Glossary

De-osseointegration is the loss of a previously achieved osseointegration of a dental implant due to peri-implantitis, occlusal overload, or other factors. Osseointegration takes place when there is direct contact between living bone and a functionally loaded dental implant surface without any interposed soft tissue. Osseointegration creates a secure foundation for the implant and prevents any movement or instability. When de-osseointegration takes place, this foundation is compromised, and implant instability or failure can occur. Peri-implantitis can arise in situations where excess cement is not completely removed following the placement of a cement-retained implant or prosthesis. It has the potential to lead to complications such as de-osseointegration and is one of the greatest disadvantages of a cement-retained implant. Occlusal overload can also cause de-osseointegration and occurs when the chewing force exceeds the capacity of the dental implant, dental interface, or dental componentry. This causes a failure in the overall implant and can reverse the osseointegration process.

Dental decortication refers to the intraoperative perforation or removal of cortical bone to induce bleeding and the release of bone forming cells from the underlying marrow. It is routinely used in combination with onlay block grafts or guided bone regeneration (GBR) procedures. In addition to the dental definition, decortication also refers to a medical procedure including the lung, diaphragm, and chest wall. There are a variety of medical disorders that can lead to the need for decortication. These disorders cause a fibrous tissue layer to form over the lung which causes lung complications. Decortication of the lung removes this tissue layer and frees the lungs to move normally. Indications for this process include difficulties that arise from pathogenic disorders such as tuberculosis and pneumonia. When asking how serious is decortication, it should be understood that while the procedure has high success rates, issues with bleeding, infection, or pain at the incision site are still possible.

A defect is simply an imperfection in something. In dentistry, there are many different types of defects. For example, dental enamel defects (DEDs) are a flaw in the enamel, or the hard outer surface of the tooth. When enamel formations of primary or adult teeth are deficient, dental health can become compromised as it’s easier for bacteria and plaque to enter the structure of the tooth. Since dental enamel cannot regenerate on its own, enamel defects like hypoplasia or hyperpigmentation must be managed by a dental health professional. Congenital dental defects are imperfections that occur during the earliest stages of fetal development in the womb, like a cleft palate, missing adult teeth, or misshapen or fused teeth. Other defects can include periodontal bone defects, furcation defects, alveolar ridge defects, gingival fenestration defects, and more. Treatment for defects depends largely on the type of defect and where it’s located in the mouth.

A dehiscence is an opening or splitting in tissue, usually of an organ. In botany, this typically refers to when a seed pod on a plant splits open to release the seeds inside. In medical terms, it is most often used to describe the reopening of an incision after surgery or a wound that has been otherwise closed. This can be either internal or external. In dentistry, the term is used to describe an entirely different process: the loss of alveolar bone on the front side of the tooth. This results in the appearance of an oval-shaped root-exposed defect underneath the gingiva. This condition is characterized by the degradation of alveolar bone, gum recession, and exposure of the tooth root. Dehiscence can cause patients severe pain, especially when the root of the tooth has become exposed to hot and cold temperatures. It can also result in aesthetic changes and self-esteem issues.

When patients don’t have enough bone to support a dental implant, a bone graft may be necessary. The success of bone grafting depends on the ability of the donor bone to bring in host cells to the site graft and convert them into cells that will form bone. If the bone cannot recruit host cells or facilitate their conversion to bone cells, the graft is usually a failure. The osteogenic, osteoinductive, and osteoconductive capabilities of the donor bone dictate a large part of how successful the graft will be. Demineralized bone matrix (DBM) is a type of allograft bone that has been processed to remove inorganic minerals, leaving only the organic bone matrix behind. The demineralization process increases the bioavailability of allograft donor bone, making it a superior material to demineralized bone grafts. Demineralized bone matrix (DBM) was discovered in 1965 by Marshall Urist, a U.S. orthopedic surgeon practicing in Los Angeles, California.

A demineralized freeze-dried bone allograft (DFDBA) is an allograft composed of demineralized bone matrix (DBM) following the demineralization of a freeze-dried bone allograft (FDBA). Though a variety of bone graft options have been used in the regeneration of periodontal tissue, DFDBA is used the most often. It has been shown to be effective in the reconstruction of both furcation and periodontal defects and has also demonstrated osteoinductive effects. When implanted in bone that is already well-vascularized, it has the ability to stimulate cell attachment, cell migration, and osteogenesis. DFDBA contains bone morphogenic protein (BMP) that causes new bone formation to take place during healing. It is therefore an effective option for bone regeneration. Some dental and oral surgery patients may require bone enhancing procedures prior to receiving an implant or other dental prosthesis. Due to the many benefits of DFDBA, it is a commonly used material for such bone enhancement and bone development processes.

A dentin grinder is a special tool used to grind extracted teeth into usable dentin for autogenous grafts. Autogenous grafts are considered the “gold standard” of grafting material since they come from the patient’s own body, however, the need for a second surgical site typically meant that a different kind of graft was selected to prevent having two incisions and the additional risk for infection. With a dentin grinder, a dentist or periodontist can create autogenous grafting material from the patient’s own extracted teeth. The tooth is inserted into the grinder, which typically produces particulate dentin about three times the volume of the original tooth. Most dentin grinders come with a sterilization kit that allows dental professionals to sterilize the ground dentin before using it in a grafting procedure. Autogenous grafts are at a low risk for infection, improving patient outcomes and overall satisfaction after the procedure has been completed.

Dentures are one of the most commonly used dental devices, along with braces and mouthguards. Dentures are either one or two sets of artificial teeth and gums that are designed to be temporarily worn and removed for cleaning and rest. There are three different types of dentures: traditional full dentures, immediate full dentures, and partial dentures. Traditional full dentures are generally the most common and are a complete set of top and bottom dentures. Partial dentures are as the name indicates: a partial set of upper or lower dentures. Partials can be used when a patient is able to retain some of their natural teeth and only needs dentures for one or two sections of missing teeth, which are connected by a wire similar to a retainer. Finally, immediate full dentures are dentures that are placed right after the extraction of natural teeth so patients do not have to be without their teeth for any length of time.

Depassivation is the loss or the removal of the surface oxide layer of a metal. Since metals will corrode in certain environments, including when in the presence of water, the chemical process of passivation is used to add a protective metal oxide layer to combat this characteristic. Metals are frequently used in dental work in creating crowns, fillings, bridges, and other dental implants or prostheses. These metal-based dental structures are exposed to saliva—a water-based substance—as well as digestive enzymes and acids from foods and the digestive tract. All of these substances can lead to corrosion and therefore metal dental components undergo passivation prior to use. When depassivation takes place, this protective oxide coating is lost, and the metal is once again susceptible to deterioration. This corrosion can lead to several complications including failure of the component, an infection in the tissues of the mouth, or the need for more expansive dental work.

Dexamethasone is a long-acting synthetic glucocorticoid used as a potent anti-inflammatory drug. It may be administered intramuscularly, orally, or intravenously. Inflammation, swelling, and discomfort are common side effects experienced following an oral procedure or surgery. Dexamethasone has been shown to reduce these symptoms and provide a more comfortable patient recovery. Many dental practitioners choose this corticosteroid for postoperative treatment due to its safe and noninvasive delivery methods. It is believed to work by decreasing the immune and inflammatory response to prevent or significantly lessen the swelling at the procedure site. In addition, it decreases the inflammatory mediators that are responsible for amplifying and maintaining the perception of pain. Many oral surgeons prefer to give the steroid as a sublingual injection immediately following the procedure so the patient can experience immediate relief. The dosage of dexamethasone prescribed as well as the duration of the treatment will depend upon the type of procedure and specific patient needs.