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Restorative Dentistry

How to manage white spot lesions in fixed orthodontic appliances?

This summary is based on the article published in the Journal of Esthetic and Restorative Dentistry: A contemporary review of white spot lesions in orthodontics (April 2013) Context White spot lesions (WSL) associated with fixed orthodontic appliances are a common adverse effect of orthodontic treatment and represent a significant challenge to achieving esthetic excellence. Purpose The purpose of this article is to review the current evidence regarding diagnosis, risk assessment, prevention, intratreatment management, and post-orthodontic treatment of WSL and to provide clinical recommendations useful for both the orthodontist and the general dentist. Key Messages White spot lesions associated with orthodontic treatment are a ...

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Could Chlorhexidine varnish be effective in preventing root caries?

This summary is based on the Critical Summary published in the Journal of the American Dental Association: Use of chlorhexidine varnish to prevent root caries may benefit some patients (September 2013) Clinical Question The critical summary was in response to the following question: “Does the application of CHX-V reduce the incidence or activity of root caries in adult patients with gingival recession compared with that in adult patients who do not receive CHX-V application?” Key Message Chlorhexidine varnish (CHX-V) may be effective in preventing root caries in the absence of regular professional tooth cleaning and oral hygiene instructions for patients who need special care. Clinical Implications Although ...

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Diagnosing periodontal disease: what is the periodontal classification system?

This question was submitted by a general dentist: What are the latest thoughts on periodontal disease and the classification used for its diagnosis? Dr. Sayed Mirbod, representing the Canadian Academy of Periodontology (CAP), provided this initial quick response The benefit of a classification system is to provide a framework to study the etiology, progression and treatment for a disease. The system can also be used by clinicians to organize their patients’ health-care needs. Diagnosing periodontal disease is directly related to the classification system that is used by the clinician and the variations in the definition of periodontal health, gingivitis and periodontitis ...

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Posterior Partial Coverage Restorations: how fracture resistant and what is the risk of failure?

This summary is based on the article published in the Journal of Esthetic and Restorative Dentistry: Evaluation of fracture resistance and failure risks of posterior partial coverage restorations (April 2013) Context The interest in posterior partial coverage restorations has increased because these restorations provide a more conservative treatment option than traditional cohesively based restorations; however, material selection has been a controversial topic in the current literature. Purpose of the Study To evaluate the fracture resistance of posterior partial coverage restorations restored with different materials, examine their stress distribution, and calculate failure risks using three-dimensional (3D) finite element analysis. Key Messages Fracture resistance and ...

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Composite restorations: how could matrixing and contact be less challenging?

This question was submitted by a general dentist: Matrixing and contact can be a task with composite restorations. Do you have any recommendations that would make this process less challenging? This summary response is based on the JCDA Express (June 2012 Edition) by Dr. Dorothy McComb: Restoring Proximal Contacts with Composite Resin Restorations Dr. Dorothy McComb is the former Head of Restorative Dentistry at the University of Toronto, Faculty of Dentistry The series of 4 articles review the clinical challenges of class ΙΙ posterior composites and address common clinical concerns with proximal contact tightness.  Key Messages The use of interdental ...

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How to preserve coronal tooth fragments prior to reattachment?

This summary is based on the article published in the Australian Dental Journal: Preservation of coronal tooth fragments prior to reattachment (September 2013) Shirani F, Sakhaei Manesh V, Malekipour M. Preservation of coronal tooth fragments prior to reattachment. Aust Dent J. 2013 Sep;58(3):321-5. Context Crown fractures are the most common form of dental injuries caused by trauma. If the fragment is retrieved after the trauma, reattachment could be a viable treatment option. Reattachment of the tooth fragment is a well accepted treatment option in dealing with crown fractures. Hydration of the fragment is an important aspect in this treatment. Purpose of the Study The ...

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What is the clinical evidence on approaches to caries removal?

This summary is based on the Critical Appraisal published in the Journal of Esthetic and Restorative Dentistry: Approaches to caries removal: what the clinical evidence says (April 2013) Context  It is very common that complete caries removal in vital, asymptomatic teeth with deep carious lesions ends in unavoidable exposure of the pulp. As a result, the complexity and cost of treatment increases dramatically and many patients are left with extraction as their only viable option.The review appraises evidence which supports alternative treatments designed to preserve the vitality of the tooth and thus avoid extraction. Studies Reviewed Evaluation of Atraumatic Restorative Treatment and Sealants under ...

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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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