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

Advances in computing, specifically those used for simulation and games technology has allowed for exciting developments in dental and surgical education. At the same time concerns are being raised that students with relatively little training, practise to improve their skill on patients with all of the inherent risks that may occur. Simulation in dentistry has been practised for many years and so the concept is not new to the profession. New tools have been developed that both enhance teaching and learning and are also useful for assessment of students and trainees. The challenge of virtual and simulated reality tools is to have the required fidelity to improve teaching and learning outcomes over the currently utilized methodology.

Lifestyle factors and the increased longevity of the dentition due to greater life expectancy have resulted in greater wear and tear (cracking) of teeth. Often there exists interplay between damage and repair. An understanding of these mechanisms of damage and repair will assist the clinician in correct diagnosis and treatment planning. Preventive strategies as well as interdisciplinary measures are required for optimal outcomes. However, are some of our restorative interventions causing further damage to tooth structure?

Post-extraction the alveolus undergoes modelling which reduces height and width. This may present a problem for subsequent crown and bridge or implant therapy. Ridge preservation is the use of grafts and/or membranes to try to minimize the loss of the alveolar ridge. Extraction sockets have been filled with autogenous, allogenic and alloplastic materials. Membranes or soft tissue were used to contain the graft. More recently biodegradable sponges and materials coated in growth factors have been tested. Studies have primarily looked at either maintenance of vertical and horizontal dimensions or the healing of the socket and how much of the graft material is incorporated into the newly formed bone. Irrespective of method or materials, there seems to be some maintenance of the alveolus. Bone fill seems to occur in preserved extraction sockets, but in most cases with a high percentage of residual graft particles. In general, there is a lack of evidence to show that ridge preservation aids in correct 3-D implant placement, maintains hard and soft tissue volume over a prolonged period of time or for success and survival of implants placed into ridge preserved sockets. Still the most effective way to maintain ridge volume is to keep the natural tooth.

Chronic diseases have created a growing burden of ill-health as populations age, become more obese and as survival with many conditions improves. Cardiovascular disease, cancer and anxiety/depression merit priority by being common and treatable. Genomics aid diagnosis and understanding but have limited impact on management. Early diagnosis requires comprehensive annual clinical reviews, in which dental practitioners have an important role. Relevant imaging can be helpful. Useful early interventions include tactical lifestyle measures, weight control, appropriate supplements and low dose pharmacotherapy.

E-health and the national electronic medical record are on our doorstep. As an integral part of the healthcare system, dentistry needs to get on board with this national initiative. How prepared is the dental profession for this? How can a culture of online clinical records be promoted and what protocols and infrastructure exist for this to occur? The lack of government restriction means that dentistry should be taking full advantage of what is possible. The benefits and barriers to adoption of online records will be presented to provide a frame of reference for the next major shift in electronic communication.

Despite significant improvements in our understanding of the pathogenesis of dental caries, it remains one of the most common chronic diseases of childhood. Given that few very young children actually attend dental health services, there is a role for non-dental healthcare professionals in the prevention of dental disease and the promotion of oral health. This presentation will take an evidence-based approach to explore opportunities for increased collaboration between dental and non-dental healthcare professionals to optimize the health outcomes for children. The role and responsibilities of the dental profession in developing this model of shared care will also be discussed.