Kristen Mott is the associate editor for Dental Products Report and Digital Esthetics.

Kristen Mott

A snapshot of some of the top milling machines in the market today. Purchasing a dental milling machine is a big-and often confusing-decision. From dry or wet milling to chairside or high-tech laboratory mills, the options appear to be endless.

Purchasing a dental milling machine is a big-and often confusing-decision. From dry or wet milling to chairside or high-tech laboratory mills, the options appear to be endless.

These machines are constantly evolving and utilizing the latest technology and software to provide dentists and lab technicians with efficient, quality results. Many are compatible with CAD/CAM software options and a variety of materials in order to provide greater flexibility. Before making a decision, keep in mind your overall budget, specifications you require and which materials you prefer to use.

Click through the slides to take a look at some of the newest and best milling machines available in the dental market.

Articles

A snapshot of some of the top milling machines in the market today.

A guide to selecting a milling machine

	Dental implants are a common and effective tooth replacement option, which is why it's no surprise that about 3 million Americans have dental implants. That number is rising by 500,000 people each year, according to the American Academy of Implant Dentistry.

	While dental implants are a great option for many patients, a major issue is the implant failure rate. According to a 

, almost 8 percent of patients with dental implants experienced the loss of at least one implant over a 9-year period.

	To combat the dental implant failure rate, scientists from the School of Biological Sciences, Peninsula Schools of Medicine and Dentistry and the School of Engineering at the University of Plymouth have developed a new nanocoating for dental implants that’s designed to reduce the risk of peri-implantitis. Peri-implantitis is a localized lesion involving bone loss around an osseointegrated implant. It has been identified as the main reason for dental implant failure.

	In the study, the scientists evaluated the effectiveness of nanocoatings. Titanium alloy implants were surface modified to create a combination of silver, titanium dioxide and hydroxyapatite (HA) nanocoatings. Their antibacterial performance was assessed by measuring the growth of a proportion of live/dead cells and lactate production by microbes over a 24-hour period.

	The results of the study showed that the application of a dual-layered silver-HA nanocating to the surface of implants successfully inhibited bacterial growth and the formation of bacterial biofilm on the implant surfaces was reduced by 97.5 percent. Uncoated controls and titanium dioxide nanocoatings showed no bacterial effect.

	Based on the results, the researchers concluded that applying a dual-layered silver-HA nanocoating to titanium alloy implants creates a surface with antibiofilm properties without compromising the HA biocompatibility required for successful osseointegration and accelerated bone healing.

	“In this cross-faculty study, we have identified the means to protect dental implants against the most common cause of their failure,” says professor Christopher Tredwin, head of Plymouth University Peninsula School of Dentistry. “The potential of our work for increased patient comfort and satisfaction and reduced costs is great and we look forward to translating our findings into clinical practice.”

Antibacterial activity and biofilm inhibition by surface modified titanium alloy medical implants following application of silver, titanium dioxide and hydroxyapatite nanocoatings

Scientists have developed a new nanocoating that’s designed to reduce the risk of dental implant failure.

New discovery could reduce the dental implant failure rate

No matter how careful you are with your teeth, accidents are bound to happen. Whether you lost a permanent tooth due to a sports injury or poor dietary habits, replacing the missing tooth with a dental implant is probably your best option. But what if you were able to regrow your missing tooth?

Researchers at Okayama University in Japan recently studied successful tooth regeneration in a postnatal large mammal. They first tested whether bioengineered tooth germ led to the formation of a proper tooth. To do this, they dissected embryonic tooth germ cells and tissues of a beagle dog 55 days prior to birth. Then, they reconstructed bioengineered tooth germ with a technique known as the organ germ method, a 3D cell manipulation technique. Several weeks after the germs were transplanted into mice, the researchers discovered tooth-crown formation featuring both the hard and soft tissues present in natural teeth.

	To take things one step further, the researchers conducted autologous transplantation experiments. Rather than using a donor, these experiments used the dog’s own stem cells, which helps to avoid immunological rejection. The researchers extracted deciduous teeth from the jawbone of a 30-day-old beagle dog. Tooth germ engineered from the dog’s permanent tooth cell and tissue was transplanted into the dog’s mandible, which resulted in tooth eruption 180 days later.
	 
	According to the study, micro-CT analysis showed that the developmental process of the bioengineered tooth’s formation was practically identical to that of a natural tooth. In addition, the bioengineered tooth was found to have the same structure and chemical composition of a natural one.
	 
	“This study represents a substantial advancement in organ replacement therapy through the transplantation of bioengineered organ germ as a practical model for future whole-organ regeneration,” the study states. “Whole-tooth replacement therapy holds great promise for the replacement of lost teeth by reconstructing a fully functional bioengineered tooth using three-dimensional cell manipulation in vitro.”

	This isn’t the first time that tooth regeneration in humans has been studied. In 2015, researchers at Georgia Institute of Technology and King’s College in London studied hundreds of Lake Malawi cichlids, small fish that are native to Tanzania. The researchers discovered that, with the right stimulation, human epithelial tissue might be manipulated into regenerating new teeth. 
	The researchers at Okayama University noted that immature wisdom tooth germ may be considered a potential candidate for reconstruction of bioengineered tooth germ. However, there are some limitations. For instance, elderly patients do not have developing tooth germ that could be used for this process. Autologous transplantation of tooth germ is also limited by the number of available teeth and the size of a given type of tooth. They concluded that additional evidence and testing will be required for the medical application of this process.

Practical whole-tooth restoration utilizing autologous bioengineered tooth germ transplantation in a postnatal canine model

New research takes a closer look at bioengineered tooth restoration.

Will humans one day be able to regrow teeth?

Taking a look at some of the top dental chairs and treatment units.

Maximizing comfort and efficiency with dental chairs: A product roundup

	Options abound when it comes to dental chairs and treatment units. While once a basic piece of dental equipment, dental chairs have evolved to maximize comfort for both the patient and the dentist.

Patient comfort remains at the core of dental chair design. From double articulating headrests to programmable touch pads to even built-in heat and massage systems, companies are making sure patients have a comfortable experience when they visit the dentist office.

	A greater emphasis is being placed on the comfort of the dental teams, too. Dentists and hygienists spend countless hours hovering over patients, so it is important to select a chair that will lower the risk of developing discomfort or pain. Dental chairs and treatment units now feature narrow backs and height-adjustable components, allowing practitioners to maintain proper posture while providing treatment.

	Ensuring the dental chair or treatment unit fits in with the esthetics of the office is also key. Multiple colors, fabrics and paint finishes are being offered to allow dentists greater flexibility when it comes to selecting the right products for their office.

Trending article: The 4 ergonomic 'must-haves' in a patient chair 

	We at Dental Products Report wanted to take a look at some of the newest options the dental chair market has to offer. Whether you are looking to upgrade your current equipment or start designing your dental office from scratch, we hope you will find a dental chair or treatment unit that works best for you and your patients.

	Click through the slides to view some of the best dental chairs availabile

	The A-dec 500 dental chair is designed to provide the ultimate in comfort for dental teams and their patients. This chair reportedly allows practitioners to get close enough to the patient to maintain a healthy posture, reducing pain and discomfort. Scientific pressure mapping is engineered to offer ultimate patient comfort. Unique cushioning is said to reduce pressure points and provide support across the patient’s body. In addition, the dental chair is designed to synchronize the chair’s movement with the natural movement of the patient, creating a “virtual pivot” that reportedly eliminates repositioning when the chair is lowered or raised.

 Chair from DentalEZ is engineered to provide support and help patients stay relaxed to create a positive dental experience. Featuring a heavy duty cast iron frame, strong baseplate and stable footprint, the chair reportedly situates patients in an ideal position with a durable hydraulic lift cylinder. The chair is designed to be quiet yet powerful with smooth operation. In addition, the CORE Chair is said to feature an emergency shut-down control, a double articulating, easily adjustable headrest, flip-down armrests, a touch pad control with four programmable preset positions and 30-degree swivel rotation with lock. The chair also reportedly comes with an optional foot control with programmable preset options. Standard Naugahyde and NaugaSoft upholstery with wide back is available as well as an optional upgrade of Ultraleather upholstery.

	The Series 5 dental chair by DCI Edge features a thin, narrow back and low height adjustment, designed to allow the operator to be in proper working position regardless of patient size. The dental chair is available in three back styles: wide, narrow and narrow with slings. The backrest features a deep scoop that’s engineered to allow the headrest to be positioned lower to support smaller patients or children while also comfortably supporting larger patients’ shoulders and heads. Foldout armrests reportedly facilitate easy entry and exit of patients. Each chair comes with a five-year warranty.

	The 3900 dental chair is engineered to offer molded rather than vacuum-formed plastic for longevity and better fit. The chair reportedly provides numerous upgrades and options, including nine powder coat paint finishes and 18 upholstery colors to choose from, three upholstery options (seamless, stitched and memory comfort), contrast color stitching and dual color upholstery. Additional options are said to include a narrow back with slings, knee pillow, pedo-wedge, IV board and self-contained back massager. Built to each dentist’s exact specifications, the 3900 chair is designed to offer the best value on the market today.

	KaVo ESTETICA E70/E80 Vision is designed to offer simple operation, integrated solutions, smooth workflow and automated hygiene-encompassed within a ergonomic suspended chair. KaVo ESTETICA E70/E80 is engineered to allow dentists to customize their dental equipment to meet the needs of their specialty and practice. Many functions reportedly can be individually adapted to the practitioner, including the types of treatment, the direct key allocation on the start screen and the name of the practitioner. Adding equipment and extensions is said to be possible at any time thanks to new and innovative interfaces. The backrest and headrest are designed to allow patients to relax, offering tailor-made comfort combined with effortless workflow and flexibility.  

	Designed to deliver sophisticated styling, optimal patient access and exceptional patient comfort, the Elevance® dental chair is said to be a genuine departure from any chair on the market today. A thin, narrow cast aluminum backrest is engineered to allow for optimal access to the patient as well as superior patient support. The exclusive SerenEscape

 heat and massage system is designed to enhance the patient experience and keep the patient relaxed. A unique Cantilever Forward

 design reportedly allows for an unsurpassed range of motion for greater flexibility. The chair is available in chair only, left/right and console mount configurations, and it can be paired with Elevance

	The Spirit 3300 builds on a strong foundation and is said to provide enhancements in doctor access, patient comfort and aesthetic appeal. The narrow backrest, coupled with the ability for the chair to go lower to the ground, is engineered to enable ideal oral cavity access for practitioners of any stature in a comfortable ergonomic position. The base design reportedly makes it easy for patients to enter and exit and provides enhanced stool access alongside the chair. Dual touch pads with one-touch programming are designed to simplify chair operation, minimizing unnecessary movement for dentists and their team.

 Q5000 dental chair reportedly sets a new benchmark for operator and patient interaction, with premium level features in appearance, comfort and accessibility. With a thin and narrow backrest, the design of the chair is engineered to grant a higher level of access to each patient, which is said to result in a better working posture and convenient work experience. Patient comfort is reportedly enhanced by the synchronous backrest recline mechanism, which is designed to simulate natural body movement and seamlessly support the patient while the chair is in motion. The shockless hydraulic system is engineered to gently maneuver the seat for smoother transitions between patient treatment positions. With its convex shape, the dual-axis headrest reportedly cradles the occipital bone as the tilting mechanism moves the head to allow access to the oral cavity. Armrests swing outward 130 degrees to create a wider entry and exit area for patients, and integrated armrest touch pads are engineered to permit easy access for doctors and assistants in adjusting patient seat positioning for treatment.

	Manufactured in the U.S., Westar’s E Sense

 Nautica delivery system is designed to bring quality and comfort together. The chair is reportedly made from 100 percent steel construction, including the cantilever base. The chair is said to feature only the highest quality motors, a double articulating headrest, and a seven-function foot control with two programmable present positions and an automatic exit. In addition, there is an option to add a programmable touch pad with five presets. The chair comes with a five-year warranty and is available in four different upholstery options.  

	Everyone knows that caring for your child’s teeth is critical-but a new study has found another reason why early intervention is crucial.

	Although the American Academy of Pediatric Dentistry recommends taking children to the dentist for their first dental checkup when their first tooth appears or before their first birthday, about 40 percent of children ages 2 to 5 have cavities, according to Parents magazine. In addition, at least 4 million preschoolers suffer from tooth decay, an increase of more than 600,000 kids in the last decade. To avoid these problems, researchers at the 

University of Alabama at Birmingham School of Public Health

 are taking a closer look at a group of children under the age of 2 enrolled in Medicaid in Alabama to determine if early preventive dental care may lead to more long-term care.

 compared tooth decay-related treatment, visits and dental expenditures for children receiving preventive dental care from a dentist or primary care provider to those receiving no preventive dental care. The authors of the study analyzed data from 19,658 children in Alabama who were continuously enrolled in Medicaid from birth between 2008 and 2012.

Trending research: New discovery could eliminate infections after root canals 

	Among the eligible children, 25.8 percent received preventive dental care from a dentist before age two. Forty-four percent of the children were black, 37.6 percent were white and 16.3 percent were Hispanic.

	The study found that children who had received early preventive dental care from a dentist had more frequent subsequent caries-related treatment (20.6 percent vs. 11.3 percent), a higher rate of visits (0.29 vs. 0.15 per child-year) and greater dental expenditures ($168 vs. $87 per year). Preventive care delivered by a primary care provider did not significantly affect caries-related treatment use or expenditures.

	The study did not include information on oral health behaviors like teeth brushing or water fluoridation. It also did not measure other benefits of preventive care, such as improved quality of life.

	While the researchers concluded that they found no evidence of a benefit of early preventive dental care regardless of the provider, they did note that children who went to the dentist for early preventive care visits were more likely to have subsequent dental care, such as caries-related treatment, and greater expenditures.     

	“This study highlights the need for continued careful evaluation of the evidence basis for clinical recommendations,” says 

 assistant professor in the department of health care organization and policy at UAB and one of the researchers involved in the study. “What we find is that we cannot definitively say whether early preventive dental visits reduce tooth decay with the available data.”

 notes there are inherent limitations to Medicaid data and little is known about the state of the children’s oral health when they were seen by the dentist for the first time, such as whether they were referred to a dentist because they showed signed of cavities or if they were already experiencing tooth decay. 

	“A study like this is great for initiating conversation, but it tends to pose more questions than provide answers, and that can be good because that prompts additional research,” says Jane Grover, D.D.S., M.P.H., ADA spokesperson. “Researchers will be inspired to say, ‘What does that higher rate of visits actually mean?’”

	“Studies of this nature are important in advancing our knowledge about early childhood cavities and their prevention and treatment, but these findings are not definitive, and further study is critical, in view of other findings supportive of early care and the epidemic nature of early childhood cavities,” says Paul Casamassimo, D.D.S., M.S., director of the AAPD’s Pediatric Oral Health Research & Policy Center.

More from the author: Can estrogen therapy lead to healthier teeth and gums? 

 done by researchers at King’s College London and the University of Washington found chronic maternal stress is associated with a higher prevalence of cavities among children. Researchers discovered that dental cavities were more common among children whose mother had two or more biological markers of chronic stress.

	“We look for ways to educate parents on aspects of optimizing oral health for their families,” Grover says. “Part of that includes an understanding of some of the basics of dental decay, which foods pose a higher risk, what consumption patterns pose a higher risk. We want parents to be well-versed in the information they need to keep their families healthy.”

	Infants and children exposed to secondhand smoke may also be at a greater risk of caries in deciduous teeth. 

, researchers in Japan found four-month-old babies that had been exposed to tobacco smoke were two times as likely to have caries than children in a non-smoking home.

	The University of Alabama study, titled “

Outcomes Associated With Early Preventive Dental Care Among Medicaid-Enrolled Children in Alabama

, the Journal of the American Medical Association.

A new study suggests preventive dental care provided before the age of 2 is associated with a higher rate of dental visits and more frequent tooth decay-related treatment.

Does early preventive dental care for kids lead to more long-term care?

	Dental implants, in one form or another, have been around for centuries. In the mid-1960s, Per-Ingvar Brånemark, a Swedish physician known as the “father” of the modern dental implant, greatly advanced the technique by discovering that titanium could be used to create an anchor for artificial teeth, a process called osseointegration.

	Now, implant dentistry is taking another large step forward as Neocis Inc. introduces Yomi, a robotic guidance system for dental implant procedures. 

	It’s estimated that 69 percent of Americans between the ages of 35 and 44 have at least one missing tooth, according to the American Academy of Implant Dentistry, while one in four people over the age of 74 have lost all their natural teeth. It may come as no surprise then that nearly 4 million dental implants are placed annually in the United States, according to Neocis Inc. 

Trending article: How technology is changing the game for implants

	After receiving clearance from the U.S. Food and Drug Administration, Neocis is marketing Yomi as a computerized navigational system intended to aid in both the planning (pre-operative) and surgical (intra-operative) phases of dental implantation surgery. The system reportedly provides software to preoperatively plan dental implantation procedures and is designed to provide navigational guidance of the surgical instruments. 

	“Yomi will revolutionize dental surgery,” says Alon Mozes, CEO and co-founder of Neocis. “Dentists can currently capture a pre-operative cone beam CT scan (CBCT), but much of that information is effectively lost during the most critical part of the dental implant process: intra-operative surgery. Yomi enables dentists to bridge the digital imaging pre-operatively into their operating environment through the use of haptic robotic technology. They receive real-time physical and visual guidance throughout the surgery. This provides accuracy and reliability without the need to manufacture a custom plastic guide or worry about performing an unguided freehand approach.”

	Haptic robotic technology provides sensory feedback by applying vibrations, forces or motions to the user. In Yomi, the technology is designed to contain the drill in position, orientation and depth. It’s engineered to leave the surgeon in control at all times and allow for clear visualization of the surgical site.

	In addition, Mozes says patients will benefit from surgeons’ use of Yomi due to its accuracy, reliability and flexibility. Yomi is engineered to eliminate dentists’ dependence on plastic drill guides, which can impede the site of surgery and block proper irrigation and visibility.

Related reading: The state of dental implants 

	“Yomi solves all of these challenges by providing dynamic digital guidance with haptic robotic technology,” Mozes explains. “No plastic guides are manufactured or block the site of surgery. Dentists can change their plans in the middle of surgery without losing the benefit of guidance. They can simply change their software plan and Yomi will instantly update the guidance to the new position.”

	Mozes says Neocis is committed to ensuring that dentists are fully trained if they choose to use Yomi in their practice.

	“Neocis experts will train dentists on every feature of the planning software and every aspect of the Yomi workflow. Yomi is designed to be easy to incorporate into the dental practice. Neocis is excited to enable dentists to make their practice state of the art,” he says.

A robotic guidance system for dental implant procedures just received FDA clearance.

Changing the future of implant dentistry with robotics

	Estrogen therapy is known to help women manage a variety of menopause-related issues: improving bone density and heart health and reducing hot flashes, to name a few. As such, many women choose to take hormones to treat the numerous symptoms associated with menopause.

, during the menopausal transition the ovaries begin to work less and less well, causing the production of hormones like estrogen and progesterone to decline over time. Hormone therapy is designed to steady the levels of estrogen and progesterone in the body, which can help with symptoms like hot flashes and mood swings. 

	Hormone replacement therapy may involve estrogen-only treatment, estrogen plus progesterone or estrogen plus progestin. Women who have had a hysterectomy are generally prescribed estrogen alone, according to the 

, while women who have not had the surgery are typically prescribed estrogen plus progestin. The U.S. Food and Drug Administration has approved numerous hormone products for use in menopausal hormone therapy. 

	Now, a new study suggests that estrogen therapy may also lead to healthier teeth and gums.

Related reading: New study finds blueberry extract could reduce antibiotic use in treating gum disease

	According to the study, which was published online in “

,” estrogen levels begin to fall during menopause, leading women to become more vulnerable to health issues. For instance, the loss of bone mineral density can result in osteoporosis. At the same time, women’s teeth and gums also become more susceptible to disease, which can result in pain, bleeding, inflammation, and even loose or missing teeth.

	This isn’t the first time that hormones have been linked to periodontal health. A 

 by Texas A&M University Baylor College of Dentistry researchers indicated that lack of testosterone in rhesus macaque monkeys resulted in periodontal disease and other oral problems. The study was viewed as unique because while the link between estrogen, oral health and the temporomandibular joint is well known, the correlation between male sex hormones and oral health is not as widely publicized.

	The cross-sectional estrogen study examined 492 postmenopausal Brazilian women who were between the ages of 50 and 87. One hundred thirteen women were in osteoporosis treatment while 379 were not treated. The treatment consisted of systemic estrogen alone or estrogen plus progestin, as well as calcium and vitamin D supplements, for a minimum of six months.

	The women were evaluated to determine whether the osteoporosis treatment could help to increase the bone mineral density in their jaws and improve their overall oral health.

Trending research: Limiting dental benefits increases hospital visits 

	The results of the study found that the rate of occurrence of severe periodontitis was 44 percent lower in the postmenopausal osteoporosis-treatment group than in the untreated group. Women receiving treatment exhibited less periodontal probing depth, less clinical attachment loss and less gingival bleeding than women not receiving treatment. The researchers concluded the results suggest that women treated with estrogen for postmenopausal osteoporosis have a lower prevalence of severe periodontitis than women not receiving treatment. 

	“Osteoporosis can occur throughout the body, including the jaw, and lead to an increased risk of periodontal disease,” says Dr. JoAnn Pinkerton, executive director of The North American Menopause Society. “This study demonstrates that estrogen therapy, which has proven to be effective in preventing bone loss, may also prevent the worsening of tooth and gum disease. All women, but especially those with low estrogen or on bisphosphonate treatment for osteoporosis, should make good dental care a part of their healthy lifestyles.”

Association between osteoporosis treatment and severe periodontitis in postmenopausal women

A new study finds links between estrogen therapy and reducing tooth and gum diseases in postmenopausal women.