Glossary

A reamer, or endodontic reamer, is a surgical tool used for endodontic procedures, most often a root canal. A reamer is often used in conjunction with a file to clean out the inside of the root canal and prepare it for the root canal filling material. Root canal fillings can be done with amalgam, composite resin, nickel, or least often, zirconium dioxide. A reamer is designed to be able to thoroughly debride the interior of the root canal to the apical foramen so it can be disinfected prior to filling. A reamer is created by twisting a triangular or square shaft just enough to create cutting edges that are approximately parallel to its axis. The reamer is inserted into the root canal and rotated 1/4 or 1/2 turn, which scrapes the walls of the canal allowing it to be thoroughly debrided. The reamer must be loosely touching the interior walls of the canal.

Recombinant Human Bone Morphogenetic Protein, or rhBMP, is an osteoinductive protein produced by recombinant DNA technology. It has been found to be an efficient product in assisting with bone re-growth and the osseointegration of implants. The use of recombinant technology and tissue engineering combines the most recent biotechnology techniques with the body’s natural response to injured tissues. This process boosts the body’s ability to heal following an implant procedure by increasing the rate of osseointegration. The technology used in rhBMP often consists of combining mesenchymal stem cells with added attachment and form properties to promote growth factor. Despite the advantages of recombinant human bone morphogenetic proteins, oral surgeons must still perform a detailed examination of the patient’s oral anatomy to determine if the use of rhBMP will be effective. This is due in part to the necessity of choosing the correct bone grafting technique to ensure the highest possibility for implant success.

Regenerate maturation refers to the completion of both mineralization and remodeling of the regenerate tissue. In dentistry and oral surgery, tissue regeneration is an essential part of implant success and patient recovery. Many types of tissues are affected in dental procedures and require proper integration and regeneration in order to support the dental prostheses. These tissues include bone, pulp, enamel, dentin, root tissue, periodontal ligaments, gum tissue, and other oral tissues and support structures surrounding the teeth. The importance of proper regeneration has led to many studies on topics including faster regeneration, new ways to promote regeneration, regeneration time of specific tissues, and the use of stem cells to increase the rate of regeneration. There are some dental procedures, such as implants following bone grafts, that cannot be completed until the regeneration process is complete. For example, a bone graft that has not undergone osseointegration will not be stable enough to support the new implant.

Regeneration is the reproduction or reconstitution of a lost or injured part to its original state. In the body, regeneration takes place as part of the natural healing process as cells undergo mitosis to repair or replace the cells damaged or lost due to injury or pathology. By following the genetic instructions held in the cells’ DNA, the body is able to regenerate many types of damaged tissues and bone to restore function. In dentistry, advances are being made that may allow for regenerative therapies that guide the body to replace or repair the oral tissues and structures without the need for implants and prostheses. Such regeneration may take place due to the introduction of a patient’s stem cells, the placement of bioactive scaffolds, and the triggering of growth factors. Dental regeneration procedures have seen success in encouraging partial regeneration though whole tooth regeneration is not yet possible.

Regional acceleratory phenomenon, or RAP, is a local response to a stimulus in which tissues form two to ten times more rapidly than the normal regeneration process. The duration and intensity of RAP are directly proportional to the kind and amount of stimulus and the site where it was produced. Each type of tissue has its own response to RAP as well as its own time period in which RAP is experienced. However, regardless of tissue type, RAP usually lasts approximately four months in humans though it can take up to two years to subside. While no new processes in tissue formation appear to occur during RAP, a significant decrease in the normal time required for healing takes place. The stimuli that can cause RAP include fractures, injuries, inflammation or inflammatory diseases, and infections. In dentistry, RAP can be stimulated by tooth extractions, implants, and periodontal flaps.

Bone remodeling is a natural process that continues throughout a person’s life as bone cells die and regenerate. This allows the skeleton to continuously renew, which helps promote stability, integrity, and mineral homeostasis. During bone remodeling, old or dead bone tissue is removed and replaced with new tissue, often on a microscopic level. However, the term “bone remodeling” is also used in implant dentistry to describe a procedure called osteoplasty. Essentially, this is a bone graft where dead or decaying bone may be removed by the periodontal surgeon and a graft of healthy bone — taken either from another part of the patient’s mouth or a donor — is grafted into the patient’s mouth. The graft is covered with a protective membrane and the soft tissue of the gums is usually sutured closed. The new bone will begin to integrate into the patient’s existing bone in a process called osseointegration. Once bone modeling is complete, a dental implant may be placed.