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

A colorless, nonflammable, virtually odorless gas, nitrous oxide is widely used in medicine and dentistry for its anxiolytic, analgesic, and amnesic properties. In the dental setting, it is particularly valuable for its ability to reduce pain perception, alleviate anxiety, and induce a state of conscious sedation while maintaining patient cooperation and protective reflexes. Nitrous oxide exerts its effects rapidly and predictably, making it a versatile tool for managing patients with dental fear, special healthcare needs, or those undergoing lengthy or uncomfortable procedures. Its suggestive properties further enhance its utility by facilitating communication and trust between the patient and healthcare provider, often serving as an adjunct to behavioral management strategies. With its rapid onset and recovery, minimal systemic effects, and excellent safety attributes when administered appropriately, nitrous oxide is deemed one of the safest pharmacological agents for sedation in dental practice. The gas has an extensive history of clinical use, with well-established guidelines for its safe administration. Nevertheless, clinicians must remain vigilant to potential adverse effects, including nausea, diffusion hypoxia, or rare idiosyncratic reactions, and be equipped to manage emergencies should they arise. Proper patient selection, preparation, and monitoring are essential to ensuring effective and safe sedation outcomes. This article provides a comprehensive overview of nitrous oxide sedation, including its pharmacodynamics and pharmacokinetics, indications and contraindications, potential side effects, emergency protocols, and practical guidelines for administration. Clinical considerations relevant to dental practitioners are emphasized, offering an evidence-based approach to integrating nitrous oxide into routine dental care.

This case report highlights the importance of periodic dental examinations in identifying progressive hypercementosis and its rare complication, root concrescence, which can complicate future dental extractions. Hypercementosis may be idiopathic or secondary to either local factors or systemic disorders. However, evolution to concrescence raises questions about future treatment approaches should the involved teeth become nonrestorable and require extraction. This article presents a case of generalized hypercementosis affecting multiple quadrants with progression. The severe hypercementosis led to concrescence of Nos. 25/26 and 29/30 surrounded by one joint lamina dura. Generalized wear was noted on all occlusal and incisal surfaces of dentition with periodontal pocket depths of teeth Nos. 29 and 30 buccally of 3 mm and 2 mm and distally of 3 mm and 4 mm, respectively. Periapical radiographs from full-mouth series x-rays revealed that the roots of both teeth were grossly thickened, bulbous, and blunted. Because of a lack of contributory medical history, the presumptive diagnosis was hypercementosis sequela to occlusal trauma.

This article presents a clinical case of a comprehensive full-mouth rehabilitation in a 26-year-old female patient with an anterior open bite and accompanying mild chronic generalized periodontitis. Contemporary digital methods involving diagnosis, modeling, and restoration fabrication were utilized. The case encompassed the use of CAD software, a Kois deprogrammer, extraction of impacted molars, cut-back technique, and artistic layering of ceramics on a lithium-disilicate framework. Significant improvements were demonstrated in both esthetics and function, with results remaining stable after 1 year of follow-up.

Background: The objective of this randomized controlled trial was the comparison of a stannous fluoride (SnF2) dentifrice stabilized with nitrate and phosphates (test) to a regular fluoride dentifrice (negative control) for the control of plaque and gingivitis over 6 months.

Methods: A total of 80 adult participants were enrolled in this study that was conducted in Loma Linda, California. After randomization and blinding of study personnel and patients, enrolled participants were provided instructions for the use of their assigned dentifrice. At three visits (0, 3, and 6 months), various gingival and plaque indices were collected to determine the clinical efficacy of the SnF2 stabilized dentifrice. These results were compared with the results of the negative control dentifrice.

Results: A total of 77 participants completed the study. The test dentifrice demonstrated statistically significant reductions versus baseline in all plaque and gingivitis indices after 3 and 6 months of product use. The negative control dentifrice demonstrated significant reductions versus baseline in all plaque indices, but not gingivitis indices, after 3 months of product use and in all plaque and gingivitis indices after 6 months of product use, with the exception of the interproximal gingivitis index, which did not reach statistical significance. The test SnF2 dentifrice showed statistically significant reductions in all plaque and gingivitis indices compared to baseline and with the negative control dentifrice (P less than .001) after 3 months and 6 months of product use.

Conclusions: The results of this clinical trial showed statistically significantly improved clinical outcomes for reduction of gingival inflammation and improvement in plaque control over 6 months when using a new SnF2 dentifrice stabilized with nitrate and phosphates as compared to the results from a regular fluoride dentifrice.

Practical implications: This newly formulated SnF2 dentifrice may be of benefit to patients who need help controlling plaque biofilm and in reducing gingivitis, leading to an improvement in overall oral health.

The Alpha Omega International Dental Society represents around 5,000 active dentists and dental students across the United States, Canada, South America, Europe, Israel, South Africa, Australia, and New Zealand, with combined charitable contributions estimated at over $60 million. As the oldest international Jewish dental society in the world, Alpha Omega was founded in Baltimore, Maryland, in 1907, with a mission to combat the widespread anti-Semitism present in educational institutions and the broader dental community. From its inception, philanthropy has been central to its goals.

Plasma cell gingivitis and cheilitis are diagnostic challenges for dental practitioners. To the best of the authors' knowledge, concomitant plasma cell gingivitis and plasma cell cheilitis in the same patient has not been reported in the dental literature, although these conditions have been reported separately (on lips and gingiva) several times. Underreporting of these coexisting clinical conditions may be attributed to a lack of awareness of both conditions and underperformance of comprehensive histopathological examinations. This article describes a case of plasma cell gingivitis with plasma cell cheilitis in a 63-year-old female patient. Histopathology and immunohistochemistry evaluations confirmed the diagnosis. After being informed about her condition and educated about possible allergens, which could be present in certain toothpastes, foods, and other foreign substances, the patient responded well to the stoppage of the use of suspected allergens. Identification and elimination of causative allergens is considered the accepted treatment for these conditions.

Implant-supported hybrid prostheses have become popular solutions when treating patients with terminal dentitions or who are completely edentulous. Since the implementation of osseointegrated dental implants to treat edentulism, multiple prosthetic designs and materials have been used for full-arch fixed hybrid prostheses. While these restorations can be highly successful, the most common restorative failures are attributed to lack of prosthetic space or a framework without passive fit, consequently leading to possible chippings, delamination, and/or fractures. This article reviews the clinical and laboratory steps for fabrication of definitive implant-supported hybrid prostheses with the implementation of bone reduction guides, implant osteotomy guides, and immediate provisionalization using digital manufacturing technologies.

In 1948, the United Nations General Assembly in Paris declared that a standard of health was a universal human right.1 There is no reason to suggest that this affirmation should not include oral health as well. Oral health is a human right! Oral diseases are a public health problem that impair quality of life and generate increased costs and demands.2 The World Economic Forum reported this year that almost half the world's population suffers from oral diseases that impact daily life and subject the population to a higher risk of systemic health issues.3 It is time for radical policy action. Governments, industries, academic institutions, and scientific organizations must help change the burden of oral diseases.4 Concerned about the lack of attention to oral health, a historic resolution was adopted by the World Health Assembly in 2021 stating that oral health should be firmly embedded within the noncommunicable disease agenda and that oral healthcare interventions should be included in universal health coverage programs.5.

Background: Oral malodor, whether from systemic disease, dietary sources, or bacteria in the oral cavity, can negatively impact patients' quality of life. Oral malodor due to bacteria in the oral cavity can be managed by mechanically or chemically removing bacteria. Dentifrices are ideal vehicles to deliver therapeutic active ingredients that promote and maintain oral health since most consumers brush their teeth daily. Consumer preference drives consistency in oral hygiene routine. This study first identified a favorite flavor via consumer flavor testing and then measured the clinical efficacy of the dentifrice with a new flavor formulation to reduce malodor.

Methods: Consumer testing was conducted via an online product evaluation questionnaire to gauge consumer flavor preferences for stannous fluoride toothpaste stabilized with nitrate and phosphates (SNaP). In a 3-week randomized, single-center, double-blind clinical study, the malodor reduction ability of SNaP was compared to the negative control toothpaste containing 0.76% sodium monofluorophosphate via the organoleptic method.

Results: Consumer testing was used to determine a winning flavor for the new flavor formulation of SNaP tested in the clinical study. In this study, after 3 weeks of product use, on average, malodor clinical trial subjects (n = 97) randomized into the SNaP group had a 32.7% malodor score reduction from baseline (P less than .001) 12 hours post-brushing compared to a 9.4% reduction in the negative control group. Relative to the negative control group, the SNaP group had a statistically significant reduction of 25.7% (P less than .001) in oral malodor via organoleptic scores.

Conclusions: SNaP toothpaste delivered superior malodor reduction 12 hours post-brushing when compared to a negative control toothpaste.

Practical implications: Incorporating therapeutic active ingredients like stannous fluoride into toothpaste is an effective way to deliver oral health benefits, such as caries prevention, reduction in gingivitis and dentin hypersensitivity, and protection against enamel erosion and bad breath.

Digital smile design has transformed the approach to planning and executing esthetic dental treatments, allowing clinicians to digitally visualize and customize a patient's smile before taking any clinical interventions. By leveraging modern digital technologies, clinicians can streamline diagnostics and treatment planning while also improving accuracy in predicting the final results. This article explores the advantages of digital smile design in esthetic treatment planning along with the key principles of smile design and facial harmony that must be considered for a successful smile transformation.