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Recent Restorative Articles
Three-Dimensional (3D) Facially Driven Workflow for Anterior Ridge Defect Evaluation: A Treatment Concept

Three-Dimensional (3D) Facially Driven Workflow for Anterior Ridge Defect Evaluation: A Treatment Concept
The esthetic rehabilitation of anterior ridge defects and achieving patient satisfaction have become major clinical challenges for dentists and technicians. Poor diagnosis and treatment planning are frequently associated with multiple surgical procedures that fail to meet patient expectations. The loss of hard and soft tissues in anterior ridges results in an esthetically compromised zone that affects the rehabilitation prognosis. The presence of interdental papilla and papillary configuration play a decisive role in patient satisfaction.

Author(s): Maurice Salama, DMD;Christian Coachman, DDS, CDT
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When Esthetic Becomes Challenging

When Esthetic Becomes Challenging
This case report shows the successful change of a young lady smile, by following standard dental esthetic guide lines. With careful, detailed examination and diagnosis, we could reach our goal toward providing a high esthetic smile change.

Author(s): Ahmed M. Shamiyah - BDS, MSc, FIDc
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Treating Two Adjacent Missing Teeth in the Esthetic Zone - Part 1: The Pink Hybrid Restoration & the Unilateral Versus Bilateral Defect Concept

Treating Two Adjacent Missing Teeth in the Esthetic Zone - Part 1: The Pink Hybrid Restoration & the Unilateral Versus Bilateral Defect Concept
This article, the first of a planned three-part series, outlines a new surgical & prosthetic approach for treating cases involving two missing adjacent teeth in the esthetic zone. These type of cases, particularly when combined with a three-dimensional ridge deficiency, represent one of esthetic dentistry's most challenging dilemmas. A Clear understanding of the unilateral and bilateral defect concept is necessary to properly evaluate each particular case, understand surgical limitations, perform a better risk assessment, establish an esthetic prognosis, develop the best clinical-laboratory strategy, and adjust patients' expectations. While not recommended for every case, represents a useful, economical, and predictable alternative that decreases the umber and complexity of interventions.

Author(s): Christian Coachman, DDS, CDT;Maurice Salama, DMD;Eric Van Dooren, DDS; Eduardo Mahn, DDS, DMD, PhD
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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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Recent Surgery Articles
The Root Submergence Technique at Single Tooth Sites to Short-Span Edentulous Sites: A Step-By-Step Partial Extraction Therapy Protocol

The Root Submergence Technique at Single Tooth Sites to Short-Span Edentulous Sites: A Step-By-Step Partial Extraction Therapy Protocol
Submerging roots for ridge preservation was the earliest partial extraction therapy and has been described since the 1970s. Despite the approximately 47 animal and human studies published since, an updated and contemporary step-by-step protocol has not yet been provided. This technique report describes in detail how to manage submerged roots at single tooth sites and at short-span edentulous areas.

Author(s): Jonathan Du Toit, BChD, Dip Oral Surg, Dipl Implantol, MSc, MChD (OMP), FCD(SA) OMP, PhD;Maurice Salama, DMD;Howard Gluckman, BDS, MChD, PhD;Katalin Nagy, DDS, PhD
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Fibrinogen-Induced Regeneration Sealing Technique (F.I.R.S.T.). An Improvement and Modification of Traditional GBR: A Report of Two Cases

Fibrinogen-Induced Regeneration Sealing Technique (F.I.R.S.T.). An Improvement and Modification of Traditional GBR: A Report of Two Cases
Guided bone regeneration is a technique widely known, clinicians know very well indications and limitations of this technique. One of the principles to achieve bone augmentation and formation resides in the stability of the blood clot forming under a barrier membrane. The technique proposed in this article has the goal of providing stabilization to the bone graft by adding fibrin sealant (FS) to the bone graft and also using the fibrin sealant to attach a bone membrane (cortical lamina) to the recipient site. This simple modification of the technique of guided bone regeneration is presented in two successful cases.

Author(s): Vincenzo Foti, MD, DDS;Roberto Rossi, DDS
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Buccal Sliding Palatal Pedicle Flap Technique for Wound Closure After Ridge Augmentation

Buccal Sliding Palatal Pedicle Flap Technique for Wound Closure After Ridge Augmentation
One standard approach for wound closure after ridge augmentation is coronal flap advancement. Coronal flap advancement results in displacement of the mucogingival junction and reduction of the vestibulum. In the maxilla, a buccal sliding palatal flap can be applied for primary wound closure after ridge augmentation. The dissected part of the palatal connective tissue is left exposed, thus eliminating or reducing the amount of the coronal flap advancement respectively and increasing the amount of keratinized gingiva. In combination with guided soft tissue augmentation, this flap design enables a three-dimensional peri-implant soft tissue augmentation.

Author(s): Snježana Pohl, MD, DMD;Maurice Salama, DMD;Pantelis Petrakakis, DDS, DPH
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Recent Orthodontics Articles
Decision Making for Soft and Hard Tissue Augmentation in Surgically Facilitated Orthodontics

Decision Making for Soft and Hard Tissue Augmentation in Surgically Facilitated Orthodontics
The purpose of this article is to present a decision-making algorithm for soft and hard tissue augmentation in surgically facilitated orthodontics (SFOT). In cases where there is adequate hard and soft tissue envelope, selective corticotomies may be adequate. In cases, where the existing hard and soft tissue anatomy is inadequate, hard and soft tissue augmentation is recommended. Also, hard and soft tissue augmentation is recommended to avoid teeth extractions during orthodontics.

Author(s): Thanos Ntounis, DDS, MS;Lillie M. Pitman
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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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