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Restorative Dentistry

Is the epidemiological scoring system for tooth erosion/wear useful?

This summary is based on the article published in the International Dental Journal: An epidemiological scoring system for tooth wear and dental erosive wear (June 2013) Context The prevalence and severity of tooth wear and dental erosion is rising in children and there is no consensus about an index to be employed.  Purpose of the Study The study aims to assess the reliability of an epidemiological scoring system dental wear index (DWI) to measure tooth wear and dental erosive wear.  Key Messages Tooth wear increases with age and males experience it more than females in primary teeth. No significant gender difference of ...

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Is there a relationship between GERD and dental erosion?

This summary is based on the Critical Appraisal published in the Journal of Esthetic and Restorative Dentistry: Dental Erosion (June 2013) Context Dental erosion or erosive tooth wear not only can be caused by extrinsic (dietary) acids but also intrinsic acids. Historically, anorexic and bulimic patients have been the population dentists have had to be aware of, but with the increasing prevalence of gastroesophageal reflux disease (GERD) in the general population, another population must be monitored. Tooth wear is usually multifactorial, and it is often difficult to assign a specific etiology; abrasion, attrition, and erosion must all be considered as potential etiologies. This critical ...

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How effective are antibiotics in the treatment of peri-implantitis?

This summary is based on the article published in the International Dental Journal: Clinical efficacy of antibiotics in the treatment of peri-implantitis (August 2013) Context  Various treatment regimes for Peri-implantitis (PI) have been proposed in the literature. As it is known that bacteria can transfer from periodontally involved teeth to an implant, and that the microbes associated with PI resemble those of periodontal disease, local or systemic delivery of antibiotics with traditional PI treatment regimes may eliminate periodontopathogenic bacteria to a greater extent compared with when these treatment regimes are performed alone. This in turn may facilitate healing of PI ...

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How would you treat a patient with neuropathic orofacial pain?

This summary is based on the article published in the Journal of the American Dental Association: Dental treatment for patients with neuropathic orofacial pain (September 2013) Clinical Case A 56-year-old woman visited a dental office with acute dental pain in the left mandibular molar area. The treating dentist established a diagnosis of trigeminal neuralgia (TN) related to the left V3 branch, for which the patient was treated with nerve membrane–stabilizing anticonvulsants. The patient’s medical history included mild hypertension, hypothyroidism and intermittent low back pain for which she was being treated adequately by her physician.  The clinical examination revealed the left mandibular permanent first molar (tooth ...

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Your Opinion: what is the etiology behind the erosion on the 7-4 and how would you treat it?

This case is presented by Dr. Matt Gilchrist I am completely stumped as to the etiology behind the extreme wear/erosion on this child’s 7-4. The child is 9 years old and has generalized wear and early erosive-looking lesions on his occlusal/incisal surfaces. His mom admits to him having a grinding problem, which would account for the look of most of his teeth, but as for this 7-4, there has to be something more. We’ve been monitoring this tooth for the past 2 years and at every recall, it’s getting worse. I’ve questioned the patient about any reflux or dietary habits ...

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What is the concept of restorative volume?

This summary is based on the article published in the Journal of Esthetic and Restorative Dentistry: Clinical decisions for anterior restorations: the concept of restorative volume (December 2012) Context The choice of the most appropriate restoration for anterior teeth is often a difficult decision. Numerous clinical and technical factors play an important role in selecting the treatment option that best suits the patient and the restorative team. Experienced clinicians have developed decision processes that are often more complex than may seem. Less experienced professionals may find difficulties making treatment decisions because of the widely varied restorative materials available and often numerous similar products offered ...

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What are the clinical outcomes of implant abutments in the anterior region?

This summary is based on the article published in the Journal of Esthetic and Restorative Dentistry: Clinical outcomes of implant abutments in the anterior region: a systematic review (June 2013) Context Current paradigms for treatment success in implant dentistry are based not only on true clinical outcomes, such as implant survival, restoration survival, and patient satisfaction but also on surrogate clinical outcomes such as dentogingival esthetics, rate of mechanical complications, bone levels, and health of surrounding soft tissues. This is especially important for implant therapy in maxillary and mandibular anterior regions, where esthetics play a predominant role in treatment success. Purpose of the Study The clinical outcomes of ...

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Does stepwise excavation enhance pulp preservation?

This is a summary of the article published in the Journal of Dentistry: Ways of enhancing pulp preservation by stepwise excavation. A systemic review (February 2011) Context  The best possible methods and materials in stepwise excavation for deep caries in permanent teeth were investigated. Purpose The  review considers the questions from many aspects including clinical success, effects of reducing cariogenic bacteria, possibility of hardening softened dentin, and likelihood of generating tertiary dentin. Data This systematic review includes the use of data from randomized controlled trials, controlled clinical trials as well as from case series in which pulp exposure resulted following the treatment and ...

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