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

A comprehensive understanding of the factors that influence treatment outcomes is crucial in endodontic diagnosis and treatment planning. Having knowledge that takes into account dental and patient-related conditions when choosing procedures can help clinicians maximize the prognosis of natural teeth and reduce postoperative complications. That being said, the landscape of outcome studies in endodontics is continually evolving, presenting a challenge for many clinicians trying to stay current with the latest literature. This article reviews factors that influence the outcomes of the following endodontic therapies: primary root canal treatment, nonsurgical retreatment, and surgical retreatment. An emphasis is placed on the importance of considering preoperative and treatment-related factors as prognostic indicators before developing a treatment plan, with the ultimate goal of enhancing tooth durability and ensuring patient satisfaction.

The adoption of vital pulp therapy (VPT) is a significant advancement in preserving the longevity of vital mature pulp. VPT represents a potential alternative approach to nonsurgical root canal therapy in which compromised pulp is treated such that it maintains its vitality and function. With the introduction of novel bioceramic materials, including calcium silicate cements and mineral trioxide aggregate, the prognosis for VPT in mature permanent teeth has greatly increased, and as a result, adaptation of VPT in these teeth has garnered considerable support. This article reviews evidence-based guidance for case selection and procedural methods associated with the adoption of VPT in mature permanent teeth.

Vital pulp therapy (VPT) was once a treatment modality that was only considered for immature permanent teeth to allow for the continued development of the radicular system if the pulp was vital. With the advent of bioceramics and bioactive materials such as calcium silicate cements, the applications for VPT have greatly increased, giving dentists a treatment option other than nonsurgical root canal therapy (RCT) for mature teeth previously diagnosed to have an irreversible pulpitis. This approach can serve as a less invasive, simpler procedure than RCT while allowing for the preservation of natural tooth structure. It also may be a more amenable treatment alternative for patients than RCT. This article outlines and reviews the protocol for VPT with pulp exposure.

The use of cone-beam computed tomography (CBCT) imaging often elicits changes in both diagnostics and treatment plans when incorporated into endodontic workups. In endodontic practice, CBCT scans enable detection of periapical pathology before it is apparent on traditional 2-dimensional intraoral radiographs. The visualization provided by CBCT scans can help clinicians confirm suspected diagnoses, including but not limited to periapical pathology, traumatic tooth displacement, and vertical root fracture. This article discusses the use of CBCT imaging in the field of endodontics with an emphasis on its utilization to identify incidental findings, which can introduce complexities to a diagnosis and yield valuable information to enhance the scope of care for the patient.

Orthodontic treatment (OT) has become a means of improving psychosocial well-being secondarily to enhanced occlusal function and can help patients obtain normal oral physiologic function, coordinated facial profiles, and healthy dentomaxillofacial development. With more adult patients undergoing OT, the need for interdisciplinary treatment and collaboration is vital to ensure periodontal health. This article highlights the importance of combined efforts between periodontics and orthodontics in adult patients with a history of periodontitis who are interested in OT. Furthermore, the article discusses the technological and surgical advances within these specialties, as well as timing of synchronization of treatment. A clinical case demonstrates the results of a collaborative periodontics and orthodontics approach to treat an adult patient with a history of advanced periodontal disease.

Obtaining an accurate assessment of the causes of severe dental destruction is crucial when planning a clinical workflow for full-mouth rehabilitation cases. Some cases that initially appear extremely challenging may be surprisingly straightforward, especially if the patient presents with an acceptable functional occlusion. In the seemingly highly complex case presented, only a Lucia jig was required to obtain a reliable restorative reference point for the full-mouth rehabilitation. Increasing the vertical dimension of occlusion allowed for predictable restoration of function and esthetics. The treatment was completed in phases for patient comfort, and the final outcome provided the patient with regained confidence in his smile and comfort when eating.

As Penn Dental School prepares for its Commission on Dental Accreditation (CODA)-approved dual-certificate periodontics/prosthodontics program, this article looks back at the roots of these specialties at the university via the renowned Periodontics and Periodontal Prosthesis program co-founded byCompendium's founding editor Dr. D. Walter Cohen as seen through the eyes of one of its graduates. The article commends the program's impact on public health today.

Adhesive dentistry is an essential component in the delivery of direct and indirect restorations. Ongoing discussions among scientists and clinicians have focused on whether or not current self-etch and universal adhesives adequately prepare enamel surfaces to achieve optimal bond strengths. To address these concerns, a selective enamel etch technique has been recommended. The definition of a selective enamel etch technique is as its name suggests. The clinician selectively etches the enamel of a cavity preparation by applying phosphoric acid etchant to the enamel surfaces of the preparation while refraining from applying the etchant to the dentin. This article explores the current research to help guide clinicians to achieve ideal outcomes when using dental adhesives. With few exceptions, the current scientific evidence recommends a selective enamel etch technique in conjunction with the clinician's adhesive system of choice.

Stress among dental practitioners is highly prevalent and is an issue that demands attention. Dental practice has been linked to mental, physical, chemical, and biological hazards that often foster high stress levels, anxiety, depression, burnout, and potential suicidal ideation. This can lead to unhealthy coping mechanisms and low quality of life, increasing the risk of chronic disease, mental issues, and lower patient care quality. This article summarizes data on stress in dentistry, highlighting its high prevalence and deleterious consequences. Five primary stress dimensions in general dental practice contribute to stress and burnout: productivity, patient-derived issues, regulations, fear of litigation, and work-related aspects. Reducing stress can decrease the risk of chronic conditions and mental health issues and potentially increase dental professionals' health span and career longevity.

Dental fusion is defined as an abnormality in tooth shape caused by developmental tooth disturbances that produce an intimate union of dental tissues. This case report discusses treatment of a mandibular impacted "double" third molar in a 21-year-old patient that could have been related to either gemination or tooth fusion. Radiological examination allowed for careful analysis of the tooth's shape and root development, relation to the inferior alveolar nerve, and 3-dimensional position. After evaluation of therapeutic options and risks, and with the patient's consent, the authors opted to extract the tooth in question. Such favorable conditions as the incomplete development of the roots and the relatively young age of the patient, combined with the use of an antibiotic and antiseptic prophylaxis as well as a standard surgical approach, enabled a successful result to be achieved with no related complications.