Glossary

Sandblasted, large grit, acid-etched implant surface, (SLA) is a type of surface treatment that creates surface roughness with the goal of enhancing osseointegration through greater bone-to-implant contact (BIC). The SLA process increases the rate at which osseointegration occurs by using a combination of grit and acid etching to give the surface increased roughness on multiple levels. This allows osteoblasts to proliferate and adhere to the implant surface. Through osseointegration, SLA can help provide increased stability of the implant which will ultimately lengthen its longevity. The use of specialized implants by Straumann SLA implants, such as the SLActive implant and the Roxolid SLA implant, reduces the amount of treatment time required while also increasing the treatment predictability. The Roxolid SLA implant can also reduce the need for bone augmentation to assist those patients who have insufficient bone. The SLA process offers a variety of benefits to patients requiring increased ossification prior to an implant.

Treating the surface of a dental implant has been shown to promote osseointegration and reduce the likelihood of dental implant failure. The sandblasting procedure is just one way that the surface of a dental implant can be altered using different equipment to help encourage the success of the implant. The sandblasting process is straightforward and involves using a stationary or portable sandblaster to “blast” sand at the surface of a dental implant at a high velocity to change the texture of the surface. On a microscopic level, the sandblasting procedure “roughs up” the outer layer of the implant, creating a surface that is easier for the bone to grip as the implant heals. Like sandpaper, different sizes of sand or grit can be used to create different outcomes — larger pieces of sand are going to create a rougher surface while smaller grains of sand create a smoother but still textured surface.

The sandwich technique is a specific strategy in restorative dentistry used for fillings. In both open and closed sandwich techniques, the different materials of the composite resin is layered or “stacked” onto the tooth, similar to building the layers of a sandwich. This is done instead of mixing the materials of the resin together before filling the cavity. An open sandwich refers to when the filling is located on one of the sides of the tooth and comes into contact with the oral cavity. A closed sandwich refers to a filling in the center of the tooth that does not come into contact with the oral cavity. Many dental professionals who work in restorative dentistry feel that the sandwich technique provides a stronger filling, because the glass ionomer cement that is layered on first bonds to the tooth structure below and the composite to follow, offering a better seal and increasing filling retention.

The sausage technique is a term used in implant dentistry to describe a specific technique used for bone regeneration. Created by Hungarian periodontist Dr. Istvan Urban, the sausage technique is much less invasive than its predecessors. Before this technique was developed, more autogenous bone had to be harvested, which typically resorbs over time. Now, periodontists attempting to regenerate bone prior to a dental implant can use 50% autogenous bone and 50% xenogenic bone. Instead of using only one material or the other, both materials are used and much less autogenous bone is necessary, which results in a less invasive harvesting procedure. The sausage technique receives its name from the way the native collagen membrane looks when it is stretched out like a skin with small tacks to keep the bone graft from moving. The membrane allows for improved blood flow during healing and bone regeneration, and the host bone is typically reabsorbed by 6 weeks.

Endodontic treatment, or root canals, are a common, although often dreaded, dental procedure. They are often successful at preserving a natural tooth instead of having it extracted, which can cause bone loss and other complications. Endodontic treatment was introduced by Hermann in the 1920s, when he outlined the administration of calcium hydroxide for pulp therapy. This essentially created the foundation for modern endodontic therapy as it is known in dentistry today. Ideally, the outcome of a root canal is the removal of diseased pulp and the replacement of healthy pulp that begins to regenerate itself. To control the differentiation, metabolism, and proliferation of stem cells and to provide spatially correct positioning, appropriate scaffolding is necessary. Different types of scaffolding facilitates the regeneration of various tissues, making it critical that the treating dentist has a robust knowledge of which scaffolding is suitable for the type of tissue attempting to be regenerated.

A scalloped dental implant is an older style of implant that was created to biologically facilitate and guide interproximal bone remodeling during procedure healing and to retain papillae and bone height during functional loading. The scalloped implant design includes areas for both soft and hard tissue apposition, which are set parallel to each other, mirroring the cementoenamel junction. The area for the apposition of hard tissue is meant to facilitate osseointegration, while the area for soft tissue is designed to create a space for the subgingival margin of the restoration and to support various connective tissues. While the design was well-intentioned, it did not work as well as expected during application. A study of 17 scalloped implants that were evaluated for 18 months revealed that the scalloped design increased bone loss more than conventional dental implants that were properly placed. There were no differences in papillae formation in the study.

A scanning abutment is a type of abutment that is used to transmit data related to the angulation and position of seated implants. The data is collected with a digital desktop scanner or an intraoral scanner and is extremely accurate. A scanning abutment includes a biocompatible abutment body. Inside the body is an internally threated titanium screw, which is designed to be compatible with other materials and components used within the specified dental implant system. There are two types of scanning abutments: clinical scanning abutments and laboratory scanning abutments. The former contains barium, a radiopaque material, and is designed to be used with intraoral scanners. The latter contains radiolucent material and is used with both blue-light and red-light desktop scanners. Scanning abutments should be inspected for damage before use, and the use of multiple scanning abutments is not recommended due to the possibility of cross contamination.

A scanographic template, also called a scanography template and sometimes spelled scannography, is a template created for the process of capturing digital images of an object. Typically, the purpose of the template is to create a printable image using a flatbed scanner with a charge-coupled (CCD) array capturing device. Scanograpy differs significantly from conventional document scanning by utilizing three-dimensional or atypical objects. In dentistry, scanography is a type of radiography that is used to produce images of the oral structures of a patient for the purpose of creating restorations. It can also be used as a diagnostic tool to detect abnormalities in the mouth and jaw, as well as tumors, cysts, impacted teeth, dental implant malalignment, caries (tooth decay), and other clinically significant issues. There are two types of scanography used in dentistry: rotational scanography and linear scanography. Linear scanography is used most often as it produces panoramic views.

The Schneiderian membrane, also called the Schneiderian epithelium, is the lining of the paranasal sinuses and nasal cavity. It’s unique in that the ciliated columnar lining is ectodermally derived and features goblet cells. The neighboring respiratory epithelium, which appears similar to the Schneiderian membrane, is derived from the endoderm. One of the most common complications that can occur during a sinus grafting surgery is a tear or perforation in the Schneiderian membrane of the maxillary sinus. If this occurs, typically, the surgeon will repair the perforation at the same time the graft is placed, and few additional risks of complications exist. However, in some cases, patients will develop an infection in the maxillary sinus or surrounding areas of the maxillofacial complex after a substantial or complete tear in the membrane. This infection is serious and may result in the failure of a recently completed bone graft or dental implant.

For many decades, dental implants have been one of the most desirable ways to replace one or more missing teeth. Their outcomes are generally predictable, and the failure rate of dental implants is low overall. However, failure can still occur both in the short and long term. Screw fracture, or the fracture of the screw implanted into the bone to hold the dental prosthetic, is a common reason dental implants fail within the first 10 years. Although nearly half of dental implant patients suffer a screw fracture, removing it is a complex procedure, especially if the screw is fractured or broken in more than one place. Considered a mechanical complication, the fracture of a dental implant screw is often caused by high occlusal loads. In cases of bruxism, where there is constant pressure on the teeth from clenching or grinding them (usually at night), screw fractures are more common.