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Dental India Newsletter dated  21st August 2005... Choice of 22000 dentists
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This week
 
Endo cosmetic dentistry - a case study
Tips to care for Baby Teeth
Bonded sealer..
MClinDent course staff visit to India   -
Help us to update our database
 

Keep this immensely informative website going. My best wishes for the fabulous job you people are doing to update us on a variety of subjects pertaining to Dentistry.  Dr Sharad Jhingran - Guwahati(Assam)
 
This is one of the most informative and useful exclusive dental website i have browsed. Excellant layout and featuristic site.
Keep it up! Your web site never ceases to amaze me.! Wonderful work and keep up the constant updates.- Best wishes -
Dr. Murali Srinivasan, Dubai.

Endo cosmetic dentistry - a case study
 
The opinions and photographs within this newsletters are not ours. Authors have been credited for the individual posts where they are. - Photos courtesy of Ahmad Tehrani - ROOTS

after 4 months of treatment this case is slowly is coming to an end. retreatment of #7 and AP #8. also internal bleaching of #8 with sodium perborate.
 
just to be clear.....Jan and Stephane did teach me better than this to isolate these teeth, but these pictures are in the heat of the battle. So I am ashamed of the poor job of isolation, but used gobs of liquid-dam to isolate whenever I could.
 #7 has a custom made heat pressed temporary crown which I forgot to take a picture of.  It looked beautiful in the mouth too. Oh well...)) when tissue inflammation has subsided, we will impress for a new crown.
 
she is the nicest lady you can ever hope for to have in any practice. Patients like her deserve a whole lot better than this crappy dentistry she got right here in the US of A. It goes to show you that no geographic area is immune to this kind of tooth carpentry billed as "cosmetic dentistry". - ahmad
 
 
Hi Rajiv:
 
Is this your normal protocol to place CaOH2 + CHX  and delay obturation till you observe radiographic signs of healing in progress, or were there other reasons in this case??
 
with AP cases, I always try to wait at least a month before obturation. She had a ST that took a while to close ( 12 days). I was very hesitant to obturate 2 weeks afterwards, so I packed it twice with CH with 3 weeks in between to make sure ST closure was not just a fluke and pure luck. I don't put that much stock in short term radiographic healing specially with CH as you never know the tooth has finally healed until you give it a tincture of time after definitive treatment (molten rubber and Kerr sealer ) is completed.
 
but, if it is failing ( ST returns, percussion sensitivity continues, PARL lesion extending, widened lamina dura, unexplained episodes of pain ....etc...) you know right away. I wish some one would write a  protocol for implants like Strindberg did for endo...))
 

PDA Offers Tips To Care For Baby Teeth
8/8/2005 

Harrisburg, PA - It's never too early to begin preventive care that can protect your child's oral health. To ensure that your child enjoys healthy smiles throughout childhood and beyond, the Pennsylvania Dental Association (PDA) encourages parents to become familiar with proper oral hygiene techniques and implement them as early as possible.

Baby teeth will begin to appear typically around six months of age. Some babies may have sore or tender gums when teeth begin to erupt. Gently rubbing your child's gum with a clean finger, a small, cool spoon or a wet gauze pad can be soothing. Your PDA member dentist or a pediatrician may recommend a clean pacifier, teething ring or a special "numbing" salve for the gums.

After the teeth begin to erupt, parents should brush them with a very soft-bristled toothbrush and a little bit of water to prevent tooth decay. Toothpaste is not recommended until a child reaches two years of age. At that time, supervise brushing to ensure that your child does not swallow the toothpaste.

From the time these first teeth erupt a child is susceptible to tooth decay. This condition is often called early childhood caries (cavities) or baby bottle tooth decay. It is caused by prolonged exposure of infant's teeth to liquids that contain sugar, such as milk (including breast milk), formula, fruit juice and other sweetened drinks. Remember, it is not just what children drink, but how often and for how long their teeth are exposed to decay- producing acids. It is important to only put water in your child's naptime or bedtime bottle so harmful sugary liquids will not harm the teeth during sleep. It also helps to wipe your baby's gums and teeth with a clean gauze pad or washcloth after each feeding.

Children should be encouraged to drink from a cup rather than a bottle as they approach their first birthday. The American Dental Association recommends parents take their children to the dentist by the child's first birthday. The dentist will demonstrate how to properly care for your child's teeth, evaluate any adverse habits and identify your child's fluoride needs.


Bonded Sealer ...
 
For you guys dentinal bonding is a novelty and something to argue about and shout across rooms at each other about.  Endodontics will stand on the ZOE sealer standard as long as we live probably...just as restorative dentistry stands on the gold standard.  The problem is that gold is no longer utilized to any degree in restorative dentistry.  Adhesive dentistry is utilized by the vast majority of restorative dentists in everything from endo to surgery.  We are gluing joints into the human body with adhesives when nails/mechanical retention is more stable. 
 
Realizing that my opinion means zero/zilch to the BU guys who live for a good research battle and shouting match, I practice with a certain amount of faith in certain practitioners in my profession.  That includes the ones mentioned above.  Dr. Pashley and Tay both have my utmost respect.  Still, I'll reiterate, where are the independent studies and who pays for them?
 
Take Kanca, Bertollotti, Pashley, Leinfelder, Tay, Nash, Finnigan, et al and put them in a room and let them beat each other to death with research proving their own points.  The result would be that no filling material is perfect but theirs is the best.  IS ZOE the gold standard of endo forever or do you think that there will be improvements.  We've been using ZOE now for at least sixty years and Terry wants to wait at least another ten.  That's longer than I've been alive.  Few things other than gold or amalgam have survived that dang long. 
 
I don't stand totally on anecdotal practice.  I have to trust someone.  I actually trust Tay and Pashley.  They just aren't clinical practitioners.  I have to base my trust on the guys like Barnett and Watson who are clinical and scientific.I can't base my practice on the "wait ten years and see" theory that so many aspire to. 
 
Tay and Pashley  don't do direct bonded restorations every day that they go to work as I do.  I'm not naive enough to think that every restoration I bond gives me a 100% bond over the total surface area but I do know that I am getting bonding because I watch the cusps crack when I over bulk the material and it contracts.  I have to cut off bonded veneers.  I can bond to dentin.  I know little about the C Factor because as far as a porcelain veneer in general practice it is just the C Factor with no practical basis. 
 
Whether Epiphany bonds to dentin absolutely is not the deciding factor in endodontic success.  You know that.  Whether Epiphany degrades may be.  People I respect say it does not degrade.  People in science say they don't know yet.  Hell, people in science say it doesn't degrade.  If I get 1/3 of my canal with a bonded seal with no more shrinkage than GP and ZOE then I'm much more satisfied with the bonded sealer.  Ben can explain the C factor to you.  I just try to learn to do better endo.  - Guy
 
Guy W. Moorman, Jr. DDS - ROOTS
 

MClinDent course staff visit to India  
 
Dear colleague

I have arranged  two seminars for prospective students who are
interested to apply for the Masters in Clinical Dentistry
(Prosthodontics). The seminars will give the chance for us to meet and
I will be able to address questions relating to this distance learning
programme. You will be able to receive application forms and specific
information regarding  this MClinDent course you will have the
opportunity to ask any questions.

This is also an opportunity to bring along your original qualification
certificates (as well as a photocopy of these documents) and have them
signed and verified  by myself there and then. The signed copy can be
used to speed up the application procedure and it is sent to the
University when you apply for a place, together with the application
form.

The venues will be:

Wednesday 7th September 2005 at 7pm
Taj Residency Hotel
41/3 M G Road
Bangalore 560001.

OR

Saturday 10th September 2005 at 7pm
Taj Mahal Hotel
Number One, Mansingh Road
New Delhi. 110011

Places are limited, so I would request that you indicate your interest
and choice of venue by return e mail.

Yours Sincerely

Dr Subir Banerji
Postgraduate Tutor & Consultant
MClinDent (Prosthodontics)
Distance Learning
----------------------
Unit of Distance Education
Guy's, King's and St Thomas' School of Dentistry
King's College London
Denmark Hill Campus
Caldecot Road
Fourth Floor, Rooms 433-435
London SE5 9RW
UK

Email:
m.clindent@kcl.ac.uk
Tel +44 (0) 20 7346 3597
Fax +44 (0) 20 7346 3496

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