Complications of augmentation procedures for dental implants in private practice, Victoria, Australia.

PURPOSE: This study audited complications associated with augmentation for dental implants, retrospectively over a 5-year period in a variety of private dental practices in Victoria (Australia). METHODS: Complications were categorized as surgical or biological and compared to a group not requiring augmentation. Implant factors underwent univariate and multivariate analysis. RESULTS: The study assessed 8486 implants with 26.9% undergoing augmentation. Augmentation had no effect on implant survival, however, a significant increase in complications for those implants requiring augmentation was found (P = <0.001). The hard tissue augmented group had significantly more cases of insufficient bone/dehiscences at implant placement (P < 0.001), and post-placement bone loss (P = 0.0014). These implants were grafted simultaneously (P < 0.05) with particulate autogenous bone and/or Bio-Oss (P < 0.05) with resorbable xenograft membrane (P < 0.001). There was significantly more bone loss in open sinus lifted cases than implants placed in native bone (1.90% v 0.30%; P = 0.009). CONCLUSIONS: The study demonstrated no increase in graft complications that could be related to any specific augmentation technique, suggesting that routine grafting procedures used in private practice were safe and appropriate. Previously augmented sites were found to be more likely to require further augmentation at implant placement.

Clinical uses of botulinum toxin A in smile aesthetic modification.

In this article we review the pharmacodynamics of commercially available preparations of botulinum toxin type A, and discuss the potential uses of the drug in smile modification. A major emphasis is placed on applications relevant to modern dental practice, and to the complications arising from its use. Botulinum toxin A, when applied correctly, is a safe and effective means of achieving aesthetic smile modification, with limited data on any demonstrable long-term adverse effects.

Analysis of commonly reported medical conditions amongst patients receiving dental implant therapy in private practice.

BACKGROUND: The population seeking implants in private practice is a demographically and medically unique group. Understanding their medical needs can improve treatment planning and service delivery specifically for this population. METHODS: Privately practising dental clinicians from Victoria, Australia, participated in a five-year retrospective study. Data were collected from the medical histories of 4116 patients who met the inclusion criterion of at least one implant placed within the study period of 1 January 2005 to 31 December 2009. Descriptive statistics were used to describe patient demographics and commonly reported medical conditions. RESULTS: The most common age group to receive implant therapy was between 51 and 60 years (30.4% of patients). The patient population reported a broad range of co-morbidities including psychiatric disorders (83 patients), cardiovascular disorders (253 patients), gastrointestinal disorders (224 patients) and respiratory disorders (502 patients). Smoking was less prevalent amongst the study population compared to the general population. CONCLUSIONS: The population assessed in this study was a medically diverse group. Clinicians must be familiar with their target demographic and understand how the common co-morbidities amongst this patient group can influence clinical decision making and outcomes.

The first UK dental undergraduate programme for medical graduates--a student perspective.

The nature of the primary dental undergraduate qualification is continually evolving to keep pace with the ever changing climate of medical and dental education and postgraduate speciality training. In the aftermath of "Modernising Medical Careers", there has been a surge in interest in careers of dental origin by members of the medical profession, particularly in the specialities of oral and maxillofacial surgery (OMFS), oral medicine and oral surgery. Furthermore, following the suggestion by the recent Postgraduate Medical Education and Training Board (PMETB) report into OMFS training that both registrable medical and dental degrees be obtainable by the age of 26 much attention has focussed on the entity of the accelerated undergraduate dental qualification. In this article we report our personal and educational experiences one year after enrolling in the UK's first official dental undergraduate degree for medical graduates, an accelerated three year BDS programme provided by King's College London.