Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995)最新文献

Background: The success of dental implant treatment is influenced not only by technical factors but also by patient behavior. Despite its critical role, behavioral assessment remains underutilized due to a lack of standardized tools. Patient-reported outcome measures (PROMs) offer potential for screening prior to implant therapy but are often overlooked in clinical practice. The objective of this study was to synthesize current research on behavioral psychology in dental implant treatment and apply findings to daily practice through a case-based approach.

Methods: A PubMed search strategy used keywords related to "implant therapy" and "behavioral psychology." Articles were screened by title and abstract, with full-text review as needed. Additionally, a retrospective case series was conducted at a periodontal office, examining five implant patients categorized by dominant personality traits using the five-factor model (openness, conscientiousness, extraversion, agreeableness, neuroticism).

Results: The search yielded 564 articles, with 24 included in the final analysis. Studies highlighted key self-reported factors affecting outcomes, such as patient expectations, perceptions, attitudes, anxiety, and personality traits. Likert scale surveys emerged as promising tools for assessing these factors. The present case series further illustrated the impact of personality traits on treatment experiences.

Conclusions: Although patient behavior significantly impacts implant outcomes, limited awareness and inconsistent use of behavioral analysis tools remain challenges that need to be overcome. Standardizing behavioral assessments could enhance provider communication, improve pretreatment screening, and ultimately optimize patient care and treatment success.

This case details a single-arch rehabilitation incorporating digital tools and traditional methods. The systematic approach taken was aimed at balancing functional, esthetic, and financial concerns of the 45-year-old patient, who presented with severely damaged dentition and occlusal issues. Digital scans with intraoral mock-ups enhanced communication with the dental laboratory. A second set of provisionals was also incorporated into the workflow to refine the restoration. The final outcome provided the patient with a beautifully restored dentition that accommodated his treatment preference without increasing periodontal, functional, biomechanical, or periodontal risks.

One type of traumatic injury to which young people especially are vulnerable is tooth avulsion, which may occur as a result of sports activities, automobile accidents, or other mishaps. This article describes a case of a 17-year-old female who suffered an avulsion of her maxillary right central incisor due to an incident in which she fell out of a motor vehicle and onto the pavement. The tooth was recovered by friends, who transported her and the avulsed tooth to a local emergency room. One of the patient's friends achieved replantation of the tooth later that night after leaving the emergency room, and the following morning, at the originating author's dental office, a fixed splint was applied facially from tooth No. 6 to tooth No. 11. After various endodontic treatments and careful follow-up, 10 years after the trauma occurred the patient showed no signs or symptoms of failure. Additionally, root resorption that was observed at 7 years post-replantation had not progressed at the 10-year recall appointment. This case demonstrates that although delayed replantation usually has an unfavorable prognosis, every effort should be made to maintain the natural tooth in place whenever possible.

The restoration of anterior dental implants involves the use of either cement- or screw-retained crowns. While both of these options offer good functionality and long-term stability, the dark color of titanium implant abutments can pose esthetic challenges. One method to mitigate esthetic limitations due to titanium show-through is to anodize the abutment and thereby modify its color to more closely match the ceramic crown and/or soft tissue. Gold anodization improves the color match of overlying ceramics, while pink anodization better masks titanium beneath soft tissue. This study compared the color of zirconia and lithium-disilicate specimens at varying thicknesses against different shades of titanium to a reference of dentin shade composite. The aim of the investigation was twofold: to assess whether the hue of titanium affected the final color of either ceramic material, and to determine what thickness of each ceramic over different hues of titanium would allow adequate color match with the same ceramic over dentin. The article discusses the process to anodize titanium abutments and concludes that selective anodization offers a practical method for balancing esthetics and structural integrity in anterior implant restorations.

The increasing demand for efficient, precise, and patient-centered care in prosthodontics has driven the development of microscope-guided dentistry and digital workflows that streamline the restoration process. This article presents the microscopic and digital one-day-dentistry technique, a clinical approach that integrates the use of a dental operative microscope into a chairside digital workflow for single-unit prosthetic restorations. The technique aims to maximize precision and consistency throughout each step of the restorative process, from tooth preparation to final restoration delivery, while eliminating the need for provisionalization. By fostering collaboration between the clinician and in-house technician, this contemporary approach enables high-quality preparation and marginal adaptation to bolster both short-term and long-term restoration success. Utilizing this technique, multiple appointments are eliminated thereby increasing efficiency, and occlusion and marginal fit are preserved, reducing the risk of occlusal discrepancies. The workflow enables highly predictable, time-efficient, same-day single-tooth restorations with maximum accuracy to help ensure patient satisfaction.

Immediate implant placement is a commonly utilized treatment in the maxillary anterior when a natural tooth fails. This method of treatment can pose challenges related to the available anatomy and adjacent teeth when placing the implant in an extraction socket. Virtual planning and the use of a surgical guide allows for implant placement in a more ideal position relative to the contour of the facial plate so as to avoid dehiscence of the implant at placement and enable prosthetic considerations to be followed for the planned restoration. The case illustrated in this article highlights a simplified approach to immediate implant placement and its restoration for a failing maxillary single anterior tooth.

Due to better healthcare, society appears to be headed toward what could be called a "gray tsunami" of patients. In many areas of the country the number of patients is starting to exceed the capacity of the dental industry. While this is a considerable concern in and of itself, perhaps the bigger problem is that as these numbers continue to increase, a growing number of patients will lack mobility and will need to be seen outside the traditional dental office setting.

In this retrospective clinical study, 32 oral implants were placed subcrestally in 30 patients who were followed from 1 to 3 years to identify the effect of platform bone switch implants on cervical bone preservation and associated soft-tissue profile. Peri-implant bone, including subpapillary bone and marginal gingival bone, as measured from the implant-abutment junction, was evaluated quantitatively. Preliminary findings indicate that the platform bone switch implants used in this study, compared to conventional straight-wall implants, appear to preserve additional bone at or above the implant-abutment junction to help support papillae and marginal gingiva and maintain coverage of the implant body, with most bone levels shown to be above the implant-abutment junction.

Periodontal phenotype refers to the physical expression of the periodontium, including thickness of the gingiva and alveolar bone, as determined by genetic and environmental factors. Gingival recession is significantly more prevalent in individuals with a thin periodontal phenotype, which suggests that a thick periodontal phenotype is more resistant to gingival recession than a thin one. Most patients with untreated gingival recession have progression, even with good oral hygiene. Periodontal phenotype also has an important role in the outcomes of periodontitis, restorative, implant, and orthodontic treatments, with a thicker phenotype offering advantages for all treatment modalities. Practitioners can perform periodontal phenotype modification to enhance outcomes for patients with naturally thin phenotype to enable them to reap the benefits of a thick periodontal phenotype. The evaluation of periodontal phenotype should be a routine part of dental assessment to allow oral healthcare professionals to determine if phenotype augmentation would benefit a patient's long-term oral health outcome. This article focuses on techniques to classify periodontal phenotype and the indications for phenotype modification.

The dental profession has evolved rapidly in recent years-from digital imaging and CAD/CAM restorations to the integration of artificial intelligence (AI) in diagnostics and treatment planning. Understandably, many dentists wonder whether AI could soon render years of education, experience, and skill obsolete. The good news? You don't need to fear redundancy-at least not yet. Here's why.