Indirect or direct restorations for heavily restored posterior adult teeth?

CLINICAL BOTTOM LINE: There is no high quality evidence that supports or rejects the practice of placing a crown or onlay on a vital posterior tooth rather than a composite or amalgam restoration to ensure longer tooth survival.     

Jaw cysts – Filling or no filling after enucleation? A review

IntroductionJaw cysts are common lesions in the oral and maxillofacial region. Enucleation of the lesions and primary closure of the defects, the so-called “cystectomy”, has evolved as the treatment of choice. In order to reduce infections and to accelerate bone regeneration, different types of bone grafts are increasingly investigated for defect filling.Material and methodsThe present review reflects the most recent studies using autogenous, allogenic, xenogenic and alloplastic bone grafts and compares the results to current investigations about conservative cyst enucleation without using any filling materials. Relevant studies with significant patient sample sizes were electronically searched in PubMed and Medline.ResultsSimple cyst enucleation and blood clot healing show low complication rates and sufficient bone regeneration even in large defects. Prospective randomized trials comparing the additional use of filling materials to the “cystectomy” are rare. Currently available data do not indicate the superiority of additional bone grafts.ConclusionEnucleation of jaw cysts and primary closure without bone substitutes remains “state of the art” in most cases.     

Gone to waste, or something to get your teeth into?

Geoff Dillow, author of Dental compressed air and vacuum systems--2003, a supplement to the NHS Estates publication Health technical memorandum No 2022: Medical gas pipeline systems, examines issues surrounding the use of scavenging systems for nitrous oxide during relative analgesia (RA) procedures in dentistry. Practical advice to help reduce unnecessary exposure of practice staff is offered.     

Do teeth want to be straight? A nonsurgical approach to unerupted teeth

Although some orthodontists believe that ectopic labially positioned canines may erupt without surgical exposure, many articles emphasize the surgical management of the nonpalatally impacted canine. In this article, the author discusses the treatment and results of 3 cases, with a total of 4 impacted maxillary canines. All cases were treated with a conservative approach and without surgical intervention. This nontraumatic, nonsurgical approach demonstrates the viability of conservative options for the management of unerupted teeth in carefully selected cases.