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Dental India newsletter dated 25th Mar 2007 -  10th year of online in Feb 2007

LOST CASE: 8 year old boy with history of trauma. Tooth was completely out of the mouth for two hours. His Pedodontist replanted it and splinted it with composite - Rob Kaufmann  - ROOTS  ( More )

MagnificationAttached I have lined up images that are 10x10, 20x20, 50x50, 70x70, 100x100, 250x250, 500x500 pixels in size and another attachment of a series of images that are all the same size showing the relative information that those images give. The point is that when you look at an image that is 10x10 you have 100 bits of information. When that image is 100x100 then you have 10,000 bits of information. If you have an image that is 1,000x1,000 then you have 1,000,000 (or as illustrated 700x700 giving 490000). - Bob  ROOTS

read more.....

The XXXII Indian society of Periodontology conference will be held from 28-30th December 2007 at Davangere, Karnataka,India

I have authored a book on- Biodental waste management called- Going Green - A manual of waste management  for the dental practitioner.Jaypee Publication has published the book and it will be available in the book store in a fortnight. I wanted to share this happy moment with all of you. Dr.Vidyaa Hari

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From: Harald Prestegaard
Sent: Sunday, November 27, 2005 9:29 PM
Subject: Not an implant case

A case from yesterday showing a case whithout an implant solution, but still using the techniques that aquired from implant treatment.

So I think that a bridge still can be a good solution
45 years-old woman with a loose crown on tooth 21.
X-ray showing a quiet big post on a root resected tooth done 20 years ago.
Suspected root fracture. Removed the crown very easy and the post followed the crown.
Root fracture was confirmed.
The patient did not want an implant so we decided to make a bridge 11-22.
The root 21 was sectioned and removed very carefully to not damage the buccal bone plate.
A temporary bridge was made to tray to support the gingiva/papilla under the healing.
Healing 2-3 months before final treatment.

Harald Prestegaard, Norway
     Click here for more images

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An Interview with AAE President Dr. John Olmsted

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Endodontics is Far From Dead by Dr. Jeff Rohde

Eliminating File Separation with Anatomic Endodontic Technology by Dr. James

Mark,  I know you have a large practice and even if the iCat stayed at the   180,000 figure you could afford it.  I on the other hand, up heah at the terminus of the appalachian  trail, have trouble seeing the day when virtually all orthos have an  iCat or equivalent in the office.  I think for most of us out to at  least the 20 yr mark, we will continue to rely on alginate.

Another issue that I don't hear many people talk about is the cost  involved in all of this.  do we pass that along to the patient or do  we absorb it partially or do we become so much more efficient (no  impressions) that we eat the whole thing for routine records.  In  general, the good old USA is becoming poorer as the world economy  shifts eastward.  You can see what is happening: orthos are using  better appliances and treating in less time.  That usually means a  higher fee paid over a shorter time period.  How does all this work  for the patient's ability to pay? - charlie ruff

Basically, we are right around the corner from using the CT scan   for our models, appliances, etc.  It will be a bit before the labs are on   board but  using the scan for indirect bonding, 3-D models, etc is not out of our  reach.  The software has been written, we just have to wait for the   price to  come down from $180K.  I have decided to wait on both the price and   the software to work out the bugs.  The difference between the higher   resolution and lower resolution is not a great difference in terms of exposure   but the  patient does have to sit still longer 30-40 sec versus 10-20 sec.    Dental impressions will be a thing of the past over the next 10-15 years. -   MARK  (Source: ESCO Digest) 
Systemic Antibiotics in Periodontitis
From: Walter Loesche
Date: March 21, 2007 10:51:30 AM EDT
Subject: antibiotics in moderate/severe infections

I don't know. My guess is that is goes against two powerful  myths and the failure of dental and dental hygiene schools to 
educate their students. The myths are

1. The myth of the macho dentist. The few periodontists that i  have talked to about this issue, assure me that they can obtain the  desired result simple by scaling and root planing. Their skills are  such that they do not need any additional help. Many hygienists  also subscribe to this line of thinking. But we have shown in 4  studies that metronidazole plus S&RP is statistically better than  Placebp plus S&RP, the standard of care. Our data indicated that  it may be unethical to deny patients the benefits of antimicrobial  therapy, especially in the light of the American Academy of  Periodontology (AAP) defining periodontal disease as "serious  infections".

2. The myth of antibiotic resistant bacteria. This is perhaps the  most widely cited objection to the use of antibiotics in 
periodontal disease. Yet after years of publicity, no one to my knowledge has shown an increase in antibiotic resistant bacteria in  the clinical setting, especially to metronidazole.

The dental schools and hygiene schools do not teach  students to use antibiotics to treat periodontal disease. In fact 
just the opposite. Don't use them. The AAP has indicated in its guidelines that antibiotics  are not needed. This provides a strong legal disincentive to use antibiotics, if  the "authorities" in the field discourage their use.  In regard to the amox/metro combo, there is no scientific  evidence, ie. double blind, random assignment studies to support  this usage. In most, if not all instances, metronidazole alone  would do the job. So another myth is being perpetrated, that of  shot-gun antibiotic therapy.

In response to Dr. Loesche's comment:
<<2. The myth of antibiotic resistant bacteria. This is perhaps the  most widely cited objection to the use of antibiotics in periodontal  disease. Yet after years of publicity, no one to my knowledge has  shown an increase in antibiotic resistant bacteria in the clinical  setting, especially to metronidazole.>>

Maybe not so far amongst periodontal bacteria.  But if the antibiotic  is administered systemically, what about the risk of generating  metronidazole resistant gram-negative bacteria elsewhere in the  body?  Specifically, metronidazole resistant Heliobacter pylori, a  well documented etiological agent in stomach cancer.

Two references to this.

1) From a UK Parliament report:


“Memorandum by the Association of Clinical Oral Microbiologists ........Considerable use of the antibiotic metronidazole is made in  the treatment of periodontal disease and this probably accounts for  the reason why dental prescriptions of metronidazole represent the  largest number of prescriptions for this antibiotic in the community.  The widespread use of metronidazole may have contributed to the  increased burden of metronidazole resistance in Helicobacter pylori,  a well documented aetiological agent in stomach ancer.”

2. Source:

“St. Louis, April 13 -- Scientists in Halifax, Nova Scotia, and St.  Louis, Mo., have discovered why the bacteria Helicobacter pylori,  which causes peptic ulcer disease, is sensitive to metronidazole, a  critical component of the leading H. pylori therapy. They also have  determined how the bacteria becomes resistant to this drug. H. pylori  infects more than half the world's people and is a major early risk  factor for stomach cancer.The researchers' findings also raise concern about a possible link  between the drug and stomach cancer in people infected with H.  pylori. "The real danger lurks when a person takes metronidazole  without the complete complement of drugs that eradicate this  bacterium," says Paul S. Hoffman, Ph.D., professor of microbiology  and immunology and medicine at Dalhousie University Medical School in  Halifax. "When metronidazole is taken alone, it can be activated by  one of the bacterium's enzymes to produce hydroxylamine, a mutagen  and cancer-causing chemical."

Goodwin A, Kersulyte D, Sisson G, Veldhuyzen van Zanten SJO, Berg DE,  Hoffman PS. Metronidazole resistance in Helicobacter pylori is due to  null mutations in a gene (rdxA) that encodes an oxygen-insensitive  NADP nitroreductase. Molecular Microbiology, 28(2), April 14, 1998.- Stephen Millar    (Source: Periotherpist group)