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Innovative solutions in modern dentistry

In the recent years, we have seen significant changes in the fields of implantology and reconstructive dentistry. The interaction between digital imaging, optical scanners, and computers has become an integral part of our practice today.

What does that mean for implantology?

In the field of implantology, we now have the option of using three-dimensional imaging (digital volume tomography), which we combine with an optical scan on the computer screen, and plan our optimal implant position there. The implant operation can thus be carried out with the help of printed splints and in accordance with the planning made on the computer. This is called guided implantology.

What are the advantages of guided implantology?

With guided implant surgery, the operation time is shortened, and the operational risks can be minimized in delicate cases. In addition, we can make optimal use of the patient’s bone and therefore, can often avoid extensive bone augmentation procedure.

What are the modern solutions for augmenting bone in implant surgeries?

In some cases, there is too little bone to place an implant, and the implant cannot be anchored to the patient's own bone by adjusting the implant axis even with appropriate computer planning. In such situations, bone augmentation must be carried out during or before the implantation.

While we mainly used to choose bone substitute material and membranes of animal origin for bone augmentation, today we are increasingly using the patient’s own bone in case of large defects. The bone is usually taken from the lower wisdom tooth area and allows to achieve regeneration of living bone at the place of the defect. However, these are difficult techniques that can no longer be carried out by every dentist and require special training.

Are crowns in reconstructive dentistry still the state of the art?

Studies show that around 10% of all crowned teeth are no longer alive after 10 years, and some of them require root canal treatment. Today, there are still clear indications for crowns in some cases, but most of the time we can produce much nicer and at least as long-lasting restorations with much less invasive procedures by adhering restorative materials to the remaining tooth structure. These minimally invasive solutions are not only gentler on the tooth, but also look better and, in some cases, even cost less.

What are the developments in aesthetic treatments?

Even with aesthetically motivated interventions, the top priority is not to endanger health for the sake of more beautiful teeth. For the restoration of entire fronts, for example, we can use wafer-thin ceramic shells with minimally invasive grinding corrections, which look very natural and optimally protect the underlying tooth substance. Most of the time, after the teeth have been prepared, you don't even need a temporary restauration, as it is barely visible that the teeth have been ground. As the procedure is performed in the enamel, i.e. in the non-innervated part of the teeth, such interventions are also absolutely painless.

Are dental impressions still a necessity?

Many people are afraid of impressions that remain in their mouths for minutes and have to be removed with great force. In our practice, an intraoral scanner has been used for several years, which in most cases completely replaces an impression. Therefore, the entire treatment, from planning to taking an impression and manufacturing the tooth, can often be completely digital.

Dr. Thomas Truninger is a co-owner of the practice Heller Kübler Truninger Zahnärzte, specialist dentist for reconstructive dentistry SSRD / SSO. He has two advanced training certificates WBA SSO (in oral implantology and general dentistry), works part-time as a senior physician at the University of Zurich and teaches future specialists in the field of implantology and aesthetic reconstructive dentistry.

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