Fluoride: a controversy revisited

The purpose of this article is to provide a review of the small but loud debate that has surrounded fluoride over the past 50 years. The benefits of fluoridation and its effect on public health are well known throughout the dental community. What is far less well known are the objections from people--in the tradition of the old amalgam and radiograph radiation debates-who feel that fluoride has adverse effects serious enough to warrant a cessation of its use. This article will present both sides of the issue, not to influence the reader, but to allow the reader to realize that this issue exists and to understand what the key arguments are.     

"The mother of all black triangles" case

Before the Bioclear matrix and a disciplined approach to composite treatment of black triangles, many treatments ended with significant compromise in periodontal health. Many cases debonded soon after placement. Others suffered problems with stain. Nonetheless, our patients are hopeful for a better solution. The interdental papilla serves as both a functional and aesthetic asset. Anatomically ideal interproximal composite shapes that are mirror smooth can serve as a predictable scaffold to regain this valuable gingival architecture. Clean enamel surfaces can be leveraged to permanently retain the restorations. However, the reader is cautioned that to attempt this elective procedure using no magnification, without a strict adherence to dentin detoxification with a blasting appliance, and using a flat matrix, nontreatment or referral is recommended. Our profession can change its thought processes, retrain its hands and expand its armamentarium to perform techniques that were previously impossible.     

In the interests of taking one's time even when one reads a scientific article! Critical review of the literature on tooth eruption

Nowadays everybody has access to the medical literature, not only through the libraries of the universities, but even more conveniently via Medline and Pubmed. It is very tempting only to read abstracts and summaries instead of "wasting time" by reading the whole article. Reading the article itself however enables the reader to select only these articles that have a good methodological and statistical basis. In this contribution several topics will be discussed that may help the reader to read scientific articles with a critical mind: definitions, quality of the data, study concepts, composition of the sample, control group, statistical analysis, sample size and interpretation of the results. Different items are exemplified with articles that deal with the emergence of permanent teeth.     

Dental laser safety

The purpose of this article is to inform the reader about dental laser safety and to suggest practical guidelines. The laser safety officer plays a major role, ensuring that the instrument is used safely and effectively. With adequate precautions and proper training, dental lasers can be used to deliver excellent care.     

3D surface imaging in medicine: a review of working principles and implications for imaging the unsedated child

This article provides an overview of the methods used for optical surface imaging during the last 30 years, with the primary focus on the imaging of the unsedated child. The goal is to provide the reader with an overview of the working methods behind the published articles. This will enable the reader to better interpret current data and decide if a certain approach is suitable for their particular research question.     

The Bonded Visible Light Cured Appliance Intermediate Splint Therapy for the Temporomandibular Joint Patient

The purpose of this article is to trace the history of cemented segmental occlusal splints and to show how the visible light cured (VLC) materials available today remove the disadvantages caused by the material used in the past. The author felt that the advantages of these VLC materials make this appliance a viable choice when repositioning appliances are part of a treatment plan. Because of the technique sensitivity of all procedures involving VLC materials, a step by step technique outline was included in the article. Three cases are shown to help the reader visualize the use of this generation of fixed TMJ appliances.     

Bisphosphonates and the dental patient: Part 2

With the increased popularity of bisphosphonate therapy for a variety of medical conditions, it is likely, even inevitable, that all dental practitioners will encounter patients on these medications. The purpose of this article is to acquaint the reader with possible treatment options for patients on bisphosphonate therapy, both oral and intravenous. This article will build on the reader's knowledge obtained from part 1, which was published in the August 2007 issue of the Compendium.     

The management of the Muslim dental patient

There are aspects of the practice of the religion of Islam that have some relevance to receiving dental treatment. This article aims to provide dentists with background knowledge of normal practices which may affect the treatment offered. The author does not attempt to inform the reader about Islam, but to assist the dentist in the management of a Muslim patient. Much of the content of this article describes how to manage a patient who is fasting during the Islamic month of Ramadan. Ramadan takes place this year in early October, lasting for 29 or 30 days. During Ramadan patients may present to dentists with the signs and symptoms described in this article.     

Retentive pins. Their use and misuse

Retentive pins have brought with them both ecstasy and agony. Their history, use, and situations resulting from their misuse are reviewed in this article. Correction of common errors will prove useful to the reader.     

Fundamentals of dental lasers: science and instruments

This article provides the reader with an understanding of the essential physical science of a laser device. Various dental tissues have unique interactions with laser light, and the principles of safe and effective use of this unique instrument are presented. Each wavelength's applications for treatment are outlined.     

Rehabilitation of the edentulous mandible with a fixed implant-supported prosthesis.

Implant rehabilitation of an edentulous mandible presents significant improvements over conventional complete denture therapy with regard to patient satisfaction, and it can improve a patient's quality of life. Several implant prosthetic designs have been developed and successfully utilized in clinical practices. The goal of this article is to describe the prosthetic design and technical steps in the fabrication of a fixed implant-supported mandibular prosthesis. A technique is described in which the positioning of appropriately selected abutments is completed in a predictable manner. LEARNING OBJECTIVES: This article discusses the prosthetic designs and technical steps in fabricating a fixed implant-supported mandibular prosthesis. Upon reading this article, the reader should: Understand the prosthetic design for the treatment of an edentulous mandible. Recognize the significance of the technical steps in this rehabilitation process.     

Getting your back back to work: pain relief--where to start?

Dental health care workers are vulnerable to back and neck pain resulting from poor occupational posture. While numerous choices exist for treatment, this article will provide them with a practical approach to seeking out appropriate care for this common malady. The McKenzie treatment approach is discussed and recommendations for its application are presented to provide the reader with a starting point for treatment. For the dental health care worker experiencing pain and dysfunction of the back and/or neck, as more than half will during their careers, this article will seek to provide an overview of potential causes while creating a roadmap for seeking the most appropriate conservative "antidote" for their care.     

Anxiety control in the dental patient

Oral sedation with benzodiazepines and anxiolysis with nitrous oxide are 2 effective methods to help alleviate anxiety and fear of dental procedures. Many patients would prefer to have their dentistry performed with sedation if it were offered to them. This article presents a detailed discussion on minimal sedation that should give the reader a good understanding of this valuable aspect of clinical care.     

Nosocomial Pneumonia and Oral Health

This article will critically review the evidence linking pneumonia to the aspiration of microbe‐laden oropharyngeal secretions and tie that to the predisposition for these processes to affect dependent, medically compromised individuals. The goal of this review is to alert the reader to the role that oral disease and oral health play in fostering and preventing, respectively, widespread and potentially fatal pulmonary disease among high‐risk individuals.     

Clinical aspects of occlusion: 1. Occlusal terminology and the conformative approach.

This two-part series aims to familiarize the reader with essential occlusal principles and terminology and to give some guidelines as to which cases are suitable for crown and bridgework. The first article covers occlusal terminology and the conformative approach, whilst the second will describe the reorganized approach. Both papers contain clinical cases which demonstrate how to overcome some of the occlusal problems encountered in this area.     

Current trends in implantology: part II--treatment planning, aesthetic considerations, and tissue regeneration.

In implant dentistry, bone loss is attributed to numerous factors that often include infection or trauma. Various surgical techniques and implant components have been developed to enable more effective management of such deficiencies. While the first installment of this article discussed the role of biological response and implant stability in implant therapy, this portion focuses on decision-making factors related to the number of implants, grafting materials, and achieving aesthetics with implant restorations. LEARNING OBJECTIVES: This article discusses factors that influence the outcome of implant restorations. Upon reading this article, the reader should: Be able to identify these factors and their effects. Be aware of the current trends in implant dentistry.     

The muscle engram: the reflex that limits conventional occlusal treatment

The engram (the masticatory "muscle memory") is shown to be a conditionable reflex whose muscle conditioning lasts less than two minutes, far shorter than previously thought. This reflex, reinforced and stored in the masticatory muscles at every swallow, adjusts masticatory muscle activity to guide the lower arch unerringly into its ICP. These muscle adjustments compensate for the continually changing intemal and external factors that affect the mandible's entry into the ICP. A simple quick experiment described in this article isolates the engram, enabling the reader to see its action clearly for the first time. It is urged that every reader perform this experiment. This experiment shows how the engram, by hiding the masticatory muscles' reaction (the hit-and-slide), limits the success of the therapist in achieving occlusion-muscle compatibility. This finding has major clinical implications. It means that, as regards the muscle aspect of treating occlusion, the dentist treating occlusion conventionally is working blind, a situation the neuromuscular school of occlusal thought seeks to correct. The controversy over occlusion continues.     

Treatment planning and smile design using composite resin.

Recent advances in dental materials and adhesive protocols have expanded the restorative procedures available to today's clinicians. Used in combination with proper treatment planning, these innovations enable dental professionals to provide enhanced aesthetic care that achieves the increasing expectations of their patients. Using a case presentation, this article will document the steps required to harmoniously integrate smile design, material selection, and patient communication that are involved in the provisional of aesthetic dental care. Learning Objectives: This article discusses the utilization of composite resin as a tool to enhance the patient's smile. Upon reading this article, the reader should: Become familiar with a smile-enhancing technique which can be completed in one office visit. Realize the benefits that intraoral composite mockups offer in terms of prototyping and confirming patient satisfaction.     

Direct applications of a nanocomposite resin system: Part 1--The evolution of contemporary composite materials.

The delivery of functional, aesthetic restorations has been simplified by the introduction of contemporary composite materials. The most recent innovation in composite resin technology is the revolutionary application of nanocomposite theories in restorative materials. Contemporary nanocomposite materials deliver increased aesthetics, strength, and durability, combining scientific principles for increased longevity. This article discusses the application of nanocomposite resin systems and demonstrates the historical perspective of composite resin technologies in restorative treatment. The second installment to this series will address the clinical applications of such a system in the anterior region. LEARNING OBJECTIVES: This article addresses material selection considerations that must be addressed when selecting an appropriate direct restorative material. Upon reading this article, the reader should: Understand the historical background and application of nanocomposite materials. Be aware of the clinical implications of a nanocomposite resin system.