Glossary

A PAC, or Political Action Committee, is an organization within the United States that raises funds privately to spend on political endeavors in an attempt to influence legislation or elections, especially at the federal level. Often, PAC funds are donated to the campaign of a politician running for a particular office. The American Dental Association has a political action committee, called the ADPAC. Many dentists, periodontists, orthodontists, and other dental professionals support PACs that help lobby for legislation to be passed that benefits their practice, their patients, and the overall profession. Dental professionals can contribute financially to PACs that lobby for initiatives that support them. ADPAC is one of the largest health PACs in the United States and has raised more than $1.2 million. Other smaller dental PACs may exist, however, they are unlikely to be as influential as the American Dental Association PAC.

A palatal graft, or gingival graft, is a surgical procedure performed to establish an adequate amount of keratinized tissue around a tooth or dental implant. It can also be performed to increase the quantity of tissue of an edentulous ridge. This type of connective tissue graft often takes place prior to a dental implant. It helps provide stability and longevity to the implant by building up the amount of keratinized tissue surrounding it. Most patients experience pain or discomfort during gum tissue graft recovery though the severity varies from one individual to another. During the recovery period, patients are encouraged to eat only soft foods of moderate temperature that won’t irritate or burn the graft site. Though gum graft complications are rare, it is possible for an infection to form or for the grafted tissue to not properly adhere to the graft site. Most dental insurance plans will cover at least a portion of the gum graft cost.

The palatal vault is the curvature of the maxillary palate, also called the hard palate. The growth of the maxilla (upper jaw) and the hard palate is influenced by both environmental and genetic factors, and begins transversely. Then, it grows in length and finally in height. The overall shape of the palatal vault can impact chewing and swallowing, sucking, breathing, and language articulation. Narrow or high palates are associated with a variety of health conditions, and oral habits like thumb sucking can cause structural abnormalities in the palate over time. The hard palate is of particular significance to orthodontists, who often need to modify palatal dimensions of dental orthotic devices, such as retainers or dentures, to provide the best fit to patients. The height of the palatal vault increases with age, and male palatal vaults tend to be higher than those of their female counterparts of the same age.

Pamidronate is a type of medication that is used to treat bone lesions, bone metastases, and high blood calcium levels that occur with certain types of cancer, such as prostate cancer, breast cancer, and multiple myeloma. It can also be used to treat Paget’s disease and osteoporosis, both conditions that cause abnormally formed and/or weak bones. Pamidronate is a bisphosphonate, which works by reducing the release of calcium from bones into the blood. This reduces the amount of blood calcium, fractures and broken bones, and associated bone pain. Bisphosphonate therapy can cause a complication known as osteonecrosis of the jaw (ONJ). ONJ can develop after any dental surgery, however, the risk is much higher in patients who receive IV bisphosphonate drugs. The most common presentation of osteonecrosis of the jaw caused by bisphosphonate therapy includes the formation of a socket without extraction, swelling of the gums, discharge, and exposed bone.

A panoramic radiograph is a special type of x-ray that utilizes a minuscule amount of ionizing radiation to produce a single image of the entire mouth. This includes the mandible, maxilla, teeth, and surrounding tissues and structures. While bitewing radiographs and other intraoral x-rays are often still done, the panoramic x-ray has become integral to the diagnosis and treatment of a wide variety of oral and dental health conditions. Unlike other types of radiographs, it provides dental professionals with information about possible bone abnormalities, the position of the teeth and their roots in relation to each other across the entire mouth, and the maxillary sinuses. Panoramic radiographs are often used by dentists to diagnose gingivitis (periodontal disease), oral cancer, tumors in the jaw, sinusitis, jaw bone cysts, impacted wisdom teeth, and TMJ (temporomandibular joint disorder) and other jaw disorders. There is no special preparation needed for patients to undergo a panoramic x-ray.

A panoramic reconstruction is a thin, reformatted section of computed tomography (CT) scan data which is parallel to and following the curvature of the alveolar process as seen in the axial view. Data from a panoramic reconstruction scan can be used in dental applications for the diagnosis of disease. It is also commonly used in implant dentistry to provide a detailed image of the maxilla, maxillary sinuses, and the mandible. There are several advantages of the panoramic reconstruction scan which include the ease of identifying opposing landmarks, the convenience and speed of performance, the information provided on vertical bone height, and the ability to evaluate pathologic findings. Despite these advantages, there are a few concerns regarding the use of panoramic reconstruction as well. These include errors caused by improper patient positioning, the fact it does not show bone quality, and spatial relationships between structures can be difficult to identify.

The papilla is the soft tissue that occupies the interproximal space confined by adjacent crowns in contact. In relation to oral anatomy, the term may apply to interdental papilla which is a portion of the free gingiva that occupies the interproximal space and which is confined by the adjacent teeth that are in contact. It may also refer to interimplant papilla. This is the soft tissue that occupies the interproximal space while being confined by adjacent implant-supported fixed partial dentures which are in contact. In either case, the papilla can become damaged or inflamed due to poor dental hygiene or gingivitis and may recede. If this occurs, oral surgery may be required to restore the papilla between the teeth and restore good oral health. If inflammation and recession of the papilla are taking place due to gingivitis, the condition can be more serious as immediate intervention is required to prevent the development of periodontitis.

Papilla preservation is a surgical and prosthetic measure taken to maintain and/or reduce trauma to the interproximal tissue. One of the negative side effects of periodontal surgery is the reduced papillary height and papillary shrinkage that can lead to the exposure of underlying tissues. To prevent this, a papilla preservation technique can be used by the surgeon to help the papilla maintain a more aesthetic look for the patient’s comfort and confidence. One such technique utilizes the papilla preservation flap method in which no incision is made along the facial surface of the interdental papilla. The modified papilla preservation flap method is another technique that may be utilized following periodontal surgery and involves incisions made around the teeth next to the surgery location. These types of papilla preservation techniques allow patients to enjoy both the benefits of the surgery or implant as well as the appearance of the affected area following surgery.

Papilla reformation is the spontaneous reformation of the interproximal papilla following the establishment of a contact point and the management of the interproximal prosthetic papillary space. The term also refers to the re-establishment of the lost interproximal papilla by surgical means. Following the placement of an implant, the papilla between the neighboring tooth and the implant may be lost or significantly reduced if the neighboring tooth’s periodontal attachment is compromised. Papilla may be regenerated through papilla reformation by using a combination of hard and soft tissue grafting procedures. Bone grafting to replace missing or weakened bone between the teeth is an especially essential step that is often required for papilla reformation to take place. Another possible pathway to papilla reformation involves the use of growth factors used with bone grafting procedures. Papilla reformation is often a challenging process and therefore, proper patient preparation should take in an effort to avoid the loss of interproximal papilla.