Las Vegas Family Dentist

Invisalign is a series of clear, removable teeth aligners that both orthodontists and dentists use as an alternative to traditional metal dental braces. As of April 2008, more than 730,000 patients have completed or are currently in treatment.[1]

Invisalign is designed, manufactured, and marketed by Santa Clara-based medical-device company Align Technology, Inc. Align says that over 35,790 doctors are trained to provide Invisalign treatment in the U.S., with 48,130 doctors worldwide.[1] As of January 29, 2008, Align Technology has 1,307 employees worldwide, and has manufactured more than 32 million aligners. The company has 133 patents[citation needed].

Align Technology was in a legal battle with the makers of a competing product, OrthoClear, from early 2005 until September, 2006.[2] Zia Chisti, one of the founders of Align, had started OrthoClear to compete against Invisalign. In a complaint filed with the United States International Trade Commission (ITC) on January 11, 2006, Align alleged that OrthoClear utilized Align’s trade secrets and infringed twelve Align patents, comprising more than 200 patent claims, in the production of OrthoClear aligners at a facility in Lahore, Pakistan. On September 27, 2006, Align Technology settled its litigation with OrthoClear. OrthoClear has stopped accepting new cases and discontinued its aligner business worldwide. Align acquired all disputed intellectual property. Contrary to some reports, Align did not purchase OrthoClear.[2]

In dentistry, a veneer is a thin layer of restorative material placed over a tooth surface, either to improve the aesthetics of a tooth, or to protect a damaged tooth surface. There are two main types of material used to fabricate a veneer, composite and dental porcelain. A composite veneer may be directly placed (built-up in the mouth), or indirectly fabricated by a dental technician in a dental laboratory, and later bonded to the tooth, typically using a resin cement such as Panavia. In contrast, a porcelain veneer may only be indirectly fabricated.

Dental Amalgam is the most commonly used dental restorative material used for dental fillings. First introduced in France in the early 1800s,^[1] it contains a mixture of mercury with at least one other metal. Amalgam has been the restorative method of choice for many years due to its low cost, ease of application, strength, durability, and bacteriostatic effects. Factors that have led to recent decline in use are a lingering concern about detrimental health effects, aesthetics, and environmental pollution. The aesthetic issue is due to the fact that the metallic color does not blend very well with the natural tooth color. This is especially a concern when used on front teeth, but it can be addressed using alternative dental materials. The environmental concerns are regarding mercury emissions during preparation and from waste amalgam upon cremation of deceased individuals.

Digital radiography is a form of x-ray imaging, where digital X-ray sensors are used instead of traditional photographic film. Advantages include time efficiency through bypassing chemical processing and the ability to digitally transfer and enhance images. Also less radiation can be used to produce an image of similar contrast to conventional radiography.

Digital Radiography (DR) or (DX) is essentially filmless X-ray image capture. In place of X-ray film, a digital image capture device is used to record the X-ray image and make it available as a digital file that can be presented for interpretation and saved as part of the patient’s medical record. The advantages of DR over film include immediate image preview and availability, a wider dynamic range which makes it more forgiving for over- and under-exposure as well as the ability to apply special image processing techniques that enhance overall display of the image. The largest motivator for healthcare facilities to adopt DR is its potential to reduce costs associated with processing, managing and storing films. Typically there are two variants of digital image capture devices. These devices include Flat Panel detectors (FPDs), and High Density Line Scan Solid State detectors.

FPDs are classified in two main categories:

1. Amorphous Silicon (a-Si) is the most frequent type of FPD sold in the medical imaging industry today. With a-Si detectors, a scintillator in the detector’s outer layer, which is made from Cesium Iodide (CsI), or Gadolinium Oxysulfide (Gd2O2S), converts X-ray to light. Because the X-ray energy is converted to light, the a-Si detector is considered an indirect image capture technology. The light is then channeled through the a-Si photodiode layer where it is converted to a digital output signal. The digital signal is then read out by Thin Film Transistors (TFT’s) or by fiber coupled Charged Couple Devices (CCD’s). The image data file is sent to a computer for display where the X-ray technologist can determine whether the image is appropriate for the intended anatomy. Once the Technologist determines the image is appropriate it can be sent to the radiologist’s workstation or printed on film for interpretation.

2. Amorphous Selenium (a-Se) FPD devices are known as “direct” detectors because no X-ray energy conversion to light takes place within the detector. The outer layer of the flat panel in this design is a high voltage bias electrode. The bias electrode accelerates the captured energy from an X-ray exposure through the selenium layer. X-ray photons flowing through the selenium layer create electron hole pairs. These electron holes transit through the selenium based on the potential of the bias voltage charge. As the electron holes are replaced with electrons, the resultant charge pattern in the selenium layer is read out by a TFT array or Electrometer Probes. The image data file is sent to a computer for display where the X-ray technologist can review the image and check positioning and if desired, transmit the image to the radiologist’s workstation for diagnosis.

3. The third type of DR detector is the High Density Line Scan Solid State device. It is comprised of a Photostimulable Barium Fluoro Bromide doped with Europium (BaFlBr:Eu) or Cesium Bromide (CsBr) phosphor. The phosphor detector records the X-ray energy during exposure and is scanned by a linear laser diode to excite the stored energy which is released and read out by a digital image capture array of Charge Coupled Devices (CCD’s). The image data file is transmitted to the X-ray technologist at a computer for review and then sent to the radiologist for further interpretation.

Note: this term is restricted to flat, two-dimensional imaging. For more advanced forms of three-dimensional calculated images, see Computed tomography.

A root canal is the space within the root of a tooth. It is part of a naturally occurring space within a tooth that consists of the pulp chamber (within the coronal part of the tooth), the main canal(s), and more intricate anatomical branches that may connect the root canals to each other or to the surface of the root. The smaller branches are most frequently found near the root end (apex) but may be encountered anywhere along the root length. There may be one or two main canals within each root. Some teeth have more variable internal anatomy than others. This space is filled with a highly vascularized, loose connective tissue, the dental pulp. The dental pulp is the tissue which forms the dentin portion of the tooth. The formation of secondary teeth (adult teeth) is completed by 1-2 years after eruption into the mouth. Once the tooth has reached its final size and shape, the dental pulp’s original function ceases for all practical purposes. It takes on a secondary role as a sensory organ.

Root canal is also a colloquial term for a dental operation, endodontic therapy, wherein the pulp is cleaned out, the space disinfected and then filled.

When decay is first detected in a tooth, the usual action taken by the dentist is to provide the tooth with an intracoronal restoration: a restoration consisting of a dental material that will exist totally within the confines of the remaining tooth structure. The restoration commonly referred to as a “cavity filling”, or more colloquially as a “filling”, is an intracoronal restoration, and can consist of a number of materials, including silver-colored amalgam, tooth-colored resin or gold. Inlays are also intracoronal restorations.

In a situation where there is not enough remaining solid tooth structure after decay and fragile tooth structure is removed, or the tooth has fractured and is now missing important architectural reinforcements, the tooth might very well require an extracoronal restoration: a restoration consisting of a dental material that will exist around the remaining tooth structure to a varying degree. Restorations that fall into this category include the various types of crowns and onlays, and these can consist of a number of materials as well, including gold, ceramic, or a combination of the two. Ceramic crowns are increasingly being substituted in place of gold crowns for aesthetic and structural reasons. In a recent study, only 1.7% of the ceramic crowns needed to be replaced after 2 years, with 3.7% showing occlusal chipping without need of replacement.[1]

The circumstance of the damaged tooth defines the restoration. In other words, based upon factors such as remaining solid tooth structure, aesthetics, the location of the tooth within the dental arch and the consequent forces of function that said tooth will have to deal with once restored, the dentist will then decide on the proper way to treat the tooth.

Things are not always straightforward when it comes to restoring a tooth. An advantage of crowning a tooth over restoring the tooth with an excessively large pin-supported amalgam or composite restoration is that crowns provide much more protection against future fracture or recurrent decay. The indirect techniques of crown fabrication translate into a more adapted tooth-restoration margin, and thus a better seal against the decay-causing bacteria present in saliva.

A crown is a type of dental restoration which completely caps or encircles a tooth or dental implant and is typically bonded to the tooth using a dental cement. Crowns can be made from many materials, which are usually fabricated using indirect methods. Crowns are often used to improve the strength or appearance of teeth.

The most common method of crowning a tooth involves using a dental impression of a prepared tooth by a dentist to fabricate the crown outside of the mouth. The crown can then be inserted at a subsequent dental appointment. Using this indirect method of tooth restoration allows use of strong restorative materials requiring time consuming fabrication methods requiring intense heat, such as casting metal or firing porcelain which would not be possible to complete inside the mouth.

As new technology and materials science has evolved, computers are increasingly becoming a part of crown and bridge fabrication, such as in CAD/CAM technology.