Guided Nitinol-Retained (Smileloc) Single-Tooth Dental Restorations.

Nitinol metal alloy that changes shape according to temperature has been in clinical use at select clinics worldwide for the past 2 years and is now released for general use. The Smileloc Abutment and nitinol sleeve enable "cementless," "screwless," crown fastening that saves time and cost with the prospect of replacement of much of the present, sometimes troublesome, anthropic, soon to be anachronistic, technology.

Understanding the Potential of Digital Intraoral and Benchtop Scanning Workflows.

Although the overwhelming majority of dental offices now use digital radiography and patient records, relatively few yet use either stand-alone intraoral scanning systems (6%) or complete systems that combine intraoral scanning with computer-aided design and computer-aided manufacturing (12%). This should change as dentists become more aware of the numerous advantages scanning systems offer in terms of patient care and communication of patient information, particularly with the dental laboratory. This article reviews the various types of scanner architecture as well as potential workflow models.

CBCT technology for diagnosis and treatment planning: what general practitioners should consider.

The use of cone-beam computed tomography (CBCT) for diagnosis and treatment planning for a range of applications, including tooth removal, implant, endodontic, orthodontic, temporomandibular joint disorder, and obstructive airway cases, is well known. However, general practitioners should understand that beyond diagnosing fractures and tooth/root anomalies and assessing hard tissue before and after implant placement, this extraoral 3-dimensional (3-D) technology can be beneficial for performing more common diagnostic tasks, such as panoramic x-rays and bitewings. When used in place of intraoral sensors, it spares patients the discomfort of the rigid sensor. CBCT, which uses a fraction of the radiation dose of medical CT, can also be used to help clinicians create digital versions of their conventional impressions and poured models for digital transmission to other dental team members. For the growing number of practitioners who place implants, CBCT provides the ability to execute "top-down" treatment planning to offer patients restorative-based implant placement.

Sequential provisional implant prosthodontics therapy.

The fabrication and long-term use of first- and second-stage provisional implant prostheses is critical to create a favorable prognosis for function and esthetics of a fixed-implant supported prosthesis. The fixed metal and acrylic resin cemented first-stage prosthesis, as reviewed in Part I, is needed for prevention of adjacent and opposing tooth movement, pressure on the implant site as well as protection to avoid micromovement of the freshly placed implant body. The second-stage prosthesis, reviewed in Part II, should be used following implant uncovering and abutment installation. The patient wears this provisional prosthesis until maturation of the bone and healing of soft tissues. The second-stage provisional prosthesis is also a fail-safe mechanism for possible early implant failures and also can be used with late failures and/or for the necessity to repair the definitive prosthesis. In addition, the screw-retained provisional prosthesis is used if and when an implant requires removal or other implants are to be placed as in a sequential approach. The creation and use of both first- and second-stage provisional prostheses involve a restorative dentist, dental technician, surgeon, and patient to work as a team. If the dentist alone cannot do diagnosis and treatment planning, surgery, and laboratory techniques, he or she needs help by employing the expertise of a surgeon and a laboratory technician. This team approach is essential for optimum results.

The use of implants as retainers for removable partial dentures.

There has been little presented in the literature regarding the use of implant bodies as retainers for removable partial dentures. However, these fixtures can be a useful asset for restorative dentists, as they can be used when there is insufficient bone for a fixed prosthesis or as retainers for a provisional appliance until additional dental treatment is possible.

Solutions to complications of implant therapy.

Restorative dentists face challenges when implant dentistry is performed without a surgical template. Manufactured component parts (particularly screws, gold cylinders, and the implant bodies themselves) can also cause problems during these procedures. These problems will occur regardless of the mode of retention used for the prosthesis, since the same metals are involved and nearly all implant restorations have a screw somewhere. Managing these complications is essential to avoid treatment failures.