DT Middle East and Africa
Columbia University announces break-through in tooth regeneration / News & Opinions / Media CME / PROSTHODONTICS
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DTME
June 2010_DTME 6/16/2010 7:43 PM Page 1
DENTAL TRIBUNE
The World’s Dental Newspaper · Middle East & Africa Edition
PUBLISHED IN DUBAI
May-June 2010
News & Opinions
2
Did you see the STARS Twinkle in Alexandria?
4Page
Media CME
Trends & Applications
Getting to know you
Prosthodontics
Hours
2
4Page
Columbia University announces
break-through in tooth regeneration
Daniel Zimmermann
DTI
NEW YORK, USA/LEIPZIG,
Germany: Dental implants could
soon become a secondary choice
for replacing natural teeth. According to new research from the College of Dental Medicine at Columbia University in New York, threedimensional scaffolds infused with
stem cells could yield an anatomically correct tooth in as soon as nine
weeks once implanted. The new
technique, developed by Columbia
University professor Jeremy Mao,
has also shown potential to regenerate periodontal ligaments and
alveolar bone, which could make
way to re-grow natural teeth that
fully integrate into the surrounding
tissue.
Previous research on tooth regeneration has been focusing on
harvesting stem cells directly on
dental implants to improve osseointegration or outside the body
where the tooth is grown under laboratory conditions and implanted
once it has matured. Mao’s tech-
nique, which has been tested on
animal-models, is moving the harvesting process directly into the
socket where the tooth can be
grown ‘orthotopically’.
DT page 2
3M ESPE new composite takes restorative dentistry to new heights
3M ESPE announced its newest
universal restorative Filtek™ Z350
XT Universal Restorative, which
was launched in Middle East and
was supported by scientific events
in Saudi Arabia, UAE, Lebanon and
Kuwait . The scientific event was a
NO. 5 VOL. 8
great success and there was high
attendance of dentists.
The scientific events held in
UAE, Lebanon and Kuwait was
about Conservative Esthetic Solutions. The topics which were addressed were esthetic concepts,
color parameters, shade selection,
finishing and polishing and postop sensitivity. Also, scientific
events showcased some innovative
techniques that showed to reach
aesthetic success, respecting
DT page 2
6
4Page
8
Cleaning teeth twice a day
can prevent heart attack
People who have poor oral hygiene have an increased risk of
heart disease compared to those
who brush their teeth twice a day.
That's according to research published in the British Medical Journal. There has been increased interest in links between heart problems and gum disease over the past
20 years.
While it has been established
that inflammation in the body (including mouth and gums) plays an
important role in the build up of
clogged arteries, this is the first
study to investigate whether the
number of times individuals brush
their teeth has any bearing on the
risk of developing heart disease,
says the research. The authors, led
by Professor Richard Watt from
University College London,
analysed data from more than
11,000 adults who took part in the
Scottish Healthy Survey. The research team analysed data about
lifestyle behaviours such as smoking, physical activity and oral
health routines.
Individuals were asked how often they visited the dentist (at least
once every six months, every one to
two years, or rarely/never) and
how often they brushed their teeth
(twice a day, once a day or less than
once a day). On a separate visit,
nurses collected information on
medical history and family history
of heart disease, blood pressure
and blood samples from consenting adults. The samples enabled
the researchers to determine levels of inflammation that were present in the body.
The results demonstrate that
oral health behaviours were generally good with six out of ten (62%)
of participants saying they visit the
dentist every six months and seven
out ten (71%) reporting that they
brush their teeth twice a day. Once
the data were adjusted for established cardio risk factors such as
social class, obesity, smoking and
family history of heart disease, the
researchers found that participants who reported less frequent
toothbrushing had a 70% extra risk
of heart disease compared to individuals who brushed their teeth
twice a day, although the overall
risk remained quite low. Professor
Watt says:'Our results confirmed
and further strengthened the suggested association between oral
hygiene and the risk of cardiovascular disease - furthermore inflammatory markers were significantly associated with a very simple measure of poor oral health behaviour.' DT
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[2] =>
DTME
June 2010_DTME 6/16/2010 7:43 PM Page 2
2
DENTAL TRIBUNE Middle East & Africa Edition
News & Opinions
Did you see the STARS
Twinkle in Alexandria?
By all measures, figures and
Statistics, the Stars meeting (AOIA
2010) was the most successful Implantology meeting the history of
the Middle East and Africa
The AOIA was honored to have
the brightest stars in the field of oral
Implantology gathering to achieve
its aim of spreading the knowledge
and getting people together
The Super Star, Dr. Henry
Salama, -a main member of Team
Atlanta- conducted a half day
course "Minimally Invasive Implants protocols and Management
of risk factors in Esthetic therapy:
Success by design" which received
a magnificent applaud by the attendants who reached 2000 registrations on the first day.
me feel like part of the family.”
The Congress was also enlightened by the presence of Dr Kenneth Judy the ICOI co- founder & co
chairman, Dr Morton Perel the
chief editor of Implant Dentistry
journal, ICOI & Mr. Craig Johnson
DentalXp would like to congratulate Professor ElAttar and
all the AOIA Academy members for a great and successful
meeting in Alexandria Egypt, in March 2010
DT Page 1
“A key consideration in tooth
regeneration is finding a cost-effective approach that can translate
into therapies for patients who cannot afford or who aren’t good candidates for dental implants,” Dr
Mao told Dental Tribune Asia Pacific. “Our findings represent the
first report of regeneration of
anatomically shaped tooth-like
structures in vivo.”
Dr Mao’s study has been published in the recent Journal of Dental Research and will be presented
at this year’s International Association of Dental Research congress in
Barcelona. Columbia has also announced to have filed patient applications in relation to the engineered tooth and is actively seeking partners to help commercialise
the technology through its technology transfer office Columbia Technology Ventures. DT
DT Page 1
the ICOI Executive Director coming specially to reward our fellowship recipients.
The scientific program hosted
other stars like Dr Gerald
A.Niznick, Prof Nabil Barakat, Dr
Mohamed Hassan, Prof dr Ates Par-
Dr Henry Salama: “I
would like to personally
thank all those who made
lar, Dr Nadim Aboujouade, Prof
Ahmed El Serafi, Dr Nik Sisodia,
and many others..
To continue their leadership,
the AOIA hosted the ICOI fellowship rewards ceremony, which was
held on 24th March during the Gala
Dinner in Crystal palace where 26
dentists received their ICOI fellowships & masterships.
Whether you were there or not,
don’t miss the coming event. Mark
your calendar for the AOIA 2012
great event: Stars Beyond the Horizon. April 25-27, 2012 DT
periodontal and dental tissues. It
was conducted by Prof. Angelo
Putignano a professor in restorative dentistry and the head of operative dentistry and endodontic department at the University of
Marche – Ancona – Italy. He is the
co-author of the book “Adhesive
dentistry: the key to success”. It was
his first visit in Middle East.
While in Saudi Arabia, Dr Rachdan was speaking about Latest Advancements In Restorative Dentistry, classifications of bonding
systems, compared the advantages
and disadvantages of Total etch Vs
Self etch adhesives, the features of
nanocomposites and the use of the
layering technique for the challenging anterior cases
Filtek Z350 XT universal
restorative delivers even better esthetic qualities through an expanded range of body shades. This
offers more universal options for
creating easy, natural-looking,
one-shade restorations, while
maintaining the composite’s versatility for dual or multi-layering
techniques (four opacities are
available). Additional advancements include improved polish retention of dentin, body and enamel
shades, as well as improved handling of translucent shades. Beyond the product attributes, additional simplification is seen in the
form of new, bold labeling and
color-coded opacities, which simplify the shade selection process.
“Feedback from dental professionals is at the core of 3M ESPE innovation, and it’s what allows us to
take industry-leading composite
technology and make it even better,” said Dr. Samer Aouad, Scientific Marketing Supervisor-3M
ESPE - Middle East and Africa who
was also present in the scientific
event.
“With Filtek Z350 XT, we’ve
modified the technology to maintain the excellent handling dentists
love while improving upon polish
retention and simplifying the shading system.”
As the first and only composite
system to incorporate true nanotechnology, the Filtek line has
gained a strong following over the
past six years for its ability to provide the polish and polish retention
of a microfill, while maintaining
the strength and wear properties of
a modern hybrid. DT
Editorial Board
Prof. Abdullah Al-Shammary, Restorative Dentistry, KSA
Prof. Hussain F. Al Huwaizi, Endodontics, Iraq
Prof. Samar Burgan, Oral Medicine, Jordan
Dr. Abdel Salam Al Askary, Implantology, Egypt
DENTAL TRIBUNE
The World’s Dental Newspaper · Middle East & Africa Edition
Dr. Talal Al-Harbi, Orthodontist, Qatar
Dr. Mohammed H. Al Jishi, Bahrain
Dr. Lara Bakaeen, Prosthodontist , Jordan
Dr. Aisha Sultan, Periodontist, UAE
Dr. Kamal Balaghi Mobin Aesthetics, Iran
President/CEO
Yasir Allawi
y.allawi@dental-tribune.ae
Director mCME:
Dr. D. Mollova
info@cappmea.com
Marketing manager
Khawla Najib
khawla@dental-tribune.ae
Production manager
Hussain Alvi
dentalme@dental-tribune.ae
Published by Education Zone
in licence of Dental Tribune International GmbH
© 2010, Dental Tribune International GmbH. All rights reserved.
Dental Tribune makes every effort to report clinical information and manufacturer’s product news accurately, but cannot assume responsibility for the
validity of product claims, or for typographical errors. The publishers also do
not assume responsibility for product names or claims, or statements made
by advertisers. Opinions expressed by authors are their own and may not reflect those of Dental Tribune International.
PO Box 214592, Dubai, UAE, Tel + 971 4 391 0257
Fax + 971 4 366 4512 www.dental-tribune.com
[3] =>
DTME
June 2010_DTME 6/16/2010 7:44 PM Page 3
[4] =>
DTME
June 2010_DTME 6/16/2010 7:44 PM Page 4
4
News & Opinions
DENTAL TRIBUNE Middle East & Africa Edition
New Sensodyne Rapid Action provides clinically
proven relief for sensitive teeth
GlaxoSmithKline (GSK)
announced the Middle East
launch of Sensodyne Rapid Action. The new toothpaste provides an answer for the large
number of people who suffer
from sensitive teeth but do not
treat the problem. In response,
fast-acting Sensodyne Rapid
Action works in just 60 seconds
and offers long-lasting protection.
Tooth sensitivity is a common
problem affecting 1 out of 3 consumers, yet many do not actively
address the problem. A large
number of sufferers try to ignore
their sensitive teeth or develop
ways to avoid the pain, for example, by changing the way they
consume certain food and drinks
or avoiding them altogether.
Also, some people choose to ignore this problem since they
have a hectic lifestyle and do not
have the time to look for a solution.
For those sensitivity sufferers
looking for a quick and easy solution, the new Sensodyne Rapid
Action can be massaged directly
onto the exposed sensitive den-
THE EVENT
Dubai hosts for the 4th time the
CAD/CAM & Computerized
Dentistry International Conference organized by Emirates
Dental association and Centre
for Advanced Professional
Practices (CAPP).
The annual conference was a
great success and achieved
record attendance further establishing our reputation as the industry’s leading CAD/CAM scientific Conference.
tine for sixty seconds, and hence
provide rapid relief from the pain
of sensitive teeth. Plus, Sensodyne Rapid Action provides the
benefits of an ordinary daily
toothpaste including all-round
protection, cleaning and freshness.
Mohammad Otaibi, Group
Brand Manager GSK Consumer
HealthCare, said, “Sensitive
teeth can start in late teens and –
if untreated – can infringe the enjoyment of certain food and
drinks. That is why people adopt
all sorts of behaviors to avoid the
This year’s agenda offered a
wide variety of topics and it is
clear from the participant’s feedback that the sessions they attended were greatly appreciated.
All sessions were very well attended. This was not only due to
the quality of input from the
speakers and panelists but also
due to the richness and pertinence of the discussions.
pain of sensitivity, but the simplest solution is to use a toothpaste that is specially designed
for sensitive teeth. The new Sensodyne Rapid Action provides a
physical seal against sensitivity
triggers and, used twice daily, it
provides long-lasting protection
from sensitivity.”
Sensodyne Rapid Action can
be bought at major supermarkets
and pharmacies across the region. To find out more about Sensitive teeth and Sensodyne Rapid
Action talk to your dentists.
[5] =>
DTME
June 2010_DTME 6/16/2010 7:44 PM Page 5
DENTAL TRIBUNE Middle East & Africa Edition
News & Opinions
3M Incognito Certification Course, Dubai March
Recently in Dubai, at The Atlantis Hotel Palm Jumeirah, 3M
hosted an Incognito Certification
Course with up to 50 Orthodontists
from across the Middle East region.
Dima Zein, Business Development Manager of 3M™Unitek™ in
Middle East & Africa says, “Those
patients that rejected orthodontic
treatment for aesthetic reasons in
the past can now reconsider thanks
to the new technology and - if we
judge by the significant up-take of
Incognito based on sales – consumers are responding well. With
the growing level of adult interest in
aesthetics, we expect even more focus on the Incognito™ Lingual System by orthodontists, as they respond to this consumer demand.”
The patented manufacturing
process of the Incognito™ system
guarantees a remarkable flat design and as a result, offers patients
seeking straighter teeth and effective treatment and maximum comfort.
The new Incognito™ Bracket
System is based on digital registration of the malocclusion situation.
The brackets are then individually
designed and optimally positioned
in the computer. State-of-the-art
Rapid Prototyping technology is
used for the actual manufacturing
of lingual brackets. The single production stages are illustrated and
described in the category production.
Interview with Dr. Khaled A. AlKhayat, D.D.S., M.S. Assistant
Professor Orthodontist
1) Why do you think that 3M’s
Incognito treatment is such a beneficial treatment to use at your practice?
The Incognito treatment is very
beneficial treatment, not only for
my practice but also for my patients
both in the short and long-term.
The biggest advantage is that this
treatment is custom-made for each
individual, chair time is reduced
and the whole treatment is much
more efficient in its design and application. I have actually had patients come in and ask me if we
could provide the Incognito treatment, which just goes to show how
good this treatment actually is.
2) Please can you tell me a bit
about the 3M products you have
used in your practice and how you
think they have fared?
Up until now I have been using
the Clarity SL treatment which has
seen some very good results, and is
very beneficial in the sense that it
doesn’t stain as much as other
braces, and is much more aesthetically pleasing due to its smaller
size. Again, chair time is greatly reduced with Clarity SL.
3) Have you seen an increase in
adults receiving orthodontist treatments to achieve that ‘Perfect
Smile’, and if so why do you think
that is?
There has always been demand
for orthodontic treatment among
adults, but this trend has most definitely increased over the last 15 to
20 years. This is due to more and
more people wanting to emulate
celebrities, and get that ‘Hollywood
Smile’. With a product like Incognito, which is a lingual treatment, it
is now much easier and more acceptable for adults to receive the
treatment.
Interview with Jean-Stephane
Simon, Clinical Director – Lingual Certificate University of
Paris, Speaker at the certification
course.
1) Why is it so important for orthodontists form the region to complete this course?
It is really important because
this is the only customized treatment in the world; there is nothing
else like it which exists. Therefore
AD
it is vital that orthodontists are
trained to be able to use the treatment in the most effective way possible.
2) Do you think that through
hosting these workshops you will
raise awareness of the Incognito
brand?
Yes, we have definitely seen an
increase in the number of people
worldwide who are asking about
Incognito. Once orthodontists
know about the great benefits of
this treatment, then of course they
will want a bit of the action.
3) Can you tell me about why
you work with 3M and what Incognito’s story is?
In 2002 Incognito was tested on
its first patient, and the treatment
was then on the market by 2004. Up
to 500 custom-made Incognito
braces are built every week, all
over the world (apart from the US).
5
[6] =>
DTME
June 2010_DTME 6/16/2010 7:44 PM Page 6
6
Media CME
2
Hours
DENTAL TRIBUNE Middle East & Africa Edition
Getting to know you
A detailed history is an essential element in understanding the
background to a patient’s oral health and planning effectively for
their present and future treatment - Dental Protection
efore providing any treatment, it is a clinician’s responsibility to ask the right
questions, in the right way, and to
listen carefully to the patient’s responses. If an important aspect of
a patient’s history does not come
to light in the consultation process,
and problems arise as a result of
this, attention tends to focus upon
the clinical records and what they
do (and do not) contain. In the absence of any evidence that certain
key questions were ever asked, it is
extremely difficult to demonstrate
at a later date that they were.
B
If, on the other hand, there
is a clear answer – perhaps in a
medical history questionnaire
which has been completed (and
preferably, signed and dated) by
the patient on a particular day,
then there can be no doubt that
the clinician asked the relevant
question and was entitled to
work from the assumption that
the answer(s) given were correct.
Four specific areas of the patient’s history are worthy of particular consideration in this brief
overview: • Medical history
• Dental history
• Personal/social history
• History of the presenting complaint (if any)
General observations
Creating any history about a patient is essentially an information
gathering exercise. Specific techniques can usefully be employed
to maximise the effectiveness of
the process. The experienced clinician will choose between the
available techniques according
to the communication abilities of
the individual patient that they
are dealing with.
Closed questions
There are times when you need
a definite ‘yes’ or ‘no’ answer to
a specific question. The first
stage of medical history screening may be one such occasion.
Such questions are sometimes
called ‘closed’ questions because there is little or no opportunity to obtain a more detailed
reply from the patient. A direct
‘yes’ or ‘no’ is exactly what you
are looking for. Closed questions
can also be useful when dealing with patients whose answers
tend to stray from the purpose of
the question.
Open questions
These questions tend to begin with… What? Why? When?
How? etc and because of this,
they require the patient to provide more information for you
in their reply. This is often helpful when dealing with less communicative patients, or when
you are hoping to gather information of a better quality, and in
greater detail.
‘Why’ questions
These questions, which are a
specific kind of open question,
can be extremely useful. They
‘Shopping list’ questions
This approach is a little like a
multiple-choice test, where you
give the patient several possible answers to choose from. For
example ‘What makes the pain
worse?... is it hot things?... or cold
things?... or biting on the tooth?’...
and so on. They can be useful when dealing with patients
who seem not to understand the
meaning of open questions and
can thereby speed up the information gathering process.
Leading questions
These questions tend to be worded
in such a way as either to suggest
the answer or to invite a specific
reply. For example ‘You have been
wearing your appliance, haven’t
you?’ They can be useful when
trying to establish confidence and
communication with a nervous,
quiet, or uncommunicative patient but are of limited value when
seeking specific accurate information, or a more detailed reply.
Medical history
One of the first principles one
learns at dental school is that of
the importance of taking a detailed
medical history before treating
any patient. Most dental schools
have their own design of medical
history questionnaire, and this
shapes the format, style and extent
of any further questioning of the
patient on particular points arising from the medical history.
Many practices, in similar
fashion, take commendable care
in designing and using their own
medical history questionnaires
which patients are asked to complete when attending the practice
for the first time. In most cases
the design provides for the patient
to answer ‘yes’ or ‘no’, to a set of
specific predetermined questions,
and then to sign and date the completed questionnaire. The dental
surgeon then ensures that the
patient has properly understood
all of the questions (for example,
where patients leave one or more
answers blank), and where ‘yes’
answers have been given, further
questioning of the patient will
allow the details of any response
to be clarified and expanded
upon. Sometimes this highlights
areas where further information
needs to be gathered – perhaps by
contacting the patient’s medical
practitioner, perhaps by asking
the patient to bring any medication they are taking along to the
next visit, so that the precise
drugs and dosages can be identified with certainty.
In several recent cases, the
patient’s medical history has
been at the heart of negligence
claims brought against dentists
and other dental team members.
It is crucially important, for example, to investigate the nature
of heart murmurs, or other functional heart disease, in order to
decide whether prophylactic antibiotics are indicated to prevent
the risk of infective endocarditis.
Infective endocarditis is a serious and life-threatening disease,
and most patients are left with
permanent damage which has
the potential to shorten their life
and/or restrict its quality. Damages in such cases are therefore
very high indeed, often including
a lifetime’s loss of earnings.
Other recent cases have involved, for example, a failure to
take into account certain allergies to drugs (especially penicillin and other antibiotics), or
to recognise the significance of
long-term aspirin medication
predisposing to postoperative
bleedings, or to recognise the potential for drug interactions.
Cases such as these often reveal the fact that although a practitioner might have taken a comprehensive medical history when
the patient first attended as a new
patient, this process has either
not been repeated, or has been
much more superficial, when
the patient has returned for successive courses of treatment. In
the majority of cases, no further
written medical history questionnaire is ever undertaken, and
indeed there is rarely any note
on the record card to confirm
what (if any) further questioning has taken place to update the
patient’s medical history. This
can be a considerable embarrassment when the patient has
attended the same practice over
a large number of years, and the
practitioner is apparently still relying upon the patient’s original
medical history details.
It is self-evident that a patient’s medical status is not static,
and indeed, a patient’s medication prescribed by others may
change from visit to visit – it is
prudent, therefore, to ensure not
only that changes in medical history (including medication) are
regularly checked and updated,
but also that this fact is clearly
recorded as a dated entry in the
patient’s clinical notes.
‘Any clinical examination is still only
a snapshot of a
patient’s dental and
oral tissues at a moment in time’
Many practices take medical
histories verbally and if no positive or significant responses are
elicited, an entry such as ‘MH
– nil’ is made in the records.
While better than nothing at all,
this approach carries the disadvantage that it can be difficult or
impossible to establish precisely
what questions were asked of the
patient, in what terms, and what
answers were given. Clearly, a
well structured medical history
questionnaire form, which is
completed, signed and dated by
the patient, and subsequently updated on a regular basis (ideally,
during each successive course
of treatment), is not only in the
patient’s best interest, but is also
the best platform for the successful defence of cases where failure
to elicit or act upon a relevant aspect of medical history leads to
avoidable harm to the patient.
In all cases, the taking and
confirmation of a medical history is the role of the dental surgeon and is certainly a key part
of a dentist’s duty of care. If in
doubt, it may be sensible to defer
treatment pending clarification
of any areas of uncertainty in a
patient’s medical history.
• Is there a history of fractured
teeth/fillings?
• Are any teeth painful
or sensitive?
• If so, what causes any
such sensitivity?
• Do the patient’s gums
bleed on tooth brushing or
spontaneously?
• Is the patient apprehensive
about receiving dental care?
• If so, do these concerns
relate to any particular
dental procedure(s) or to the
experience in general?
• Has the patient experienced
any particular problems
associated with treatment
provided for them in the past?
If so, what?
Not only will questions like
those above help to inform the
clinician regarding areas which
may or may not need treatment,
or which should be kept under
review, they will also guide the
clinician regarding the success
(or failure) of treatment approaches that have been tried in
the past. If this knowledge helps
the clinician to avoid repeating
the previous mistakes of other
clinicians, it can also help to
avoid claims and complaints that
might otherwise have resulted.
Social history
The social history should include
details of employment (and interests, hobbies, etc) as well as
other social and family related
information. The patient’s occupation should be included in the
consideration of relevant factors
affecting diagnosis, treatment
planning, consent and treatment,
bearing in mind the fact that this
is an aspect of a patient’s history
that may change as time passes.
It is worth establishing a routine
of checking the patient’s contact
details and employment, when
carrying out a periodic update of
the patient’s medical history.
Dental history
However thoroughly it is carried
out, any clinical examination
is still only a snapshot of a patient’s dental and oral tissues at
a moment in time. While it will
provide a lot of useful basic information, the clinician’s understanding of the patient’s presenting condition is greatly improved
by knowing how the patient
reached the present position.
The ability to attend for appointments could affect the
success of complex or extensive treatment, eg crown and
bridgework, implants, long term
periodontal treatment and orthodontics. Certain occupations can
place severe constraints on a patient’s ability to attend regularly
for appointments.
Issues relating to a patients
employment or recreational interests have also been known to
have an impact on treatment:
• Is the patient a regular or
irregular attender?
• What treatment has been
provided in the last five years?
For example:
• Bruxism in air traffic controllers, marathon runners and
certain other sports players
[7] =>
DTME
June 2010_DTME 6/16/2010 7:44 PM Page 7
DENTAL TRIBUNE Middle East & Africa Edition
• Aerodontalgia in (pilots and
cabin crew)
• Stress and its relation to periodontal disease (including episodes of pericoronitis involving
young adults in the armed forces,
or studying for examinations)
not collected and recorded in a
clear and logical fashion. Having a structured and systematic
approach to history taking and
record keeping makes it less
likely that critical information
will be overlooked, or lost.
The outcome of treatment
can have a general effect or a
more specific effect on a given
patient. For example, chronic severe pain, which can arise from
some form of nerve damage, or
TMJ/muscle disturbance associated with dental procedures,
or perhaps a facial paralysis, or
permanent loss of sensation in
the lip or tongue, would all be
likely to reduce the quality of life
for most patients.
Later in the treatment planning process, when it becomes
If the patient is complaining
of pain, for example, it is helpful
to know what kind of pain it is
(dull ache, or throbbing, or acute
bursts of pain), or how long it
lasts, and what makes it worse
or better and whether it has occurred previously and if so under what circumstances.
Each of these findings needs
to be recorded carefully in the
notes to demonstrate this important part of the diagnostic
process. The significance of this
becomes apparent on occasions
when a mistaken diagnosis is
made. If, however, the diagnosis
is supported by the information
which was available to the clinician at the time, as noted in the
records, such situations can often be defended successfully.
Summary
It will be appreciated that there
is very little value in gathering information from the above
sources if the responses are
Contact Information
7
The article has been accredited by Health Authority Abu Dhabi as having educational content and is acceptable for up to 2 (Category 1)
credit hours.
Credit may be claimed for one
year from the date of subscription.
Dental Protection is the world’s largest
specialist provider of dental professional indemnity and risk management for
the whole dental team. The articles in
this series are based upon Dental Protection’s 100 years of experience, currently handling more than 8,000 cases
for over 48,000 members in 70 Countries. Email querydent@mps.org.uk or
visit www.dentalprotection.org.
MEDIA CME Self-Instruction Program
Dental Tribune Middle East & Africa in collaboration with CAPP introduce to the market the new
project mCME - Self Instruction Program.
mCME gives you the opportunity to have a quick
and easy way to meet your continuing education
needs.
mCME offers you the flexibility to work at your own
pace through the material from any location at any
time. The content is international, drawn from the
upper echelon of dental medicine, but also presents a regional outlook in terms of perspective and
subject matter.
How can professionals enroll?
They can either sign up for a one-year (10 exercises) by subscription for the magazine for one
year ($65) or pay ($20) per article. After the payment, participants will receive their membership
number and will be able to attend to the program.
3. Fill in the Questionnaire and Submit the answers by Fax (+971 4 36868883) or
Email :info@cappmea.com
After submission of the answers, (name and membership number must be included for processing)
they will receive the Certificate with unique ID
Number within 48 to 72hours.
Articles and Questionnaires will be available in the
website after the publication.
www.cappmea.com
How to earn CME credits?
Once the reader attends the distance-learning program, he/she can earn credits in three easy steps:
1. Read the articles.
2. Take the exercises
AD
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History of present complaint
When a patient attends with a specific problem it is helpful to know
how long the problem has existed,
when it was first noticed, whether
it has ever occurred before, whether any previous treatment has
sought to resolve the problem and
if so, with what success.
a little clearer what treatment
possibilities are under consideration, it may be necessary to
explore some aspects of the history in greater depth, in order to
ensure that the patient is aware
of any way in which their treatment (and its prognosis) might
be affected by some aspect of
their history. DT
On the other hand, the loss
of ability to articulate clearly
when speaking or singing, because of a change in anterior
tooth shape, position or angulation, or perhaps because of lingual or inferior alveolar nerve
damage, would have a more profound affect on an opera singer,
lecturer or telephonist than for
an agricultural worker who did
not depend upon singing for his
livelihood. Similarly, there are
many jobs in which appearance
is important and an adversely altered appearance can either lose
a patient a job or severely affect a
patient’s confidence, particularly
if they have to face the public in
their working life. Awareness of
information such as this is critical when contemplating any aesthetic/ cosmetic procedures.
Media CME
202- 21
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4O ACCESS THE COURSES AND RECEIVE #-% CREDIT YOU
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[8] =>
DTME
June 2010_DTME 6/16/2010 7:44 PM Page 8
8
DENTAL TRIBUNE Middle East & Africa Edition
Trends & Applications
PROSTHODONTICS
Prosthodontics is a specialty of
dentistry that involves the
restoration of damaged teeth
and the replacement of missing
teeth with artificial substitutes.
The prosthodontist is the expert in improving the patient’s
smile while restoring function.
Prosthodontists receive 3 years
of full-time formal education
after dental school to become
specialists. The prosthodontist
uses a variety of materials and
methods when restoring and
replacing teeth.
Porcelain laminate veneers
Discolored teeth or teeth with
minor structural defects can be
restored with porcelain laminate
veneers. Veneers are very thin
porcelain restorations that are
bonded to the teeth. Well made
and well placed veneers can be
strikingly beautiful (Fig 1).
Fig 1 A, Discolored teeth with structural defects.
Fig. 1 B, Finished result. Note that the spaces between the teeth have been closed
with the veneers.
Porcelain inlays and
onlays
Posterior teeth with large
cavities or old defective restorations can be restored with porcelain inlays (restorations that fit
within the tooth structure) or onlays (restorations that cover one
or more cusps of the teeth).
These restorations can be handmade by a technician or milled
with computer-assisted design/computer assisted machining (CAD/CAM) technology. The
Fig. 2 B, Molar with large cavity prepared for porcelain inlay.
AD
Fig. 2 B, Bonded porcelain inlay.
inlay or onlay is then bonded to
the tooth structure (Fig. 2).
K_\_lek]fidfi\%
NEW
Crowns and bridges
Upgrade available now:
> Ceramill Artex®
(virtual articulator)
> Ceramill M-Plant
abutment tool
There are many systems for
making crowns and bridges. A
very popular system uses zirconia as a substructure. Zirconia is
a very hard and strong ceramic
material that is resistant to cracking. The substructure is milled
with the use of CAD/CAM technology, and a technician places
the esthetic veneering porcelain
over the zirconia substructure to
develop the final esthetic result
(Figs. 3 & 4). All-ceramic crowns
and bridges are not as strong as
porcelain-fused-to-metal
restorations.
Dental implants can be
placed in the jaw bone to support
artificial teeth. Once the bone
heals around the implant (2-4
months), an abutment is attached to the implant and a
crown is cemented over the abutment. These implant-supported
LING R
EL
SE
Summary
Prosthodontics is a complex
specialty that requires extensive
training and education after
graduation from dental school.
The prosthodontist can rehabilitate a patient’s mouth to enhance
esthetics and function by using
various materials and techniques. Modern approaches to
prosthodontics
include
CAD/CAM technology and dental implants. At Boston University we provide state-of-the-art
prosthodontic care, including
porcelain laminate veneers,
porcelain inlays and onlays, allceramic crowns and bridges,
porcelain-fused-to metal crowns
and bridges, and prostheses supported and retained by dental implants.
CA
IN
VE
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Dental implants
crowns can be indistinguishable
from natural teeth (Fig. 5).
Implants can also be used to
retain and support removable
dentures. The number of implants required depends on the
desired support and retention
(Figs. 6)
ST M E NT
About the author
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[9] =>
DTME
June 2010_DTME 6/16/2010 7:44 PM Page 9
DENTAL TRIBUNE Middle East & Africa Edition
Fig 3 A, Teeth before placement of all-ceramic crowns.
AD
Fig 4 B, Finished result.
Fig 5 A, An implant has been placed
beneath the gum and in the bone to
replace the missing right lateral incisor tooth.
Fig. 5 B, A zirconia abutment has
been attached to the implant with a
screw
Fig. 5 C, An all-ceramic crown has
been cemented over the abutment.
Fig. 8 A, Bar retained by 4 implants
provides retention and support for upper complete denture.
Fig. 8 B, Denture placed over bar retainer.
Fig 3 B, Teeth with all-ceramic crowns in place.
Trends & Applications
9
Fig 4 A, Teeth before placement of all-ceramic bridge and three
all-ceramic crowns.
[10] =>
DTME
June 2010_DTME 6/16/2010 7:45 PM Page 10
AD
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&+$5,7<75($7('3$7,(17%(67&$6(
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DTME
June 2010_DTME 6/16/2010 7:46 PM Page 11
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FDI Annual World Dental Congress
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Salvador da Bahia, Brazil
congress@fdiworldental.org
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[12] =>
DTME
June 2010_DTME 6/16/2010 7:46 PM Page 12
Everyone has a shade
And it’s simple to match it
She’s an A1B. And, with the improved, lifelike esthetics and “ single-shade simplicity”
© 3M 2010. All rights reserved. 3M, ESPE and Filtek are trademarks of 3M or 3M ESPE AG. *In vitro data on file.
of Filtek™ Z350 XT Universal Restorative, it’s the only shade you’ll need to restore
her beautiful smile.
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Your simple solution for lifelike restorations is Filtek Z350 XT Universal Restorative.
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)
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