The Emergency Dental Appointment: Restorative Emergencies Part 2 - Dental Implant Related Problems.

This is the second paper in a two-part series discussing the management of common restorative dental emergencies. The first paper focussed upon problems relating to conventional fixed and removable restorations, and this paper discusses the management of common dental implant related emergencies. With dental implant treatment becoming an increasingly popular method of replacing missing teeth, it is very likely that dentists working in general practice will routinely come across patients who have previously undergone this form of treatment, even if they themselves are not directly involved in placing or restoring dental implants. This paper is aimed at general dental practitioners (GDPs) who have some experience in managing dental implants, and those who want to gain further insight into how such situations may be managed.

The Emergency Dental Appointment: Restorative Emergencies Part 1 - Tooth Related Problems.

Dental emergencies affect a large proportion of the population. While there is ample information in the literature on how to manage medical emergencies in dental practice, there is little information on common dental emergencies and how to manage them. In the UK, the 2009 Adult Dental Health Survey reported 9% of dentate adults reporting pain at their clinical examination. 1 The prevalence of non-pain related restorative dental emergencies is estimated to be higher, and will be a common presenting situation in the dental clinic. Often these unplanned events cause difficulties for dental practitioners, who are already constrained by time, to fit in these patients and manage them. Over and above this, the increasing life spans, retention of teeth into later life and finite life of dental restorations all add to the challenges encountered by the dental practitioner. Prompt and effective management of these conditions often leads to optimising patient experience, but also offers better outcomes. This two-part series provides an overview of the more common dental emergencies encountered by the dental practitioner and their management. Paper 1 focuses on the management of common tooth-related emergencies and includes non-odontogenic and odontogenic pain. Paper 2 focuses on the management of osseointegrated dental implant related emergencies.

Maxillary Midline diastema closure after replacement of primary teeth with implant prosthesis.

This case shows an excellent esthetic treatment outcome using implant-retained crowns replacing maxillary laterals and canines in hypodontia patient with unusual incidence of spontaneous diastema closure after the placement of implants. To our knowledge, this is the first case report showing maxillary midline diastema closure after implant placement.

Factors affecting survival and usefulness of implants placed in vascularized free composite grafts used in post-head and neck cancer reconstruction.

BACKGROUND: Bone-containing vascularized grafts have been used successfully to reconstruct post-cancer surgical defects. Dental implants can be placed in these bone-containing grafts to allow implant-supported prosthodontic reconstruction of these patients. PURPOSE: The aim of this study was to evaluate the survival of dental implants used in the rehabilitation of subjects treated with bone-containing vascularized grafts to compare usability of implants placed at the time of reconstruction and after healing. MATERIALS AND METHODS: A cross-sectional study was undertaken to examine survival rates of implants placed in vascularized bone-containing grafts either immediately at the time of surgical reconstruction or after 3 months healing. Other factors such as graft type, whether radiation therapy was given, and implant type were recorded. RESULTS: A total of 41 patients had 145 implants placed in 47 vascularized bone-containing flaps. Increased failure rate of implants was seen in immediately placed implants. There was also a significant increase in the number of osseointegrated implants that were prosthodontically unusable or sub-optimally placed in the immediate placement group. Radiation therapy was associated with a significant increase in failure rate. Modern implant surfaces appeared to perform better than machined/turned surfaces. Graft donor site did not influence implant survival. CONCLUSION: This study demonstrated the difficulties encountered with immediate placement of dental implants at the time of post-cancer reconstructive surgery.

An audit to assess the quality and efficiency of complete and partial dentures delivered by junior hospital staff.

The average number of visits for the construction of metal-based and acrylic dentures by junior hospital staff was 10 visits. Our hypothesis was that supervision would optimise the number of visits and reduce any need for remakes. The first audit cycle was retrospective and included all patients treated by SHOs in the Prosthodontics Department. The standard of care was compared to the British Society for the Study of Prosthetic Dentistry. The re-audit showed that the time taken to completion was reduced by 2 visits for both denture types and the average length of time was reduced from 31 weeks to 22 weeks. These improvements were directly related to improved supervision by senior staff.

Management of a supra-erupted premolar: a case report.

Supra-erupted teeth often lead to occlusal instability that can result in a poor appearance and make subsequent restoration problematical. This case report discusses the options in the management of supra-erupted teeth and presents a novel approach. The use of a direct composite platform to intrude an upper premolar tooth using the Dahl concept is illustrated.