Wednesday, April 16, 2008

Implants in periodontitis patients and Tapered Madness

Implant therapy in aggressive periodontitis patients: A systematic review and clinical implications- Quintessence International Mar 2008 issue

A search was conducted to identify and summarize articles published in English and reported on the survival of implants in aggressive, rapidly progressive, or juvenile periodontitis patients. Our search revealed only 9 articles, 4 of which were case reports. Although available evidence is weak, it suggests good short-term survival of implants placed in periodontally well-maintained aggressive periodontitis patients. Bone loss around implants in aggressive periodontitis patients, however, appears to occur more frequently than it does in chronic periodontitis patients or periodontally healthy individuals. A summary and critical analysis of the aforementioned articles is presented.

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Taper Madness in Rotary Endodontics
Crown down was a good thing with Tapered instruments but things seem to have gone too far. Despite massive science showing that apical cleaning is the most important thing we find dentist happy to prepare the canal with 1-3 tapered instruments. If you want to see how good you are ? prepare an extracted tooth with your technique and after obturation cut the apex 1 mm and examine under high magnification, you may be shocked to see how much debris is left in the apical area with your favorite technique.
Last week at AAE meet in USA Sybron introduced another brand of Tapered instruments -Twisted file, to read articles on this by Dr Rich Mounce HERE
To know how to do a good job of cleaning apical area HERE

Implant Site Development by Orthodontic Extrusion
A Systematic Review in Angle ortho 2008 issue 4
It is a nice way if you want to save money on bone augmentation procedures.
Based on the available literature, orthodontic extrusion of nonrestorable teeth prior to implant placement appears to be a viable alternative to conventional surgical augmentative procedures in implant site development. No direct comparison to any other method was found, and therefore no conclusion could be made about its relative efficacy. Full text here


Bleaching and Bond Strength

Does vital bleaching alter the surface topography of enamel and thus affect the bond strength of adhesives to enamel? Alterations in bond strength might be significant with regard to clinical operative procedures that involve composite resin bonding, such as bonding orthodontic brackets, porcelain veneers, composite veneers, or future composite restorations.
This recent study published in Angle ortho Vol 78 No 4 concludes that use of a carbamide peroxide bleaching agent immediately before bonding significantly reduces the shear bond strength values of self-etching primer systems. But 30 days after bleaching bonding strength becomes OK. Full Article HERE

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