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Oral and Maxillofacial Radiology, also known as dental and maxillofacial radiology, is that specialty of dentistry concerned with performance and interpretation of diagnostic imaging used for examining the craniofacial, dental and adjacent structures. OMFR or DMFR is one of nine dental specialties recognized by the American Dental Association, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons.
ConeBeam CT image of a post operative orthognathic surgery
Oral and maxillofacial imaging includes cone beam CT, multislice CT, MRI, PET, ultrasound scan, dental panoramic radiology, cephalometric imaging, intra-oral imaging (e.g. Bitewing, peri-apical and occlusal radiographs) in addition to special tests like sialographs. Visible light, optical coherence tomography and tera ray imaging are examples of additional methods in use or under development. Image guidance includes haptic and robotic devices.
Occlusion, in a dental context, means simply the contact between teeth. More technically, it is the relationship between the maxillary (upper) and mandibular (lower) teeth when they approach each other, as occurs during chewing or at rest.
Static occlusion refers to contact between teeth when the jaw is closed and stationary, while dynamic occlusion refers to occlusal contacts made when the jaw is moving.
The masticatory system also involves the periodontium, the TMJ (and other skeletal components) and the neuromusculature, therefore the tooth contacts should not be looked at in isolation.
Pedodontics is a branch of dentistry which gives advice, looks after, and prevents problems for the health of mouth cavity and teeth of children from infants to approximately 12 years old. This includes polishing and coating with fluoride, filling tooth pit and fissure to prevent cavity, tooth filling, pulp treatment, dental crowns in the case of a spreading cavity, tooth extraction, X-ray, checkup, and space maintainer or space retainer.
Tooth extraction is the removal of teeth from the dental alveolus (socket) in the alveolar bone. Extractions are performed for a wide variety of reasons, but most commonly to remove teeth which have become unable to restore through tooth decay, periodontal disease or dental trauma; especially when they are associated with toothache.
A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form.
Periodontal diseases take on many different forms but are usually a result of a coalescence of bacterial plaque biofilm accumulation of the red complex bacteria (e.g., P. gingivalis, T. forsythia, and T. denticola) of the gingiva and teeth, combined with host immuno-inflammatory mechanisms and other risk factors that can lead to destruction of the supporting bone around natural teeth.
Orthodontics and dentofacial orthopedics, formerly referred to as orthodontia, is a specialty of dentistry that deals with the diagnosis, prevention and correction of malpositioned teeth and jaws.
Prosthodontics, also known as dental prosthetics or prosthetic dentistry, is the area of dentistry that focuses on dental prostheses. It is one of nine dental specialties recognized by the American Dental Association (ADA), Royal College of Surgeons of England, Royal College of Surgeons of Edinburgh, Royal College of Surgeons of Ireland, Royal College of Surgeons of Glasgow, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons. The ADA defines it as “the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth or oral and maxillofacial tissues using biocompatible substitutes.
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 atrophy after 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.
Esthetic dentistry or Cosmetic Dentistry is generally used to refer to any dental work that improves the appearance (though not necessarily the functionality) of teeths, gums and/or bite. It primarily focuses on improvement in dental aesthetics in color, position, shape, size, alignment and overall smile appearance.
Many dentists refer to themselves as “cosmetic dentists” regardless of their specific education, specialty, training, and experience in this field. This has been considered unethical with a predominant objective of marketing to patients.
The American Dental Association does not recognize Esthetic dentistry as a formal specialty area of dentistry. However, there are still dentists that promote themselves as Esthetic dentists.
Dental treatments are carried out by a dental team, which often consists of a dentist and dental auxiliaries (dental assistants, dental hygienists, dental technicians, as well as dental therapists). Most dentists either work in private practices (primary care), dental hospitals or (secondary care) institutions (prisons, armed forces bases, etc.).