Nederlands tijdschrift voor tandheelkunde最新文献

The diagnosis of an endodontic disease requires thorough research, collecting both clinical and radiographic information. The clinical examination includes history taking, visual inspection of the tooth and surrounding tissues, palpation of the soft and hard tissues, periodontal examination and percussion. The radiographic examination provides valuable information, but can never stand alone in arriving at a diagnosis. It is important to link the findings of the radiographic examination to other information. Sometimes, invasive examination is necessary, during which the coronal restoration is removed to allow better assessment of the tooth. This can provide additional information about the presence of caries, fractures, leakage of the restoration or other reasons for failure of the initial root canal treatment. A good diagnosis is essential for planning successful follow-up treatment.

The purpose of root canal posts is to obtain additional retention for build-up restorations of endodontically treated teeth so they can be functionally reconstructed. Due to developments in adhesive dentistry and a lack of clinical evidence, root canal posts are used less and less. Currently, the advice of the European Society of Endodontology is to use a root canal post only in front teeth and premolars in the absence of remaining coronal dentine walls. It is important to avoid additional preparation when placing a root canal post, because this causes (additional) weakness of the tooth. The loss of dental tissue due to preparation cannot be compensated for by placing a post.

When restoring an endodontically treated tooth, it is important to preserve the pericervical dentin so it is resistant especially to lateral forces occurring during mastication. When little pericervical dentin is seen to be present, an adhesive restoration is indicated. Tooth survival of endodontically treated teeth restored with adhesive direct and indirect restorations varies between 90.5% and 95.0% after 5 years. Deciding between a direct or an indirect restoration depends above all on the possibility to predictably restore the anatomy and on gloss retention. Because endodontically treated teeth are vulnerable to lateral forces, control of these forces after direct or indirect restoration is important. This can be achieved by a reduction in the steepness of the cuspal slope and/or by covering the cusps with the restorative material.

When problems occur in multirooted teeth, such as persistent endodontic problems following endodontic treatment, problems involving fracture or furcation, extraction may be decided on. However, removal of the tooth will result in loss of occlusal units and the alveolar process. By removing the compromised root and preserving the healthy part, the tooth can remain functional, but only after restorative treatment. A correct indication or diagnosis, a properly performed endodontic, restorative and surgical treatment and proper follow-up are mandatory for a successful treatment outcome.

After a fall from his wheelchair, a 23-year-old wheelchair-dependent patient with spinal muscular atrophy type 1 was initially seen by an emergency dentist, who repositioned and splinted the luxated teeth number 31 and 32. For stabilization, the patient was subsequently referred to a centre for special dental care. In the past, few treatments had been carried out on the patient. A jaw defect and very limited mouth opening compromised dental treatment. In addition, due to the muscle disease, the patient had respiratory and breathing problems, for which he used respiratory equipment. This case describes the importance of a multidisciplinary team in the treatment of patients with spinal muscular atrophy, and the options for performing minimally invasive dental treatment, where the priority is a painless dentition.

Matrix metalloproteinases (MMPs) are enzymes involved in the remodelling and degradation of the extracellular matrix, which is essential for maintaining healthy oral tissues. It is therefore important for dental students to know the role of MMPs in biological processes and diseases. Using a questionnaire, a cross-sectional study was conducted among master's dental students from 3 universities in the Netherlands and Belgium. The general level of knowledge about MMPs of the 80 respondents was predominantly low (91.3%). Significant differences were observed among students from the various dental schools, with students from the University of Groningen and Ghent University scoring significantly higher than those from the Academic Centre for Dentistry in Amsterdam (ACTA). Gender was associated with a few questions on the relationship between MMPs and dentistry, with female students achieving higher scores. Improving dental curricula regarding MMPs and their role in dental processes seems warranted.

Duchenne muscular dystrophy is a hereditary progressive neuromuscular disorder. Deterioration and weakening of the muscles is also present in orofacial muscles. Both weakness of the muscles and the fact that patients become more dependent of care, can make oral care more difficult. At this moment, it is unknown how patients with Duchenne muscular dystrophy experience their oral health and which problems regarding oral health and oral care may impact their oral health related quality of life. In this cross-sectional study, we found that, despite a high percentage of gingivitis, a high percentage of patients who experience halitosis and a high percentage of malocclusions, patients score their oral health related quality of life as good.

Many older individuals with dementia show care-resistant behavior for oral care. Providing care despite resistance is considered to be involuntary care. The Dutch law, 'Wet zorg en dwang' (care and coercion), states that care must be ceased in the presence of resistance, unless there is (a risk of) serious harm. This study was conducted to gain insight into the attitudes of healthcare providers with regard to involuntary oral care in older individuals with dementia. An online questionnaire consisting of general questions, case specific questions and knowledge questions about the Dutch law was filled out by 392 care providers. In all cases, a discrepancy was seen between the assessment of oral health problems as potentially harmful and the willingness to provide involuntary oral care. Hence, many healthcare providers are aware of the subsequent potential health risks related to not providing care, but are still reluctant to provide involuntary oral care. A large part of the healthcare providers also has a low level of knowledge with regard to the Dutch law 'Wet zorg en Dwang'.

Surgical procedures that rejuvenate and/or harmonize the face are known for their long-lasting and clinically relevant positive effects on the psychological well-being and quality of life of the client. Despite the popularity of cosmetic injectables, facelift surgery remains the most powerful and durable treatment for restoring aging symptoms, especially in the female face. Skin correction of the upper eyelids is the most commonly performed aesthetic facial surgery. This article provides an overview of the most important cosmetic surgical procedures for the face, focusing on the facelift, neck lift, forehead lift, upper and lower eyelid correction, subnasal lip lift and rhinoplasty. The indications, contraindications, treatment techniques, advantages and disadvantages are explained. Due to the increasing demand for cosmetic treatments, it is important that dentists and oral and maxillofacial surgeons have knowledge of these procedures in order to provide optimal information, referral or treatment when desired.