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Recent Orthodontics Articles
Manejo Integral de Maloclusion Clase III en Adulto, con Requerimientos Periodontales y Protesicos; Reporte de un caso clinico

Manejo Integral de Maloclusion Clase III en Adulto, con Requerimientos Periodontales y Protesicos; Reporte de un caso clinico
En nuestra clinica observamos un aumento de pacientes adultos con problemas esqueletales, compromiso periodontal y necesidades protesicas. Debemos recurrir a la interconsulta con el periodoncista, protesista y cirujano maxilofacial, para la correccion del caso, prestando especial atencion al componente dentario, esqueletal y los tejidos blandos faciales del paciente. La cirugia ortognatica, que generalmente la realizamos luego de una preparacion ortodoncica, permite corregir discrepancias en el adulto y restaurar la funcion y estetica en los tres planos del espacio. Realizada la correccion oclusal, procedemos a sustituir dientes ausentes, mediante implantes y protesis fijas. El Periodoncista, mantiene un control constante de la salud de los tejidos de soporte, durante todas las fases de la terapia multidisciplinaria.

Author(s): Miguel Hirschhaut, DDS;Jorge Ravelo, DDS
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Sequencing of Periodontal Procedures and Orthodontic Treatment

Sequencing of Periodontal Procedures and Orthodontic Treatment
Severe cases of periodontal disease often require periodontal surgery and realignment of teeth. Surgical techniques have been developed that attempt to minimize post-surgical gingival recession and compromise the interdental papillae. A case report is presented in which reversal and correction of a deteriorating maxillary frontal dentition were effectively achieved through combined use of periodontal and orthodontic principles. The treatment plan included the control of periodontal inflammation, restoration of lost attachment apparatus, realignment of anterior dentition, stabilization of occlusion, and minor periodontal plastic surgery. The anticipated loss of a maxillary lateral incisor was avoided. Restoration of a pleasant smile with nicely aligned teeth and esthetic gingival contours was achieved. The correct sequencing of the procedures involved was considered a key factor for the long-term esthetic outcome.

Author(s): Cobi J Landsberg, DMD;Ofer Sarne, DMD
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Esthetic Rehabilitation of the Periodontally Compromised Dentition - A Novel Interdisciplinary Approach Using Orthodontic Extrusion and Dental Implants

Esthetic Rehabilitation of the Periodontally Compromised Dentition - A Novel Interdisciplinary Approach Using Orthodontic Extrusion and Dental Implants
Rehabilitation of esthetics in advanced periodontal cases presents a major challenge in dentistry today. Patients with advanced disease affecting teeth in the esthetic zone, where significant asymmetrical bone loss and tissue recession are present, constitute a challenging treatment-planning dilemma when choosing the optimum therapeutic option for long-term maintenance. This article reviews a novel interdisciplinary approach for vertical augmentation of bone and soft tissues by means of orthodontic extrusion of severely periodontally compromised teeth, facilitating the restoration of esthetics with improved bone and soft tissue volume around immediate implants.

Author(s): Tidu Mankoo, BDS
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Recent Restorative Articles
Surgical Veneer Grafting - Compensation for Natural Labial Plate Remodeling After Immediate Implant Placement

Surgical Veneer Grafting - Compensation for Natural Labial Plate Remodeling After Immediate Implant Placement
Contemporary implant therapy aims to provide highly esthetic and predictable treatment outcomes while decreasing treatment duration and complexity. The clinician must therefore be cognizant of circumstances with a predisposition toward esthetic outcomes and treatment plan accordingly. Preservation of the surrounding hard and soft tissues associated with an immediate postextraction socket implant to replace a nonrestorable tooth in the esthetic zone is one of the greatest challenges facing the dental team. A case report of a hopeless maxillary left central incisor in a patient with a thin periodontal phenotype illustrates this new surgical and prosthetic approach. Clinical, radiological, and esthetic parameters were recorded to evaluate primary treatment outcomes.

Author(s): Alessandro Agnini, DMD;Maurice Salama, DMD;Henry Salama, DMD;David Garber, DMD;Andrea Mastrorosa Agnini, DDS
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CAD/CAM Solutions for Minimally Invasive All-Ceramic Rehabilitation of Extended Erosive Lesions

CAD/CAM Solutions for Minimally Invasive All-Ceramic Rehabilitation of Extended Erosive Lesions
Dental erosion is a global health problem that can lead to significant functional and esthetic impairments of the affected patients. Treatment of sever cases with augmented loss of the vertical dimension of occlusion (VDO) represents a challenge for both the dental team and the patient. CAD/CAM technology was used in the presented case to analyze the inter-occlusal space. The case report documents a practical, digital approach and discusses the advantages related to treatment time, ease of treatment, and predictability.

Author(s): Petra C. Guess Gierthmuehlen, DDS; Enrico Steger, MDT
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Updating Classifications of Ceramic Dental Materials

Updating Classifications of Ceramic Dental Materials
The indications for and composition of today’s dental ceramic materials serve as the basis for determining the appropriate class of ceramics to use for a given case. By understanding the classifications, composition, and characteristics of the latest all-ceramic materials, which are presented in this article in order of most to least conservative, dentists and laboratory technicians can best determine the ideal material for a given treatment.

Author(s): Edward A. McLaren, DDS, MDC;Johan Figueira, DDS
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Recent Surgery Articles
Surgical Veneer Grafting - Compensation for Natural Labial Plate Remodeling After Immediate Implant Placement

Surgical Veneer Grafting - Compensation for Natural Labial Plate Remodeling After Immediate Implant Placement
Contemporary implant therapy aims to provide highly esthetic and predictable treatment outcomes while decreasing treatment duration and complexity. The clinician must therefore be cognizant of circumstances with a predisposition toward esthetic outcomes and treatment plan accordingly. Preservation of the surrounding hard and soft tissues associated with an immediate postextraction socket implant to replace a nonrestorable tooth in the esthetic zone is one of the greatest challenges facing the dental team. A case report of a hopeless maxillary left central incisor in a patient with a thin periodontal phenotype illustrates this new surgical and prosthetic approach. Clinical, radiological, and esthetic parameters were recorded to evaluate primary treatment outcomes.

Author(s): Alessandro Agnini, DMD;Maurice Salama, DMD;Henry Salama, DMD;David Garber, DMD;Andrea Mastrorosa Agnini, DDS
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Antimicrobial Effect of a Single Dose of Amoxicillin on the Oral Microbiota

Antimicrobial Effect of a Single Dose of Amoxicillin on the Oral Microbiota
Amoxicillin is commonly used in oral surgery for antimicrobial prophylaxis against surgical-site infection and bacteremia because of its effect on oral streptococci. The aim of this study was to determine whether amoxicillin reaches the break-point concentrations in saliva and has any effect on the salivary microbiota, colonizing bacteria on mucosal membranes and on the gingival crevice after a single dose of amoxicillin. A single dose given as prophylaxis to prevent a surgical-site infection results in a significant reducing effect on the oral streptococcal microflora in the gingival crevice and may have an impact on bacteria spreading into tissues and the bacteria of streptococci.

Author(s): Cecilia Larsson Wexell, DDS, PhD; Henrik Ryberg, PhD; Wivi-Anne Sjöberg Andersson, DDS; Susanne Blomqvist, BSc; Pieter Colin, PhD; Jan Van Bocxlaer, PhD; Gunnar Dahlén, DDS PhD
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Reconstruction of a Single-Tooth Traumatic Defect in the Anterior Maxilla Using the Khoury Bone Plate Graft

Reconstruction of a Single-Tooth Traumatic Defect in the Anterior Maxilla Using the Khoury Bone Plate Graft
Trauma to teeth and the dentoalveolar process may result in a ridge defect that precludes straightforward implant therapy of the patient. Typically bone and soft tissue augmentation of the area would first be needed to adequately prepare the tissues for the implant and its restoration..Grafting of the site is substantially more difficult in cases where the ridge also lacks adequate height, and techniques to recreate a bony envelope to apply guided bone regeneration may be required. Moreover, defects in the anterior aesthetic zone that require both bone and soft tissue grafting and a restoration that harmonizes the adjacent pink and white aesthetics may be an even more significant challenge to the restorative team. Hereafter a case of trauma to an anterior maxillary tooth that saw destruction of the ridge is presented, with the defect reconstructed to accommodate a functional and aesthetically pleasing implant supported restoration.

Author(s): Howard Gluckman, BDS, MChD;Jonathan Du Toit, BChD
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Recent General Articles
Antimicrobial Effect of a Single Dose of Amoxicillin on the Oral Microbiota

Antimicrobial Effect of a Single Dose of Amoxicillin on the Oral Microbiota
Amoxicillin is commonly used in oral surgery for antimicrobial prophylaxis against surgical-site infection and bacteremia because of its effect on oral streptococci. The aim of this study was to determine whether amoxicillin reaches the break-point concentrations in saliva and has any effect on the salivary microbiota, colonizing bacteria on mucosal membranes and on the gingival crevice after a single dose of amoxicillin. A single dose given as prophylaxis to prevent a surgical-site infection results in a significant reducing effect on the oral streptococcal microflora in the gingival crevice and may have an impact on bacteria spreading into tissues and the bacteria of streptococci.

Author(s): Cecilia Larsson Wexell, DDS, PhD; Henrik Ryberg, PhD; Wivi-Anne Sjöberg Andersson, DDS; Susanne Blomqvist, BSc; Pieter Colin, PhD; Jan Van Bocxlaer, PhD; Gunnar Dahlén, DDS PhD
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Effectiveness of a Super-Pulsed CO2 Laser For Removal of Biofilm From Three Different Types of Implant Surfaces: An In Vitro Study

Effectiveness of a Super-Pulsed CO2 Laser For Removal of Biofilm From Three Different Types of Implant Surfaces: An In Vitro Study
As dental implants become a routine part of dental practice, so too will the prevalence of peri-implant diseases. Inherent to the treatment of peri-implant disease is the removal of microbial biofilms from the implant surface. Currently, there is no standardized protocol for application of any treatment modality directed at implant surface decontamination. In this in vitro study, we report on the effectiveness of a super-pulsed CO2 laser, delivering an average fluence of 6.3 to 113 J/cm2, to remove biofilm from three different types of implant surface topographies. Biofilms ranged in thickness from 5 to 15 μm. An average fluence of 19 J/cm2 was sufficient to achieve 100% ablation of the biofilm on hydrophilic sandblasted and acidetched surface specimens (SA). However, to achieve 100% ablation of biofilm on HA and highly crystalline, phosphate enriched titanium oxide (PTO) surfaced implants required an average fluence of 38 J/cm2.

Author(s): Peter Vitruk, PhD;Charles M. Cobb, DDS, MS, PhD
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Oral Soft Tissue Laser Ablative and Coagulative Efficiencies Spectra

Oral Soft Tissue Laser Ablative and Coagulative Efficiencies Spectra
The key to the success of soft tissue lasers is their ability to cut and coagulate the soft tissue at the same time. Present work is aimed to derive the wavelength-dependent differences in photo-thermal ablation and coagulation efficiencies for oral soft tissue pulsed dental Near-IR Diode, Mid-IR Erbium and IR CO2 lasers. Even though the soft tissue photothermal ablation has been extensively studied, there remains a discrepancy between (a) the widely proliferated notion about efficient Near-IR 800-1,100 nm laser ablation of the oral soft tissue, and (b) studies reporting the inefficient soft tissue Near-IR absorption/ablation. Indeed, the notions about “the key to the usefulness of the Nd:YAG is that this wavelength is highly absorbed in oral soft tissue”, and “all currently available dental laser instruments and their emission wavelengths have indications for use for incising, excising... oral soft tissue surgery”, contradict an observation illustrated here...

Author(s): Peter Vitruk, PhD
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