The ability to machine components in the shortest possible time is an issue of ever increasing importance. Any development in engineering which can give faster delivery, and at the same time improve quality, must, therefore be given serious consideration by the toolmaker at the leading edge in the development of High Speed Machining (HSM). These use a combination of techniques to ensure rapid delivery of high quality machined components.
Modern developments in cutting tool technology have led to a revolution in the way CNC programmers now tackle jobs. These specialist tools have totally different cutting characteristics to traditional tooling. Whereas traditional programming methods would consider machining a component from the top down, modern HSM tooling can sometimes prefer to cut from the bottom up.
The main requirements of these machining strategies are to keep the load on the cutter as consistent as possible and to minimize any sudden changes in the cutting direction. New high-efficiency roughing strategies to take full advantage of the latest cutter designs that can cut with the side of the tool and so take defect cuts. High speed machining which result in the smooth consistent cutting conditions required to ensure rapid stock removal and excellent surface finish. finishing gives an excellent surface finish
Consistent tool loading and the few possible sudden changes in direction are needed for high-speed finishing. They will also be of value to experienced operators maximize productivity by setting feed-rates as fast as their machines will allow; on the other hand, they need to ensure safe reasons that will not break the tool.
From this point of view, even a tool in pristine condition leaving a neat square edge is leaving a burr, in that the edge is still sharp. This is a positive advantage to some clients but sub-contractors often are not aware of their customer's preferences until a batch is failed and returned due to "sharp edges". Best then to smooth off all edges and ensure that no ragged areas are left.
This system is a wet process and deburrs and finishes the cut edges of parts in all directions in a single pass. The actual surface of the component also undergoes some improvements, including cleaning, during the process.
The use of the latest methods and using the availability of the latest developments in machinery can not be underestimated when it comes to your bottom line. The cost of any investment in new machinery must be balanced against any downtime you are experiencing with your old kit. Many of the newer machines are able to carry out more than one function. This not only cuts down on the workspace needed but also on the tool changes that are needed. Added to this is the fact that most new machinery is more energy efficient and will cost less to run.
Chances are, you do not have perfect, decay and disease-free teeth and gums. Most patients have at least one cavity and have had a bout or two with minor, reversible gum disease.
Maybe you've experienced bleeding gums, tooth sensitivity or lost teeth. If you went to the dentist, the dentist likely treated the condition to halt its progress or to eliminate the condition all together.
This treatment of a dental condition after it's already begun is called restorative dentistry, which is often partly covered by dental insurance.
While preventive treatments are used to avoid a lot of pain, discomfort, embarassment, excess dental office trips, and forking over funds, sometimes things happen that are out of your control. Sometimes you do not feel the pain and discomfort of a dental problem until it's too late. Accidents and other things may also occur and necessitate some of these more serious measures.
You do not have to feel embarrassed about it, though. Most of these procedures are very common, and chances are you've already experienced some of them yourself.
The goal of restorative dentistry is to protect and preserve the teeth. Here is a list of the most common procedures:
Fillings. This is a very common restorative dental procedure while the dentist will fill a hole in the outer surface of the tooth caused by plaque and tooth decay (cavities). The fillings can be gold, amalgam or composite resin. Resin fillings are the most expensive and least likely to be covered by insurance like amalgam fillings are. Amalgam fillings are most common because they are the least expensive.
Some patients (and dentists) prefer the composite resin fillings because of their appearance and their lack of mercury, which is in traditional amalgam fillings.
Crowns. This is simply a tooth-shaped and colored covering that is cemented over a tooth that is too poorly damaged by decay. Crowns are also used on top of dental implants which replace missing teeth. They are often made offsite in a dental lab, resulting in the need for multiple dental office visits. Some dental offices, however, have the technology to make crowns onsite, giving patients new crowns in a single office visit.
Inlays and Onlays. These dental procedures are ideal for patients with chipped teeth or those whose teeth are too disappointed for fillings, but not damaged enough for a crown.
Inlays are made of composite resin that is bonded to one cusp of the tooth (located on the chewing surface of the tooth). An onlay covers more than one cramp of the tooth and is sometimes called a partial crown.
Implants. Further, and possibly more serious, dental health issues can raise from missing teeth.
Implants are used to fill in these gaps and preserve the proper stability of a patient's remaining teeth.
Implants are made of three components: the titanium rod (implant), the abutment and the crown. The titanium implant is surgically inserted into the patient's jaw where the missing tooth formerly was. The abutment is then placed on top of the implant. Finally, a tooth-shaped crown is placed on top of the abutment.
Implants restore a patient's smile as well as reserve the strength of the jawbone and proper alignment of surrounding teeth.
Dentures. Some patients, many of which who are older, have lost all or most of their teeth due to a life time of wear and tear. A toothless mouth not only takes away from one's smile and self-confidence, it can hinder one's ability to eat and speak.
Patients in these circumstances would be best treated with dentures.
There are two common types of dentures: full and partial.
Dentures have come a long way thanks to modern dental technology. Some dentists now offer patients permanent dentures, called all-on-four dentures that use dental implants to anchor the implants into place in the mouth.
While fillings, crowns, implants, inlays and onlays and dentures are the most common restorative dental procedures , there are other procedures your dentist may recommend to preserve your teeth and smile.
It is important to schedule regular visits with your dentist and have your teeth examined when there's any kind of pain or discomfort.[Top]
Do you have a crystal clear vision of what you want from life or do you have a vague ache to be doing something different?
In many years of working with people on their personal and professional development, in a variety of capacities, I frequently asked the question ‘What do you want from life?’ and, almost without fail, the answer I got was ‘I don’t know.’ In fact I heard the same answer so often I started looking at the issue in more depth to try and understand why we so often say we don’t know what we want. Could if be that we simply haven’t learned to get beyond ‘I don’t know’?
Perhaps we don’t know what we want because we’ve never really thought about it — not in a holistic way such as ‘I want my life to be exactly like this five years from now,’ not beyond ‘I want to be in management,’ or ‘I want to win the lottery.’
Or maybe we ‘don’t know’ because if we did know, if we made a decision and followed it through and it was ‘wrong’ it would be our fault. Or perhaps we don’t believe in ourselves: ‘There’s no point wanting that. I’ll never get it,’ or we don’t believe there’s any point in working out what we want because family, the mortgage, work or other responsibilities will always keep us where we are and what’s the point in dreaming? Or if we go for what we want we might have to leave a lot of things behind and that’s scary — better to stay with ‘the devil you know’?
Making changes is scary — it’s stepping into the unknown, and that’s always scary. But the alternative is to get towards the end of your life and find yourself thinking: ‘If only …’
The reality is that everything changes, whether we want it to or not. Day follows night, the seasons come and go, babies are born and people die. We’re confronted by change every day of our lives — more often than not by change that is imposed on us, that we feel we have no control over. It’s far more empowering to learn how to bring about change yourself, to be part of driving that change instead of just reacting to external events, to learn how to embrace change and to ride the wave with a feeling of excitement and exhilaration. And the first step in making changes is to get clear about what you want.
So let’s try and get specific about what you want from life.
Say you’re going out to buy a new outfit for a wedding. You probably already know the kind of wedding it’s going to be, the venue, the time of year — all this information helps you get clear about the kind of outfit you’re looking for. You probably know what styles suits you, what colours you like, and you’ll probably have a rough idea of how much you can afford.
So you already have all the necessary skills to get clear about what you really want. You just need to apply those same skills to getting clear about the bigger picture, about questions like ‘What do I want from life?’ or ‘How would I really like my life to be?’
Another element of the process of ‘getting clear’ is making sure you’re prepared to take responsibility for what you decide you want.
An exercise I devised to help people understand this part of the process was ‘Winning the Lottery’. It went something like this:
Q. Imagine you’ve just won £5 million! What are you going to do with the money?
A. I’ll give up my job and go on a long holiday.
Q. Who with?
A. My friends.
Q. Can your friends go on a long holiday? What if they can’t get the time off work?
A. Okay, I’ll give them each a chunk of money so they can give up work too.
Q. How much?
A. £50,000 each.
Q. How long would that last them?
A. Okay, £200,000 each.
Q. So you’re going to give all your friends the same amount? How much would that amount to?
A. Um! I’ve got 9 friends … but I don’t like that one as much as her so …
Q. And what if one of them decides to take the money and buy themselves a house instead of going on holiday with you?
Do you get the gist? We all have dreams — and right now in the UK each week around 14 million people dream of winning the lottery. But how many have a clear idea of what they would do if they did win? Most people want to share their luck with the people they love. But if you give money away are you going to give it with strings attached? What are the ramifications you might not have thought of. When a woman I know of won £3 million+ on the lottery one of the first things that happened was she was told she would have to take her children out of their school because of the security risk!
If you dream of owning a large house with a big garden who’s going to maintain the house and clean it, who’s going to take care of the garden? If you’ve always yearned to live in the country and own a horse are you prepared to go out in the rain to feed it, to exercise it, can you afford the vet’s fees you might incur?
Getting clear is about letting go of any woolly, un-thought-through wish and questioning yourself honestly and thoroughly, checking out in minute detail what you truly want, and why, and whether you’re prepared to take responsibility for it once you have it.
But once you have a crystal clear vision about what you want, once you can feel it, see yourself as that person, then the whole world seems to unite to turn your dream into reality.[Top]
Several factors come into account when calculating implants prices. Gaining information about the procedure and its requirements would benefit you in maintaining your estimated budget. The prices can vary according to locations. The procedures are more expensive in some cities and locations than others. Dentists also have their own fee infrastructures which can vary greatly from one dentist to another.
The implant is effectively transported out on a healthy jawbone and gum. If one of these or both are not in mint condition, extra procedure may be necessary. Bone grafting procedure may be in order if the jawbone is weak. That will be an added cost to the process.
The location of affected area in the mouth cavity is another variable that counts in dental implants prices. Specific areas in the mouth are relatively difficult to reach and operate on. If work is required in a difficult mouth region, it will cost more.
In general terms, dental implants prices may range from $ 1500.00 to $ 10000.00. the best way to obtain a good estimate is to request for information from the dentist. Get quotes on the whole procedure. Get down to the nitty-gritty details, such as the cost of the X-ray, any additional procedure (bone grafting), anesthesia, a supplement implant during healing time after the first phase of process, and the implant itself. Inquire about various types and brands of implants. Choose the one which is less expensive. Do not be daunted by dental implant prices.
Regain your dental health with satisfaction. Gain this satisfaction by obtaining accurate information on dental implant prices and procedure.
For a mouth with a smile insure yourself![Top]
There is no denying that in modern times hygiene is a top priority. Be it the use or Purel stands in public places or by providing disinfectant wipes in libraries, sanitation is something that is always considered. This is the case especially in medical and dental facilities. Or, at least it should be. In dental practices world wide, dental bibs play an important role-keeping patients clothes clean from all splatter and debris that may be generated during a procedure. However, they do little prevent the spread of infection. In fact recent studies conducted at the although they effectively keep patients superbly clean the hygiene of these tools have been brought into question.
A University of North Carolina Study
A recent study at the University of North Carolina made a startling observation. After testing 50 different bib chains (the non-disposable section used to attach the bib to the patient) from various dental centers it was discovered that 1 in 5 are contaminated with what are referred to as "significant microorganisms". These included E. coli, pseudomonas and Staph, each of which can be potentially fatal.
To give a better context to just how filthy these items were considered this. After testing the dental bibs the research team analyzed the bathroom floor of a large airport. Shockingly reported the level of bacteria on both surfaces was roughly the same. Although this is rather disgusting to consider, some may question whether patients are actually at risk from these bacteria. After all, the chains are not used in the mouth and only make contact with a patient's neck. The real concern involved with these microorganisms is cross contamination.
The following is an example of how cross contamination can be dangerous. A chain is used for several weeks to attach dental bibs to a number of different patients. In this time it accumulates hair, particles from neck acne, sweat residue as well as blood and saliva from the procedure. Each one of these potentially exposes the chain to a new bacterium. When reused on a new patient without proper disinfecting these bacteria are in turn transferred to the neck areas of new patients. If these patients touch their necks and then brush their lips or rub their eyes they are at a fundamental risk of cross-contamination
Types of Bacteria Found
As explained above, a number of different harmful microorganisms were found on different dental bib chains. These included, but were not limited to:
Escherichia Coli -More commonly referred to as E. Coli This is a bacterium that comes in a variety of strains. Certain strains are harmless residing in the livers of hosts. Other strains are more dangerous. These virulent varieties can be linked to a number of fatal diseases including neonatal meningitis, urinary tract infections and gastroenteritis.
Staphylococcus Aureus -More commonly knows as Staph, this is another bacterium that ranges in it's threat level. Certain strains are very common and occur on the outer skin with only minor symptoms. Others, like the famous MRSA strain, can cause a variety of potentially lethal ailments. These inclue pneumonia, toxic shock syndrome, chest pain, bacteremia, meningitis, osteomyelitis, endocarditis, and sepsis.
Pseudomonas -Pseudomonas are a class of bacteria known to thrive in a wide range of environments. Its main symptoms include pollution and sepsis. Although not always harmful, if affecting vital organs, such as the lungs, it can be fatal.[Top]
All well-experienced clinicians who routinely place dental implants will take every possible precaution when planning this treatment. This includes thoroughly assessing a patient's dental and medical health. It is particularly vital when treating people who have chronic kidney disease.
They can use this when placing dental implants in people with chronic kidney disease. The guidelines include sensible suggestions such as consulting with a nephrologist prior to surgery and following up with patients after their surgery.
Chronic kidney disease is a condition affecting approximately 11% of adults worldwide and the number of people afflicted with this disease is growing. Up to 90% of people with chronic kidney disease may have oral symptoms.
Symptoms such as gingival bleeding which is where the gums bleed, or advanced gum disease or even periodontitis can lead to problems such as early tooth loss. Another common issue is xerostomia or dry mouth, where a patient is able to produce sufficient saliva to keep the mouth clean and comfortable. When there is not enough saliva, the risk of dental disease increases which is another important factor to consider for anyone wishing to have dental implants.
One problem with chronic kidney disease and poor oral health is that these conditions can worsen each other. Poor oral health increases the risk of bacteria entering the bloodstream and affecting kidney disease.
Additionally, people with loose or missing teeth will often find its very uncomfortable to eat properly and poor nutrition can affect the kidneys. Similarly, people with chronic kidney disease are less likely to visit dentists compared to healthy patients.
A lack of good dental care increases the likelihood of dental plaque which in turn increases the risk of periodontal disease.
Furthermore, another problem is that diabetes has become increasingly recognized as potentially causing chronic kidney disease. It is an added risk factor for poor oral health. People who need to undergo hemodialysis may have advanced periodontal disease which in turn can lead to jawbone loss. These patients often receive anticoagulants which increase the risk of their gums bleeding.
Dental implantants who treat patients with chronic kidney disease are being advised to look out for dry mouth and for a condition called parotitis. This is a condition resulting in inflammation in one or more of the major saliva glands.
Often people with kidney disease will have altered saliva chemistry that can result in increased dental calculus or tartar. Thus, they are more likely to suffer from tooth loss, overcrowding, malocclusion and from loose teeth.
The treatments used can also cause oral health problems. To further complicate things, it's estimated that many have bone disorders. After this, it's been found that the alveolar bone or the jawbone is generally still fine for dental implants.
Some dentists may avoid treating people with this condition due to the increased risks. Yet, a new medical paper published in the International Journal of Oral Science has proposed guidelines for practitioners to follow.
In addition to consulting a nephrologist, the paper recommends dental implant dentists thoroughly review their patient's medical history. This includes their history of diabetes and cardiovascular disease.
In addition, they recommend a complete blood count and measuring bleeding times and the implant surgery be carried out on the day after hemodialysis. This can help to minimize the risk of bleeding.
After the surgery is completed, dental implant maintenance is particularly important for patients with chronic kidney disease. These precautions can easily be carried out by an experienced and skilled dental implant dentist who already takes extensive precautions when evaluating patients for surgery. They will use the most up-to-date techniques available today.
Using Computer Guided Surgery During Implant Placement
One particular technique that can be helpful is computer guided surgery. This is increasingly being used by dental implantants wishing to provide their patients with the very best treatment.
With this technique, patients have a cone beam CT scan in addition to dental x-rays prior to treatment being carried out. A cone beam scan provides detailed 3-D images of the jaws and is used to pre-plan surgery down to the very last millimeter.
The images allow a clinician to decide where best to place each dental implant, avoiding vital structures while maximizing use of available bone. Once the surgery is planned, the treatment plan is converted into a detailed stent that is used during oral surgery. This is used to accurately replicate the plan, greatly minimizing room for error. Often, it's possible to use what's called computer guided flap-less surgery.
This is where implants are inserted directly through the gum tissue eliminating the need to make incisions into the gums to expose the underlying bone. This technique can be very useful when treating patients with medical problems. This is because it reduces the risk of infection and bleeding, plus, healing is quicker and smoother.
Is It Worth Having Implant Surgery When You Have Medical Problems?
It can seem as if there is a lot to consider for implant surgery without throwing medical problems into the mix.
With this treatment being worthwhile, should you consider another way to replace missing teeth?
There are lots of advantages in having dental implants . This treatment can provide a long-term solution for tooth loss and many people have their implants for life. With dental implants, you receive stable teeth that make it easy to eat almost anything you like.
It's easier to maintain good nutrition which in turn can help protect your general health. This could be invaluable if you have medical issues and know you have problems eating properly.
Then there are the improvements to your general sense of well-being and self-confidence. Tooth loss can be quite debilitating and many people feel self-conscious about smiling or socializing with others and will avoid sharing meals.
Implant supported teeth look extremely good. Especially as a skilled dental implant dentist will make sure they function properly and provide excellent aesthetic results, complementing your appearance.
If you do have chronic kidney disease or any other medical problems and are suffering from tooth loss, it's worth investigating the potential of dental implants.
Try to see a dentist who specializes in placing dental implants as they are more likely to have the knowledge required to properly assess your condition. They can give you an honest opinion as to whether dental implants will help you and they can discuss any possible complications. Once you know the pros and cons and possible risks, you can make an informed decision about whether to go ahead.[Top]
Orthodontic dental treatment is very popular among young people especially the teenagers. Many parents came under pressure from their kids who want to wear braces and looks good.
Of course the treatment is best done at a young age for better results. The only drawback that makes the parents step back is the cost of the treatment. Orthodontic treatment could cost anywhere between $ 4000 to $ 6000 on average.
I try to answer many questions that parents are asking regarding the orthodontic dental treatment cost.
Is there an orthodontic dental insurance coverage?
Yes orthodontic dental insurance is meant to take care the cost of orthodontic procedures, equipments and general orthodontic care. If you already have dental insurance, your policy may included orthodontic coverage already. If your policy do not cover orthodontic then you may need a supplementary form of dental orthodontic insurance in order to cover your costs. This is very true if you have family members that need braces or orthodontic work.
How does the orthodontic coverage works?
Just like your regular health or dental insurance coverage, you will be required to pay for the monthly or yearly premium. Your insurance provider will typically pay for your orthodontic care up to a maximum amount. How much is the maximum amount covered and what percentage that your provider would pay depend on your insurance plan and insurance company. There are some insurance companies that will cover up to 50% of the orthodontic care costs.
Why do orthodontic dental insurance necessary?
As mentioned above, orthodontic care expenses can run into thousands of dollars per year or until the completion of the treatment.If you have a few family members that need the treatment at the same time, this could be quite a financial burden.
Why do orthodontic care a lot more expensive than regular dental care?
The chunk of the expense are from the equipment cost such as braces, retainers and other additional products. Also the costs of dental x-rays, regular monthly checks and adjustments that would need to be made.
All of these expenses make the cost of orthodontic care more expensive than the regular dental care.
On the average the basic dental plan only required a provider to cover up to a certain amount of dental care per year. After this maximum annual amount, you are responsible for all of the dental costs on your own. For orthodontic treatment, braces alone can cost more than $ 1000. That's the reason why a basic dental coverage normally does not cover orthodontic care. In a lot of cases orthodontic procedures are considered as dental cosmetic, therefore many insurance providers do not cover orthodontic work at all.
For all of the above reasons orthodontic dental insurance seems to make a lot of sense. Even though you have to pay additional premiums on top of your regular dental or health insurance, it is still a wise long term investment.[Top]
Dental implants may be the recommendation that your dentist has for you. What is this? Is this really going to be something you have to do? Is it really a surgery? Many people ask questions about the use of an implant but the fact is, this treatment is outstanding. It offers plenty of key benefits that other types of procedures do not offer. Although it is up to you whether to have it, most people who have the ability to do so opt for it. Before you make a decision, find out what to expect from this type of procedure.
What Is It and Why Do You Need It?
The first question you probably want an answer to has to do with what the procedure is. The procedure is often used to replace missing or severely damaged teeth. An artificial tooth is put into the place of the existing one. However, it looks and works just like any other tooth in your mouth, it will not finish and break down almost as easily. It is one of the best options for those who have one or more teeth that need to be removed and replaced with a durable option.
Your dentist may recommend this procedure for several reasons. First, it is ideal in situations where the jawbone is healthy. Unlike bridgework, this process does not require any anchoring of the artificial component to other teeth. This means the integrity of your other teeth remain intact. Additionally, it is beneficial because it can be created to the size of the space and even in the color of your existing teeth. Because it is so realistic looking, no one will know you have it unless they tell you.
What to Expect
If you are having this procedure, it will usually involve multiple stages. You will be prepped on the exact process as it fits your needs. In most cases, though, the process takes between three and nine months to complete because there is a period of healing between each stage. Once in place, your dentist will want to see you back for regular appointments and cleaning. You can expect some pain and discomfort initially, but pain medications are available to reduce this for you.
Discuss your options with your dentist thoroughly. If you are unsure if dental implants are right for your needs, talk about alternatives including leaving the space, fixing the broken areas and using bridges. However, do not rule out having it done without you have a good reason to do so. For most people, it provides the best lasting result with outstanding looks. That, absolutely, makes the biggest difference in the long-term for both physical function and esthetics of your smile.[Top]
If you are in the military, your insurance will cover dental care. This coverage will be assured during the time when you are still in active service. For some in active service, that may be in real need of excess dental care for their family members, a supplemental dental insurance coverage can be made. Actually, this is not a common occurrence among most military personnel as the coverage they get to cover the cost of their family's dental care are usually more than enough to cover their family needs
Retirement from the military will make you to reconsider getting a supplemental dental insurance coverage for your family. This is most especially true to some military men who retired with teenage sons and daughters. Since retirement in the military service is a little bit early as compared to other branches of the government, it would be necessary that a supplementary insurance for dental care of your family will have to be made.
And if you are one of those who have decided to leave the military early for civil life, you would have to reexamine your insurance coverage and consider all the possible needs that your family might have in the near future. An example will be if there is a need for the teeth of your son or daughter to be subordinated to a growth correction with the use of dental braces.
As you will know, dental braces are now quite expensive, away from the dental service that goes with it. This is more particularly true now, since there seems to be a fad among the youngger generation to have dental braces. Because of these growing demands for dental braces, the cost and service in the installation of these braces have skyrocketed that without the required insurance coverage, you will be hard put to pay for them.
In looking for supplementary dental insurance outside of the military service, you have to be careful because of the proliferation of many insurance scams that are going on today. To be sure, do not insure yourself through agents. Visit an insurance company near your place if any, and ask them if they have supplementary dental insurance offerings.
If you want you can first visit the websites of insurance companies and look for supplementary dental insurance offers. You can find complete listings of supplementary insurance offerings in most sites of insurance companies, complete with price listings and the amount of dental service covered.
If you are looking for dental brace coverage, there are sites that you can go into that offer insurance for dental braces which might be able to suit your needs. Once you find what you are looking for you can then visit their office and personally inquire from them regarding the offer in their website.
More importantly, before you sign on for a policy with the insurance company, try to read first the content of the policy. Study the words of the policy and if there are words or phrases you do not fully understand, you can then ask the officer in charge for an explanation. This is important because you have to know up to what extent will be the coverage. Once you fully understand all the content you can then proceed in applying for the supplementary dental insurance coverage.[Top]
Contamination of the implant site by organic and inorganic debris can prejudice the achievement of OI. Material such as necrotic tissue, bacteria, chemical reagents and debris from drills can all be harmful in this respect.
It is known that where an implant fits tightly into its osteotomy site then OI is more likely to occur. This is often referred to as primary stability, and where an implant body has this attribute when first placed failure is less probable. This property is related to the quality of fit the implant, its shape, and bone morphology and density. Thus screw-shaped implants will be more capable stable than those with little variation in their surface contour. Soft bone with large marrow spaces and sparse cortices provides a less favorable site for primary stability to be achieved. Some manufacturers produce 'oversized' and self-tapping screw designs to help overcome these problems.
This bone property is well recognized by clinicians but is more difficult to measure scientifically. It is a function of bone density, anatomy and volume, and has been described using a number of criteria. The classifications of Lekholm and Zarb and of Cawood and Howell are widely used to describe bone quality and quantity. The former refers to the thickness and density of cortical and cancellous bone, and the latter to the amount of bone resorption. Bone volume does not by itself influence OI, but is an important determinant of implant placement. Where bone bulk is lacking, then small implants may need to be used, with the consequent risk of mechanical overload and implant failure.
Early implant designs were often associated with downgrowth of oral epithelium, which was originally exteriorized the device. When the newer generation of CPTi devices was introduced great care was taken to prevent this by initially covering the implant body with oral mucosa while OI occurred. The implant body was then exposed and a superstructure added, since it was known that the osseointed interface was resistant to epithelial downgrowth. More recently, there has been a growing interest in using an implant design, which penetrates the mucosa from the time of placement.
While this technique has no long-term data to rival that of the earlier methods, it does appear on the basis of preliminary results to be effective and successful in suitable patients and locations. A recent development of this has been the introduction of a technique for placing a prefabricated superstructure on dental implants, which permits their use within hours of placement.[Top]