Annals of the Royal Australasian College of Dental Surgeons最新文献

The placement of dental implants is dependent on a number of factors relating to both the patient and the site in which implant placement is contemplated. Additionally, there has been a general trend towards immediacy in implant therapy. This paper considers case selection and clinical decision-making and treatment guidelines in cases where immediate implant placement is contemplated. Treatment alternatives, including site preservation, early and delayed implant placement are also discussed.

Molar incisor hypomineralization (MIH) involves enamel hypomineralization of systemic origin affecting one or more first permanent molars (FPM) and is often associated with other teeth, particularly the incisors. A challenging condition for both the clinician and the patient, MIH affected teeth are often subjected to repeated treatments and frequently the decision to extract one or more FPM is made. At present, there are no clinical reports of available restorative materials that are able to provide consistently adequate restorations on hypomineralized teeth. The concept of resin infiltration, which involves occluding incipient enamel carious lesions with low viscosity resins to arrest or slow the development of caries has the potential to be applied to hypomineralized enamel. Successful penetration of resin infiltrant into MIH affected enamel may aid in improving its micromechanical properties.

Adverse, that is unintended untoward effects of medications, are increasing in incidence and their severity, given the aging of the Australian and New Zealand population and associated drug use. Not only are the number of agents that our patients are using increasing, including the increased use of "alternate" or "complimentary" medications, but also their complexity, with the advent of potent, targeted, biological agents. The result is an increasing number of our patients will be at greater risk of adverse effects from their medications. These adverse effects include the impeding of the safe delivery of dental treatment and the adverse oral and dental manifestations and complications related to the use of medications.

The management of patients with extensively worn and badly broken down dentitions presents a difficult challenge in dental practice and restorative treatments are often complex, time consuming and costly to implement, so careful case selection and treatment planning is essential. Ultimately the success of any restorative intervention is very dependent on the stability of the oral environment and the status of the remaining tooth structure. Prior to the commencement of any restorative treatment an understanding of the importance of the disease process, the risk factors in the mouth, and the intrinsic and extrinsic factors which affect the oral balance is critical. While there is a growing range of materials and techniques available for cost effective and conservative management of these cases, failure to take a systematic approach to assessment and stabilization may result in early restorative failure, rapid recurrence of the problems and a repeat restoration cycle. Therefore successful management of these patients must include an appropriate mix of preventive and restorative strategies.

An interdisciplinary treatment plan is often required to allow restoration of function and aesthetics in the "mutilated dentition". Loss of teeth is associated with social and psycological impacts for the patient, however most often aesthetic requirements and financial constraints predominate in the treatment decision making. Historically, unfavourable occlusal contacts have been viewed as predisposing factors in the development of temporo-mandibular joint dysfunction (TMD). This linkage has now been refuted by many authors and it is understood that occlusion may be a co-factor only in TMD. In determining the "ideal occlusion" to restore the mutilated dentition consideration must be given to an occlusion that is physiologic for the patient, and the simplest scheme to construct from a clinical and technical view point. In successfully restoring function of the teeth an aesthetic outcome can be achieved. The planning and treatment for three patients is reviewed to highlight interdisciplinary patient care from a prosthodontics perspective.

Molar Incisor Hypomineralization (MIH) is a common condition in New Zealand children and children around the world and can result in a significant defect in first permanent molars. This condition inevitably leads to a large amount of dental treatment for young children and may even result in the removal of their first permanent molars. This lecture will outline the understanding of the physical properties of these teeth and provide an evidence based review of the treatment options for affected teeth.