'The punch technique' for the soft tissue exposure of superficial, buccally impacted teeth.

The management of impacted teeth can be complex, time-consuming and expensive for the patient and healthcare system. These cases often require referral to a different specialty which increases the overall treatment time and number of appointments. This article introduces a simple, efficient technique using a cylindrical punch biopsy instrument to expose superficial, buccally impacted upper permanent canines and incisor teeth in carefully selected cases. This patient- and operator-friendly technique avoids the need for a referral to a different specialty, gives the orthodontist autonomy of the position of the bond, allows immediate traction, thereby reducing the number of appointments and overall treatment time for the patient.

Molar-incisor malformation: A case report and clinical considerations.

Molar-incisor malformation (MIM) is a dental anomaly that has recently been presented in the literature. It features morphological root abnormalities affecting the permanent first molars, resulting in narrow, shortened or almost completely absent roots in patients who interestingly still present with clinically normal crowns. In some cases, this condition also involves the roots of the deciduous second molars in a similar manner and the maxillary central incisors may exhibit notching around the cervical region of the clinical crown. Root dysplasia of the permanent first molars compromises the long-term survival of these teeth and, in itself, presents a challenge when attempting to undertake any orthodontic treatment. This case report describes an incidental finding of a patient presenting with similar features to that of MIM, discusses the features and clinical implications of this newly discovered condition, and highlights the importance of undertaking a comprehensive radiological investigation before treatment.

Review suggests high survival rates for veneers at five and ten years.

DATA SOURCES: The Cochrane Library, Medline, Embase, and Web of Knowledge databases were searched and the Evidence-Based Dentistry, International Journal of Prosthodontics, Journal of Prosthetic Dentistry, Journal of Adhesive Dentistry, Journal of Esthetic and Restorative Dentistry, and Journal of Oral Rehabilitation were hand searched. Clinical trials registers, conference proceedings and academic colleagues were contacted to identify unpublished data, abstracts and other gray literature. There were no language limits. STUDY SELECTION: Article identification, screening, and eligibility and inclusion assessments were completed independently by two reviewers. Prospective and retrospective cohort and controlled trials assessing the outcome of feldspathic porcelain veneers in more than 15 patients were included. Some veneers in each study had to be in situ for five years. Veneers placed using unusual techniques, such as with no enamel preparation or excessive incisal edge lengthening, were excluded. DATA EXTRACTION AND SYNTHESIS: Estimated cumulative survival and standard error for each study were assessed and used for meta-, sensitivity and post hoc analyses. The I(2) statistic and the Cochran Q test and its associated P value were used to evaluate statistical heterogeneity, with a random-effects meta-analysis used when the P value for heterogeneity was less than 0.1. Heterogeneity, publication patterns and small study biases were explored. RESULTS: Eleven studies were included with six (four prospective and two retrospective cohorts) contributing to the meta-analysis. The estimated cumulative survival for feldspathic porcelain veneers was 95.7% (95% confidence interval [CI]: 92.9% to 98.4%) at five years and ranged from 64% to 95% at ten years across three studies. A post hoc meta-analysis indicated that the 10-year best estimate may approach 95.6% (95% CI: 93.8% to 97.5%). High levels of statistical heterogeneity were found. CONCLUSIONS: When bonded to enamel substrate, feldspathic porcelain veneers have a very high 10-year survival rate that may approach 95%. Clinical heterogeneity is associated with differences in reported survival rates. Use of clinically relevant survival definitions and careful reporting of tooth characteristics, censorship, clustering, and precise results in future research would improve meta-analytic estimates and aid treatment decisions.

Necrotizing ulcerative gingivitis and the orthodontic patient: a case series.

Necrotizing ulcerative gingivitis (NUG) can be a painful periodontal disease that can lead to loss of the interdental papillae. It is usually accompanied by systemic signs of fever, malaise and cervical and submandibular lymphadenopathy. It is caused by the profileration of anaerobic bacteria and has been linked to smoking and immunosuppression. This case series reports the occurrence of NUG in orthodontic patients and demonstrates that there is a varying scale of severity of the condition. Orthodontists should be aware of the clinical signs of NUG to ensure early detection and treatment of their patients in order to prevent irreversible loss of the interdental papillae and reduce the likelihood of recurrence. A treatment regime is suggested.

The role of a dentist in managing patients with dystonia.

UNLABELLED: Oromandibular dystonia is a neurological condition where the muscles of the mouth and jaw contract in involuntary spasms. Dystonia currently has no cure, but there are treatment options to manage symptoms. This case report describes the treatment of a 41-year-old male who presented at University of Glasgow Dental Hospital and School with established oromandibular dystonia. The use of removable appliances as a treatment option for this condition will be discussed. CLINICAL RELEVANCE: This case highlights the potential role of the dental practitioner in providing oromandibular dystonia sufferers with an effective and relatively easy treatment modality in the form of a removable appliance.