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Restorative Dentistry

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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What is the continuum of behaviour guidance?

This is a summary of the article published in the Dental Clinics of North America: The continuum of behaviour guidance (January 2013) Context Most treatments provided within the comprehensive dental care of children are relatively simple, yet many practitioners find that delivering high-quality care to young children is challenging simply because they are performed on a child. The provision of dental care to children presents unique challenges and opportunities. To effectively treat children, providers must be prepared to address child behavior and leverage appropriate behavior guidance techniques. Key Messages Behavior guidance is a continuum of skills spanning from basic to ...

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What is a safe level of mercury due to dental amalgam? A Canadian descriptive study

This summary is based on the study published in the BMC Oral Health journal: Dental amalgam and urinary mercury concentrations: a descriptive study Full Article (html) Full Article (PDF) Authors Alexandra Nicolae, Community Dental Health Services Research Unit at the University of Toronto Carlos Quiñonez, Community Dental Health Services Research Unit at the University of Toronto Harry Ames, Alberta Dental Association and College Context Dental amalgam is a source of elemental and inorganic mercury. The safety of dental amalgam in individuals remains a controversial issue. Urinary mercury concentrations are used to assess chronic exposure to elemental mercury. At present, there are ...

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How do you manage a patient undergoing an allogeneic bone marrow transplant?

This question was submitted to us by a general dentist: How should we manage a patient undergoing an allogeneic bone marrow transplant? Dr. Jeff Chadwick, at Princess Margaret Cancer Centre, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question The allogeneic bone marrow transplant (BMT) is a medical procedure that may be employed for the treatment of several hematologic malignancies including, but not limited to, aplastic anemia, myelodysplastic syndrome, acute and chronic leukemias and lymphomas. BMTs typically involve the insertion of a central venous catheter (CVC), high dose chemotherapy and, in some cases, total body irradiation, prior ...

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