Osseointegrated Implant Therapy

From the Minnesota group, Pihlstrom et al., studied on 453 teeth, including molar teeth, of 17 patients with moderate to advanced periodontitis. In the study, scaling and root planing was done, and one maxillary and one mandibular quadrant of each patient received modified Widman flap. Patients were under regular periodontal maintenance for a follow up to 6 ½ years. They found that in shallow pockets (1-3mm depth), there was loss of clinical attachments, and this is consistent with other studies; For pockets with 4-6mm depth, both non-surgical and surgical methods were equally effective in pocket depth reduction, although scaling and root planing had slightly greater clinical attachment level gain; in deep (>7mm) pockets, scaling and root planing showed pocket depth reduction for 3 years, modified Widman flap showed longer reduction for up to 6 ½ years, and both treatments showed effective attachment gain. Although the non-molar teeth tended to respond more favorable, the results indicated that both treatments were effective in treating periodontitis and maintenance of clinical attachment levels on molar and non-molar teeth.

Several people live with teeth problems, and it is a promulgated fact that losing one’s teeth comes with numerous challenges to the nutritional and aesthetic health of an individual. One can lose their tooth or teeth, to numerous causes like injury, tooth decay, or even deformities. The most common solution to this problem is undergoing dental implant surgery.

Like most of my colleagues, I entered dental school unsure of specialty choice. It then motivated me to seek opportunities in various internship and externship programs to explore the many facets of dental medicine. Upon graduation from dental school, I attended the Eastman Institute for Oral Health of the University of Rochester, where my curiosity and interest in endodontics arose. Through various lectures and hands-on workshops on endodontics and microscopic dentistry, I was amazed and intrigued by the intricate and precise aspects required in the field of endodontics. I have also come to further appreciate the importance of preserving the integrity of a natural dentition.

Subsequent a symposium held at McGill University in 2002, a panel of experts prepared the following statement: (the evidence currently available suggests that the restoration of the edentulous mandible with a conventional denture is no longer the most appropriate first choice prosthodontic treatment. There is now overwhelming evidence that a two-implant overdenture should become the first choice of treatment for the edentulous mandible) .Moreover, empirical studies have reported

The main goal of endodontic treatment is to prevent or heal apical periodontitis. The cleaning and shaping procedures are adversely affected by the highly variable root canal anatomy. The presence of additional canals needs to be detected in to avoid incomplete instrumentation and preservation of bacteria and their toxins, which can compromise the outcome of the root canal treatment. Therefore, the knowledge of the internal anatomy of teeth is a prerequisite for successful endodontic therapy(1).

Implant overdentures have contraindications, mainly in relative to the risks related to the surgical procedures, even if in specific cases it can be regarded as a minimally invasive one. Additionally, using this specific treatment concept is limited to cases with reduced prosthetic vertical space that makes it impossible to apply the attachment systems and also provide adequate prosthesis resistance (e.g., using Locators requires a minimum of 8.5mm vertical space and 9mm horizontal space; bar attachments require 10 to12 mm vertical space) .Implant overdentures are not recommended when there is a decreased D4 bone density, in bruxism and in severe oral hygiene deficiency.

Along with fractography and fractographic analysis of different types of instrument failure, with prevention and management of endodontic instrument fracture. My research strives to combine studies of basic biomaterial science questions with research on clinical applications. I must mention that this was only possible with the help of the UBC graduate endodontic team.

With the 580 veneers on 66 patients, several parameters were examined in this study. The type of margins and depth of the preparation, crown lengthening, presence of restoration, diastema, crowding, discoloration, abrasion, and attrition. A cox regression modeling was used to determine which factors would relate and predict porcelain laminate veneer failure. 42 veneers 7.2 percent failed in 23 patients, and an overall survival rate of 86 percent was seen. A significant association was noted between the failure and the limits of the prepared tooth surface including the margin and depth. The most frequent failure type was fracture. A multivariable analysis also showed that veneers bonded to dentin and teeth with preparation margins on dentin were 10 times more likely to have failures than veneers bonded to enamel. A survival rate of 99 percent was observed for veneers with preparations confined to enamel and 94% for veneers with enamel only at the

In the last few decades, Science has discovered many fascinating discoveries which has increased life expectancy and have made human lives less painful. One of the brilliant discoveries has been being able to renovate human body parts. However, all of these great techniques and methods to “repair” human body parts also have the side effects. The greatest example would be dental implantation which brings back the ‘taste’ in many lives. While reading the article, “Prevalence and Predictive Factors for Peri-Implant Disease and Implant Failure: A Cross-Sectional Analysis”, I learned that dental implantation is also causing the disease called “Peri-implant” which cause discomfort, negative impact on health and may lead to loss of the implant.

If going to the dentist for a procedure didn't make your life easier or improve it in a number of ways, you might be left questioning whether or not you should do it. With implants, however, the advantages are clear and abundant:

Today in the clinic I worked on my patient Evelyn Serrano. I started her a month ago, but could not see her again until now because she is a stay home mom and is hard for her to find who babysit her kids. For today, her boyfriend did not go to work to stay home with the kid. Also, she lives in Danbury and do not drive, so she come to her appointment with me. The dental office where she had her last dental radiographs taken two years ago, was not able to send us her radiographs, and we decided on taking vertical bite wings (VBW) because she while doing her periochart she had some pockets depth between 6-8 mm. However, taking the VBW resulted very challenging experience because my patient Evelyn had difficulty biting down on the sensor. Her teeth never reached the bite block and she was trying holding it in place with her lips. In addition, she had a bad gagging reflex. At the end, I was able to take 4 horizontal bite wings and 4 periapical for the Mx/Mn anterior. The radiographs allowed me to corroborate my probing findings on her extensive bone loss. My patient had active sings of periodontal disease since she had generalized bleeding with minimum manipulation of the gingivae tissue and some of the pocket depths readings were higher today than on her last visit (which is an indicator the gingivae tissue is more inflamed than the last visit). Her diagnosed was a generalized chronic moderate periodontitis with localized chronic advanced periodontitis; and due to the presence of generalized calculus and inflammation, we decided that she will benefit if we first did a power instrumentation cleaning in her teeth to help reduce the inflammation. With the cleaning and the OHI

New attachment apparatus forms in infrabony defects through differential tissue response, increasing functional periodontal support. This functional periodontal support results in reduced pocket probing depths, reduced crestal bone loss, increased bone level, and increased clinical attachment levels (Trombelli, et al., 1997. P. 367). In one case study, treatment sites revealed a minimal mean bone level gain, and demonstrated an increased bone level from the baseline with regeneration of periodontal ligament and cementum in a span of 56 days (Vercellotti et al, 2005. P. 546-547). Although not all constructive surgery is eventful, osseous surgery proves to support the dentition and overall oral

I like this patient because she is not an easy case. Since day one, I had to be on my toes and make sure I was asking all the right questions, and documenting everything. For example, she suffers from high blood pressure and I have to ask her before staring if she took her medication. Also, in class we have been talking about risk factors that can affect the progression of periodontal disease. In her case, her smoking habit has contributed to the progression of her periodontitis. However, clinically the gingiva tissue appears pale pink with some stippling, and very minimum BOP. As I learned in class, that color, consistency, and the BOP are not effective ways to determine the presence of periodontitis. The more reliable way is probing because it will let you know for sure if there has been bone loss. In her case, I also had to take in consideration that she had gum recession and a probe reading of 3mm with a recession of 3mm is really 6mm of bone loss. On her last visit, I collected all the assessment data, and today everything was checked including her SOAP. For the future, I need to make sure that when I am probing the interproximal surfaces, I walk the probe a little more until I reach the col area. Some of my probe reading in these areas were not accurate. As part of her treatment plan, I started talking to her about the relation between plaque and periodontal disease, and the need for her to use dental floss,

A dental implant is usually installed in either two steps or one step. A two-step dental implant installation is also called a compound dental implant installation. In a compound implant installation, your dentist will install the abutment during the first surgery. After the first surgery, the abutment needs to time heal before your dentist your dentist can perform the second surgery. During the healing process, your gum area can easily become infected. This happens because there are gaps between the abutment and the actual implant. These gaps make it easy for food and bacteria to get stuck. If the bacteria are not removed, then the infection can cause your dental implant to fail. Therefore, there are a few tips that you should use in order

“A dental implant is an artificial tooth root that is placed into the jaw to hold a replacement tooth or bridge” (American Academy of Periodontology, 2014). Dental implants may be an option for people who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason. Over a period of time, the jawbone associated with missing teeth atrophies or is resorbed. This often leaves a condition in which there is not enough bone suitable for placement of the dental implants. In these situations patients are