Year : 2010 | Volume
: 2 | Issue : 1 | Page : 1--2
Clinical dental care: An integrated multidisciplinary approach
Associate Professor, Endodontics, Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON, M5G1G6, Canada
Associate Professor, Endodontics, Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON, M5G1G6
|How to cite this article:|
Kishen A. Clinical dental care: An integrated multidisciplinary approach.J Int Clin Dent Res Organ 2010;2:1-2
|How to cite this URL:|
Kishen A. Clinical dental care: An integrated multidisciplinary approach. J Int Clin Dent Res Organ [serial online] 2010 [cited 2021 Jan 23 ];2:1-2
Available from: https://www.jicdro.org/text.asp?2010/2/1/1/89982
One of the main objectives in dentistry is to prevent oral diseases such as periodontal disease and dental caries, and subsequently preserve the natural dentition. Periodontal disease is a common chronic inflammatory disease, which may lead to root caries, tooth loss, impaired eating habits, and socialization. It also increases the risk of developing systemic diseases such as heart disease and stroke. In an article published in 2010, Centers for Disease Control and Prevention (CDC) and American Academy of Periodontology (AAP) suggested that more American adults may have periodontal disease, and previous estimates have underestimated the prevalence of periodontal disease in the US population. Endodontic infections are also very prevalent, because they mostly represent complications of dental caries and its treatment, as well as traumatically injured teeth. Jointly, the periodontal and endodontic infections represent the majority of dental infections that require significant clinical attention.
Preservation of natural dentition is frequently achieved by non-surgical root-canal-treatment (NSRCT). When this is not possible, osseointegrated implants can be used to rehabilitate the edentulous regions. The decision between retention of endodontically involved teeth versus extraction and implant placement is a clinical decision that requires careful evaluation. Restorability is an important aspect that should be confirmed before initiating NSRCT. Options for restoration are also considered in the beginning phase of the treatment, although the final choice is often made as the treatment progresses. The options for restoration need careful consideration because more root-filled teeth are lost due to restorative factors than due to failure of the endodontic treatment itself. In most cases, the restorative considerations are straight forward and the choice is to retain the tooth as a functional unit, in the long-term.
Implants are increasingly being used to replace missing teeth in a variety of clinical situations. The longevity of the implant-supported restoration depends on the careful evaluation of clinical parameters, proper design of the treatment plan, and its precise execution. One important presurgical assessment required is the quality of the bone, the vertical bone height, and the orofacial bone width. If the width of the alveolar ridge is insufficient at the desired implant locations, reconstructive surgery is required. The ridge augmentation technique is based on the principle of guided tissue regeneration using barrier membranes, which was initially developed for periodontal regeneration. Techniques such as guided-bone regeneration, immediate implantation, and distraction osteogenesis have been utilized as ridge enhancement therapies. The current techniques and protocols offer predictable solutions in most therapeutic interventions, by solving the functional problems and at the same time achieving an aesthetic result.
This issue of the Journal of International Clinical Dental Research Organization features eight articles. In this we have a clinical study, a review article, an in vitro experiment and a series of case reports. The first article is a clinical study that evaluates the bone density of the peri-implant sites using the Dentascan software. Twenty-five patients in the age group of 10 and 80 years, requiring implant placement, have been selected for this study. Based on this investigation, it is concluded that the Dentascan provides a subjective assessment of the bone density at the peri-implant sites. The second article is a comprehensive review on the topic of ridge augmentation. This review article discusses different methods of soft and hard tissue ridge augmentations. The third article presents a case report describing the surgical technique of 'flapless' and 'with flap' approaches for posterior single-tooth implant placement . The fourth article describes a case report on the guided implant placement in an edentulous mandible. In this article an acrylic resin implant placement guide, which is based on the bone mapping of the edentulous ridge at the implant site, is described. The fifth article in this issue is a pilot investigation carried out to assess the effects of scaling and root planing on the blood glucose levels in type II diabetes patients. This clinical study has been conducted in fifteen Type II diabetic patients of the Dr. D. Y. Patil Dental College and Hospital in Pune, India. It was concluded from this study that there was no significant change in the fasting and post prandial blood glucose levels in patients treated with scaling and root planing. The fifth article is a clinical case report demonstrating apexification in a pulpless tooth. Calcium hydroxide was applied in this study to control infection, and to provide an appropriate environment to facilitate the healing of the periradicular (apical) region. The seventh article describes a technique to manage the transverse root fracture with dowel inlay . It is suggested that this approach can save considerable time over other alternative treatment options available for the management of such root fractures. The eighth article is an in vitro study that compares the sealing ability of different root canal sealers (AH-plus, Gutta percha flow, and Roekoseal) at the gutta-percha-root canal dentin interface, using a microbial leakage model.
It is my belief that these articles will collectively bring valuable insights into some of the clinical problem areas in restorative dentistry.