Referring to the remaining “core” of a tooth that has been “prepped” (ground down) by a dentist in order to make room for the placement of a restoration like a crown or bridge.
The same word is used (or slightly modified; “implant abutment”) when referring to the intermediary piece that is fabricated to serve as the attachment mechanism between an implant post and the implant crown.
Implant abutments can be made from titanium, zirconia or lithium disilicate which are precision milled using advanced CAD/CAM technology – the method currently preferred by most modern dentists and dental labs.
The Lithium disilicate or Zirconia abutments are usually preferred for use in the anterior (aesthetic zone) since they are metal free/tooth colored and can have porcelain artistically stacked directly on the abutment to achieve optimal aesthetics and strength in the final restoration.
The term ‘All-on-four’ describes a system for implant supported full arch dentures or long span bridges wherein the prosthetic restoration rests on a bar (usually titanium) that has been precision milled to attach to the four implant supports and simultaneously retain the prosthetic with either clips (removable) or screws (semi-permanent – only removable by a dental professional).
The basic concept was pioneered by Nobel Biocare but has since been adapted by implant manufacturers and dental labs all over the US and Canada. It is probably the most popular version of an over-denture or hybrid denture and is widely considered one of the most straightforward, reliable and economical approaches to restoring a complete arch.
The acronym ‘CAD’ stands for Computer-Aided Design while ‘CAM’ stands for Computer-Aided Manufacturing. The terms are frequently used in conjunction to refer to the computer automated process of designing and milling dental components such as single unit monolithic crowns or multi-unit bridges, as well as metal bars and abutments made for implant based full arch restorations.
The crowns and bridges made with CAD/CAM technology are milled from a single block of homogenous material (usually lithium disilicate or zirconia). The resulting product is known as a monolithic crown. Popular versions of CAD/CAM dental crowns are the Zirconia ‘Lava’ Crown from 3M and the lithium disilicate or Zirconium Oxide versions of the e.max crown from Ivoclar Vivadent.
The metal bars and abutments, on the other hand, are usually milled from a solid piece of titanium (or other type of noble metal) intended for use with hybrid dentures such as in the ‘all-on-four’ system.
The dental lab is where highly trained and experienced technicians use a variety of time tested technologies and techniques (i.e. high-temp burnout furnace, lost wax casting, porcelain stacking, etc.) to create beautiful, long-lasting dental restorations such as crowns, bridges and dentures.
Dental Milling Center:
A technologically advanced department within the dental lab dedicated to CAD/CAM precision milling of dental restorations including crowns, bridges and implant abutments and bars. Dedicated specialists must be highly trained and employ top-quality products in order to produce craftsman quality restorations with the aid of modern technologies.
Based on dental impressions provided by the dentist, the dental lab technician can sculpt a preliminary version of the restoration out of wax to allow for a preview of the final aesthetic result of any restoration – be it a single unit crown or multi-unit bridge.
While diagnostic wax-ups are considered an optional step, they are commonly used for complex implant cases or cosmetic smile designs in order to ensure that an ideal clinical and aesthetic outcome can be achieved.
Porcelain (aka – Feldspathic Porcelain):
A ceramic material made by mixing certain minerals together and then baking them in a kiln or high-temp furnace. This process has long been used in dental labs to create beautiful looking crowns, bridges and veneers.
Modern advances has made it more customizable (color shading and stacking) as well as much stronger and more durable. Although other, even stronger, tooth colored options have entered the marketplace of late (lithium disilicate, zirconia), porcelain remains the best choice for achieving optimal aesthetics while still providing long-lasting clinical results.
The term ‘Hybrid dentures’ refers to the concept of restoring a completely edentulous arch with an implant supported prosthetic. The prosthetic itself is usually fabricated to resemble traditional dentures but with much less pink acrylic material (especially on the upper arch where palatal acrylic is completely unnecessary with this method). Occasionally, depending on the individual case, the ‘denture’ or final prosthetic restoration can even be fabricated with no acrylic material and be made to look more like a long-span porcelain bridge.
Any hybrid denture will be supported by at least four or more implants and may or may not rest on an intermediary bar (usually titanium) that spans from implant to implant and serves as a stabilizing structure as well as the mechanism for attaching to the denture. If a bar is not used then each individual implant will have its own connection platform that will interface directly with the final prosthetic restoration.
The ‘All-on-four’ concept is the most popular version of the ‘hybrid denture’.
A dental implant is a post (usually made from titanium) that is surgically implanted in the jawbone essentially acting as a replacement tooth root and, once completely healed (6-8 weeks), can be utilized to replace missing teeth with an implant crown, bridge or over-denture.
An abutment is an intermediary attachment piece that serves to connect the implant post below to the dental crown above. They can be made by traditional lab techniques or precision milled with CAD/CAM technology. They are made so that the dental crown can be either screw-retained (semi-permanent – can be removed if needed but only by a dental professional) or adhesive-retained (permanent – can only be removed by destroying the crown).
Implant abutments are traditionally made from titanium or stainless steel. Modern advances in CAD/CAM techniques now allow for the abutment to be made from the same material as monolithic crowns (i.e. lithium disilicate or Zirconia) which is both strong and more aesthetically pleasing at it is tooth-colored.
The implant crown is the final step in the implant restoration process that is either adhesive- or screw-retained to the implant abutment. It is also the most aesthetically critical part as it will be seen during normal function of eating, speaking, and smiling. The implant crown itself can be made out of full metal, porcelain-fused-to-metal. Or a monolithic crown can be precision milled with CAD/CAM technology from a homogenous block of tooth-colored material, which usually results in the most aesthetically pleasing outcome.
A tooth colored glass-ceramic material that can be precision milled into a monolithic crown, inlay or onlay from a single homogenous block of material using a CAD/CAM process. The most well-known lithium disilicate material is ‘e.max’ by Ivoclar Vivadent.
It is one of the strongest, most durable dental materials available. It can be used for crowns, bridges, and implant crowns and implant abutments. Under certain conditions, it can be considered for use in the aesthetic zone as it comes in a variety of shade variations and can be customized to create an aesthetically pleasing final result.
A comparable alternative would be Zirconia/Zirconium Oxide
This term refers to the concept of milling a dental crown from one monolithic or homogenous block of material (usually lithium disilicate or Zirconia) using a CAD/CAM milling process. These crowns are distinctive from Porcelain fused to metal (PFM) crowns in that they are completely metal free and can therefore typically achieve a higher level of natural tooth-like translucency and aesthetics than a PFM. The metal free nature of monolithic crowns also ensures that the patient will never see exposed metal or the dreaded ‘black gum line’ often associated with PFM restorations.
In addition, PFM crowns are known to break and fracture at the interface where the metal meets the porcelain – this is a known design weakness in all PFMs. There are no such interfaces or perceivable weak points due to the inherent design or homogenous nature of monolithic crowns.
Finally, both types of monolithic crowns (lithium disilicate, zirconia) are much stronger than porcelain, which often results in a more durable restoration.
A dental veneer is a thin piece of tooth colored material (usually porcelain) that is bonded in place to cover existing tooth structure in order to improve the structural integrity or – in most cases – the aesthetic appeal of the tooth or entire smile.
The dental lab can fabricate a veneer to be placed on a single solitary tooth (generally considered one of the most difficult procedures in dentistry due to the complex nature of color-matching; not the preferred method) or concurrently as in the case of restoring the entire smile (preferred method).
A tooth colored ceramic material that can be precision milled into a monolithic crown, inlay or onlay from a single homogenous block of material using a CAD/CAM process. The most well-known Zirconia crown is the ‘Lava’ crown from 3M.
It is one of the strongest, most durable dental materials available. It can be used for crowns, bridges, and implant crowns and implant abutments. Under certain circumstances, it can be considered for use in the aesthetic zone as it comes in a variety of shade variations and can be customized to create an aesthetically pleasing final result.
A comparable alternative would be Lithium Disilicate.