digital impression making

examination, Diagnosis, and Treatment Planning

Figures 1a and 1b. The patient stated that she was tired of the unaesthetic appearance of her teeth.

Ginny, a 69-year-old female, presented to the office in early 2008. Her chief complaint involved 3 teeth that fractured in the past year, and she was tired of the overall appearance of her teeth (Figures 1a and 1b). She stated that she wants to keep her teeth "…until I die."

Figure 2. The provisionals were removed from teeth Nos. 22 to 27.	Figure 3. The prepared teeth, after placement of retraction cord and application of scanning powder.

Laboratory Processing of the Digital Impression

Figure 4. The laboratory technician uses video images captured by the doctor to accurately and confidently mark the margin.	Figure 5. A virtual model can be simultaneously sent to the crown and bridge laboratory and model manufacturing facility. Dental technicians then use software to design the final restoration.

Figure 6. A ditched and fully articulated stereolithography apparatus model is sent to the crown and bridge laboratory, as well as a solid model like the one pictured above.

Figures 7a and 7b. The model is used for the final steps in the fabrication of the final crown.

Delivery Appointment

Figures 8a and 8b. The final crowns.

The zirconium oxide (Lava) crowns were completed by the dental ceramist and sent back to my office

LASER CAVITY PREPARATION BY WATERLASE

What is Waterlase™?

The Waterlase™ Hard and Soft tissue laser features a patented Laser-energized water technology which treats cavity preps precisely and safely with little or no discomfort. The water quickly and gently removes enamel, dentin and decay without causing heat or microfractures associated with traditional high-speed drills. 2. What Is HydroKinetic Technology? The HydroKinetic process is the removal of tissue with YSGG laser-energized water droplets. HydroKinetic energy is produced by combining a spray of atomized water with laser energy. The resulting HydroKinetic energy gently and precisely removes a wide range of human tissue including tooth enamel (the hardest substance in the body), and soft tissue (gum tissue) with no heat and no pain in most cases. 3. Does Waterlase™ Hurt? Almost never! Heat and vibration are the causes of most of the discomfort associated with the drill. since Hydrokinetic™ cutting does not transmit heat or vibration, many dental procedures can be preformed without anesthesia, in most cases. Since a shot is not necessary in most cases, you will not have numb or drooping lips after your dental procedure. The art and science of dentistry have changed, offering a no needle, no drill, no fear procedure for removing decay. 9. Why is Waterlase™ better than the old drill? The waterlase device that we use instead of the drill eliminates the odors, noise, vibration, micro-cracks and, in most cases, the shot associated with the drill.

Latest advances in dentistry

Some of the latest advances in dentistry are featured in the Daily Mail this week. We might have to wait 2 years or more for some of them to be widely available. But we can look forward to:

• Toothpaste that contains microscopic glass particles to help protect teeth from decay and hot/cold sensitivity
• Anaesthetic spray to numb your top teeth, long enough for the dentist to do his work. Only works for the upper jaw unfortunately.
• A magic wand that can help reduce gum disease and tooth decay – available in a limited way now
• Turning cheek cells into new gum tissue
• Vibrating gumshield that can speed up tooth straightening but only if you have braces fitted, coming in now
• Keyhole dental implant surgery, less invasive and faster healing, in some clinics now, generally more in use abroad than in the UK
• A drug to unblock nerve channels, speed up blood flow and quickly reverse the effects of anaesthetic, so hours of numbness after a filling will be avoidable
• Tooth coloured fillings which will replace veneers
• A new type of mouth guard to correct your bite, reduce stress on your body and improve your muscle strength, apparently in limited use now
• Saliva tests to detect a range of diseases from cancer to diabetes

GIANT AMELOBLASTOMA

GIANT AMELOBLASTOMA (CASE PICTURES )

STEM CELL IMPLANTS IN DENTISTRY

STEM CELL IMPLANTS IN DENTISTRY

• For the first time scientists have regenerated a biological tooth within the oral cavity using stem cell development, suggesting a possible cheaper alternative to dentures or implants for adults who have lost some or all of their teeth.
• 
• Scientists demonstrated in an animal model the ability to 'grow' both rodent and human teeth accompanied by ligament and bone regeneration at the site. The US research team directed the body's own stem cells to a growth factor covered three-dimensional scaffold of natural material integrated in surrounding tissue (termed 'cell-homing'). Significant growth and maturation occurred within nine weeks.
• The 'cell-homing' method could overcome the need to isolate harvested stem cell lines, or create an environment external to the body (e.g. a Petri dish) where the tooth is grown and then implanted only after it has matured. This could accelerate regulatory, commercial, and clinical processes according to Dr Mao, the lead researcher on the study.
• 'A key consideration in tooth regeneration is finding a cost-effective approach that can translate into therapies for patients who cannot afford or who aren't good candidates for dental implants' said Dr Mao. 'Cell-homing-based tooth regeneration may provide a tangible pathway toward clinical translation'.
• Implants are hampered by long recovery times, of up to 18 months, and are unable to 'remodel' with surrounding jaw bone that undergoes changes throughout a person's life, according to a press release issued by Columbia University Medical Centre where the technique was pioneered.
• Dr Ira B Lamster, dean of the College of Dental Medicine said: 'This research provides an example of what is achievable when today's biology is applied to common clinical problems. Dr Mao's research is a look into the future of dental medicine'.
• SOON WE WOULD BE ABLE TO GROW TEETH IN ORAL CAVITY REDUCING NEED FOR PROSTHESIS AND NO PROBS ASSOCIATED WITH USE OF PROSTHESIS..:) :)

New Trends in Dentistry Means Less Pain, More Gain

New Trends in Dentistry Means Less Pain, More Gain

The practice of dentistry has been revolutionized. New instruments and techniques help dentists diagnose and treat their patients faster, less painfully, and with more accuracy.

New cosmetic procedures make smile makeovers a reality for more and more people.

While it may not be your favorite place to go, new trends in dentistry can make your dental visit much more pleasant than ever before.

• It is easy to dislike dental x-rays the film holders pinch your gums, gagging is common, and you worry about exposure to too much radiation. A new digital x-ray called a digital panorex films all your teeth at once by traveling around your head. It generates much less radiation than traditional x-rays and produces pictures of your teeth, bone, and surrounding tissue in seconds. Digital images can be enlarged and colorized for a more accurate and complete diagnosis, and can then be emailed to specialists, insurance carriers, etc.
• Computer imaging also helps dentists to create life-like images of their patients smiles. Before starting a treatment like porcelain veneers or bonding, a dentist can create a picture that approximates the look of the patients appearance after treatment. This allows the patient and dentist to discuss changes to the treatment for the end result the patient desires, as well as giving the spouse and/or lab an opportunity for their input.
• 
• Two new machines help dentists diagnose tooth decay in the early stages, before significant cavities form. DIFOTI (Digital Imaging Fiber-Optic Trans-Illumination) is an extremely intense light that is shined on and through the tooth to show decay between teeth and in hard-to-see areas. It is completely painless and does not use radiation.
• 
• DIAGNOdent is a small laser-like wand that looks for cavities based on the softness of a tooth. It is more accurate than the traditional metal explorer used by dentists and dental hygienists. These two new diagnostic aids help dentists find decay sooner and more precisely. Fillings in the early stage of decay require less drilling, less destruction of the tooth, and, in most cases, no pain.
• One of the instruments used to produce pain-free dentistry on the incipient early-stage cavities is called Air Abrasion. It is like a mini-sandblaster. It removes decay with a powerful air stream of fine aluminum oxide powder. Air abrasion allows the dentist to remove less of the decayed tooth and to drill and fill cavities in seconds, usually without anesthesia. It is particularly suited to children, many of whom are afraid of needles or the noise of the drill.
• 
• Cosmetic dentistry is a growing trend, especially among aging baby boomers seeking a more youthful look. Bleaching restores stained, mottled teeth to a whiter and brighter color. The procedure is relatively painless and quick, short enough to be done during a lunch break or on the way home from work.
• Porcelain laminate veneers correct crooked, broken, misshaped, or seriously discolored teeth. They are like fake fingernails, with almost 100% long term success. They are made from a thin layer of porcelain that is colored to look natural in the patients mouth. No more false tooth or dentures look — todays veneers look completely natural. The veneer process is relatively quick. In just two dental visits over one to two weeks, patients can get a brand new smile. You probably have seen hundreds of veneers on Hollywood smiles, and even friends, and never new it!

15 Dental Advancements You Need to Know

15 Dental Advancements You Need to Know

1) Adhesive Dentistry
Contemporary term for dental restorations that involve "bonding" of composite resin or porcelain fillings to natural teeth.

2) Air Abrasion
Removal of tooth structure by blasting a tooth with air and abrasive, a relatively new technology that may avoid the need for anesthetic.

3) Block Injection
Anesthesia of a nerve trunk that covers a large area of the jaw; a mandibular block injection produce numbness of the lower jaw, teeth, half the tongue.

4) Bonding
Adhesive dental restoration technique; a tooth-colored composite resin to repair and/or change the color or shape of a tooth. A procedure to adhere tooth-colored resin to the tooth's surface, creating a bond. The composite resin bonding process is where a resin (similar to an enamel) is bonded to a tooth's surface, but then sculpted into shape, hardened, and polished.

5) Cavitron
Dental tool that uses high frequency ultrasonic waves to clean teeth.

6) Composite Resin
Material composed of plastic with small glass or ceramic particles; usually cured with filtered light or chemical catalyst.

7) Cosmetic Dentistry
Treatments performed to enhance appearance.

8) Cosmetic Contouring
A McMinnville Cosmetic dentist will sculpt and reshape the natural teeth to make them straighter.

9) Dental Implant
A (usually) titanium cylinder surgically placed in the bone of the upper or lower jaw to provide support for a dental restoration or appliance.

10) Intraoral Camera
A small video camera used to view and magnify oral conditions;
images may be printed by your McMinnville cosmetic dentist.

11) Laughing Gas
Nitrous oxide; odorless inhalation agent that produces relative analgesic (sedation); reduces anxiety and creates a state of relaxation.

12) Porcelain Fused to Metal (PFM) Crown
Restoration with metal coping (for strength) covered by porcelain (for appearance).

13) Porcelain Inlay or Onlay
Tooth-colored restoration made of porcelain, cemented or bonded in place.

14) Sealants
Thin resin material bonded in the pits and fissures of back teeth for the prevention of decay. Sealants are used almost exclusively on the biting surfaces of posterior, or back, teeth. These areas are especially vulnerable to cavities because these teeth see the bulk of chewing duty, and their surfaces are so irregular. They are usually covered with pits, fissures, indentations, and small cracks which tend to retain food and conceal plaque deposits.

15) Veneer
Plastic or porcelain facing bonded directly to a tooth to improve its appearance. Porcelain or composite very-thin, special laminates bonded to teeth. Typically, Veneers are used for repairing chipped, cracked, or worn teeth