The transition from amalgam to other restorative materials in the U.S. predoctoral pediatric dentistry clinics.

Increased concerns about the safety of amalgam restorations in children have resulted in many dental schools emphasizing the teaching of alternative dental materials. This study investigated the current teaching of different dental materials for use in posterior teeth in the United States predoctoral pediatric dentistry programs. In 2011, the authors invited the chairs of the predoctoral pediatric dentistry departments in all accredited dental schools at that time (N = 57) to participate in an internet-based survey. Descriptive statistics were calculated to describe the frequency of using different restorative materials. Regression models were developed to explore the factors related to the use of dental restorations in predoctoral pediatric clinics. Among the 44 dental schools that responded (77% response rate), 74% used amalgam, and 93% used composite in primary posterior teeth. Glass ionomer was used by 61% of the schools in primary posterior teeth. Placing amalgam in primary posterior teeth was associated with programs that treated more 3-5-year-old patients (ß = .302, p < .043), whereas the use of glass ionomer was associated with having students serving at off-site satellite dental clinics (ß = .015, p < .012). In general, having departments with chairs who had positive attitudes towards Minimal Invasive Dentistry (MID) used composite (ß = .091, p < .0001) and glass ionomer (ß = 103, p < .0001) more frequently and were less likely to use amalgam (ß = -.077, p < .005) in primary posterior teeth. Although teaching MID concepts in predoctoral pediatric clinics in dental schools is increasing, the use of amalgam in posterior primary and permanent teeth is still widely practiced.

Estratégia clínica para minimizar a fragilidade do remanescente radicular / Clinical strategy to minimize the fragility of the remaining root

As endocoroas adesivas (endocrowns) propiciam, comprovadamente, retenção e estética suficientes para suportar tensões e forças mastigatórias. Sua infraestrutura a base de dissilicato de lítio, suscetível ao condicionamento ácido e à silanização, fornece ótima adesão entre peça e cimento resinoso, proporcionando um bloco único entre remanescente dentário e coroa cerâmica. Pacientes jovens, com endodontia satisfatória, são bastante indicados para receber este tipo de tratamento, pois, ao ferulizar a raiz, a endocoroa oferece ao paciente a chance de ser submetido a uma futura intervenção sem a perda radicular. Desta forma, o profissional estará adiando o momento de um procedimento mais invasivo. No presente relato clínico, esta estratégia clínica visa minimizar a fragilidade do remanescente radicular, objetivando proporcionar ao paciente uma reabilitação estética e funcional menos invasiva e mais adequada para a sua idade

Future of bone pathology, bone grafting, and osseointegration in oral and maxillofacial surgery: how applying optical advancements can help both fields.

In recent years, advances in technology are propelling the field of oral and maxillofacial surgery into new realms. With a relatively thin alveolar mucosa overlying the underlying bone, significant diagnostic and therapeutic advantages are present; however, there remains an enormous gap between advancements in physics, in particular optics, and oral and maxillofacial surgery. Improvements in diagnosis, classification, and treatment of the various bone pathologies are still being sought after as advancements in technology continue to progress. Combining the clinical, histological, and pathological characteristics with these advancements, patients with debilitating pathologies may have more promising treatment options and prognosis. Defects in the facial bones, particularly in the jaws, may be due to a number of reasons: pathology, trauma, infections, congenital deformities, or simply due to atrophy. Bone grafting is commonly employed to correct such defects, and allows new bone formation through tissue regeneration. Growing use of dental implants has focused attention on osseointegration and its process. Osseointegration refers to the actual process of the direct contact between bone and implant, without an intervening soft tissue layer. The theories proposed regarding this process are many, yet a clear, unified stance on the actual process and its mechanisms has not emerged. Further investigation using optical probes could provide that unifying answer. The primary goal of this manuscript is to introduce pioneers in the field of optics to the field of oral and maxillofacial surgery. With a brief introduction into the procedures and techniques, we are hopeful to bridge the ever-widening gap between the clinical science and the basic sciences.

Minimum intervention dentistry--a new horizon in public oral health care.

Public dental patients suffer from poorer oral health than the general population. Management of dental caries tends to focus on surgical interventions, such as restorations and extractions, rather than prevention and early intervention of the disease process. The current public dental system struggles to address the lifestyle and broader health issues affecting oral health and although an immediate dental problem can usually be alleviated, it can often be through the unnecessary removal of tooth structure, which invariably leads to other health and quality of life problems. There is widespread recognition by oral health clinicians that the restorative approach to the management of dental caries in the public sector is failing to improve oral health outcomes for many public patients. Oral health experts have recently adopted a national consensus statement on minimum intervention dentistry indicating their intention to work together to develop ways to implement this approach across the public dental sector. It is clear that, despite some significant challenges and required changes, the momentum for minimum intervention dentistry continues to grow across Australia. There is an urgent need to undertake research to assess the cost-effectiveness of this approach in the public sector.