MINIMAL INTERVENTION DENTISTRY

Minimal intervention dentistry is a modern dental practice designed around the principal aim of preservation of as much of the natural tooth structure as possible. It uses a disease-centric philosophy that directs attention to first control and management of the disease that causes tooth decay—dental caries—and then to relief of the residual symptoms it has left behind—the decayed teeth. The approach uses similar principles for prevention of future caries, and is intended to be a complete management solution for tooth decay.

History

Classical restorative dentistry has traditionally followed the century old approach of GV Black in classification and treatment of tooth decay. This was based on very limited knowledge at the time about the pathology of the underlying dental caries disease, and the need to specially prepare a cavity to repair a lesion (decayed area) with the limited available materials.

Therefore, the only approach was to treat the symptoms—to remove the decay and restore the tooth surgically. Modern science has since allowed for better understanding of the pathology, thus opening the door for new methodologies and approaches to treatment. The practice of minimal intervention dentistry was designed to utilise these new possibilities by implementing a disease-centric philosophy to management of tooth decay. While advances in dental science are of course used in mainstream dental practice, MI dentistry has redesigned the treatment guidelines beginning with a new classification of caries lesions. This classification was intended to reflect the possibility of curing the disease and remineralising (hardening) early lesions before irreversible damage has been done. It was first published by Mount and Hume in 1997 and has subsequently been revised.

Some see MI dentistry as merely a philosophical change, but since the practice has been in mainstream discussion in the late 90s it has acquired some respectable international academic backing.

 Approach to restorative dentistry

The approach of minimal intervention dentistry is centred on management of the dental caries disease responsible for tooth decay, first controlling and curing the disease, then restoring the tooth, filling only where necessary, and finally prevention from future caries.

 Treatment: controlling and curing

Classical dietary and oral hygiene techniques of reducing sugar content and eating frequency, and removing plaque by effective brushing, are still very important practices for treatment as well as prevention. Also, biochemical techniques can be used to treat the bacterial infection directly.  Agents such as chlorhexidine can help fight gum disease and thus reduce the amount of bacteria in the mouth that are responsible for tooth decay. After a wave of empirical studies on the efficacy of Xylitol (a sugar alcohol) a consensus report in the British Dental Journal considered it to give a reduction in the risk of caries. There is also increasing use of newer technologies such as photo-activated disinfection and treating with ozone.

There is also an aspect of minimising the effect of the caries to control the symptoms of decay. Constant remineralisation (hardening) with continuous application of fluoridetoothpaste is highly common practice that reduces the impact of the caries on decay. Changing the biochemical properties of saliva, potentially through the use of appropriate drugs, can help the buffering capacity of the saliva to resist changes in pH caused by plaque acid, resisting the acid attack caused by the active caries.

Restoration

Decay is the process or result of demineralisation (softening) of an area of dental tissue, creating a decayed lesion on the tooth. The process of restoring decay begins with an analysis of the decayed lesions together with their location and severity, with particular regard to the state of reversibility. Where decay is reversible, it is referred to as non-cavitateddecay, where healing is possible by the hardening process of remineralisation. Where a cavity has formed from excessive demineralisation, the decay has reached the point of no return where the tooth structure has been lost and the decay is permanent and non-reversible. In this situation of cavitated decay, the cavity will have to be filled to restore the tooth. Minimal intervention dentistry is focused on filling only cavitated regions, leaving non-cavitated decay to be remineralised, thus restoring the tooth while removing as little of the tooth structure as possible, enhancing the strength and aesthetics of the restoration. Classifications of the location and severity of decay are made in order to establish guidelines for suitable treatment methods.

 Identification and classification of carious lesions

The minimal intervention approach to classification was originally introduced by GJ Mount and RW Hume in “A new classification for dentistry”, and later modified by other journal articles and books mainly by Mount and Hume. This classification aims to provide a useful guide to the clinical approach required in treatment, depending on the characteristics of the lesion. The first stage is to determine cavitation, then followed by determining the restorative approach to any cavitated areas, with suitable treatment for remineralisation of the non-cavitated areas.

 Remineralisation of non-cavitated lesions

Various techniques exists for remineralisation, varying from simple application of fluoride to using special substances for filling materials that interact with the tooth to aid the process from within. Glass Ionomer Cements (GICs) have been shown to undergo ion exchange with the surrounding tooth structure, and also engage in fluoride feeding. Research by Prof. Hien Ngo and others has shown that these methods can in practice heal some non-cavitated lesions.

 Prevention

The same methods for cure of the disease can be used for prevention, as well as other techniques such as the use of fissure sealants in high risk individuals.

PATIENT EDUCATION

Like many health concerns, people have questions about things they hear or read online about vaccines. As the most trusted profession, nurses can be critical in helping to improve confidence in vaccines and to help people feel good about their decision to be vaccinated or to have their children or loved ones vaccinated.

Nurses should understand the concept of risk communication, as it is a vital tool in helping to discuss immunizations with patients, colleagues, family and communities. Being able to communicate about risk is very important, especially now that many vaccine-preventable diseases like polio and diptheria are practically extinct in the U.S. Nurses need to help people understand the risk of the diseases is still very real.

And the sagging confidence in vaccines and the subsequent drops in immunization coverage have caused the re-emergence of diseases, and in some cases, death.

Be sure to have the facts—learn about how immunizations work in the human body, how vaccine safety is monitored, and how to effectively communicate about the risk of disease versus the risk of a vaccine side effect. Think critically about what you hear or read about the risks of vaccinating. Remember, you don’t always have approach the conversation in terms of risk—help people understand the benefits of vaccines, both to individuals and the community at large.

Looking for some fliers for your clinic or office? Need a poster for your break room? Going to a health fair and need some hand-outs on immunization? Look no further!

Here there are links to lots of great information and educational materials addressing nurses and other health care workers, adults and adolescents, parents, and more!

Please see the materials below in the blue box under Resources beginning with “Talking to Parents about Vaccines – CDC” and ending with “Resources for Communicating to Parents.”

Giving a vaccine? Then you need to give a VIS!

Vaccine information statements, or VIS, are fact sheets about an immunization, including a clinical description of the diseases it prevents, common side effects and treatment, how to report a vaccine adverse event, and more. It is federal law that anyone receiving a vaccine be given the corresponding VIS to ensure they are making an informed choice about being vaccinated.

Nurses, as primary patient educators and advocates, should ensure that everytime a vaccine is given, the patient or parent receives a VIS – even for booster doses and annual seasonal influenza vaccines. VISs are available in many languages, even Arabic, Chinese, Russian, and Thai.

PATIENT MANAGEMENT

In the prior post I mentioned I was the “Patient Management Officer” here at Hello Health. One of the questions you get asked a lot when you’re a Patient Management Officer is, “What the heck is Patient Management?”

If you’re a doctor you know better than I that healthcare is becoming more consumer-oriented all the time. Patients’ expectations of their doctor – like the “customers” of nearly every service provider – have risen right alongside healthcare costs. The demand for better outcomes and service quality levels that inspire patient loyalty have never been higher, and that’s putting pressure on doctors to go beyond “just” taking care of patient’s basic needs.

The set of activities practices are undertaking to manage and deliver on these rising expectations are sometimes referred to as “patient management.” It’s an approach more than a procedure, really, an orientation to place more focus and attention on the management of patient relationships, rather than just illnesses.

The best patient management programs bring patients into a practice in a meaningful manner – they enhance patient loyalty by contributing meaningfully to both the quality of care and the quality of service, as perceived by the patient.

Think back to how technology first arrived in your practice. It was probably the fax machine, followed closely by a rudimentary billing system on a now-woefully outdated computer, next it was the lab company dropping of another computer for your lab reqs. Today you may or may not have an EMR up and running, and if you are one of the lucky few, you are happy with how things are progressing. But what’s missing in this picture? All of this health IT has been for the benefit of your staff, you, and of course the lab company.

But what’s in it for the patient? More specifically, what’s in it for the person you’re caring for, not just the electronic chart that represents them? In so many cases, the answer is “very little.” That’s why we need to stop thinking about healthcare IT as a general ledger expense and start thinking about it as an asset that enables improved Patient Management.

The time is right to examine more of your practice through the lens of how it creates value for the patients it serves. If you decided to be a primary care doctor you’ve always held those values. Now the technology exists to deliver on that promise, today and every day. Perhaps more than that, people’s expectations of how they communicate, share information and build relationships have changed a lot since the old phone and fax days. It’s time to step into the 21st century.

ORTHODONTICS

Orthodontics is the branch of dentistry that corrects teeth and jaws that are positioned improperly. Crooked teeth and teeth that do not fit together correctly are harder to keep clean, are at risk of being lost early due to tooth decay and periodontal disease, and cause extra stress on the chewing muscles that can lead to headaches, TMJ syndrome and neck, shoulder and back pain. Teeth that are crooked or not in the right place can also detract from one’s appearance.

The benefits of orthodontic treatment include a healthier mouth, a more pleasing appearance, and teeth that are more likely to last a lifetime.

A specialist in this field is called an orthodontist. Orthodontists receive two or more years of education beyond their four years in dental school in an ADA-approved orthodontic training program.

How do I Know if I Need Orthodontics?

Only your dentist or orthodontist can determine whether you can benefit from orthodontics. Based on diagnostic tools that include a full medical and dental health history, a clinical exam, plaster models of your teeth, and special X-rays and photographs, an orthodontist or dentist can decide whether orthodontics are recommended, and develop a treatment plan that’s right for you.

If you have any of the following, you may be a candidate for orthodontic treatment:

Overbite, sometimes called “buck teeth” — where the upper front teeth lie too far forward (stick out) over the lower teeth

Underbite — a “bulldog” appearance where the lower teeth are too far forward or the upper teeth too far back

Crossbite — when the upper teeth do not come down slightly in front of the lower teeth when biting together normally

Open bite — space between the biting surfaces of the front and/or side teeth when the back teeth bite together

Misplaced midline— when the center of your upper front teeth does not line up with the center of your lower front teeth

Spacing — gaps, or spaces, between the teeth as a result of missing teeth or teeth that do not “fill up” the mouth

Crowding — when there are too many teeth for the dental ridge to accommodate

How Does Orthodontic Treatment Work?

Many different types of appliances, both fixed and removable, are used to help move teeth, retrain muscles and affect the growth of the jaws. These appliances work by placing gentle pressure on the teeth and jaws. The severity of your problem will determine which orthodontic approach is likely to be the most effective.

Fixed appliances include:

Braces — the most common fixed appliances, braces consist of bands, wires and/or brackets. Bands are fixed around the teeth or tooth and used as anchors for the appliance, while brackets are most often bonded to the front of the tooth. Arch wires are passed through the brackets and attached to the bands. Tightening the arch wire puts tension on the teeth, gradually moving them to their proper position. Braces are usually adjusted monthly to bring about the desired results, which may be achieved within a few months to a few years. Today’s braces are smaller, lighter and show far less metal than in the past. They come in bright colors for kids as well as clear styles preferred by many adults.

Special fixed appliances — used to control thumb sucking or tongue thrusting, these appliances are attached to the teeth by bands. Because they are very uncomfortable during meals, they should be used only as a last resort.
Fixed space maintainers — if a baby tooth is lost prematurely, a space maintainer is used to keep the space open until the permanent tooth erupts. A band is attached to the tooth next to the empty space, and a wire is extended to the tooth on the other side of the space.
Removable appliances include:

Aligners — an alternative to traditional braces for adults, serial aligners are being used by an increasing number of orthodontists to move teeth in the same way that fixed appliances work, only without metal wires and brackets. Aligners are virtually invisible and are removed for eating, brushing and flossing.

Removable space maintainers — these devices serve the same function as fixed space maintainers. They’re made with an acrylic base that fits over the jaw, and have plastic or wire branches between specific teeth to keep the space between them open.

Jaw repositioning appliances — also called splints, these devices are worn on either the top or lower jaw, and help train the jaw to close in a more favorable position. They may be used for temporomandibular joint disorders (TMJ).

Lip and cheek bumpers — these are designed to keep the lips or cheeks away from the teeth. Lip and cheek muscles can exert pressure on the teeth, and these bumpers help relieve that pressure.

Palatal expander — a device used to widen the arch of the upper jaw. It is a plastic plate that fits over the roof of the mouth. Outward pressure applied to the plate by screws force the joints in the bones of the palate to open lengthwise, widening the palatal area.

Removable retainers — worn on the roof of the mouth, these devices prevent shifting of the teeth to their previous position. They can also be modified and used to prevent thumb sucking.

Headgear — with this device, a strap is placed around the back of the head and attached to a metal wire in front, or face bow. Headgear slows the growth of the upper jaw, and holds the back teeth where they are while the front teeth are pulled back.

PEDODONTICS

Pedodontics and Preventive Dentistry is a subject that deals with the care and treatment of children’s teeth. It is thus an age defined specialty. It involves, but is not limited to: conselling parents regarding diet, prevention and management of dental caries, pediatric endodontics, management of traumatic injuries of teeth, preventive and interceptive orthodontics, cosmetic dental treatment using latest technology, managing gingival and periodontal diseases in infants, children and adolescents including those with special health care needs.

The department is of the firm belief that “every child has a fundamental right to total oral health” and strives towards achieving this end.

Apart from regular out- patient consultation the department also.

It conducts school dental health camps and various other programmes for the care and treatment of children’s teeth. In short, it caters to the dental needs of pediatric patients.

CHAIR, EQUIPMENTS AND INSTRUMENTS

With our expertise in manufacturing products for medical and research laboratories, we are specialize in manufacturing variety of instruments & equipment for blood banks. Our array includes Tube Sealers, Blood Donor Chair, Blood Collection Monitors, Blood Bank Equipment, Donor Chair and more. Our products have advanced features that allows ease of handling and provide complete safety. Available in standard models, we also customize our product range as per the requirement of our clients.

  1. Provides a comfortable position for the donor.
    Variable positioning for either arm with a comfortably wide arm – rests.
  2. Arm rests having up and down moving facility.
  3. Reclining and upright body positions with a smooth shifting to any position.
  4. Supporting base is completely attached with chair.
  5. Drawers provided for the upkeep of equipment & consumables. In back side we already provided with Telescopic Tray.
  6. If a vasovagal attack occurs the Donor’s head need to be lowered immediately and his legs lifted above his heart level so that blood can flow facility should be available. For this purpose we specially provide multipurpose cushion which is use normally at back side of head but when this situation will occur that cushion can be used in down side also.
  7. castors are easy lockable and we given the additional stopper option in back side of castor between two castor only press it will be fixed it at floor side which is required on base.

PAINLESS AND NONINVASIVE DENTISTRY

Painless Cavities and Fillings

Dr Sudhir can perform a painless cavity preparation and natural-color filling procedure faster than ever and you will avoid the Novocain shot and pain associated with fillings.

No Drill No Pain. The Ozone Dental System uses laser-energized water to gently wash away tooth decay with incredible accuracy. You won’t hear the whine of the drill or smell drilled enamel. There is no heat or vibration, which reduces the dependence on needles and anesthesia.

The Ozone laser prepares your teeth in a way that maximizes bond strength and provides you with longer lasting fillings. It’s perfect for decay removal, cavity preparation and general dentistry for enamel and dentin.  It’s painless and precise dentistry.

And We Make The Fillings Look Natural. Traditional fillings can be unsighly, metalic distractions from your smile-especially when associated with the front teeth. Dr Sudhir offers patients at his Tyson’s Corner practice the superior appeal of natural-colored fillings. They utilize hard enamel matched to your natural tooth color.  Next time you get fillings- go natural!

 Non-Surgical Therapy for Gum Disease

Early detection of gum disease may mean the elimination of painful gum surgery. Tooth brushing and flossing removes plaque that is above the gum line of your teeth. Should tartar and bacteria attach to your teeth below the gum line, they will pull the gum tissue away from the teeth and create a deep pocket. Six-month dental hygiene checkups and oral exams will reveal this issue.

Should you or a family member have gum disease, count on Dr Sudhir and his team to offer two non-surgery options:

The first option is to clean the tartar and bacteria before they deteriorate bone and tissue resulting in the loss of teeth. The goal of this non-surgical therapy is to allow the gum to heal and pocket depth be reduced.  Gingivitis, caught in its earliest stage with no damage done, can be managed with one to two regular cleanings.  You will also be instructed on how to improve your daily oral hygiene habits and book regular dental cleanings.

The second alternative for treating gum disease is Perio Protect. Perio Protect is an FDA-approved, non-surgical treatment for gum disease that can be applied in the comfort of your own home. For more information, visit PerioProtect.com (why do we want to send people away from the site?) or schedule an appointment with Dr Sudhir today.  This dentist prescribed treatment is not for everyone with periodontal disease, but it is less costly than conventional periodontal treatment.

 An Alternative to Dental Surgery: Laser Periodontal Therapy

If you or a loved one has been diagnosed with Periodontal Disease and surgery is recommended, there is a less invasive, less painful alternative – Laser Periodontal Therapy.  Laser Periodontal Therapy is the only FDA-approved procedure for regaining new tissue attachment and bone around your teeth.

Laser Periodontal Therapy is much less painful than traditional gum surgery and can be completed in just two one-hour sessions, utilizing either the ezLase dental laser or the Waterlase laser.

A tiny laser fiber about the thickness of three hairs is placed between the tooth and gum, and the infection is cleared away. The procedure is fast! It takes just two one-hour sessions for Dr Sudhir to treat one half of your mouth at each session.

Pocket Elimination Therapy addresses severe loss of tissue attachment between the tooth and gum and may require special localized treatment.  Dr Sudhir uses a Ozone laser to treat the area. A tiny fiber the thickness of a paperclip is used to remove and decontaminate the periodontal pocket.  An enamel protein matrix is placed into the pocket in order to stimulate and generate bone growth and attachment to the tooth.

DISNFECTION AND STERILIZATION

General Description

The purpose of this Guidance Document for Disinfectants and Sterilization Methods is to assist lab personnel in their decisions involving the judicious selection and proper use of specific disinfectants and sterilization methods.

Introduction

The purpose of this Guidance Document for Disinfectants and Sterilization Methods.

It is to assist lab personnel in their decisions involving the judicious selection and proper use of specific disinfectants and sterilization methods. For information concerning the proper disposal of all disinfected or sterilized waste, please refer to the Generators’ Guide to Hazardous Material / Waste Management.

 

Definitions

Antisepsis: A process involving the destruction or inhibition of mico-organisms in living tissue thereby limiting or preventing the harmful effects of infection.

Antiseptic: Typically an antiseptic is a chemical agent that is applied to living tissue to kill microbes. Note that not all disinfectants are antiseptics because an antiseptic additionally must not be so harsh that it damages living tissue. Antiseptics are less toxic than disinfectants used on inanimate objects. Due to the lower toxicity, antiseptics can be less active in the destruction of normal and any pathogenic flora present.

Autoclave: An autoclave is a high pressure device used to allow the application of moist heat above the normal-atmosphere boiling point of water.

Biocidal: Active substances and preparations which serve to repel, render harmless or destroy chemically or biologically harmful organisms.

Biocide: Substance or chemical that kills biological organisms.

Decontamination: The killing of organisms or removal of contamination after use, with no quantitative implication, generally referring to procedures for making items safe before disposal.

Disinfectant: A germicide that inactivates virtually all recognized pathogenic microorganisms but not necessarily all microbial forms. They may not be effective against bacterial spores.

Disinfection: A procedure of treatment that eliminates many or all pathogenic microorganisms with the exception of bacterial spores.

Germicide: An agent that destroys microorganisms, particularly pathogenic microorganisms.

Pathogenic: A microbe or other organism that causes disease.

Sanitization: The process of reducing microbial contamination to an acceptable “safe” level. The process of cleaning objects without necessarily going through sterilization.

Steam Sterilization: Autoclave, the process of sterilization by the use of heated steam under pressure to kill vegetative microorganisms and directly exposed spores. Common temperature and pressure for being effective is 121°C (250°F) at 15 psi (pounds per square inch) over pressure for 15 minutes. Special cases may require a variation of the steam temperature and pressure used.

Sterilization: The complete elimination or destruction of all forms of life by a chemical or physical means. This is an absolute not a relative term.

A. Disinfectants

The information presented in this section will provide a general guideline for selecting a particular disinfectant for use with a given agent.

The best way of ascertaining the suitability of a disinfectant against a particular agent is to challenge that agent with the disinfectant at the manufacturer’s recommended concentration. A brief description of the mode of action of each class of chemical disinfectant is given below.

Although physical methods are often superior to chemical disinfection / sterilization, it is not practical to autoclave or subject many items to high heat, especially if the items can be damaged through repeated exposure to heat. Treatment of inert surfaces and heat labile materials can be accomplished through the use of disinfectants, provided that the following factors are considered:

type and level of microbial contamination

concentration of active ingredient

duration of contact between disinfectant and item to be disinfected

pH

temperature

humidity

presence of organic matter or soil load

The interplay of these factors will determine the degree of success in accomplishing either disinfection or sterilization. In all situations, review the manufacturer’s recommendations for correct formulation and use. Do not attempt to use a chemical disinfectant for a purpose it was not designed for.

Most Environmental Protection Agency (EPA)-registered disinfectants have a 10-minute label claim. However, multiple investigators have demonstrated the effectiveness of these disinfectants against vegetative bacteria (e.g., Listeria, Escherichia coli, Salmonella, vancomycin-resistant Enterococci, methicillin-resistant Staphylococcus aureus), yeasts (e.g., Candida), mycobacteria (e.g., Mycobacterium tuberculosis), and viruses (e.g. poliovirus) at exposure times of 30–60 seconds. Federal law requires all applicable label instructions on EPA-registered products to be followed (e.g., use-dilution, shelf life, storage, material compatibility, safe use, and disposal).

IMPLANT DENTISTRY

A dental implant (also known as an endosseous implant or fixture) is a surgical component that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, facial prosthesis or to act as an orthodontic anchor. The basis for modern dental implants is a biologic process called osseointegration, in which materials such as titanium form an intimate bond to bone. The implant fixture is first placed so that it is likely to osseointegrate, then a dental prosthetic is added. A variable amount of healing time is required for osseointegration before either the dental prosthetic (a tooth, bridge or denture) is attached to the implant or an abutment is placed which will hold a dental prosthetic

Success or failure of implants depends on the health of the person receiving the treatment, drugs which affect the chances of osseointegration

And the health of the tissues in the mouth. The amount of stress that will be put on the implant and fixture during normal function is also evaluated.

Planning the position and number of implants is key to the long-term health of the prosthetic since biomechanical forces created during chewing can be significant. The position of implants is determined by the position and angle of adjacent teeth, by lab simulations or by using computed tomography with CAD/CAM simulations and surgical guides called stents. The prerequisites for long-term success of osseointegrated dental implants are healthy bone and gingiva. Since both can atrophyafter tooth extraction, pre-prosthetic procedures such as sinus lifts or gingival grafts are sometimes required to recreate ideal bone and gingiva.

The final prosthetic can be either fixed, where a person cannot remove the denture or teeth from their mouth, or removable, where they can remove the prosthetic. In each case an abutment is attached to the implant fixture. Where the prosthetic is fixed, the crown, bridge or denture is fixed to the abutment either with lag screws or with dental cement. Where the prosthetic is removable, a corresponding adapter is placed in the prosthetic so that the two pieces can be secured together.

The risks and complications related to implant therapy divide into those that occur during surgery (such as excessive bleeding or nerve injury), those that occur in the first six months (such as infection and failure to osseointegrate) and those that occur long-term (such as peri-implantitis and mechanical failures). In the presence of healthy tissues, a well-integrated implant with appropriate biomechanical loads can have 5-year plus survival rates from 93 to 98 percent and 10 to 15 year lifespans for the prosthetic teeth. Long-term studies show a 16- to 20-year success (implants surviving without complications or revisions) between 52% and 76%, with complications occurring up to 48% of the time.

Medical uses

The primary use of dental implants is to support dental prosthetics. Modern dental implants make use of osseointegration, the biologic process where bone fuses tightly to the surface of specific materials such as titanium and some ceramics. The integration of implant and bone can support physical loads for decades without failure.

For individual tooth replacement, an implant abutment is first secured to the implant with an abutment screw. A crown (the dental prosthesis) is then connected to the abutment with dental cement, a small screw, or fused with the abutment as one piece during fabrication. Dental implants, in the same way, can also be used to retain a multiple tooth dental prosthesis either in the form of a fixed bridge or removable dentures.

An implant supported bridge (or fixed denture) is a group of teeth secured to dental implants so the prosthetic cannot be removed by the user. Bridges typically connect to more than one implant and may also connect to teeth as anchor points. Typically the number of teeth will outnumber the anchor points with the teeth that are directly over the implants referred to as abutments and those between abutments referred to as pontics. Implant supported bridges attach to implant abutments in the same way as a single tooth implant replacement. A fixed bridge may replace as few as two teeth (also known as a fixed partial denture) and may extend to replace an entire arch of teeth (also known as a fixed full denture). In both cases, the prosthesis is said to be fixed because it cannot be removed by the denture wearer.

A removable implant supported denture (also an implant supported over denture is a type of dental prosthesis which is not permanently fixed in place. The dental prosthesis can be disconnected from the implant abutments with finger pressure by the wearer. To enable this, the abutment is shaped as a small connector (a button, ball, bar or magnet) which can be connected to analogous adapters in the underside of the dental prosthesis. Facial prosthetic, used to correct facial deformities (e.g. from cancer treatment or injuries) can utilize connections to implants placed in the facial bones. Depending on the situation the implant may be used to retain either a fixed or removable prosthetic that replaces part of the face.

In orthodontics, small diameter dental implants, referred to as Temporary Anchorage Devices (or TADs) can assist tooth movement by creating anchor points from which forces can be generated. For teeth to move, a force must be applied to them in the direction of the desired movement. The force stimulates cells in the periodontal ligament to cause bone remodeling, removing bone in the direction of travel of the tooth and adding it to the space created. In order to generate a force on a tooth, an anchor point (something that will not move) is needed. Since implants do not have a periodontal ligament, and bone remodelling will not be stimulated when tension is applied, they are ideal anchor points in orthodontics. Typically, implants designed for orthodontic movement are small and do not fully osseointegrate, allowing easy removal following treatment.

ORAL SURGERY