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The difference between paediatric dentistry and most other branches of dentistry is that in the child the occlusion is changing. Consequently 'Good Occlusal Practice' in children is a matter of making the right clinical decisions for the future occlusion. The clinician needs to be able to predict the influence that different treatment options will have on the occlusion when the child's development is complete.
Cores for teeth with vital pulps is the seventh in the series of crowns and other extra-coronal restorations. A core is defined as 'that part of a preparation for an indirect restoration consisting of restorative material'. This article questions the need for routine pin placement and addresses the following issues--removal of existing restorations, the need for a core, core materials, core retention, and problem solving.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Dental injuries are the commonest type of orofacial injury sustained during participation in sports. Of the types which are currently available, custom-made mouthguards fitted by a dentist have been demonstrated to provide the greatest protection from dental injuries. Such mouthguards should therefore be recommended for use by those who participate in contact sports, and their provision should be actively encouraged by dental care workers.
Scuba diving is one of the fastest growing sports in the world. It is inevitable that the general dental practitioner (GDP) will have patients who participate in this sport and they should be aware of a number of problems that a diver can experience that are associated with the teeth and related structures. The aim of this article is to introduce the GDP to the dental problems associated with diving and make recommendations on dental care for scuba divers.
The dentine-bonded ceramic crown is a full coverage restoration luted to the underlying tooth tissue via a dentine bond and resin composite luting system. The main advantage of using this technique is that removal of tooth tissue can be kept to a minimum. Additionally, the final aesthetic results may be excellent. In this paper, the provision of dentine-bonded crowns on the upper anterior teeth for two patients is described.
There are several methods available for the replacement of missing anterior teeth. These include a removable prosthesis, a conventional fixed bridge, an adhesive bridge or a dental implant. The choice of the most suitable technique depends on several factors, such as the condition of the adjacent teeth, the occlusion, the patient's wishes and the financial implications of the proposed treatment.
Dentistry is becoming more sophisticated and capable of providing much higher treatment standards than ever before. Treatments previously considered impossible can now be achieved as a direct consequence of these advances. However, this increased complexity of treatment also means that the different branches of dentistry have, as a necessity, become more and more specialised. It is important that the specialities collaborate in a systematic focused way to ensure the optimal treatment outcome with the minimum burden of care for the patient.
This is the first in a series of four papers related to the management of root canal treated teeth. When teeth compromised by extensive restorations become non-vital, suggestions have been given as to how root canal treatment can be carried out with the greatest chance of success. Once root canal treated, either by a previous dentist or by the current dentist, a review of the assessment process that should be carried out prior to placing costly indirect definitive restorations is given. It will be clear that post-retained restorations are mainly reserved for anterior or single-rooted teeth, posterior teeth rarely requiring a post for core retention. The second paper in this series describes the basic tooth preparation that should be carried out prior to placing a post. Depending on the type of post system used, further modifications to tooth preparation may be required and the cementation techniques may also have to be modified. The third paper therefore discusses the various post types, when and how they should be used for optimum results. The final paper addresses reinforcement and restoration of compromised root canals, such as those with immature, open apices, or those that have been over-prepared for previous post-retained restorations.
Orthodontic treatment is not without risk. The risks may be due to patient factors (which may not always be evident before treatment) or may come about because of the treatment itself. While the common types of risk are well documented, less information is available as to how some of the more unusual problems can best be managed when they arise; often the need for teamwork between the patient, orthodontist and general dental practitioner (GDP) are underestimated. This paper presents three patients in whom various root-related problems existed either before orthodontic treatment or which arose during orthodontic treatment; demonstrates how they were managed; and highlights the need for teamwork to ensure a 'least harmful' outcome. All patients were followed up for over a year.
BACKGROUND: The 2003 Children's Dental Health Survey is the fourth of the 10-yearly surveys of children's oral health. AIM: To report the prevalence of three non-carious tooth conditions in children in the UK. METHOD: A representative sample of children five, eight, 12 and 15 years of age were examined by calibrated examiners in schools across the UK. The dental examination included accidental damage to incisors, tooth surface loss (TSL) and enamel opacities (age 12 only). A postal questionnaire sought parental and child views on marks on teeth which could not be removed by brushing. RESULTS: The proportion of children sustaining accidental damage to permanent incisors decreased to 11% of 12 and 13% of 15-year-olds, but the majority of accidental damage remained untreated. TSL was found on 53% of five-year-olds and on approximately a third of 12 and 15-year-olds. There was a statistically significant change for TSL on permanent teeth at age 15 where 27% upper incisors had TSL palatally in 1993 compared to 33% in 2003. Thirty-four per cent of 12-year-old children had enamel opacities on one or more of their teeth compared with 36% in 1993. CONCLUSIONS: Tooth surface loss remains a common finding in children in the UK. A large proportion of accidental damage to teeth remains untreated.
The aim of this in vitro trial was to evaluate the external and internal adaptation of class II composite restorations to tooth structure by means of replica scanning electron microscope (SEM) observation. Standard MOD preparations were cut in human extracted teeth with margins located above and below the cementoenamel junction. Cavities were restored with either a direct multilayered technique, inlays (using conventional or dual DBA application) or prepolymerized composite inserts, using similar restorative material (Syntac, Variolink and Tetric). Evaluations were performed after mechanical and thermocycling. For the marginal adaptation in enamel, the bevelled margins of the direct group resulted in higher percentages of "continuity" (92.5% mesially and 94.6% distally), while the "marginal tooth fracture" was the most commonly found defect in groups with a butt preparation (up to 29.4%, with inserts). For the marginal adaptation in dentin, "continuity" percentages varied from 59% (inlay) to 87.9% (insert). As regards the internal adaptation, results for the whole dentin interface varied from 43.1% (inlay) to 63.9% (inlay with dual bonding) of "continuity". No regional difference in internal adaptation was found between the different preparation areas, except between gingival dentin and gingival enamel (44.9% vs. 80.7% of continuity, all group pooled data). Debonding occurred only at the dentin-restoration interface and consistently took place at the top of the hybrid layer. In the present experimental conditions, the inlay or insert techniques, which make use of the Dual bonding concept, proved to have the best potential to maintain the integrity of dentin-restoration interface.
LITERATURE REVIEW: A ferrule is a metal ring or cap used to strengthen the end of a stick or tube. It has been proposed that the use of a ferrule as part of the core or artificial crown may be of benefit in reinforcing root-filled teeth. A review of the literature investigating this effect is presented. The literature demonstrates that a ferrule effect occurs owing to the artificial crown bracing against the dentine extending coronal to the crown margin. Overall, it can be concluded that a ferrule is desirable, but should not be provided at the expense of the remaining tooth/root structure.
Several alternative materials have been suggested to take the place of amalgam, because of the environmental toxic effects of its mercury component. One such material is gallium-based alloy restoratives. The aim of this in vivo study was to compare the long-term clinical performance of a commercial gallium alloy with an admixed high copper amalgam alloy. For this purpose, 32 gallium and 32 amalgam restorations were placed in molar teeth in 14 human subjects. All the selected patients had at least two molar teeth that required restoration. In this way both restoratives were used in the same oral cavity. The restorations were examined at baseline, 6 months, 1, 2 and 3 years. At baseline, six teeth restored with gallium alloy showed post-operative sensitivity, whereas none of the amalgams were sensitive. At the end of 3 years, only a few amalgam restorations showed slight surface tarnish and marginal integrity loss. None of them needed replacement. Of the 32 gallium restorations placed, five had to be removed because of sensitivity, corrosion and tooth fracture. Also dramatic surface roughness and corrosion were noticed in 12 gallium restoration. According to the results of this clinical study, gallium-based restoratives should not be used before their physical properties are improved.