The term cement-retained refers to the use of dental cement for the retention of a prosthesis to an abutment or to the transmucosal portion of a one-piece dental implant. The use of cement in retaining an implant is common in dentistry and has a number of advantages. First, it allows for the correction of improperly angled implants or prostheses. By creating a slope in the cement, a dental professional can compensate for the incorrect incline thus making the entire implant level. Second, unlike the screw-retained structure, the cement-retained structure lacks a screw access channel which provides more occlusal control by providing an intact occlusal table. However, the use of cement in implant retention does have disadvantages as well, the greatest being the complications associated with excess cement. Any excess cement around the implant or prosthesis that has not been properly removed can lead to patient complications such as peri-implantitis.
The Chi-Square statistic is a mathematical equation often used to test the relationship between two or more categorical variables. The test’s null hypothesis is that no relationship between two or more variables can exist; they are entirely independent. By comparing the pattern of responses that can be observed to the anticipated pattern of truly independent categorical variables, researchers can compare a critical value from the Chi-Square distribution to the calculated Chi-Square statistic to determine if an association does, in fact, exist. It’s important to be aware that the Chi-Square statistic is quite sensitive to sample size; in larger sample sizes, small differences will appear more statistically significant than they are. Researchers can mitigate this issue by choosing appropriately sized samples and merging categories when possible to create a smaller table. Dental health professionals often use the Chi-Square statistic to determine causal relationships between types of treatment and patient outcomes.
A chin graft is one of the various types of periodontal procedures that require a surgeon to remove natural bone from one source and graft it onto a different boney area in the mouth. This is usually done to support other cosmetic or corrective dental procedures, like dental implants. While a chin graft is technically considered a type of gum surgery because the gums are manipulated during the procedure, it’s really a surgery that primarily treats bone loss along the jaw after it has deteriorated or collapsed due to gum disease, tooth extraction, or injury. Tooth extraction is one of the most common causes of bone loss, however, some medications can also cause the loss of bony tissue in the jaw. While it is helpful to determine the initial cause of bone loss so it can be treated or discontinued if needed, the cause doesn’t change the treatment plan.
There are many hand instruments used by dentists and periodontists. One of the most common instruments used for dental implants is the chisel dental instrument. This instrument is critical to the dental implant procedure as it is used to remove, smooth, and contour areas of bone so that implant hardware can be inserted. A chisel may have a beveled cutting edge on one side of the dental instrument, which is used for cutting or removing bone. Some chisels have a beveled cutting edge on both sides of the dental instrument, which typically is used for splitting teeth in circumstances where this must be done to remove a broken or damaged tooth. Additionally, chisels may be straight or biangled, or may be triple angled to allow a periodontist to flatten the pulpal floor. Each chisel has unique applications and may be used in a variety of ways during dental implant procedures.
Chlorhexidine gluconate is a bis-biguanide antimicrobial used as an oral rinse or local antiseptic. It is most often used as a mouthwash with its mechanism of action being the lysis of bacterial membranes. Chlorhexidine gluconate is often used in the treatment of gingivitis, a disorder of the gums that causes the tissue to become inflamed and bleed. Used in conjunction with proper oral care, regular brushing and flossing, this drug can help in the reduction of gingivitis related inflammation and bleeding by reducing the number of bacteria in and around the affected tissues. The dosage and frequency of use may be adjusted by a dental practitioner depending upon the severity of the gum disease and any other underlying factors. Though chlorhexidine gluconate is a very effective treatment for gingivitis, it does come with possible side effects including alteration of the user’s sense of taste, an increase in tartar formation, and staining of the teeth, mouth, and tongue.
The initial clamping force, or preload, is created when the elastic recovery of a dental implant screw creates a force that pushes the abutment and the dental implant together. This occurs within the neck of the screw, in between the head of the screw and the first mating thread. When the clamping force is greater the external forces the screw should not loosen, however, this requires an accurate clamping force calculation. Although a clamping force calculator doesn’t exist, the force can be calculated if the coefficient of friction is known. Other factors that affect the calculation include screw stiffness and geometry, the rate of tightening, and the integrity of the hardware. Accurate preload is extremely important in implant dentistry and prevents the screw from coming loose by improving the fatigue strength of the screw and its locking effect. In cases of moderate lateral loads, 75% to 90% of the material elastic limit may be necessary to prevent the loosening of the screw.
Clarithromycin is a semisynthetic macrolide antibiotic used in the treatment of orofacial infections caused by gram-positive cocci and susceptible anaerobes. Its mechanism of action involves the prevention of bacterial growth by interfering with protein synthesis. It is an alternate drug used for antibiotic prophylaxis. Clarithromycin is an effective drug for patients who are allergic or have sensitivities to penicillin. Clarithromycin is often used in the treatment of dental abscesses. Such abscesses can be either periapical, inside the tooth itself, or periodontal, within the gums. Though there are some at-home measures that can be taken to temporarily relieve symptoms, orofacial infections and oral abscesses require antibiotics to eliminate the bacteria and properly heal. The dosage and length of time prescribed will depend upon the severity of the infection and any underlying conditions. Patients should complete their entire prescription as directed to avoid re-infection, partial healing, or further damage to teeth and gums.
Clavulanic acid is a beta-lactamase inhibitor that is sometimes combined with penicillin group antibiotics to overcome certain types of antibiotic resistance. Patients suffering from a tooth or oral infection due to poor oral hygiene, tooth decay, abscess, gum disease, or injury are generally prescribed an antibiotic to destroy the bacteria at the source of the infection. Though the initial infection may be located in a tooth or surrounding tissues, if left untreated, it may spread to other parts of the face, head, or even to the brain. To prevent this and to ensure that even some antibiotic-resistant strains are eliminated, practitioners may prescribe a penicillin-derived drug along with clavulanic acid in a more aggressive treatment. Though other antibiotics, such as azithromycin, clindamycin, or metronidazole, may be used for those who are allergic to penicillins, an amoxicillin/clavulanic acid combination has proved to be equally as effective, especially when compared to the results and side-effects of clindamycin.
The clean technique refers to a surgical procedure that takes place in a clinical setting. All instruments, implants, grafts, and irrigation solutions used are sterile. Surgeons wear sterile gloves, but hospital operating room level sterility is not achieved. The surgeons and assistants wear non-sterile attire and the patient is not necessarily covered by sterile drapes. This technique minimizes the contact with pathogens or potential pathogens that may be encountered during procedures such as dental fillings and dental care. Though hospital-level sterile environments are not required, practitioners utilizing the clean technique still follow tight guidelines and regulations to avoid cross-contamination or pathogen exposure to either themselves or the patient. Any tools, equipment, attire, and solutions used for one patient are not re-used for another patient nor are they taken into another procedure room. In addition, many tools and tool accessories are disposable and come sterile and pre-packaged for the patient’s protection.
Clindamycin is a lincosamide antibiotic used in the treatment of orofacial infections caused by anaerobic bacteria. It is also active against aerobic bacteria, such as streptococci and staphylococci. Clindamycin is an alternate drug used for patients who are allergic to or intolerant of penicillin and penicillin-derived drugs. Oral infections often involve infection caused by more than one type of bacteria. Since clindamycin is effective against both aerobic and anaerobic bacteria, it can treat a wide variety of bacterial pathogens and is therefore a good choice for infections of the teeth, gums, and mouth. Though most patients take clindamycin orally, in some cases, the drug may also be given intravenously. The dose a patient is prescribed will depend on the type of infection being treated as well as patient factors such as age and weight. Though clindamycin has a low risk of serious side effects, it can cause stomach upset, throat irritation, and loss of appetite.