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January 7, 2007

CALCIUM IMPORTANT FOR NURSING MOTHERS’ ORAL HEALTH
A low-Calcium diet can harm the supporting structures around teeth and gums, especially for nursing mothers

CHICAGO- Mothers who breastfeed should be sure to have enough Calcium in their diet, or may risk bone loss around their teeth and gums, according to a new study that appears in the January issue of the Journal of Periodontology (JOP).

Researchers from Tohoku University in Japan investigated if lactation affects alveolar bone loss, the bone surrounding the roots of teeth, in rat models of experimental periodontitis.  They found mothers who are lactating could put the bone structures around their teeth at risk, especially when there was not enough Calcium in their diet. 

“Our research emphasized the importance of having a high-Calcium diet while breast-feeding,” said Dr. Kanako Shoji, Division of Periodontology and Endodontology at Tohoku University.  “While our study was on a rat population, the evidence confirmed that breastfeeding can cause increased bone loss in the mother, especially when the mother has insufficient Calcium intake.  But additional studies in human populations are necessary to confirm these findings.”

The study showed that all groups with insufficient Calcium intake saw an acute inflammatory reaction in periodontal tissues and disruption of the gingival epithelium, the tissues surrounding the teeth, in addition to increased attachment loss, and increased alveolar bone loss.  Those groups which were lactating saw even greater attachment loss and bone loss. 

“We know a high-Calcium diet can promote healthy teeth and gums,” said Dr. Preston D. Miller, DDS, President of the American Academy of Periodontology, “But this research indicates that nursing mothers should be especially conscious of having enough Calcium in their diet.  While breast milk is critical to their baby’s bone development, mothers should be sure to have enough calcium, or risk bone loss in her mouth, which can worsen periodontal diseases.  Given that a thorough periodontal evaluation should be done as soon as a woman finds out that she is pregnant, monitoring periodontal tissues, including more frequent cleanings during pregnancy and continuing until 3 months after delivery, will help assure periodontal health.”

Visit the AAP website, www.perio.org, for a referral to a periodontist and free brochure titled Maintaining Periodontal Health Throughout a Woman’s Life.  Or call 800/FLOSS-EM (800.356-7736) toll-free.

The American Academy of Periodontology is an 8,000-member association of dental professionals specializing in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants.  Periodontics is one of nine dental specialties recognized by the American Dental Association

CONTACT INFORMATION:
Kerry Gutshall
The American Academy of Periodontology
Phone:  312.573.3243
Fax:  312.573.3234
http://www.perio.org

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4, 5 or 5 canals
This one took away some of my lifetime.
 
Upper First Molar with CAP. The MB2 was hard to find. Finally the access cavity looked nice and I thought this one should be a nobrainer. The tooth must have read my thoughts. DB was waiting for me. First I could not get patent. After using extremly prebended handfiles i found a severe curvature to the buccal side. Again I thought I made it. Handfiles went in and out very easy. I took a M2 10/04 , felt resistance, did not stop and broke the file :((((.
After 10 minutes I could remove the fragment and was happy that I blocked out all other canals with sponges. At that day without blocking the canals the fragment sure would have entered one of the already shaped canals.
 
Then I entered the DB again, this time with the bend to the palatal side. There was a deep splitting: Just for my personal records: Is this a 5 or only a 4,5 canal molar ;)))
 
After shaping, modified Schilder in all canals. adhesive buildup - Jörg Schröder 
  (ROOTS)
 
 
Dear Jorg, I don't mind how many canals this molar has. I do mind the effort that went into this. Not only the documentation is excellent, what a nice case ! - Thomas
 
Beautiful work and documentation Jörg! Congratulations!!  Carlos
 
Jörg, That was beautifully done. That was not a 4.5; rather, it should be a 5+, since you went the distance and found the hidden branch in the DB. - wes

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Root Canal Repair Material
 
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• Repair of Root Perforation
• Repair of Root Resorption
• Root End Filling
• Apexification
• Pulp Capping

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The effects of aluminum poisoning can range from subtle symptoms to serious diseases. DiaRoot is completely aluminum free and will not pose any toxic threat to the human body.
• Biocompatibility
DiaRoot BioAggregate is more biocompatible than any other root end filling and repair materials. It does not produce any adverse site effect on microcirculation of the connective tissue. It also has excellent biocompatibility with the vital periradicular tissue.
 
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The working time of DiaRoot is at least 5 minutes. Upon mixing DiaRoot and BioA Liquid, a thick paste-like mixture is formed. If additional working time is required, simply cover the mixture with a moist gauze sponge while unattended.
 
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DiaRoot is not off-white, like other root canal repair materials. DiaRoot complements the natural color of teeth and all the ingredients are pure white in color.
 
1004 - 104: DiaRoot Intro Kit $39
1 Treatment of BioAggregate (1.0 g each)
1 Vial of BioA Liquid (0.38 ml each)
1 Mixing cup
1 Spatula
 
1004-101 DiaRoot Regular Kit $200
6 Treatments of BioAggregate (1.0 g each)
8 Vials of BioA Liquid (0.38 ml each)
6 Mixing cups
6 Spatulas
 
Gregori M. Kurtzman, DDS  (ROOTS)
Tips to become proficient in using the scope
 
It will take from 1 month to 1 year to become proficient in using the scope for everything.  It depends on the many things including your ability to use mirrors for both arches, your past history with magnification, the setup of your office and your operatory, how busy you are, how many ops you work out of, the type of dentistry you do etc.
 
I can tell you that there are several things that can help you along the way.
 
1. Slow down your schedule by adding 10 mins onto each patient or scheduling one day that you normally dont work with scope only patients.

2. Use the scope 1 x a day for the first week , then 2x a day for the 2nd week , 3 times for the third week.

3. Use the scope til you get to 10-20 mins ahead of the next scheduled patient and then finish the procedure with loupes.

4. Take a training course (www.ncofi.com) or with Stefan Luger.

5. Go to AMED (www.microscopedentistry.com)

6. Look into a DVD that has been made on microscope positioning ( I do have one that is for sale)

7. Go to your local endodontist and spend some time with them.

8. Work on upper teeth, extracted teeth, trimming temps in your hand or anything that you can use direct vision for.

9. Use the lower levels of magnification with only quick checks at higher levels until you feel that it is getting easier to learn to use the scope for eveything.

10. Lastly, learn to move the patient, their head, or your mirror as opposed to moving yourself and you will be well on  your way to conquering the scope.  There is a learning curve especially on lower molars (incline the patient sitting up from 15-45 degrees and tip the oculars toward yourself to give yourself a head on view of the occlusal surface) and if necessary to use the mirror place it distal to the tooth.  I typically will instrument the mesials first then the distals .  Often the distals I can get a direct view of the canals with the
movements I described.  Sometimes I leave the patient more horizontal for the mesial canals.
 
Hope that gets you started....there are tons of little tips but the light and the improved visual acuity through magnification are nothing like high powered loupes.
 
Stick with it........you won't regret it and nothing worth anything comes  easily in life! - Glenn    (ROOTS)
 

 
 

Implant placement  - Implants forum

Sorry, no photos or xrays, nothing much to see anyway.  Four months healing on an edentulous mandible.  After significant ridge smoothing and flattening, the ridge in position B and D was still only 5 mm wide at the new crest.  I decided to expand the ridge slightly with osteotomes.  Pretty challenging in type 1 bone.  But it expanded just enough to get two 4 mm implants in - Daniel Shalkey
 
Questions:
what flap design would you use?  I tried a midline release and did not like it.  Would you strictly go with a crest of the ridge incision with no release?  I tried this on a previous case and had trouble getting good reflection.

Answer: no images came thru so will take a stab at this..... if one extends the mid crestal incision further mesial and distal it will allow openning the envelop wider gaining more visibility. its hard to see much with a small crestal incision.  and sometimes a vertical releasing incision is needed, but this should be far enough anterior to the site that when sutured the releasing incision doesnt fall over the site worked on.  this may mean if sat 28 is being implanted you make the releasing incison on the mesial of 27.  also remember care when making releasing incisons in the area of the lower premolars because of the mental nerve.

I had trouble seating the implants even at 50 Ncm despite using the 3.25 mm drill and countersinking.  Could this be because I was in type 1 bone and needed to tap?  My 3i surgery kit does not come with a flap.

Answer: density of the bone is determined as you are drilling.  in the mandible you will never have a problem tapping the site (you cna in the maxilla as you may not acheive good insertion torque due tot he softer bone if you tap)  what size was the implant if you only used a 3.25mm drill?  in dense bone you have to go to the final drill size and can't use the implant to expand the site - danS