Dental implants in the older adult.

A need for dental implant treatment in the older population is recognized considering the prevalence of partial and complete edentulism and the positive predictability of implant therapy. Even with a number of barriers to overcome for the older adult seeking implant care, dental implants provide stabilizing support for removable dental appliances and have been shown to be successful in that population. In this paper, we describe quality of life, systemic, surgical, and prosthodontic considerations of this prosthetic treatment along with maintenance challenges.

Early failure of Class II resin composite versus Class II amalgam restorations placed by dental students.

Using the information from remake request slips in a dental school's predoctoral clinic, we examined the short-term survival of Class II resin composite restorations versus Class II dental amalgam restorations. In the student clinic, resin composite is used in approximately 58 percent of Class II restorations placed, and dental amalgam is used in the remaining 42 percent. In the period examined, Class II resin composite restorations were ten times more likely to be replaced at no cost to the patient than Class II dental amalgam restorations.

Management of invasive cervical resorption: observations from three private practices and a report of three cases.

Invasive cervical resorption (ICR) is a type of external resorption that is not well understood or well known in the dental community. It is often misdiagnosed, leading to improper treatment or unnecessary loss of the tooth. Treatment may involve the periodontium as well as the tooth and pulp, and management can be complex.

Distraction osteogenesis for craniomaxillofacial problems.

Distraction osteogenesis (DO) is a biological process involving the formation of new bone between viable bone segments that are gradually separated by incremental traction. This technology has proved useful in several craniomaxillofacial applications where conventional techniques were previously used. This article describes DO and demonstrates three disparate uses for this technology.

A 5-year prospective multicenter study of early loaded titanium implants with a sandblasted and acid-etched surface.

Purpose: For dental implants to be successful, osseointegration must occur, but it is unknown how much time must pass for osseointegration to be established. Preclinical studies suggested that titanium implants with a sandblasted and acid-etched (SLA) surface were more osteoconductive and allowed more rapid osseointegration than machined or turned implant surfaces. The hypothesis of this study was that implants with an SLA surface could be loaded in half the conventional healing time of machined-surface implants and that, after loading, the implants would be successful for 5 years.

Adhesive dentistry and endodontics: materials, clinical strategies, and procedures for restoration of access cavities: a review.

The complexity of restorative dentistry has increased greatly in recent years, with the myriad of products used in "adhesive dentistry." So too has the "simple" matter of restoring access cavities after completion of endodontic treatment. This review discusses current methods of "bonding" to tooth structure, ceramic materials, and metals, with emphasis on those aspects that are important to endodontics.

How effective is that treatment? The number needed to treat.

The Number Needed to Treat (NNT) is a tool useful for comparing the relative effectiveness of two or more therapeutic or preventive interventions. The NNT may be presented by authors of a clinical research article, or, if not provided, may be calculated by the reader if the authors have reported outcomes as positive or negative per research subject. The NNT is simply calculated as the inverse of the absolute risk reduction.

26-year follow-up of screw-retained fixed dental prostheses supported by machined-surface Brånemark implants: a case report.

Background: Rough-surface implants have become very popular during the last 10 years due to greater reported bone-implant-contact and bone volume between implant threads compared to machined-surface implants.

Purpose: The aim of this clinical report is to present the 26-year clinical outcomes of machined-surface implants supporting screw-retained fixed dental prostheses in a 77-year-old woman. A 51-year-old woman received five mandibular and six maxillary implants supporting screw-retained fixed dental prostheses.

Restorative dentistry for the pediatric patient.

The American Academy of Pediatric Dentistry sponsored the Pediatric Restorative Dentistry Consensus Conference in 2002. This paper will review the consensus statements that were issued as a result of the conference. Since the conference there have been advances in procedures, materials, and techniques that need to be considered in terms of some of the consensus statements.

Dental unit waterline contamination--a review.

Manufacturers of dental units have responded positively to the challenge from the American Dental Association (ADA) and the subsequent guidelines issued by the Centers for Disease Control and Prevention (CDC) to deliver patient treatment water that is at least as pure as drinking water. Dental units are now routinely manufactured with anti-retraction devices that are designed to control oral fluids from being aspirated into the lines during treatment and many units have water systems that isolate source water from municipal water supply. The dental industry has also produced an array of devices and cleaning/disinfectant products to further facilitate the use of clean patient treatment water.

Imaging modalities to access bony tumors and hyperplasic reactions of the temporomandibular joint.

Benign and malignant tumors in the temporomandibular joint (TMJ) are rare. However, when a patient presents with clinical findings such as altered occlusion or facial asymmetry, a morphologic alteration in the condyle should be ruled out. The differential diagnosis for benign hyperplastic bony lesions in the TMJ should include condylar hyperplasia, osteochondroma, osteoma, chondroma, and osteoblastoma.

Urinary fluoride levels in Jamaican children in 2008, after 21 years of salt fluoridation.

Rationale: In 1984, the DMFT12 in Jamaican children was 6.7 (very severe). In 1987, national salt fluoridation was implemented (250 mg F-/kg salt).

Competing roles of TGFbeta and Nma/BAMBI in odontoblasts.

Nma/BAMBI is a novel pseudoreceptor with homology to a TGFbeta type I receptor that lacks a serine/threonine kinase domain. Nma/BAMBI functions as a dominant-negative protein that regulates reciprocal epithelial-mesenchymal interactions during organogenesis. Therefore, we hypothesized that Nma/BAMBI regulates TGFbeta signaling and downstream gene expression during dentinogenesis.

Antimicrobial efficacy of soap and water hand washing versus an alcohol-based hand cleanser.

The emergence of alcohol-based hand cleansers may represent an alternative to soap and water in the clinical dental setting. In this study, the antimicrobial efficacy of traditional hand washing vs. a unique alcohol-based hand cleanser with persistence was evaluated.

HIV: medical milestones and clinical challenges.

Since its discovery in the 1980s, HIV has infected every continent on the globe by crossing socioeconomic, racial, ethnic, and gender barriers, and it continues to contribute to human morbidity and mortality. Advances in medicine and technology have led to new combination medications for HIV-positive patients, early HIV testing methodologies, and potential for an HIV vaccine, and they have given researchers and clinicians a larger armamentarium with which to treat and prevent the disease. Even with these vast improvements in HIV prevention, detection, and treatment, scientists have been unsuccessful in developing its vaccine.

Clinical evaluation of brushing time and plaque removal potential of two manual toothbrushes.

Aim: To compare plaque removal efficacy of Oral-B CrossAction (CA) used for 1 min with an American Dental Association (ADA) manual toothbrush used for 2 or 5 min in an examiner-blind, three-treatment, six-period crossover study.

Materials And Methods: After refraining from all oral hygiene procedures for 23-25 h, subjects were randomly assigned to one of nine possible six-period (visit) treatment sequences. Plaque was assessed at baseline (Rustogi Modified Navy Plaque Index).

The effect of ultrasound on bone dimensional changes following extraction: a pilot study.

Background: Because of bone resorption following tooth extraction, preservation of adequate bony dimension is performed often for subsequent treatment with dental implants. This study evaluated a novel, non-invasive treatment using ultrasound to accelerate healing following extraction to minimize alveolar bone loss. The objective of this study was to evaluate the effect of ultrasound on the dimensional healing changes of alveolar bone following tooth extraction using cone-beam volumetric tomography (CBVT).

Plaque-removal efficacy of four types of dental floss.

Background: Effective plaque removal is essential for gingival health, and dental floss is used to augment plaque removal achieved with a toothbrush.

Methods: This randomized, controlled, examiner-masked, five-period crossover study examined plaque removal in 25 subjects following single use with an American Dental Association reference manual toothbrush alone and in combination with four floss products: three traditional (unwaxed, woven, and shred-resistant) and one powered flosser. Plaque was scored before and after brushing for 1 minute.

Does faculty development enhance teaching effectiveness?

Academic dentists and members of the practice community have been hearing, for more than a decade, that our educational system is in trouble and that the profession has lost its vision and may be wavering in the achievement of its goals. A core of consistently recommended reforms has framed the discussion of future directions for dental education, but as yet, most schools report little movement toward implementation of these reforms in spite of persistent advocacy. Provision of faculty development related to teaching and assessment strategies is widely perceived to be the essential ingredient in efforts to introduce new curricular approaches and modify the educational environment in academic dentistry.

Phonetics and tongue position to improve mandibular denture retention: a clinical report.

The fabrication, use, and wear instructions for complete dentures are often the factors determining success. The dentist must help guide the mental attitude of the skeptical patient to foster acceptance and success of complete dentures. A "feeling of looseness" may be a condition experienced while patients learn to wear a new mandibular complete denture.

Risk stratification and dental management of patients with adrenal dysfunction.

Intrinsic and extrinsic physiological stressors (physical, metabolic, or psychological) are constantly challenging the body's homeostatic mechanisms. Regardless of their nature, the body will initiate a series of autonomic responses in an effort to maintain homeostasis. For example, to cope with a perceived threat, cardiac output and respiration are increased, the availability of glucose is increased, and blood flow to the heart, brain, and muscles is increased.

The patient with actinic cheilosis.

Recent research has greatly enhanced the understanding of the etiopathogenic pathways underlying squamous cell carcinoma (SCC) of the skin. The predominant etiologic agent is ultraviolet radiation. Excessive exposure to sunlight may lead to the development of sunburn, premature aging of the skin, cataracts, immune suppression, and skin cancer.

A review of premalignant oral conditions.

The value of mass oral cancer screenings has come under scrutiny, as a consequence of a lack of improvement in the long-term outcomes associated with oral carcinoma over the past several decades. However, it is generally accepted that most oral carcinomas are preceded by visible changes to the mucosa and certain high risk lesions have been identified. The responsibility to evaluate the mucosal tissues of the oral cavity clearly falls under the purview of the dentist.

Clinical trial evaluating two peroxide whitening strips used by teenagers.

Double-blind clinical research was conducted to compare the clinical response of a thin, concentrated peroxide whitening strip (relative to a marketed control) among a teenage population with preceding safety and efficacy data. Informed consent and child assent was obtained from 48 teens, 13-17 years of age. After baseline measurements were taken, subjects were divded randomly into two groups, one using a thin 10% hydrogen peroxide whitening strip, the other using a 6.