Novel tier 2 service model for complex NHS endodontics.

Aim The use of tier 2 practitioners has been suggested as an intermediate tier in the NHS workforce completing cases of moderate difficulty previously referred to secondary care. Provision of such services varies depending on speciality and local commissioning priorities. This service evaluation investigated reasons for and outcomes of endodontic referrals to an NHS tier 2 service in Powys, Wales.

NMR Profiling of Metabolites in Larval and Juvenile Blue Mussels (Mytilus edulis) under Ambient and Low Salinity Conditions.

Blue mussels () are ecologically and economically important marine invertebrates whose populations are at risk from climate change-associated variation in their environment, such as decreased coastal salinity. Blue mussels are osmoconfomers and use components of the metabolome (free amino acids) to help maintain osmotic balance and cellular function during low salinity exposure. However, little is known about the capacity of blue mussels during the planktonic larval stages to regulate metabolites during osmotic stress.

Decision-making in the provision of extra-coronal restorations.

Unlabelled: Decision-making when choosing an extra-coronal restoration for a molar tooth is often multifactorial, requiring consideration for material properties, the underlying tooth tissue, aesthetics and functional requirements. This article reviews the various factors associated with the decision-making when considering an extra-coronal restoration for a molar tooth. The current literature is disseminated and compared to results obtained from clinicians at the Dental Pan Society meeting in 2007.

Management of a patient suffering with Cherubism with dental implants.

Cherubism is a rare non-neoplastic, fibro-osseous hereditary disorder characterized by bilateral expansion of the maxilla and mandible producing a characteristic facial appearance. It can affect the facial and dental growth of the individual and often results in gross aesthetic and functional deficiencies. The teeth may also be displaced or submerged and these problems can often compromise successful restorative rehabilitation.

The use of implants for anchorage in the correction of unilateral crossbites.

The provision of orthodontic anchorage in the adult patient can be compromised due to reduced periodontal support, insufficient number of teeth and limited supra-gingival tooth tissue. Where tooth borne anchorage is unavailable for significant orthodontic movement implants represent a viable alternative. This paper describes the use of dental implants for orthodontic anchorage in a partially dentate patient with a severe unilateral cross-bite where orthognathic surgery was the only other realistic option.

A report on the clinical and radiographic outcomes of 38 cases of apexification with mineral trioxide aggregate.

The aim of the study was to report on the clinical and radiographic assessment of 38 cases of apexification using MTA over a three year period. Thirty-eight cases of immaturely developed teeth requiring endodontic therapy were treated using MTA to achieve an apical barrier prior to obturation with gutta-percha. The teeth were clinically and radiographically assessed.

A prosthetic management technique for osteopetrosis affecting the maxilla.

Bony anatomical anomalies can complicate the construction and successful wearing of removable prostheses. Osteopetrosis is a group of diseases that affect the growth and continuous remodelling of bone which in turn can result in gross irregular alveolar bone morphology. This paper describes the management of a patient with this problem and emphasises the challenges in constructing a successful complete maxillary removable prosthesis.

Modern restorative management of patients with congenitally missing teeth: 4. The role of implants.

Unlabelled: In this fourth and final paper on the management of patients with congenitally missing teeth, the use of dental implants is considered. This group of patients often provides unique challenges when implant reconstruction is considered. Often a multidisciplinary approach is required involving orthodontists, oral surgeons and restorative dentists.

Modern restorative management of patients with congenitally missing teeth: 3. Conventional restorative options and considerations.

Restoration of spaces in hypodontia patients needs to take into account many factors including, the number of missing teeth, the distribution of space, the size of the teeth, and the age of the patient. This paper considers adhesive and conventional bridgework, as well as removal alternatives for the restoration of spaces. The various merits of each are discussed, together with treatment planning considerations for such cases.

Modern restorative management of patients with congenitally missing teeth: 2. Orthodontic and restorative considerations.

Managing edentulous spaces in patients with congenitally missing teeth demands careful planning and, often, a multidisciplinary approach. Orthodontic tooth movement can be considered to close spaces as well as improve the distribution of available teeth. In this second paper, the advantages of a collaborative approach are discussed.

Modern restorative management of patients with congenitally missing teeth: 1. Introduction, terminology and epidemiology.

The management of patients with congenitally missing teeth can be a challenge and, in many cases, requires multidisciplinary care. In this four-part series, a contemporary approach to managing this group of patients is discussed. This first paper examines the terminology, epidemiology and restorative challenges that such patients can exhibit.

Cleidocranial dysplasia--a late diagnosis.

Unlabelled: Cleidocranial dysplasia is a rare congenital disorder of bone characterized by abnormalities of clavicle, skull and dentition. There are features which are pathognomic for this condition and diagnosis can usually be made early in life. This report presents a case that was diagnosed very late in life, with a resultant compromised dental state, and discusses current treatment modalities and the differential diagnosis with another condition with which this was mistaken.