Category Archives: Facilities & Equipments Update

Digital Dentistry

Digital dentistry refers to the use of dental technologies or devices that incorporates digital or computer-controlled components to carry out dental procedures rather than using mechanical or electrical tools. The use of digital dentistry can make carrying out dental procedures more accurate, efficient than using mechanical tools, both for restorative as well as for diagnostic purposes.

Digital dentistry can be use for:

  • Fabricating a veneer, crown or bridge in just ONE DAY. So, patient can have a crown done and cemented in his/her mouth on the same day, without the need of 2 visits or multiple injections or temporary prosthesis.
  • Planning of teeth movement in orthodontic patient. After planning, a series of teeth models will be printed out where the vacumme-formed aligners will be fabricate for patient to wear. This aligners will move the teeth as planned and achieve final result.
  • Planning and creating a new smile for patient in digital smile design. By changing the teeth colour and alignment in the computer, both clinician and patient can immediately appreciate the outcome of the smile design. From there, clinician can give several treatment options for the patient to achieve the final result.
  • Surgical guide for implant placement – making implant surgery safe and precise

Digital dentistry basically involved 3 basic steps:

  • data acquisition
  • data manipulation and analysis; and finally
  • output

Data Acquisition

We need to collect data or information from patient to start the outflow in the digital dentistry, for example:

  • Dental and Face images. Good image of the teeth or oral cavity region, patient’s smile or portrait picture of patient are essential data for planning digital smile design (DSD). These information can be obtained using a SLR Camera in the Photo Studio environment.
  • Intra-oral 3D scan. With a Intra-oral scanner (such as 3hape scanner), 3D images of the oral cavity region can be record and save in the computer.
  • CT-scan or 3D image of the teeth and jaw bone of patient mouth. Cone Beam CT (CBCT) is the radiograph unit acquire the data. With CT-scan

Miller Machine

Digital crown- What is it and how does it work?

With our new Rainbow-Mill Clinic machine, we can now produce natural and functional ceramic indirect restorations (crowns, onlays, inlays) within a day!

Our miller machine!!

The creation and placement of indirect restoration is one of the most commonly performed procedures in dentistry today. Like traditional crowns and onlays, digital crowns and onlays are ideal for teeth which are badly decayed or broken and commonly used as routine finishes for procedures like Root Canal Therapy.

However, anyone who has had a standard crown or onlay done will know that it can be a time consuming process which takes a minumum of 1 week or more for it to complete.

The crown that was millerd out from the hybrid-ceramic block

Normally in the case of traditional crowns, impressions are taken and sent off to a dental lab for crown fabrication. It may take a week or two for the lab to receive the impression, make the crown and send it back to us. The waiting time and having a temporary crown in the mouth are the drawbacks of this method.

With Digital crowns/ onlays, we can shorten the entire process significantly. The biggest advantage of digital crown is that it can be designed and milled right here in our clinic. Using the latest CAD/CAM technology and state of art equipment, patients receive a perfect crown/onlay in just one day! In addition to that, the crowns are incredibly accurate as we scan your tooth instead of taking impressions.

So how does a Digital Crown work?

Your dentisty will prepare your tooth for a crown as per usual and instead of having you bite down on gooey plasticine like impression materials which are messy and uncomfortable, your tooth will be scanned with our intra oral scanner that takes a 3D image of your tooth, which is then fed into a computer programme. After designing your crown, we will use our milling machine to cut out or “mill” the exact crown that was designed out of a ceramic block. Once milled, the crown is then fitted, polished and bonded to your tooth- all on the same day.

A Digital crown fafricated from the unit

So there you go.. now that you know about Digital crowns that can be milled (cut out) in our own clinic, you can consider giving it a go next time to save an extra visit to the clinic! Talk to your dentist about this if you have more questions or make an appointment to find out more.

Digital Smile Design (DSD)

Digital Smile Design

Nowadays, more and more people are concerned about their esthetic. A perfect smile can affect a person’s overall appearance, making them to have more confidence when meeting with people. Recently, Digital Smile Design (DSD) has become more and more popular, providing more predictable results for every patient.

What is Digital Smile Design

DSD is a dental treatment planning tool that helps the dental providers to have improved diagnostic vision, better outcome predictability and improved communication between the providers and patients. With DSD, the dental providers would be able to design a better and beautiful smile customized to every patient and be able to deliver the treatment planning confidently to the patients. With the patients’ complete understanding, they could perform the dental treatments efficiently.

How does DSD work?

When the patients have decided to make their smile look better, the dental providers will communicate with them to understand their expectations and needs from the treatment. Then, the providers will take photos of them and their teeth. Later, all the required photos will be imported into the DSD software.

Then, the software will help the dental provider to analyze the patients’ dental and facial proprotions thoroughly. There are various forms and shapes that can be chosen from the digital library which suits best for the patient. This gives the patients a quick glimpse into what they can expect at the end of the treatment.

Next, the providers will explain to the patients the problem lists. A thorough treatment plan is created based on the problem lists and what dental treatments are needed to achieve the final outcome. The treatment can range from simple restorative procedures, orthodontic treatment to orthognathic surgery.

Case Sample

First, patient is required to take photos of their smile.

Patient with smile
Patient with retracted smile

Next, photos are imported into the DSD software. The providers identify the patient’s smile issues. Then, the software is used to analyze their dental and facial proportion, thus designing a better smile design customized to every patient.

Patient’s smile design
Patient’s close up smile design
Patient’s smile design simulation

Lastly, the final outcome of the smile design is then displayed on the software. Treatment plan based on the design is then discussed with the patient.

What makes DSD unique?

After smile design simulation

Although digital imaging and diagnostic mock-up can show to the patients how will they look like at the end of the treatment, they have their limitations in terms predictability. With DSD, the providers are able to tell the patients exactly what their smile will look like because final outcome of the patient’s smile will be displayed in the software and the accuracy of the the final outcome is high. With these, miscommunication between the patients and providers can be avoided as they will be on the same page.

Who is a best candidate for DSD?

Good news is everyone is a good candidate as long as they want to have a better and beautiful smile.

So, if you have always wanted to do something about your smile, this is the opportunity to bring up your wants and needs.

Cone Beam CT (CBCT)

Our new CBCT, OPG and Lat Ceph X-Ray unit
Our new CBCT, OPG and Lat Ceph X-Ray unit

Cone Beam CT (CBCT) is an X-ray based imaging technique that, like a conventional medical CT scan, provides fast and accurate visualisation of bony anatomical structures in three dimensions. In another words, CBCT produces a 3-dimensional images of your teeth and jaws.

It is also sometimes called “Digital Volumetric Tomography” (DVT) or other alternative names.

Unlike CT-scan, CBCT scanning resolution is higher, with less artefact and scatter. The scan field of view can also be reduced to image smaller volumes and lower the radiation dose associated with each scan.

CBCT
CBCT image in 3D, with vertical, coronal and axial cross-section plane

CBCT scans are useful in many different types of dentistry, especially for dental implant planning, managing impacted teeth and root canal treatments, basically to get the 3D images of the teeth and jaws. It is used by general dentists and specialists to improve diagnosis and treatment planning in the following cases:

CBCT5
Clinician uses CBCT for diagnosing diseases and treatment planning

Dental implants

  • Size and shape of ridge, quantity and quality of bone
  • Position and orientation of implants insertion
  • Location of anatomic structures: mandibular canal, submandibular fossa, incisive canal, maxillary sinus
  • Need for bone graft, sinus lift
  • Acquire for implant planning software

Oral and maxillofacial surgery

  • Orthognathic surgery planning
  • Localization of impacted teeth, foreign objects
  • Relationship of third molar roots to mandibular canal
  • Evaluation of facial fractures and asymmetry
  • Oral and maxillofacial pathology
  • Localization and characterization of lesions in the jaws
  • Effect of lesion on jaw in 3rd dimension: expansion, cortical erosion, bilateral symmetry
  • Relationship of lesion to teeth and other structures

Orthodontics

  • Treatment planning for complex cases when 3D information needed to supplement (or substitute for) other imaging
  • Patients with cleft palate
  • Impacted/missing teeth
  • Root angulation, root resorption
  • Temporomandibular joint
  • Osseous structures of TMJ
  • Relationship of condyle and fossa in 3D
ID-nerve
CBCT image can be used to determine the position of the ID nerve in the jaw bone

FAQ on CBCT

When should CBCT be used?
  • Whenever information in the 3rd dimension is needed for the diagnosis, treatment planning, or management of conditions in the jaws and the maxillofacial complex.
What does the scan look like when it is done?
  • The CBCT examination produces 3-dimensional pictures of the hard and soft tissue of your face. The size of the volume depends on the scanner and your particular clinical needs. The information can be viewed on a computer screen in different cross-section plane and can be rotated by the dentist to help plan treatment.
What is the difference between ordinary X-ray pictures and CBCT?
  • Ordinary X-ray images (such as OPG) are 2-dimensional, flat, pictures. Your teeth and jaws are 3-dimensional, so 2-dimensional images may not give the best information.
CBCT-3D-image
3D image of the jaw bones
Where do I go for a scan?
  • You can come to us for CBCT scan
  • or certain hospital X-ray Department in Klang Valley with CBCT unit
What are the advantages of CBCT?
  • Lower radiation dose than medical CT
  • Equivalent to ~1 Full mouth series of intra-oral radiographs or 6-7 panoramic radiographs
  • Comfortable for patient
  • Patient standing
  • Only 20 second scan
  • Wheelchair accessible
  • Images available almost immediately on screen
  • Images can be imported into other software
What will happen when I attend for the scan?
  • First, you will be asked to wear a lead apron to protect your body from radiation. Next, you will be positioned carefully in a standing position. You will then be ready for the scan itself.
  • The machine will move around your head in a circular motion, but will not touch you. Once the scan is finished, you will be asked to stay in the chair until the images are checked.

CBCT4

How long does the scan take?
  • The scan itself takes only a minute or so but, in most cases, the preparation and positioning will mean that the complete scan will take about 20 minutes.
Is there anything I need to do before I come for my appointment?
  • If you have earrings or other facial jewellery or piercings, these may need to be removed before the scan, so doing this in advance of your visit will save time. If you wear dentures, you will probably be asked to remove these before the scan.

CBCT-remove-earrings

Should the amount of X-rays I will receive worry me?
  • No. All CBCT referrals should be justified and only carried out when it is judged that the scan is appropriate. Although the X-ray exposure with CBCT is greater than with a traditional dental X-ray examination, it is almost always much less than you would get with a “medical” CT scan that might be the only alternative.
Other Radiograph Modalities…

Nitrous Oxide Delivery System

Matrx Fraser MDM® Mixer

nitrous-oxide-delivery-syst

Matrx Fraser MDM® is a unique nitrous oxide/oxygen mechanical mixer which allows easy titration of nitrous oxide levels for quick and effective pain relief.

  • Allows titration with tidal volumes as low as 3.2 lpm
  • Changes to flow rate do not affect the titration level
  • Changes to titration levels do not affect the flow rate

Indications

Nitrous oxide sedation – also called Relative Analgesia(RA) – is indicated for pain relief and management ofanxiety during moderately painful procedures and painful surgery such as:
  • Dental surgery
  • Emergency medical care
  • Obstetrics
  • Suturing of superficial wounds
  • Reduction of simple fractures

Benefits of Nitrous Oxide Sedation

  • Reduced pain and anxiety
  • Nitrous Oxide (N2O) has analgesic, anxiolytic as well as mild amnesic properties which make it an excellent agent to reduce patients’ pain and fear.
  • Relaxed patients remain fully conscious and responsive
  • Rapid onset / rapid recovery
  • Clinical effects may begin in less than 30 seconds with peak effects occurring in less than 5 minutes.
  • Rapid recovery is achieved after administering 100% oxygen for 5 minutes.

Why choose Fraser MDM® Mixer?

  • Allows easy titrationMDM®allows easy incremental titration of nitrous oxide levelsIts unique auto-compensation system eliminates the need to constantly readjust the flowrate and mixture percentage during the titration process.
  • Built-in safety features to ensure patient oxygenation MDM®is designed to supply a minimum of 30% oxygen.
  • Fail-safe system immediately stops the flow of nitrous oxide if the oxygen supply is discontinued.
  • Integrated oxygen flush button immediately increases the flow of oxygen to the reservoir bag by 20 lpm.
  • Automatic air intake valve opens to provide ambient air to the patient if the reservoir bag is depleted
  • Check valve protects the patient against from re-breathing expired gases.

More Info

How patient benefit from nitrous oxide gas sedation? Click here.

Dental Laser Unit

elexxion [email protected] nano

Nano

Efficient performance – gentle cutting action – innovative design. That’s what modern diode lasers are all about. The elexxion claros nano is based on the use of superior DPL technology, which opens the way to dozens of soft tissue applications. Painless, efficient and gentle.

The patented pulse technology of the elexxion claros nano combines the benefits of high energy output with the safety and simplicity of a conventional compact diode laser. In addition, the ultra-short pulse duration of 16 μs permits thermal relaxation of target tissue, which keeps undesirable tissue damage to a minimum.

The combination of high output power and extremely short pulses makes it possible to achieve exceptional cutting speed and precision. The patented pulse technology also prevents virtually all tissue carbonization and as a result shortens recovery time.

The wavelength of 810 nm ensures outstanding results in terms of coagulation.

Laser02

Technical Data

Wavelength: 810 nm
Energy output: 0 – 15 W
CW operation: 7 W
Repetition rate: CW – 20.000 Hz
Pulse duration: 16 µs / CW
Dimensions: H 34 cm, B 18 cm, T 20 cm
Weight: 3,7 kg
Laser class: 4
CE 0535

More Info

To read more on clinical applications of Diode Laser click here

Gas Sedation

Topics

  • Introduction
  • What is nitrous oxide?
  • The goal of nitrous oxide inhalation..
  • Is nitrous oxide safe?
  • Is nitrous oxide safe for children?
  • What are the advantages of nitrous oxide?
  • Disadvantages of nitrous oxide?
  • Contraindications of nitrous oxide
  • What does it feel like?
  • Before taking nitrous oxide
  • Is nitrous oxide right for me?

Feeling Anxious About Dental Treatment?

Introducing…….

Nitrous Oxide Relaxation….

Transforming dental anxiety into soothing, peaceful relaxation with absolute safety.

Breathing nitrous oxide will put a smile on your face from the moment you slip into the dentist’s chair. This safe and highly effective method of patient relaxation has helped millions of people overcome their anxieties about dental treatment.

As you try nitrous oxide, your feelings of anxiety will melt away quickly and be replaced by a warm, gentle feeling. Patient describe the experince as peacefully floating in pleasant dreamlike state. The apprehensive child or adult, nitrous oxide can be the key to an enjoyable, comfortable and anxiety-free dental experience.

Nitrous oxide administrator unit

What is nitrous oxide?

Commonly known as “laughing gas”, nitrous oxide is a non-allergenic, non-irritating gas that affects the central nervous system. It is one of the safest forms of sedation available and is easily and completely reversed by breathing normally for 5 to 10 minutes following treatment.Nitrous oxide is used in combination with pure oxygen to relieve dentistry-related anxiety. When inhaled and absorbed into the body, nitrous oxide has a natural calming effect that lasts only as long as your dental procedure.

The goal of nitrous oxide inhalation..

The goal of use of nitrous oxide in dentistry is to eliminate dental anxiety, making the patient more comfortable while the sedation dentist is able to more effectively complete the planned dental care procedure while the patient is sedated. Consult with your dentist to find out if this pain free procedure right for you.

Is nitrous oxide safe?

COMPLETELY. Nitrous oxide is recognized as the safest sedative used in dentistry today. It is mild, non-toxic and removes itself naturally from your body after use. Its benefits are even recommended for patients with certain medical conditions, including high blood pressure, angina and a history of heart attacks. And, unlike general anaesthesia, patients on nitrous oxide remain fully conscious and responsive at all times.

Is nitrous oxide safe for children?

ABSOLUTELY. While our practice goes to great lengths to make every child feel at ease, some children required a degree of sedation to achieve successful treatment. Nitrous oxide is the safest, most effective form of sedation to relieve your child’s fears and ensure a positive experience.

Patient ready for nitrous oxide adminstration

What are the advantages of nitrous oxide?

  • It’s fast acting – Within minutes of administration, your stress will be transformed into a sensation of smoothing relaxation and pain-killing properties develop after 2 or 3 minutes..
  • Your depth of sedation can be adjusted easily – The depth of nitrous oxide sedation can be adjusted to quickly achieve your optimal level of relaxation. Other sedation techniques don’t allow for this. For example, with IV sedation, it’s easy to deepen the level of sedation, but difficult to lessen it.
  • Recovery time is short – In just 3 to 5 minutes after the flow of nitrous oxide is stopped (100% Oxygen flush), the effects completely disappear from your system. In fact, nitrous oxide is the only form of sedation that has no lasting after-effects that impair your ability to drive. You will simply feel refreshed and ready to go about your daily activities.
  • Certain procedures can be done without local anaesthesia – those that usually involved the gums such as deep cleaning. Nitrous oxide acts as a painkiller on soft tissues such as gums. However, its pain-relieving effects vary a lot from person to person and can’t be relied upon.
  • Very safe – Inhalation sedation has very few side effects and the drugs used have no ill effects on the heart, lungs, liver, kidneys, or brain.
  • Reduce gagging – Inhalation sedation can be very effective in eliminating or at least minimizing severe gagging.
Monitoring the oxygen level and the hearth rate throughout the procedure will make gas sedation a safe procedure

Disadvantages of nitrous oxide?

  • Not comfortable with laughing gas – Some patients might afraid they might ‘lose control’ and some actually feel nauseous when inhaling nitrous oxide which are quite rare and usually due to over-sedation.
  • Inadequate of sedation – Some people will not achieve adequate sedation with permissible levels of oxygen.
  • Not comfortable with nasal mask – If you can’t breathe through your nose (either because you’re a pure mouth breather, or because your nose is blocked), or you feel too claustrophobic when something is put over your nose, it can’t be used.

Contraindications of nitrous oxide

  • Significant respiratory compromise
  • Upper respiratory tract infection
  • Conditions related to vitamin B12 deficiency
  • Nitrous oxide is relatively contraindicated in pregnancy

What does it feel like?

The most common sensations that patients experience are:

  • tingling of hands and feet
  • a general feeling of warmth
  • numbness of your legs, tongue and oral tissues
  • a ringing sensation or droning sound
  • feelings of euphoria
  • feelings of heaviness or lightness

If you feel nauseous while breathing nitrous oxide, please inform the dentist immediately so that the level can be adjusted.
Not everyone enjoys the feeling of nitrous oxide. If you feel uncomfortable at any time while breathing nitrous oxide, you can discontinue it at once by breathing deeply through your mouth. Be sure to let the dentist know so that the gas can be turned off.

Before taking nitrous oxide:

1. Do not eat or drink anything for 2 hours prior to your appointment. Otherwise you may feel nauseous or vomit during treatment.
2. Inform us of any changes to your medical history or any medications you are presently taking.
3. Use the restroom before your dental procedure.

Is nitrous oxide right for me?

Please discuss the possibility of nitrous oxide conscious sedation with us. It may be just the solution you or your child have been waiting for. If you have any questions regarding the use of nitrous oxide, feel free to discuss it with our dentist or email us at [email protected].

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Bone Graft

Dental-Implant

What is bone graft in dentistry?

bone block
Bone Block

bone graft
Bone Graft

 

Bone graft is a material that used to replace missing bone or bone defect in the face and mouth region, particularly in jaw area for support of  implant during implant placement. Bone graft can also be use support the cheek or the chin area for aesthetic reasons.

Usage of bone graft in dentistry:

  • Orthognathic (Corrective jaw surgery) Surgery
  • Alveolar Bone Grafting (ABG) procedure in cleft patient
  • Periodontal surgery (eg. Guided Bone Regeneration)
  • In implant dentistry, bone grafts are widely used  in:
    • Sinus augmentation
    • To preserve the socket after dental extraction of implant placement later
    • To repair defect after dental extraction
    • To cover exposed implant fixture during implant placement

Bone augmentation is a term that describes a variety of procedures used to “build” bone so that dental implants can be placed.

 

Bone graft was use during open sinus augmentation
Bone graft was use during open sinus augmentation

When do we use bone graft in implant surgery?

Bone graft is used when there is not enough of bone at the site where implant is intended to be placed. Usually, when the width or the height of the jaw bone is not enough to support the placement of implant.

Bone graft can be obtain from outside or from patient’s own bone (autologous bone). Autologous bone is the best bone to substitute missing bone due to its high survival rate  and its capability of attract new bone formation.

 

Bone-graft-procedure
Xenograft material was used to graft bone defect after implant placement

 

Bone graft sources

Autograft (Autogenous Bone)

Autologous bone grafting involve taking bone graft from patient’s bone of the  same individual who is receiving the graft. Bone can be harvested from intra-oral (in mouth) or extra-oral (outside the mouth); example iliac crest, rib, cavarium.
In oral and maxillofacial surgery, bones are harvested extra-oral under general anaesthesia to repair alveolus in cleft patient, reconstruct mandible or maxilla after tumor resection, condyle reconstruction etc.
 

autologous-bone-graft
Autologous bone graft taken from the external ridge of the ramus of lower jaw

In implant dentistry, the usual site in the mouth that used to get bone graft (Donor site) usually depends on surgeon preference, the quality and quantity required:

  • External oblique ridge (bone behind the lower last molar)
  • Chin area
  • Tuberosity (bone behind the upper last molar)

Advantages of autograft:

  • Less rejection because graft originated from the patient’s own body
  • The graft doesn’t carry any disease
  • Using autograft bone as grafting material produce the highest successful outcome and predictability because the graft is a vital (living) bone which has the property of  osteoinductive and osteogenic, as well as osteoconductive to regenerate new bone.

Disadvantages:

  • Additional surgical site is required (2 site surgery)
  • Post-operative pain and complications

 

Allografts

Allograft bone, like autogenous bone, is derived from humans; the difference is that allograft is harvested from an individual other than the one receiving the graft. Allograft bone can be taken from cadavers that have donated their bone so that it can be used for living people who are in need of it.

puros-from-zimmer
Puros from Zimmer is allograft bone particles

 

There are three types of bone allograft available:

  1. Fresh or fresh-frozen bone
  2. Freeze-dried bone allograft (FDBA)
  3. Demineralized freeze-dried bone allograft (DFDBA)

Allograft bone used in dentistry uses bone from cadaver that undergo process of removal of unwanted material such as fats, cells, antigens, and inactivates pathogens, while preserving the valuable minerals and collagen matrix. This material is than freeze-dried before package.

Advantages of allograft:

  • Less antigenic rejection because allogaft bone originated from the same species
  • No need additional surgical site is required (2 site surgery)
  • The success of grafting using allograft will be lesser than autograft as the material used is basically a dead tissues
  • However, this material still carry property of  osteoinductive and osteoconductive to regenerate new bone

Disadvantages:

  • Allograft bone might carry certain unknown diseases that resist the cleaning process during preparation of the graft
  • The graft usually resorb faster than xenograft material
  • Additional cost to the surgery

Xenografts

Xenograft bone substitute has its origin from a species other than human, such as bovine bone (or recently porcine bone) which can be freeze dried or demineralized and deproteinized. This material still has the property of  osteoinductive and  osteoconductive to regenerate new bone.

 

Bio-oss
Bio-Oss from Geislich contains xenograft material

Advantages of xenograft:

  • No need additional surgical site is required (2 site surgery)
  • This material still carry bone regeneration property of  osteoinductive and osteoconductive.
  • However,  success of grafting using xenograft will be lesser than autograft as the material used is basically a dead tissues
  • Xenograft material last longer in the mouth therefore, it with maintain the bone thickness for years

Disadvantages:

  • Just like allograft, xenograft material might carry certain unknown diseases that resist the cleaning process during preparation of the graft
  • Additional cost to the surgery

 

Alloplastic grafts

Alloplastic grafts may be made from hydroxylapatite, a naturally occurring mineral that is also the main mineral component of bone. They may be made from bioactive glass. Hydroxylapatite is a Synthetic Bone Graft, which is the most used now among other synthetic due to its osteoconduction, hardness and acceptability by bone.

 

boneceramic
BoneCeramic isone of the example of alloplastic graft

 

Some synthetic bone graft are made of calcium carbonate, which start to decrease in usage because it is completely resorbable in short time which make the bone easy to break again.

Tricalcium phosphate which now used in combination with hydroxylapatite thus give both effect osteoconduction and resorbability.

Polymers such as some microporous grades of PMMA and various other acrylates (such as polyhydroxylethylmethacrylate aka PHEMA), coated with calcium hydroxide for adhesion, are also used as alloplastic grafts for their inhibition of infection and their mechanical resilience and biocompatibility. Calcifying marine algae such as Corallina officinalis have a fluorohydroxyapatitic composition whose structure is similar to human bone and offers gradual resorption, thus it is treated and standardized as “FHA (Fluoro-hydroxy-apatitic) biomaterial” alloplastic bone grafts.

 

Biological mechanism

Properties of various types of bone graft sources.
  Osteoconductive Osteoinductive Osteogenic
Alloplast +
Xenograft +
Allograft + +/–
Autograft + + +

Bone grafting is possible because bone tissue, unlike most other tissues, has the ability to regenerate completely if provided the space into which to grow. As native bone grows, it will generally replace the graft material completely, resulting in a fully integrated region of new bone. The biologic mechanisms that provide a rationale for bone grafting are osteoconduction, osteoinduction and osteogenesis.[1]

Osteoconduction

Osteoconduction occurs when the bone graft material serves as a scaffold for new bone growth that is perpetuated by the native bone. Osteoblasts from the margin of the defect that is being grafted utilize the bone graft material as a framework upon which to spread and generate new bone. In the very least, a bone graft material should be osteoconductive.

Osteoinduction

Osteoinduction involves the stimulation of osteoprogenitor cells to differentiate into osteoblasts that then begin new bone formation. The most widely studied type of osteoinductive cell mediators are bone morphogenetic proteins (BMPs). A bone graft material that is osteoconductive and osteoinductive will not only serve as a scaffold for currently existing osteoblasts but will also trigger the formation of new osteoblasts, theoretically promoting faster integration of the graft.

Osteopromotion

Osteopromotion involves the enhancement of osteoinduction without the possession of osteoinductive properties. For example, enamel matrix derivative has been shown to enhance the osteoinductive effect of demineralized freeze dried bone allograft (DFDBA), but will not stimulate de novo bone growth alone.

Osteogenesis

Osteogenesis occurs when vital osteoblasts originating from the bone graft material contribute to new bone growth along with bone growth generated via the other two mechanisms.

 

 

Air Polishing with EMS:Air Flow®

Air polishing is an alternative, non-contact, method of polishing teeth using a polishing cup and paste after teeth scaling. It requires a special ultrasonic unit (e.g. Air Flow from EMS) that allows use of this insert in the handpiece.

Air polishing uses medical-grade sodium bicarbonate and water in a jet of compressed air to “sandblast” the surface of the enamel smooth. Examples include the Prophy-Jet® and Cavitron Jet® (Dentsply Ltd.). The nozzle is held 3 to 5 mm from the tooth, centred on the middle third of the tooth. Use at 60° to the long axis of the root. Do not direct into the gingival sulcus.

Air polishing with EMS Air Flow®

Before air polishing

Afer air polishing

Read More…

ZOOM!! Whitening System

ZOOM!! Whitening System

The Zoom! ™ In-Office Whitening System is a revolutionary tooth whitening procedure. It’s safe, effective and fast, very fast. In just over an hour, your teeth will be dramatically whiter. Zoom!™ Whitening is ideal for anyone looking for immediate results. The convenience of Zoom!™ in comparison to days of wearing trays and gradual whitening makes it the perfect choice for the busy individual.

Get ready to Zoom!

The Zoom! ™ Whitening procedure is simple and painless. It begins with a short preparation to isolate your lips and gums. The Zoom! ™ clinician then applies the proprietary Zoom!™ Whitening Gel, which is activated by a specially designed light. Teeth typically become at least six to ten shades whiter, sometimes more. A fiveminute fluoride treatment completes the procedure. You’ll be amazed with the results. In most cases, teeth get even whiter the first few days after the procedure.

How Zoom! works

The Zoom!™ light activated gel was developed after years of research by Discus Dental, the leaders in professional take-home tooth whitening. The gel is a scientifically formulated, pH balanced Hydrogen Peroxide that, when activated by the Zoom!™ light, gently penetrates the teeth to remove deep stains and discoloration. With proper care and an occasional touch-up at home, your whiter smile will sparkle for years.

Zoom! Teeth Whitening procedure

The Zoom! Whitening procedure is simple. It begins with a short preparation to isolate your lips and gums.

Isolation of lips and gums before bleaching

The accredited and trained dentist then applies the proprietary Zoom Whitening Gel, which is activated by a specially designed light.

Activation of bleaching gel with Whitening Lamp

Teeth typically become at least six to twelve shades whiter, sometimes more. A fluoride treatment for a few minutes completes the procedure. You’ll be amazed with the results. In most cases, teeth get even whiter the first few days after the procedure. We recommend a consultation and a thorough clean around one or two weeks before the Zoom! Teeth Whitening procedure if you have tartar or superficial stains.

Tune in to Zoom!

Ask your dental professional how the Zoom!™ In-office Whitening System will work for you. Take your first step to feeling good, looking great and making a memorable impression every time you smile. You owe it to yourself!

Frequent Asked Questions

Q. What is Zoom!™ tooth whitening?

A. Zoom!™ is a bleaching process that lightens discoloration of enamel and dentin.

Q. What causes tooth discoloration?

A. There are many causes. The most common include aging and consumption of staining substances such as coffee, tea, colas, tobacco, red wine, etc. During tooth formation,  consumption of tetracycline, certain antibiotics or excessive fluoride may also cause tooth discoloration.

Q. Who may benefit from tooth whitening?

A. Almost anyone. However, treatment may not be as effective for some as it is for others. Your dental professional can determine if you are a viable candidate for this procedure through a thorough oral exam, including a shade assessment.

Q. Do many people whiten their teeth?

A. More people than you might imagine. A bright, sparkling smile can make a big difference for everyone. The Zoom!™ Whitening System makes it easier and faster than ever before.

Q. Is whitening safe?

A. Yes, extensive research and clinical studies indicate that whitening teeth under the supervision of a dentist is safe. In fact, many dentists consider whitening the safest cosmetic dental procedure available. As with any tooth whitening product, Zoom!™ is not recommended for children under 13 years of age and pregnant or lactating women.

Q. How does Zoom!™ work?

A. The Zoom!™ light-activated whitening gel’s active ingredient is Hydrogen Peroxide. As the Hydrogen Peroxide gel is broken down, oxygen enters the enamel and dentin bleaching colored substances, while the structure of the tooth is unchanged.

Q. What does a patient experience during the  Zoom!™ procedure?

A. During the procedure, patients may comfortably watch television or listen to music. Many actually fall asleep. Individuals with a strong gag reflex or anxiety may have difficulty undergoing the entire procedure.

Q. How is exposure to the Zoom!™ light controlled?

A. The Zoom!™ procedure requires that all soft tissue in and around the mouth be protected. The clinician is required to monitor the procedure to insure any exposed skin or tissue is isolated and protected. Protective eyewear is required during the procedure. Light sensitive individuals including those undergoing PUVA therapy (Psoralen+UV Radiation) or other photochemotherapy, as well as patients with melanoma, should not undergo the Zoom!™ in-office procedure. Also, patients taking any light sensitive drugs or substances, whether over-the-counter, prescription or homeopathic, should consult their primary physician prior to procedure.

Q. How long does Zoom!™ Whitening take?

A. The complete procedure takes just over an hour. The procedure begins with a preparation period followed by one hour of bleaching. A five minute fluoride treatment completes the procedure. (A cleaning is recommended prior to the actual Zoom!™ Whitening session)

Q. Are there any side effects?

A. Sensitivity during the treatment may occur with some patients. The Zoom!™ light generates minimal heat which is the usual source for discomfort. On rare occasions, minor tingling sensations are experienced immediately after the procedure but always dissipate.

Q. How white will my teeth become ?

A. The results are spectacular. Clinical studies have shown that the Zoom teeth whitening treatment achieves up to 12 shades lighter with the average being 8 shades (On Vita-Shade guide). Individual results may vary and will depend upon your age, type of stain, initial tooth colour and any visible restorations (White fillings, crowns etc). Please ask our qualified dental staff how much whiter your teeth can be and we will show you what is possible on a tooth shade guide as shown below.To boost your results we recommend using custom made whitening trays for only 30 minutes a day for 5 to 10 days.

Some whitening clinics will only recommend either surgery whitening or home whitening. We have found that combining both methods is the best way to get the most dramatic results and keep them for life.

Vita Shade Guide

Q. How long do the results last?

A. By following the Zoom!™ Post Whitening Care Instructions, your teeth will always be lighter than they were prior to the procedure. The Zoom!™ whitening procedure includes a take-home touch-up kit and trays that can be used whenever discoloration is noticed. Most often a touch-up once a year will maintain a whiter smile that sparkles for years.

A Note of Assurance

Tooth whitening is a well-established procedure in cosmetic dentistry. Hydrogen Peroxide, the active agent in Zoom!,™ has also been safely used for many years in the treatment of gums and other oral soft tissue. The whitening process is effective on most discolored teeth. Darker stains, such as those caused by antibiotics, are more difficult to whiten. The degree of whiteness will vary from patient to patient, depending on the structure of the teeth. If you have any questions, please ask your dental professional who is there to help maximize your smile using the Zoom!™ Whitening System.

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