Le Journal dentaire du Quebec最新文献

Most people are surprised to hear that many dentists suffer from burnout and that there is a lot of unhappy practitioners that would rather be elsewhere than in their dental offices. The public refers to dentistry as a profession which is quite easy to deal with, not very stressful and without surprises, a well paid one, etc. In fact, the consequences of a fixed daily routine, working with unappreciative patients, organizing the dental office and staff, coping with tight schedules, and concentrating on very small tasks result in burnout among dentists. What causes this emotional dropout or burnout among dentists? Can it be prevented or managed by practitioners? This article proposes a pattern for the evolution of burnout among dentists and enumerates the various physical and psychological signs or symptoms that could lead to the prevention and/or management of the stress and professional difficulties related to being a dentist.

The completely edentulous patient who has been fitted with osseointegrated implants poses new challenges for the restoratie dentist. Besides having to make up for loss of teeth and alveolar bone, the prostheses have to provide function and aesthetics, and be designed to facilitate oral hygiene procedures. The metal superstructure should be strong, have a passive fit, be resistant to corrosion and be easy to clean. Three designs are proposed: the sanitary bridge, the aesthetic bridge and the removable overdenture. The patient's expectations regarding function and aesthetics should be assessed initially by the restorative dentist. General principles of aesthetics in complete dentures are still to be followed: proper upper anterior tooth selection (shape and shade), and correct tooth positioning in relationship to lip line, smile line and profile. Lower teeth should be level with the lower lip and the retromolar pad. Success is based on the patient's capacity to adapt and the dentist's sound application of basic principles.

At the beginning of the century the radical approach to treatment of an occlusal surface carie of a molar were related to the principles developed by G.V. Black. Extension for prevention in the occlusal fissures, whether they were decayed or not, respected the needs of that era. Those ideas were based on the epidemiology of dental caries and mechanical properties of the filling materials in use to treat them. The parameters of treatment have changed, the reality is not the same. Nowadays, conservative composite resin restorations, demand a less destructive approach for small carious pit and fissure lesions in both the primary and permanent dentitions.

It is a known fact that many patients who need major orthodontic treatment, simply refuse treatment for reasons related to the esthetics of fixed appliances. These refusals, which occur more often among adults, usually jeopardize the patient's entire treatment plan, and in the long run will endanger the patient's oral health. This article reviews the different alternatives which are available, in order to resolve this major inconvenience which some people tend to have when they need fixed orthodontic appliances (braces). In each case, their advantages and inconveniences, and their indications and contra-indications are described.

Single tooth replacement using an implant is a relatively new technique. During a study at Université de Montréal, the esthetic appearance of a single tooth restoration was directly related to the presurgical evaluation and to the implant placement. The goal of this article is to enumerate the clinical requirements and to illustrate the prosthetic results in relation to implant placement.

Dental esthetics has been based for a long time, on time-honoured theories where the restored or replaced teeth had to match the face shape while providing due respect to the sex, the age and the personality of the patient. Most of these theories have since been disproved and the standards of dental esthetics have been revised following surveys of naturally perfect smiles and patients' preferences. Guidelines are presented in a sequence of 5 easily applicable steps with the objective of creating the right smile for the right patient.

Diastema closure by simple direct techniques has to take advantage of modern photo-cure systems. This paper reviews the basic concepts of diastema closure and describes a technique that does not necessitate the use a conventional matrix.

Even with the advent of new dental technology (e.g. implants), of improved asepsis control and of a better comprehension of physiological phenomena, a dentist should look at mastering another alternative, namely, autogenic dental transplants. This article describes, the indications, technique and prognosis.

This paper presents data collected in March of 1989 from a sample of dentists practicing in the province of Quebec. A survey was mailed to dentists in order to determine to what degree sealants are used and the various characteristics relative to the dentists in question. Other questions related to how dentists obtained information about sealants, the difficulties encountered with their application and the problems relative to their use by the dental profession. The results indicate that nearly three quarters of Quebec dentists use sealants at least sometimes. This level of usage is comparable to American findings. A dentist is more likely to use sealants, if he is a recent graduate, a female dentist, and in a child-oriented group practice. A high proportion of dentists (2/3) use sealants selectively (in less than 25% of their patients). According to the dentists surveyed, the main obstacle to using sealants is the lack of coverage by the government dental program and the public's ignorance of the benefits of sealants. Most dentists who admitted never trying sealants, reported that they simply preferred to place an amalgam filling. In general, dentists knew the indications for sealants and had a positive attitude relative to their use.

This article is the last of a series of four. This article describes in detail the fabrication of a crown connected to a Brånemark implant.