Dental Tribune International
Complex direct ORMOCER composite restorations in the posterior region

July 3, 2017

For reasons of cost, patients and dentists today often find themselves obliged to use restorative materials for the treatment of large structural, functional and aesthetic defects. This case report demonstrates how an innovative, organically modified ceramic composite with extremely low shrinkage stress and volume contraction can be used to restore teeth while preserving tooth substance. Occlusal functionality is key to the longevity of the restoration.

Update on teeth whitening and remineralisation with nHAp

June 26, 2017

Consider this the new era of painless teeth whitening and the end to soft tissue damage caused by hydrogen peroxide. Developments in the past five years have made a huge impact on the daily work of dentists, dental hygienists and well-trained dental nurses in the EU regarding the parameters for inoffice teeth whitening and the purchase of teeth bleaching products containing hydrogen peroxide or carbamide peroxide.

Cosmetic enamel restoration using naturomimetic layering technique—Part I

June 23, 2017

A human face takes priority when determining physical attractiveness. If we group the facial components according to their influence on appearance, the mouth takes precedence over the others. Smiling is one of the most important facial expressions and is essential in expressing friendliness, agreement and appreciation. A smile develops when a person senses happiness, pleasure or humour. Whatever may be the emotion, a smile plays an important role in society, and for a variety of psychological reasons makes both giver and receiver feel good. The face, gums (gingival complex), teeth (dentition) and emotion are the four basic components of a smile. A smile requires coordination of these four components with voluntary or involuntary stimulation by various emotions; hence it is evident that every smile is different and denotes a sense of individuality.

Non-ablative melanin depigmentation of gingiva

June 7, 2017

Melanin depigmentation of gingiva using various laser wavelengths have been reported for over ten years. Layer by layer, the mucosa is ablated to the basal layer of the epithelium where the melanocytes are located. The use of lasers have been compared with the use of scalpel and diamond bur (Fig. 1). By incorporating the optical properties and absorption characteristics of 810 nm together with specific power parameters, a non-ablative technique was developed (Fig. 2).

The use of CBCT and CAD/CAM techniques in complex implant-supported rehabilitation of maxilla—Part I

May 29, 2017

Patients who visit our clinic and wish to receive prosthetic treatment are frequently unaware of the possibilities that modern medicine has to offer. Neither are they aware of the fact that implantological treatment is not a ‘one-day’ treatment and that the integration of implants with bone tissues takes some time.

Creating a five-star dental practice

May 22, 2017

Dentists are not only health care professionals but also health care professional service providers. The word "service" is important to remember because it changes our perspective to focus on the needs of our patients as we treat them. Our education at dental school teaches us to take care of our patients' oral health needs; however, patients have other physical and psychological needs too that we cannot overlook.

Acupuncture: Probing its way into dentistry—Part II

May 18, 2017

Dental applications of acupuncture in managing xerostomia, dental anxiety and gag reflex

Evaluating the fit of removable dentures with magnification systems

May 5, 2017

Nowadays, implant-supported prostheses are used more and more in people’s daily routines and removable prostheses in case of large rehabilitation offer aesthetic and functional advantages especially when support of the soft tissues is necessary. In this article, much attention will be given to the analysis and the design of the prosthesis in order to achieve predictable and repeatable results. During the construction of the structure and superstructure the microscope will be critical to achieve the maximum precision.

Comprehensive rehabilitation and natural esthetics with implant and orthodontics (CRANIO): An interdisciplinary approach to missing maxillary lateral incisors

April 24, 2017

The absence of the maxillary lateral incisors creates a functional and esthetic problem that can be managed with different treatment modalities.

Acupuncture: Probing its way into dentistry—Part I

April 21, 2017

An introduction to acupuncture and its practical applications in contemporary dental practice

Open-cohort prospective study on early implant failure and physiological marginal remodeling expected using sandblasted and acid-etched bone level implants featuring an 11° Morse taper connection within one year after loading

April 11, 2017

Objective: The objective of this study was to evaluate the implant survival and success rates as well as the physiological marginal bone remodeling expected using Osstem implants.

Kinesiographic analysis of lateral excursive movement on the horizontal plane: the retrusive component

April 10, 2017

The temporomandibular joint (TMJ) has a functionally complex articulation that during phylogeny underwent an adaptation also linked to posture change after the acquisition of upright posture and subsequent reduction of the postglenoid process. This articulation supports numerous functions of the stomatognathic apparatus, and the part physiologically designed to withstand greater loads associated with mastication is essentially the frontal one; the rear portion of the TMJ is unfit to absorb retrusive forces owing to the poor support of the thin bone component and the histological characteristics of the tissue component. The purpose of this article was to analyze the angles of lateral tracings both on the frontal plane and on the horizontal one through kinesiographic analysis (functional masticatory angle of Planas and functional horizontal masticatory angle) in seeking to observe their mutual relations with respect to those planes.

Essential communication: The use of technology for virtual patient records

April 7, 2017

Records are an essential and integral component of diagnosis and treatment planning. Moreover, the acquisition of records allows the required communication between the clinician, laboratory, patient, and other third party stakeholders. This is critical in all aspects of dentistry, but holds immense value in implant dentistry. Unfortunately, there is a growing epidemic in which clinicians are utilising the minimal amount of records. This becomes a paramount issue in the delivery of predictable and successful dental prosthetics.

Importance of a preoperative radiographic scale for evaluating surgical difficulty of impacted mandibular third molar extraction

April 7, 2017

Objective: The objectives of the study were to evaluate the correlation between the degree of surgical difficulty measured by an established scale and the total surgical time, the ostectomy time and the tooth sectioning time, and to analyze which of the factors involved had a greater influence on total surgical time.

Retrospective analysis of periimplantitis therapy of 158 implants

April 6, 2017

Objective: The objective of the retrospective analysis was to evaluate the efficacy of periimplantitis treatment up to a five-year observation period.

Bone augmentation of canine frontal sinuses using a porous α-tricalcium phosphate for implant treatment

April 5, 2017

Objective: Compared with hydroxyapatite, alpha-tricalcium phosphate (α-TCP) is more biodegradable and shows better integration during physiological bone remodeling. The objective of this study was to evaluate the effects of porous α-TCP as a tissue-engineered scaffold for maxillary sinus augmentation in a canine model.

Biological and physical properties of bone block grafting biomaterials for alveolar ridge augmentation

April 4, 2017

Objective: Bone resorption of maxillary ridges is an unavoidable process that occurs after tooth extraction. Many treatment alternatives have been proposed to facilitate implant placement in these scenarios. Drawbacks such as morbidity, cost and excessive resorption owing to the procedure have prompted clinicians to seek biomaterials as an alternative to autogenous bone. The objective of this article was to review the current state of the art by means of the biological and physical properties of biomaterials used for block grafting in atrophic maxillary ridges. Secondly, it was aimed herein at presenting the clinical and histological findings when using these biomaterials.

Replacing a failing dentition with new technology

April 4, 2017

Having the ability to take a patient from start to finish in a fewer amount of appointments within your practice allows you to position yourself as a provider that can fulfill your patient's surgical and restorative needs. With the proper training, a dental provider may provide extraction, grafting and implant placement within one appointment at one location. Not only does this allow you to reduce the amount of visits for the patient, but this type of service also helps maintain the cost to the patient since they are not seeing multiple dental providers. Most importantly, this enables the dental provider full control of the surgical and prosthetic outcome. Depending on the patient's desires, the clinical conditions of the oral environment present and the skills of the provider, a dentist may choose to extract teeth, level bone, and graft with guided dental implant placement within his/her dental practice.

Cutting endodontic access cavities— for long-term outcomes

March 9, 2017

Errors accumulate during procedures. That’s the reason botching the access at the start of an RCT is so much more devastating than say, problems that come from misfitting a gutta-percha cone just before finishing the case. Miss a canal and the case is going down, regardless of how brilliant the remaining procedure is carried out. Perforate the tooth, and suddenly titanium starts looking better. Cut huge access cavities, and expect to see relatively huge numbers of root-fractured teeth within five years of treatment. Simply cheat the access procedure by beginning the instrumentation of canals before a straight, perfectly smooth path has been cut to each canal orifice, and be punished every time a file, an irrigating needle, an explorer, a gutta-percha point, a paper point or a plugger is taken into each of the canals scores of times.

Stairs to the Apex

March 9, 2017

Sometimes endodontic specialists have to go the extra mile to save teeth. Only with the proper endodontic instruments success can be ensured in the most challenging situations. This case shows how the aid of HyFlex CM-files can help to deal with multiple iatrogenic deformations after several previous temporary root canal therapies. The use of these pre-bendable NiTi-files help us to get the root canal preparation “back on track”.

The role of the operating microscope – in conjunction with ultrasonic in preparation of root canal systems

March 9, 2017

The purpose of preparing of the root canal system is well understood and contemporary techniques involve the use of both hand and rotary instruments used in conjunction with an irrigation regime. However, the complexity and variability of root canal morphology can make effective preparation very challenging, particularly in canals with irregular cross sections. Current techniques are not always completely effective and it has been well recognised that while some part of the root canal are over prepared with rotary instrumentation, other surfaces are not touched. One study concluded that at least 35 % of the surface area of canals had remained untouched by rotary preparation (Peters et al., 2001). In another study the results were even worse, 60–80 % untreated surfaces were left in the distal canals of lower molars, with 65–75 % in the apical 4 mm after preparation (Paque et al., 2010). Oval canals are particularly challenging as the debris collects in the extensions and in isthmuses (Figs. 1a & b).

An indirect method for provisionalisation: The team approach in a complete mouth hybrid reconstruction

February 26, 2017

A periodontist and ITI colleague whose office is two hours from our practices referred this patient to our team. Initially, she was seen by the prosthodontist, Dr Harry Randel, and subsequently referred to the periodontist, Dr Robert Levine, for a team approach to solve her failing dentition. The patient presented at our office as a 65-year-old non-smoking female (ASA 3: Illnesses under treatment: anxiety/ depression, osteoarthritis, fibromyalgia, hypothyroidism and history of myofacial pain dysfunction, Figs. 1–3). There was a history of TMJ issues (i.e. clicking and pain with her right side TM joint) which presently is under control and pain-free.

Augmentation and implant treatment: Two-stage surgery in the severely resorbed edentulous mandible

February 13, 2017

An adequate bone volume at the future implant site is a prerequisite for ideal implant placement and implant success. A residual bone with a vertical dimension less than 5.0 mm indicates a cut-off point and implies the need of additional augmentation procedures in connection with implant insertion, whereas higher values of the alveolar crest ≥ 5.0 mm are considered to be sufficient for treatment with standard-diameter implants without the urgent need of any horizontal bone augmentation.

Guided surgery for single-implant placement: A critical review

February 13, 2017

The objective of this review was to evaluate the scientific evidence on accuracy, as well as esthetic and clinical outcomes of single-tooth implants placed using computer-assisted, template-based surgery.

Exploring the fracture resistance of retentive pin-retained e.max press onlays in molars

February 12, 2017

Retentive titanium dentinal pins have been combined with indirect restorations. Application of pins has been used with lithium disilicate, an indirect pressed ceramic restorative material, termed e.max. The objective of this study was to investigate the fracture resistance of pin-retained versus non pin-retained indirect e.max press restorations. Ten human extracted teeth were used for the control and ten for the test group. Titanium dentinal pins were placed and e.max press restorations were fabricated, by a commercial laboratory, and then cemented. Fracture resistance was assessed. Data was collected and results were obtained. Fracture resistance of both groups indicated no significant difference in values. An observation from testing illuminated that pin-reinforced e.max benefitted from a controlled fracture, which minimized tooth damage. The data suggests that pin-reinforced indirect e.max restorations offer no appreciable  difference in fracture resistance. Further testing would be required to expand upon the sample size, explore other strength vectors and consider a clinical in vestigation.

Manager versus clinician

February 8, 2017

Practitioners’ expectations of the kind of manager they want for their practice vary considerably in terms of experience and skills. How guilty are you of promoting a nurse or receptionist to a management role without determining the skills gap and providing the necessary training? It is a common scenario in our industry. Practitioners have a responsibility to their teams and to the financial success of their practices to appoint someone who either has the necessary skills or has the capacity to learn them in the appropriate time frame. How realistic are your expectations and how can you ensure your management role results in success?

Twisted files and adaptive motion technology: A winning combination for safe and predictable root canal shaping

January 31, 2017

The ultimate goal of endodontic treatment is the prevention and/or treatment of apical periodontitis, such that there is complete healing and absence of infection1 while the overall long-term goal is the placement of a definitive, clinically successful restoration and preservation of the tooth.

Long-term analysis of primary, non-surgical root canal treatments – A retrospective study

January 31, 2017

The aim of this study was to exam more than 8,000 primary, non-surgical root canal treatments in the author’s general practice during 1985–1999 and followed- up for 25 years. Factors that have influence on failure and extraction rate were evaluated. Statistically, the data were analysed by log-rank test and Cox regression. The estimated survival rates were shown in Kaplan- Meier curves. With regard to the multivariat Cox regression the significant factors were: overfilled root canal, poor root filling quality, restoration, and fractured canal instrument, via falsa. Further on failure was influenced by the operator and the preoperative status of the pulp. Insurance conditions, patient age and type of tooth influenced the extraction risk. After 20 years, 82.3 % were not subject to failure and 51.5 % were saved from extraction.

From a distal

January 26, 2017

Limited workspace is a common problem in endodontic treatments. Before the arrival of pre-bendable NiTi files, a lot of RCT’s seemed to be almost inexecutable due to severe constraints in the access area. The following three cases illustrate how modern endodontic instruments help specialists to enter a new era of canal preparation, particularly if the apex is comparatively hard to reach. Standard endodontic treatment begins with placement of a dental dam to isolate the working environment, access to the canal via opening of the pulp chamber, and gauging the correct working length using a state-of-the-art electronic apex locator. However, root canals often come in extraordinary shapes: an unusually curvy anatomy with hidden accessory canals or horizontal branches might pose a real challenge to the most experienced of endodontic experts.

Localized ridge augmentation utilising titanium mesh with CPS morsels and simultaneous implant placement—A case report

January 25, 2017

Implant placement in the atrophic anterior maxilla can often be a difficult task due to deficient bone height, width, and volume. Many procedures have been introduced to aid in the reconstruction of the maxillary alveolar ridge to gain adequate bone to enable implant placement. Surgical modalities for alveolar ridge augmentation, along with guided bone regeneration, has been proven to be successful in re-establishing an appropriate alveolar ridge width. Guided bone regeneration is generally accomplished with the use of particulate bone of various types, and this bone is often protected by membranes. It has been found that the quantity of bone regenerated under the membranes has been demonstrated to be directly related to the amount of the space under the membranes.

© 2019 - All rights reserved - Dental Tribune International