Are you happy with your smile? If yes, don’t feel that you are “The One”, as research on smile evaluation shows that 80% of us are dissatisfied with our smile. With the age, people see the color changes of their teeth, chips, cracks or areas of tooth wear that makes you older than you are, do you have a gummy smile or are you self-conscious of crooked teeth or do you have gaps between teeth. Are you facing any of the dental problems mentioned above? If yes, then cosmetic dentistry will be the answer of your dental problems.

In contrast with traditional dentistry of oral hygiene, diagnosing & treating oral disease, Cosmetic dentistry is a dental treatment related with improving the appearance of teeth, its proper functioning and enhance your smile in order to restore your self-esteem or confidence of life.

With the technological advancement in dental industry, today’s Cosmetic dental treatments are more durable and produced desired result in order to preserve your natural tooth structure. Cosmetic dentistry uses such technologies i.e. lasers to perform some of dental procedure in order to makeover your dazzling smile.

Cosmetic dental procedures include followings :

• Teeth Bleaching & Teeth Whitening
• Composite Bonding
• Matching Tooth filing to repair Chips, Cracks or Rough Stops
• Aligning Teeths by reshaping them with other teeth
• Removing gaps between Teeths
• Restoring broken teeth by porcelain crown
• Inlays & Onlays
• Porcelain & Composite Veneers
• Porcelain Bridgework
• Dental Implants
• Clear Orthodontic Aligners
• Cosmetic Gum Surgery
• Tooth-Colored Fillings

What Is Hypersensitivity Of Teeth?

Sharp pain in response to various stimuli like HEAT, COLD, CHEMICALS etc... This condition is called Dentin Hypersensitivity.

Dentin Hypersensitivity is fairly common condition with between 8-35%of the population being affected. Adults in the age group of 20-50 years are the most affected with the peak of 20-50 years.

CAUSES OF HYPERSENSITIVITY

Sensitivity occurs due to loss of enamel (outer most layer of crown structure) or cementum (outer most layer of root structure) which leads to the exposure of the underlying dentin. So the main reason of sensitivity is exposure of dentin.

It happens with several reasons like

Faulty tooth brushing habits: Excessive tooth brushing or brushing with wrong method causes loss of enamel and may cause loosing of gums (gingival recession) which may cause sensitivity.

Dietary habits: Excessive amount of oral acids like soda, fruit juice, swimming pool chlorine etc. Even faulty food habits like having lots of food in short time (BULIMIA) also causes sensitivity.

Maintenance of oral hygiene: Due to improper cleaning of mouth there will be accumulation of plaque & food debris which may cause gum diseases. Enlarged & swollen gums allow the plaque to retain in the junction of gums & tooth.

TREATMENT OF HYPERSENSITIVIY

Patient’s education: By: Dietary counselling

: Proper tooth brushing technique

: Plaque control & oral hygiene maintenance.

Formation of smear layer over exposed dentin.

Use of topical agents: To occlude n lock the exposed tubules of dentin.

E.g.: Fluorides, dentin adhesive, varnishes.

Placement of restorations: E.g.: Glass ionomer cement

 : Composite resins.

Use of lasers: CO2 lasers

 : Nd:YAG,Er:YAG lasers

 : He:Ne lasers.

As lasers are quite expensive every patient can’t effort the treatment & it is not easily available to frequent clinics or hospitals.

 There are many tooth pastes available to get relief from sensitivity E.g.: Colgate sensitive, Sensoform, Sensodyne etc…

Special types of tooth brushes are also available for sensitive teeth.

Visit Web Dentist for more information on dental health and care tips.

As an experienced Oral and Maxillofacial Surgeon, I have the privilege of being involved with the California CareForce (CCF) Clinic, which began through my affiliation with the California Association of Oral and Maxillofacial Surgeons (CALOMS). I have always felt strongly that it is important to help those in need and organizations like CCF make getting involved easy. 

We are incredibly fortunate as Americans to live in a wealthy country where we have much more than others; however, it’s important to always keep in mind that there are still many people here at home whose needs are left unmet. In my practice, we often care for patients with limited resources from local hospitals and clinics, and that is why I feel such a close connection to CCF’s mission. They set up clinics in areas where people have the greatest unmet needs and deliver healthcare services to patients who would otherwise not have access.

The CCF Clinic, hosted at the Riverside County Fairgrounds from April 3-6, provided a unique platform for Remote Area Medical USA (RAMUSA), California CareForce, Goldenvoice, the California Association of Oral and Maxillofacial Surgeons (CALAOMS), the Flying Doctors, and a number of other professional and non-professional volunteers to offer much-needed services to more than 2,000 patients. While over $1 million in services were provided by hundreds of highly skilled medical professionals, they were complimentary for patients at the Clinic thanks to the support of CCF, whose mission is to provide free health, dental and vision care to Californians.

This particular experience in the Coachella Valley was perhaps one of my most memorable, as I left my clinic on Friday, one of my busiest workdays, I flew from Oakland to Ontario, California, rented a car, and drove two hours to Indio – a remote location in the middle of the desert. When I arrived at the clinic early the next morning (6 a.m.), patients were already waiting in line for services, as they had either camped out overnight or arrived early that morning to be treated.

As I scanned the crowd, I could see that these patients came from all walks of life and I found it incredibly rewarding to work with them. They weren’t homeless or drug addicts or even terribly underprivileged – they were just like anyone else. They were simply there because they could not afford a new pair of glasses or have their teeth filled or pulled on their own. These patients quietly suffer, hoping someone will help them get what they need to better themselves and improve their life. Looking at them made it impossible not to take a step back and realize that we are just one major illness or catastrophic event away from being in their exact position!

My primary role at the clinic was to extract teeth, so I spent a majority of my time there pulling the teeth of patients suffering from pain and infections. After a full day of pulling teeth, I drove back to the airport, flew back to Oakland and drove back home, arriving around 10:30pm that day. As I settled in to my warm bed at home that night, visions of the many different faces I saw that day made me realize that we are so fortunate to be in the position we’re in. Seeing how a procedure as simple as extracting a tooth truly made a difference in someone’s life was incredibly rewarding, and I would go through the same process all over again to get the opportunity to help someone in need.   

For more information about Santa Rosa Oral Surgery, visit www.santarosaoralsurgery.com.

You broke a tooth? The dentist is suggesting the root canal treatment or dental implants. Before finalizing the treatment, the biggest challenge is the lifespan of the proposed restoration. How long will the restoration last? What will happen if it fails?

Why to choose Dental Implants

With considering the mathematical solution, there are multiple ways to solve a problem. As well, there are multiple options to replace a missing tooth or teeth. Dental implant is an advanced medical technology which provide an excellent choice to conventional treatment of a dental bridge for the treatment of tooth loss or a full denture.

In dental implants, a titanium implant is anchored in the toothless area of the jawbone. The jawbones fuses with titanium surface to provide a strong anchorage for implants. In contrast, the adjacent teeth are not modified to fill the gap created due to tooth loss. It decreases the stress exerted on adjacent teeth as it absorbs the load generated during normal chewing. Ultimately, it is long term solution for a dental replacement and having less chances of developing TMJ (Temporomandibular Joint) problems.

Benefits of Dental implants

• It can last a lifetime and doesn’t require replacement, if maintained properly.

• It heals those dental problems which are untreatable in conventional dental methods of dental bridges and denture.

• It prevents further resorption of jawbone.

• It restores chewing function perfectly.

• It avoids cutting down and overloading the natural teeth occurring in conventional treatment.

• It restore the self-confidence of the patient as it gives the feeling of regaining the ‘Real Tooth’.

• It functions better than dental bridge and dentures.

• It gives esthetically pleasing result.

Prime Complications during Dental Implants procedure

• It can fail to integrate with bone and come out.

• It can fracture or break.

• It may have problem with connection between the implants and final crown.

• It can be an expensive treatment

• As a result of dental implants, there is possibility of  Infection or an inflammatory condition in the soft tissue or bone.

• There is also possibility of nerve damage in the lower jaw and damage to the maxillary sinus or the nasal cavity.

All of these complications are accounted less than 5% during the dental implants procedure and usually be corrected easily.

Apart from these complications, the dental implants is still provide superior function, stability and esthetic results. It is the best alternative in the wide range of dental treatment options available.

Are You a Good Candidate for Dental Implants?

If you’ve lost – or are definitely going to lose – one or more of your adult teeth, you may be wondering if you’re a good candidate for dental implants. After all, false teeth such as dentures have to be removed regularly from your mouth for cleaning. Many people don’t like the feeling of the “impermanence” of these types of false teeth.

A dental implant, in contrast, is an artificial tooth root that a dentist places into your jaw to support a bridge or replacement tooth. Once surgery is complete, they feel and look like real teeth.

Basically, there are two different types of implants: endosteal (in the bone) and subperiosteal (on the bone).

Subperiosteal implants are put on the top of the jaw.  The posts of the metal frameworks protrude through the gum in order to hold the false tooth. Fast, subperiosteal implants are best for patients who can’t wear conventional dentures and whose bone height is minimal.

Endosteal are the most common type of implants. The different types include blades, cylinders and screws that your dentist places via surgery into the jaw bone. Each of these implants holds at least one, sometimes more, prosthetic teeth. This type of implant is ideal for individuals who wear – or can wear – removable dentures and/or bridges.

Implants can be used to replace a single tooth, several teeth, or even all of your teeth.

Can YOU Get Dental Implants?

An experienced implant dentist will need to examine you thoroughly to see if you’re a candidate and, if so, which type of implant would be best for you. Generally, however, if you’re health is good, your oral hygiene is good, you have enough bone in your jaw to support the implant, and if your gum tissue is healthy, you should be able to have dental implants.

Important note: because implants are connected with bone and gum tissue, seriously consider working with an experienced periodontist when it comes to getting dental implants. Periodontists specialize in gum and bone issues and they also have the experience to ensure your implants look and feel as real as possible.  You can work with a dentist as well as with a periodontist, or you can find a periodontist who offers dental implants.

As you look for an implant dentist you’ll want to be sure he or she has had a minimum of 300 or more hours of postdoctoral/continuing education in both endosteal and subperiosteal implants. He or she also should be certified in dental implants.

While cost probably will be a factor, beware of going with the least-expensive dental implant practitioner. Your comfort factor with the doctor should also be noted – you’re going to be spending a lot of time in his or her office and so you should feel at ease in the facility and interacting with the dentist’s team members.

If you are interested in finding out if you are a good candidate for dental implants or have any questions feel free to contact the office of Dr. Brent Cornelius at (817) 431-4200 or visit our website at www.brentcornelius.com today!

Image courtesy of cooldesign/FreeDigitalPhotos.net

Insufficient room?...Try Full contour zirconia crown...with minimal layering ...for better glazing sake.

Another great All-on-4 dental implant case with computer guided surgery in partnership with Ira and Brandon Dickerman of Dickerman Dental Prosthetics!  The patient was scanned in a Carestream CS 9300 CBCT scanner while wearing a surgical/diagnostic guide with radiopaque teeth.  With that information, the virtual implants and other components are located within the prosthesis and bone during an online treatment planning conference session with the doctor and lab technician.  The locking pins are also located which will stabilize the guide on the arch during surgery. 

This case was set up for the use of Nobel Biocare NobelReplace Conical Connection implants which provide maximum stability due to the tapered body design, and crestal bone preservation due to the horizontal "platform shift" of the restorative table.  Of course, the proprietary NobelBiocare surgical kit must be used for the implants in this particular case.  However, any dental implant that is designed for guided surgery may be used, per the choice of the surgeon, as long as that manufacturer's guided surgery kit is utilized.

The surgery typically involves minimal discomfort for the patient and can be completed in significantly less time than conventional implant surgery.

These cases are cost-effective, durable, and esthetic, which vastly improves the quality of our patients' lives.

Cary Feuerman, DMD

Periodontal Associates

Newton and Framingham, MA

My partner, Giovanni Castellucci, and I have been placing dental implants in our periodontal practice for over 27 years. In the early days, the Branemark "hybrid" prosthesis was the standard of care for restoration of fully edentulous patients with five or six implant fixtures. We followed the traditional two-stage protocol and our patients enjoyed tremendously successful outcomes which have improved their quality of life. However, as time progressed, the hybrid prosthesis became less popular as more conventional PFM fixed restorations were fabricated on custom abutments.

In recent years, we have seen a resurgence of the use of the hybrid prosthesis with the "All-On-4" Immediate Dental Implant (Teeth in a Day) protocol. Now, we successfully restore fully edentulous arches on four implant fixtures on the same day that the hopeless teeth are removed, oftentimes without the need for bone grafts. Our patients are thrilled with the results, and the functional and esthetic benefits are instant.

When speaking with many of our restorative colleagues in Boston, Newton, Framingham, and the Metrowest communities, I occasionally hear them say "my practice doesn't have edentulous patients", or "we don't make dentures". This would imply that the demographic profile of these practices does not include a major component of the general population. Yet, we know that millions (if not billions) of dollars are spent annually on denture adhesives, and that the national dental clinics that focus on denture fabrication are thriving. And, let us not forget that many people with hopeless teeth due to severe gum disease or decay oftentimes avoid treatment because of fear of having to wear a complete removable denture. The "All-On-4" treatment is the perfect solution for these patients as they can have their natural teeth replaced by non-removable, fixed implant-supported teeth on the same day in one dental appointment.

In our practice, we see "All-On-4" patients from all communities, even the most affluent. After all, dental and periodontal diseases do not discern one community from another. With this in mind, we urge all clinicians to "open their eyes" to the benefits of immediate dental implant restorations as another tool to help enhance the lives of our patients.

Have any of you had similar experiences? Please share them with the community.

Cary Feuerman, DMD
PERIODONTAL ASSOCIATES
photo credit:

Cavities tend to plague the young; gum disease gets us when we’re older.

Sure, most of us brush our teeth at least once a day (maybe lackadaisically, but we still brush). And since we aren’t getting cavities any more (we’re brushing, after all!) we assume that we’re home free.

Hardly. If we don’t take care of our gums as we get older we very likely will lose at least one tooth after 65 – if not sooner.

What’s more, gum disease – its clinical term is periodontal disease – can also lead to other health risks such as heart attack and stroke.

Periodontal disease starts out as gingivitis – the least severe form of the disease. Symptoms can include swelling, redness, and bleeding gums (often when you brush your teeth). You’ll probably feel no pain with gingivitis, but if left untreated (and most people can take care of gingivitis with better oral care under the direction of their Keller dentist), it can develop into periodontitis.

This happens because plaque spreads beneath your gum line and the toxins produced by plaque cause irritation. Your body responds with inflammation, causing the tissue and bone beneath your teeth to degrade, with your teeth and gums growing more and more separate from each other. Infection can set in and the cycle continues, with the destruction of more supporting tissue and bone. Given enough time, your teeth can loosen and need to be removed.

But wait! There’s more: there are multiple types of periodontitis. What’s known as aggressive periodontitis usually shows up in healthy people. This type of periodontitis is characterized by rapid destruction of bone and loss of attachment. Chronic periodontitis is the most common type and it’s known for the inflammation of supporting tissue and a slow progression of attachment loss.

As hinted at above, periodontitis can also be a product of another disease (respiratory disease is common), diabetes, heart ailments, and so on.

Finally, a particularly bad form of the disease is necrotizing periodontal disease. This is where the periodontal ligaments, gum tissues and bone die. This type of periodontal disease is most common in patients who have suppressed immune systems.

The treatment for periodontal disease depends on how severe it is. As mentioned above, gingivitis can be tamed with good oral hygiene habits (flossing regularly, brushing for at least one minute each time, regular dental checkups with tooth cleaning and plaque and tartar buildup removed from your teeth).

Scaling and root planning are other non-surgical treatments. Treatments that require surgery include flap surgery/pocket reduction surgery, bone grafts, soft tissue grafts, guided tissue regeneration, and bone surgery.

Most gum disease can be treated non-surgically; the surgical procedures listed above are almost always necessary when the tissue around the teeth is unhealthy and can’t be repaired otherwise.

As serious as periodontal disease is, it’s relatively easy to prevent: take care of your teeth and gums!

For more information about Dr. Brent Cornelius please visit www.brentcornelius.com

Biomimetic dentistry

Introduction

• Biomimetic dentistry is based on the philosophy that the intact tooth in its ideal hues and shades and, more importantly, its intracoronal anatomy, mechanics and location in the arch, is the guide to reconstruction and the determinant of success.
• This approach is conservative and biologically sound and in sharp contrast to the porcelain fused- to-metal technique in which the metal casting with its high elastic modulus makes the underlying dentin hypo functional.
• The goal of biomimetics in restorative dentistry is to return all of the prepared dental tissues to full function by the creation of a-tissue bond that allows functional stresses to pass through the tooth, drawing the entire crown into the final functional biologic and esthetic result.
• Bio: meaning life and mimesis meaning imitation are from Greek.
•  Biomimetics is the field of scientific endeavor which attempts to design system and synthesize materials through biomimicry.
• It’s the concept of taking ideas from nature and implementing them in another technology such as engineering design computing etc.
• The subject matter of biomimetics is known by several names bionics, biognosis etc .
• Biomimectics is an emerging inter disciplinary field that combines information from the study of  biological structures and their function with physics mathematics chemistry and engineering in the development of principles that are important for the generation of novel synthetic materials and organs.

History

• The name biomimeitcs was coined by Ottoschmit in the 1950s. The term bionics coined by JackE.Steele in 1960 at continence in Dayton.
• The foundation of this broad new field has ancient roots. Replacing body parts goes back at least 2,500 years when bridges made them artificial teeth carved them the bones or oxen.
• Evidence of crude dental implants dates back to roman population of the first or second century AD and to pre-Columbian cultures of central and south America.
•  The first use of dental amalgam to repair decayed teeth was recorded in the Chinese literature in the year 659.
• The middle of 20^th century same sophisticated inventions in the heart pacemaker the artificial heart valve and hip and knee joint replacement historically organ and tissue loss have been treated by surgical reconstruction and more recently the use of mechanical devices such as kidney dialyzers and the transplantations of organs from one individual to another.

REGENERATION OF DENTAL STRUCTURES

Regeneration of the dentin pulp complex :-

• The recombinant human BMP2 and BMP4 can induce new dentin .
• Recombinant BMP delivered in a scaffold of demineralized dentin matrix induces classic tubular dentin in amputated pulp where as BMP delivered using reconstituted type I collagen matrix induces instead osteodentin .
• Reparative dentin is also induced on freshly cut healthy pulp tissue in nonhuman primate using recombinant human BMP7 with an insoluble type I collagen matrix.
• The size and shape of the inductive material controls the size and shaped of the reparative dentin.
• The reparative dentin appears initially with cellularand soft tissue inclusions a portion of which (comprising only about 20% of the reparative dentin ) subsequently changes into a more tubular form of matrix with associated odontablast like cells attached to the mass of a tubular matrix.
• Therefore the extra cellular matrix scaffolding is a critical component and a prerequisite to odontoblast differentiation and tubular dentin formation.

Periodontal regeneration :-

• The periodontium which consist of cementum PDL and alveolar bone functions to anchor the teeth to the jaws.
• The morphogenetic potential of BMPs makes them ideal candidates for use in periodontal regeneration o p t i m i z i n g  t h e r e s p o n s e o f s t e m cells to BMP induction requires the use of a delivery system that is conducive to the migration and attachment of the responding stem cells on to the scaffolding using a baboon model recombinant BMP7 and baboon type I collagen has been used as a biomimetic scaffold to regenerate surgically created function defects in molars.
•  The formation of alveolar bone and the creation of cementum and sharpey’s fibers inserted at the optimal orientation into the root surface.
• Platelet rich plasma (PRP) used in different surgical procedures.
• It consists of thrombocyte concentrates and high amounts of growth factors (GFs) especially platelet desired growth factor (PDGF), insulin like growth factor (IGF -I) and transforming growth factor (TGF- beta ) which are important in wound healing and regeneration combination of PRP and tricalcium phosphate can be used in the treatment of periapical inflammatory lesion.
• Platelet gel biotechnology a method which has all the components of “tissue engineering” techniques with healing process of guided tissue regeneration procedures (GTR) by multiplying the number of molecules that activate the healing response and by grafting in the host site various cell types among which stem cell host is applied to regenerative surgery of intrabony defects in patients with refractory g e n e r a l i z e d a g g r e s s i v e p e r i d o n t i t i s .

THE BIOMIMETIC PRINCIPLE IN RESTORATIVE DENTISTRY

• There are two major perspectives to which the term “biomimetic” is applied: a purist perspective that focuses on recreating biological tissues and a descriptive perspective that focuses on using materials that result in a mimicked biological effect.
• Although different, both share a common goal of mimicking biology in restoration. This has been an increasingly common goal for dentists and patients alike in achieving esthetic and functional dentistry.
•  The goal of biomimetics in restorative dentistry is to return all of the prepared dental tissues to full function by the creation of a hard tissue bond that allows functional stresses to pass through the tooth drawing the entire crown into the final functional biologic and esthetic result .
•  Bonded porcelain restorations are recommended to treat the most perilous situation ( non vital or fractured teeth) thus avoiding the use of intraradiucular parts or full coverage crowns e.g.- inlay onlay laminates cemented with the adhesive resins .
• Biomimetic dentistry techniques provide the patient with minimally invasive options that conserve sound tooth structure as a clinical imperative.
•  Biomimetics is essentially described as a mimicking of natural life, which can be accomplished using contemporary composite resins and adhesive dental procedures.
• Conservation and biological mimicry make up the foundation of a biomimetic philosophy and together produce the effect that today’s patients expect.
• From an esthetic/restorative perspective, biomimetics or biomimicry is the application of methods and systems to artificially replace biologic elements in order to recreate optimal oral health.
•  Practicing interdisciplinary esthetic restorative dentistry enables dentists to achieve biomimetic results with cosmetic dentistry.
•  These techniques and materials are crucial to modern dentistry in that they combine a focus on dental health and appearance.
• A biomimetic material should match the part of the tooth that it’s replacing in several important ways, including the modulus of elasticity and function of the respective areas (e.g., pulp, dentin, enamel, dentoenamel junction)
• The low elastic modules of most composites can never fully compensate for the loss of strong proximal enamel ridges especially in extremely large class II restorations .
• In these situations including those with cusp coverage indirect ceramic inlays onlays seem to be best alternative .
•  In case of total occlusal coverage in vital teeth with a short clinical crown ceramic indirect overlays are indicated. .
• With the development of improved adhesives and immediate dentin sealing the use and indications for base lines have decreased.
• This group of materials traditionally performs many different function including the partial lining as a biologic protection for deep preparation areas the total lining for the dentin insulation against chemical or thermal injuries and the dentin replacement as a base prior to further restoration procedures.
• The indication for placing a linear under on adhesive restoration is mainly for pulp protection in the form of a partial lining using Ca (OH2) cements.
• Modern adhesives are capable replacing the total living function of former varnishes and cements.
•  Base materials are mainly indicated to reduce the volume of the inlay/ onlay (e.g.- excessive depth ) and to create an adequate preparation geometry by providing an even cavity floor and filling up internal undercuts .
• Endodontically treated teeth are more susceptible to fracture not because of pulp removal but due to the increased strain resulting them tooth substance loss.
• For posterior teeth total cuspal coverage with porcelain is recommended as it will significantly stiffen the crown and increase cusp stabilization for vital teeth
• .A composite resin base in indicated to reduce the volume of the inlay/onlay and to create an adequate preparation geometry (by providing an even cavity floor and filling up internal undercuts)

DEVELOPMENT OFARTIFICIAL SALIVARY GLAND

• Many people suffer a loss of salivary gland function as a result of radiation treatment for head and neck cancer, and also many people affected for sjogren’s syndrome an autoimmune disease whose symptoms include dry mouth and dry eyes without adequate saliva patient may experience difficulty in speaking, chewing and swallowing.
• The application of state – of – the- art methodologies include the use of adult and embryonic stem cells for the regeneration of the salivary glands, parenchyma and restorations of its secretary functions.
• Efforts have focused on creating a rather simple device a “blind- endtube” suitable to graft in the buccal mucosa of patients whose salivary parenchyma has been destroyed.
• The lumen of these tubes would be lined with compatible epithelial cells and be physiologically capable of unidirectional water movement. A realistic opportunity to develop a first generation artificial salivary gland suitable for clinical testing is believed to exists.

BIOMATERIALS

• According to Douglas A. Terry, DDS, in dentistry there is no one biomaterial that has the same physical, mechanical and optical  properties as tooth structure (i.e., dentin, enamel, cementum) and possesses the physiological characteristics of intact teeth in function.
•  By utilizing biomimetic therapeutic approaches, dentists can improve and become closer to natural biological structures and their function
• Synthetic Polymer: The polymer can be biodegradable or non degradable .biodegradable polymers include polylactic acid and polyglycolic acid and co polymers.
•  These polymers are used as suture materials but are also being examined for usage such as bone ,skin and liver substitutes.
• These polymers are broken down in the body hydrolytically to produce lactic acid and glycolic acid.
• Newer biomaterials are polyanhydrites, Polyphosphazenes. Polymethyl Methacrylate(PMMA),Polytetrafluoroethylene(PTFE)andPMMA, polyhydroxyethylmethacrylate (PHEMA) may be described as alloplastic , synthetic, Nonbiodegradable polymers.
• PMMA used for dentures and as a cement for many orthopedic prosthesis. PTFE used for augmentation and guided bone regeneration.

CERAMICS

• It is used in dental applications and are being examined for bone tissue engineering application.
• Two common ceramics used in dentistry and hip prosthesis are alumina and hydroxyapatite.
• Alumina has excellent corrosion resistance, high strength, high wear resistance.
• Hydroxyapatite is a calcium phosphate based ceramic and it is a major component of inorganic compartment of bone.
• Advantages of a BioMimetic crown

• Less healthy tooth structure is removed.

• Less potential chances of damaging the nerve inside the tooth.

• T he visual look of the restoration is identical to the natural tooth structure.

• Chances of decay getting under the restoration are small compared to a conventional crown.

• Disadvantages of a BioMimetic crown

• There is the possibility that the porcelain crown could fracture.

• T here is the possibility that the porcelain crown could de-bond (fall off) the tooth. This would require a new crown to be made.

BIOMIMETIC PRINCIPLES IN DENTAL IMPLANT

• Biomimetic dental implants may be the next development in the field.
• A variety of biomimetic coatings may prove helpful for application in individual patients.
•  For example, coating implants with factors known to induce endothelial cell differentiation and proliferation may promote greater vascularity in highly cortical bone, thereby improving conditions for early and long-term (in response to functional loading) bone remodelling.
• Ceramics such as the calcium phosphate hydroxyappatite and various types of aluminum oxides are proved to be bio compatible and they are coated to implant which increases osteointegration.
• Coating implants with pharmacological agents such as bisphosphonates6 may be a way of locally improving bone density in highly cancellous bone.
• Coating implants with BMPs may also accelerate initial healing times during integration of the dental implant, thereby reducing overall treatment times and improving implant success rates.
• Experimental investigations with a BMP known as recombinant human BMP-2 (rhBMP-2) in animal models have shown that it promotes initial integration of dental implants and “rescues” implants affected by experimentally induced peri-implant bone loss.
•  Modifying the surface characteristics of the implant can promote migration of mesenchymal cells to the implant surface, enhance attachment and proliferation of these cells, and, in some instances, stimulate osteoblastic differentiation.

SCOPE

• Biologist study biomimetics not only for an understanding of the biological processes but also to trace the evolution of various classes of organism biochemist have interest in the field due to the complexities associated with the interaction of biopolymers with ions of metal leading to the mineralization in living organisms.
• On the whole the field of biomimetics addresses more than one issue those engaged in this field of research activity try to mimic natural method of manufacture of chemicals in order to create new ones, learn new principles from phenomenon observed in nature, reproduce mechanism found in nature and copy the principles of synthesizing materials under ambient conditions and with easily available raw materials.
•  Design of biodegradable scaffolds to serve as platforms for cells to organize tissues for repair and regeneration of teeth and periodontal tissues.
• Develop biodegradable synthetic polymers for gene therapy identify isolate culture and characterize multipotent stem cells for adult tissues type for repair of TMJ associated structures.

CONCLUSION

• There is a need for a firmer scientific and technical basis in order to develop the next generation of medical implants that are safe reliable smart and long lasting integrated and multidisciplinary research should advance our understanding of biological system and provide the basis for the design and development of normal synthetic medical materials that are compatible with the environment of the host and significantly increase the functional life time of implants.
• Future advances in this field will require materials and computer scientist, physicists, bioengineers, clinicians, biologist and industries working together towards a shared vision rather than pursuing their separate objectives

STEM CELLS

TERMINOLOGIES

Tissue Stem cells :

• Potten and Loeffler, 1990 definition
• Stem cells of a particular tissue are undifferentiated cells (relative to a functional tissue) capable of

 1.proliferation;

2. production of a large number of differentiated functional progeny;

3.self-maintenance of their population;

4. regeneration of the tissue after injury;

5.flexibility in the use of these options

• Amended Definition of Tissue Stem Cells

Stem cells of a particular tissue are:

1. a potentially heterogeneous population of functionally undifferentiated cells, capable of:

2. homing to an appropriate growth environment;

3.proliferation;

4. production of a large number of differentiated progeny;

5.self-renewing or self-maintaining their population;

6.regenerating the functional tissue after injury with

7. flexibility and reversibility in the use of these options

• Potency -differentiation potential (the potential to differentiate into different cell types) of the stem cell.

1.Totipotent /omnipotent stem cells –

• differentiate into embryonic and extraembryonic cell types. –
• a complete, viable organism.
• produced from the fusion of an egg and sperm cell.
•  Cells produced by the first few divisions of the fertilized egg are also totipotent.

2.Pluripotent stem cells –

• descendants of totipotent cells
• can differentiate into nearly all cells,  i.e. cells derived from any of the three germ layers.

3. Multipotent stem cells

•  -can differentiate into a number of cells,
• - but only those of a closely related family of cells.

4.Oligopotent stem cells

• can differentiate into only a few cells, such as lymphoid or myeloid stem cells.

5.Unipotent cells

• can produce only one cell type, their own,but have the property of self-renewal,
• - distinguishes them from non-stem cells (e.g., muscle stem cells)

Introduction

• Russian histologist Alexander Maksimov in 1908
• Stem cells grew out of findings by Canadian scientists in the 1960s
• Dental exfoliation-genetically regulated event
• Lost- donot regenerate
• Stem cells-divide to produce one stem cell and one cell capable of differentation .
• Stem Cells in Dentistry
• 2000- Discovery of adult Stem-cells in dental pulp cells, the living tissue at the centre of tooth.
• 2003- Stem-cells found in baby teeth.
• 2004- Stem-cells found in periodontal ligament, which holds the teeth in place in gums.
• 2007- Researchers learn how to reprogram some adult cells from mice to assume a State like Embryonic Stem-cells called induced pluripotent Stem-cells.
• 2008- Cells in dental pulp identified as adult Stemcells.
• 2003 Dr. Songtao Shi - baby tooth Stem-cells by using the deciduous teeth of his six year old daughter-  isolate, grow and preserve these Stem cells with regenerative ability, and he named them as SHED (Stemcells from Human ExfoliateD Deciduous teeth)
• CLASSIFICATION
• two broad types of Stem-cells
• Embryonic stem- cells
•  Adult Stem-cells.
• Embryonic Stem cells
• Pluripotent-differentiate into all types of somatic cells and theoretically divide an unlimited number of times
• Embryoblast cells –part of blastocyst –interest for stem cell research
• Ability to self regenerate
• Adult-Stem cells
• cells are also called as somatic Stem-cells because they refer to body cells
• can only proliferate a limited number of times.
• Distinguished according to their developmental potential. There are uni- and bipotent progenitor cells-only be differentiated into mature cells of their parent tissue
• Multipotent adult stem cells-are not identical to the parent tissue
• Sources Of Stem-Cells
• Bone marrow -from the long bones. The best sources are pelvic bones, femur and sheen bone.
•  Umbilical cord blood -collected just after the birth of the baby.
•  Embryonic cells -from the blastocyst phase of the embryo.
• Placental Stem-cells
•  Menstrual Stem-cells -extra-ordinary improvement over the umbilical cord blood cells-  have a rapid growth rate.
•  Dental Stem-cells -from the pulp of deciduous or wisdom teeth. - has been found to produce bones, cartilage, and muscle cells if cultured.
•  Present in natal teeth, mesiodense or supernumerary teeth.
• Applications- Parkinson’s diseases,paraplegia, leukemia, and brain tumors
• therapeutic use in dentistry - to regenerate individual tissue types- such as bone,periodontal tissue
• Someday even entire teeth
• 2 means of regenerating teeth
• 1.conventional tissue engineering-the application of cells in a carrier material in vitro under the influence of a stimulus leads to tissue regeneration.
• 2. using dental epithelium and mesenchymal cells in vivo after direct implantation
• - Based on knowledge of general embryogenesis and physiological tooth development during childhood
• CLINICAL APPLICATIONS
• Craniofacial applications.
•  Dental pulp applications.
• Creation of artificial embryonic teeth primordia fromcultured cells.
• Cementoblast like cells applications.
• Periodontal regeneration.
• Over 200 regulatory genes-odontogenesis
• Growth factors from four families
• 1. fibroblast growth factor (FGF),
• 2.Hedgehog,
• 3.wingless (WNT)
• 4. transforming growth factor- (TGF-), to which the bone
• morphogenic proteins (BMPs) belong
• The basis for the regeneration of teeth or individual dental tissues –
• is the acquisition of suitable stem cells and
•  a suitable environment in which these cells can
•  differentiate into the target tissues
• Carrier materials
• collagen sponges
• HA/TCP (hydroxyapatite tricalcium phosphate
• calcium phosphate
• fibrin polymer ceramic
• alginate
• or polymers
•  PCL gelatin scaffolds
• the use of growth factors such as fibroblast growth factors
• and some of the transforming growth factor  family, e. g. bone morphogenic proteins

Dental epithelial stem cells

• The embryonic oral epithelium induces odontogenesis
• Ameloblasts- arise from epithelial stem cells
• the only cells of ectodermal origin which play a role in odontogenesis.
• Lost after tooth eruption- leaving no adult human ectodermal stem cells available for cell therapy.
• Dental epithelial stem cells –obtained from third molars of newborn or juvenile, still developing animals
• A source of epithelial stem cells,
• -the apical bud cells (ABCs), in the apical epithelium is responsible for continuous enamel production
• Dental mesenchymal stem cells
• With the exception of ameloblast progenitor cells,all stem cells involved in odontogenesis originate in mesenchyme
• Mesenchymal stem cells - differentiate into nerve, muscle, vascular, fat, cartilage or bone cells

• Dental pulp stem cells
• isolated from the dental pulp
• Depending on specific signals from their environment, DPSCs can either regenerate new stem cells or undergo  a differentiation process.
• Dental pulp acquired from third molars or pulpectomized teeth left in situ.
• Even after temporary storage in liquid nitrogen- the DPSCs do not lose their multipotent ability to differentiate
• In vitro, DPSCs - differentiate to odontoblasts, osteoblasts, endothelocytes, smooth muscle cells, adipocytes, chondrocytes, and neurons.
• DPSCs differentiate in vitro to osteoblast progenitor cells and mature into osteoblasts which produce LAB (living autologous fibrous bone tissue
• DPSCs in vivo can form calcified bone tissue with Haversian canals and osteocytes and dentin/pulp-like tissue complexes
• odontogenic, myogenic, adipogenic, and osteogenic differentiation.
•  DPSCs influence angiogenesis
• Regeneration potential of adult stem cells in human dental pulp - tertiary dentin
• therapeutically employed for direct and indirect pulp capping after caries excavation near the pulp
• Stem cells from human exfoliated deciduous teeth (SHEDs
• relatively easily accessible source of adult stem cells
• coronal pulp of exfoliated deciduous teeth
• Role
• in the eruption of permanent teeth
• influence the osteogenesis
• In vitro-odontogenically, osteogenically, adipogenically, chondrogenically, or neurally
• In vivo- neurons, adipocytes, odontoblasts, and osteoinductive and endothelioid cells
• Periodontal ligament stem cells (PDLSCs)
• Periodontal ligament - contains stem cells which have the potential to form periodontal structures such as cementum and ligament
• from the roots of extracted teeth
• In vitro-differentiate into osteoblasts, cementoblasts,
• and adipocytes.
• In vivo, after transplantation into mice, structures resembling bone, cementum, cartilage, and PDL have been found.
• Dental follicle stem cells (DFSCs)
• The dental follicle plays a major role in the genesis of cementum, periodontal ligament, and alveolar bone.
• isolated from the follicles of impacted third molars
• in vitro exhibit characteristics of cementoblasts and osteoblasts-can differentiate neurally.
• In vivo, tissue similar to dental cementum and differentiation into PDL progenitor cells
• Stem cells from the dental apical papilla (SCAPs)
• SCAPs - stem cells from the apical part of the papilla,
• a precursor tissue of the dental pulp.
•  Impacted third molars
• In vitro, SCAPs -differentiate osteogenically, odontogenically, and adipogenically.
• In vivo, SCAPs -differentiate into odontonblasts and osteoblasts.
• Non-dental stem cells
• Human bone marrow-bone marrow derived mesenchymal stem cells (BMSCs) can replicate themselves and, in experiments, be differentiated into osteoblasts, myoblasts, adipocytes, and neuron-like cells
• In humans, BMSCs -used therapeutically in bone augmentation by sinus lifts
• -minimally invasively harvested from the iliac crest and inserted into the maxillary sinus on a carrier.
• MBMSCs -(mandibular bone marrow stem cells)
• -possess a high osteogenic potency
• Mesenchymal cells can be isolated from odontomas and differentiated into dental hard tissue, such as dentin
• Other sources :
• From umbilical cord blood
• cartilage
• the cornea
• mammary glands
• adipose tissue
• Renal stem cells
• Medical research- multipotent neural stem cells
•  from areas such as the hippocampus and subventricular zone
• Dermal multipotent cells -differentiated to odontoblasts in embryonic tooth-bud medium
• Dental Stem cell markers
• Identify,characterize, and isolate stem cells.
• STRO-1, a trypsin-resistant cell-surface antigen- most common-early surface markers of mesenchymal stem cells
• STRO-4, binds to heat shock protein–90 beta of multipotent MSCs
• The osteoblast marker osteocalcin -a stem cell marker of DPSCs
• The neural marker nestin on dental stem cells
• Conclusion
• For dentistry, stem cell biology and tissue engineering are of great interest.
• A great deal of research must be done before it is possible to cultivat eentire teeth as natural, autologous tooth replacements

Are you in a cash crunch? Need to consolidate a business or personal debt? We are healthcare specialists; we will succeed when banks have failed; funding in as little as 7-10 business days; funds can be used at your discretion.

If you’d like to hear more about our programs or even take a look at some figures so you can quickly evaluate whether this would be worth your time feel free to send me an email at kasandra@imsfinancial.net and/or call me anytime at (818) 762-6611.

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Web Dentists are those who come to know your teeth problems then provide suggestions and prescribe methods over internet. Many dentists and oral hygiene experts are associated with Webdentist. Patients can communicate via emails and also register to connect with doctors of their choices.

Cavities are the prime reason which develop bacteria and cause tooth ache. Tooth ache is also caused by tooth decay, tooth fracture, infected gums and damaged filling. When the toothache becomes severe and lasts for more than two days then one should immediately seek doctor’s help.

Many first aid treatments and emergencies are prescribed over the webdentist and some of the treatments include:

• One should have a clean mouth by rinsing mouth with warm water and flossing also removes the food particles. Salt and warm water solution also happens.
• To subside the pain a cool compressor is used outside of the mouth or cheek, some pain killers should also be given but some pain killers like Aspirin should not be given to any one below the age of 18 and such pain killers should not be taken on the gum area which will make it burn with sensation.
• If the pain does not subside one should visit a dentist.
• There are some natural remedies by which one can get rid of toothache like rubbing clove oil on the affected tooth can bring relief to the toothache since clove oil has properties which kill bacteria and it also acts as a local anesthetic. A paste of ginger powder and red pepper can be applied on the affected tooth for a quick relief. Rinsing one’s mouth with a drop of myrrh acts as an astringent. Peppermint tea also has a numbing power. To kill bacteria a solution of hydrogen peroxide solution can also be taken for a temporary relief. Ice cubes, tea bags also bring relief.
• Better toothpaste for sensitive tooth is the usual norm. Apple Cedar vinegar, vanilla extract, garlic and oil of oregano al help to bring down the pain.
• A softened chewing gum, soft bristle brush and acupressure techniques should be taken care of.

Toothache has many treatments depending on the type of toothache. If cavity is the reason for toothache the dentist will fill the cavity or extract the tooth. If the toothache causes infection on the nerve’s end then the dentist may also go for root canal and for reducing the pain phototherapy is done along with a cold laser which gives relief. The dentist also prescribes antibiotics. Toothaches can be prevented by following simple daily care routine like maintaining a good oral hygiene which consists of brushing regularly with a fluoride based toothpaste, regularly going to the dentist for proper clean ups, less consumption of sugar based foods.

Read more on Tooth Decay and Cavity at www.webdentist.in

A beautiful smile breaks many barriers between two people. A fight or an argument dissolves immediately when a person receives the warm smile by another person. It is estimated that around 99.7 percent of Americans think that smile is an important social asset. A smile is a timeless asset, with 45 percent of the people thinking that smile is the most attractive feature in a personality.

A smile not only breaks the barriers but makes one attractive to the opposite sex. People with a beautiful smile turn many heads and gather more attention. On the other hand, it is believed that people who sport an unattractive smile have fewer chances of career success. A smile brings many benefits, from friendships to long term relationships have all started with a beautiful smile. So, if you want to benefit from a beautiful smile, maintain it by keeping its straightness, whiteness, cleanliness and sincerity most of all.

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Hello All, my name is Kasandra Bell I am an Executive Accountant for IMS Financial.

I would like to introduce myself and share with you a little bit about IMS Financial and what it is that I do.

“IMS financial” operates as a financial resource servicing areas throughout the US. With 40+ years of expertise, we’ll bring to you and your practice unmatched resources in fulfilling your commercial or private loan, financing and refinancing needs.

Our team focuses on providing Dental Professionals of all specialties with the most competitive rates, while removing the hassle of dealing with traditional lenders and finding the right financial solution for our clients, which will ultimately help them achieve greater financial satisfaction, security and success. We will use our expert up-to-date knowledge and banking network connectivity to achieve the most unique packages possible for our Dental Professionals all over the country.

“IMS Financial” provides growth opportunities for our healthcare professionals who provide jobs in our community, quality of life for their patients and preservation for their families. Our medical working capital loan programs are available to both startups and well established practices.

Here are just a few programs we provide:

• Dental Working Capital
• Working Capital
• Practice Acquisition
• Practice Expansion
• Practice Refinance
• Commercial Mortgage  

• Residential Mortgage

If you’d like to hear more about our programs so you can quickly evaluate whether this would be worth your time, feel free to send me an email at kasandra@imsfinancial.net and/or call me anytime at (818) 762-6611.

Looking forward to connecting with all of you, and have a wonderful day!!!

All the best,

Kasandra

Tooth decay is a serious problem and some of us don't realize that there are solutions out there that will help prevent tooth decay. Sometimes tooth decay pain can be so bad that it's difficult to work or do your daily routine chores. Here are some causes for tooth decay, which one can know and prevent from happening:

For more information visit SedationConsulting.com