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

The Philips® Sonicare® Power Flosser (PSPF) is highly effective in reducing gum disease. Next to effective supragingival cleaning, this may be partially driven by subgingival cleaning. This in vitro study aimed to assess the effectiveness of the PSPF in removing biofilm from a model periodontal pocket up to 6 mm deep and to investigate the taxonomic composition of biofilm regrown after use of the PSPF.

The objective of this study was to evaluate the effect of different interdental oral cleaning modalities on gingivitis and plaque following a 6-week period of home use. This was a randomized, four-arm, parallel design clinical trial. Study subjects were manual toothbrush (MTB) users with moderate to severe gingivitis, aged 18 to 65 years. Subjects were required at baseline to have a gingival bleeding score of ≥1 on at least 50 gingival sites per the Gingival Bleeding Index (GBI) and to have an overall plaque score of ≥0.6 per the Rustogi Modified Navy Plaque Index (RMNPI) following a 3- to 6-hour plaque accumulation period. Subjects were randomly assigned to use one of four oral care cleaning modalities: (1) NON group: MTB alone, (2) FLS group: MTB plus string floss, (3) IDB group: MTB plus an interdental brush, or (4) CPF group: MTB plus the Philips® Sonicare® Cordless Power Flosser with the Quad Stream nozzle. Efficacy measures (Modified Gingival Index [MGI], GBI, and RMNPI) and safety were assessed at baseline, 2 weeks, and 6 weeks. The primary efficacy endpoint was the reduction in gingival inflammation from baseline to week 6 as measured by the MGI. Of the 372 subjects randomized in the study, 364 completed a post-baseline MGI evaluation and were included in the analyses. The adjusted mean percent reduction in gingival inflammation from baseline to week 6 was -2.10% for the NON group, 2.82% for the FLS group, 2.60% for the IDB group, and 29.10% for the CPF group. Pairwise comparisons indicated that the CPF group was statistically significantly different from the NON, FLS, and IDB groups (.0001). In conclusion, adjunctive use of the Philips Sonicare Cordless Power Flosser with the Quad Stream nozzle and an MTB showed statistically better results in term of reducing gingival inflammation following 6 weeks of home use when compared to an MTB alone, an MTB used with string floss, and an MTB used with an interdental brush.

The study objective was to evaluate the effect of different interdental oral cleaning modalities on gingivitis and plaque following a 6-week period of home use. This was a randomized, parallel, examiner-blinded study. Study subjects were routine manual toothbrush (MTB) users with moderate to severe gingivitis, aged 18 to 65 years. Subjects were required to have a gingival bleeding score of ≥1 on at least 50 gingival sites per the Gingival Bleeding Index (GBI) and to have a minimum average plaque score of ≥0.6 per the Rustogi Modified Navy Plaque Index (RMNPI) following a 3- to 6-hour plaque accumulation period. Subjects were randomly assigned to one of four groups based on the oral care cleaning modality: (1) NON group: MTB alone, (2) FLS group: MTB plus string floss, (3) MPF group: MTB plus a Philips® Sonicare® Power Flosser with the Quad Stream nozzle, or (4) PPF group: Philips Sonicare power toothbrush plus the power flosser. Safety and efficacy measures (Modified Gingival Index [MGI], GBI, and RMNPI) were assessed at baseline, 2 weeks, and 6 weeks. The primary efficacy endpoint was the reduction in gingival inflammation from baseline to week 6 as measured by the MGI. A total of 260 subjects were randomized and 256 subjects completed the study. The adjusted mean percent reduction in gingival inflammation from baseline to week 6 was 14.90% for the NON group, 13.16% for the FLS group, 33.51% for the MPF group, and 49.30% for the PPF group. Pairwise comparisons indicated that both the PPF and MPF groups were statistically significantly different from both the NON and FLS groups. In conclusion, use of either the Philips Sonicare power toothbrush with the Philips Sonicare Power Flosser or an MTB with the Philips Sonicare Power Flosser was statistically superior to an MTB alone and an MTB used with string floss in reducing gingival inflammation following 6 weeks of home use.

At its core, endodontics is a specialty centered on saving patients' teeth. Nonsurgical root canal therapy and nonsurgical retreatment, arguably the "bread and butter" of endodontics, not only facilitate the preservation of the natural dentition, but in many cases, alleviate pain. Most patients arrive for endodontic treatment expecting symptom relief. A small percentage of these patients, however, experience just the opposite. Within 48 to 72 hours, these select patients experience worsening symptoms, including swelling and pain, and may wonder what mishaps may have occurred during their treatment. These symptom exacerbations are referred to as endodontic flare-ups and are well-documented in the literature. In most cases their occurrence does not reflect a lack of practitioner judgment or skill, but rather a biologic event resulting from a shift in the delicate balance of the bacterial communities and inflammatory events at the periapex. This article reviews the pathophysiology and treatment of endodontic flare-ups, thereby informing patient communication strategies surrounding these events, to preserve both the teeth in question as well as patient relationships.

Guided bone regeneration (GBR) requires a stable graft-membrane complex. This article presents a novel technique that uses membrane fixation screws to serve as anchors for membrane stabilization sutures without the need for periosteal dissection and biting of the buccoapical periosteum. This technique may be a viable alternative when there is a preference to avoid the complexities of periosteal suturing and direct membrane fixation using tacks or screws. The technique, which utilizes anchoring screws as mooring lines, can be used at the time of tooth extraction as well as for ridge augmentation of an edentulous site in preparation for future dental implant placement. Two case reports are presented that illustrate the feasibility of the technique, in which the integrity and stability of a resorbable membrane is preserved prior to final closure, suggesting that screws used as anchors for stabilization sutures might be a predictable option when addressing challenging horizontal defects requiring GBR.

Because of the nature and positioning of their work, dental professionals are at a relatively high risk for musculoskeletal disorders (MSDs) and shoulder injuries. The most common injuries occur in the neck, back (spine), shoulders, elbows, and hands. Poor posture and fatigue are the most significant causes of MSDs. Poor posture, repetitive motions, and working in awkward positions cause MSDs and shoulder injuries in dental professionals. The use of ergonomic supports can be effective in preventing MSDs and shoulder injuries. Choosing and implementing ergonomic tools, such as an appropriate chair, magnifying devices for improved visualization, and specific ergonomic equipment, can help avoid physical stress and injuries.

Advancements in the field of implantology have made dental implants a mainstay treatment for both fully and partially edentulous patients. As a result, practitioners need to be able to identify clinical signs of peri-implant disease in its early stages and provide patients with reliable treatment options. The objective of this article is to provide a differential diagnosis of peri-implant lesions, outlining the clinical, radiographic, and histopathologic features of similar benign and malignant conditions. Additionally, two case studies are presented that showcase lesions that mimic peri-implantitis, providing practitioners with practical examples of how to apply the discussed features in a clinical setting. Lesions described in the differential diagnosis include physiologic bone loss, implant fracture, loosened abutments, pyogenic granuloma, peripheral giant cell granuloma, peripheral ossifying fibroma, squamous cell carcinoma, and metastasis extending to the oral cavity.

Swallowed or aspirated dentures may result in serious systemic complications and require multidisciplinary attention or intervention. With an increasing number of edentulous elderly patients, such situations are not uncommon occurrences in everyday dentistry. In fact, dentures are the most ingested foreign body in the elderly patient population, and this is a particular risk if the dentures are lacking in stability. The present case report discusses the swallowing of an overdenture by a 95-year-old patient, who underwent endoscopic removal of the foreign body. The aim of this article is to highlight the risks of prosthetic restoration in older patients and the importance of thorough, scrupulous follow-up.

Besides meticulous application of proper bonding protocols and clinical technique, the clinical success of direct resin-based restorations is dependent on the selection of the appropriate restorative material, curing light, and, whenever certain contours of the tooth need to be rebuilt, matrix band system. All of these aspects have seen significant developments and improvements over the years, all geared toward increased clinical success and longevity. Highlighting some of these key developments, this article provides an update on resin-based composites, curing lights, and matrix bands.

Articifial intelligence (AI) is impacting many aspects of people's lives today. In fields such as finance, manufacturing, agriculture, insurance, education, and healthcare, AI has been commissioned to cut costs, increase efficiency, and improve accuracy. Like many innovations, the use of AI can have both positive and potentially negative consequences. As an example, if used in dentistry to detect interproximal carious lesions, AI technology does not have the ability (at least not yet) to recognize the individual uniqueness of each patient. For instance, some patients are highly caries prone and may be best served by prophylactic intervention of even small borderline lesions, while other patients are very caries resistant and may simply require the monitoring of suspected carious lesions.