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Transcript of team
Radiopaque Composite Implants
What are they? Bridge In the 1960's, composite resin was introduced and it is continually improving. A dental implant is actually a replacement for the root or roots of a tooth. Like tooth roots, dental implants are secured in the jawbone and are not visible once surgically placed. They are used to secure crowns, bridgework or dentures by a variety of means. They are made of titanium, which is lightweight, strong and biocompatible, which means that it is not rejected by the body. Titanium and titanium alloys are the most widely used metals in both dental and other bone implants, such as orthopedic joint replacements. Dental implants have the highest success rate of any implanted surgical device. Dental Restorations
by Team Fluoride Amalgams have been used successfully for the restoration of teeth for over 170 years Typical life expectancy of about 15 years many can last much longer, some amalgams have been documented as lasting 30-40 years The safety of amalgam has been called into question, but a study concluded by the National Institute of Health concluded that amalgam is safe for human use Insurance carriers have seen a reduction in the use of amalgam for posterior restoration by approximately 40 % in the past 15 years Composites are not as strong as an amalgam. Composites wear faster than amalgams, but they are beginning to approach the wear rate of amalgams under normal function. Vary in radiographic appearance from radiolucent to slightly radiopaque. Single implant Teeth attach to the surrounding bone by a periodontal ligament (“peri” – around; “dont” – tooth) made up of collagen fibers that join into the tooth on one side and bone on the other. Dental implants fuse directly to the bone.
The gum tissues also attach to the root of a tooth with collagen fibers as described above. However, gum tissues can only stick to the surface of dental implants. Implant Dentures The role of the hygienist in maintenance of an implant Removal of deposits on the implant should be accomplished with instruments that are implant-safe. Use instruments that are unable to scratch the softer titanium implant surface. A variety of implant scalers are available which are similar to curettes. Plastic, resin, graphite and gold-tipped scalers are acceptable for implant debridement. A soft-tip plastic sleeve placed on the tip of a sonic or ultrasonic scaler (use low power and extra water) does not damage the implant surface and is clinically effective in debriding the area. Most deposits of calculus are not firmly attached to the implant due to the smooth nonporous titanium surface. The dental hygienist can effectively debribe the implant with gentle working strokes and light pressure. Before After What Restorations are these? What Restoration? What types of Restorations are seen? Sealant Amalgam overhang disrupts the natural cleansing contours of the tooth, traps food and plaque, and contributes to bone loss. It is the dentists responsibility to practice the highest standard of care. If an amalgam has overhangs it must be removed. Sealant procedure should be carefully documented.
Patient or parent consent as obtained
Type of isolation
Teeth and surfaces sealed
Statement that the patient or parent was informed of the need for periodic inspection and maintenance of the sealants
And adverse events, such as difficulty with isolation or patient management that may lead to sealant failure Dental Bridges -Dental bridges use permanent artificial teeth (pontics) anchored with crowns to the adjacent (abutment) teeth. The abutment teeth are those teeth that take most of the stress during the chewing of food. -Fixed bridges or pontics or prosthetic devices accustomed to replace missing teeth cannot be removed from the mouth compare with removable partial dentures. Who should get a bridge? If you are missing a tooth or some teeth between other healthy or restorable teeth that have not yet severely encroached upon the empty space between them you may be a good candidate for a dental bridge. The history of restorative dentistry can be traced back as far as ancient Egyptian times. Examples of tooth replacement from that era are prostheses made from gold wire, ox bone or wood have been found.
More recent restoratives had a renaissance about two hundred years ago when air fired porcelains and cast gold restorations were made to restore and replace teeth.
It seems that in ancient times the main requirement was to replace teeth lost as a result of gum disease.
Restorations today are largely required as a result of trauma, decay, gum disease and aesthetics. History of Dental Restorations The use of ceramics for the restoration of teeth has been a part of dentistry’s modern period of evolution. The period started in the late 1700’s but major advances have mainly come about this century.
Dental ceramics in restorations are essentially oxide based glass-ceramic systems.
There are 4 main reasons of why to use ceramics
Appropriate aesthetic appeal
Relative ease for customized units Ceramic Dental Restorations There are a series of differing ceramic structures available for dentistry
3 main subcategories of ceramic dental materials.
They vary in mechanical properties (strength and toughness), aesthetically and economically. Ceramic Materials Types of Bridges Traditional bridges: Involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Traditional bridges are the most common type of bridge and are made of either porcelain fused to metal or ceramics. Cantilever bridges: They are used when there are adjacent teeth on only one side of the missing tooth or teeth. Maryland bonded bridges (also called a resin-bonded bridge or a Maryland bridge) are made of plastic teeth and gums supported by a metal framework. Metal wings on each side of the bridge are bonded to your existing teeth. 3 types of materials There are three basic types of materials for dental bridges: (1) All porcelain dental bridges (2) Porcelain fused to metal (e.g. gold) dental bridges and (3) all metal dental bridges. On a radiograph, a porcelain-fused-to-metal crown has two different parts. The metal component appears completely radiopaque, and the porcelain section appears more radiolucent. Removable Partial Denture A removable partial denture is made from a several different kinds of base materials. Examples of these includes cast metal, a combination of cast metal and acrylic, and all acrylic. The removable partial denture made of cast metal appears densely radiopaque on a radiograph. The size and shape of the radiopacity depend on the design of the metal framework of the partial denture. A removable partial denture consisting of a metal base with acrylic sides is densely radiopaque where metal is present and slightly radiopaque in the areas of acrylic. A removable partial denture base constructed totally of acrylic is usually seen with wrought-metal clasps. The acrylic base appears slightly radiopaque or radiolucent on a dental image. The metal clasps appear radiopaque and are seen resting on abutment teeth. Teeth in a removable partial denture can be made of acrylic or porcelain. Porcelain teeth are radiopaque and resemble the radiodensity of dentin. Acrylic teeth appear faintly radiopaque or radiolucent. A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. Root canal procedures are performed when the nerve of the tooth becomes infected or the pulp becomes damaged. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Inlays and Onlays
Are made from a variety of the systems mentioned, with no real preference.
Ceramic inlays and onlays enable the tooth to be restored in a durable and aesthetic way. Veneers
Essentially an enamel replacement used mainly for aesthetic reasons on anterior teeth.
Generally, the use of porcelain ceramic material Porcelain Jacket Crown and Bridges
Also known as full-porcelain
Was popularized in the mid 1960’s.
Alumina ceramic material is used, which is toughened and has high strength underlying core. Porcelain restorations are slightly radiopaque and resemble the radiodensity of dentin. Implant Suprastructures
Can be made using the metal-ceramic systems or the alumina based ceramic systems (Full Porcelain). Metal-Ceramic Crowns and Bridges
Also known as Porcelain fused to metal
The base usually contains noble metal, which includes gold, platinum and palladium or base metal like nickel and chromium to form a tough and rigid base for the porcelain ceramic. Complete Dentures A complete denture consists of two component parts: (1) a base material and (2) denture teeth. The typical denture base material is composed of acrylic and appears as a very faint radiopacity on a dental image or, in some cases, may not be seen at all. Denture teeth may be composed of porcelain or acrylic and vary in appearance.
Porcelain denture teeth appear radiopaque and resemble the radiodensity of dentin. Anterior porcelain denture teeth include one or two metal retention pins, or diatorics. On a dental image, diatorics appear as tiny, dense radiopacities superimposed over the radiopaque porcelain denture teeth.
Posterior porcelain denture teeth also appear radiopaque but do not contain diatorics. Acrylic (plastic) denture teeth lack density and appear faintly radiopaque or radiolucent on a dental image.
A complete denture that is not removed before the exposure of a dental image gives the illusion of rootless, or “floating,” teeth. The first step in the procedure is to take an X-ray to see the shape of the root canals and determine if there are any signs of infection in the surrounding bone. An endodontist will then use local anesthesia to numb the area near the tooth. Anesthesia may not be necessary, since the nerve is dead, but most endodontists still anesthetize the area to make the patient more relaxed and at ease. Next, to keep the area dry and free of saliva during treatment, a rubber dam (a sheet of rubber) will be placed around the tooth.
An access hole will then be drilled into the tooth. The pulp along with bacteria, the decayed nerve tissue and related debris is removed from the tooth. The cleaning out process is accomplished using root canal files. Water or sodium hypochlorite is used periodically to flush away the debris. What restoration is this? Legal Responsibilities: Why Knowledge is Important: To be aware of the materials used to ensure no damage is done to existing restorations and to know when a restoration is failing. As Hygienists, we can assess, but the dentist is the only one who can diagnose and prescribe.
To fill the interior of the tooth, a sealer paste and a rubber compound called gutta percha is placed into the tooth's root canal. To fill the exterior access hole created at the beginning of treatment, a filling is placed.
The final step may involve further restoration of the tooth. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or other weakness, a crown, crown and post, or other restoration often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it to full function.