on-4?

The survival rate for All-on-4 implant systems is quite high, with most studies indicating success rates exceeding 90% over several years. In the short-term, studies have shown a survival rate of 99.8% after 24 months. In the long-term, research has found a success rate of 98.1% after five years and 94.8% after 10. 

Hybrid dentures are a great long term solution for some patients. We hope this helps dental professionals make more informed decisions when prescribing fixed restoratives to their patients and helps patients identify the procedures they need for their specific case. 

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Wax rim for dentures https://www.meetdandy.com/learning-center/glossary/wax-rim-for-dentures/ Fri, 08 Dec 2023 17:59:23 +0000 https://www.meetdandy.com/?p=16671 Wax rims are temporary structures used in the process of creating complete and partial dentures. They are not actual dentures, but rather a crucial step in the fabrication process. What is the purpose of a wax rim?  This denture tool serves three purposes: determining the position and arrangement of artificial teeth, verifying the correct jaw […]

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Wax rims are temporary structures used in the process of creating complete and partial dentures. They are not actual dentures, but rather a crucial step in the fabrication process.

What is the purpose of a wax rim? 

This denture tool serves three purposes: determining the position and arrangement of artificial teeth, verifying the correct jaw alignment and bite, and delivering an evaluation of the aesthetics of the denture before finalization. 

Wax rim for dentures

Why are wax rims important? 

Wax rims play a crucial role in occlusal correction within the denture fabrication process. They serve as a diagnostic and therapeutic tool, helping dentists achieve optimal bite and jaw function for the patient.

One of the most important roles of wax rims is in providing verification of jaw alignment. Confirmation of the correct vertical dimension of occlusion (VOD) and the relationship between the upper and lower jaws ensures proper biting and chewing function. The wax rim also provides a stable base for the final denture, preventing it from moving around in the mouth.

This allows patients to be involved in the denture creation process. They can provide feedback on the appearance of the denture, including the smile line, lip support, and overall facial aesthetics. 

The bite rim workflow

There are two different ways to create wax rims: analog and digital. Let’s take a look at the workflow for both methods. 

The analog bite rim workflow

The analog bite rim workflow involves several steps to create and utilize wax rims for accurate denture fabrication. Here’s a detailed breakdown:

  • Step 1: Preparation
    • Preliminary impressions: Take preliminary impressions of the patient’s upper and lower jaws to create study models.
    • Jaw relation records: Depending on the patient’s needs, record jaw relations using methods like face-bow transfer or visual analysis.
    • Mounting casts: Mount the upper and lower study casts on an articulator according to the recorded jaw relations.
  • Step 2: Base plate fabrication
    • Select prefabricated baseplates: Choose appropriate baseplates based on the patient’s jaw size and ridge anatomy.
    • Trim and adapt baseplates: Trim the baseplates to fit the patient’s gums and adapt them for proper extension and border molding.
    • Heat and adapt baseplates: Heat the baseplates and adapt them to the patient’s gums for a comfortable and accurate fit.
  • Step 3: Wax rim construction
    • Apply wax to baseplates: Apply a thin layer of softened wax to the baseplates, ensuring even coverage and appropriate thickness.
    • Sculpt the wax rims: Sculpt the wax rims to create the desired shape and contour of the gums and lips, considering aesthetics and function.
    • Establish vertical dimension: Adjust the vertical dimension of occlusion (VDO) by manipulating the wax rims vertically based on measurements and patient feedback.
  • Step 4: Tooth positioning
    • Select and arrange teeth: Choose appropriate artificial teeth based on size, shade, and morphology.
    • Position teeth on the wax rims: Arrange the teeth on the wax rims in the desired position and angulation, ensuring proper alignment and occlusion.
    • Evaluate aesthetics and function: Assess the smile line, lip support, and overall aesthetics—making adjustments to the tooth position and wax rim shape as needed.
  • Step 5: Bite registration
    • Instruct the patient: Guide the patient to bite together gently but firmly on the wax rims to register the bite.
    • Verify bite registration: Check for any occlusal discrepancies or premature contacts and refine the wax rims accordingly.
    • Secure the bite registration: Cool the wax rims and secure them in a stable position for transportation to the dental laboratory.
  • Step 6: Laboratory processing
    • Cast preparation: The dental technician prepares the casts and mounts them on an articulator using the bite registration.
    • Denture fabrication: The technician fabricates the final denture base and incorporates the teeth based on the wax rim configuration.
    • Finishing and polishing: The technician finishes and polishes the denture after ensuring proper fit, aesthetics, and occlusal function.
  • Step 7: Delivery and adjustments
    • Denture fitting: Place the final denture in the patient and evaluates the fit, comfort, and aesthetics.
    • Occlusal adjustments: Fine-tune the occlusion if necessary to ensure optimal chewing function and patient comfort.
    • Patient instructions: Provide the patient with instructions on denture care and maintenance.

The analog bite rim workflow was the best method for years, however, advancements in digital technologies are increasingly offering alternative workflows with potential benefits in terms of accuracy, efficiency, and patient experience. Which brings us to…

The digital bite rim workflow

The digital bite rim workflow is far quicker. Let’s go over the process. 

  • Take upper and lower intraoral scans
    • Select the arch (or arches) that need a full denture to be fabricated.
    • If facing difficulty scanning, doctors may take a standard impression and scan either the impression or the model.
  • Register bite via wax bite rim and take 360 extraoral scan of wax rim
    • After receiving the wax bite rim, guide it into the patient’s mouth to get an accurate bite impression.
    • Apply a light amount of body wash to the bite rim for border molding and accuracy.
    • Clearly mark the bite rum with the patient’s smile lines, canine lines, and midlines.
    • Add blue mousse to register bite.
    • It is highly recommended to take photos of the patient:
      • Head on with patient smiling naturally with wax bite rim in place
      • Two profile pictures (one from each side) with the patient smiling naturally with wax bite rim in place
      • A head on photo of the patient with cheek retractors and wax bite rim in place if possible
  • Set up case and scan the denture
    • Select the arch (or arches) that need a full denture to be fabricated.
    • When scanning an arch (or arches) with wax bite rims, select “denture” from pop-up.
    • Perform 360 extraoral scan of the wax bite rims
    • To obtain bite registration:
      • If scanning a single arch, scan with wax bite rim in mouth (from molar to midline) with blue mousse.
      • If scanning a dual arch, scan both arches in occlusion outside of the mouth (full arch from molar to molar) with blue mousse.

Using wax rims in denture cases

Whether you’re practicing analog dentistry or leveraging digital dentistry, wax rims are a crucial part of the full denture bite registration process. 

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Removable dentures https://www.meetdandy.com/learning-center/glossary/removable-dentures/ Fri, 08 Dec 2023 17:40:07 +0000 https://www.meetdandy.com/?p=16668 Removable dentures are artificial replacements for missing teeth and surrounding tissues. They are made of a plastic base that fits snugly over your gums and contains replacement teeth made of acrylic, porcelain, or metal. Often removable dentures are partial dentures, however if a patient were missing all of their teeth (on any given arch), they […]

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Removable dentures are artificial replacements for missing teeth and surrounding tissues. They are made of a plastic base that fits snugly over your gums and contains replacement teeth made of acrylic, porcelain, or metal. Often removable dentures are partial dentures, however if a patient were missing all of their teeth (on any given arch), they would get a full denture.

Types of removable dentures

Partial dentures

Description: Removable partial dentures, also known as “RPDs,” are prosthetic devices for patients with some missing teeth. Long-term partials are common for patients who can’t afford implants or don’t have the proper underlying bone structure to get implants.

Lifespan: Studies of the lifespan for RPDs has shown there are many different variables to be considered, but on the whole, they are quite durable with many studies showing a survival rate of 90% or greater over a period of 5-10 years. 

Complete dentures

Description: This is the type of denture used when a patient does not have any teeth in one or both arches at the beginning of the denture process.

Lifespan: Studies have shown that removable complete dentures have a lifespan of roughly 10 years, with most complete dentures lasting at least five years.

Immediate dentures

Description: An immediate denture is made to be placed into a patient’s mouth on the same day that the dentist extracts any remaining teeth that are in the patient’s mouth. Sometimes, these are called “temporary dentures” because they are ultimately replaced by better-adhering dentures at some point in the future. These are often used to allow the patient’s mouth to heal before fabricating a more permanent denture. The patient has teeth at the start of this process, therefore the dentist can record notes and make measurements about the patient’s current bite and the length and size of the patient’s teeth. These records and measurements are used and incorporated into the denture to replicate the patient’s original teeth and bite. They look just like complete dentures. 

Lifespan: Immediate dentures are intended to be temporary, thus a patient isn’t expected to be using them for longer than four to six months giving their gums time to heal before a more permanent option is implemented. 

Implant supported overdenture

Description: A removable denture that uses implants to provide more stability. These implant supported dentures click in either to locators or to a bar in the patient’s mouth. These dentures can at times be supported by less than four implants and are used whenever a patient isn’t a good candidate for all-on-X but requires additional retention. An implant overdenture sits on gums so any vertical biting force is dispersed on gums similar to a standard denture.

Lifespan: In a study of 650 implants, implant overdenture showed a survival rate of 95.3%.

Removable dentures vs. fixed dentures

Both removable and fixed dentures are solutions for replacing missing teeth, but they offer distinct advantages and disadvantages. Each process has its own pros and cons, let’s compare the two to help determine when each should be utilized. 

Removable dentures offer many different advantages for the patient, most notably that they are a more cost-effective option. Since they do not require surgery to install, they are also a less invasive procedure. Removable dentures are also easy to clean and a good option for patients with limited jawbone. 

Most of the drawbacks with removable dentures are related to the fact that they are, well, removable. Removable dentures can slip around in the mouth while eating and speaking, which can sometimes lead to speech problems, as well as the need for adhesives to prevent further slipping. They can also cause a patient discomfort as they sometimes feel bulky and unnatural in the mouth. Over time, removable dentures can also contribute to bone loss. 

The main advantage of fixed dentures is that they feel much more natural in the mouth than removable dentures do. This natural feel leads to improved chewing and speaking, and because they are fixed, there are no issues with slippage. With proper care, fixed dentures can last for many years. 

The process of installing fixed dentures is both more invasive and more expensive than with removable dentures, which can be a significant drawback for some patients. Fixed dentures are more difficult to clean as well. Fixed dentures require a significant amount of jawbone support, so they are not suitable for all patients. 

Further suggested reading: Implant-supported dentures vs. implant retained dentures.

There are many factors to discuss with a patient before deciding upon removable dentures or fixed dentures: cost, invasiveness, comfort, and more. A thorough discussion between you and the patient can help decide the best way to move forward with their restoration.

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Dental implant parts https://www.meetdandy.com/learning-center/glossary/dental-implant-parts/ Wed, 22 Nov 2023 15:40:19 +0000 https://www.meetdandy.com/?p=16595 Dental implants are a popular and effective way to replace missing teeth. Let’s take a look at how dental implants work and why they are so beneficial for your patients.  Firstly, what are the components of a dental implant? The three dental implant parts are the implant fixture, the abutment, and the implant crown. The implant […]

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Dental implants are a popular and effective way to replace missing teeth. Let’s take a look at how dental implants work and why they are so beneficial for your patients. 

Firstly, what are the components of a dental implant? The three dental implant parts are the implant fixture, the abutment, and the implant crown. The implant fixtures and abutments are most often made from metal, while crowns come in a range of materials.

Dental implant fixture

The implant fixture is a screw-shaped metal rod that is inserted into the jaw bone to serve as a replacement for the tooth root. It is typically made of titanium, a biocompatible material that fuses well with bone. In some instances zirconia is used, particularly for patients who may have an allergy to titanium.

Dental implant abutment

The abutment is a small connector piece that is attached to the implant fixture. It provides a foundation for the implant crown to be placed on. Abutments can be made of a variety of materials, most commonly titanium and zirconia

There are a few different types of abutment—screw retained, cement retained and screwmentable—with each having its own benefits. 

  • Screw retained abutments are delivered as a single unit from the lab with the crown (which includes an access hole) cemented to the abutment. 
  • Cement retained abutments are delivered from the lab in two separate units and without an access hole in the crown. 
  • Screwmentable abutments arrive in two units with the crown not cemented to the abutment, but with an access hole in the crown. The doctor will need to seat the abutments first, then cement the crown over the abutments in the mouth. The doctor can then unscrew the and remove the crown to clean and remove excess cement before final torque into place.

Dental implant crowns

The implant crown is the visible part of the dental implant. Crowns are used to replace single teeth, with other dental implant components used if more extensive work is needed. A bridge is used to replace multiple teeth, and dentures are used to replace all of the teeth in the arch. Implant crowns can be made of a variety of materials including zirconia, metal, porcelain fused to metal (PFM), and ceramics like lithium disilicate (eMax).

The crown is the most expensive part of the dental implant.

How the dental implant parts work together

The implant post, abutment, and implant crown work together to create a strong and durable replacement for a missing tooth. The implant post provides a stable foundation for the restoration, while the abutment connects the implant post to the implant crown. The implant crown is the visible part of the dental implant and it is what gives you a natural-looking smile.

dental implant parts

How implants are retained in the mouth

Dental implant parts are retained in the mouth in two ways:

Osseointegration: Osseointegration is the process by which the implant post fuses with the jaw bone. The bone cells grow around and adhere to the implant post, creating a durable bond. The process of osseointegration occurs over the span of several months. This is the primary way that dental implants are retained in the mouth.

Abutment screw: The abutment screw is a small screw that attaches the abutment to the implant post. This provides additional retention and stability for the dental implant.

Benefits of dental implants

Dental implants offer a number of benefits over other tooth replacement options, including:

  • Improved function: Dental implants allow your patients to eat, speak, and smile with confidence.
  • Enhanced aesthetics: Dental implants look and feel like natural teeth.
  • Durability: Dental implants can last a lifetime with proper care.
  • Improved oral health: Dental implants help to preserve your patient’s jaw bone and prevent gum disease.

Parts of dental implants

Implant parts stay consistent across retention styles and through the digital process. If you’re looking to learn more about the tooth extraction and implant timeline, read more of our glossary definitions relating to the dental implant process.

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Implant crowns https://www.meetdandy.com/learning-center/glossary/implant-crowns/ Wed, 22 Nov 2023 15:38:12 +0000 https://www.meetdandy.com/?p=16586 Chances are every single person in America will have a crown placed at some point in their life. Some crowns may be able to be bonded to the patient’s tooth but in the case of too much tooth decay, crowns will need to be paired with a dental implant. We’re going to dive into implant […]

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Chances are every single person in America will have a crown placed at some point in their life. Some crowns may be able to be bonded to the patient’s tooth but in the case of too much tooth decay, crowns will need to be paired with a dental implant. We’re going to dive into implant crowns, looking into their benefits, how they are installed, why they are more durable than other options, and the impact they have on existing teeth. 

What is an implant crown?

An implant crown is a type of dental restoration that is used to replace a missing or damaged tooth. It is a cap that is attached to a dental implant, which is a surgical post that is inserted into the jawbone. The implant crown restores the function and appearance of the missing tooth.

An implant crown consists of two main components:

  • Abutment: The abutment is a small connector that is attached to the dental implant. It acts as a bridge between the implant and the crown.
  • Crown: The crown is the visible part of the implant restoration. It is made to look and function like a natural tooth.

Implant crown materials

Implant crowns can be made out of multiple different materials including zirconia, eMax, porcelain fused with metal (PFM), and gold. Each material offers distinct benefits for a patient’s needs. 

Zirconia

Zirconia is a versatile and highly desirable material for implant crowns due to its exceptional properties and suitability for a wide range of dental applications. Here are some compelling reasons why zirconia should be considered for implant crowns:

  • Superior strength and durability: Zirconia is renowned for its exceptional strength and resistance to wear and tear. This makes it an ideal choice for implant crowns, especially for posterior teeth that bear more significant biting forces. 
  • Biocompatibility and reduced risk of allergies: Zirconia is highly biocompatible with the human body, making it an excellent option for patients with metal allergies or sensitivities. Unlike traditional metal-ceramic crowns, zirconia crowns do not trigger allergic reactions or gum tissue irritation, ensuring a comfortable and well-tolerated restoration.
  • Natural aesthetics and seamless integration: Zirconia’s translucent properties allow it to mimic the natural appearance of teeth. The crown can be customized to match the exact color, shape, and shade of your patient’s surrounding teeth, resulting in a natural-looking smile that enhances your patient’s overall appearance.
  • Metal-free design and elimination of dark gum lines: Zirconia implant crowns are completely metal-free, eliminating the potential for dark gum lines or metal discoloration. This is particularly beneficial for patients with thin gum tissue or those who prefer a more natural-looking restoration. 
  • Reduced risk of peri-implant infections: Zirconia’s smooth surface is less prone to bacterial adhesion, reducing the risk of peri-implant infections. This is crucial for maintaining implant health and long-term stability.
  • Long-term longevity: Zirconia implant crowns are known for their exceptional longevity, often lasting for many years with proper care and maintenance.

Zirconia crown best use cases

Zirconia crowns are versatile and suitable for a wide range of dental applications. Here are some specific instances where zirconia crowns are particularly beneficial:

  • Posterior teeth replacement: Zirconia crowns are an excellent choice for replacing posterior teeth, particularly those subjected to significant biting forces. Their strength and durability make them well-suited for these demanding areas.
  • Patients with metal allergies or sensitivities: For patients with metal allergies or sensitivities, zirconia crowns offer a metal-free alternative that eliminates the risk of allergic reactions or gum tissue irritation.
  • Aesthetically demanding situations: Zirconia crowns are ideal for patients seeking a natural-looking tooth replacement solution. Their ability to mimic the natural appearance of teeth enhances aesthetics and blends seamlessly with surrounding teeth.
  • Patients with thin gum tissue: Zirconia crowns are a good option for patients with thin gum tissue as they eliminate the risk of dark gum lines and metal discoloration.
  • High-Risk Patients for Peri-Implant Infections: Zirconia crowns are beneficial for patients at higher risk of peri-implant infections due to their smooth surface that reduces bacterial adhesion.

eMax

eMax, also known as lithium disilicate, is a highly regarded material for implant crowns due to its exceptional properties and suitability for a wide range of dental applications. Here are some compelling reasons why eMax should be considered for implant crowns:

  • Superior aesthetics and natural appearance: eMax is renowned for its ability to mimic the natural appearance of teeth, making it an excellent choice for implant crowns. Its translucent properties allow light to pass through the crown, replicating the natural light transmission of dentin, the tooth’s inner layer. This results in a crown that blends seamlessly with surrounding natural teeth, creating a natural-looking smile.
  • High strength and durability: eMax is a strong and durable material, making it suitable for implant crowns that need to withstand significant biting forces. While not as strong as zirconia, eMax offers sufficient strength for most applications, particularly for anterior teeth that are less subjected to wear and tear.
  • Biocompatibility and reduced risk of allergies: eMax is highly biocompatible with the human body, making it an ideal option for patients with metal allergies or sensitivities. 
  • Conservative tooth preparation: eMax crowns require minimal preparation of the underlying tooth structure, preserving healthy tooth tissue. This is particularly beneficial for patients with limited tooth structure or those who want to minimize tooth damage.
  • Bonding strength and secure attachment: eMax crowns can be bonded to the implant abutment with a strong and reliable adhesive, ensuring a secure and stable attachment. This prevents the crown from loosening or falling off over time.

eMax crowns best use cases

eMax crowns are versatile and suitable for a wide range of dental applications. Here are some specific instances where eMax crowns are particularly beneficial:

  • Anterior teeth replacement: eMax crowns are an excellent choice for replacing anterior teeth, particularly those in the smile zone. Their superior aesthetics and natural appearance enhance the overall aesthetics of the smile.
  • Patients with metal allergies or sensitivities: For patients with metal allergies or sensitivities, eMax crowns offer a metal-free alternative that eliminates the risk of allergic reactions or gum tissue irritation.
  • High Aesthetic Demands: eMax crowns are ideal for patients seeking the most natural-looking tooth replacement solution. Their ability to mimic the natural appearance of teeth is unmatched by other materials.
  • Minimally invasive procedures: eMax crowns require minimal tooth preparation, making them a good option for patients who prefer a more conservative approach to tooth restoration.
  • Secure attachment and long-term stability: eMax crowns are securely bonded to the implant abutment, ensuring long-term stability and preventing crown loosening or loss.

Porcelain fused to metal (PFM)

Porcelain fused to metal (PFM) is a type of dental crown that combines the strength of metal with the aesthetics of porcelain. It has been used for many years and is still a popular choice for implant crowns. ​​Here are some reasons why an implant crown should be made of porcelain fused to metal:

  • Strength and durability: PFM crowns are very strong and durable, making them ideal for implant crowns that need to withstand significant biting forces. The metal substructure provides the strength and support, while the porcelain layer provides a natural-looking appearance.
  • Biocompatibility: PFM crowns are made of biocompatible materials that are well-tolerated by the body. This is important for implant crowns, which need to be well-integrated with the surrounding bone and gums.
  • Aesthetics: PFM crowns can be made to match the color and shape of your patient’s surrounding teeth, resulting in a natural-looking smile. The porcelain layer can be customized to achieve the desired level of translucency and brightness.
  • Cost-effectiveness: PFM crowns are more affordable than some other types of implant crowns, such as all-zirconia crowns.

PFM crown best use cases

PFM crowns are versatile and suitable for a wide range of dental applications. Here are some specific instances where PFM crowns are particularly beneficial:

  • Posterior teeth: PFM crowns are a good choice for replacing posterior teeth, such as molars and premolars. These teeth are subjected to more biting forces than anterior teeth, so it is important to choose a crown that is strong and durable.
  • Patients on a budget: PFM crowns are a more affordable option than some other types of implant crowns. 
  • Patients who want a natural-looking smile: PFM crowns can be made to match the color and shape of your patient’s surrounding teeth, resulting in a natural-looking smile. This makes them a good choice for patients who are concerned about their appearance.

Gold

Gold has been used in dentistry for centuries due to its unique properties, making it an excellent choice for implant crowns. Here are some compelling reasons why gold should be considered for implant crowns:

  • Superior strength and durability: Gold is one of the strongest and most durable materials available for dental crowns. It is highly resistant to wear and tear, even when subjected to significant biting forces.
  • Biocompatibility and reduced risk of allergies: Gold is a highly biocompatible material, meaning it is well-tolerated by the body and unlikely to cause allergic reactions or gum tissue irritation. This makes it a suitable option for patients with metal allergies or sensitivities.
  • Long-term longevity: Full gold crowns are known for their exceptional longevity, often lasting for many years with proper care and maintenance. 
  • Conservative tooth preparation: Gold crowns require minimal preparation of the underlying tooth structure, preserving healthy tooth tissue. This is particularly beneficial for patients with limited tooth structure or those who want to minimize tooth damage.
  • Versatile aesthetics: Gold crowns can be customized to match the color and shade of surrounding natural teeth, resulting in a natural-looking smile. They can also be designed to have a more traditional gold appearance, if desired.

Gold crown best use cases

Gold crowns are versatile and suitable for a wide range of dental applications. Here are some specific instances where gold crowns are particularly beneficial:

  • Patients with metal allergies or sensitivities: For patients with metal allergies or sensitivities, gold crowns offer a safe and reliable solution for tooth replacement.
  • High-risk patients for peri-implant infections: Gold’s smooth surface is less prone to bacterial adhesion, reducing the risk of peri-implant infections. This is crucial for maintaining implant health and long-term stability.
  • Patients with limited tooth structure: Gold crowns require minimal preparation of the underlying tooth structure, making them a good option for patients with limited tooth structure.
  • Patients seeking a traditional gold appearance: Some patients prefer the look of a visible gold crown.

How long do implant crowns last?

Implant crowns can last for many years with proper care and maintenance. On average, implant crowns last between 10 and 15 years. However, some implant crowns can last for up to 25 years or more.

The lifespan of an implant crown depends on a number of factors, including:

  • The type of material used: Some materials, such as gold and zirconia, are more durable than others, such as porcelain fused to metal.
  • The quality of the workmanship: The skill and experience of the dentist who places the implant crown can also affect its lifespan.
  • The patient’s oral hygiene: Patients who practice good oral hygiene and see their dentist for regular checkups and cleanings are more likely to have implant crowns that last longer.
  • The patient’s bite: Patients with a strong bite or who grind their teeth are more likely to damage their implant crowns.

How implant crowns are retained in the mouth

There are three main ways that dental implant parts are retained in the mouth:

Screw retention: A screw is threaded into the implant fixture to hold the abutment and crown in place. This is the most common type of implant retention because it is strong and secure. It is also relatively easy to place and remove, which is helpful if the implant needs to be repaired or replaced.

Cement retention: Cement is used to bond the abutment and crown to the implant fixture. It is less common than screw retention, but cement retention can be a good option for patients with limited bone height or who have difficulty with screws. Cement retention is also a good option for patients who want a more natural-looking restoration, as the cement can be used to create a smooth transition between the implant and the surrounding teeth.

Friction retention: The abutment and crown are designed to fit tightly over the implant fixture, creating a friction-based retention. This is the least common type of implant retention, but it can be a good option for patients with limited space in their mouth or who have difficulty with screws or cement. Friction retention is also a good option for patients who want a more conservative restoration, as it requires less tooth preparation.

Which type of retention is best for your patient will depend on their individual needs and circumstances.

How implant crowns are used

Implant crowns are used to replace missing or damaged teeth. They are attached to dental implants, which are surgical posts that are inserted into the jawbone. Implant crowns are used to restore the function and appearance of a missing tooth, to improve chewing and speaking ability, to prevent the shifting of surrounding teeth, to maintain bone density in the jaw and to enhance the overall smile. 

  • The installation of an implant crown can be a collaboration between a dentist and an oral surgeon. Recently technology like intraoral scanners and 3D printed surgical guides have give general dentists more confidence in the outcome of an implant procedure.
  • It is up to the dentist to determine the best material to use for the dental implant crown.
  • It is up to the dentist to determine the best retention style and abutments for the implant crown.

We hope this information gives you a good introduction or refresh into implant crowns with an understanding of the different options for your patients.

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What is an impression coping? https://www.meetdandy.com/learning-center/glossary/what-is-an-impression-coping/ Wed, 22 Nov 2023 15:37:57 +0000 https://www.meetdandy.com/?p=16594 Impression copings are an essential part of the dental implant process. They allow for the fabrication of a precise and accurate restoration that fits perfectly and looks natural. What is an impression coping? An impression coping is a pre-manufactured component that helps to situate and measure the implant in the mouth when impressions are being […]

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Impression copings are an essential part of the dental implant process. They allow for the fabrication of a precise and accurate restoration that fits perfectly and looks natural.

What is an impression coping?

An impression coping is a pre-manufactured component that helps to situate and measure the implant in the mouth when impressions are being taken for a dental implant. When using impression coping or implant copings, a transfer cap is placed over the new fixture or implant, so that it can be transferred to a surgical guide for cleaner and easier crown installation.

The different types of impression copings

Impression copings are available in two main types:

Closed tray impression copings: This technique requires a clinician to capture the post within the impression. Then after curing, the impression is removed and the clinician unscrews the post from the dental implant and replaces it into the impression.

Open tray impression copings: This technique involves using impression copings attached to implants where a retaining screw extends past the tray, thus embedding it into the impression. Prior to moving the impression, the coping is unscrewed by a clinician through an opening in the tray. 

Once the impression is taken, the impression copings are removed and sent to the dental laboratory. The laboratory uses the impression to create a master cast of the implant site. The master cast is then used to fabricate the final dental implant restoration, such as a crown, bridge, or denture.

What is an implant analog and coping?

Implant analogs and copings are both important tools in the dental implant process. They help to ensure that the final restoration is accurate, precise, and fits perfectly.

An implant analog is a replica of an implant post or abutment used in the dental laboratory to create a master cast of the implant site. The master cast is then used to fabricate the final dental implant restoration, such as a crown, bridge, or denture.

An implant impression coping is a temporary abutment that is attached to the implant post or abutment while the final restoration is being fabricated. It is typically made of plastic or metal and is used to protect the implant site and to maintain the proper spacing between the implants.

How do you take impressions with an impression coping? 

There are two different methods of taking an impression coping, each with their own benefits, let’s look at the techniques and see how they differ. 

How to take open tray impressions

  • Use adhesives to coat the impression tray and retain impression material.
  • Take heavy-body impression material and load it into the tray, then capture the soft tissue by placing light-body impression material around the copings.
  • Once the custom tray is inserted into the patient’s mouth, expose the coping to facilitate access by removing excess material around the occlusal opening.
  • After polymerization, the screws should be loosened from the temporary copings.
  • Remove the impression.

How to take impressions with the closed tray technique

  • Place closed tray impression copings on the dental implants.
  • Fill the tray with impression material and seat it within the patients’ mouth.
  • After polymerization, extricate the closed tray impression copings.
  • Affix the implant or abutment analogs to the copings.
  • Finish by placing the coping-analog assembly into the definitive impression.

Taking digital impressions with impression copings

You cannot take a digital impression with a traditional impression coping. Instead, you use scan bodies. Scan bodies are intraoral implant-positioning-transfer devices utilized in the digital Implant restoration workflow. They play an essential role in successfully designing and fabricating accurately fitting implant-supported restorations. Learn more about how scan bodies are used when taking digital impressions for implants.

Implant impression copings

Implant copings are an important part of the dental implant workflow. We hope this article helped you better understand how impression copings are used when restoring and placing implants. Now we recommend taking some time to learn about the essential dental implant parts and how they work together to restore a patient’s teeth in a natural way. 

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Dental implant systems https://www.meetdandy.com/learning-center/glossary/dental-implant-systems/ Wed, 22 Nov 2023 15:20:45 +0000 https://www.meetdandy.com/?p=16585 A dental implant system is comprised of a few medical devices that work in congruence when embedded in a patient’s jaw for both the aesthetics of housing a tooth replacement and the functionality of chewing. Dental implant systems have come a long way over the years, evolving to fit both the visual and practical needs […]

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A dental implant system is comprised of a few medical devices that work in congruence when embedded in a patient’s jaw for both the aesthetics of housing a tooth replacement and the functionality of chewing.

Dental implant systems have come a long way over the years, evolving to fit both the visual and practical needs of patients and doctor’s preferences. Each patient is different and there is a dental implant that fits them. We’ll be looking at the various implant systems in dentistry and discuss how to choose the best one for your practice. 

There are three distinct types of dental implant systems:

  • Endosteal implants: These are the most common type of dental implant. They are placed into the jawbone and fuse with the bone to create a stable foundation for the replacement tooth. Endosteal implants are available in a variety of shapes and sizes to accommodate different patient needs.
  • Subperiosteal implants: These implants are placed on top of the jawbone, under the gum tissue. They are not as common as endosteal implants, but they may be an option for patients who have inadequate jawbone density.
  • Zygomatic implants: These implants are placed into the zygomatic bone, which is located in the cheekbone. They are used for patients who have severe jawbone loss and cannot support traditional dental implants.

What makes up a dental implant? 

Dental implant systems are composed of three major parts: the implant fixture, the abutment, and the implant crown. 

  • The implant fixture is a screw-shaped metal rod that is inserted into the jaw bone to serve as a replacement for the tooth root. It is typically made of titanium, a biocompatible material that fuses well with bone. In some instances zirconia is used, particularly for patients who may have an allergy to titanium.
  • The implant abutment is a small connector piece that is attached to the implant fixture. It provides a foundation for the implant crown to be placed on. Abutments can be made of a variety of materials, most commonly titanium and zirconia
  • The implant crown is the visible part of the dental implant. Crowns are used to replace single teeth, with other dental implant components used if more extensive work is needed. A bridge is used to replace multiple teeth, and dentures are used to replace all of the teeth in the arch. Implant crowns can be made of a variety of materials, including zirconia, metal, porcelain fused to metal (PFM) and ceramics like lithium disilicate.

The top eight dental implant brands 

Straumann

Founded in 1954 in Basel, Switzerland, Straumann has been a leader in dental implant systems since introducing the world’s first one-stage dental implant in 1974. Straumann products are available in more than 70 countries with manufacturing facilities in Brazil, Germany, India, Switzerland and the United States. Straumann implants have a 10-year success rate of 97-99%.

Nobel Biocare

The Nobel Biocare story begins with the groundbreaking work in osseointegration done by professor Per-Ingvar Brånemark and the Swedish company Bofors back in 1965. Today the company is based in Zurich, Switzerland. Nobel Biocare products are available in more than 80 countries with four manufacturing facilities in the United States, Sweden and Japan. Over a 10-18 year period Nobel Biocare implants have a prosthetic survival rate of 98.8%.

Zimmer Biomet 

Zimmer Biomet was founded in 1927 in the United States. Today their headquarters are located in Warsaw, Indiana. The company has operations in more than 25 countries and sells their products in more than 100 countries around the world. Production of their dental implant systems takes place primarily at their Warsaw headquarters. Over a 10-year period Zimmer Biomet implants have a survival rate of 99.3%.

Biohorizons

Biohorizons was founded in 1994 through the research conducted by Carl E. Misch, DDS, Martha Bidez, PhD and Todd Strong, COO of BioHorizons at the University of Alabama at Birmingham. The company still calls Birmingham their home today, while they have expanded operations to 90 markets across the globe. Their dental implant systems boast a success rate of 99.2%.

Hiossen

Hiossen was founded in 1996 by parent company Osstem, with the company now known as Hiossen Implants emerging in 1997 out of Englewood Cliffs, New Jersey. Today the company has operations in more than 40 countries with a sales presence in more than 70 countries worldwide. All Hiossen implants are manufactured in the United States at their facility located in Pennsylvania. In a 2010 study that surveyed 1246 implants across 340 patients, Hiossen dental implants had a survival rate of 98.6%.

Dentsply Sirona

Prior to their 2016 merger, DENTSPLY and Sirona each had a respective history stretching back to the 19th century. DENTSPLY was founded in New York City in 1899 with Sirona getting their start even earlier in 1877 based out of Erlangen, Germany. Dentsply Sirona is currently the world’s largest manufacturer of professional dental products and technologies with operations in more than 40 countries and a sales presence in more than 120 countries worldwide. The company has production facilities in the United States, Sweden, Belgium and Japan. A 10-year prospective study of single tooth implants placed in the anterior maxilla was able to confirm a 100% survival rate for implants and a 90% survival rate for crowns.

Implant Direct 

Implant Direct was founded in 2006 in Valencia, California. The company is part of the Envista family and they say their aim is to disrupt the industry by improving standards focusing on usability, pragmatism and simplicity. Implant Direct’s dental implant systems are all manufactured in the state of California. We could not find success rate for Implant Direct’s implant and have reached out to the company.

MegaGen

MegaGen was founded in Seoul, South Korea in 2002. Since the company’s earliest days they have followed a vision to provide the best tools to dental professionals so they can achieve the best results for their patients. The company has a presence in over 100 countries thanks to their relationship with more than 90 distributors and 12 affiliates. A study conducted in 2017 surveyed 34 patients and found a survival rate of 100% with an overall success rate of 95.2% as two implants had their prosthetic abutments loosened.

Different implant retention methods

Dental implant retention methods are the techniques used to keep dental implants in place. There are three main types of implant retention methods: screw-retained, cement-retained, and friction-retained.

  • Screw-retained implants are the most common type of implant retention method. They are held in place by a screw that is threaded into the implant. Screw-retained implants are easy to place and remove, and they offer a strong and secure connection between the implant and the restoration.
  • Cement-retained implants are held in place by a cement that is applied to the implant and the restoration. Cement-retained implants are less common than screw-retained implants, but they can be a good option for patients who have bone loss or who are allergic to metals.
  • Friction-retained implants are held in place by friction between the implant and the restoration. Friction-retained implants are the least common type of implant retention method, but they can be a good option for patients who have limited space in their mouth or who have difficulty with traditional screw-retained or cement-retained implants.

The best type of implant retention method for you will depend on your individual needs and circumstances. Your dentist can help you decide which method is right for you.

Choosing a dental implant system 

Choosing the right dental implant system is a crucial decision that should be made by weighing the needs of your patient and your trust in the manufacturer. Another factor that we want to give you the grace to add to the decision-making process is your comfort as the doctor with the particular system. We hope this overview helps you make more informed decisions about your next implant procedures.

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