Saturday, December 31, 2011

Old Years Night / New Years Eve

I big hearty thank you to all the readers of the blog in 2011.

As Benjamin Franklin said
"Be always at war with your vices, at peace with your neighbors, and let each New Year find you a better man."

Best Wishes for a Happy, Healthy and Profitable 2012!
Marty



Friday, December 30, 2011

The Madow Brothers Announce Nation-Wide “Love Dentistry, Have Fun, and Prosper” Tour in 2012



Madow Brothers’ “Love Dentistry” Seminars Coming to a City Near You! 

Baltimore, MD (December 21, 2011) – Dr. Richard H. Madow and Dr. David M. Madow, better known in the dental industry as “The Madow Brothers,” have officially announced their 2012 “Love Dentistry, Have Fun, and Prosper” seminar schedule.  The seminars will be held in 25 cities throughout the U.S., and additional locations will be added upon popular demand. 

The full-day seminars will reveal The Brothers’ inside secrets to extremely successful dental practices, and all attendees will receive six hours of Continuing Education credits.  The fun, fast-paced seminars are intended for all dentists, spouses, and staff members, and will be held in typical Madow Brothers-style, a blend of invaluable information mixed with fun and entertainment for all.  The “Love Dentistry” seminars are also updated with brand new topics such as social media marketing and profitable dental scheduling.

During the seminars some of The Brothers’ “Best Kept Secrets” will be revealed, such as:

·         Closing every phone call with seven words that will make your office profits explode
·         A simple technique to ensure you will never run late again
·         How to save thousands of dollars in dental supplies each year
·         Twenty things to remove from your dental office IMMEDIATELY
·         ALMOST free ways to get and retain new patients
·         One thing you need to do each and every morning before going to the office
·         The number one critical element in operating a profitable practice
·         Five magic words that will increase revenue by 10%
·         How to retire young and rich

In addition, all who register for the “Love” seminar will be automatically registered to win a Flip video camera.  For those unable to attend The Madows’ “Love” seminar, a “Love Dentistry in a Box” series will be available for purchase in early 2012. 

For a complete list of Madow Brother seminars, please visit www.madow.com, or call 1-888-88-MADOW. 

About The Madow Brothers

For over two decades, the Madow Brothers have been teaching dentists and team members how to be more successful in their personal lives and professional practices.  Founders of The Best Seminar Ever, The Madow Brothers have taken the industry by storm with their unique and motivational teaching approach.  The in-demand national speakers incorporate entertaining skits and songs into their seminars.

Wednesday, December 28, 2011

What Changed The Way I Practiced In 2011


Q: What changed the way you practiced in 2011?
A: As usual nothing remained constant in my practice in 2011. I really enjoy writing this column as I get to do a retrospective of the past year and see the changes technology makes in my practice.  There were some new technologies that have supplemented and replaced my previous way of doing things. The big thing about 2011 is that I can now say there is nothing that I do on a regular basis that I was taught in dental school.  This is not to say I don’t fall back to the tenants of my dental school education at times but those teachings are not the first way I do things in 2012.
So what was the last procedure to change in my office? It was extractions. I acquired the Golden Physics Forceps.  Physics Forceps are useful for achieving atraumatic extractions of all teeth. The unique design delivers a powerful mechanical advantage by employing an efficient first-class lever. Think of it the same way you take the top off a beer bottle with an opener. 

When the periodontal ligament is traumatized with the Physics Forceps or elevators, hyaluronidase (hyaluronate glycanohydrolase) is released. These forceps in many cases make extractions easier for me and less traumatic for the patients. In this age of regularly placing dental implants the need to preserve bone is paramount.  These forceps help preserve the buccal plate and have made extractions less stressful for me. Get a discount when purchasing the Physics Forceps by using promo code Marty100.

I am a big fan of the use of magnification and illumination in the practice of dentistry for use in every procedure. I have been wearing surgical loupes for years and have gone on a progression from tethered halogen lamps to battery powered LED’s along with increasing my magnification.   

The tethered halogens would give me whiplash when I would forget to remove the light from my head as I exited the operatory and were expensive to repair the broken fiber. I was very happy to switch to the smaller and lighter LED’s. Initially the battery packs were large but they have since come down in size and weight. The only problem with these portable LED’s lights and batteries for me was the cord was like a magnet for any doorknob or object jutting out in my office. I would occasionally watch the battery back fly down the hallway as it snagged on something. This year I acquired the Orascoptic Freedoms surgical loupes. They are surgical loupes with a cordless LED light attached. I chose the 4.8 magnifications. They are available in magnifications from 2.5 X  to 4.8.

The battery packs are attached to the back of the eyeglass frame. I love the fact I can now wander around the office with them on or dangling from my neck and I no longer have any errant battery packs being launched around the office.
The face of oral cancer is changing and I decided to step up my ability to find pathology in my patients so I acquired both a Velscope and an Identifi.




These devices assist me through the use of fluorescent technologies to help identify any areas of potential dysplasia in the mouth. So why did I need both? Because one is an extra oral device and the other is an intraoral device. Many HPV related oral pharyngeal cancers are located far back at the base of the tongue.  This can make visualization difficult. Each device has its benefits and weakness and I chose both to offer my patients all the possible tools to assist in identifying pathology. I can say that both of these devices have assisted me in detecting potential pathologic areas that required further follow up and that I may have previously missed with a standard white light examination. In retrospect it is not that the areas were not visible under white light exam but both the Velscope and Identifi helped to highlight these potential pathologic areas and assisted me in their visualization.

The use of cone beam 3-D imagining technology is assisting me in the treatment planning of implants and retreatment of failing endodontics. I have not yet purchased a cone beam machine but I hope to do so in the future.  I am lucky that there is a mobile cone beam scanning service available in my area that will either come to my office or the patient’s home or office to take the scan. This makes it easy to use the latest imaging technology without the capital outlay at this time.
I had never done orthodontics in my office but I started doing short term orthodontic treatment using the 6 Month Smile program in 2011.  The excellent 2-Day course gave me the confidence to try orthodontics. This easy to use system has allowed me to enhance the smiles of many of my patients in a way I had never been able to do before.  Treating cases has been easy and assistance from the 6 Month Smile webs site has been excellent. The orthodontist that I refer to is also happy because I have a better understanding of orthodontics and have referred additional cases to him that are outside the 6 Month Smile protocols and beyond my capabilities. Get a discount on the 6 Month Smile Course by using promo code Marty100.
The last thing that changed the way I practice in 2011 has been Kerr’s Sonicfill. Sonicfill is a specially formulated bulk fill composite and handpiece combination. Through the use of sonic forces the composite changes from a very high viscous state to a lower one.
The composite comes out of the handpiece and is fluffy. It reminds me of a soft ice cream machine dispensing my favorite flavor. As the sonic energy dissipates the composite starts to harden making for very easy carving of the composite. You can place up to 5mm increments into your preparations and light cure. This bulk filling greatly reduces the time and effort to place posterior composites.  Watch the Sonicfill video for how easy it is to place the composite restoration.
So these are the new technologies and procedures that I have incorporated into my practice in 2011.  What new technologies will be incorporated into my practice in 2012? I have some ideas of what is coming down the road in my practice and I am sure I will be in for a few surprises.  I have a whole year to see what new technologies enhance my practice of dentistry and make the 2012 list of things that changed the way I practice.




Monday, December 26, 2011

New Orascoptic Endeavor

Lightweight Comfort and Power Combined

Orascoptic's lightest & smallest light system ever! For over 30 years, Orascoptic has been a leader in lighting innovation. Applying advanced technology, Orascoptic has created the Endeavour™, a high resolution headlight system that incorporates today's best technology at an affordable price.
  • Compact and lightweight for comfort. Designed with comfort in mind, the compact light and battery unit allow you to focus on your patients.
  • Innovative "Gumdrop" technology. The miniature light delivers a high quality focused beam for better visibility during treatment and diagnosis.
  • Advanced Light-Touch controls allow you to easily and quickly adjust light settings without reaching into a coat or pants pocket.
  • Four-year warranty on the LED and cable, and one-year warranty on the battery unit.
Watch the video

Saturday, December 24, 2011

Thank You For Being There!

I wish everyone Happy Holidays.  I want to especially thank those people who put themselves in harms way to protect my family and allow us to enjoy the freedom and safety at home while they are out doing their jobs. To all of the soldiers, first responders police etc. a big THANK YOU! Stay safe.
Marty

Friday, December 23, 2011

F. Nucleatum Enables Breaking Bond On Blood Vessels To Allow Invaders In

A common oral bacteria, Fusobacterium nucleatum, acts like a key to open a door in human blood vessels and leads the way for it and other bacteria like Escherichia coli to invade the body through the blood and make people sick, according to dental researchers at Case Western Reserve University.

Yiping Han, professor of periodontics at the Case Western Reserve School of Dental Medicine, made the discovery in her continued work with the Fusobacterium nucleatum bacterium, one of the most prevalent of the more than 700 bacteria in the mouth.

She found the gram-negative anaerobe has a novel adhesin or bonding agent she's named FadA that triggers a cascade of signals that break the junctures in an interlocking sheath of endothelial cells on blood vessel's surface just enough to allow F. nucleatum and other bacteria into the blood.

A description of bond-breaking process was described in the Molecular Microbiology article, "Fusobacterium nucleatum adhesin FadA binds vascular endothelial cadherin and alters endothelial integrity."

The microbiologist at the dental school has studied the oral bacteria over the past decade and was the first to find direct evidence that linked it to preterm labor and fetal death. But its presence is found in other infections and abscesses in the brain, lungs, liver, spleen and joints.

After finding and genetically matching the oral bacteria in the fetal death, she began to unravel the mystery of how an oral bacterium can be found throughout the body and jumps the blood-brain and placental barriers that usually block disease-causing agents.

Through years of lab work, her research led to the vascular endothelial (VE)-cadherin, cell-cell junctures that link the endothelial vascular cells together on the blood vessels.

These junctures are like a hook and loop connection, but for some unknown reason when F. nucleatum invades the body through breaks in the mucous membranes of the mouth, due to injuries or periodontal disease, this particular bacterium triggers a cascade of signals that causes the hook to recede back into the endothelial cell. The oral bacterium leads the way with any other harmful invaders following along.

This "deceding" was observed by confocal microscopy when Han used cells from human umbilical cords. The researchers introduced F. nucleatum and demonstrated the VE-cadherins break on bonds on the endothelial cells and creating enough space in the endothelium for the invaders to move in.

Lab tests included introducing F. nucleatum with and without other bacteria. When E. coli alone was introduced, the bond did not break. But when F. nucleatum was introduced first, the bond broke, and the E. coli bacteria were able to move through the otherwise intact cell layers.

"This cascade knocks out the guard on duty and allows the bacteria to enter the blood and travel like a bus loaded with riders throughout the system. Whenever the F. nucleatum wants to get off the bus at the liver, brain, spleen, or another place, it does," Han said.

When it disembarks from its ride through the blood, it begins to colonize. The colony of bacteria induces an inflammatory reaction that has a range of consequences from necrosis of tissue to fetal death.

Thursday, December 22, 2011

Addition Of Mannitol Increases Effectiveness Of Dental Nerve Block Anesthesia

Allowing a patient to be comfortable and pain-free during surgical and restorative dental procedures is an essential part of the process. The most commonly used local anesthetic injection for lower teeth is the inferior alveolar nerve (IAN) block. However, failure rates ranging from 10 to 39 percent have been reported.

The current issue of the journal Anesthesia Progress presents a study testing the efficacy of adding a solution of mannitol to the anesthetic typically used in IAN blocks. Forty adult subjects participated in the study, receiving an IAN block at each of three separate appointments at least one week apart.

The study compared the effectiveness of the standard anesthetic, lidocaine with epinephrine, to the effectiveness of two different volumes of lidocaine with epinephrine plus 0.5 M mannitol. Mannitol is a sugar alcohol that occurs naturally in fruits and vegetables. It is rapidly excreted by the kidneys.

Though its impact is short-lived, mannitol has the positive effect of opening the perineurial membrane. It is believed that, in cases of IAN block failure, the perineurial barrier around the nerve does not allow complete diffusion of the anesthetic into the nerve trunk. The addition of mannitol apparently allows enhanced permeability, increasing the success of an IAN block when administered concurrently.

After injections of the IAN block solutions, subjects' pain levels were measured by an electric pulp test of their mandibular teeth at 4-minute intervals for 60 minutes. The study concluded that the addition of mannitol to lidocaine with epinephrine significantly increased the effectiveness of the anesthesia.

Tuesday, December 20, 2011

Bone Fractures Can Be Predicted By Dental X-Rays

It is now possible to use dental X-rays to predict who is at risk of fractures, reveals a new study from researchers at the Sahlgrenska Academy reported in the journal Nature Reviews Endocrinology.

In a previous study, researchers from the University of Gothenburg's Sahlgrenska Academy and Region Västra Götaland demonstrated that a sparse bone structure in the trabecular bone in the lower jaw is linked to a greater chance of having previously had fractures in other parts of the body.

X-rays investigates bone structure

The Gothenburg researchers have now taken this a step further with a new study that shows that it is possible to use dental X-rays to investigate the bone structure in the lower jaw, and so predict who is at greater risk of fractures in the future. Published in the journal Bone, the results were also mentioned in both Nature Reviews Endocrinology and the Wall Street Journal.

Linked to risk of fractures

"We've seen that sparse bone structure in the lower jaw in mid-life is directly linked to the risk of fractures in other parts of the body, later in life,"says Lauren Lissner, a researcher at the Institute of Medicine at the Sahlgrenska Academy.

Study started 1968

The study draws on data from the Prospective Population Study of Women in Gothenburg started in 1968. Given that this has now been running for over 40 years, the material is globally unique. The study included 731 women, who have been examined on several occasions since 1968, when they were 38-60 years old. X-ray images of their jaw bone were analysed in 1968 and 1980 and the results related to the incidence of subsequent fractures.

For the first 12 years fractures were self-reported during followup examinations. It is only since the 1980s that it has been possible to use medical registers to identify fractures. A total of 222 fractures were identified during the whole observation period.

One out of five in higher risk

The study shows that the bone structure of the jaw was sparse in around 20% of the women aged 38-54 when the first examination was carried out, and that these women were at significantly greater risk of fractures.

The study also shows that the older the person, the stronger the link between sparse bone structure in the jaw and fractures in other parts of the body.

Applies for both sexes

Although the study was carried out on women, the researchers believe that the link also applies for men.

"Dental X-rays contain lots of information on bone structure," says Grethe Jonasson, the researcher at the Research Centre of the Public Dental Service in Västra Götaland who initiated the fractures study. "By analysing these images, dentists can identify people who are at greater risk of fractures long before the first fracture occurs."

Monday, December 19, 2011

Rutgers study: When it comes to use of dental services, not all NJ youngsters are equal

When it comes to receiving dental care, New Jersey has its share of underserved children, according to a Rutgers study.

In 2009, more than one-fifth of the state's children between 3 and 18 received no dental care within the previous year. While an improvement over 2001, when almost one-third of the state's children received no care, the study found that foreign-born children and those without health insurance were still likely to forgo visits to the dentist.
The Facts & Findings report, New Jersey Children without Dental Services in 2001 and 2009, was prepared by Rutgers' Center for State Health Policy (CSHP). The study used data from the center's 2001 and 2009 New Jersey Family Health surveys (NJFHS) to describe the characteristics of children ages 3 to 18 who received no dental services within a year. The report concludes that generally, New Jersey's children experienced improved access to dental care between surveys but that gaps remain largely based on race/ethnicity, health insurance status and family income.
The NJFHS, funded by the Robert Wood Johnson Foundation, provides population-based estimates of health care coverage, access, use and other topics important for New Jersey policy formulation and evaluation.
Many groups recommend regular trips to the dentist for children. An American Dental Association report calls for regular dental check-ups, including a visit to the dentist within six months of the eruption of the first tooth and no later than the child's first birthday. An American Academy of Pediatric Dentistry advisory calls for a dental check-up at least twice a year for most children.
"Tooth decay remains one of the most preventable common chronic diseases among children," said José Nova, research project coordinator and lead author of the study. He cited a U.S. Surgeon General report that tooth decay affects more than 25 percent of American children ages 2 to 5 and 50 percent of those ages 12 to 15.
CSHP found that the percentage of study-age children without dental care in the previous year decreased between surveys by 11 percentage points to 22 percent in 2009. A high percentage of Hispanic children did not have a dental visit in each year (51 percent and 38 percent, respectively). By about a 2 to 1 margin, non-Hispanic black children were also less likely than white children to have had a visit to the dentist in each survey year. This group, however, also experienced the most improvement: nonvisitors fell 18 points to 28 percent in 2009.
Health insurance status is a major determinant of dental care utilization, the research found. The rate of uninsurance for New Jersey children fell by almost 50 percent to 7 percent in 2009, but the percentage of uninsured children who went without dental care increased from 68 percent to 76 percent. The large majority of publicly insured children are covered by Medicaid/NJ Family Care. Still, about one-third did not see a dentist in 2009. Children with employer-sponsored or privately purchased insurance were much more likely to receive dental care.
Youngsters in families with incomes less than double the federal poverty level (FPL) were less apt to receive dental care. About half of children whose family's income was below the FPL did not see a dentist in both 2001 and 2009. Also, foreign-born children were much more likely to lack dental care than U.S.-born children with or without an American-born parent.
The report also called well-care doctor visits an important indicator of the likelihood of a child receiving dental care, perhaps due to concerted efforts to increase dental referrals in managed care plans and the expansion of dental care in federally qualified health centers. "The odds were three times as great for children who did not have a well-child doctor visit in the past year to not receive dental care as those who visited a doctor," Nova said. He added that care for underserved youngsters could be improved with expanded health coverage under the Patient Protection and Affordable Care Act.

Saturday, December 17, 2011

Effect of vegetable oil (Brazil nut oil) and mineral oil (liquid petrolatum) on dental biofilm control

Brazilian Oral Research

Print version ISSN 1806-8324

Braz. oral res. vol.25 no.6 São Paulo Nov./Dec. 2011

http://dx.doi.org/10.1590/S1806-83242011000600014 


ABSTRACT
Dental biofilm control represents a basic procedure to prevent caries and the occurrence of periodontal diseases. Currently, toothbrushes and dentifrices are used almost universally, and the employment of good oral hygiene allows for appropriate biofilm removal by both mechanical and chemical control. The aim of this study was to evaluate the effectiveness of adding vegetable or mineral oil to a commercially available dentifrice in dental biofilm control. A comparison using the Oral Hygiene Index Simplified (OHI-S) was performed in 30 individuals who were randomly divided into three groups. Group 1 (G1) received a commercially available dentifrice; the composition of this dentifrice was modified by addition of mineral oil (Nujol®) for group 2 (G2) or a vegetable oil (Alpha Care®) for group 3 (G3) at 10% of the total volume, respectively. The two-way repeated-measures analysis of variance (two-way ANOVA) was used to test the effect of group (G1, G2 and G3) or time (baseline, 45 days and 90 days) on the OHI-S index scores. Statistical analysis revealed a significant reduction in the OHI-S at day 90 in G2 (p < 0.05) and G3 (p < 0.0001) in comparison to G1. Therefore, the addition of a vegetable or a mineral oil to a commercially available dentifrice improved dental biofilm control, suggesting that these oils may aid in the prevention and/or control of caries and periodontal disease.

Friday, December 16, 2011

Landmark identification errors on cone-beam computed tomography-derived cephalograms and conventional digital cephalograms

 American Journal of Orthodontics & Dentofacial Orthopedics
Volume 140, Issue 6 , Pages e289-e297, December 2011

Introduction

In this study, we investigated the landmark identification errors on cone-beam computed tomography (CBCT)-derived cephalograms and conventional digital cephalograms.

Methods

Twenty patients who had both a CBCT-derived cephalogram and a conventional digital cephalogram were recruited. Twenty commonly used lateral cephalometric landmarks and 2 fiducial points were identified on each cephalogram by 11 observers at 2 time points. The mean positions of the landmarks identified by all observers were used as the best estimate to calculate the landmark identification errors. In addition to univariate analysis, regression analysis of landmark identification errors was conducted for identifying the predicting variables of the observed landmark identification errors. To properly handle the multilayer correlations among the clustered observations, a marginal multiple linear regression model was fitted to our correlated data by using the well-known generalized estimating equations method. In addition to image modality, many variables potentially affecting landmark identification errors were considered, including location and characteristics of the landmark, seniority of the observer, and patient information (sex, age, metallic dental restorations, and facial asymmetry).

Results

Image modality was not the significant variable in the final generalized estimating equations model. The regression coefficient estimates of the significant landmarks for the overall identification error ranged from −0.99 (Or) to 1.42 mm (Ba). The difficulty of identifying landmarks on structural images with multiple overlapping—eg, Or, U1R, L1R, Po, Ba, UMo, and LMo—increased the identification error by 1.17 mm. In the CBCT modality, the identification errors significantly decreased at Ba (−0.76 mm).

Conclusions

The overall landmark identification errors on CBCT-derived cephalograms were comparable to those on conventional digital cephalograms, and Ba was more reliable on CBCT-derived cephalograms.

Thursday, December 15, 2011

Implications of caries diagnostic strategies for clinical management decisions

Baelum, V., Hintze, H., Wenzel, A., Danielsen, B. and Nyvad, B. (2011), Implications of caries diagnostic strategies for clinical management decisions. Community Dentistry and Oral Epidemiology. doi: 10.1111/j.1600-0528.2011.00655.x


Abstract –  Objectives:  In clinical practice, a visual–tactile caries examination is frequently supplemented by bitewing radiography. This study evaluated strategies for combining visual–tactile and radiographic caries detection methods and determined their implications for clinical management decisions in a low-caries population.
Methods:  Each of four examiners independently examined preselected contacting interproximal surfaces in 53 dental students aged 20–37 years using a visual–tactile examination and bitewing radiography. The visual–tactile examination distinguished between noncavitated and cavitated lesions while the radiographic examination determined lesion depth. Direct inspection of the surfaces following tooth separation for the presence of cavitated or noncavitated lesions was the validation method. The true-positive rate (i.e. the sensitivity) and the false-positive rate (i.e. 1-specificity) were calculated for each diagnostic strategy.
Results:  Visual–tactile examination provided a true-positive rate of 34.2% and a false-positive rate of 1.5% for the detection of a cavity. The combination of a visual–tactile and a radiographic examination using the lesion in dentin threshold for assuming cavitation had a true-positive rate of 76.3% and a false-positive rate of 8.2%. When diagnostic observations were translated into clinical management decisions using the rule that a noncavitated lesion should be treated nonoperatively and a cavitated lesion operatively, our results showed that the visual–tactile method alone was the superior strategy, resulting in most correct clinical management decisions and most correct decisions regarding the choice of treatment.

Wednesday, December 14, 2011

Repairing Spinal Cord Injury With Dental Pulp Stem Cells

One of the most common causes of disability in young adults is spinal cord injury. Currently, there is no proven reparative treatment. Hope that a stem cell population, specifically dental pulp stem cells, might be of benefit to individuals with severe spinal cord injury has now been provided by the work of Akihito Yamamoto and colleagues, at Nagoya University Graduate School of Medicine, Japan, in a rat model of this devastating condition.

In the study, when rats with severe spinal cord injury were transplanted with human dental pulp stem cells they showed marked recovery of hind limb function. Detailed analysis revealed that the human dental pulp stem cells mediated their effects in three ways: they inhibited the death of nerve cells and their support cells; they promoted the regeneration of severed nerves; and they replaced lost support cells by generating new ones. Yamamoto and colleagues therefore hope that this approach can be translated into an effective treatment for severe spinal cord injury.

Tuesday, December 13, 2011

Associations between sleep-disordered breathing symptoms and facial and dental morphometry, assessed with screening examinations

American Journal of Orthodontics & Dentofacial Orthopedics
Volume 140, Issue 6 , Pages 762-770, December 2011

Introduction

Chronic snoring is considered abnormal in a pediatric population. This disorder is often attributed to enlarged tonsils and adenoids, but multiple anatomic obstructions should also be considered. Facial and dental morphometry associations with various sleep-disordered breathing symptoms were investigated at an orthodontic clinic.

Methods

Parents or guardians were asked to complete a 4-part questionnaire on behalf of their children (n = 604; <18 years of age), including medical and dental history, bruxism and temporomandibular disorder habits, sleep and daytime behavior, and sleep duration and quality. All subjects underwent a clinical screening assessment by the same orthodontist to identify standard dental, skeletal, functional, and esthetic factors.

Results

In contrast to sleep-disordered breathing or sleep apnea in adults, which is predominantly associated with obesity, sleep-disordered breathing symptoms in this pediatric cohort were primarily associated with adenotonsillar hypertrophy, morphologic features related to a long and narrow face (dolichofacial, high mandibular plane angle, narrow palate, and severe crowding in the maxilla and the mandible), allergies, frequent colds, and habitual mouth breathing.

Conclusions

Because of the recognized impact of pediatric snoring on children’s health, the determination of these good predictors can help in preventing and managing sleep-disordered breathing. If a health professional notices signs and symptoms of sleep-disordered breathing, the young patient should be referred to a sleep medicine specialist in conjunction with an orthodontist if there are dentoskeletal abnormalities.

Sunday, December 11, 2011

DentalEZ® Group Updates its Identafi® Website with Free Marketing Kit for Clinicians


Malvern, PA – (December 8, 2011) – DentalEZ® Group, a supplier of innovative products and services for dental health professionals worldwide, has officially updated its Identafi® website to include a useful section that provides various marketing tools to help clinicians increase oral cancer awareness and promote the benefits of the Identafi oral cancer screening device.    

The new clinician section now included on the Identafi website, www.Identafi.net, offers clinicians several easy-to-use patient education and marketing materials targeted to local residents and existing patients who may not know that their dental office offers the advanced oral cancer screening technology device.  Dental professionals who offer the Identafi oral cancer screening examination in their practices can now download these FREE useful marketing tools, such as:

Saturday, December 10, 2011

UCLA researchers identify new method for generating stem cell-like cells from human ski

Researchers from the UCLA School of Dentistry investigating how stem cells can be used to regenerate dental tissue have discovered a way to produce cells with stem cell–like characteristics from the most common type of human skin cell in the epidermis.
 
These skin cells, called keratinocytes, form the outermost layer of skin and can be cultured from discarded skin tissues or biopsy specimens.
 
The findings, published in the Nov. 4 edition of the peer-reviewed Journal of Biological Chemistry, may be beneficial for individuals with limited sources of endogenous stem cells.
 
The gene known as ∆Np63α is highly synthesized in regenerating cells of various tissues. The UCLA researchers found that introducing ∆Np63α into skin keratinocytes makes them lose their skin-cell characteristics and de-differentiate to resemble mesenchymal stem cells (MSCs), undifferentiated cells that can self-renew and differentiate to yield specialized cells of various tissue types.
 
MSCs may serve as an internal repair system by replenishing cells needed for tissue regeneration and homeostasis and are currently being investigated for a number of regenerative therapeutics.
 
The conversion of keratinocytes into mesenchymal-like cells involves a process known as epithelial–mesenchymal transition. This is the first study to show that the gene ∆Np63α triggers this process in human skin keratinocytes and that the transformed cells acquire multipotent stem cell characteristics.  
    
Since the skin cells transformed by ∆Np63α are induced to acquire the mesenchymal and stem cell characteristics, the research team named them "induced mesenchymal stem cells," or iMSCs. Specifically, the researchers demonstrated that iMSCs can be triggered to form bone-like tissues or become fat tissues in a laboratory setting.
 
Dr. Mo K. Kang, the Jack A. Weichman Chair of Endodontics at the UCLA School of Dentistry and a member of the research team, said the finding had great significance for human health.
 
"Since iMSCs may be obtained by taking a small punch-biopsy of skin tissues from patients, these cells are an easily accessible, patient-specific source of stem cells, which can be used for regenerative purposes," Kang said.    
 
Stem cell–based therapies are currently being developed to treat degenerative conditions such as heart disease, diabetes, neuronal disorders and liver diseases. Many of these diseases are strongly associated with aging. Endogeneous MSCs found in various tissues, such as bone marrow, fat tissues and, in certain cases, dental tissues such as dental pulp, lose their regenerative potential during the aging process.
 
"It is possible that iMSCs retain their stem-cell characteristics even when derived from aged patients," Kang said. "In such cases, this new approach may be useful, especially for geriatric patients or individuals with limited therapeutic value of their endogenous stem cells."
 
"The UCLA School of Dentistry is very proud to be at the forefront of this research inquiry, which may facilitate future advances in regenerative dentistry and medicine," said Dr. No-Hee Park, dean of the UCLA School of Dentistry and one of the study's co-authors. "While the focus of this study was on the use of adult stem cells to regenerate dental tissue, including dental pulp and periodontal ligament, these findings could lead to further development of a variety of cell-based therapies."
 
The research was funded in part by the National Institute of Dental and Craniofacial Research and the Jack A. Weichman Endowed Fund.
 
The UCLA School of Dentistry is dedicated to improving the oral health of the people of California, the nation and the world through its teaching, research, patient care and public service initiatives. The school provides education and training programs that develop leaders in dental education, research, the profession and the community; conducts research programs that generate new knowledge, promote oral health and investigate the cause, prevention, diagnosis and treatment of oral disease in an individualized disease-prevention and management model; and delivers patient-centered oral health care to the community and the state.

Friday, December 09, 2011

Undersized Implant Site Preparation to Enhance Primary Implant Stability in Poor Bone Density: A Prospective Clinical Study

Journal of Oral and Maxillofacial Surgery
Volume 69, Issue 12 , Pages e506-e512, December 2011

Purpose

Achieving primary implant stability in areas with poor bone density is often challenging to the clinician. Previous research has suggested that modified surgical protocols might be beneficial in such situations. The objective of the present clinical study was to evaluate the survival rate of implants placed using undersized implant site preparation in areas with poor bone density.

Materials and Methods

A total of 52 implants were placed in 29 patients. Of the 52 implants, 26 were surgically placed according to the standard drilling protocol (control group) and 26 were placed in low-density bone using an adapted bone drilling method (test group). The maximum insertion torque values and resonance frequency analysis measurements were also recorded. All implants were examined clinically and radiographically at follow-up visits during the study period. Oral hygiene status, bleeding on probing, peri-implant probing depth, and implant survival rate were assessed.

Results

According to the survival criteria used in the present study, no failure was recorded, and the overall survival rate was 100% for both groups after 12 months. The mean probing depth was 2.75 ± 0.75 mm in the test group and 2.87 ± 0.79 mm in the control group. The mean insertion torque value was 35.19 ± 4.79 Ncm in the test group and 34.62 ± 5.82 Ncm in the control group. The resonance frequency analysis value was 68.58 ± 4.81 implant stability quotient and 66.69 ± 5.41 implant stability quotient in the test and control groups, respectively. The observed differences were not statistically significant (P > .05).

Conclusions

The results of the present study suggest that placement of implants by an adapted drilling technique in sites with poor bone density is beneficial in enhancing primary implant stability and improving the implant survival rate.

Thursday, December 08, 2011

FTC issues final order in teeth whitening case

Washington—The North Carolina State Board of Dental Examiners “sought to, and did, exclude nondentist providers from the market for teeth whitening services,” the Federal Trade Commission said in a unanimous ruling and final order issued Dec. 2. The board has 60 days to file a petition for review with the U.S. Court of Appeals.
“As a result of the Board’s actions, many nondentists stopped providing teeth whitening services and several marketers of teeth whitening systems stopped selling their products and equipment in North Carolina,” the FTC said in upholding an administrative ruling. “In addition, several mall operators refused to lease space to, or cancelled existing leases with, nondentist teeth whitening providers.”
The FTC order, effective through Dec. 2, 2031, bars the board from:
  • directing a nondentist provider to cease providing teeth whitening goods or services;
  • prohibiting, restricting, impeding or discouraging provision of teeth whitening goods or services by a nondentist provider;
  • communicating to a nondentist provider that the provider is violating or has violated the Dental Practice Act by providing teeth whitening goods or services, or that providing such services would violate the Act;
  • communicating to a prospective nondentist provider that the provider would violate the Act by providing teeth whitening goods or services or that providing such services would violate the Act;
  • communicating to a commercial property lessor or other third party that the provision of teeth whitening goods or services by a nondentist provider is a violation or that any nondentist provider is violating the Act by providing such services;
  • communicating to an actual or prospective manufacturer, distributor or seller or any third party that providing such goods or services is a violation;
  • inducing, encouraging, assisting or attempting to induce anyone to engage in any action that would violate the above-listed restrictions.
Nothing in the order prohibits the board from investigating other non-dental providers for suspected violations of the Act, filing a court action against a nondentist for alleged violations or communicating the board’s “belief or opinion” whether a particular method of providing teeth whitening goods or services may violate the Act.

Wednesday, December 07, 2011

Glass ionomer cement as an occlusive barrier in Class III furcation defect

Singhal R. Glass ionomer cement as an occlusive barrier in Class III furcation defect. Indian J Dent Res 2011;22:583-6



Predicting the prognosis of molars that have experienced furcation invasion, is often a frustrating experience to the dental clinician and disappointing report to the patient involved. Although multiple treatment modalities have been attempted to retain teeth with severe furcation invasion, clinical success has not been predictable. A case report involving the use of glass ionomer cement (GIC) as an occlusive barrier in the management of Class III furcation defect involving mandibular first molar is presented. A literature review on the subject matter was conducted using Medline, Google search engines, and manual library search. GIC restoration of Class III furcation invasion gives a satisfactory result. Surgical and nonsurgical treatment options are available for the management of the condition. GIC as an occlusive barrier in Class III furcation invasion is an economical and less invasive treatment option. It also makes home care easy for the patient.

Tuesday, December 06, 2011

Invisaligns Response To Social Coupons

December 5, 2011
Dear Doctor,
A small number of Invisalign practices have recently elected to offer their dental services and Invisalign treatment specifically through social coupons such as Groupon and Living Social. In response to this marketing practice, Align has received a number of complaints from other Invisalign customers who highlight that Invisalign is a rigorously regulated class II medical device which requires specialized medical training and a doctor’s prescription. As neither Invisalign nor the associated dental services are generic commodities, these Invisalign customers feel the use of social coupons is not in the patient’s best interests, and is unethical and demeaning to the dental profession.
We agree. In fact, Align does not endorse the arbitrary sale of dental services and Invisalign treatment through social coupons and is not a party to any such offerings. Align believes that the interests of both prospective patients and the practitioner are best protected by requiring a patient examination to confirm a patient`s suitability for Invisalign treatment before extending an offer to treat. Because both your services and each Invisalign treatment are unique (like the needs of each patient), we do not believe that either are appropriate for the web-based, group-buying social coupon process.
You should also be aware that the laws of most States prohibit practitioners from splitting fees with third-parties or non-practitioners. In response to the increase in the sale of medical services through social coupons, there is a growing sentiment that the sharing of fees between a doctor and social coupon sponsor may constitute such an illegal fee splitting arrangement. As a result, we encourage all Invisalign practitioners who may be considering participation in the social coupon process to consult with their attorney to evaluate the legal risks associated with such a transaction.
We hope you find information on these issues helpful. Because the dental services environment is evolving almost as rapidly as the technology itself, we intend to keep you current with our assessment of the latest trends so you can better achieve your practice goals. If you have any questions or comments, please contact your Invisalign representative or email us at customersupport@aligntech.com.
Best Regards,
Dan Ellis
Vice President, North America Sales
Align Technology, Inc.

Monday, December 05, 2011

Imaging For Better Diagnosis and Patient Education

Imaging For Better Diagnosis and Patient Education
Join me for this webinar on Wednesday December 7th at 7:30PM EST.
Earn 1 CE credit.
To register contact by email: kmenekou@airtechniques.com

Saturday, December 03, 2011

Influence of the LED curing source and selective enamel etching on dentin bond strength of self-etch adhesives in class I composite restorations

DOI: 10.1007/s10103-011-1030-y

Abstract

The aim of this study was to evaluate the influence of the LED curing unit and selective enamel etching on dentin microtensile bond strength (μTBS) for self-etch adhesives in class I composite restorations. On 96 human molars, box-shaped class I cavities were made maintaining enamel margins. Self-etch adhesives (Clearfil SE – CSE and Clearfil S3 – S3) were used to bond a microhybrid composite. Before adhesive application, half of the teeth were enamel acid-etched and the other half was not. Adhesives and composites were cured with the following light curing units (LCUs): one polywave (UltraLume 5 - UL) and two single-peak (FlashLite 1401 - FL and Radii Cal - RD) LEDs. The specimens were then submitted to thermomechanical aging and longitudinally sectioned to obtain bonded sticks (0.9 mm2) to be tested in tension at 0.5 mm/min. The failure mode was then recorded. The μTBS data were submitted to a three-way ANOVA and Tukey’s (α = 0.05). For S3, the selective enamel-etching provided lower μTBS values (20.7 ± 2.7) compared to the non-etched specimens (26.7 ± 2.2). UL yielded higher μTBS values (24.1 ± 3.2) in comparison to the photoactivation approach with FL (18.8 ±3.9) and RD (19.9 ±1.8) for CSE. The two-step CSE was not influenced by the enamel etching (p ≥ 0.05). Enamel acid etching in class I composite restorations affects the dentin μTBS of the one-step self-etch adhesive Clearfil S3, with no alterations for Clearfil SE bond strength. The polywave LED promoted better bond strength for the two-step adhesive compared to the single-peak ones.

Friday, December 02, 2011

Carestream Dental Inks Partnership with Lexicomp for Access to Clinical Data

I am a Lexicomp Online user and recommend their products. This integration will make it easier for Carestream users to get valuable information. MJ
 
Integration of drug and clinical content database with practice management software improves patient care, further streamlines office administration

ATLANTA and HUDSON, OHIO – Carestream Dental LLC, a subsidiary of Carestream Health, Inc., and the exclusive manufacturer of KODAK Dental Systems, announces today it has entered into a comprehensive data-sharing agreement with Lexicomp, a global provider of drug information and drug data solutions for healthcare professionals.

Through this venture, Lexicomp’s vast, subscription-based database of comprehensive drug information and clinical reference content will be made accessible through Carestream Dental’s SoftDent, PracticeWorks, Windent and WinOMS CS software.*

“As with many of our products and services, our goal for this partnership is to maximize oral health professionals’ ability to further streamline office management and spend quality time on patient care,” said Patrik Eriksson, president and CEO, Carestream Dental LLC.

“By giving practice professionals the ability to access Lexicomp data and pull it directly into patient records with their existing practice management software, we can improve decision support to ensure patient safety and eliminate several steps in an otherwise lengthy data entry process,” Eriksson said. “This reduces the chance of errors and saves practices valuable time as they check on drug interactions.”

Lexicomp maintains an in-house clinical team comprised of advanced-degreed pharmacists with significant clinical and academic experience. This team performs daily surveillance of announcements by the U.S. Food and Drug Administration plus pharmaceutical manufacturers. This critical information is compiled and made available to heath care systems regarding drug availability; new dosage forms; and revisions to contraindications, warnings or other changes.

For more information, call (800) 944-6365 or visit www.carestreamdental.com.

*The release date will vary for each software platform.

About Carestream Dental LLC
Carestream Dental LLC, the exclusive manufacturer of KODAK Dental Systems, provides industry-leading imaging, software and practice management solutions for dental and oral health professionals. With more than 100 years of industry experience, Carestream Dental products are used by seven out of 10 practitioners globally and deliver more precise diagnoses, improved workflows and superior patient care. For more information or to contact a Carestream Dental representative, call (800) 944-6365 or visit www.carestreamdental.com.

About Carestream Health, Inc. Carestream Health, Inc., is a worldwide provider of dental and medical imaging systems and healthcare IT solutions as well as molecular imaging systems for the life science research and drug discovery/development market segments, and X-ray film and digital X-ray products for the non-destructive testing market. For more information about the company’s broad portfolio of products, solutions and services, please contact a Carestream Health representative at (888) 777-2072 or visit www.carestreamhealth.com.

Thursday, December 01, 2011

WSU researchers use a 3-D printer to make bone-like material

Clears way for custom-made replacement tissue

IMAGE: Using a 3D printer, Washington State University Mechanical and Materials Engineering Professor Susmita Bose created a bone‑like material that can be used for orthopedic and dental work. Shelly Hanks photo courtesy...

Click here for more information.
PULLMAN, Wash. -- It looks like bone. It feels like bone. For the most part, it acts like bone.
And it came off an inkjet printer.
Washington State University researchers have used a 3D printer to create a bone-like material and structure that can be used in orthopedic procedures, dental work, and to deliver medicine for treating osteoporosis. Paired with actual bone, it acts as a scaffold for new bone to grow on and ultimately dissolves with no apparent ill effects.
The authors report on successful in vitro tests in the journal Dental Materials and say they're already seeing promising results with in vivo tests on rats and rabbits. It's possible that doctors will be able to custom order replacement bone tissue in a few years, says Susmita Bose, co-author and a professor in WSU's School of Mechanical and Materials Engineering.
"If a doctor has a CT scan of a defect, we can convert it to a CAD file and make the scaffold according to the defect," Bose says.
IMAGE: Washington State University researchers used a 3‑D printer to make a variety of bone‑like materials, including pieces of hip bone.

Click here for more information.
The material grows out of a four-year interdisciplinary effort involving chemistry, materials science, biology and manufacturing. A main finding of the paper is that the addition of silicon and zinc more than doubled the strength of the main material, calcium phosphate. Theresearchers also spent a year optimizing a commercially available ProMetal 3D printer designed to make metal objects.
The printer works by having an inkjet spray a plastic binder over a bed of powder in layers of 20 microns, about half the width of a human hair. Following a computer's directions, it creates a channeled cylinder the size of a pencil eraser.
After just a week in a medium with immature human bone cells, the scaffold was supporting a network of new bone cells.
###
The research was funded with a $1.4 million grant from the National Institutes of Health.
Video of Bose discussing her work can be found at http://www.youtube.com/watch?v=XvkfMu76drE.