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

This review paper firstly provides an outline of the development of resin-based adhesives. A simple classification method is described based on whether an acid etching agent requiring a washing and drying step is used. These systems are called etch and rinse systems. The other adhesives that do not have the washing and drying steps are referred to as self-etching adhesives. The advantages and disadvantages of these groups of adhesives are discussed. Methods of adhering to the tooth surface are provided, especially where the resin-based adhesive reliability is difficult to control.

The modification of implant surfaces from the original machined to 'micro-rough', and more recently 'bioactive', surfaces has been proposed to improve clinical outcomes. This review outlines the evidence for the superior performance of modified implant surfaces. Pre-clinical trials consistently show that modified implant surfaces are more osteogenic and improve the degree of osseointegration. Clinically, there is a clear trend for improved clinical success with 'micro-rough' compared with machined implants. This is particularly the case in compromised sites, such as the posterior maxilla, and compromised patients, such as smokers. Furthermore, 'micro-rough' implant surfaces perform better in augmented sites, and facilitate the more predictable use of short implants, thus reducing the need for more invasive augmentation procedures. 'Micro-rough' implants have been associated with an increased susceptibility to peri-implantitis, but these findings relate to a surface that is no longer manufactured. Newly developed 'bioactive' surfaces have only been evaluated in a limited number of clinical studies.

The author has been managing osteonecrosis of the jaws (ONJ) for more than six years. This paper will outline the dental management of patients taking bisphosphonates. This will include: 1. The predisposing factors causing ONJ, 2. Its clinical presentation, 3. Staging for the appropriate conservative and surgical management, 4. Guidelines for prevention, 5. Case report.

When confronted with facial dysmorphologies, three-dimensional (3D) facial harmony is preferably assessed with regard to normality. This, however, presents two major challenges. The first challenge is to define normality. What makes non-dysmorphic faces appear normal? The second challenge is to situate the craniofacial dysmorphology with respect to normality. What makes the dysmorphic face not appear to be normal? To tackle these challenges, a novel approach based on a Face Space is proposed. In essence, faces are represented as points in a High-dimensional space, the dimensions of which capture important sources of allowed facial variation within a normal population. To establish an aesthetic objective of a given dysmorphic face, the novel concept of the "normal equivalent" of that face via robust projection into the Face Space is proposed. This technique is demonstrated on an artificial example in which smiling whilst showing teeth is considered a surrogate for facial dysmorphology.

High-end implant aesthetics requires precise steps from diagnosis through surgery to the restorative phase. These steps are not exclusive of each other. They are deliberate and require a clear understanding of what is possible and the skills that are required to carry out each procedure. Every small advancement will help in the initial and long-term stability of the treatment. This article will dissect implant treatment into key concepts and procedures, illustrating how these steps are crucial to a highly successful aesthetic outcome.

An ability to identify individuals at risk for progressive periodontal disease would enable targeted prevention and treatment, thus reducing the economic burden on society. The importance of the interplay between microbial, genetic and environmental factors in risk assessment is recognized and the relative contributions of various risk factors has been determined. However, newer technologies will enable more accurate individual risk profiling in the future.

A number of materials have been implanted into skull defects to determine if improved healing outcomes can be achieved. In some instances, packing or implanting bone-inducing alloplasts into a standardized skull defect results in better healing than an untreated defect. AlloDerm is a skin derived acellular collagen membrane and has characteristics that are known to be effective in promoting bone growth. It has not been previously investigated for use in cranial bone healing. The aim of the investigation was to determine if implanting this novel scaffold into skull defects will improve the quality of bone repair. Six rabbits received AlloDerm grafts into critical-sized calvarial defects. The rabbits were sacrificed at two months and the specimens examined histologically and radiographically. At the time of sacrifice, it was found that while bony growth had commenced at the margins of the defect and as isolated islands within the graft, there did not appear to be a major benefit in using the material described.