Rinse After Eating and Drinking

What you drink can cause bad breath, too. Consuming an acidic beverage, including soda pop, coffee or alcohol, will release compounds into your bloodstream that will, in turn, release odors through your breath. Plus, acidic drinks lower the pH level in your mouth: A lower pH level allows bacteria to flourish and release volatile sulfur compounds, which smell similar to a rotten egg.

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Even if you don’t want to avoid your morning latte, you can still freshen your breath by doing one simple thing: Rinse your mouth with plain water after drinking it. This will help rebalance your mouth’s pH levels. Rinsing with water also works after meals — no matter what you’ve eaten. Swishing the water around may help remove some of the food particles left in the mouth after a meal and prevent bad breath from setting in [source: Dellorto].

Looking for more natural cures for bad breath? Explore nature-made breath fresheners on the next page.

There are a number of reasons why you might be a candidate for these replacements. These can greatly improve your appearance, boost your self confidence, make you comfortable and feel good about yourself. By having your missing tooth replaced, it will be easier for you to chew your food, and an implant is sturdy and can last you a lifetime. An added advantage of the dental implants when matched up to the removable dentures, there is no requirement of using an adhesive. When you do have the substitute, it compensates the cost of the dental implant.

Being able to stand behind your products as a dental professional can help your practice gain confidence and local notoriety, and Innova Dental Lab has the tools and abilities needed to help you offer meaningful satisfaction guarantees. With our advanced equipment and attention to the latest in dental prosthetics technology, we can produce uncompromising porcelain veneers that make the most of this excellent material and which let the concept behind veneers themselves shine. Your patients will enjoy attractive and comfortable results while you attend to your work more easily and proficiently, creating a better outcome for everyone involved.

Deciding to employ a dental implant –or a series of implants– as part of a restoration scheme requires careful consideration and a deep understanding of the risks and potential rewards involved. Along with these requirements, it’s also necessary to pay close attention to the quality of materials used and the precision with which implants are manufactured. When you choose to work with Dental Lab to design and create individual implants and sets, you can put both your patients’ and your own concerns to rest in the knowledge that we have everything needed to prepare perfect prosthetics. From accurately receiving and interpreting your notes and specifications to using state-of-the-art laboratory equipment for part production and even throughout our logistics and customer service processes, you’ll find a dedication to quality and precision that has distinguished our lab among its competition nation-wide.

Zirconia is a very hard ceramic that is used as a strong base material in some full ceramic restorations. The zirconia used in dentistry is zirconium oxide which has been stablised with the addition of yttrium oxide. The full name of zirconia used in dentistry is yttria-stabilized zirconia or YSZ. The zirconia substructure of a crown is usually designed on a digital representation of the patients mouth which is captured with a 3d digital scan of the patient, impression or model. The substructure is then milled from a block of zirconia in a soft pre-sintered state. Once milled the pre-sintered zirconia is sintered in a furnace where is shrinks by 20% and reaches it full strength of approximately 850MPa. To the core structure a dental technician can layer an æsthetic ceramic to create the final colour and shape of the tooth.^[13] Sometimes a ‘monolithic’ crown can be made exclusively of the zirconia ceramic with no æsthetic ceramic layered on top. These crowns tend to be dense in appearance with a high value and lack translucency and fluorescence.

A Ceramist is a very Important Dental Lab Technician.

He controls the shade and profile of a PFM(porcelain fused to metal) or all ceramic.

A very famous ceramist, Mr George H. Whiteley is the one of the founders of Densply.

Whiteley’s contributions to the company were invaluable as he was responsible for many innovations such as a patented process involving platinum rings that reduced tooth breakage. Other innovations (credited to doctors like James Williams who were hired by the company for research purposes) included better fitting dentures, tooth size for people of different face shapes and age specific colored teeth

Aesthetics

A fourth situation in which a crown would be the restoration of choice is when a patient desires to have his or her smile aesthetically improved but when partial coverage(i.e., a veneer/laminate) is not an option for one or more reasons. If the patient’s occlusion does not permit for a mildly-retentive restoration, or if there is too much decay or a fracture within the tooth structure, a porcelain or composite veneer may not be placed with any adequate guarantee for its durability. Similarly, a “bruxer” (someone who clenches or grinds their teeth) may produce enough force to repeatedly dislodge or irreversibly abrade any veneer a dentist can plan for. In such a case, full coverage crowns can alter the size, shape or shade of a patient’s teeth while protecting against failure of the restoration.

Makeover shows such as Extreme Makeover make extensive use of crowns, as the time-frame of the makeover is too short to allow up to 18 months for orthodontic treatment for problems that might otherwise be corrected more conservatively.

Paste that has not set may be removed with ethanol or by rinsing with water and soap.

The adhesive can be removed from metal trays with acetone.

At temperatures below 18 celsius, the pastes cannot be extruded from the tube due to their increased viscosity. However, at room temperature processability is re-established without compromising quality.

Direct exposure to sunlight and damp storage conditions may damage the impression.

Polyether impressions should not be exposed to solvent-containing liquids under any circumstances, swelling and imprecise modeling may result.

Polyether materials may only be combined with polyethers. The working and setting times of the individual products must be strictly observed.

Good Impression, Good Dental Lab products

A dental implant is an artificial tooth root that a periodontist places into your jaw to hold a replacement tooth or bridge. Dental implants are an ideal option for people in good general oral health who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason. Dental implants are so natural-looking and feeling, you may forget you ever lost a tooth.

Under proper conditions, such as placement by a periodontist and diligent patient maintenance, implants can last a lifetime. Dental implants are intimately connected with the gum tissues and underlying bone in the mouth. Since periodontists are the dental experts who specialize in precisely these areas, they are ideal members of your dental implant team. Not only do periodontists have experience working with other dental professionals, they also have the special knowledge, training and facilities that you need to have teeth that look and feel just like your own.

Your periodontist and dentist will consult with you to determine where and how your implant should be placed. Depending on your specific condition and the type of implant chosen, your periodontist will create a treatment plan tailored to meet your needs.

Replacing a Single Tooth

If you are missing a single tooth, one implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root.

What are the advantages of a single-tooth implant over a bridge?
A dental implant provides several advantages over other tooth replacement options. In addition to looking and functioning like a natural tooth, a dental implant replaces a single tooth without sacrificing the health of neighboring teeth. The other common treatment for the loss of a single tooth, a tooth-supported fixed bridge, requires that adjacent teeth be ground down to support the cemented bridge.

Because a dental implant will replace your tooth root, the bone is better preserved. With a bridge, some of the bone that previously surrounded the tooth begins to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact.

In the long term, a single implant can be more esthetic and easier to keep clean than a bridge. Gums can recede around a bridge, leaving a visible defect when the metal base or collar of the bridge becomes exposed. Resorbed bone beneath the bridge can lead to an unattractive smile. And, the cement holding the bridge in place can wash out, allowing bacteria to decay the teeth that anchor the bridge.

How will the implant be placed?
First, the implant, which looks like a screw or cylinder, is placed into your jaw. Over the next two to six months, the implant and the bone are allowed to bond together to form an anchor for your artificial tooth. During this time, a temporary tooth replacement option can be worn over the implant site.

Often, a second step of the procedure is necessary to uncover the implant and attach an extension. This small metal post, called an abutment, completes the foundation on which your new tooth will be placed. Your gums will be allowed to heal for a couple of weeks following this procedure.

There are some implant systems (one-stage) that do not require this second step. These systems use an implant which already has the extension piece attached. Your periodontist will advise you on which system is best for you.

Finally, a replacement tooth called a crown will be created for you by your dentist and attached to the abutment. After a short time, you will experience restored confidence in your smile and your ability to chew and speak. Dental implants are so natural-looking and feeling, you may forget you ever lost a tooth.

Replacing Several Teeth

If you are missing several teeth, implant-supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

What are the advantages of implant-supported bridges over fixed bridges or removable partial dentures?
Dental implants provide several advantages over other teeth replacement options. In addition to looking and functioning like natural teeth, implant-supported bridges replace teeth without support from adjacent natural teeth. Other common treatments for the loss of several teeth, such as fixed bridges or removable partial dentures, are dependent on support from adjacent teeth.

In addition, because implant-supported bridges will replace some of your tooth roots, your bone is better preserved. With a fixed bridge or removable partial denture, the bone that previously surrounded the tooth root may begin to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact.

In the long term, implants are esthetic, functional and comfortable. Gums and bone can recede around a fixed bridge or removable partial denture, leaving a visible defect. Resorbed bone beneath bridges or removable partial dentures can lead to a collapsed, unattractive smile. The cement holding bridges in place can wash out, allowing bacteria to decay teeth that anchor the bridge. In addition, removable partial dentures can move around in the mouth and reduce your ability to eat certain foods.

How will the implants be placed?
First, implants, which looks like screws or cylinders, are placed into your jaw. Over the next two to six months, the implants and the bone are allowed to bond together to form anchors. During this time, a temporary teeth replacement option can be worn over the implant sites.

Often, a second step of the procedure is necessary to uncover the implants and attach extensions. These small metal posts, called abutments, complete the foundation on which your new teeth will be placed. Your gums will be allowed to heal for a couple of weeks following this procedure.

There are some implant systems (one-stage) that do not require this second step. These systems use an implant which already has the extension piece attached. Your periodontist will advise you on which system is best for you.

Finally, replacement teeth, or bridges, will be created for you by your dentist and attached to the abutments. After a short time, you will experience restored confidence in your smile and your ability to chew and speak.

Replacing All of Your Teeth

If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

What are the advantages of implant-supported full bridges and implant-supported dentures over conventional dentures?
Dental implants provide several advantages over other teeth replacement options. In addition to looking and functioning like natural teeth, implant-supported full bridges or dentures are designed to be long lasting. Implant-supported full bridges and dentures also are more comfortable and stable than conventional dentures, allowing you to retain a more natural biting and chewing capacity.

In addition, because implant-supported full bridges and dentures will replace some of your tooth roots, your bone is better preserved. With conventional dentures, the bone that previously surrounded the tooth roots begins to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact.

In the long term, implants can be more esthetic and easier to maintain than conventional dentures. The loss of bone that accompanies conventional dentures leads to recession of the jawbone and a collapsed, unattractive smile. Conventional dentures make it difficult to eat certain foods.

How will the implants be placed?
First, implants, which looks like screws or cylinders, are placed into your jaw. Then, over the next two to six months, the implants and the bone are allowed to bond together to form anchors for your artificial teeth. During this time, a temporary teeth replacement option can be worn over the implant sites.

Often, a second step of the procedure is necessary to uncover the implants and attach extensions. These small metal posts, called abutments, along with various connecting devices that allow multiple crowns to attach to the implants, complete the foundation on which your new teeth will be placed. Your gums will be allowed to heal for a couple of weeks following this procedure.

There are some implant systems (one-stage) that do not require this second step. These systems use an implant which already has the extension piece attached. Your periodontist will advise you on which system is best for you.

Depending upon the number of implants placed, the connecting device that will hold your new teeth can be tightened down on the implant, or it may be a clipped to a bar or a round ball anchor to which a denture snaps on and off.

Finally, full bridges or full dentures will be created for you and attached to your implants or the connecting device. After a short time, you will experience restored confidence in your smile and your ability to chew and speak.

Sinus Augmentation

A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. If you’ve lost bone in that area due to reasons such as periodontal disease or tooth loss, you may be left without enough bone to place implants.

Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. Several techniques can be used to raise the sinus and allow for new bone to form. In one common technique, an incision is made to expose the bone. Then a small circle is cut into the bone. This bony piece is lifted into the sinus cavity, much like a trap door, and the space underneath is filled with bone graft material. Your periodontist can explain your options for graft materials, which can regenerate lost bone and tissue.

Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. After the implants are placed, an additional healing period is required. In some cases, the implant can be placed at the same time the sinus is augmented.

Sinus augmentation has been shown to greatly increase your chances for successful implants that can last for years to come. Many patients experience minimal discomfort during this procedure.

Ridge Modification

Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. This defect may have been caused by periodontal disease, wearing dentures, developmental defects, injury or trauma. Not only does this deformity cause problems in placing the implant, it can also cause an unattractive indentation in the jaw line near the missing teeth that may be difficult to clean and maintain.

To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Your periodontist can tell you about your options for graft materials, which can help to regenerate lost bone and tissue.

Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. In some cases, the implant can be placed at the same time the ridge is modified.

Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come. Ridge modification can enhance your restorative success both esthetically and functionally.

 The introduction of zirconia to the dental field opened the design and application limits of all-ceramic restorations. Thanks to its high strength and fracture toughness, long-span posterior restorations are now possible with high accuracy and success rate. Additionally, its white color allows better reproduction of the required color especially in the anterior zone.

These properties make zirconia an interesting material for the construction of implant abutments and superstructures.¹

The fabrication of zirconia implant abutments utilizes state-of-the-art CAD/CAM technology, which uses patients’ models for the production of an individual customized abutment.²

Moreover, the CAD phase allows accurate positioning and angulation of the zirconia abutment ensuring obtaining the best esthetics.

The fabrication of zirconia implant abutments is complicated by the problem of providing adequate fixation to the implant body.

For titanium abutments, the fixation screw exerts direct pressure on the abutment, which in turn is provided with external or internal hex to provide connection with the implant body.

On the other hand, zirconia is a brittle material and friction between the fixation screw and the internal surface of the ceramic abutment could produce high internal stresses that could lead to unexpected fracture.³

This problem is solved by insertion of a friction fit internal metallic nut (Procera zirconia abutment for Straumann implants), which is equipped with an external hex for establishment of proper contact with the implant body (Fig. 1).

Additionally, the fixation screw interlocks with the metallic nut during tightening procedure (Fig. 2). This design is associated with the problem of generation of internal stresses, which could lead to unexpected fracture of the zirconia implant abutment.

This article will evaluate the fracture causes of several broken zirconia implant abutments. Fractographic analysis of the broken segments will allow recognition of the location and site of the critical fracture.

Case presentations

Case 1

A broken zirconia implant abutment was sent by the treating dentist for fracture analysis. Patient’s records indicated that the patient complained of loosening of the implant-supported zirconia-veneered crown (#21).

The treating dentist also complained that the internal metallic nut lost friction contact with the zirconia abutment and that he had to re-assemble the components before screw fixation. The abutment was fractured after two incidents of screw loosening.

The same problem led to fracture of the second abutment, after which the dentist decided to insert a titanium abutment.

Scanning electron microscopic examination indicated that the abutment was fractured due to pressure from the metallic screw nut.

The solution

Once the metallic nut has lost friction fit with the zirconia abutment, it cannot be correctly reinserted inside the abutment, and areas of friction contact between the improperly assembled components could lead to generation of high internal stresses causing fracture of the zirconia implant abutment as was reported for the two examined abutments. A new abutment should be used in such case.

Case 2

This next case featured a broken zirconia implant abutment. SEM analysis revealed that it was an angled abutment, which corrected the tilt of an implant replacing a maxillary lateral incisor. The entire buccal wall was fractured beneath the temporarily cemented zirconia-veneered crown.

The solution

Zirconia is a brittle ceramic material that must be used in adequate thickness to gain full potential of its high strength. A minimal wall thickness (0.5-0.7 mm) is required in the entire structure of the zirconia implant abutment.

This thickness must be increased in areas of high stresses to avoid unexpected fracture. Tilt correction resulted in over-reduction of the buccal wall (0.3 mm thickness), which resulted in fracture of the weakened segment.

To reduce possibility of fracture, it is recommended to use a metallic abutment for correction of angle of insertion.

Case 3

The final case featured a broken veneer porcelain from a Procera zirconia superstructure. This new design combines both the implant abutment and the framework of the restoration in one single structure, thus reducing the number of components the dentist uses during the prosthetic phase.

This single component zirconia structure does not utilize an internal metallic nut for achieving contact with the implant body.

On the contrary, this single component super structure utilizes the fixation screw to obtain direct fixation to the implant body.

The solution

Using single component superstructures has several advantages as they simplify the handling procedure, do not require anti-rotation feature and reduce the number of structural interfaces of the entire restoration. On the other hand, they require careful design to provide adequate support for the veneer ceramic.

Discussion

Analysis of the broken zirconia implant abutment gave insight about the cause of fracture.

For Procera abutments with the metallic nut, the friction fit system lost adequate retention after a short service time in the mouth leading to loosening of the inserted restorations.

According to complaints of the treating dentists, it is not recommended to reassemble the metallic nut and tighten the fixation screw as this will not result in reliable retention of the restoration. In such case, it is recommended to insert a new abutment from the manufacturer using patient’s records.

Moreover, over-tightening the fixation screw beyond the recommended torque could lead to generation of wedging forces inside the zirconia abutment.

The screw head could exert pressure on the metallic nut leading to spreading of its vertical walls.

Using a confirmatory X-ray before tightening the fixation screw and keeping to the recommended torque could prevent such problem. For cases with marked angle correction, it is recommended to use a metallic abutment in order to avoid over-reduction of the axial walls.

On the other hand, using single component zirconia implant superstructure, which is composed of zirconia abutment and the framework as one component, could facilitate easier handling and simplify the insertion procedure due to reduction of the components used.

Moreover, careful design consideration of the requirements of both the abutment and the zirconia framework is mandatory to ensure good function of each element. Lack of adequate support beneath the veneer ceramic or over-reduction of the axial walls of the zirconia abutment could lead to unexpected fracture.

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