Glossary

Individuals who were born without one or both of their external ears, or individuals who have suffered trauma to their external ears, can get a realistic looking ear prosthesis attachment. In many cases, the prosthesis looks so natural that the average person won’t be able to tell that it’s a prosthetic. Getting an ear prosthesis is an involved process, because surgery is usually necessary. Ear prosthesis surgery involves placing titanium posts in the bone around the ear to anchor the prosthetic to. Without a solid anchor, the prosthetic could fall off or be torn very easily. This is similar to how dental implants are done — with dental implants, a titanium rod (or a rod of another implant-grade material) is placed into the jawbone and once that heals, the prosthetic tooth can be anchored to the implant. One difference is that a prosthetic ear is removable, while a dental implant generally is not.

Early Crestal bone loss takes place around implants prior to occlusal loading. This means that bone loss occurs around the implant in the first year following the implant procedure. The loss may be caused by a variety of issues including the biological factors of the patients. These factors may include:

• The condition of surrounding teeth
• The quality and volume of the patient’s crestal bone
• The condition and quality of the patient’s soft tissue
• Biomechanical factors can also lead to early crestal bone loss. These factors can include:
• Aspects of the surgery such as irrigation time at the procedure site and suture techniques used
• The design, dimensions, and material of the implant
• Augmentation procedures

How well the patient follows post-surgery directions and the patient’s overall long-term care of their teeth, as well as the care of their implant following surgery also play a role in early crestal bone loss.

Early implant failure occurs when a dental implant is rejected or fails in some other way in the early stages of healing. Although failure rates are low with dental implants as a whole, there are some things that increase the risk of early implant failure. How successful a dental implant is depends largely on the patient’s overall oral health, the experience of the periodontist, where the implant is placed in the mouth, and the type of dental implant used. Early implant failure is usually due to poor osseointegration, which can indicate impaired bone healing. Risk factors for failure include but aren’t limited to smoking, infection, insufficient bone quantity, poor bone quality, and characteristics of the implant. Other risk factors may include patient age and sex, implant height and surface properties, the type of surgical procedure, and not using prophylactic antibiotics. Recognizing preventable risk factors and mitigating them can help dentists improve patient outcome.

The loading of a dental implant refers to the placement of the prosthetic onto the dental implant hardware after the implant has healed. However, early loading is becoming more popular as patients are demanding shorter treatment times. This means that the implant may be loaded before tissues have fully healed and before the implant has completely osseointegrated. There are three types of loading: conventional, early, and immediate. Conventional loading of a dental implant takes place between three and six months after the placement of the implant hardware. However, extended treatment times may be undesirable for some patients, especially when the implant is being done in the front of the mouth. Immediate loading occurs about 48 hours after the placement of the implant hardware, however, studies show that immediately loaded implants are less successful than their conventional counterparts. Early loading refers to loading that occurs at any time between 48 hours and 3-6 months.

Edentulism is the clinical word for being wholly or partially toothless, or having one or more missing teeth. The loss of all teeth is called full edentulism, while the loss of only some teeth is called partial edentulism. While edentulism can be a genetic defect and takes place naturally in some species such as sloths and anteaters, this is rare and most cases of edentulism in humans is the consequences of tooth loss. A person who has one or more missing teeth is said to be edentulous or edentate. The causes of edentulism in humans are most often cavities, poor oral hygiene, gum disease, bone loss, and other periodontal issues. Teeth play an important role in appearance and health: they give the face a fuller appearance while also enabling the proper enunciation of words and syllables. Untreated edentulism can cause the chin to protrude and the cheeks to appear sunken into the face.

Edentulous simply refers to a lack of teeth; an edentulous space is an area of the mouth that no longer has (or was always missing) teeth. An edentulous patient may have only one or two missing teeth, either in one spot or throughout the mouth. An edentulous site with just a few missing teeth may be prime for a dental implant, while a fully edentulous patient may want to consider dentures. Causes of tooth loss include tooth decay, oral trauma, and advanced periodontal disease (gum disease), and an increased risk of tooth loss is noted in patients with hypertension, diabetes, poor nutrition, smoking, and arthritis. The large majority of edentulous adults are missing teeth as a result of periodontal disease; this begins with bacteria that multiplies deep underneath the gums, causing inflammation and the destruction of the bone underneath. This removes the anchor that teeth have, causing them to become loose.

The electrical discharge method, also called electrical discharge machining or spark erosion, is a process used in dentistry to obtain the best passive fit of dental implants, removable dental prosthetics, and titanium/ceramic crowns. During electrical discharge machining (EDM), the desired shape of metal is achieved by using erosion created by an electric current. The current is precisely controlled via two conductive objects placed inside a liquid medium. Essentially, two types of electrical discharge machining exist — a wire type and a probe type, the latter of which is primarily used in the field of restorative dentistry. EDM increases how long a dental restoration lasts and removes the need for traditional soldering techniques. Fitting restorations using the electrical discharge method can be expensive for the patient, but the results are longer lasting than many other restorative procedures. EDM is also used in die making, prototype parts, stamping tools, and even aerospace components.

An emergence profile in dentistry is simply defined as the contour of the tooth or dental restoration where it meets, or “emerges” from the gingiva. Optimizing the emergence profile is a key component of cosmetic dentistry, and recreating a natural emergence when completing dental restorations is critical to the overall aesthetics of the patient’s smile. This is what enables the implant or other restoration to begin to resemble a lifelike tooth. Emergence profiles are important in common types of cosmetic dental procedures, including veneers, crowns, dentures, partial dentures, and dental implants. A good emergence profile should create a smooth, natural-looking transition from the circular implant platform to the tooth at the gingival level, resulting in a completely flawless restoration that is difficult or impossible to spot with the naked or untrained eye. Naturally, the emergence profile is most important when restorations are being done on the upper or lower front teeth.

An enamel matrix derivative, or EMD, is a sterile protein aggregate which comes from the enamel matrix, specifically from amelogenins, and is the precursor of the enamel of developing teeth. The proteins necessary for EMD are harvested from around the developing teeth of pig embryos using a special processing procedure. Enamel matrix protein derivatives are used in the restoration and regeneration of periodontal tissues and assist in the growth or further development of the periodontal ligament, root cementum, and alveolar bone. Though enamel matrix derivatives are harvested from pig embryos, they have not been shown to create a significant immune response when used in humans. The use of EMDs have also demonstrated anti-inflammatory properties. Both of these results suggest that the use of EMD is safe for humans. In addition, the results of EMD therapy are longer-lasting and have been shown to provide significant benefits to patients undergoing periodontal regeneration.

An endodontic implant (also known as an endodontic pin or endodontic stabilizer) is a pin placed into a root canal of a tooth. It extends beyond the apex of the tooth and into the bone. An endodontic implant is also known as a stabilizer because of its function in providing more stability to a weakened tooth. By increasing the root to crown ratio, the implant can provide the patient with tooth stability and allow them to avoid replacement procedures for years. An endodontic implant may be used in situations where a patient has experienced periodontal bone loss, has a chronic abscess where the root apex has been reabsorbed, has a tooth with a very short root, or has a poor crown to root ratio due to tooth fracture. An endodontic stabilizer may also be appropriate in patients where the loss of a tooth would be difficult to manage using other dental processes.