Monthly Archives: October 2011

Hyaluronic Acid in Dental Implants

Hyaluronic Acid is a natural occurring substance found in our joints, eyes and neural tissues with the highest concentration in the connective tissue and skin. It plays an important role in tissue repair and regeneration but unfortunately it gets depleted as we age. Extensive research has shown that this can be reproduced and prescribed as a supplement to minimize inflammation and accelerate wound healing. Aside from dental implant placement, its various dental applications are for: gingivitis, periodontitis, tooth extraction and bone grafting.

Dental Implant Dentist

Dental Implantology is not a specialty yet. It is not correct to call a dentist as Dental Implant Dentist.

With adequate training, any dentist can perform a dental implant procedure.

A general dentist can perform basic dental implant surgery only if he has acquired the skills to do such procedure. A general practitioner can also carry out bone grafting, but he must have an additional training first.

Bone grafting is not a simple procedure. It requires special training and clinical experience before doing this procedure correctly in the patient’s oral cavity.

A Prosthodontist is one of the most qualified specialists to carry out a dental implant procedure. His specialty lies in dentures. Prosthodontics is a specialty that requires 2 to 3 years of university based or dental school based education. It is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes. He is the most qualified to do the the prosthetic aspect of the dental implant treatment.
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Dental Implant Surgery: Two Stages

The success of a Dental Implant treatment depends on adherence to Dental Implant Surgery principles, the Prosthodontic aspect of the treatment, and proper Dental Implant Maintenance.

There are two types of Dental Implant Surgery according to number of stages; the single stage and the two stage dental implant surgery. The type of surgery may increase or decrease the dental implants cost.
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Q&A: What are Mini Dental Implants?

Question: What are Mini Dental Implants?

Answer: Mini Dental Implants are small diameter implants which are mainly used for Denture Stabilization especially in the lower arch. MDI has a diameter of less than 3 mm. MDIs are also very useful in orthodontic cases as anchors.

History: Over 20 years ago, a New York dentist by the name of Victor I Sendax designed and started utilizing his surgical technique. Mini dental implants, also known as MDI are 1.8 mm diameter biocompatible titanium alloy implant screws. In early 1998, Dr. Ronald A Bulard, who had previously formed the IMTEC Corporation, entered into a strategic alliance with Dr. Sendax. After studying and refining Dr. Sendax’s original protocol, Dr. Bulard added a single one piece O-Ball design to Dr. Sendax’s concept. With Dr. Bulard’s material enhancement and Dr. Sendax’s patented insertion protocol, the IMTEC Sendax MDI was created.
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Titanium Mesh in Dental Implants

Titanium mesh and autogenous bone graft was first introduced by Boyne in 1969, and was re-introduced by Von Arx and others in 1996 as the TIME technique. It is characterized by the use of microtitanium augmentation mesh. Although this technique is widely used for alveolar ridge augmentation, data in the literature regarding the amount of bone gain and the comparison with other augmentation technique is still not sufficient.

In a study of Dr. Tetsu Takahashi, the use of titanium mesh for alveolar ridge augmentation in atrophic jaws was evaluated in the overall success rate, magnitude of ridge augmentation and the rate of complications. Several complication can occur, but most of the trouble are not influenced by the implant treatment results. The results demonstrate that autogenous bone graft with titanium mesh has shown enough alveolar bone reconstruction quantitatively and qualitatively for the implant placement.
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Leader Italia Tixos Cylindrical Implants – Internal Hex

Tixos Cylindrical Implants - Internal Hex

Tixos Cylindrical Implants – Internal Hex by Leader Italia has the following features:
• It is self-threading fixture in titanium, Grade 5
• Microfused, porous, isoealstic surface
• Interconnected cavities: 2-200 microns
• Active porous surface thickness: about 200 microns
• All implants are packaged with a color coded multi-functional tool named Mount-transfer (in titanium, Grade 5).
• High adherence to bone structure
• It has a great resistance to horizontal stresses
• Round apex: minimum trauma during insertion
• An annual check of the implant stability is recommended.
• Compatible with Anoticel Susej Method of Implantology

Tixos dental implants are equipped with a transport tool that allows the surgeon to transport and position the implant in conditions of absolute sterility.
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Leader Italia Tixos Line Dental Implant System

Leader Italia Tixos Line Dental Implant System

Tixos Implant by Leader Italia, is the result of 4 years research on new technology applied to Titanium. The structure and morphology of the implant surface are designed by a computer that, with a focused laser beam, produces the desired model by sintering the titanium powder layer after layer. This technology, also known as Laser Microfused Titanium Powder, allows the production of a porous surface characterized by open intercommunicating cavities that widen to an established depth.

Geometry of Implants Surfaces

Recent studies showed the importance of surface geometry in promoting bone formation also in extraskeletal sites. The implant topographic surface modification may optimize the interactions with host tissue during healing phase, in order to obtain the best tissue response in a shorter time.
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Zimmer Puros Cortical Particulate Allograft

Zimmer Puros Cortical Particulate Allograft

Puros Cortical Particulate Allograft by Zimmer offers the density and strength of a cortical autograft without the need for costly and invasive bone harvesting. It can be used alone or as a composite graft in space maintenance and volume enhancement procedures. It also maintains an open network for the proliferation of bone-forming cells. It is denser than cancellous bone and has been used in applications where cortical particulate is needed. Puros Cortical Particulate retains the natural collagen matrix and mineral structure of human cortical bone

Cortical Particles remodel into a dense lamellar structure without sacrficing ridge contour, and into natural viable bone with similar density to native bone. When used in a sandwich technique for the treatment of localized buccal dehiscence defects, Park and Wang reported an average gain of 1.8 mm in bone thickness. While according to Anoticel Sej Method, an average of 1.9 mm of bone thickness was gained. Combining Puros Cortical Allograft with a combination sandwich and mucogingival puch flap technique, one study achieved 1.5 mm to 3.5 mm gain in mean ridge thickness, and 84% to 100% gain in mean ridge height.
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Bone Graft – bone augmentation

A good brand of particulate allograft is Puros Allografts by Zimmer. From its line of allografts for bone augmentation, puros cancellous particulate allograft has become the bone grafting of choice for many dentists.

Cancellous particulate allograft acts as an osteoconductive scaffold for new bone formation. In large volume of applications, studies have shown faster bone regeneration at 6 months than grafts containing sintered bovine bone matrix. While in small volume applications, regeneration of hard bone has been reported as early as 3-5 months.

Cancellous particulate allograft retains osteconductive properties due to preservation of the natural bone matrix collagen and mineral composition, trabecular pattern, and original porosity enabling the ingrowth of vascular and cellular connective tissue.
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Dental Screws in Dental Implant Prosthodontics Part 4 of 4

Classification based on the positions of the screw assembly.

Screw assemblies in two adjacent abutments
This method may be used to connect two cast crowns, two roots or a cast crown and a root.

Screw assemblies in the removable section of a combined prosthesis
The fixed part of the prosthesis is cemented in the usual manner and the removable part is then screwed to the fixed component. In this way it is possible to construct a prosthesis on divergent abutments.

Screw assemblies in the removable section of a combined prosthesis.

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