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Restorative Dentistry

Are there any detrimental effects of tooth-whitening agents on enamel?

This question was submitted by a general dentist: Are there any detrimental effects of tooth-whitening agents on enamel? Some have shown increased microfracture in the enamel seen only under SEM; however, is it clinically relevant? Dr. Laura Tam, from the Faculty of Dentistry at the University of Toronto, and Dr. Suham Alexander provided this quick initial response     Tooth whitening has become an increasingly popular esthetic service for patients and is well-integrated in dental practices. At-home whitening with carbamide peroxide and hydrogen peroxide (H2O2) was originally part of a complete dental procedure which included the dentist examining the patient ...

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What is gutta percha and how did it come to be used in dentistry? An interview with Dr. Mary Dabuleanu

Dr. Suham Alexander, Oasis Clinical Editor, interviewed Dr. Mary Dabuleanu, Endodontist at Dabuleanu Dental about the history of gutta percha and its use in dentistry.                 Listen to the Audio Interview (11 mins)   References Jeon KA, Lee IB, Bae KS, Lee WC, Baek SH. Measurement of thermal expansion characteristic of root canal filling materials : Gutta-percha and Resilon. J Kor Acad Cons Dent. 2006;31(5):344-351. doi: 10.5395/JKACD.2006.31.5.344.   Khatavkar RA, Hedge V. The weak link in endodontics: Gutta-percha – A need for change. World J Dent. 2010;1(3)217-24. Shipper G, Ørstavik D, Teixeira FB, Trope M. An ...

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Who should do the post-endodontic restoration – the restorative dentist or the endodontist?

This question was submitted by a general dentist: Who should do the post-endodontic restoration – the restorative dentist or the endodontist? Drs. Stephen Ferrier, Manny Friedman, and Suham Alexander prepared the following response The most important aspect of the post-endodontic restoration is establishing a sound coronal seal to prevent re-infection of the root canal system and to protect the weakened tooth from mechanical failure. Ideally, this should be completed when the endodontic obturation is done. Whether or not this is the ‘final’ or ‘ultimate’ restoration depends upon the tooth. The coronal seal may take the form of a: Core (including postless ...

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How would you treat this case?

The following case was presented by a general dentist: 27 year-old Indian male. Patient had ortho treatment done 2 years ago with another dentist. Just after 2 days of debonding of brackets, patient had a fall with sustained tooth injuries to his upper front teeth 11,21,22 causing them to extrude in a retrolined inclination. Patient was treated by an oral surgeon at a private hospital and the patient’s pictures after 2 year plus are shown. Patient claims there were no follow ups after admission in the hospital.                       Patient’s concerns: ...

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Does diabetes affect implant failure rates?

This summary is based on the article published in the Journal of Dental Research: Diabetes and oral implant failure: a systematic review (September 2014) B.R. Chrcanovic, T. Albrektsson, and A. Wennerberg Context Dental implant survival is initially dependent on successful osseointegration following placement. As an implant is restored and placed into function, bone remodeling becomes a critical aspect of implant survival in responding to the functional demands placed on the implant restoration and supporting bone. The critical dependence on bone metabolism for implant survival may be heightened in patients with diabetes (1). Diabetic patients have increased frequency of periodontitis and ...

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How do you treat a patient with scleroderma who has periodontal issues – advanced recession, stripping of the attached gingiva from the roots?

This question was submitted by a general dentist: How do you treat a patient with scleroderma who has periodontal issues – advanced recession, stripping of the attached gingiva from the roots? Dr. George Sandor, DDS MD and Dr. Suham Alexander, Oasis Clinical Editor provided this initial response.      Systemic Scleroderma  Systemic scleroderma is a relatively rare condition that affects ~19/1,000,000 adults annually. Women experience the condition 3 times more than men. A vasoconstrictive event known as Raynaud’s phenomenon is often one of the first signs of the disease which is precipitated by emotional distress or exposure to cold. (It should ...

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How effective are contemporary adhesives for the restoration of non-carious cervical lesions? A systematic review

This summary is based on the article published in Dental Materials: Clinical effectiveness of contemporary adhesives for the restoration of non-carious cervical lesions. A systematic review (August 2014) M. Peumansa, J. De Munck, A. Mine, B. Van Meerbeek     Context Non-carious cervical lesions (NCCLs) should be restored as minimally invasive as possible. Currently, adhesive materials indicated to restore NCCLs include glass-ionomers and their resin-modified version, poly-acid modified composites (most frequently referred to as ‘compomers’), composite (1) and recently also self-adhesive composites (2, 3). Contemporary adhesives can be classified according to their mode of action into etch & rinse (E&Ra) ...

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What are the local and systemic interventions for the prevention of dry socket? An evidence-based update

This summary is based on the article published in the British Dental Journal: Interventions for the prevention of dry socket: an evidence-based update (July 2014) M. O. Sharif, B. E. S. Dawoud, A. Tsichlaki and J. M. Yates       Context Infection control and knowledge of common infectious agents is a cornerstone of safe dental practice. Alveolar osteitis (AO) or ‘dry socket’ is a relatively common post-operative complication that is reported to be associated with up to 37% of dental extractions. (1) The condition develops when a blood clot fails to form or becomes dislodged from the socket of ...

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