Glossary

An additive manufacturing file (AMF) is a data format that can be used in additive manufacturing. It was proposed by the American Society of Testing and Materials (ASTM). An AMF contains information that describes the shape and composition of any 3D object that will be fabricated on a 3D printer. Unlike the STL format, AMF has native support for color, materials, lattices, texture, and constellations. An additive manufacturing file contains a 3D image of a patient’s oral anatomy and allows for the 3D printing of a precise dental implant or prostheses. This means each patient will receive a prosthesis that has been custom created to match the unique features of his or her mouth. The use of an AMF and the additive manufacturing process provides patients and dental professionals with a more sustainable, reliable, and biocompatible product. This can reduce the number of fittings, adjustments, and physical discomfort a patient may experience.

Additive manufacturing or 3D printing requires the use of specialized technology to create solids by injecting materials into preplanned, precise points in space. This is done with computer software that controls a 3D printing machine. To print a customized object, such as a dental implant, a certain file type must be used. This is called an Additive Manufacturing File and the format is considered the standard for describing an object for the additive manufacturing process. The data format for this type of file has been proposed by the American Society of Testing and Materials (ASTM) and will communicate to the 3D printer the shape, size, color, texture, materials, and composition of the object to be created. Although this file is considered standard for all types of additive manufacturing or 3D printing, it is used frequently in the dental implant industry to create customized implants for patients with unique needs.

A crucial component of implant dentistry is the topography of the dental implant surface. The texture of a dental implant surface can be modified in a variety of ways with the addition or removal of a material or chemical. Additive surface treatment occurs when a material or chemical is added to a dental implant to change the topography of the surface. Different surface textures can help increase the rate of healing and osseointegration and reduce the risk of dental implant failure. One example of additive surface treatment is acid-etching. An acid-etched implant has been treated with acid to change the implant topography and ideally improve retention of the implant once it is placed. What type of additive surface implant is used for a procedure depends on the patient’s unique needs, their bone quality in the area receiving the implant, and the preferences of the treating periodontist.

An aesthetic buccal flap or ABF is a buccal flap that has been designed to improve the preservation of soft tissue architecture while simultaneously gaining access to the facial cortical plate. Aesthetic buccal flaps are most often used in the dental implant industry to correct buccal fenestration defects and the procedure is often called a “flapless procedure”. This technique helps to reduce trauma to the soft tissue during surgery, which may impact aesthetics, and to help maintain natural gingival anatomy. Since fenestration defects in the buccal cortical plate can negatively the overall aesthetic outcome, the ABF or aesthetic buccal flap procedure can help improve the appearance of the completed procedure. When implants are placed in the front of the mouth, either on the upper or lower jaw, the aesthetic buccal flap procedure should be strongly considered to reduce the chances of damage to the soft tissue that can be easily seen when a patient smiles or speaks.

After a dental implant procedure, there’s always a risk — no matter how small — that the implant may fail. However, a failed implant is different from an ailing implant. For an ailing implant, prompt treatment may be able to save the implant and prevent complete failure. However, leaving an ailing implant untreated can be detrimental and create a host of problems. An ailing implant is affected by peri-implant mucositis without bone loss. A variety of techniques can be used for surface decontamination, or a periodontist can choose to use a regenerative approach. A YAG laser, which is also used after cataract surgery to remove cloudiness of the artificial lens, can be used to effectively remove bacterial colonies and calculus from around the implant. While ailing implants were often hastily removed in the past, newer technology has allowed periodontists to help save implants from failure and it’s often not necessary to remove an implant affected by peri-implant mucositis right away.

Alendronate sodium is a nitrogen-containing bisphosphonate medication that is most commonly used in the treatment of osteoporosis because it inhibits the resorption of osteoclast-mediated bone. One of the most well-known alendronate sodium medications is Fosamax. While treatment with these types of medications can be effective for preventing bone loss due to osteoporosis, the dental industry has seen negative side effects. Alendronate sodium dental extraction patients have a risk osteonecrosis of the jawbone or jawbone death. This means that after having a tooth extracted, a patient taking alendronate sodium medication may not heal properly after the extraction procedure. The jawbone may fail to heal after surgical trauma, which can lead to complications such as swelling, pain, infection, and exposed bone. This can prove challenging for periodontists who intend to place an implant in the area where the tooth was extracted, and bone grafting may become necessary.

The All-on-4® treatment concept is a technique for the total rehabilitation of the edentulous patient or for patients with badly broken-down teeth, decayed teeth, or compromised teeth due to periodontal disease. It is performed by placing four implants in either arch with the distal-most implants being placed in a tilted position to increase support for a fixed prosthesis. This tilted placement allows patients to undergo prosthetic surgery without first requiring a bone graft as it utilizes already available bone. In addition, with the All-on-4® technique, the prosthesis is usually placed immediately on the day of surgery, though patients must first be carefully evaluated to ensure they meet the criteria needed for immediate implant loading. The patient benefits of All-on-4® include no need for bone grafts, immediate function and aesthetics of the prosthesis, fewer surgeries, reduced healing time, and less expense. All-on-4® is a registered trademark of Nobel Biocare.

Allogeneic grafts, or allogenic bone grafts, are becoming more popular in the field of implant dentistry. In cases where a patient does not have sufficient bone density for an implant, a graft may be necessary. There are many different types of grafts available, and the treating periodontist selects which graft is the best choice for the patient’s unique needs. An allogenic bone graft is done using human bone, but unlike other types of bone grafts, the bone is not harvested from the patient receiving the graft. Instead, it is donor bone, typically harvested during other surgeries, such as hip surgeries. The bone is cleaned, sanitized, and meticulously prepared for donation. Because of this, allogenic bone cannot grow new bone by itself, like other types of bone grafts. Instead, it is used as a framework for the patient’s existing bone to grow around to fill the area.

An allograft is a type of graft which utilizes tissue from genetically dissimilar members of the same species. Four types of allograft exist: frozen, freeze-dried bone allograft (FDBA), demineralized freeze-dried bone allograft (DFDBA), and solvent-dehydrated mineralized allograft. Allograft bone is processed and prepared by tissue banks. In dentistry, allografts such as bone grafts are used to build up the bone where an implant or prosthesis will be placed. Some patients have insufficient bone due to disease or other health concerns and therefore do not have the proper foundation for an implant. A bone allograft ensures a stable structure for the placement and success of dental prosthetics. Bone used in allograft procedures generally comes from human cadavers that have willingly donated their bodies for such purposes. Due to its source, allograft material is strictly regulated by both the American Association of Tissue Banks and the US Food and Drug Administration

Patients without sufficient bone mass for an implant may require a bone graft to complete nthe dental implant procedure. A bone graft can decrease the risk of implant rejection or failure, and can position the implant so that it is both functional and aesthetically pleasing. Different graft materials are available, one popular choice being an alloplastic graft. Alloplastic grafts are not made of bone like other types of grafts. Instead, the bone graft material alloplast is usually made from hydroxyapatite, which is a natural mineral that is the primary component of bone. This is considered a synthetic bone graft, however, it is used more frequently than other types of bone grafts due to the material’s superior hardness, osteoconduction, and compatibility with natural bone. Hydroxyapatite is non-carcinogenic and non-inflammatory, making it an extremely safe material to use. The patient’s natural bone grows around the material, building up the implant site.