Primary dental journal最新文献

The burgeoning public interest in techniques to enhance a smile has led to demand on clinicians that require important steps in the pre-treatment approval process. Digital dentistry provides a new level of planning and visualisation, improving clinical risk assessment and patient engagement. Dentists must acquire a sound understanding of aesthetic design parameters, including physiologic limitations, and must match patient expectations with clinical reality. Digital design offers flexibility not obtainable with the conventional analogue wax up. Multiple versions of a design can be viewed in a 2D or 3D simulation and accommodated efficiently in CAD software, with 3D printed models generated from each design. The ability to use a test drive or mock-up based on a 3D digital analysis and design, has created a new standard of care for treatment planning, providing an accurate and reversible preview before any definitive dentistry is done. It also places the responsibility for understanding biologic limitations of care on the general dentist, with the risk that digital planning may over-promise if not matched with underlying hard and soft tissue conditions. It improves interdisciplinary and laboratory communication and increases the predictability of the proposed treatment. The result is greater patient satisfaction and an improved informed consent process.

The ideal smile is one where there is harmony between the 'white' (tooth) and 'pink' (periodontal) aesthetics. The developments in the field of periodontology have enhanced aesthetic outcomes when managing excessive gingival exposure in a 'gummy' smile or excessive tooth exposure in gingival recession cases. This paper aims to outline the aetiology, classification, and management of both a 'gummy' smile and gingival recession, putting a spotlight on aesthetics.

Dental therapists have a vital role to play in the provision of dentistry in the UK. This article examines the role of dental therapists in carrying out aesthetic dentistry in the UK dental practice setting. Patient access through collaborative working, especially through a shared care model, referral, and direct access will be discussed. In addition, two clinical cases are presented to demonstrate the provision of aesthetic anterior dental restorations by dental therapists.

The aim of this article is to describe a method for correcting bone deficiencies which may compromise aesthetic, functional or oral hygiene maintenance of implant supported restorations. The generic causes of these deficiencies are mentioned. The use of autogenous block bone grafts is described alongside methods for managing the hard and soft tissues at both the recipient and donor sites. The biomechanical advantage conferred with the use of grafts in reducing the crown:implant ratio is emphasised. The sources of intraoral bone grafts are identified and the risks of damage to adjacent anatomical structures and their avoidance are addressed.The principles of healing are briefly described with an emphasis on the increasing predictability of contact healing, as opposed to gap healing.The impact and inherent risks associated with the supplementary use of membranes for containment is also addressed.Clinical cases have been used to illustrate procedures and outcomes. Previously published data is referenced.

Many "anti-something" medications, which are prescribed by medical doctors for older patients, often for dubious reasons, result in a serious reduction in the quantity and quality of saliva. That drug-induced xerostomia can produce dangerous dental decay, particularly in already compromised dentitions.This article suggests that doctors should undertake a personalised "benefits, risks, alternatives, nothing" (BRAN) analysis including an assessment of the possible dental decay risks, especially before prescribing combinations of "anti-" drugs for marginal conditions.Doctors should consider carefully if alternative approaches are feasible which could produce acceptable outcomes without incurring those serious dental decay risks. Alternative approaches may include patients altering their diet and lifestyle to include more physical exercise for controlling conditions such as marginal hypertension, for example, or perhaps prescribing counselling/talking therapies for depression or anxiety.If various "anti-" drugs really do have to be prescribed, this article describes cheap, pragmatic, and effective ways of mitigating the risks of already compromised dentitions developing new decay.

The success of Local Safety Standards for Invasive Procedures (LocSSIPs) in preventing wrong tooth extraction and other patient safety incidents is based on sustained staff compliance from the outset, ahead of implementation. This paper (the second of two on the topic of LocSSIPs) aims to equip primary care dental practitioners with key practical solutions to implement LocSSIPs successfully and sustainably, and the leadership knowledge to create a long-term, safe, patient-centred and just service.