Occlusal Concepts and Considerations in Fixed Prosthodontics.

The UK has an increasingly ageing population, many of whom are retaining more of their own teeth. This has led to an increase in the prevalence of tooth wear and the need to replace pre-existing failing restorations. In many cases this will be achieved by fixed prosthodontics. This paper provides a brief overview of important occlusal concepts that should be considered when providing non-implant fixed prosthodontics using either a conformative or reorganised approach. The aim is to give general dental practitioners the confidence to provide these types of restorations in primary care. Clinical cases demonstrate how the occlusion can be controlled to optimise clinical outcomes.

Demystifying Modern Dental Ceramics.

With increasing patient expectation for aesthetic dental restorations, there has been a drive towards developing ceramic materials to meet this expectation. Multiple ceramic systems have been introduced over the past four decades with considerable advances in material properties. Survival rates of all-ceramic crowns differ by type of ceramic used, fabrication method and clinical indication. Zirconia and lithium disilicate are the most commonly used contemporary ceramic materials in dentistry. Survival data for these types of restorations appears to be promising; however, there is a lack of high-quality long-term clinical data on the success of these restorations. In the absence of robust longitudinal clinical research, laboratory studies have provided some useful information on the performance of ceramic restorations. Further high quality long-term clinical studies are needed to inform us of modes of failure of these restorations and the range of clinical circumstances in which each type of ceramic restoration may be used.

Interocclusal Records in Fixed Prosthodontics.

An accurate interocclusal record is essential for the successful delivery of fixed prosthodontic restorations. There are various materials and techniques used to obtain an interocclusal record in order to facilitate mounting of the dental casts on an articulator. The interocclusal record describes the vertical and horizontal relationship of the maxillary and mandibular teeth. In circumstances where the vertical relationship is not supported through a tripod of widely spaced opposing contacts, the interocclusal record will be needed to restore this vertical support to prevent inaccurate mounting. The clinician should understand when an interocclusal record is required and have an awareness of the different materials and techniques available to record an interocclusal registration.

Primary Extranodal Non-Hodgkin Lymphoma in the Infra-Orbital Region ­ A Diagnostic Challenge.

Lymphomas within the head and neck region (HNR) are relatively uncommon; however, they can mimic common odontogenic conditions leading to diagnostic delays and subsequently the implementation of treatment. We report a case of a chronic infra-orbital swelling which, following excision, was diagnosed as an extranodal low grade Non-Hodgkin lymphoma. This paper explains the mode of presentation of extranodal lymphomas in the HNR, so that dental practitioners may consider it as a potential diagnosis when presented with a lump in the HNR. Clinical relevance: Extranodal lymphomas presenting within the head and neck region can have a multitude of clinical presentations, which may often resemble odontogenic conditions. This can cause confusion, resulting in diagnostic delays and treatment. This case highlights the importance of being aware of the features of extranodal lymphoma in the head and neck region, and the diagnostic challenges that may be encountered.