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Dental Specialties

How Effective Is the Neuromuscular Occlusion Approach in diagnosing and treating TMD?

This summary is based on the Rapid Response Report developed by the Canadian Agency for Drugs and Technologies in Health:  Neuromuscular Occlusion Concept-based Diagnosis and Treatment of Tempromandibular Joint Disorders: A Review of the Clinical Evidence  Full Report (PDF) Key Messages Diagnosing TMD: The use of electromyograms (EMG) is not supported by evidence. There is insufficient evidence to determine the diagnostic value of kinesiography. Treating TMD: Electrical stimulation is not supported by evidence. The efficacy of occlusal splints is uncertain. Context Temporomandibular disorder (TMD) is a group of clinical problems involving the chewing muscles, the temporomandibular joint (TMJ), and related structures. Symptoms may ...

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Case Solution: To Implant or Not To Implant: What Role Does Imaging Play?

This case is presented by the University of Toronto, Department of Oral Radiology Residents: Edwin Chang, Sherif El Saraj, Catherine Nolet-Levesque, Daniel Turgeon, Niloufar Amintavakoli, and Trish Lukat.  Pre-operative images provided courtesy of Dr. Milan Madhavji of Canaray | Specialists in Oral Radiology. You can view the original case here You can view the Case Follow up here Case Solution Periapical osseous dysplasia (formerly known as periapical cemental dysplasia or PCD) is classified as a bone dysplasia, in which normal cancellous bone is replaced by a combination of abnormal, disorganized bone and fibrous connective tissue. In periapical osseous dysplasia, the mineralized component of ...

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How do I manage a patient who swallowed or aspirated parts of an orthodontic appliance?

This Dental Urgent Care Scenario (USC) is adapted and presented by the JCDAOASIS team in collaboration with Dr. James Noble of Orthodontics at Don Mills in Toronto You can find the full USC on JCDAOasis Mobile Context Patients receiving orthodontic treatment are at a very high risk of having appliances swallowed into the oropharynx during treatment due to the small size of brackets and clipped wires. Orthodontic appliances that can be swallowed include wires, brackets, transpalatal arches, temporary skeletal anchorage devices, and keys for expanders and removable appliances among others. Foreign bodies entering the alimentary canal rarely represent a serious ...

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Burning Mouth Syndrome (BMS): what should you know?

This Dental Urgent Care Scenario (USC) is adapted and presented by the JCDAOASIS team in collaboration with Dr. Deepika Chugh and Dr. David Mock You can find the full USC on JCDAOasis Mobile Context Burning Mouth Syndrome (BMS) is an idiopathic burning sensation of the oral mucosa with no apparent underlying cause. Although the origin of the condition is unknown, there is possible evidence of a neuropathic basis. BMS is most found in middle-aged and elderly people, predominantly in perimenopausal and postmenopausal women. Signs & Symptoms Usually, onset is spontaneous, but previous trauma or dental treatment may be precipitating factors Most commonly ...

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What type of palliative care can I provide for persistent generalized dentin hypersensitivity?

This question was submitted to us by a practising dentist: “I had a patient present today with ongoing generalized sensitivity. No clinical evidence of recession; no bruxism or clenching that she is aware of; and no dietary changes. I would like to make trays to better deliver some palliative relief (she is currently using desensitizing toothpaste). What is the best product for the trays? Would Fluoride or relief gel or some other product that I am unaware of be best?” Dr. Hardy Limeback, former head of preventive dentistry at the University of Toronto provided this initial response: Persistent generalized dentin ...

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All-ceramic dental crowns VS. metal-ceramic dental crowns: what is the clinical and cost effectiveness?

This Rapid Response is produced by the Canadian Agency for Drugs and Technologies in Health (www.cadth.ca) Report in Brief (PDF)                                         Full Report (PDF) Key Findings The short term (< 5 years) survival of all-ceramic crowns when used for anterior teeth is comparable to porcelain fused to metal crowns. Summary of Findings Dental Crown Survival Posterior all-ceramic crowns fabricated from alumina, reinforced glass-ceramic, zirconia, or lithium disilicate had comparable survival rates to posterior PFM crowns (< 5 years analysis). InCeram and glass-ceramic, ...

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How would you manage and restore this severely worn dentition?

This question was submitted by Dr. Stephen Abrams from Cliffcrest Dental. Dr. Abrams is seeking colleagues’ opinions about the best approach to the video case that is presented below. Readers are invited to comment on this initial response and provide further insights by posting in the comment box which you will find by clicking on “Post a reply” below. You are welcome to remain anonymous and your email address will not be posted.  

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What are the advantages and disadvantages of self-adhesive resin cements for crown & bridge cementation?

This question was submitted to us by a practising dentist: What are the pros and cons of self-adhesive resin cements (i.e.: RelyX, Unicem 2) and resin modified glass ionomers (i.e.: FujiCEM 2) in crown and bridge cementation? Are they equally reliable? Dr. Omar El-Mowafy, Head of Restorative Dentistry at the University of Toronto provided this initial response: Advantages of self-adhesive resin cements 1. Eliminate the need for etching tooth structure or application of primer/bonding agent; and as a result, dramatically reduce the potential for post-operative sensitivity . 2. Dual-cured: excess cement can be briefly light-cured for ease of use. When used with a ...

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