Relationships between tooth wear, bruxism and temporomandibular disorders.

This article will provide an overview of the diagnosis of common temporomandibular disorders (TMDs) and bruxism, along with their relevance in management of tooth wear. When assessing and managing a tooth wear case, the teeth should not be considered in isolation, but as part of the articulatory system, which has three inter-related elements: the teeth, the temporomandibular joints and the masticatory muscles. The presence/absence of bruxism and TMD are highly relevant, although there may not be a causal relationship between these. A consideration of TMD and bruxism, together with the potential impact these may have on the patient during and after any management of tooth wear, will form part of patient education and the informed consent process.

How to assess and manage external cervical resorption.

External cervical resorption (ECR) is a type of pathological resorption which starts below the epithelial attachment to the root of a tooth. Various aetiologies relating to exposure of root dentine have been proposed. However, this is poorly investigated in the literature. Due to the nature of this lesion, early detection via thorough examination is essential to maintaining restorability of affected teeth. This article aims to summarise the available literature and describe management strategies for ECR, highlighting the role of clinical findings and patient-related factors in treatment planning.

Dentin dysplasia: diagnostic challenges.

Dentin dysplasia(DD) is a rare autosomal dominant disorder associated with disturbance of the dentin. While the crowns appear clinically normal, on radiography, the pulp spaces appear partially or completely obliterated, with short blunted roots, and multiple periapical radiolucencies affecting the apparently sound teeth. Clinical signs include spontaneous abscess formation or increased tooth mobility which can lead to exfoliation. DD can therefore have a significant impact on the patient's dentition, and treatment is often challenging. Shields' classification of dentin disorders has been recently criticised for failing to consider differential variations and expressions of these disorders. This paper describes a case of a 23-year-old woman with previously undiagnosed DD, who presented with clinical and histological features belonging to several of these diseases, thus highlighting the potential diagnostic challenges faced with Shields' classification.

'The last post?': assessment of the failing post-retained crown.

Failure of a post-retained restoration can provide a challenge to the general dental practitioner (GDP) in terms of diagnosis, treatment planning and communication with the patient. The cause of failure must be identified, and a thorough assessment of the restoration, remaining tooth and its functional and aesthetic demands carried out in order to plan treatment to provide the most reliable result. Clinical Relevance: This article discusses the assessment of failing post-retained crowns, with discussion of reasons for failure, thereby assisting the GDP in decision-making and treatment planning for such teeth.

Layering composites for ultimate aesthetics in direct restorations.

UNLABELLED: A number of modern materials are available which allow placement of highly aesthetic anterior restorations. However, some systems are complex and technique sensitive. The authors describe a layering technique for the provision of direct aesthetic anterior composite restorations suitable for a general practice setting. CLINICAL RELEVANCE: Aesthetic restorations can be provided directly and in a conservative manner using composite resin, often avoiding the need for more destructive indirect techniques.