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Restorative Dentistry

What is the clinical and cost effectiveness of using dental crowns for vital and endodontically treated teeth?

This summary is based on the Rapid Response Report developed by the Canadian Agency for Drugs and Technologies in Health: The use of dental crowns for vital and endodontically treated teeth: a review of the clinical and cost effectiveness and guidelines.  Full report (PDF) CONTEXT The choice of dental restoration depends on the amount of remaining tooth, which may influence long term survival and cost. For endodontically treated teeth, it is believed that coronal coverage can improve the clinical success of the restored teeth. An endodontic post is a partial prosthesis that is fixed inside the root canal. They are used to ...

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What is the preferred technique for creating a post & core, using the Rely-X Fiber Post system?

In this short video (6.38), Dr. Richard Price, Professor and Head of Fixed Prosthodontics in the Department of Dental Clinical Sciences at Dalhousie University’s Faculty of Dentistry, demonstrates a technique for cementing a Rely-X post and building up a core foundation prior to the restoration of an endodontically treated tooth From the radiograph or from the endodontic treatment notes, estimate the desired length of the post after leaving 5 mm of Gutta Percha at the apex. Prepare canal to the correct post length. Save as much of the root and tooth structure as you can.   Choose a size of post that ...

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What is the preferred technique for taking an impression for a cast post & core?

In this short video (2:36), Dr. Bob Loney, Professor and Chair of the Dental Clinical Sciences Department at the Faculty of Dentistry, Dalhousie University, demonstrates a technique that provides a bubble-free impression that won’t distort. Paint the impression tray with adhesive. Pack and remove retraction cord. Inject light-body polyvinyl siloxane impression material all around the completed crown preparation. ensuring to capture the crown margins. Squeeze some light-body material on to a pad and coat it over the length of a lentulo spiral filler on a contra-angle slow speed handpiece. Place the coated lentulo spiral filler down the canal where its ...

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Light Curing: So Easy, So Dangerous!

In these videos, Dr. Richard Price, Professor and Head of Fixed Prosthodontics in the Department of Dental Clinical Sciences at Dalhousie University’s Faculty of Dentistry, shares excellent clinical information related to light curing. The video has been divided into short theme section as follows:  Light curing so easy, so dangerous! Complete video (27 minutes) The perfect storm The success of 122+ million restorations and 16+ million sealants placed annually depends on the curing lights and how it is used. Do we have any evidence that resin restorations are not lasting as long as they could and should?  Various curing modes and irradience We ...

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What is Pre-Eruptive Intra-Coronal Radiolucency (PEIR)?

This question was submitted by a general dentist: Has anyone seen ‘pre-eruption caries’? I have several cases where radiographically. there appeared to be caries on the occlusal surfaces of unerupted teeth. On eruption, I observed them for a while and after the first one increased in size over time, I went in and restored all of them. All seemed to be carious. Dr. Anuradha Prakki, Assistant Professor in Restorative Dentistry at the University of Toronto School of Dentistry, provided this quick initial response:  Researchers identify these cases as pre-eruptive intra-coronal radiolucency (PEIR), as the etiology of pre-eruptive intra-coronal radiolucent lesions is not ...

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Are there any tooth-coloured materials that are free of BPA and estrogen-mimicking agents?

This question was submitted by a general dentist: My patient requests that her tooth-coloured restorations be free of BPA and estrogen-mimicking agents. Can you suggest any tooth-coloured materials and cements that meet those criteria? Dr. Omar El-Mowafy, Professor and Head of the Restorative Dentistry at the University of Toronto, provided this quick initial response: Bisphenol A (BPA) is an organic compound with the chemical formula (CH3)2C(C6H4OH)2.  It is widely used in the industry when making plastic products. Tooth-colored restorations that are Bisphenol-A-free would automatically exclude almost all resin composite restoratives and their corresponding bonding agents. Therefore, in this case the ...

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How is the “Dahl appliance” used in the treatment of severely worn maxillary anterior teeth prior to reconstruction?

This question was submitted by a general dental practitioner: Does anyone have experience with the “Dahl appliance” used in the treatment of a severely worn maxillary anterior teeth prior to reconstruction? Dr. Effrat Habsha, Prosthodontist at Prosthodontic Associates offered this quick initial response:  The Dahl Concept and the Dahl Appliance The Dahl Concept refers to the relative axial tooth movement that is observed when a localized appliance or localized restorations are placed in supra-occlusion and the occlusion re-establishes full arch contacts over a period of time. This concept can be achieved with a Dahl appliance, which refers to any interim restoration or prosthesis ...

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Is there a truly great online resource for the management of dental trauma cases?

Can there be many more stressful occasions during a busy day at your office than when an emergency dental trauma case shows up unexpectedly requiring immediate treatment? You are already running behind and the patient (and often the parent) is crying and upset. You don’t deal with this type of case every day, and you are concerned about putting a foot wrong “under the spotlight.” What do you do next? Having consulted with some eminent experts in the field of pediatric dentistry, I have no hesitation in recommending the Dental Trauma Guide website to you as an excellent “at the fingertips” resource ...

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