OFFICE TECHNOLOGY

Periodontal disease or bone loss around the teeth, is a difficult disease to treat and maintain for many patients. Traditional periodontal surgery was often painful due to post-operative swelling from tissue incisions, sutures and sensitive teeth and root surfaces. LANAP, or laser assisted periodontal surgery, was developed as an alternative treatment to traditional periodontal osseous surgery. The FDA-approved procedure utilizes a special wavelength, an ND:Yag laser at 1064 nm, instead of a blade and sutures. The procedure allows disinfection of the diseased gum pockets and bone, removal of bacterial hard debris and tissue hemostasis. All of this without cutting or stitching! Patients report easier healing and less pain and the results demonstrate as good a result if not a better result than traditional periodontal surgery. Only this type of laser can treat periodontal disease because this is the only wavelength of laser which interacts with blood.

For over 10 years we have provided same-day all-porcelain crowns and onlays to our patients. After lots of research and testing, our office invested in CEREC CAD/CAM technology. We tested the units against laboratory manufactured restorations on the same teeth. Our conclusion was that in-office fabrication allowed us to make crowns as good as or better than our dental laboratories. We are also able to control color more readily and we minimize patients’ time overall as there is only one visit, not to mention being numb only once! Just like other technologies, these systems are always advancing and reinvesting in the technology is important for creating the best restorations. With this technology we can make crowns, bridges and veneers in one visit. We can also replicate existing restorations so that retainers, obstructive sleep apnea appliances and night guards will still fit after restoration replacement. Additionally, Invisalign and SureSmile orthodontic appliances can be made utilizing digital impression technology and virtual laboratories.

This soft tissue laser with a wavelength of 680 nm is utilized to removed excess gum tissue around teeth for visualization of the margins for impressions, for frenectomies, treatment of apthous ulcers, etc. It is a good accessory tool in our tool belt.

The first dental implants were placed by the Egyptians. Today’s dental implants are made from grade 4 or 5 Titanium just like hip and knee joint replacements. A dental implant actually replaces the root form of the tooth. After placement and with adequate healing, the dental implant osseointegrates into the bone. Once healed, a metal tooth form and a crown are constructed for placement onto the dental implant. There are several types of dental implants being placed by dentists. Our dental office places Dentsply Sirona implants: Ankylos and Astra Tech. Both of these implants have decades of research and long term data behind them so patients may feel confident that they are receiving a high quality dental implant.

Of course, learning how to place dental implants is a long-term commitment. Initially, Dr. Shannon Allison trained both in class and in a clinical setting for 9 months. Over the last decade, she has invested additional hours into continuing education to learn new techniques and treatments to obtain optimal outcomes for her patients.

What are the benefits of CBCT analysis of the jaw bone in preparation for dental implant treatment planning and placement? A patient presents with a missing tooth. It’s in the location of the lower left molar region. Upon taking a 2D image it appears there is adequate bone to place at least a 10mm dental implant. Now let’s look at it in 3D. Upon review of a 3D X-ray, one can clearly see that there is adequate bone height, but not enough bone width from top to bottom. If the implants had been placed without the additional information, serious complications may have occurred.

One way to further prevent dental implant complications, is to look at the dental implant position while also looking at the prosthetic or restorative dentistry pieces. If a dentist wants to place a crown on the dental implant, one can first analyze the ideal position of the crown in the patients jaw with 3D virtual design. Then, the data from the predesigned crown is merged with the 3D X-ray image and analyzed. The dental implant position relative to the desired crown position may be compared. At this point, the dentist knows if there is adequate bone for the implant in the desired position. Surgery can be planned for precise placement and a surgical guide is fabricated to these exact specifications. To create this surgical guide, digital impressions are taken of the teeth and tissues and a CBCT/3D X-ray is taken of the same patient. The data is merged and the ideal implant position may be determined.

3D X-rays have been available to the medical world for several years. In the 21st century, 3D X-rays have become available in the dental office and with reduced X-ray exposure over medical CTs. These 3D images allow dentists to see “through the layers of the jaw bones and teeth.” Dentists are better able to see unusual root canal anatomies and perform more predictable root canal treatments. Dentists are better able to plan dental surgeries like implants and tooth extractions to minimize complications and improve outcomes. Dentists are also better able to see bony anatomies around teeth and plan periodontal treatment and orthodontic treatment. Lastly, larger volumes of 3D X-rays allow dentists to see collapsed airway spaces. The tools we have at our disposal are truly amazing.

Zeiss optics are the best in the world. The increased detail of a dental microscope allows us to perform less invasive dental treatment. Studies show that your eye-hand coordination improves as your visual field improves. Using a microscope enables more finite and precise finger movements so there is less damage to a tooth and better precision with decay removal, root canal therapy, and smoother crown margins.

The main goals in performing a root canal are straight line access to the nerve canals, biologic shaping/mechanical debridement of the main canals of the tooth, and chemical irrigation to remove remaining harmful bacteria. Traditionally, dentists used stainless steel hand files to remove diseased tissues and a root canal sealer without any true sealing properties. Today’s endontic therapy is performed with rotary NiTI files which easily navigate the nerve canals and prevent unwanted canal straightening. Also, bioceramic sealers are available which contain MTA, a substance which hardens like natural tooth structure and, in combination with bioceramic impregnated gutta percha, provides a bacteria tight seal of the root canal system and helps prevent future reinfections.

Still in its early stages in dental offices, 3D printing has been utilized in the dental laboratory field for many years. The process is the exact opposite of the CAD/CAM CEREC crowns. Instead of starting with something and subtracting material, 3D printing is an additive process that builds models of teeth, dentures, metal frameworks, night guards and surgical guides from the corresponding material. Along with improved digital impressions of soft tissues, we hope its not long before all impressions in dentistry are a memory.

Our hygiene operatories are equipped with intra-oral cameras so that we may better educate patients about their dental health, document existing dental concerns, and communicate with dental insurance companies on the need for dental treatment.