Minimally Invasive Dentistry

Designing a smile is just like designing a space. First, rationality sets goals. Then, creativity draws shapes. And finally, the technique builds the master piece.

As this is our philosophy, The Oral Lab’s performance is always based on scientific and artistic principles that ensure the excellence of our esthetic and oral health results. And, although today we work with the most advanced equipment and materials in this field, this would not be possible without our specialized team that works every day to make your smile our most important project.

 

What does it mean in a practical way?

  • Greater accuracy, less removal of healthy dental tissue
  • Increased longevity of your teeth
  • Small surgical incisions
  • Faster execution of procedures
  • More comfortable and shorter postoperative periods
  • Fewer complications
  • Faster return to day-to-day activities

Magnification and Microscopy

From diagnosis to execution, dental procedures require a particular degree of precision and skills. The dimensions of the area to be intervened is very small and the detail of the procedures is increasingly greater when the treatments are intended to be minimally invasive.

The microscope has redefined the concept of visualisation as we’ll only be able to treat what we can see!

The magnification of up to 32 times and the size of the target offered by our microscope, provides a totally different quality of work, enabling the doctor to be as conservative as possible, preserving all tissues of the oral cavity including teeth and their supporting tissues. Shadow free lightning translates into the quality of the treatments we perform.

Magnification in Endodontics:

Before the introduction of the optical microscope, magnifying glasses were the only available type of magnification. Although they improve visual acuity, they have numerous limitations.

Without a microscope, endodontic treatments are performed in the dark. X-ray based diagnosis and treatment using radiography are not so accurate because it only shows two dimensions of a three-dimensional object. At The Oral Lab the CBCT (cone beam computed tomography) is at our disposal as well. This three dimensional diagnostic tool allows safer treatments with a substantial increase in success rates.

Benefits:

Better visualisation: the microscope increases the field of view and allows the endodontist to see very detailed images, improving the quality of the treatment. Unique and specialised treatment situations can be addressed with greater precision.

Optimized lighting: the microscope has its own light that improves the definition of the image allowing an excellent visualisation of the working field.

Documentation through images of the working field that allows the doctor to communicate the treatment’s details.

High magnification is required to assist in the total removal of caries, identification of calcified channels, detection of microfractures and assistance on fractured instruments from inside the root system.

The microscope allows an increase in the visualisation of root canals and its anomalies, thus allowing the disinfection of the entire canalicular system. As a result, it improves the long-term prognosis of the endodontic treatment.

The Microscope is an indispensable equipment for more differentiated treatments such as:

Non-Surgical Endodontic Retreatment: teeth that have already devitalized and need to be retracted.

Removing Fractured Instruments and posts

Perforation Treatment

Root Treatment with Immature Apex (Teeth not fully formed yet)

Magnification in Oral Rehabilitation

From diagnosis to treatment, the precision of technical gestures determines a superior quality of work, resulting in the excellence of our results. The rigour with which we prepare a tooth throug mechanical means, the evaluation of its impression and the subsequent fitting tests are just some examples of how the magnification affects the final result of the treatment. The details are absolutely determinant to provide you with the most conservative and long-lasting treatment technically possible.

See also Adhesive Aesthetic Restorations and Porcelain Veneers on this page

Magnification in Surgery

Allows microsurgery principles to be applied on surgical procedures, these include

-The use of specific micro-instruments 

-The use of micro-suture that can hardly be seen without magnification

The excellent adaptation of surgical wounds with micro sutures prevents the appearance of scars, substantially improves the postoperative period and accelerates the entire healing process.

The magnification also allows for the execution of very delicate techniques that manipulate soft and hard tissues (gingivae and bone)  with all the required precision.

The high standards of our clinical work, demand up to date scientific evidenced knowledge, sound techniques and experienced professionals. 

See also:

Gingival Plastic Microsurgery, Guided Bone Regeneration, Maxillary sinus elevation, Immediate Implants / Alveolar Preservation, Minimally Invasive Implant Surgery

Digital Imaging

Panoramic XR

It is an x-ray with great diagnostic value as all the maxillary bone structures, sinus as well as all the teeth can be evaluated. Therefore, it offers a generalized view of the patient's current situation. It is a very important diagnostic aid, essential for planning future treatments and monitoring treatments over the years.

It is performed through the use of appropriate sensors allowing the XR to be viewed immediately on the computer screen. It is a very accurate examination in the diagnosis of caries, infections and diseases related to the supporting tissues of the teeth. With this technology, we managed to minimize radiation exposure.

3D Cone Beam Computed Tomography

It is a complementary diagnostic exam that allows, through the three-dimensional anatomical reconstruction of the maxillofacial structures, to obtain a three-dimensional view of a certain area for the purposes of diagnosis, planning and evaluation.

This technology has replaced conventional CT scans, reducing radiation doses by up to 40%, producing high-resolution images that make the diagnosis more accurate and the treatment safer.

At The Oral Lab we have a ‘State of the Art’ equipment that allows you to perform this exam in different areas of the mouth, thus being able to control the radiation dose according to the exam specifications.

This exam is particularly important in the planning and execution of some procedures, such as implant placement, maxillary sinus elevation, bone regeneration and endodontic procedures, exponentially increasing your safety and the treatment’s success rates.

See details in the equipment and technology tab

Digital Smile Design (DSD)

The excellence of an aesthetic and functional smile is not achieved by chance. The smile design must take into account the personality and physical characteristics of each individual. Excellence in the results can only be obtained in a consistent way by means of a protocoled diagnosis, meticulous planning, good communication, perfect execution and rigorous maintenance procedures.

The Digital Smile design is an important aid to the treatment plan that uses visual communication, through a protocol of images, videos and digital techniques to design your smile. This way you can preview the proposed changes, which can then be analysed and tested clinically, before treatment is carried out. The fact that the treatment can be viewed and approved before its execution offers the security and motivation you need.
The DSD involves the patient in the decision-making process to build his smile, by sharing his wishes, goals and expectations. The end result is a combination of what science, technology and clinical experience can offer.

Adhesive Aesthetic Restorations / Adhesion

This technique promotes the adhesion of aesthetic materials to the dental structure.
The use of materials such as composite and certain ceramics by the restorative dentist, allow for the emulation of the natural structure of the teeth through seamless restorations that cannot be distinguished from
the natural teeth.

It is a sensitive and meticulous technique, requiring time and particular care in its execution. It is applied in the  treatments of caries, fractures, repair of restorations or aesthetic changes in the colour and shape of the teeth, as well as in the bonding of various prosthetic structures.

At The Oral Lab, composite adhesive restorations are carried out within the scope of our rigorous, ultra-conservative work philosophy and under magnification, preserving the structure of your teeth and creating imperceptible and lasting restorations.

Main objectives of adhesive techniques:

  • Restoration of the esthetic, structural and biomechanical integrity of the tooth
  • Use of biocompatible materials that mimic the natural tooth at the mechanical, biological and aesthetic level.
  • Maintenance of tooth vitality and maximum conservation of dental tissues

Restorative materials have undergone a great evolution in the past years, in their aesthetic characteristics as well as in their durability. The Oral Lab works with the best materials clinically proven over the years, that give you the best results in the hands of our experienced clinicians.

Porcelain veneers

Are very thin ceramic fragments that are permanently glued to the enamel surface, allowing to change the shape, colour and position of the natural teeth, reinforcing them simultaneously.
Are very reliable and resistant restorations that can substantially change you smile.

Scientific facts:

1-The ceramic veneers restore the mechanical behaviour of the intact tooth
2-When a more flexible material than enamel (composite) replaces it, the crown does not recover its original strength

3-Ceramic is the chosen material to simulate the behaviour of the enamel and restore the original resistance to the restored tooth. Aesthetically, it is also the substance that best simulates the optical behaviour of the enamel.

Clinical Indications:

  • Discoloration non responsive to bleaching procedures
  • Conoid or abnormally shaped teeth
  • Closure of spaces and black triangles between teeth
  • Smile rejuvenation by changing the shape and colour of teeth

Veneers are a more conservative alternative than crown placement, and their natural appearance is undoubtedly one of their main characteristics.
This technique is an advantage for those who would like to obtain quick results with a great impact on their appearance. After planning, the result is achieved only with 2 consultations and is completely painless.
Veneers do not require special care beyond basic oral hygiene care.

At The Oral Lab, we carry out this restorative work with the use of magnification, which allows us to be very conservative and precise. By being more conservative and removing the minimum amount of sound dental structure, we are improving the mechanical properties of the teeth along with aesthetics and longevity. We work with high-quality laboratory technicians very experienced on this sensitive technique .

The Oral Lab has over 20 years of experience on treating veneer cases, and the outcomes we obtain are the result of an accurate diagnosis, careful planning and experienced  performance. 

Invisalign / Invisible Aligners

Invisalign is a premium brand of virtually invisible removable aligners that allow orthodontic correction to be performed from the simplest to the most complex cases.

With digital planning, the patient is able to obtain a prediction of the final result and to visualize all stages of his treatment with a very reliable forecast of its duration. With this technique, the duration of treatment is usually shorter than with traditional methods. The aligner should be used 20 to 22 hours a day and is easily removed so that oral hygiene is carried out without obstacles such as brackets of fixed devices. It is a flexible, transparent device and very comfortable to use which does not inhibit you from smiling or talking.

At The Oral Lab, we have extensive experience in the treatment with Invisalign and our orthodontist was one of the pioneers in the use of this technique.

Teeth whitening

At The oral Lab we use whitening techniques whenever possible for smile rejuvenation or to treat localised dental discolourations. However, there is a small percentage of teeth that do not react to bleaching procedures and require another type of approach.

Tooth whitening does not harm the structure of your teeth and is considered to be the most conservative technique for colour changing as there is no harm to the tooth.

Did you know that colour is a determining factor in the appearance of a young and attractive smile?
The colour and length of the teeth are very important in the smile’s appearance.

At the present time, the available techniques for removing unwanted pigmentations from the surface and internal structure of teeth are very effective. Colour changes due to ageing, tobacco, coffee, tea and red wine consumption can be eliminated through bleaching.

Over the counter bleaching products do not have the needed concentration for effective bleaching nether do advertised tooth pastes.

Our “in Office” technique allows the use of specific products to obtain quick, safe and reliable results. As an alternative, you can do the whitening at home using a tray designed for your teeth, always under the supervision of your dentist – safety is always our priority.

The Oral Lab has the answer for cases of localised teeth discolouration such as endodonticaly treated teeth or trauma related. Restorative treatment must be correctly planned to provide a good prognosis at the end. 

Guided Bone Regeneration

Bone regeneration techniques are highly safe and predictable techniques.
Its need, nearly in all cases, is detected before implant surgery through the analysis of the three-dimensional imaging exam of the jaws and individualised planning.

After tooth extraction, the underlying bone undergoes a process of physiological resorption over time and the gum accompanies this loss. Therefore, the more time that passes after extraction, the greater the likelihood of insufficient ideal bone availability for rehabilitation with dental implants.
In areas where teeth have been lost for a long time due to infection or trauma, there may be a need to forgo bone regeneration procedures.
This technique uses a material similar to the human bone that induces bone growth and a stabilised collagen membrane that separates the bone from the gum, allowing both to form separately.

These techniques are used consistently at The Oral Lab with excellent outcomes as a result of the ‘know-how’ and experience of our clinicians. They are sensitive techniques whose results absolutely depend on specialised training combined with the experience acquired over the years.

Immediate Function or Immediate Aesthetics with Implants

This technique consists of placing provisional acrylic teeth, fixed to the implant/s on the same day of its/their placement, delivering immediately aesthetics and comfort to the patient. Whenever possible, The Oral Lab chooses to place immediate teeth over the implants. However, the specificities of each case dictate whether this solution is viable, indicating that the rehabilitation modality is chosen according to the individual planning of each case.

Minimally Invasive Implant Surgery

The placement of an implant obeys to very strict criteria regarding the technique and the three-dimensional position of the implant. At The Oral Lab, surgeries are planned based on the images of the three-dimensional examination (CBCT) of the patient's bone structures, simulating the placement of the implants in the desired position using a digital planning software. This planning results in the possibility of executing surgical guides that support the surgeon with the correct positioning of the implant during surgery.

The use of surgical guides makes the whole process more precise, conservative and determinant in the achieved results. With no margin for error, the surgeon is guided to the precise place of the implant making the surgery faster and safer, according to the desired result and the previous planning. At the same time, much more comfort is provided in the postoperative period. In some cases, surgery may be performed through a small window in the gums, without the use of sutures.
This type of techniques allows us to reduce both consultation and recovery times, minimising postoperative complications with improved comfort and results. 

Gingival Plastic Microsurgery

Oral or periodontal plastic microsurgery techniques are methods that allow the improvement of the availability of soft (gum) and / or hard (bone) tissues around teeth or implants, with aesthetic and functional gains.

In addition to its aesthetic function, the gum has a protective role for both teeth and implants, being an important tissue to ensure the longevity of your teeth and/or implants.
The lack of gums can lead to hygiene difficulties, recurrent inflammation, infections and, ultimately, loss of teeth or implants.
The gums can be improved using various microsurgical techniques.

Gingival recession (“exposed roots”) consists of the migration of the gums surrounding the tooth, with consequent exposure of the root surface to the oral environment. These exposed surfaces cause not only an aesthetic compromise – greater propensity to root decay and tooth wear –  but also discomfort due to dentin hypersensitive – typically described as pain when eating cold food or in contact with cold air – which they generate.

The performance of surgical procedures aimed at resolving this condition – root coverings – is essential in these cases, procedures whose success is now very predictable.

Gingival recessions are currently one of the complications associated with orthodontic treatment, since the treatment may involve an expansion of the dental arch and the displacement of the teeth out of their natural position. In these types of situations, it is necessary to correct gingival recessions prior to orthodontic treatment.

The Oral Lab has at your disposal all these techniques which, due to their sensitive and delicate nature, require a lot of rigour, experience and know-how.

This type of microsurgical techniques should be performed only by experienced specialists, with specific training, as the wide learning curve with years of evolution is decisive in the success rates obtained.

See also Magnification in surgery at the top of the page

Endodontic Microsurgery

The techniques and materials developed in the last decades have allowed the maintenance of teeth that would have otherwise been condemned to extraction.

The repetition of previously done endodontic treatments  can be done surgically or non-surgically, and represents a therapeutic option with a high success rate when performed under ideal conditions.

Surgical endodontic treatment has a very high success rate.

The knowledge and application of the most appropriate microsurgical techniques to each situation and the correct visualization of the canal system and its anatomical variations are crucial. It is very important to maintain the maximum healthy dental structure and eliminate all inflammatory and/or infectious tissues.
The Oral Lab has the necessary know-how and experience to carry out these interventions that require the use of a microscope and specialised training.

See also Magnification in Endodontics

Immediate Implants / Alveolar Preservation

This technique aims to maintain bone and gingival dimensions after tooth extraction.

The early loss of a tooth leads to a remodelling process with loss of bone and gingival tissue. During the first 3 months after tooth extraction, the areas of collapse are clearly visible giving rise to aesthetically undesirable defects. Additionally, the longer the time elapsed the greater the size of the defect.

The way in which tooth extraction is performed – more or less traumatic, more or less conservative – influences the size of the defect. The more conservative and atraumatic the extraction is, the smaller the post-extraction defect.

Immediate implant placement meaning placed in the same clinical act as a tooth extraction is a common technique, with decades of clinical and scientific validation, that has been proven to be very advantageous to the patient. At The Oral Lab, this option always comes first when a tooth to be extracted is a candidate to be replaced by an implant. However, it is not always possible to place the implant in the same clinical procedure as the extraction. In some cases, alveolar preservation appears as an alternative technique so that bone and gingival losses are minimised – allowing that within a few months the implant can be placed in the desired position and in the best possible anatomical conditions.

Atraumatic Sinus Lift

This technique allows the placement of implants in the posterior areas of the upper jaw when bone availability is insufficient due to the presence of the maxillary sinus.

At The Oral Lab, we perform this technique whenever possible, in a non-invasive manner and using specific tools that allow the placement of implants with atraumatic (non-surgical) elevation of the maxillary sinus.

Guided Biofilm Therapy (GBT)

Conventional oral hygiene techniques include manual scraping of calculus and plaque removal with sharp instruments. This can be painful and invasive, often scratching dental surfaces, implants and restorations. At the end general polishing is performed with rotary instruments that do not reach the infra-gingival zones, often damaging the dental and gingival tissues.

The Oral Lab has implemented a systematic plaque control protocol in the prevention and maintenance of natural teeth and implants, using the latest technology based on scientific evidence.

This procedure is minimally invasive as the hygienist  is guided by the colouration of the bacterial plaque, with a single instrumentation of the needed areas, saving all other surfaces. It is an extremely safe and effective procedure, very gentle on teeth, gums, implants and other restorations or dental prostheses.
The protocol consists of the application of a dye which makes visible all the bacterial plaque and calculus to be removed by the Airflow and Perioflow in the supra and infra gingival zones. When necessary, the removal is completed with Piezon PS, a gentle ultrasound that does not cause pain and operates with water at body temperature so that sensitivity is minimised throughout the procedure. The comfort of our patients is on our top priority.

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