The labial plate is the surface of the gums and teeth that face the inside of the upper and lower lips and inside the cheek. Since this is the part of the gums that are most easily seen by people when someone smiles, people have a strong desire that the labial plate be aesthetically pleasing. This is something that must be considered when discussing a dental implant in the front area of the mouth. Calculating the density of the labial plate bone is important when determining if an implant can be placed in the labial plate or if a bone graft will be necessary. If the labial plate is not dense enough, it cannot anchor an implant. For aesthetic purposes, many periodontists use a flapless procedure on dental implants in the labial plate, so it’s extremely difficult if not impossible to tell that a dental implant was done.
A laboratory analog is a replica of an implant, abutment, or attachment mechanism, usually incorporated within a cast for a prosthetic reconstruction. The analog provides a replica which shows the exact position of a patient’s implant. It is made by taking an impression of the patient’s teeth and implants and using that impression to create a copy which exactly shows the anatomy of the implant as it exists in the patient’s mouth. This allows a dental professional to build the prosthesis and properly place the abutments. The use of a laboratory analog can cut down on error involving the placement of implants and implant abutments. There is software available, such as an analog lab app, which can aid in the process of creating a replica. In addition, the use of the lab 3 manual will provide technicians with the instructions needed to properly utilize the software.
A screw is the part of a dental implant that screws into the jawbone to anchor the abutment and the bridge or crown. There are two different types of screws: lab screws, or laboratory screws, and gold screws. A lab screw is generally considered stronger than a gold screw and can withstand excessive force. Gold screws, however, mold to the patient’s jawbone over time since gold is somewhat malleable for a metal. When force is applied, gold screws will slightly change their shape to accommodate the pressure. Laboratory screws are not the industry-recommended method for anchoring dental implants, so it’s important to double-check the warranties on other implant components and make sure they are not rendered invalid by using a lab screw. Because gold screws are created to fail when excess force is applied instead of breaking the implant, gold screws can protect the implant better than lab screws.
The surface of the various components of a dental implant play an important part in the overall success of the implant over time. Defects in the implant body, screw, or abutment can impact osseointegration and in some cases, cause the complete failure of the implant. The abutment is of special significance: it connects the internal implant hardware to the external artificial tooth, or crown. When casting an abutment, however, defects in the surface may occur, causing it to be too uneven to work with. A lapping tool is a common instrument used in dental laboratory settings to smooth any surface defects that were created during the abutment casting process. Often, lapping tools are included in dental abutment kits, along with alignment guides, screwdrivers, reamers, o-rings, and sleeves. The tool is held by the handle and inserted into the apical end of an abutment to even out any ridges in the surface.
While lasers have been used in the dental health industry since 1994, the American Dental Association (ADA) has yet to give the treatment its Seal of Acceptance. Regardless, laser dentistry is becoming an increasingly popular alternative to conventional dental treatment for a number of different issues. Tooth decay, or caries, can be removed using a laser, which also prepares the surrounding enamel for the filling material. Lasers can also be used to perform a biopsy, or the removal of a small piece of tissue to check for the presence of cancerous cells. Lasers cauterize tissue as they exercise, improving overall healing time and reducing the risk of infection. Gum disease can be treated with lasers to remove harmful bacteria and to reshape gum tissue, and can remove canker sores or lesions in the mouth. Cosmetic dentistry also uses lasers for teeth whitening to speed up the process of lightening teeth with a peroxide solution.
The texture of the surface of a dental implant is crucial to its ability to osseointegrate with the patient’s natural bone tissue. A surface that is too smooth has been shown to have a lower success rate than rougher dental implant surfaces. Additionally, a textured surface does more than just boost bone integration: it stabilizes the implant and may provide antibacterial properties as well. There are many different ways to treat the surface of a dental implant including sandblasting, chemical etching, and laser etching. Laser etching is believed to be more precise than both sandblasting and chemical etching, which produce more variable results than a programmable laser. Laser etching can also be used on top of sandblasting or chemical etching to provide a more textured surface that integrates better with bone. Dental abutments can also be laser etched to improve the texture of the surface that will adhere to the implant body, screw, and crown.
Laser phototherapy (LPT)
Laser therapy has been used in the field of dentistry since nearly its inception due to its high level of accuracy, precision, and low rate of clinical complications. LASER stands for Light Amplification by Stimulated Emission of Radiation and is a device that generates electromagnetic radiation that is uniform in polarization, phase, and wavelength. There are several different types of lasers, including surgical lasers, therapeutic lasers, and high or low powered lasers. Evidence suggests that therapeutic lasers and low powered lasers have anti-inflammatory, bio-stimulatory, and analgesic effects on living tissue. Dentists today are increasingly choosing to offer laser dentistry at their practices to meet consumer demand. Laser-assisted dental procedures can include laser suturing, cauterization, decontamination of bacteria-filled periodontal pockets and root systems, PDL regeneration, bone repair and remodeling, and healing stimulation. Often, the use of a laser during a dental procedure will eliminate the need for anesthesia or strong pain medication.
Laser welding, also called laser beam welding or manual laser welding, is a critical tool for dental labs today. It provides a high-tech, low-error alternative to traditional soldering. Manual laser welding equipment helps dental lab technicians to create or repair dental prosthetics and reconstruction materials, such as posts and loops for tooth additions, cast clasp assemblies, wrought wire single-arm clasps, and cast extensions used for existing partial dentures. Contrary to conventional soldering, laser welding offers complete freedom of controls and precision accuracy. This, along with localized heat, eliminates thermal expansion and results in superior seam welds on dental implant frames and bars, passive fit bridgework, and other frequently used dental prosthetic appliances. Other alternatives to laser beam welding and soldering include torch or plasma welding, spot or resistance welding, and single pulse tungsten inert gas welding. Of all these, laser welding provides the most desirable results for dental prosthetics.
Late Implant Failure
Although dental implantology has come a long way in recent years and the procedure is now known as one of the most widely successful dental procedures that can be done, failure still unfortunately occurs. Implant failure is typically separated into two broad categories: early implant failure and late implant failure. Early implant failure is often caused by issues like a contaminated implant, infection, excessive trauma during the surgical procedure, or lack of primary stability of the implant hardware. Late implant failure is less common, and have fewer causes. Generally, once a patient is out of the woods of early implant failure, the chances of late failure are low. However, traumatic occlusion, occlusal overload, and dental cement that is retained subgingivally. Late implant failure typically occurs within one to three years after the placement of the implant. Bruxism, or nighttime teeth grinding and clenching, is a common cause of late implant failure.
Lateral Window Technique
The lateral window technique, or external sinus graft, is the creation of an access point to the maxillary sinus through its lateral wall. The access is used to elevate the Schneiderian membrane for the placement of graft material in the inferior part of the sinus space. The lateral window technique is often used when resorption of alveolar bone leads to severely decreased bone height which impairs the placement of dental implants. An external sinus graft is achieved by placing a bone graft in the new space, or window, that has been created. The bone used in the grafting procedure may be autogenous, come from a human donor, or come from donor bovine bone. Though autogenous bone grafts have been shown to heal faster than grafts from the other two sources, their success rates are similar. If implants are needed, they may be placed during the same procedure or after the graft has healed.