Glossary / Health

Dentistry Glossary

Abscess: A localized inflammation due to a collection of pus in the bone or soft tissue, usually caused by an
Abutment: That portion of an implant above the neck utilized to provide support for a fixed, semi- fixed or re
Accreditation: Certification that an organization meets the reviewing organization's standards. Examples: accredita
Active Full-Time Employee: An employee must work for the employer on a regular basis in the usual course of the employer's busi
Adjudication: The administrative procedure used to process a claim for service according to the covered benefit.
Administrative Services Only (ASO): An arrangement in which a licensed insurer provides administrative services to an employer's health
Allograft: Transplants from one individual to a genetically non-identical individual of the same species.
Alloplast: Graft of a relatively inert synthetic material. Generally metal, ceramic or polymeric material.
Allowable Charge: The maximum fee that a health plan will reimburse a provider for a given service.
Alloys: Strong and relatively ductile substances that provide electro-positive ions to a corrosive environme
Alternative Birthing Center: A facility offering a 'non-traditional' ('not like a hospital') setting for giving birth. While alte
Aluminum Oxide (Alpha Single Crystal): An inert highly biocompatible strong ceramic material from which endosseous implants are fabricated.
Aluminum Oxide (Poly Crystal): A fused AL203 biocompatible material.
Alveolar Mucosa: The mucous membrane covering the basal part of the alveolar process and continuing without demarcati
Alveoloplasty: A surgical procedure used to recontour the supporting bone structures in preparation of a complete o
Amalgam: A dental filling material, composed of mercury and other minerals, used to fill decayed teeth.
Ambulatory Care: A general term for care that doesn't involve admission to an inpatient hospital bed. Visits to a doc
American Dental Association (ADA): A professional association of dentists dedicated to serving the public and profession of dentistry.
American Medical Association (AMA): A professional association of physicians dedicated to promoting the art and science of medicine and
Ancillary Care: Diagnostic and/or supportive services such as radiology, physical therapy, pharmacy or laboratory wo
Anesthetic: A class of drugs that eliminates or reduces pain. See local anesthetic.
Anniversary Date: The day after a coverage period ends under a health benefits plan. Usually, the month and day that a
Annual Out-Of-Pocket Maximum: The most a plan member will pay per year for covered health expenses before the plan pays 100% of co
Anterior: Refers to the teeth and tissues located towards the front of the mouth (upper or lower incisors and
Any Occupation: Under this definition, an employee will be considered disabled only if s/he is unable to work in any
Apex: The tip or end of the root of the tooth.
Apicoectomy: The amputation of the apex of a tooth.
Appeals: A process available to the patient, their family member, treating provider or authorized representat
Asepsis: Prevention from contact with micro-organisms. The state of the surgical field desirable for implant
Assignment Of Benefits: When a covered person authorizes his or her health benefits plan to directly pay a health care provi
Attached Gingiva: The portion of the gingiva extending from the marginal gingiva to the alveolar mucosa. The attached
Attachment: A mechanical device for the fixation, retention and stabilization of a dental prosthesis.
Augmentation: The placement of autogenous or alloplastic materials to correct bony insufficiencies.
Autograft: A graft taken from one part of the patient's body and transplanted to another part.
Behavioral Care Services: Assessment and therapeutic services used in the treatment of mental health and substance abuse probl
Beneficiary: A person who is eligible to receive benefits under a health benefits plan. Sometimes 'beneficiary' i
Benefit Percentage: The benefit is usually determined as a percentage of the employee's pre-disability income up to an o
Benefit Year: The coverage period, usually 12 months long, which is used for administration of a health benefits p
Benefits: The portion of the costs of covered services paid by a health plan. For example, if a plan pays the
Benefits Package: A term informally used to refer to the employer's benefits plan or to the benefits plan options from
Bicuspid: A two-cusped tooth found between the molar and the cuspid also known as an eye tooth or canine tooth
Biopsy: A process of removing tissue to determine the existence of pathology.
Bitewing X-Rays: X-rays taken of the crowns of teeth to check for decay.
Bleaching: The technique of applying a chemical agent, usually hydrogen peroxide, to the teeth to whiten them.
Board-Certified: Any physician who has completed medical school, internship and residency in his or her chosen specia
Bonding: A process to chemically etch the tooth's enamel to better attach (bond) composite filling material,
Bone Curettage: Gentle removal of medullary bone, using hand instruments, to create an implant receptor site.
Bone Loss: The breakdown and loss of the bone that supports the teeth, usually caused by infection or long-term
Brand-Name Drug: A drug manufactured by a pharmaceutical company which has chosen to patent the drug's formula and re
Bridge: A nonremovable restoration that is used to replace missing teeth.
Brush Biopsy: Brush biopsy is a painless procedure used to gather cells in the mouth. The dentist uses a small bru
Bruxism: The involuntary clenching or grinding of the teeth.
Calculus: The hard deposit of mineralized plaque that forms on the crown and/or root of the tooth. Also referr
Cancellous Bone: Spongy bone tissue located in the medulla of bone rather than the cortex which is compact. This bone
Canine Tooth: The second tooth from the big front tooth, commonly called the eye tooth or cuspid.
Cap: Another term for crown: usually referring to a crown for a front tooth.
Carbons: Vitreous (polycrystalline or glassy) or pyrolytic graphitic structures of relatively hard, inert, an
Care Management: A generic term which has been used in many different ways. Used by CIGNA, 'Care Management' refers t
Carelink: A program that offers members a comprehensive open access benefit plan with the protection they need
Caries: The correct technical term for decay which is the progressive breaking down or dissolving of tooth s
Carrier: A term historically used for licensed insurance companies, although now is sometimes used to include
Case Management: Coordination of services to help meet a patient's health care needs, usually when the patient has a
Cavity: A layman's term for tooth decay. Also, the dental term for the hole that is left after decay has bee
Cement: A special type of glue used to hold a crown in place. It also acts as an insulator to protect the to
Cementum: The very thin, bonelike structure that covers the root of the tooth.
Centers Of Excellence: A feature of the CIGNA HealthCare provider directory allowing you to compare quality and cost for ho
Ceramics: Compounds of a metal and oxygen formed of chemically and bio-chemically stable substances that are s
Charge Amount: The amount billed by a provider for services rendered to a participant.
Chemotherapy: Treatment of malignant disease by chemical or biological antinoeplastic agents.
Chrome Cobalt Molybdenum: A surgical metal alloy used to fabricate cast custom implants.
Claim: A claim is a request for payment under the terms of a health benefits plan.
Claim Status: Claims are Paid, Pended, Denied, or Received-Not-Yet-Processed.
Classification Of Metals: The noble metal classification system has been adopted as a more precise method of reporting various
Clenching: The forceful holding together of the upper and lower teeth, which places stress on the ligaments tha
Clinical Practice Guidelines: General procedures and suggestions about what constitutes an acceptable range of practices for parti
Cognitive Service: Diagnostic services a doctor provides during delivery of medical services, consultations or care.
Coinsurance: The portion of eligible expenses that plan members are responsible paying, most often after the dedu
Complex Rehabilitation: The extensive dental restoration involving 6 or more units of crown and/or bridge in the same treatm
Composite: A tooth-colored filling made of plastic resin or porcelain.
Connecting Bar: A fixed bar that connects two or more permucosal extensions. In the case of the ramus frame or subpe
Consolidated Omnibus Budget Reconciliation Act (COBRA): A federal statute that requires most employers to offer to covered employees and covered dependents
Consultation: A discussion with another health care professional when additional feedback is needed during diagnos
Consumer-Driven Health Plan (CDHP): A health care model in which the consumer (plan member) is made aware of the true costs and value of
Contract: A legal agreement between an individual subscriber or an employer group and a health plan that descr
Conversion Option: The option to purchase individual coverage by a person who will no longer have access to group healt
Coordination Of Benefits: A provision in a contract that applies when a person is covered under more than one group health ben
Copayment (Copay): Amount that a plan member must pay the provider at the time of service, usually after the deductible
Corrosion: Biomaterials where the elemental constituents are lost to the adjacent environment due to corrosion
Cortical Bone: A peripheral layer of compact osseous tissue. The average thickness of the cortex of alveolar bone i
Cosmetic Dentistry: Any dental treatment or repair that is solely rendered to improve the appearance of the teeth or mou
Coverage: The benefits that are provided according to the terms of a participant's specific health benefits pl
Coverage End Date: Coverage End Date displays the date that coverage ends for a participant. This field is blank, if th
Covered Services: Hospital, medical, and other health care services incurred by the enrollee that are entitled to a pa
Credentialing: A process that reviews a health care provider's credentials against the credentials required to part
Crown: The portion of a tooth that is covered by enamel. Also a dental restoration that covers the entire t
Crown Lengthening: A surgical procedure exposing more tooth for restorative purposes.
Curettage: A deep scaling of that portion of the tooth below the gum line. Purpose is to remove calculus and in
Cusp(S): The protruding portion(s) of a tooth's chewing surface.
Custodial Care: Care that is provided primarily to meet the personal needs of a patient. The care is not meant to be
Date Of Service: The date the service was provided to the participant as specified on the claim.
Day Treatment Center: An outpatient facility that is licensed to provide outpatient care and treatment, usually for mental
DDS: Doctor of Dental Surgery or DMD, Doctor of Dental Medicine. Degrees given to dental school graduates
Deductible: The dollar amount that a plan member must pay for eligible health expenses before a traditional heal
Definition Of Disability: One of the most important provisions in a disability contract is the definition of disability that w
Definition Of Partial-Residual Disability: This definition of disability applies when an employee is able to return to work part-time or even f
Definition Of Total Disability: One of the most important provisions in a disability contract is the definition of disability that w
Degreaser: Chemicals for the purpose of removing organic contaminants from implant surfaces.
Dehiscence: (a)Implant Dehiscence, a splitting open, a break in the covering epithelium leaving an isolated area
Delegation: Delegation is a formal process by which CIGNA HealthCare gives another entity the authority to perfo
Denied Claim: Claims that are not issued a bank draft/remittance due to a specific reason code.
Dental Floss: A thin, nylon string, waxed or untaxed, that is inserted between the teeth to remove food and plaque
Dental Hygienist: A dental professional specializing in cleaning the teeth by removing plaque, calculus, and diseased
Dental Implant: A permucosal device which is biocompatible and biofunctional and is placed on or within the bone ass
Dentin: The part of the tooth that is under both the enamel which covers the crown and the cemented which co
Denture: A removable appliance used to replace teeth. A complete denture replaces all of the upper teeth and/
Depassivation: When local conditions produce an acidic environ- ment at the metallic interface, the metallic oxide
Dependent: A person eligible for coverage under an employee benefits plan because of that person's relationship
Designated Centers For Specialized Care: Medical centers selected to provide an advanced level of care for a disease or delivery of a specifi
Designated Provider Program (DPP): A CIGNA point-of-service product. Each member chooses a CIGNA-affiliated PCP, but has the added conv
Diagnostic Tests: Tests and procedures ordered by a physician to help diagnose or monitor a patient's condition or dis
Digastric Muscle: This muscle, detached during staple implant insertion, consists of a posterior belly and anterior be
Direct Pulp Cap: The procedure in which the exposed pulp is covered with a dressing or cement that protects the pulp
Discharge Planning: Identifying a patient's health care needs after discharge from inpatient care
Disenrollment: Voluntarily terminating one's participation in a health benefits plan
Dry Socket: A localized inflammation of the tooth socket following an extraction due to infection or loss of a b
Duplicate Coverage: When a person has coverage for the same health services under more than one health benefits plan
Durable Medical Equipment: Equipment that can withstand repeated use and is primarily and usually used to serve a medical purpo
Effective Date: The date on which coverage under a health benefits plan begins.
Eligible: Provisions contained in each health benefits plan that specify who qualifies for coverage under that
Elimination Period: This is the period of time between the date the disability begins and the beginning of the benefit p
Emergency: An accident or sudden illness that a person with an average knowledge of medical science believes ne
Employee Assistance Program (EAP): An EAP is an assessment and referral program or a short-term counseling program that is pre-purchase
Employee Retirement Income Security Act (ERISA): Federal legislation that applies to retirement programs and to employee welfare benefit programs est
Enamel: The hard, calcified (mineralized) portion of the tooth which covers the crown. Enamel is the hardest
Endodontic: Endosteal Implant: A smooth and/or threaded pin implant which extends through the root canal of a tooth into periapical
Endosteal Implant: A device placed into alveolar and/or basal bone.
Enrollee: An individual who is enrolled and eligible for coverage under a health plan contract. Also called Me
Enzootics: The dental specialty that deals with injuries to or diseases of the pulp, or nerve, of the tooth.
Epithelial Attachment: The continuation of the succular epithelium that is joined to the tooth structure and is located at
Eternal Oblique Ridge: A smooth ridge on the buccal surface of the body of the mandible that extends from the anterior bord
Evidence Of Insurability: Group disability coverage is generally sold as 'guaranteed issue,' which means that evidence of insu
Excision: Surgical removal of bone or tissue.
Exclusions: Specific conditions or services that are not covered under the benefit agreement.
Exclusions: There are specific provisions included in group disability plans that preclude coverage in certain s
Exclusive Provider Organization (EPO): A specific type of CIGNA health plan with a national network of physicians. Plan members can visit s
Exclusive Provider Program (EPP): A type of CIGNA HealthCare benefits plan, offered by Connecticut General Life Insurance Company, in
Exostosis: The overgrowth of normal bone.
Experimental Procedures: Experimental, investigational or unproven procedures and treatments.
Expiration Date: The date indicated in an insurance contract as the date coverage expires.
Explanation Of Benefits (EOB): When a claim is filed under your CIGNA benefits plan, you get an Explanation of Benefits (EOB). Beca
Extended Care Facility (ECF): A medical care institution for patients who require long-term custodial or medical care, especially
Extension Of Benefits: When a person's coverage is extended under certain conditions, such as disability, after their group
Extent Of Disability: Some policies require that employees be totally disabled before payments begin. Other policies pay o
Extracoronal: The outside of the crown of the tooth.
Extraction: The removal of a tooth.
Extraoral: The outside of the mouth.
Fibrous Integration : Tissue to Implant Contact: Interposition of healthy dense collagenous tissue between implant and bon
Filling: Material used to fill a cavity or replace part of a tooth.
First Stage Surgery: This refers to the preparatory stage for an implant procedure. In the case of the subperio-- steal i
Flexible Benefits Plan: A type of benefits program that offers employees a menu of benefit options, allowing them to create
Flexible Spending Account (FSA): An account that reimburses the participant for qualified health costs or dependent care expenses thr
Fluoride: A chemical compound used to prevent dental decay, utilized in fluoridated water systems and/or appli
Formulary: A list of preferred, commonly prescribed prescription drugs. These drugs are chosen by a team of doc
Freestanding Implant: An implant which can withstand functional forces without splinting to any additional abutments.
Frenectomy: The removal of a frenum.
Frenum: Muscle fibers covered by a mucous membrane that attaches the cheek, lips and or tongue to associated
Galvanism: Electropotential difference of dissimilar metals which can occur in dental implant metallurgy.
Gatekeeper: A primary care physician who provides a broad range of routine medical services and refers patients
Generic Drug: A prescription drug that has the same active-ingredient formula as a brand-name drug. A generic drug
Genial Tubercles: Mental spines - Small round elevations (usually two pairs) clustered around the midline on the lingu
Gingiva: The soft tissue that covers the jawbone. Also referred to as the gums.
Gingivectomy: The removal of gingiva (gum).
Gingivitis: An inflammation or infection of the gingiva (gum tissue): the initial stage of gum disease.
Gingivoplasty: A surgical procedure to reshape or repair the gingiva (gum).
Graft: A portion of tissue used to replace a defect in the body. Anything that is inserted into some- thing
Group Health Coverage: A health benefits plan that covers a group of people as permitted by state and federal law.
Guest Privileges: A CIGNA HealthCare benefits option that, under certain circumstances, can provide an in-network leve
Health Alliance Plan (HAP): CIGNA HealthCare and Health Alliance Plan (HAP) are working together to provide quality care to CIGN
Health Care Financing Administration (HCFA): The federal agency responsible for administering Medicare and federal participation in Medicaid.
Health Insurance Portability And Accountability Act (HIPAA): Health Insurance Portability and Accountability Act of 1996. The law has several parts: The first pa
Health Maintenance Organization (HMO): An organization that arranges a wide spectrum of health care services which commonly include hospita
Health Maintenance Services: Any health care service or program that helps maintain a person's good health. Health maintenance se
Health Plan: A term that has different meanings depending upon the context. 'Health plan' can be used to mean an
Health Reimbursement Arrangement (HRA) : An arrangement in which the participant is reimbursed for covered health expenses by his/her employe
Health Savings Account (HSA) : A reimbursement account in which the participant pays for health costs through a fully insured, tax-
Heterograft: A graft taken from one species and placed in another.
Home Health Care: Health services rendered in the home to an individual who is confined to the home. Such services are
Homograft: A graft taken from one human subject and trans-- planted to another.
Horizontal Endosteal Implant: Flat, blade-shaped implants of varying thickness which derive their support from a horizontal length
Hospice: A health care facility that provides supportive care for the terminally ill.
Hospital: An institution whose primary function is to provide diagnostic and therapeutic inpatient services, f
Hydroxylapatite Ceramic: This is a dense, non-resorpable ceramic, which when implanted into bane, displays a highly attractiv
Hyperplasia: The abnormal multiplication or increase in the number of normal calls in normal arrangement in a tis
Hypertrophy: An increase in bulk of tissue beyond normal caused by an increase in size but not number of tissue e
Hypoplasia Implant: Defective or incomplete development. See Oral Implant
ID Card: Identification cards are provided to all participants for proper identification under their group he
Immediate Denture: A denture constructed for immediate placement after removal of the remaining teeth.
Impacted Tooth: An unerupted or partially erupted tooth that is positioned against another tooth, bone or soft tissu
Impairment: An alteration of health status, assessed by objective medical criteria. This is a medical finding.
Implant: An artificial device, usually made of a metal alloy or ceramic material, that is implanted within th
Implant Dentist: One who practices art and science of implant dentistry.
Implant Dentistry: That area of dentistry concerned with the diagnosis, design and insertion of implant devices and res
Implant Denture: A denture which receives its stability and retention from a dental implant.
Implant Interface: Tissue to Implant Contact: (a)fibrous integration, interposition of healthy dense collagenous tissue
Implant Prosthodontics: That portion of implant dentistry that concerns itself with the construction and placement of fixed
Implant Surgery: That portion of implant dentistry that concerns itself with the placement of implant devices.
Implantologist: One who practices art and science of implant dentistry.
Implantology: The study of the art and science concerned with the surgical insertion and restoration of materials
In-Network Provider: Any health care provider (physician, hospital, etc.) that belongs to a CIGNA network. Staying in-net
Incentive: An opportunity for a plan member to earn points toward prizes or extra dollars in the CIGNA Choice F
Incisive Foramen: The incisive foramen is located in the midline on the anterior extreme of the hard palate. It transm
Incisors: The four front teeth referred to as central and lateral incisors, located in the upper and lower jaw
Indemnity Plan: A type of health benefits plan under which the covered person pays 100% of all covered charges up to
Indirect Pulp Cap: A procedure in which the nearly exposed pulp is covered with a protective dressing to protect the pu
Infertility: Term used to describe a condition or the inability to conceive or an inability to carry a pregnancy
Infrastructure: That portion of the implant which lies below the soft tissue.
Infusion Therapy: Treatment accomplished by placing therapeutic agents into the vein, including intravenous feeding. S
Inlay: A cast gold filling that is used to replace part of a tooth.
Inpatient Care: Care given to a patient admitted to a hospital, extended care facility, nursing home or other facili
Interdental Implant: Implant used between natural tooth abutments.
Interproximal: The area between two adjacent teeth.
Intra-Mucosal Inserts (Mucosal Inserts): Alloplastic devices placed into the tissue bearing surface of a removable prosthesis to mechanically
Intracoronal: The area within the crown of a tooth.
Intracorp: A CIGNA subsidiary offering an array of utilization management (UM) and cost containment services. I
Intraoral: The inside of the mouth
Joint Commission On Accreditation Of Healthcare Organizations (JCAHO): The JCAHO is an independent, not-for-profit organization whose mission is to improve the quality of
Keratinized Gingiva (mucosa) : The portion of the gingiva that is covered by keratinized epithelium.
Labial: The area pertaining to or around the lip.
Limitations: There may be specific provisions included in group disability plans that limit coverage in certain s
Lingual: The area pertaining to or around the tongue.
Local Anesthetic: The injection given in the mouth to numb the areas where a tooth or area needs a dental procedure. O
Long-Term Care: The range of services typically provided at skilled nursing, intermediate-care, personal care or eld
Maintenance Medication: Medications that are prescribed for long-term treatment of chronic conditions, such as diabetes, hig
Malocclusion: The improper alignment of biting or chewing surfaces of upper and lower teeth.
Managed Behavioral Health: This is a program that covers your mental health and substance abuse care needs. In most cases, in-n
Managed Care: A system of health care delivery that manages the cost of health care and access to health care prov
Manaibular Staple (Bone Plate): A form of a trans-osseous implant in which a plate is placed partially into the inferior border, and
Mandatory Rehabilitation: A 'mandatory' rehabilitation provision encourages disabled employees to participate in rehabilitatio
Mandible: The lower jaw.
Mandibular Basal Bone: That portion of the body of the mandible that remains after resorption of the alveolar process. This
Mandibular Nerve: The third division of the trigeminal nerve. This nerve leaves the skull through the foramen ovale an
Maryland Bridge: The trade name that has become synonymous with any resin bonded fixed partial denture (bridge).
Mastication: The act of chewing.
Maxilla: The upper jaw.
Maxillary Sinus: The anatomical space located superior to the posterior maxillary alveolar which limits the volume of
Maximum Benefit Period (Benefit Duration): This is the maximum length of time for which benefits are payable under the plan as long as the empl
Maximum Monthly Benefit: This is the highest dollar amount an employee with a disability can receive on a monthly basis under
Medical Necessity: Medical necessity is a term used to refer to a course of treatment seen as the most helpful for the
Medicare: Title XVIII of the Social Security Act that provides payment for medical and health services to the
Medicare Part A: Hospital insurance provided by Medicare that can help pay for inpatient hospital care, medically nec
Medicare Part B: Medicare-administered medical insurance that helps pay for certain medically necessary practitioner
Medicare Part D: A prescription drug benefit for Medicare-eligible seniors and disabled persons. It was established a
Medigap: A term used to describe health benefits coverage that supplements Medicare coverage.
Member: An individual or dependent who is enrolled in and covered by a managed health care plan. Also called
Mental Foramen: (a)opening in the lateral surface of the mandible which allows the exit of the third division of the
Mental Illness And Substance Abuse Limitations: When a disability is caused by a psychological/behavioral/emotional disorder, or by alcoholism or th
Mesostructure Bar: Any appliance interposed between the infrastructure and superstructure.
Metals (Implant): Strong and relatively ductile substances that provide electropositive ions to a corrosive environmen
Minimum Monthly Benefit: There is usually a minimum amount paid as a monthly benefit after reductions for 'Other Income Benef
Molars: The broad, multicusped back teeth, used for grinding food are considered the largest teeth in the mo
Mucogingival Junction: The scalloped linear area denoting the approximation or separation of the gingiva and the alveolar m
Mucoperiosteum: A layer, or connective tissue, that covers bone.Periosteum in the oral cavity that is significant to
Mylohyoid Ridge: An oblique ridge on the lingual surface of the mandible which extends from the level of the roots of
Nasal Spine: A median, sharp process formed by the forward elongation of the maxillae at the lower margin of the
National Committee On Quality Assurance (NCQA): An independent, nonprofit organization which assesses the quality of managed care plans, managed beh
Network: A group of health care providers under contract with a managed care company within a specific geogra
Nitrous Oxide: A controlled mixture of nitrogen and oxygen gases (N2O) that is inhaled by the patient in order to d
Non-Participating Provider: A medical provider who has not contracted with a health plan.
Non-Resorbable: Substances that show relatively limited in-vivo degradation.
Novocaine: A generic name for the many kinds of anesthetics used in the dental injection, such as Xylocaine, Li
Occlusal Surface: The chewing surface of the back teeth.
Occlusal X-Ray: An intraoral x-ray taken with the film held between the teeth in biting position.
Occlusion: Any contact between biting or chewing surfaces of upper and lower teeth.
Occupational Therapy: Treatment to restore a physically disabled person's ability to perform activities such as walking, e
Onlay: A cast gold or porcelain filling that covers one or all of the tooth's cusps.
Open Enrollment: A period when eligible persons can enroll in a health benefits plan.
Opt-Out Privilege: A general term used when some benefits are available for out-of-network covered services. Often cove
Oral Implant: A device or inert substance, biologic or alloplastic, that is surgically inserted into soft or hard
Oral Surgery: The removal of teeth and the repair and treatment of other oral problems, such as tumors and fractur
Orthodontics: A specialized branch of dentistry that corrects malocclusion and restores the teeth to proper alignm
Osseointegration: Implies that a contact is established without interposition of non-bone tissue between normal remode
Other Income Benefits: While disabled, an employee may be eligible for benefits from other sources. Benefits payable under
Out-Of-Area Benefits: Benefits the health plan provides to covered persons for covered services obtained outside of the ne
Out-Of-Network Provider: Any health care provider that does not belong to a CIGNA network. Members can use their benefits for
Out-Of-Pocket: Copayments, deductibles or fees paid by participants for health services or prescriptions.
Out-Of-Pocket Maximum: The most a plan member will pay per year for covered health expenses before the plan pays 100% of co
Outpatient Care: Any health care service provided to a patient who is not admitted to a facility. Outpatient care may
Overbite: A condition in which the upper teeth excessively overlap the lower teeth when the jaw is closed. Thi
Own Occupation (Own Occur): Under this definition, an employee will be considered disabled only if s/he is unable to perform the
Paid Amount: The exact amount issued on a bank draft to the provider of service.
Palate: The hard and soft tissues forming the roof of the mouth.
Palliative: Treatment that relieves pain but is NOT curative.
Panorex: An extraoral full-mouth X-ray that records the teeth and the upper and lower jaws on one film.
Partial Day Treatment: A program offered by appropriately-licensed facilities that includes either a day or evening treatme
Partial Denture: A removable appliance used to replace one or more lost teeth.
Participant: A person who is eligible to receive health benefits under a health benefits plan. This term may refe
Participant ID: The unique identifier associated with a participant.
Participating Provider: A physician, hospital, pharmacy, laboratory or other appropriately licensed facility or provider of
Passivation: Metals and alloys are made less corrosive through surface treatment to produce a thin and stable ine
Pediatric Dentistry: The specialized branch of dentistry that deals solely with treating children's dental disease. Also
Pended Claim: Claims that require additional information prior to completing the adjudication process due to a spe
Peri-Implantitis: General term defining disease process surrounding and/or involving implanted foreign materials. Can
Periapical: The area that surrounds the root tip of a tooth.
Pericervical: The circular bone resorption that occurs about the necks of endosteal implants shortly after their i
Pericoronitis: An inflammation of the gum tissue around the crown of a tooth, usually the third molar.
Periodontal: Relating to the tissue and bone that supports the tooth (from peri, meaning 'around,' and odont, 'to
Periodontal Disease: The inflammation and infection of gums, ligaments, bone, and other tissues surrounding the teeth. Gi
Periodontal Pocket: An abnormal deepening of the gingival crevice. It is caused when disease and infection destroy the l
Periodontal Surgery: A surgical procedure involving the gums and jawbone.
Periodontitis: Inflammation of the supporting structures of the tooth, including the gum, the periodontal ligament,
Periradicular: The area which surrounds a portion of the root of the tooth.
Permanent Teeth: The thirty-two adult teeth that replace the baby, or primary teeth. Also known as secondary teeth.
Permucosal Pin Implants: Endosseous dental implants, shafts of which are threaded or smooth, used in bipodial or tripodial co
Physical Therapy: Rehabilitation concerned with restoration of function and prevention of physical disability followin
Pit: A recessed area found on the surface of a tooth, usually where the grooves of the tooth meet.
Plaque: A film of sticky material containing saliva, food particles, and bacteria that attaches to the tooth
Point-Of-Service (POS) Plan: A health plan allowing the member to choose to receive a service from a participating or non-partici
Policyholder: The group or individual to whom an insurance contract is issued.
Polymer: A naturally occurring or synthetic substance consisting of giant molecules formed from smaller molec
Polymer Tooth: 'Replica Tooth' Polyhydroxylethy1methacrylate (PMMA) alone or in combination with other polymers use
Pontic: An artificial tooth used in a bridge to replace a missing tooth.
Pre-Admission Certification-Continued Stay Review (PAC-CSR): The process through which the reviewer evaluates the attending physician's request for admission to
Pre-Disability Earnings: This is the amount of an employee's wages or salary that was in effect and covered by the plan on th
Pre-Existing Condition: A health condition (other than a pregnancy) or medical problem that was diagnosed or treated before
Pre-Existing Condition Limitations: When an employee has a physical or mental condition that existed prior to the effective date of his
Pre-Tax Account: An account in which contributions are subtracted from an employee's pay before withholding income ta
Precertification: The process of obtaining certification from the health plan for routine hospital stays or outpatient
Preferred Provider Organization (PPO) Plan: A specific type of CIGNA health plan with a national network of physicians. Plan members can visit p
Premolar: Another name for bicuspid.
Prescription Drug: A drug that has been approved by the Federal Food and Drug Administration which can only be dispense
Preventive Care: Medical and dental services aimed at early detection and intervention.
Preventive Dentistry: Education and treatment devoted to and concerned with preventing the development of dental disease.
Preventive Treatment: Any action taken by the patient, assisted by the dentist, hygienist, and the office staff that serve
Primary Care: The basic, comprehensive, routine level of health care typically provided by a person's general or f
Primary Care Physician (PCP): A physician, usually a family or general practitioner, internist or pediatrician, who provides a bro
Primary Teeth: The first set of teeth that humans get, lasting until the permanent teeth come in. Also referred to
Prophylaxis: The scaling and polishing procedure performed to remove calculus, plaque, and stains from the crowns
Prosthetic Devices: A device that replaces all or a part of the human body because a part of the body is permanently dam
Prosthodontics: The dental specialty dealing with the replacement of missing teeth and other oral structures.
Provider: A licensed health care facility, program, agency, physician or health professional that delivers hea
Provider Directory: Provider directories are listings of providers who have contracted with a managed care network to pr
Provider Network: A panel of providers contracted by a health plan to deliver medical services to the enrollees.
Pterygoid Notch: This notch is located at the pyramidal process of the palatine bone between the pterygoid processes
Pulp: The hollow chamber inside the crown of the tooth that contains its nerves and blood vessels.
Pulpectomy: Removal of the entire pulp from the canals in the root.
Pulpitis: An often painful inflammation of the dental pulp or nerve.
Pulpotomy: The removal of a portion of the tooth's pulp.
Quadrant: The dental term for the division of the jaws into four parts, beginning at the midline of the arch a
Ramus Frame: Full arch implant of tripodial design which consists of a horizontal supragingival connecting bar wi
Ramus Implant: Refer to Horizontal Endosteal Implant
Rebase: The process of refitting a denture by replacing the base material.
Receded Gums: A condition characterized by the abnormal loss of gum tissue due to infection or bone loss.
Receptor Site Former: A duplicate form of a root shaped or blade shaped body of an implant. Designed to form an osseous im
Receptor Sites: Areas in bone or soft tissue which are prepared to receive an implant.
Recurrent Disability: The recurrent disability provision is designed to protect an employee who tries to return to work bu
Referral: When a dental patient from one office is sent to another dentist, usually a specialist, for treatmen
Rehabilitation: Rehabilitation means the restoration of or improvement in an employee's health and ability to perfor
Reimplantation: Act of reinserting a tooth into the alveolar socket from which it had been avulsed.
Reline: The process of resurfacing the tissue side of a denture with a base material.
Replantation: The return of a tooth to its socket.
Residual Benefits: Residual benefits can help make up the difference in income if an employee is able to work, but limi
Residual Ridge: A remnant of the alveolar process and soft tissue covering after teeth are removed.
Resorption: The breakdown and assimilation of the bone that supports the tooth, i.e., bone loss.
Resorption (Of Bone): A loss of bone substances by physiologic or pathologic means is considered associated with the natur
Restoration: Any material or devise used to replace lost tooth structure (filling, crown) or to replace a lost to
Retainer: A removable dental appliance, usually used in orthodontics, that maintains space between teeth or ho
Retrograde Filling: A method of sealing the root canal by preparing and filling it from the root tip, generally done at
Return To Work Provision: To encourage employees to return to work as soon as they become physically able, an additional incen
Ridge (Alveolar): The alveolar process and its soft tissue covering that remain after the teeth are removed.
Ridge Crest: The highest continuous surface of the alveolar ridge.
Root: The part of the tooth below the crown, normally encased in the jawbone. It is made up of dentin, inc
Root Canal: The hollow part of the tooth's root. It runs from the tip of the root into the pulp.
Root Canal Therapy: The process of treating disease or inflammation of the pulp or root canal. This involves removing th
Root Planing: The process of scaling and planing exposed root surfaces to remove all calculus, plaque, and infecte
Scaling: A procedure used to remove plaque, calculus and stains from the teeth.
Screw Implant : Refer to Vertical Implant
Sealant: A composite material used to seal the decay-prone pits, fissures, and grooves of children's teeth to
Second Stage Surgery: In relation to die subperiosteal implant, this refers to die reopening of the tissue, placement of t
Second Surgical Opinion: A CIGNA HealthCare program an employer may purchase in connection with some CIGNA HealthCare benefit
Service Area: The geographical area covered by a network of health care providers.
Single Crystal Sapphire: A material for implantation composed of a single crystalline alpha aluminum oxide which is identical
Six-Year Molar: The first permanent tooth to erupt, usually between the ages of five and six.
Skilled Nursing Facility (SNF): A licensed facility that provides nursing care and related services for patients who do not require
Socket: The hole in the jawbone into which the tooth fits.
Space Maintainer: A dental appliance that fills the space of a lost tooth or teeth and prevents the other teeth from m
Specialists: Providers whose practices are limited to treating a specific disease (e.g., oncologists), specific p
Speech Therapy: Treatment to correct a speech impairment that resulted from birth or from disease, injury or prior m
Spiral Implant: Refer to Vertical Implant
Staff Model HMO: An HMO where doctors are employed by the health plan and provide care at a health care center facili
Stainless Steel Crown: A pre-made metal crown, shaped like a tooth, that is used to temporarily cover a seriously decayed o
Status Change: A lifestyle event that may cause a person to modify their health benefits coverage category. Example
Sterile Technique: A standard technique in which an aseptic area is established and maintained to a specific conclusion
Sterilization: Complete elimination of microbial viability. Caution must be exercised to insure the preservation or
Stress: Normally defined in terms of mechanical tensile stress which is the form divided by the perpendicula
Subgingival Scaling: The removal of calculus and plaque found on the tooth below the gum line.
Submerged Implant: An endosseous implant with a removable head and neck to permit healing and maturation of the osteoto
Submission Date: The date the claim was submitted and/or received by CIGNA HealthCare.
Subperiosteal Implant: A framework specifically fabricated to fit the supporting areas of the mandible or maxilla with perm
Superstructure: The prosthesis that is supported by the substructure with or without an intervening mesostructure.
Supra Gingival Scaling: The removal of calculus and plaque found on the tooth above the gum line.
Surgical Jaw Relation (Subperiosteal): A registration of the vertical dimension in centric relation of the exposed superior surface of the
Surgical Occlusion Rim (Subperiosteal): A conventional occlusion rim with a base that has been adapted to provide an accurate recording of t
Suspension Ligament: The ligament arising from a bone surface which surrounds and supports an endosseous or subperiosteal
Symphysis: The immovable dense midline articulation of the right and left halves of the adult mandible.
Systemic: Relating to the whole body.
Temporomandibular Joint (TMJ): The connecting hinge mechanism between the upper jaw and the base of the skull.
Temporomandibular Joint (TMJ) Syndrome: The problems associated with TMJ, usually involving pain or discomfort in the joints and ligaments t
Third Molar: The last of the three molar teeth, also called wisdom teeth. There are four third molars, two in the
Three-Dimensional: Implant An endosteal implant which is placed from the lateral aspect of the alveolar ridge and suppl
Torus: A bony elevation or protuberance of normal bone. Usually seen on the upper palate behind the front t
Toxicity: The adverse reactions (dose-response time relationships) of tissues to selected foreign substances r
Transitional Benefits-Plans: When an employer changes insurance carriers, transition plans enable participants already in treatme
Transoateal: This refers to the penetration of both the internal and external cortical plate by a dental implant.
Treatment Plan: A list of the work the dentist proposes to perform on a dental patient based on the results of the d
Trial Inserts: Implant replica to test a receptor site. Modified Intra-Mucosal inserts worn during the healing phas
Tricalcium Phosphate: An inorganic, particular or solid form of relatively biodegradable ceramic, which is used as a scaff
Tuberosity Maxillary: The most distal portal of the maxillary alveolar ridge, that is applicable for implant support.
Tufts Health Plan (THP) Carelink: A program that offers members a comprehensive open access benefit plan with the protection they need
Tunnel Dissection: Through a small incision the periosteum is lifted from the underlying bone in a tunnel fashion. This
Unilateral Subperiosteal Implant: A partial subperiosteal implant usually located in the posterior area of the mandible or maxilla.
Universal Subperiosteal Implant: A full arch subperiosteal implant which circum-vents the remaining teeth.
Urgent Care: When prompt medical attention is needed in a non-emergency situation, that's called 'urgent' care. E
Usual Customary Or Reasonable (UCR): The amount reimbursed to providers based on the prevailing fees in a specific area.
Veneer: An artificial filling material, usually plastic, composite, or porcelain, that is used to provide an
Vertical Endosteal Implant: Root-shaped implant which derive their support from a vertical length of bone. Implants are in the f
Waiting Period: In order to become eligible for coverage under the policy, an employee must satisfy a certain number
Waiver Of Premium: When an individual becomes disabled and eligible for benefits, no further disability premium payment
Xenograft: Transplants from one species to another.
Zygoma: The area formed by the union of the zygomatic bone and the zygomatic process of the temporal and max

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