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

Myofascial pain, a prevalent condition that often involves trigger points in the craniofacial region, can significantly impair function and quality of life. This article reports on the case of a 69-year-old patient with chronic head and neck myofascial pain and limited mouth opening, which hindered dental care and obstructive sleep apnea management. Following a series of trigger point injections (TPIs), combined with pharmacologic and physical therapy, the patient experienced substantial symptom relief and improved jaw function, and was subsequently able to receive successful dental and sleep apnea treatment. The case underscores the importance of accurate diagnosis and multidisciplinary management of myofascial pain, highlighting TPI therapy as an effective, minimally invasive treatment within a multimodal care approach.

The increasing demand for esthetic restorations has driven advancements in adhesive dentistry, with rubber dam isolation emerging as a cornerstone for achieving long-lasting and predictable outcomes. While the benefits of the use of optical magnification when utilizing rubber dam have only been briefly described in previous literature, this article's main focus is on microscopically guided rubber dam integration (MGRI), a treatment protocol that highlights the precision of a dental operating microscope (DOM) during application of rubber dam isolation. By leveraging high magnification along with aligned illumination of the DOM, MGRI addresses challenges that clinicians commonly encounter during isolation procedures, thus enhancing accuracy, efficiency, and patient safety. The protocol emphasizes a step-by-step approach from clamp selection, clamp setting, soft-tissue coverage, and marginal inversion, to rubber dam removal, supported by four-handed dentistry for optimal execution. This minimally invasive method demonstrates how integration of the DOM can significantly elevate the standards of rubber dam application in restorative and esthetic dentistry.

Antibacterial mouthwashes are an effective method for reducing plaque and gingivitis when used regularly as part of an oral hygiene regimen that includes brushing and flossing. However, mouthwashes formulated with high ethanol content can be associated with a burning sensation that typically leads to lack of compliance. Alcohol-free, antibacterial mouthwash may be an effective alternative for antiplaque and antigingivitis treatment without the burn.

Retrograde peri-implantitis (RPI) is characterized by atypical and often progressive bone loss at the periapex of a dental implant. Although RPI reportedly has a lower prevalence than marginal peri-implantitis, if left untreated it can lead to loss of dental implants. In this clinical case series, two patients with different presentations of RPI were treated with guided bone regeneration (GBR) using bone graft and collagen membrane. Longterm follow-up showed clinical and radiographic improvements that resulted in radiographic bone fill and reduced probing depths around implants. Observations reported herein suggest that GBR in defects caused by RPI is an effective treatment option.

Purpose: The aim of this retrospective pilot study was to use digital implant planning to assess radiographic outcomes of maxillary sinus augmentation bone grafting procedures (ideal, excess, or insufficient) in reference to the planned implant.

Materials and methods: After ethical approval was received, deidentified data for subjects treated for a maxillary sinus elevation procedure was extracted. Patient-specific variables (age group, gender, race, smoking, diabetes, and cardiovascular disease) and site-specific variables (type of bone graft, type of membrane, membrane perforation, and other complications) were collected, as recorded in the electronic health records. For the records that satisfied the inclusion criteria, preoperative and postoperative cone-beam computed tomography scans for lateral sinus augmentation procedures were retrieved, superimposed, and imported into the implant planning software. An ideal implant was planned digitally in a cross-sectional view by an expert in prosthodontics (KV). The implant measurements in apicocoronal (AC) and buccopalatal (BP) dimensions were kept standard for all cases and were confirmed by two previously calibrated co-investigators (GS, ID). Statistical analysis involved descriptive and bivariate analysis.

Results: A total of 350 electronic health records were reviewed and 26 were included. Descriptive analysis revealed that in the AC dimension, 40.63% of procedures resulted in insufficient amount of bone graft and 37.50% of procedures resulted in excess bone graft; 21.88% of procedures had ideal amount of bone graft in the AC dimension. For the BP dimension, 81.25% of procedures resulted in ideal and 18.75% in insufficient amounts of bone graft.

Conclusion: This study revealed that a limited number of maxillary sinus procedures resulted in ideal bone grafting in both the AC and BP dimensions when considering predetermined restorative guidelines for the final implant position. An excess and/or insufficient amount of bone grafting in at least one dimension resulted most of the times. With the use of technology and an interdisciplinary team of experts, future studies should aim to quantify the amount of bone graft needed for an ideal maxillary sinus elevation for upcoming implant placement.

This case report describes the use of a single resorbable biomaterial composite comprised of bovine collagen and bioactive calcium apatite in a combined complex defect highlighting oral tissue regeneration. Following standard-of-care procedures, a 68-year-old patient was treated in a private practice setting with the same biomaterial for two different therapeutic indications: alveolar ridge preservation in the edentulous site of tooth No. 12 and guided tissue regeneration on the mesial surface of tooth No. 13. No other biomaterials were used in the management of the combined complex defect. Healing was uneventful, and the patient was satisfied with the final treatment. The edentulous space No. 12 was treated further with a screw-retained implant-supported restoration. At the 16-month follow-up, clinical evaluation revealed preserved ridge volume and stable keratinized soft tissue. Radiographic analysis confirmed stable bone levels for implant No. 12 and positive radiographic changes of oral regeneration on the mesial of tooth No. 13, including the re-establishment of the periodontal ligament. Within the limitations of this case report, the biomaterial demonstrated efficacy, clinical manageability, and cost effectiveness as a single-modality approach, reducing the need for additional interventions.

The long-term success of dental implants depends not only on osseointegration but also on the maintenance of healthy peri-implant soft tissue. This article addresses the importance of keratinized mucosa width (KMW) and mucosal thickness (MT) in supporting peri-implant health and esthetic outcomes. Diagnostic methods for evaluating KMW and MT are outlined with clinical indications for enhancing deficient soft tissues using autogenous grafts or biomaterials such as acellular dermal matrices and collagen matrices. Clinical cases are provided that highlight the optimal timing for soft-tissue management, whether prior to implant placement, during implant placement, or at second-stage healing abutment placement, to assess outcomes.

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.