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Imagine this: An implant surgeon is performing a thorough examination of your mouth. The surgeon rotates your jaw from side to side and up and down, looking for the optimal sites in which to place dental implants — and the proper size, shape and orientation for the implants to have. He or she may test several alternatives, considering the underlying anatomical structures, and the bone density and quality that the examination reveals. Finally, a surgical plan is developed: This includes a set of precise specifications for implant position, size and depth, and a template for creating a perfectly fitting set of replacement teeth. But no invasive procedures of any type have been performed so far. In fact, you aren't even present.

Welcome to the world of computer-guided dental implant surgery. What we have described is one step in the process that allows you to receive a set of replacement teeth with the minimum amount of surgery (and time spent in the dental chair), and the maximum level of preplanning foresight. It can result in faster overall treatment time, less discomfort, and an outcome that pleases everyone. Let's look a little more closely at the entire process of computer-guided implant surgery — a procedure at the forefront of dental implant technology.

The First Phase: Making A Virtual Model

It all begins with a complete examination and modeling of your existing teeth, gum and jaw structures. In many cases, a physical impression (replica) of the jaws is made, which will aid in planning the location of the new teeth. But the modeling doesn't stop there: A high-tech, three-dimensional CT (computed tomography) scan is also performed. This allows us to examine the structures (including bone, nerve tissue and sinus cavities) which lieinside the jaw. It is often accomplished using “cone-beam” CT technology, in which the scanning device quickly captures a complete digital image of internal structures as it rotates around your head.

The next step of the process relies on powerful computers and sophisticated software to take the raw CT scan data and translate it into a 3-D model of the jaw. This virtual model can be manipulated on a computer screen — rotated, measured, even “operated” on — so that we can visualize the placement of dental implants and determine their optimum position with a high degree of accuracy. Using this technology, it's now possible for us to evaluate anatomical structures virtually — structures it once would have taken surgery to reveal — and to plan out the implant procedure accordingly.

The 3-D model we have developed is then used for two purposes: to create a precise guide for the implant surgery, and to allow the dental laboratory to pre-manufacture a set of replacement teeth that will fit precisely in the jaw. An advanced set of CAD/CAM (computer aided design/manufacture) processes is used to generate the physical objects — in this case, the surgical guide and the prosthetic teeth. Depending on your individual situation, the new teeth may be attached the same day as implant surgery, or after a healing period of 6 to 12 weeks. In either case, our precision modeling ensures that they will fit perfectly with the implants and the jaw.

Implant Surgery: Following the Plan

The implant surgery itself is typically performed under local anesthesia, and often requires no sutures (stitches). In the surgical procedure, the template we have produced (which resembles a nightguard or athletic mouthguard) is securely (but temporarily) fixed in position on the jaw. The openings in this template form precise guides for the placement of the implants — accurate in terms of position, width and depth. In fact, the implants fit so perfectly into these prepared sites that we can have new teeth placed the same day as implant surgery.

Since so many of the details have been accomplished in the planning stages, computer-guided implant surgery is typically uneventful for the patient. It can result in shorter time in the chair, less discomfort during recovery — and a highly pleasing result. It has even been called the most significant innovation in implant technology since osseointegration — the fundamental process by which a dental implant becomes fused with the bone.

Laser Dentistry.They are inside your laptop computer and your DVD player, present on the factory floor and the supermarket checkout line. And now, lasers are finding increasing use in dentistry. Someday soon, you may have a routine dental procedure performed with the aid of a powerful, yet highly controllable beam of laser light, instead of a drill or a probe.

What are dentists currently using lasers for? These devices have been proven to help in the detection and treatment of oral diseases. They can be used for treating gum disease, detecting cancer, and pinpointing tooth decay in its early stages. They can precisely remove tissue, seal painful ulcerations like canker sores, and even treat small cavities. In the future, dental laser technology will undoubtedly find even more applications.

How Do Lasers Work?

Lasers take advantage of the quantum behavior of electrons, tiny particles inside atoms. By stimulating atoms with pulses of energy, and then using a method of optical amplification, they cause the atoms to produce a beam of coherent light. Essentially, that means that they emit light which has a great deal of energy, yet can be precisely controlled. It's the combination of high energy and precision that make lasers so useful.

Where Are Lasers Being Used?

At present, the use of lasers in dentistry falls into three general categories: disease detection, soft tissue treatments, and hard tissue treatments.

There are many ways lasers can aid in diagnosis. Laser light of specific wavelength, for example, can detect tiny pits and fissures in the biting surfaces of the tooth that a traditional dental tool can't find. This enables a defect that's too small to be treated at present to be carefully monitored. Lasers can also help locate dental calculus (tartar) beneath the surface of the gums, and can even aid in the detection of oral cancer in its early stages, accurately showing where healthy tissue ends and diseased tissue begins.

For the treatment of soft tissue problems, lasers have many advantages. They are minimally invasive tools that generally involve taking away less tissue than conventional methods. Used in gum surgery, for example, lasers can treat gum disease by killing harmful bacteria deep in pockets below the gum line, and removing the diseased tissue without harming the healthy tissue. They can also remove the thin layer of cells that inhibits reattachment of the gum and bone tissues to the tooth, while sealing off the adjacent blood vessels. This type of procedure generally results in less bleeding and pain. Lasers are also effective in treating ulcers and sores on the lips or gums.

Lasers are even finding increasing use for hard-tissue procedures, like the treatment of dental caries and cavities. Not only are they more exact in the amount of material they remove, but they eliminate the noise and vibration of the dental drill, which is uncomfortable for some patients.

As lasers become more common in the dental office, these high-tech tools will be integrated into routine dental practice. This promising technology already offers some real benefits, and is sure to find increasing use in the near future.

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Laser Dentistry - Dear Doctor Magazine

Lasers Shine a Light on Dentistry Lasers have revolutionized medicine and now they're beginning to blaze a new trail in dentistry. Today, at the dawn of the 21st century there are a variety of dental uses for lasers, from diagnosing cavities and the removal of gum and tooth structure to the treatment of disease... Read Article