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Supporting Your Practice

All-ceramic dental crowns VS. metal-ceramic dental crowns: what is the clinical and cost effectiveness?

This Rapid Response is produced by the Canadian Agency for Drugs and Technologies in Health (www.cadth.ca) Report in Brief (PDF)                                         Full Report (PDF) Key Findings The short term (< 5 years) survival of all-ceramic crowns when used for anterior teeth is comparable to porcelain fused to metal crowns. Summary of Findings Dental Crown Survival Posterior all-ceramic crowns fabricated from alumina, reinforced glass-ceramic, zirconia, or lithium disilicate had comparable survival rates to posterior PFM crowns (< 5 years analysis). InCeram and glass-ceramic, ...

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How would you manage and restore this severely worn dentition?

This question was submitted by Dr. Stephen Abrams from Cliffcrest Dental. Dr. Abrams is seeking colleagues’ opinions about the best approach to the video case that is presented below. Readers are invited to comment on this initial response and provide further insights by posting in the comment box which you will find by clicking on “Post a reply” below. You are welcome to remain anonymous and your email address will not be posted.  

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Which medications are most effective for moderate to severe post-operative dental pain?

The following question was posted by a practising dentist: There is quite a bit of variation in the office with respect to drugs dentists like to prescribe for post-operative pain. Which pain medications are the most effective for moderate to severe pain and have the least number of side effects? Dr. Mark Donaldson from the University of Montana and the Oregon Health & Sciences University provided this initial response: The goal should be: “the most effective dose for the shortest period of time.”  We want to get our patients out of pain as quickly as possible. Two good recent articles come to ...

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What are the advantages and disadvantages of self-adhesive resin cements for crown & bridge cementation?

This question was submitted to us by a practising dentist: What are the pros and cons of self-adhesive resin cements (i.e.: RelyX, Unicem 2) and resin modified glass ionomers (i.e.: FujiCEM 2) in crown and bridge cementation? Are they equally reliable? Dr. Omar El-Mowafy, Head of Restorative Dentistry at the University of Toronto provided this initial response: Advantages of self-adhesive resin cements 1. Eliminate the need for etching tooth structure or application of primer/bonding agent; and as a result, dramatically reduce the potential for post-operative sensitivity . 2. Dual-cured: excess cement can be briefly light-cured for ease of use. When used with a ...

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What factors should I consider when purchasing appointment-confirmation software for my office?

This question came our way from a practising dentist in response to a recent “Plugged In” article in the JCDA: I am seriously considering adding some software which allows communication with patients by email to confirm appointments. What are the pros and cons of the different systems available to me? What specifications should I insist on in the systems I evaluate? Dr. Jeff Glaizel of Toronto who authors our “Plugged In” column provided this initial response. When evaluating a specific communication technology solution for your office there are 2 main areas to look at: 1. Does the workflow fit into ...

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How do I manage vital, irreversibly inflamed teeth with unstoppable bleeding?

This urgent care scenario is presented by the JCDAOasis Team in consultation with Dr. Brian Jafine. Peer-reviewed content that appeared in the JCDA OASIS “point of care” searchable database at www.jcdaoasis.ca  Presentation Population Patients with recent dental restorations (amalgams, resins, crowns) or trauma Medically-compromised patients Signs Large/deep restorations and crowns (broken down, leaking, open margins) Continuous bleeding after several attempts to dry, close, or fill the root canal spaces Symptoms Pain severity: the patient may experience some pain Investigation Thoroughly assess the patient’s medical history: inquire about diabetes mellitus, bleeding disorders, hypertension, history of radiation therapy, etc. Perform an oral examination: ...

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What is the QT-Prolonging effect of Epinephrine on Patients Taking SSRIs?

The following question was submitted by a practicing dentist: What may happen with patients who have a prolonged QT due to their SSRI or Prozac medication when they are administered a local anesthetics-containing epinephrine? The following response is provided by Dr. Joonyoung Ji, resident in the Department of Dental Anesthesia at the University of Toronto Main take-away message Epinephrine, stress, and using more than one psychotropic increases the QT interval. The majority of patients have significant medical co-morbidities in reported cases of arrhythmia associated with psychotropics. Therefore, limiting the use of epinephrine to under 40 mcg or no more than 2 cartridges of ...

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Recurrent Herpes Simplex: What Are the Possible Interventions?

This short consult is presented by Dr. Eric Stoopler, DMD; Dr. Arthur Kuperstein, DDS; and Dr. Thomas Sollecito, DMD Peer-reviewed content that appeared in the JCDA OASIS “point of care” searchable database at www.jcdaoasis.ca and in the sixth edition of the print JCDA. Primary and recurrent infection with herpes simplex virus (HSV-1 and HSV-2) can cause oral and/or genital lesions, although the majority of oral infections are caused by HSV-1. Symptomatic vesicles/ulcers of the oral mucosal tissues generally follow the onset of systemic symptoms and are often accompanied by significant erythema of the gingival tissues (i.e., “primary herpetic gingivostomatitis”). Treatment of primary HSV infections ...

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