Glossary

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.

A bone graft is often needed for patients who have suffered bone loss and don’t have enough jaw bone in the area where the implant will be placed. In these cases, bone grafts are typically necessary. This allows a periodontist to place the implant in a way that will be cosmetically pleasing and functional, as well as reduce the risk of implant failure. An alloplastic graft is generally the most frequently used type of bone graft in the implant industry because the material used has excellent hardness and osteoconduction, making it very compatible with the patient’s own bone. The material used for alloplastic grafts is a type of glass made from a naturally occurring mineral in bone called hydroxyapatite. This material is both non-inflammatory and non-carcinogenic, which makes it safe for the patient and particularly effective for bone grafting. Although other types of grafts are available, alloplastic grafts tend to elicit the best results.

Implant hardware surfaces are often treated to help promote osseointegration and the overall success of the implant. Some implants are textured and others have substances applied to the outside of them. Each periodontist has their preference, and some periodontists may choose different types of treated hardware for different patients. One available type of implant is an ion-beam aluminum oxide textured implant. Although in clinical studies the aluminum oxide did not produce a marked difference in how the dental implant performed, it was noted that the implant size helped to increase the chances of implant retention. Ion-beam aluminum oxide is safe and biocompatible, and can help increase BIC, or bone-to-implant contact. Ultimately, it is up to the treating periodontist to discuss goals and options with the patient to determine the best course of treatment and which type of dental implant suits that patient’s particular needs best.

The alveolar ridge is a part of the jaw that holds the teeth and secures their roots. When a tooth is extracted, an empty space or socket is left in the ridge. While this normally fills in with bone and tissue as it heals, this doesn’t always occur successfully. The bone may not grow back properly or there may not have been much bone to begin with. If the patient desires to replace the extracted tooth with an implant, alveolar ridge augmentation may be necessary. This is a surgical procedure that helps to restore the size and shape of the alveolar ridge so that an implant can be placed. A local alveolar ridge augmentation may include only the socket or space where the natural tooth was extracted. In patients who need several implants or have very significant bone loss, bone grafting may be done for the whole ridge.