Monday, March 29, 2010

Sedation Death, Choosing Right Composite, House Call, Green tea, Acupuncture, Best Retainer ? Shade Matching.

Woman sues sedation training center over husband's death
A Missouri woman whose husband died in 2007 following conscious sedation for a dental procedure is now suing the company that provided the dentist's sedation training.

Sarah Coleman originally sued the dentist, Guilan Norouzi, D.M.D., alleging that Dr. Norouzi's negligence led to her husband's death. That lawsuit was settled out of court last December for an undisclosed amount.

John Coleman, then 47, went to Dr. Norouzi in March 2007 to have nearly a dozen teeth extracted and replaced with dental implants. Prior to the procedure, he was given 2 mg of Halcion (triazolam). According to legal documents and news reports, he did not respond well to the drug and had to be restrained in order for Dr. Norouzi to complete the dental work.

Following the procedure, he was given a reversal agent, Romazicon (flumazenil), but went into cardiac arrest while still in Dr. Norouzi's office. He was taken to the hospital but was pronounced brain-dead a short while later and died the next day, leaving behind his wife and three young sons.

Best retainer routine, post orthodontic treatment
Now a new study on patient compliance with orthodontic retainers has found that initial wear of vacuum-form retainers (VFRs), followed by a Hawley appliance one to two years into the retention phase, may yield the best results.
The study was presented at the recent American Association for Dental Research (AADR) meeting in Washington, DC, March 3-6.
This is the first study that has quantitatively evaluated retainer compliance at different amounts of time following treatment, study author Michael Pratt, D.M.D., a resident in the orthodontic department at the University of Kentucky College of Dentistry.
The study shows that average patient compliance decreases dramatically the longer a patient is out of treatment, and is abysmal at five years following treatment.

Should Dentist make house call ?
Dentists went to her apartment, evaluated her dental health and took X-rays. They discovered that besides a new tooth, she needed root canals and a crown - "a huge reconstruction of her teeth," Green said.
Because she needed so much work, Bay Area House Call Dentists arranged transportation to its office in San Francisco, where all the work was done in about four hours.  
After a follow-up visit, "she did fine," Green said. "She liked the people. They kept us informed." MORE HERE

Composite in Everyday Practice: How to Choose the Right Material ?
Eur J Esthetic Dent
In daily practice, composites are the materials most commonly used for restorative dentistry. They are used for preventive seals, microinvasive restorations, build-ups and complex direct and indirect restorations in posterior sections.
Indeed, it is in the anterior sections that composites have traditionally been used to the greatest effect, enabling clinicians to carry out complex restorations using direct techniques with notable esthetic and clinical results.

Recent product developments combined with clinical research on stratification make it now possible to utilize new composites that have excellent opalescence and fluorescence characteristics and provide an excellent color range to choose from.1,2
It is however, a common complaint among clinicians that the layering techniques are rather complex and it is difficult to make the right color choice. Paradoxically, they say that the appearance on the market of sophisticated materials, designed to give ever better results in the medium and long term, only makes it more difficult to make the correct decision.
In the present article, the authors will discuss these topics and make suggestions on how to achieve high quality results every day, both from an esthetic and clinical point of view. 23 page full paper available on payment, email to gurudental@yahoo.com

Secrets of Good Shade Matching
Using daylight for shade matching may not always be the best option. Getting a second opinion from a young, female dental assistant may help you achieve a perfectly matched crown. And as for that blue card you use for eye relaxation, it may be time to rethink it.
As we age, our eyes can get old and look at objects with brownish tints, he noted. Most of the retina is composed of rods that see black and white. The eye has much fewer cones that see color, and that is why eyes are more sensitive to black and white. Women have a greater percentage of photoreceptor cells (cones) than men and can see color better. Most dentists are told to keep a blue card in their office so they can look at it and relax their retinas before taking a shade, Dr. Ziemiecki said.Instead of the blue card, he suggested using an 18% photographic gray card or gray construction paper with no color to relax the saturated receptors in the retina.
Also, peripheral information can affect our choice of shade -- even lipstick can change shade perception, Dr. Ziemiecki said. He suggested separating all the teeth by putting borders around them and making the individual teeth stand out more. Isolating the tooth can help achieve a more accurate idea of color for a better shade match, he said.

Acupuncture Calms Highly Anxious Dental Patients
A  visit to the dentist provokes extreme fear and anxiety in an estimated one in 20 people, and can put them off going altogether, a condition termed odontophobia. And up to a third of patients report moderate anxiety at the prospect of dental treatment, studies show.

The authors base their findings on 16 women and four men from eight dental practice lists.
Each of the patients was moderately or extremely anxious about going to the dentist for treatment, as assessed by a validated questionnaire -- the Back Anxiety Inventory (BAI). MORE HERE


Drink Green Tea For Healthy Teeth And Gums
According to a recent study published in the Journal of Periodontology, routine consumption of green tea can help promote superior dental health.

In the study, Japanese researchers analyzed the oral health of 940 men based on three indicators of periodontal disease: clinical attachment loss of gum tissue, periodontal pocket depth and bleeding upon probing of the gum tissue.

The research team found that every cup of green tea consumed was associated with an additional decrease in all three symptoms related to periodontal disease. MORE HERE


Japan develops Robot to train Dental students
A robot which can simulate the reactions of humans was unveiled in Japan this week.
The humanoid – Hanako –was developed to train dental students.
It's the joint creation of Showa University, a research team led by humanoid pioneer, Atsuo Takanishi, a professor at Waseda University, and robot-making company Tmusk.

The robotic dental patient is supposed to be female, can converse with dental professionals, discharges robotic saliva, sneezes and opens and closes her mouth.
Standing 157cm tall, Hanako's body is the work of Tmsuk, while the medical features were developed by the dental faculties of the universities involved in the project.
There are nine joints in her body – in her jaw, tongue and even in her eyelids. MORE HERE

Watch live action in this video
 


 

Friday, March 19, 2010

Formula for making teeth, Hypersenstivity, Powerful Painkiller, Dentists income declines in USA

Formula for Making Teeth ?
Each cusp of our teeth is regulated by genes which carefully control the development. A similar genetic puzzle also regulates the differentiation of our other organs and of all living organisms. A team of researchers at the Institute of Biotechnology of the University of Helsinki has developed a computer model reproducing population-level variation in complex structures like teeth and organs. The research takes a step towards the growing of correctly shaped teeth and other organs. MORE

30 Times more potent pain relief in Dental Pain ?
In a study, researchers at  India tried combining buprenorphine with bupivacaine to see if they could produce long-term pain relief in patients undergoing oral surgery (Journal of Oral and Maxillofacial Surgery, December 2009, Vol. 67:12, pp. 2571-2576).

The investigators selected 50 patients scheduled for such procedures as incision and drainage of abscesses, enucleation of cysts, apicectomy, and third-molar extraction. Twenty-four had procedures in the maxilla and 26 in the mandible.

The investigators randomly divided the patients into two groups similar in demographics and the type of procedure they underwent. Before the surgery, dentists administered nerve blocks consisting of 0.5% bupivacaine and 1:200,000 epinephrine alone to one group, and the same formula mixed with 0.3 mg of buprenorphine to the other group, with the injection site varying depending on the procedure. A different group of dentists then performed the surgery, and a third group asked the patients to rate their pain.

The researchers found that pain relief lasted a mean time of 8.34 (± 0.11 hours) for those patients who only got the bupivacaine and epinephrine, but 28.18 (± 1.02 hours) when buprenorphine was added to the mix, a very significant difference (p < 0.001). By the end of 12 hours, all the patients who didn't get buprenorphine had asked for additional pain relief, compared to only 8% of the buprenorphine patients.

BioDelivery is also testing buprenorphine delivered in what it calls a bioerodible mucoadhesive (BEMA). BEMA consists of a small polymer film that is applied to buccal membranes. It adheres in less than five seconds, then it dissolves in 15 to 30 minutes as the drug crosses the membrane into the bloodstream, according to the company.

Appointment/Election of DCI president challenged in High Court
CHENNAI: A writ of Quo Warranto has been filed in the Madras High Court seeking a direction to show cause under what authority Anil Kohli is holding the office of the president, Dental Council of India (DCI).

In his petition, George Paul of Fairlands, Salem, submitted that he was a registered medical practitioner. Dr. Kohli ought not to have been nominated a member of the DCI as he had become a member of the council by way of a nomination by the Government of National Capital Territory of Delhi in June 2009.

The Dentists Act enabled each State to nominate one member, who was a medical practitioner in that State. But, no Union Territory could nominate any member. “Dr Kohli, though not validly nominated, contested and was elected as president of the DCI in July 2009. As Dr Kohli’s election as a member of the DCI is void, his election as its president is also void,” the petition said. LINK 

Jail for charging Capitation fee, bill cleared by Cabinet-Cabinet Clears education reform bills
New Delhi, Mar 19 (PTI) Duping students by charging capitation fee or failing to keep promise of quality education could now attract a fine of upto Rs 50 lakh for errant institutes or imprisonment upto three years for its administrators, according a Bill cleared by the cabinet today.

Paving the way for stricter penal action against educational institutions indulging in unfair practices, the Cabinet approved the draft Prohibition of Unfair Practices in Technical, Medical Educational Institutions and Universities Bill, 2010.

The Cabinet also cleared two other education reforms bills -- one for setting up of Educational Tribunals to adjudicate disputes in campuses and another on setting up a National Accreditation Agency to give accreditation and benchmarks to institutions. These bills will now be tabled in Parliament, Information and Broadcasting Minister Ambika Soni told reporters here. LINK

Leave that Carious dentin ALONE
 Contrary to decades of tradition, dentists should leave carious dentin untouched in many lesions, researchers said Wednesday at the American Association for Dental Research (AADR) annual meeting.
For years, dental professors have taught their students to remove all infected tissue from cavities and carefully shape the preparation before placing a restoration, said Edwina Kidd, a former professor at King's College London.

"Does this fit with knowledge?" she asked. "I think the answer may be 'no,' which means I've been teaching unsubstantiated rubbish for 30 years."

James Summitt, chair of restorative dentistry at the University of Texas at San Antonio agreed, citing multiple studies that suggest sealing over a lesion can arrest its progress.
And even when a restoration is needed, it may be sufficient to seal over the cavity without removing the infected tissue, said Dr. Kidd, citing four randomized, controlled trials of this approach. In two of them, the investigators re-entered the lesions to see what had happened under the filling, and the results looked promising, she said.
She also cited a study of the Hall technique, in which a preformed metal crown is placed over an unprepared molar. The procedure is less traumatic for the patient -- typically a child. A randomized trial led by Nicola Innes, in BMC Oral Health found that this type of restoration had no more failure than traditional restorations for the same type of lesion.

USA Dentist used paper clips in Root Canals !
Paper clips are really handy. You can use them for things like hitting that tiny reset button on your DVR and, well, clipping paper. And according to the Attorney General's office in Massachusetts, one dentist was using them in patients' mouths during root canals.

A grand jury in the Bay State have indicted a dentist who had once had a practice in Fall River, Mass., of using paper clips in place of stainless steel posts during root canal procedures. According to the indictment, he would then bill Medicaid for the steel posts and presumably pocket the difference.

Charges brought against the dentist, who now lives in Maryland, include assault and battery, larceny, submitting false claims to Medicaid and illegally prescribing prescription drugs. You can see patient interview video HERE

Best way to Treat Dentin Hypersensitivity, JADA Mar 2010
Three agents were tested, Pain-Free -Parkell, BisBlock-Bisco, Seal & Protect-Dentsply. The results of the statistical analysis showed that all visual analog scale (VAS ) scores at the posttreatment evaluation periods were reduced significantly compared with those at baseline (P < .05). More teeth were sensitive to air stimuli than to tactile stimuli. The mean VAS scores for Dentin Hypersensitivity (DH) in the mandibular teeth were significantly higher than for those in maxillary teeth immediately after treatment (for tactile stimuli) and two weeks after the first application (for air stimuli) (P < .05)
Conclusions. All three desensitizing agents were effective in relieving DH up to four weeks, independent of their application procedures. There was, however, a significant reduction in mean sensitivity scores of teeth that had been treated with Seal & Protect and Pain-Free compared with those of BisBlock at weeks two, three and four.

Dentist's income decline in USA
Dentists' net incomes fell by 5% in 2009, according to a new ADA quarterly survey report. If the finding is borne out by the organization's more detailed annual survey, it would be the biggest drop since at least 2003. Dentists have reported a decline in income for six straight quarters in the survey. In the fourth quarter of 2009, 56.7% of dentists reported that they made less money than they had in the previous quarter. Only 17% said they made more money.

"The fourth quarter of 2009 was another difficult period for dentists who participated in the American Dental Association Quarterly Survey of Economic Confidence," the authors wrote. "Although a number of indicators moved upward, the general results were quite negative."

USA lawsuit Dismissed Listerine's False claims
A Los Angeles court has dismissed a class-action lawsuit challenging Listerine's claim that its mouthwash is "as effective as floss" when used regularly. The suit, originally filed in 2005, alleged false advertising and fraudulent business practices, and was brought on behalf of anyone who purchased Listerine in California from June 2004 through January 2005.

The litigation stemmed from Listerine TV commercials that declared, "It's clinically proven. A quick, easy rinse with Listerine Antiseptic twice a day is actually as effective as floss." Flashy animated graphics showed streams of Listerine flowing around teeth, magically removing bits of food and plaque. The judge in that ruling ordered the company to stop the ads, noting that "substantial evidence" suggests that no amount of mouthwash can replace daily flossing. MORE

Video showing inferior alveolar nerve block
It demonstrates the technique very nicely

Sunday, March 14, 2010

Perio helps combat Preterm birth, 3 D revolution, Suremile

Avoid Preterm baby, get Perio treatment
Previous studies have explored the effect of periodontal treatment, irrespective of efficacy of treatment, in reducing infant prematurity. In a study titled "Risk of Preterm Birth Is Reduced with Successful Periodontal Treatment," (from the University of Pennsylvania, Washington University) determined whether a reduction in infant prematurity was associated with successful periodontal treatment. Subjects who were successfully treated for their periodontal disease had a significantly lower incidence of preterm birth less than 35 weeks gestation. MORE 
See it on BBC

Efficiency And Effectiveness Of Suresmile  WJO 2010;11:16–22.

Patients treated using the SureSmile process and a conventional approach were anonymized and randomized prior to independent scoring by two ABO OGS–calibrated examiners. Results: Intra- and interexaminer reliability was consistent in all components with no differences between examiners (r = 0.96, P < .001). The ABO OGS score for the SureSmile patients (mean 26.3) was 4.4 points lower (P < .001) than for those treated conventionally (mean 30.7). Furthermore, treatment with the SureSmile process was shorter (14.7 months vs 20.0 months). Conclusion: The SureSmile process results in a lower mean ABO OGS score and a reduced treatment time than conventional approaches. The approach has great potential to both decrease treatment time and improve quality.

Throw away your plaster models AJODO Feb 2010

The aim of this study was to compare the accuracy of dental measurements taken with calipers on plaster dental casts and those from computed tomography scans of the dentition with a dental measurement program.
Dental measurements obtained from the 3DD are comparable with those from conventional models in the 3 planes of space. This technology has the added benefits of eliminating the need for taking impressions and the time needed for making models. With conebeam
CT becoming mainstream in orthodontic practice, are we going to an era whereby a single step of data acquisition can compute all our diagnostic information?

Instant Orthodontics !

There are several treatment alternatives for slight-to-moderate anterior tooth malpositioning. The first option to be considered should be orthodontic treatment, especially in younger patients with unrestored teeth. However, the cost or length of orthodontic treatment often makes this treatment undesirable for many patients. Recent literature suggests that minor tooth-alignment issues, such as facio-lingual displacement and crowding, may be resolved with indirect porcelain veneer restorations.1,2 However, others have questioned the value of this treatment because of the nonconservative nature of the indirect preparations. Full Paper

And Now the 3D Facial Norms ? AJODO Mar 2010

The aim of this study was to assess the use of 3-dimensional facial averages in determining
facial morphologic differences in 2 white population groups. Methods: Three-dimensional images were obtained in a reproducible and controlled environment from a commercially available stereo-photogrammetric camera capture system. The 3dMDface system (3dMD, Atlanta, Ga) photographed 200 subjects from 2 population groups (Budapest, Hungary, and Houston, Tex); each group included 50 men and 50 women, aged 18 to 30 years. Each face was obtained as a facial mesh and orientated along a triangulated axis. All faces
were overlaid, one on top of the other, and a complex mathematical algorithm was used until an average composite face of 1 man and 1 woman was obtained for each subgroup (Hungarian men, Hungarian women, Texas men, and Texas women). These average facial composites were superimposed (men and women) based on a previously validated superimposition method, and the facial differences were quantified.

Reconstruction of Endodontically Treated Posterior Teeth - with or without Post? Guidelines for the Dental Practitioner- Eu J of Esthetic issue 4, 2009

The clinical concepts regarding the restoration of root canal treated teeth are not clear today and often based on conjecture due to a lack of sound empirical data. The diversity of published opinions is confusing and may lead to less-than-optimal treatment selections. There is also emerging debate whether or not a post is necessary. The purpose of the present article is to organize this topic in evidence-based principles and provide dental practitioners with clear guidelines about restorative therapy for premolar and molar teeth. Two clinical reports are presented, to exemplify the different clinical situations.
The first case highlights a conservative restoration of an endodontically treated molar, maintaining an adequate quantity of healthy residual tissue and only covering the cusp with restoration material, which was not sustained by healthy dentin. In the second case, the fact that the premolar was so badly damaged by carious pathology meant that it was necessary to use a pin to anchor the composite material, and the cusp was covered completely. Request full paper email to icdr@hotmail.com

Saturday, March 6, 2010

Tooth GENE, London Dentist SICK,, Short Implant selection, Healthy Baby ?

Scientists uncover genes that influence tooth development
Genes that influence tooth development in the first year of life have been identified by scientists.

The research team has also uncovered a link between the delayed appearance of milk teeth and the need for future corrective work.

The research, which involved teams from Imperial College London, the University of Bristol and the University of Oulu in Finland, has identified several genes which affect tooth development in the first year of life.

They found that babies who carried specific genetic variants tended to have fewer teeth by their first birthday than other children. Full PAPER

How to achieve best position for Microimplants by Park et al
The midpoints between the roots were located distally to the contact point and from the cervical to the apical areas. The lines connecting these midpoints from the cervix to the
apex of the roots in the mandibular arch had more distal inclination than in the maxillary arch.
Conclusions: To minimize root contacts, microimplants need to be inclined distally about 10-20 degrees and placed 0.5 to 2.7mm distally to the contact point to minimize root contact according to sites and levels, except into palatal interradicular bone between the maxillary first and second molars. (AJODO Feb 2010)

Dentists in LONDON 'sickest of all health professionals'
The free, confidential service for practitioners living or working in the London area was launched by the National Clinical Assessment Service amid concerns that some doctors and dentists were either struggling to access appropriate care or were suffering in silence rather than seeking proper medical help because of fears they would be stigmatised.
Dentists are the sickest of all health professionals, according to the head of an NHS service aimed at helping clinicians struggling with physical or mental illnesses. MORE

How to Select Short implants ?
The key to the implants' strength is their width, Dr. Urdaneta said. As long as they are at least 3 mm wide, they do not break, he said. Typically, such implants are embedded about 7.9 mm into the bone, but some are inserted only 5 mm deep. By contrast, long implants can be placed more than 11 mm into bone.
With short implants, "most impressive is what happens below the gum," he said. Some patients who wear these implants for five years have gained more than 1.5 mm of bone, according to Dr. Urdaneta.
Contrary to popular belief, he said, relatively large crown-to-implant ratios don't cause crestal bone loss. He cited a study in the International Journal of Oral and Maxillofacial Implants that compared bone loss of implants with different crown-to-implant ratios (JOMI, January-February 2005, Vol. 20:1, pp. 69-76). "Long implants and/or splinting can result in greater crestal bone loss," the study authors concluded. MORE


Want to deliver a healthy Clean baby ? Clean your teeth in time.
PREGNANT WOMEN have been warned not to ignore dental problems following the case of an unnamed woman with the common gum disease gingivitis who delivered a stillborn baby at 39 weeks.
Doctors were able to trace the oral bacteria in the 35-year-old mother’s mouth to bacteria found in the baby’s bloodstream, lungs and stomach.
The research was carried out by microbiologist Yiping Han in the Department of Periodontics at Case Western Reserve University School of Dental Medicine, Ohio.
The findings, published in the February issue of Obstetrics Gynecology , suggest that any disruption to the amniotic fluid could present a risk to both mother and baby – making the infection from gum disease a real risk.

Researchers from Queen Mary University of London have also found that bacteria from a woman’s mouth could be transferred through blood and amniotic fluid to her child while still in the womb. MORE

Banana Tooth Brush
Baby Banana® Brush Teether for Infants ages 3 months to 1 year. Dental hygienist mom-invented. Gently massages gums and teeth. Develops good oral hygiene habits early, preventing cavities later. Easy to grasp "a-peel-ing" banana handles. Flexible material decreases risk of mouth injury. Non-allergenic medical grade silicone. BPA, latex, and phthalate free. Non-allergenic 100% highest quality silicone. Dishwasher and freezer friendly.
Teeth Show Evidence of Radiation Exposure
Researchers at Howard University in Washington College of Dentistry believe that tooth enamel stores important data about a person’s exposure to radiation. The team is developing Electron Paramagnetic Resonance (EPR) to determine the level of free radicals in substances, including tooth enamel.

What will this information be used for? The hope is that EPR can assist medical workers in triaging patients or dividing victims of radiation exposure into classes by the amount of radiation received. The new technology is minimally-invasive and would provide data useful in treating people exposed to radiation in an accident or by a “dirty bomb,” which refers to a radiation dispersal device.  MORE

Dentistry Goes fully Digital
Gilbert Achermann, President and CEO, commented: “Digitalisation will impact all aspects of dentistry as digital workflows supersede labour-intensive manual processes, enhancing interfaces, shortening treatment, reducing potential for error and improving quality assurance.” MORE

Self Adjusting file Video 
It is true or most likely a marketing gimmick ? whatever it is, fun to watch, very interesting video