Heat generated during dental treatments affecting intrapulpal temperature: a review.

INTRODUCTION: Heat is generated and transferred to the dentine-pulp complex during various dental procedures, such as from friction during cavity preparations, exothermic reactions during the polymerisation of restorative materials and when polishing restorations. For in vitro studies, detrimental effects are possible when intra-pulpal temperature increases by more than 5.5°C (that is, the intra-pulpal temperature exceeds 42.4°C). This excessive heat transfer results in inflammation and necrosis of the pulp. Despite numerous studies stating the importance of heat transfer and control during dental procedures, there are limited studies that have quantified the significance. Past studies incorporated an experimental setup where a thermocouple is placed inside the pulp of an extracted human tooth and connected to an electronic digital thermometer. METHODS: This review identified the opportunity for future research and develop both the understanding of various influencing factors on heat generation and the different sensor systems to measure the intrapulpal temperature. CONCLUSION: Various steps of dental restorative procedures have the potential to generate considerable amounts of heat which can permanently damage the pulp, leading to pulp necrosis, discoloration of the tooth and eventually tooth loss. Thus, measures should be undertaken to limit pulp irritation and injury during procedures. This review highlighted the gap for future research and a need for an experimental setup which can simulate pulp blood flow, temperature, intraoral temperature and intraoral humidity to accurately simulate the intraoral conditions and record temperature changes during various dental procedures.

The prospective association between periodontal disease and brain imaging outcomes: The Atherosclerosis Risk in Communities study.

AIM: We investigate if periodontal disease is prospectively associated with cerebrovascular and neurodegenerative markers of dementia and Alzheimer's pathology. MATERIALS AND METHODS: N = 1306 participants (Visit 5 mean age = 76.5 [standard deviation = 5.4] years) in the Atherosclerosis Risk in Communities study with completed dental exams at Visit 4 underwent brain magnetic resonance imaging scans at Visit 5 while N = 248 underwent positron emission tomography scans. Participants were classified as edentulous or, among the dentate, by the modified Periodontal Profile Class. Brain volumes were regressed on periodontal status in linear regressions. Cerebrovascular measures and ß-amyloid positivity were regressed on periodontal status in logistic regressions. RESULTS: Periodontal disease was not associated with brain volumes, microhaemorrhages, or elevated ß-amyloid. Compared with periodontally healthy individuals, odds ratios [95% confidence interval] for all-type infarcts were 0.37 [0.20, 0.65] for severe tooth loss and 0.56 [0.31, 0.99] for edentulous participants. CONCLUSIONS: Within the limitations of this study, periodontal disease was not associated with altered brain volumes, microhaemorrhages, or ß-amyloid positivity. Tooth loss was associated with lower odds of cerebral infarcts.

Management of peri-implantitis - A contemporary synopsis.

Prevalence of peri-implant complication is expected to be on the rise with the increased number of implants being placed. Depending on the degree of osseous involvement, the clinician needs to decide if the treatment goal is to arrest the disease progression, regeneration or explantation and replacement. Host's medical status, defect configuration, aesthetic outcome, ability to access for plaque control post-treatment, and the patient's wishes are key factors to consider. The purpose of this review is to provide a contemporary synopsis on the management of peri-implantitis with emphasis on explantation. Guidance on the identification of factors/situations where salvaging an implant may be less favourable is discussed and the various techniques to remove a fractured, or peri-implantitis-affected non-mobile implant are described.

Successful Surgical Protocols in the Treatment of Peri-Implantitis: A Narrative Review of the Literature.

BACKGROUND: The aim was to identify and evaluate those surgical protocols reporting on positive clinical outcomes for treating peri-implantitis with 12 or more months of follow-up. Method of surface decontamination (SDC) was evaluated for any correlation with outcomes. RESULTS: A literature search was performed of all articles published in English between January 1, 2001 and April 30, 2015. Of the 639 identified, 26 satisfied the inclusion criteria. Outcomes reported on included reductions in bleeding on probing (BoP) and probing depth (PD), mean radiographic bone fill (RBF), and mean change in marginal soft tissue levels (MR±). Methods of SDC included mechanical debridement (MD) with and without saline use, MD plus laser or photodynamic therapy, MD with air powder abrasion, MD with chemotherapeutic implant surface decontamination, and combination approaches. The results suggested that various methods of SDC were effective. Heterogeneity of the studies made it impossible to determine correlations between clinical outcome and SDC method. Most studies over 12 months reporting better treatment outcomes employed a bone replacement. Additionally, studies where patients with periodontitis were treated before their peri-implantitis care also had better outcomes. CONCLUSION: The current review failed to reveal any correlation between any particular method for SDC or defect treatment protocol and positive clinical outcomes. Further comparative studies are warranted to determine the most appropriate approach for both of these topics.

Utilization of extracted teeth as provisional restorations following immediate implant placement - A case report.

This case report utilized a patient's natural teeth as provisional restorations supported by immediately placed implants to provide a seamless transition from hopeless teeth to implant supported restorations.

A New Concept of Safety Distance to Place Implants in the Area of the Inferior Alveolar Canal to Avoid Neurosensory Disturbance.

Inferior alveolar nerve (IAN) damage following implant placement is a severe complication that can compromise a patient's quality of life. Previous studies have suggested that a safety zone of 2 mm, if maintained, might avoid this problem. This retrospective study evaluates implants placed in closer proximity to the IAN without resulting in any postoperative neurologic complications and suggests a new concept of safety distance. A total of 60 consecutive patients receiving 101 mandibular implants < 2 mm from the IAN were included in this study. All enrolled patients had a CBCT scan done for radiologic assessment before implant placement and following final restoration. Measurements were obtained through cross-sectional views using Simplant software. In patients without neurologic disturbances, a mean distance of +0.75 mm was seen from the closest portion of the implant to the nerve bundle. In cases where a direct transection and/or compression of the nerve was not observed, the patients did not experience neurosensory disturbances.

Maritime trap-jaw ants (Hymenoptera, Formicidae, Ponerinae) of the Indo-Australian region - redescription of Odontomachus malignus Smith and description of a related new species from Singapore, including first descriptions of males.

The maritime trap-jaw ant Odontomachus malignus Smith, 1859 is thought to be widespread throughout islands in the Indo-Pacific and parts of the Oriental realm. Because of its unique nesting preference for harsh littoral habitat and distinct morphology, O. malignus has usually been assumed to consist of only one species. We, however, describe a new species similar to O. malignus found in the mangroves of Singapore, Southeast Asia - Odontomachus litoralis sp. nov. We find strong evidence of both species existing in (near) sympatry, and also distinct morphological differences between O. malignus and the new species. Additional complementary DNA evidence in the form of COI barcodes (313 bp) supporting putative species identification and delimitation is provided. Defining morphological characteristics for the O. malignus species group (nested within the larger O. infandus clade) are given in detail for the first time. The worker and queen castes of the new species are described; a redescription of the worker caste of O. malignus, based on specimens from Singapore and the Philippines in addition to the holotype, is also given. The males of both species are also described for the first time, including male genitalia. A preliminary key to most known species of the O. infandus group based on the worker caste is provided.

Discovery of a new ant species of the elusive termitophilous genus Metapone in Singapore (Hymenoptera, Formicidae, Myrmicinae), with the first detailed description of male genitalia of the genus.

A new species of the rare ant genus Metapone, Metapone murphyi sp. nov., is described based on museum material consisting of a single nest series (workers, queens, and males) collected from a decayed coconut palm stump on Pulau Sakra, previously an offshore island south of mainland Singapore. Workers can be distinguished from other named congeners mainly by the following characters: 1) subpetiolar lamella subrectangular; 2) short median longitudinal ventral subpetiolar edge and roundly obtuse posteroventral subpetiolar angle; 3) outer margin of posterior subpetiolar face in posteroventral view forming a continuous, U-shaped, translucent, laminate carina; and 4) petiole subtrapezoidal in dorsal view with extended blunt tooth-like posterolateral corners. Detailed description and illustrations of male genitalia of the genus are given for the first time. The key to Asian species of Metapone is updated to include the new species.

Risks and Benefits of Probing Around Natural Teeth and Dental Implants.

Periodontal probing around natural teeth and dental implants remains an efficient and non-invasive method to diagnose loss of attachment, determine presence of diseases, monitor marginal recession, and evaluate positive treatment outcomes. Risks of probing around natural teeth and dental implants include inaccurate measurements, bacteria inoculation, spread of disease, and damage to the implant surface. Improper probing can lead to undiagnosed or overdiagnosed diseases. Some clinicians have questioned the value versus the risk of probing around implants. This article discusses the risks and advantages of probing around teeth and dental implants and suggests methods of probing intended to enable more accurate evaluation of periodontal and peri-implant conditions.

Retrospective Evaluation of Factors Related to the Outcomes of Regenerative Therapy for Implants Affected by Peri-implantitis.

The aim of this retrospective study was to examine the histories of 100 patients with 170 implants that were consecutively treated and reported in a previous study to identify which patient and implant factors might have affected the outcomes of therapy. Patient factors included history of periodontitis, hypertension, cardiac problems, rheumatoid arthritis, smoking, and penicillin allergy. Implant factors included whether the prosthesis was cemented or screw retained and initial bone loss (≤ 50% or > 50% of implant length). Frequency of maintenance visits (≤ 3 months or > 3 months) were recorded, as was patient age (≤ 60 years or > 60 years). On the patient level, only postoperative maintenance (≤ 3 months) showed a statistically significant effect on radiographic bone gain (RBG) compared to patients with > 3 months maintenance frequency. Nondiabetic patients showed a trend toward soft tissue gain. On an implant level, screw-retained prostheses demonstrated a statistically significant RBG compared to those with cement-retained prostheses. Significant favorable differences were seen in all outcomes when evaluating presurgical bone level loss (> 50% of the implant length). Further studies with larger groups of patients are necessary to substantiate the findings in this report.

Incision Design and Soft Tissue Management to Maintain or Establish an Interproximal Papilla Around Integrated Implants: A Case Series.

Maintenance or reconstruction of interproximal papilla for a successful dental implant restoration can be challenging. To date, the results from various surgical and prosthetic techniques to maintain or regenerate papilla adjacent to dental implants have been unpredictable. To maintain the quality of the soft tissue around an implant, the blood supply must be preserved and formation of scar tissue must be minimized during surgery. Therefore, incision design is vital to producing an esthetic and successful dental implant restoration. In this study, specific incision designs and soft tissue management techniques were used to preserve or create interproximal papilla around single or adjacent implants.

Interface dimensions of CEREC-3 MOD onlays.

Evaluation was undertaken of the interface dimensions of MOD ceramic onlays fabricated using the Cerec 3 system. A master die was prepared on a maxillary second premolar Ivorine tooth from which 20 Cerec 3 onlays and 20 feldspathic onlays were made. A total of 80 cement analogues were produced using elastomeric impression material and sectioned orthogonally. Interface dimension was measured using Image Analysis Software. The ceramic onlays constructed using Cerec 3 demonstrated significantly larger cement lute space compared with laboratory produced feldspathic porcelain onlays with mean thickness of 201.3 +/- 78.0 microm and 139.7 +/- 49.7 microm respectively (P < 0.001). Large interface dimensions were particularly noted in the proximal boxes. The multiple variables involved in the construction of the Cerec onlays as well as the complexity of the onlay design may be contributing factors to the large cement space.

A lighting approach for clinical photographs of the face.

This article describes an alternative approach of lighting setup for taking clinical photographs of the face. The lighting techniques presented in this article will help the clinician obtain good-quality clinical photographs.

Acupuncture and acupressure techniques for reducing orthodontic post-adjustment pain.

Orthodontic post-adjustment pain is one of the most common complaints of adult patients undergoing orthodontic treatment. This article aims to introduce the combination of acupuncture and acupressure techniques for reducing orthodontic post-adjustment pain using a single acupuncture point, Hegu (LI-4).

Delayed immediate single-step maxillary sinus lift using autologous fibrin adhesive in less than 4-millimeter residual alveolar bone: a case report.

This paper presents a combination of techniques to replace a missing first premolar in an atrophic posterior maxillary ridge with less than 4 mm of residual bone. Simultaneous sinus lift and implant placement were carried out as a delayed-immediate procedure 6 weeks following the extraction of the premolar. The osteotome technique was used to gain primary stability. Demineralized freeze-dried bone and deproteinized cancellous bovine bone (Bio-Oss) were used to create the bone volume. Autologous fibrin adhesive was subsequently used to stabilize the bone grafting materials both in the sinus and on the coronal part of the implant. This combined technique preserves the alveolar bone after extraction; simplifies the primary closure; avoids a second surgical site; and reduces the total operation time, cost, and inconvenience to the patient.

Treatment of xerostomia in prosthetic patients using local acupuncture points on the face.

Acupuncture is gaining popularity in mainstream dentistry to treat various conditions. This paper aims to present acupuncture techniques to treat prosthetic patients with xerostomia using local acupuncture points on the face.

The use of acupuncture in implant dentistry.

This article aims to review how acupuncture can provide complimentary treatments to patients through implant rehabilitation. The following topics are discussed: control of gagging reflex, control of postoperative vomiting, control of postoperative pain, enhance anesthetic effects, control of anxiety, increase saliva production, enhance immune responses, management of temporomandibular dysfunction, smoking cessation, control diabetic mellitus, stimulation of peripheral nerve regeneration, and adverse effects.