Revue belge de medecine dentaire最新文献

Despite the undoubtedly large impact of saliva on the patient's oral health, little is known about its exact properties and role. More research has been put into serum, when compared to saliva, although that is changing. More and more researchers are interested in the role of certain proteins or electrolytes in an oral disease process. Besides the purely laboratory research, practitioners are also interested in the bacterial colonisation of the oral fluids, especially in assessing a patient's caries risk. The use of bacterial chair-side tests illustrates this aspect of progression in oral health care. For the dental professional, saliva is an important ally in preventing dental caries and mucositis. The lubrication properties and antibacterial/antiviral function of saliva play an important role in the protection of the oral cavity. These aspects may be suppressed in some medically compromised patients. In those cases, the dental professional is faced with a challenge to solve the oral health problems.

Over the last years, current technologies in dental ceramics are strongly improved, constantly producing new materials for the restoration of the single or plural teeth. Feldspathic porcelains fused to a cast metal substructure, the so-called "metal-ceramic crown," has been long time the gold standard; this is primarily due to their predictable long-term strength characteristics. All-ceramic systems are a focus of interest, because they offer aesthetic results that may be difficult to achieve with metal-ceramic systems. Nowadays, the new ceramics associate aesthetic and good mechanical qualities, biocompatibility, accurate marginal fit and low invasive preparations. Thanks to the diversification of all-ceram processes, materials properties and clinical situations are now the prime criteria which determine the practitioner's choice. In this article, we try to summarize different clinical concepts for peripheric all-ceram restoration, such as crowns and bridges used in a daily dental practice.

The management of benign and malignant neoplasms of the salivary glands requires precise knowledge of tumor histogenesis and classification as well as surgical skills. Pleomorphic adenoma and Whartin's tumor are the most frequent tumors in parotid glands while the probability for malignant tumors is higher in other glands, especially in sublingual and minor salivary glands. Those malignant salivary glands tumors are rare and necessitate multidisciplinar staging and management in close collaboration with the pathologist and the radiation oncologist.

Sjögren syndrome is one of the most prevalent autoimmune diseases in which the body's immune system mistakenly attacks its own moisture producing glands. Although Sjögren syndrome occurs in all age groups in both women and men, women in their fourties are the most affected. Sjögren's syndrome can occur alone or in the presence of another connective tissue disease, respectively called primary and secundary Sjögren syndrome. When two of the three clinical hallmarks: keratoconjunctivitis sicca, xerostomia or connective tissue disease are present, Sjögren 's syndrome should be considered. To confirm the diagnosis of Sjögren's syndrome several tests are required. e.g. blood tests, ophthalmologic tests and oral tests. Rheumatologists have the primary responsibility for managing Sjögren's syndrome. Other specialists can treat the related symptoms. The incidence of lymphoma is higher in patients with Sjögren's syndrome than in the general population. Therefore patients must be monitored carefully for the development of related autoimmune diseases, lymphoma and other complications. Sjögren's syndrome is serious but generally not fatal if complications are diagnosed and treated early.

As a result of ceramics and all-ceram technologies development esthetic inlay core and abutments flooded the market. Their tooth-colored appearance enhances restoration biomimetism principally on the marginal gingiva area. This article reviews indications and types of cores designed for natural teeth and implants.

This article presents an historical background of dental ceramics. It synthesises the evolution of such material and its technical improvements from the stone-age to our time. Focusing on the importance of dental aesthetics, it shows the investigations realised to upgrade the prosthetic results.

Many factors are important for the existence of supplier-induced demand (SID). Not just the individual practitioner is responsible; his or her behaviour might be influenced by the specific organisation of the market for health care/dental care. The article investigates the characteristics of the Belgian market for dental care and analyses the way in which they might influence the occurrence of SID and/or overconsumption. Attention goes to the payment system of dentists in Belgium, the health insurance system, dentist density and the regulation of the sector. Also mentioned are the recall system and other (governmental) initiatives that may influence patients' and practitioners' behaviour. Some factors--not yet systematically investigated--may be relevant as well: personal characteristics of the dentist (gender in particular) and the way companies direct practitioners' and patients' behaviour.

Patients suffering from xerostomia lack oral comfort which reduces their ability to take up food properly and impairs their speech. Furthermore they suffer easily from caries and oral yeast infections. If it is impossible to stimulate a minimal salivary gland activity, salivary substitutes can be prescribed. Unfortunately, not all functions of saliva can be replaced by artificial products satisfactorily. Artificial saliva lacks a satisfactory efficacy with regards to lubrication, antimicrobial action and protection against demineralization. This can explain why these products are not widely known and their demand is very low. The optimal saliva substitute is not yet found.

Posterior ceramic bonded partial restorations are conservative and esthetic approaches for compromised teeth. Overlays constitute a less invasive alternative for tooth tissues than crown preparations. With inlays and onlays they are also indicated in case of full arch or quadrant rehabilitations including several teeth. This article screens indications and realization of this type of restorations.

The objective of this article is to synthesize the current scientific data relating to the bonding of ceramic restorations in order to present a reliable and reproductive clinical method for the general practitioner. The different ceramic treatments are explained with a distinction between those which can be etched and the others. A precise check list is suggested for the conditioning of dental tissues and ceramic surfaces.