Dentistry

Long-term success of distraction osteogenesis depends on the ability of the surrounding soft tissues to tolerate distraction forces and to adapt to the resulting increase in skeletal length and volume. The hypothesis tested in this study was that mandibular elongation by distraction induces myocyte proliferation. Unilateral mandibular angle osteotomies were performed in 16 Yucatan minipigs. The hemimandibles were lengthened using semiburied distraction devices (Synthes Maxillofacial, Paoli, PA) with 0-day latency, 1, 2, or 4 mm/d distraction rates, and a neutral fixation period of twice the gap size in days. In 2 additional animals, the dissection and osteotomies were performed, and distraction devices were placed without activation (sham control). At the end of neutral fixation, tissues were taken from masseter muscle overlying the osteotomy and the equivalent region on the unoperated side (contralateral control). Proliferation of myocytes was estimated using immunohistochemical localization with antibodies against proliferating cell nuclear antigen (PCNA). Muscle overlying the distracted mandible showed 6-fold more PCNA-positive myocytes (16.8% +/- 11.3%) than the contralateral control side (2.8% +/- 1.1%, P < .0001). In the 2 sham-control animals, there was a low index of PCNA-positive myocytes on both the osteotomy (2%, 5%) and the contralateral sides (1%, 2%). The results of this study suggest that distraction of the porcine mandible by the protocol described induces myocyte proliferation in the masseter muscle. A proliferative response may contribute to improved long-term stability of mandibular expansion by distraction osteogenesis.

Excavations at the Gebel Ramlah cemetery, in Upper Egypt’s Western Desert, have provided numerous data concerning mortuary practices of the local Final Neolithic period populace. Previous articles have chronicled treatment of disturbed inhumations, in which great care had been taken to recover and rebury all grave goods and skeletal elements including, most notably, dental remains. In several cases, the Neolithic gravediggers apparently went so far as to reinsert, or to in other ways reincorporate, teeth that had fallen from their alveoli during handling. This report describes and interprets a new find, i.e., an anatomically accurate, life-size shell carving of a human incisor, that provides additional insight into the apparent importance of teeth to these desert people.

The objective of implementing newer techniques in dentistry is to overcome the shortcomings of traditional ones. Dentistry, being a dynamic field, is always on the lookout for innovative techniques, and embracing newer technology has indeed improved patient care in many ways. Lasersare being used as an adjunct or alternative tool to conventional dental procedures. Many dental disciplines such as oral surgery, oral medicine, periodontics, paediatric dentistry, implantology, and operative dentistry have benefitted from the use of laser technology. Lasers have become an invaluable tool in many procedures, including caries removal, caries decontamination, caries prevention, cavity preparation, soft tissue surgeries, root canal decontamination, analgesic and anti-inflammatory effects, to name a few. Laser treatment in dentistry can be quicker and more efficient. Other benefits would include markedly less pain, lack of bleeding, minimal need of anaesthesia and reduced postoperative discomfort. Also, patients may be able to resume
their daily activities shortly after the treatment is rendered, owing to faster healing. However, the caveat would be that adequate training is a mandatory prerequisite before handling patients with these powerful instruments.

Self-assessment is an integral component of learning and developing decision making and critical thinking skills in the practice of dental hygiene. Dental hygienists must think critically and develop problem-solving strategies during their formal education to ensure lifelong quality and ongoing development of their personal knowledge and skill as related to providing comprehensive, evidence-based patient care. The primary focus of this qualitative investigation was to obtain undergraduate dental hygiene students' perceptions of and experiences with self-assessment. The sample consisted of an intact undergraduate dental hygiene class of seventeen students in their final semester of a two-year, entry-level dental hygiene program at a community college in the southeast United States. Data for this research were obtained from three sources: 1) a program-designed self-assessment survey assignment, 2) in-depth interviews with four second-year dental hygiene students, and 3) program-de...

AIM: To present a case that emphasizes the importance of the use of intentional replantation as a technique to successfully treat a periapical lesion and an odontogenic maxillary sinusitis through the alveolus at the same time. SUMMARY: This case report presents a patient with odontogenic maxillary sinusitis secondary to periapical disease of a maxillary molar that had previously received root canal treatment. The molar was extracted, with drainage and rinsing of the maxillary sinus. The apices were resected extra-orally, the retrograde cavities prepared with ultrasound and retrograde fillings of silver amalgam placed. The tooth was then replanted. After 2 years, the patient was asymptomatic, periapical radiography showed no evidence of root resorption and computed tomography scanning demonstrated the resolution of maxillary sinusitis. Key learning points: *When root canal treatment or periapical surgery cannot be undertaken or has failed, intentional replantation may be considered....

Halitosis is an unpleasant condition that may be the origin of concern not only for a possible health condition but also for frequent psychological alterations which may lead to social and personal isolation. The most frequent sources of halitosis that exist in the oral cavity include bacterial reservoirs such as the dorsum of the tongue, saliva and periodontal pockets. Volatile sulphur compounds (VSCs) are the prominent elements of oral malodour. Genuine halitosis and pseudo-halitosis should be in the treatment realm of dental practitioners. Clinical Relevance: Halitosis can be a symptom of underlying systemic disease, therefore the exact diagnosis and its source (oral or non-oral) is important in the proper approach to its management.

To study incidence and distribution of deciduous molar ankylosis. study design: longitudinal retrospective study. A total of 512 consecutive subjects (aged 5 to 15 years) were examined at the Orthodontics and Paediatric Dentistry Department of the Genoa University School of Dentistry; for each subject an ortopantomography x-ray was taken. Thirty-four children were affected by deciduous molars ankylosis (6.6%). A statistically significant difference was revealed between the distributions: the lower deciduous molars were ankylosed more frequently than the upper ones (P < 0.001); the second deciduous molars were ankylosed more frequently than the first molars (P < 0.001). No statistical significance was found between sex and number of infraoccluded teeth (P = 0.74). This study found an incidence of deciduous molar ankylosis of about 6.6%; the lower deciduous molars and second deciduous molars were ankylosed more frequently (P < 0.001).

The aim of this study was to evaluate whether the introduction of a device, resulting from the combination of an o'ring attachment with an orthodontic implant (o'ring ortho implant, O'ROI), to affix the surgical template of CAD/CAM-guided implant surgery contribute to minimizing the deviations in the position and inclination of implants at the time of their placement. Ten models simulating bone tissue were fabricated and randomly divided into 2 groups: 5 with the scanning and surgical template of the usual technique, representing the Control Group (C), and 5 with scanning and surgical templates fixed by o'ring ortho implants (O'ROI), representing the Test Group (T). Forty implants measuring 4×11 mm were placed in the groups, using the respective templates. The results were evaluated by the fusion of CT images of the planned and placed implants. The locations and axes were compared. There were no statistically significant differences for the angular (Tukey's t...

Currently, no consensus exists regarding the best adhesion protocol for zirconia used in dentistry; this is important particularly for restorations where mechanical retention is deficient. This systematic review analyzed the adhesion potential of resin-based and glass-ionomer luting cements to zirconia and aimed to highlight the possible dominant factors affecting the bond strength results to this substrate. Original scientific papers on adhesion to zirconia published in the MEDLINE (PubMed) database between 01/01/1995 and 01/06/2011 were included in this systematic review. The following MeSH terms, search terms, and their combinations were used: "Dental bonding", "Zirconium", "Zirconia", "Y-TZP", "Y-TZP ceramic", "Materials Testing/methods", "Test", "Cement", and "Resin bonding". Two reviewers performed screening and data abstraction. Descriptive statistics were performed and the frequencies o...

Using a sample of dental students (N=373) from four Canadian dental schools, this longitudinal study determined whether the new Canadian Dental Association (CDA) structured interview was a predictor of clinical and academic performance. The new interview predicted clinical performance in the third and fourth years of dental school, but not academic performance. The Canadian Dental Aptitude Test (DAT) continued to predict first- and second-year academic performance, but not clinical performance in the senior years. A personality factor, "Conscientiousness," predicted clinical and academic performance to various degrees across the four years of dental school. A second personality factor, "Openness to Experience," predicted third-year academic performance. The results suggest that a combination of scores from the DAT, a valid measure of personality, and a well-designed structured interview will provide the best prediction of those applicants who will do well in both...

This clinical manual details the surgical and prosthetic protocols for clinicians who wish to utilize immediate implant loading in qualified patients. It details the fundamental principles, from patient selection to surgical procedures to the final adjustment of the definitive restoration. In addition, the chapters describe solutions to various challenges, such as when to use screw-retained or cement-retained provisional prostheses, how to prepare the prosthesis chairside, and when to have the prosthesis prepared in the laboratory. Including ample clinical photographs and decision-making flow charts, this comprehensive volume offers readers concrete guidelines for a proven technique that simplifies implant procedures and provides clear benefits to patients.

Aim  To evaluate marginal seal, water sorption, solubility and loss of mass after brushing of several temporary filling materials.Methodology  For marginal seal, Class I cavities, including endodontic access preparations, were made in human molar teeth and restored using one or other of several temporary filling materials (n = 10): zinc oxide/calcium sulphate-based cement (Cavit, 3M,ESPE, St. Paul, MN, USA), zinc oxide/eugenol cement (IRM, Dentsply Caulk, Milford, DE, USA), glass ionomer cement (Vidrion R, SSWhite, Rio de Janeiro, RJ, Brazil) or a dimethacrylate-based filling (Bioplic, Biodinâmica, Londrina, PR, Brazil). Dye penetration was assessed after thermocycling and immersion in 0.5% basic fuchsine solution. For water sorption, solubility and loss of mass analyses, disc-shaped specimens were made. Water sorption and solubility were evaluated by mass alteration after storage in distilled water for 7 days (n = 7). Loss of mass was calculated based on the difference of mass after abrasion with a toothbrush (n = 5), and surfaces were analysed by SEM. Data of water sorption, solubility and loss of mass were submitted to anova and Tukey’s test, and marginal sealing data to Kruskal–Wallis test (P < 0.05).Results  Statistically significant differences were observed for marginal sealing (P < 0.0001), water sorption (P < 0.01), solubility (P < 0.01) and loss of mass (P < 0.05). Bioplic had the best marginal seal. Cavit had the greatest water sorption and solubility. Vidrion R and Bioplic had the lowest solubility. Loss of mass after brushing was higher for Cavit, followed by Bioplic, IRM and Vidrion R. Cavit and Vidrion R were worn aggressively by brushing.Conclusions  The resin-based temporary filling Bioplic produced the best marginal seal, and was associated with the lowest water sorption, solubility and loss of mass.

The management of the interim phase of a complete oral rehabilitation in patients with severely worn dentition is often challenging due to loss of occlusal vertical dimension, loss of tooth structure, uneven wear of teeth creating an uneven plane of occlusion, and para-functional habits. This paper will demonstrate how a clear thermo-forming matrix fabricated from the diagnostic wax-up can be used as a guide to facilitate treatment.

Since 9/11, intelligence has evolved within a changing atmosphere of modern tactics and techniques for information collection. This atmosphere, coupled with massive leaps in technological advancement such as social media, mobile communications, processing analytics, large-form solid-state data storage, novel computational hardware, and software equipment, has thrust intelligence communities around the world into a strange new world of multi-dimensional intelligence. While science and technology and human capability both remain valuable facets of the same overlapping intelligence construct, there is an emerging trend of diametrically opposed camps pushing for one method over the other. This article explains how in terms of field application and intelligence information processing and analysis, both HUMINT and TECHINT could be maximized by the elimination of forced rivalry and by the encouragement of mutual cooperation that is currently lacking.

Unsatisfactory anatomical shape of anterior tooth promotes disharmony in the smile esthetics. The conservative dental esthetic reestablishment treatments has been improved and evaluated with the development of adhesive materials. The adhesive dentistry allowed minimally invasive preparation through direct treatments with composite resin and indirect ceramic laminates veneers. These two treatments methods present advantages and disadvantages. The aim of this manuscript is to describe two clinical reports and compare alternatives to rehabilitate the smile esthetic appearance by direct and indirect minimally invasive treatments. In the first case, a 24-years-old patient, female, complained of unsatisfactory anterior maxillary size and incisal wear. After the functional and esthetic planning, nanoparticle composite resin by free hand technique was indicated to rehabilitation. In the second case, a 24-years-old patient, male, reported dissatisfied with his anterior central incisive shape. On clinical examination, maxillary anterior conoid teeth were verified. Based on this evaluation, a conservative treatment using minimally invasive ceramic veneers in maxillary central and lateral incisor and ceramic fragments on canine was planed to the smile rehabilitation. It can be concluded that conservative treatment using direct composite resin restorations and minimum thickness ceramic veneers laminate, even with their specific limitations and advantages, provide satisfactory esthetic and functional treatment results, preserving the dental structure.

A 26-year-old man with an aggressive periodontitis sought for orthodontic treatment to improve the appearance of his smile. He presented with generalised anterior spacing, missing lower left central incisor and deep traumatic bite. He was treated successfully with a combination of orthodontic and periodontal treatment. After 18 months of orthodontic treatment and follow up by the periodontist, his alignment of teeth was improved, a stable occlusion was achieved, and occlusal trauma was prevented. As a result, the patient's smile appearance and selfconfidence were improved. Orthodontic tooth movement is not only to correct the alignment of his teeth but also to improve the bone level especially at the anterior region. This case report shows the successful treatment outcome in aggressive periodontitis patient which requires good collaboration between the orthodontist and the periodontist.

In case of severe dental erosion, the maxillary anterior teeth are often particularly affected. Restoring such teeth conventionally (ie, crowns) would frequently involve elective endodontic therapy and major additional loss of tooth structure. A novel, minimally invasive approach to restore eroded teeth has been developed and is currently being tested in the form of a prospective clinical trial, termed The Geneva Erosion Study. To avoid crowns, two separate veneers with different paths of insertion have been used to restore the affected anterior maxillary teeth, regardless of clinical crown length and amount of remaining enamel. This treatment is called The Sandwich Approach. The purpose of this case series study was to analyze the mid-term clinical outcome of maxillary anterior teeth affected by severe dental erosion that were restored following the Sandwich Approach. Twelve consecutively consulting patients (mean age: 39.4 years) suffering from advanced dental erosion have been en...

A maxillary midline diastema (MMD) is a common form of incomplete occlusion and often is a primary complaint of patients during dental consultations. MMD is considered to be a multifactorial phenomenon and can therefore be best restored with a multidisciplinary approach. This clinical report presents a multidisciplinary approach to the management of a 4.0-mm MMD by using limited orthodontics combined with periodontal and prosthodontic treatments.

Intentional replantation has been practised for many years as a treatment modality for pulpless teeth. Although the success ratio for intentional replantation is far below that for routine or surgical endodontics, this procedure should be considered an alternative to tooth extraction. A case of mandibular second molars treated with intentional replantation and retrograde fillings is reported in this article. At the eight-year recall visit, radiographs showed no evidence of pathological changes.