bluuebunny/crossref_metadata_2025 huggingface dataset:
The Initial Management of Dento-Alveolar Trauma in General Dental Practice
Authors: Auld David N T , Wright Graeme B
Published: August 2017

Dento-alveolar trauma presents commonly in general dental practice, but may prove difficult to manage for those unfamiliar with it. Timely and well-informed intervention can significantly improve the clinical outcome for the patient. This article aims to inform the clinician on best current practice for the assessment and initial management of dental traumatic injuries, incorporating current international guidelines and practical arrangements for follow-up care.
Improving Access to Dental Care for Older People
Authors: Borreani Elena , Jones Kate , Wright Desmond , Scambler Sasha , Gallagher Jennifer E
Published: August 2017

Population demography is changing and the proportion of older people in society is increasing globally, particularly in western countries. Furthermore, as many more people survive into older age and retain their natural teeth so their risk of oral disease remains, or increases, bringing challenges such as root caries and periodontal diseases, together with the long-term effects of dental care. Despite their increased need, the uptake of dental care by older people is characteristically poor and unmet need may be high. Barriers to the uptake of care include a lack of perceived need, together with concerns about availability, cost and fear. This paper therefore outlines a series of actions for dental teams to take to minimize barriers and facilitate the uptake of dental care amongst older people. It draws on the findings of research conducted amongst older adults living in the community in a socially deprived inner city area as well as the wider literature.
Are You Using The Best Post and Core System?
Authors: Carrotte Peter
Published: August 2017

The effect of post type and length on the fracture resistance of endodontically treated teeth. McLaren JD, McLaren CI, Yaman P, Bin-Shuwaish MS, Dennison JD, McDonald NJ. J Prosthet Dent 2009; 101: 174–182.
Book Review
Authors: Miller Alasdair G
Published: August 2017

How to keep your TEETH FOR LIFE. The essential guide to healthy teeth for you and your family. By Dr Simon Riddle and Dr Hap Gill. Nutbourne Publications 2010 (138pp., £9.99 p/b). ISBN: 978-0-9564933-0-9.
Antimicrobial Irrigants in Endodontic Therapy: 1. Root Canal Disinfection
Authors: Eliyas S , Briggs PF , Porter RWJ
Published: August 2017

This paper highlights the importance of root canal disinfection. It discusses the different endodontic irrigants available and comments on how these can be used most effectively.
Do You Make A Good Impression on Your Implant Patients?
Authors: Carrotte Peter
Published: August 2017

The accuracy of implant impressions: a systematic review. Lee H, So JS, Hochstedler JL, Ercoli C. J Prosth Dent 2008; 100: 285–291.
An Osteosarcoma, Presenting as a Loose Maxillary Bridge, with Pain and Swelling
Authors: Duggan David , MacLeod Iain
Published: August 2017

An osteosarcoma (OS) is the second most common primary bone malignancy, yet rarely presents in the jaws. This paper describes the progress of a patient, with osteosarcoma of the jaw (OSJ), from the initial presentation at the dental surgery, through to diagnosis and treatment.
Is Dental Prevention Cost-Effective?
Authors: Carrotte Peter
Published: August 2017

Cost-analysis of school-based fluoride varnish and fluoride rinsing programmes. Skold UM, Petersson LG, Birkhed D, Norlund A. Acta Odontologia Scandinavica 2008; 66: 286–292.
Full-Mouth Disinfection
Authors: Sharpe Geoffrey , Seymour Robin A
Published: August 2017

Full-mouth disinfection is a relatively new technique for the management of patients, especially those with moderate to severe chronic periodontitis. In this paper, the technique is reviewed and efficacy evaluated. The methodology and possible outcomes are illustrated with a case report.
Peri-Implant Diseases
Authors: Heasman Peter , Esmail Zaid , Barclay Craig
Published: August 2017

Peri-implant diseases are inflammatory conditions that affect the soft and hard supporting tissues around implant fixtures. Peri-implant mucositis usually responds to oral hygiene instructions, scaling and prophylaxis, but peri-implantitis, which involves bone resorption, has less predictable treatment outcomes following non-surgical management. Adjunctive treatment for decontaminating sites may include the use of antimicrobials and resistant cases may sometimes be managed with a surgical approach.
Management of White Patches
Authors: Holland Ian
Published: August 2017

White patches are a worrying finding for patients, in particular with concern arising about the possibility of the lesions being or becoming cancerous. This paper looks at some of the common white patches that present and relevant considerations in deciding on a management plan for them.
Current Practice in Dental Oncology in the UK
Authors: Barclay Stewart C , Turani Duaa
Published: August 2017

The clinical management of cancer patients, particularly where it affects the head and neck, may result in short- and long-term complications. Specialist management of the dental sequelae of cancer is often recognized nowadays by the term ‘Dental Oncology’. Members of the dental team play a vital role in preventing and promptly managing such complications and all dental professionals should have a sound understanding and knowledge of the oral implications of cancer therapy and their management, and the contribution of this to the patient's quality of life.
Dental Faculty RCPSG: An Overview of How a Royal College has Evolved to Address the Needs of the Dental Profession
Authors: Jenkins William MM
Published: August 2017

This paper traces the history of the RCPSG and its Dental Faculty from its founding to the present.
First Aid for Orthodontic Retainers
Authors: Patel Anjli , Sandler Jonathan
Published: August 2017

The need for long-term retention to prevent post-treatment tooth movement is now widely accepted by orthodontists. This may be achieved with removable retainers or permanent bonded retainers. This article aims to provide simple guidance for the dentist on how to maintain and repair both removable and fixed retainers.
Three generations of led lights and clinical implications for optimizing their use. 1: from past to present
Authors: Pelissier B , Jacquot B , Palin WM , Shortall AC
Published: August 2017

In the present era of adhesive dentistry light-curing units are essential pieces of surgery equipment for everyday practice. The success and longevity of light-activated resin sealants, photo-cured restorations and orthodontic treatments are related to the efficacy of the light-curing process. Energy efficient blue LED lights are rapidly replacing their halogen lamp predecessors as the standard light source. Manufacturers are producing materials with different initiators and not all of these materials can be properly polymerized with blue LED lights.

Clinical Relevance: Adequate curing in depth is basic to the long-term clinical success of any light-activated restoration. As dentists enter the post-amalgam era they are required to restore increasingly large cavities with direct resin composite. To achieve this goal predictably, an appropriate light source needs to be combined with materials knowledge, requisite clinical skills and attention to detail throughout the entire restoration process.
The use of zirconium, single-retainer, resin-bonded bridges in adolescents
Authors: Williams Sian , Albadri Sondos , Jarad Fadi
Published: August 2017

This paper presents a series of case reports which demonstrate the replacement of the causes of tooth loss which primarily affect children by the use of all-ceramic resin-bonded bridges.

Clinical Relevance: To keep practitioners informed of alternative techniques and materials which can be used to replace missing teeth in adolescents.
Body dysmorphic disorder and aesthetic dentistry
Authors: Scott Suzanne E , Newton J Tim
Published: August 2017

This paper outlines the features and presentation of body dysmorphic disorder (BDD), a psychological syndrome which results in patients seeking treatment for an imagined defect in appearance. The assessment of patients with suspected body dysmorphic disorder is outlined, as well as management strategies.

Clinical Relevance: Clinicians working in the field of aesthetic dentistry should be aware that some patients presenting for treatment may have body dysmorphic disorder. Aesthetic dental treatment for such patients is not beneficial and carries some risks. Advice for clinicians on assessment and management is outlined.
Defective dental restorations: to repair or not to repair? part 2: all–ceramics and porcelain fused to metal systems
Authors: Blum Igor R , Jagger Daryll C , Wilson Nairn H F
Published: August 2017

With the increasing use of ceramics in restorative dentistry, and trends to extend restoration longevity through the use of minimal interventive techniques, dental practitioners should be familiar with the factors that may influence the decision either to repair or replace fractured metal-ceramic and all-ceramic restorations and, also, the materials and techniques available to repair these restorations. This second of two papers addresses the possible modes of failure of ceramic restorations and outlines indications and techniques in this developing aspect of restoration repair in clinical practice.

Clinical Relevance: The repair of metal-ceramic and all-ceramic restorations is a reliable low-cost, low-risk technique that may be of value for the management of loss or fracture of porcelain from a crown or bridge in clinical practice.
Maxillary labial fraenectomy: indications and technique
Authors: Mittal Mohit , Murray Alison M , Sandler P Jonathan
Published: August 2017

A labial fraenectomy is indicated in various clinical situations and is performed to facilitate orthodontic closure of a maxillary midline diastema. In these clinical situations, timing of surgery during the phase of orthodontic treatment is important. Labial fraenectomy can be performed before, during or after the orthodontic closure of the maxillary midline diastema, depending on the individual case. It is important to understand how to perform the procedure efficiently and effectively. Success relies as much on accurate diagnosis of the fleshy, prominent or persistent fraenum as it does on meticulous technique to ensure its complete elimination. This article presents the indications for labial fraenectomy. The appropriate timing of the labial fraenectomy procedure to facilitate orthodontic treatment is discussed.

Clinical Relevance: A surgical technique to perform maxillary labial fraenectomy procedure in an effective and efficient manner is a useful addition to the clinician's armamentarium.
Gagging during impression making: techniques for reduction
Authors: Farrier Sarah , Pretty Iain A , Lynch Christopher D , Addy Liam D
Published: August 2017

In everyday dental practice one encounters patients who either believe themselves, or subsequently prove themselves, to be gaggers. Gagging is most frequently experienced during impression making, but is also reported during the taking of radiographs, in the placement of restorations in posterior teeth and, in some individuals, the insertion of a finger for examination purposes. This paper describes some techniques that can easily be mastered by clinicians that may help both operator and patient avoid this unpleasant occurrence. Techniques such as acupressure, the adaptation of trays, or even the use of alternative impression materials and breathing techniques all have their place, and clinicians may have to try several of these, perhaps in conjunction, in order to assist their patients.

Clinical Relevance: A significant number of patients attend for dental treatment that require impressions, and for those with gagging problems it can be a horrendous experience. Being able to make the procedure less of an ordeal is better for all involved.
Conservative management of a case of plexiform ameloblastoma
Authors: Chacko Varghese , Kuriakose Sobha , K Sreejith
Published: August 2017

Ameloblastomas are locally aggressive, benign odontogenic neoplasms having a wide variety of histologic patterns. It is essential to distinguish between the three clinical types of ameloblastomas – the intra-osseous solid lesion, the unicystic type and the extra-osseous lesion, as they differ in their biological behaviour and rate of recurrence and therefore require different forms of treatment. The case presented here is of a 9-year-old boy who reported to the department with pain and swelling along the right side of the mandible of 3 months' duration. Previous histopathological examination of the lesion, performed at a local hospital, produced a picture consistent with unicystic ameloblastoma. The lesion was managed by enucleation and the patient has been followed up for the past 5 years. Radiographic and clinical examinations reveal signs of healing without recurrence.

Clinical Relevance: Conservative management of unicystic ameloblastomas may be justified in children provided that the patient can be followed up at regular intervals.
Lingual orthodontics: an overview
Authors: Singh Parmjit , Cox Shirley
Published: August 2017

As adults increasingly seek orthodontic treatment, a growth has been witnessed in the demand for aesthetic orthodontics, the ultimate of which are appliances bonded to the lingual surfaces of the teeth. Development has spanned 30 years and many of the initial challenges faced with this approach have now been overcome. An overview is provided on the development of lingual appliances from conception through to the current systems available. Lingual orthodontics is not for every patient seeking treatment and therefore the indications and contra-indications are discussed, together with the advantages and disadvantages of this increasingly popular approach.

Clinical Relevance: Patients are increasingly asking dental professional about lingual appliances.
Personal development plans (in primary dental care) – getting started
Authors: Miller Alasdair G
Published: August 2017

This article reviews how to develop a personal development plan, its benefits and how it may relate to the GDC's proposed revalidation scheme.

Clinical Relevance: Revalidation is an essential part of reassuring the public that the profession delivers care to appropriate standards in safe work environments. A personal development plan is a key element in improving performance and quality of care.
Indications for surgical endodontics and findings of an audit into referrals
Authors: Ali Zaid , Keshani Divya
Published: August 2017

Peri-radicular surgery is a valuable treatment modality allowing thorough treatment of chronic infection of the peri-radicular tissues. It is important that this treatment option is prescribed appropriately and steps are taken to help improve outcomes of surgery. We discuss the indications for peri-radicular surgery, considerations when planning treatment for teeth where orthograde endodontics has failed and present the findings of an audit into the appropriateness of referrals for peri-radicular surgery to the Department of Oral and Maxillofacial Surgery at a District General Hospital.

Clinical Relevance: This article highlights the indications and contra-indications for peri-radicular surgery to general dental practitioners.
How well are gic product labels related to current systematic review evidence?
Authors: Mickenautsch Steffen
Published: August 2017

Systematic reviews have been recommended as providing the best source of evidence to guide clinical decisions in dentistry. They appraise evidence from trials focused on investigating clinical effects of dental material categories, such as conventional glass-ionomer cements (GIC) or resin-modified GIC. In contrast, the general dental practitioner is introduced to these categories of materials in the form of branded or private product labels that are marketed during dental conventions or through advertisements. Difficulties may arise in recognizing material categories that have been subjected to systematic reviews, because of the multitude of product labels on the current market. Thus, the value and relevance of published systematic review evidence concerning the material categories represented by these labels may remain obscure. Based on a systematic literature search, this article identifies glass-ionomer cement product labels used during clinical trials which, in turn, were subsequently reviewed in systematic review articles (published between 15 April 2009 and 14 April 2011). This article further clarifies how these product labels relate to the systematic review conclusions. The results show that the conventional and resin-modified glass-ionomer cements that were used in most trials were marketed by GC and 3M ESPE, respectively. The conventional GICs used in most of the reviewed trials were Fuji III and Fuji IX, while Vitremer was the most commonly used resin-modified GIC. Evidence from the reviewed trials suggests that GIC provides beneficial effects for preventive and restorative dentistry. However, more trials of higher internal validity are needed in order to confirm (or disprove) these findings. Only GIC products of branded labels and none of private labels were identified, suggesting that private label GIC products have little or no research back-up.

Clinical Relevance: Dental products, such as glass-ionomers cements (GIC), can only be judged as effective when they are based on sufficient research back-up. Systematic reviews of clinical trials provide such back-up at the highest level. Thus clinicians must be able to identify GIC products for which reliable evidence from systematic reviews of clinical studies is available and know about what such evidence contains.
Designing written patient information in primary dental care: the right tools for the job
Authors: Elledge Ross OC
Published: August 2017

There is a good evidence base in the literature for the use of written patient information in healthcare settings to enable patients to retain information concerning procedures and treatments following initial consultations. A number of tools exist to help in the design of written patient information. These include checklists such as the Department of Health Toolkit for Producing Patient Information, EQIP and DISCERN tools, readability scores such as the Flesch-Kincaid Formula and Flesch Reading Ease score, as well as cultural sensitivity scores. These tools are presented and their possible role in dental primary care discussed.

Clinical Relevance: The tools provided here will enable clinicians to develop a better standard of patient information literature concerning procedures and treatments on offer.
A restorative approach to the clinical and aesthetic management of adult patients with class ii division 2 incisor malocclusions
Authors: Ray-Chaudhuri Arijit , Porter Richard J , Kelleher Martin GD
Published: August 2017

A Class II division 2 incisor malocclusion may be a cause of aesthetic and/or functional concern for some affected patients. Their particular concerns may include dark spaces around the misaligned teeth or uneven gingival contours. Orthodontic and/or orthognathic treatment can address some of these problems but frequently involves lengthy and expensive treatment in the adult dentition. Sadly, such treatment often produces an unstable result, with significant drawbacks such as the requirement for long-term retention. This article aims to describe alternative strategies for managing patients with this incisor malocclusion.

Clinical Relevance: This paper outlines a quicker, pragmatic and minimally destructive restorative treatment alternative to conventional orthodontic treatment and the associated long-term retention.
Removal of gutta-percha and root canal sealer: a literature review and an audit comparing current practice in dental schools
Authors: Good M-L , McCammon A
Published: August 2017

Endodontic failures often require non-surgical retreatment. The most common root canal obturating material is gutta-percha (GP), used in conjunction with various sealers. GP removal can be undertaken thermally and/or mechanically with or without solvents, however, no published guidelines exist. Following a literature review, an audit was undertaken comparing current endodontic practice in Belfast Dental School with the other dental schools across the UK and Republic of Ireland. From the findings, Belfast Dental School decided to introduce rotary files and chloroform to its Conservation Clinic with restrictions for use of the latter, although solvent use is not recommended in every case.

Clinical Relevance: Efficiency in removing both gutta-percha and root canal sealer would maximize the ability to disinfect the root canal system and therefore increase the likelihood of a successful outcome.
Anatomy and clinical applications of the maxillary nerve in dentistry: a literature review
Authors: Somayaji S Krishnaraj , Rao KG Mohandas
Published: August 2017

Few reports in the literature have addressed the course of the maxillary nerve, its regional branches and their significance in anaesthetic procedures. It was observed that the maxillary nerve varies in its branching pattern and the knowledge of the course and distribution of these branches may be useful for dental surgeons and anaesthetists while working in this region. Keeping these points in view, this review is aimed at presenting information about the course, distribution, possible variations, clinical significance and the anaesthetic applications of the maxillary nerve and its branches in dental procedures.

Clinical Relevance: Knowledge of the anatomy of the maxillary nerve is of relevance to the regional anaesthetic technique of this nerve.
Contemporary denture base resins: part 2
Authors: Rickman L J , Padipatvuthikul P , Satterthwaite J D
Published: August 2017

Provision of partial and complete dentures constructed from resin is commonplace and a satisfactory outcome requires the consideration of the properties of the resin, the oral tissues and prosthodontic principles. This second of a two-part series examines the advantages and disadvantages of flexible nylon denture base resins, which have found popularity for the provision of partial dentures. Adverse effects of denture base resins are examined and the benefits and shortcomings of softliners are explored. Chairside adjustment and polishing, and denture hygiene are also discussed.

Clinical Relevance: Knowledge of contemporary denture base resin systems will help to achieve optimal outcomes in removable prosthodontics.
Ionizing radiation regulations and the dental practitioner: 1. the nature of ionizing radiation and its use in dentistry
Authors: Rout John , Brown Jackie
Published: August 2017

Legislation governing the use of ionizing radiation in the workplace and in medical treatment first became law in 1985 and 1988, being superseded by the Ionizing Radiations Regulations 1999 (IRR99) 1 and the Ionizing Radiation (Medical Exposure) Regulations 2000, (IR(ME)R 2000), 2 respectively. This legislation ensures a safe environment in which to work and receive treatment and requires that those involved in the radiographic process must be appropriately trained for the type of radiographic practice they perform. A list of the topics required is detailed in Schedule 2 of IR(ME)R 2000 and is paraphrased in Table 1 , with the extent and amount of knowledge required depending on the type of radiographic practice undertaken.

Clinical Relevance: Virtually all dental practitioners undertake radiography as part of their clinical practice. Legislation requires that users of radiation, including dentists and members of the dental team, understand the basic principles of radiation physics, hazards and protection, and are able to undertake dental radiography safely with the production of high quality, diagnostic images.
Sectional dentures revisited
Authors: Karir N , Hindocha V , Walmsley AD , Attrill D
Published: August 2017

Sectional dentures are constructed in separate parts which join together intra-orally to create a single prosthesis. They are used to exploit undercuts around teeth, hard and soft tissues which require more than one path of insertion, and are usually of split pin or locking bolts design. By using two case studies, we aim to illustrate the provision of sectional dentures and to which situations their uses are best suited.

A 30-year-old male was referred to the Department of Prosthetics at the Birmingham Dental Hospital for a replacement upper partial cobalt chrome denture of a Kennedy Class IV bounded saddle. The patient had a history of failed upper cobalt chrome removable partial dentures owing to loss of retention and poor stability over the previous 12 months. A 40-year-old female patient was referred by her GDP for restoration of a bounded saddle in the lower right quadrant with a history of intolerance to previous dentures.

These two cases demonstrate the successful use of sectional dentures in the aesthetic zone. Although more technically demanding, they lie well within the scope of general practice and offer patients alternative solutions from dental implants and bridgework. These cases highlight the importance of the use of alternative prosthetic techniques which can be simple and achievable for all practitioners.

Clinical Relevance: Sectional dentures are a treatment modality for the edentulous space where the presence of one or more undercuts prevents restoration by more conventional techniques. This paper highlights some of the situations in which sectional dentures can be employed and emphasizes their use in general practice.
Posterior composites: a practical guide revisited
Authors: Mackenzie Louis , Burke FJ Trevor , Shortall Adrian CC
Published: August 2017

Direct placement resin composite is revolutionizing the restoration of posterior teeth. Compared to amalgam, its use not only improves aesthetics but, more importantly, promotes a minimally invasive approach to cavity preparation. Despite the benefits, the use of composite to restore load-bearing surfaces of molar and premolar teeth is not yet universally applied. This may be due to individual practitioner concerns over unpredictability, time and the fact that procedures remain technique sensitive for many, particularly with regard to moisture control, placement and control of polymerization shrinkage stress. New materials, techniques and equipment are available that may help to overcome many of these concerns. This paper describes how such techniques may be employed in the management of a carious lesion on the occlusal surface of an upper molar.

Clinical Relevance: Direct posterior composite is the treatment of choice for the conservative restoration of primary carious lesions.
Recurrent exophytic growth on maxillary posterior edentulous alveolar ridge – a diagnostic challenge
Authors: Patney Aditya , Sholapurkar Amar A , Pai Keerthilatha M , Solomon Monica C
Published: August 2017

Accurate diagnosis of recurrent intra-oral exophytic lesions require a thorough history, meticulous clinical examination and the experience of assessing these lesions, because they are not commonplace. Despite this, instituting the correct diagnosis tests the skills of an oral medicine expert. Therefore, the same is all the more challenging for a general practitioner who may encounter these lesions without any significant experience. The importance of diagnosing such lesions cannot be understated, as they may represent a myriad of conditions ranging from seemingly innocuous benign pathologic processes to much more sinister ones, like oral malignancy; occasionally some of these lesions may manifest atypically. Such atypical presentations may cloud the diagnostic process. Here a case uncharacteristic of the condition it represented is reported with the aim of increasing awareness of the diagnosis of such lesions.

Clinical Relevance: When a clinician comes across recurrent exophytic intra-oral lesions, he/she must be careful, and consider all conditions in the differential diagnosis.
Laboratory aspects of zirconia restorations
Authors: Millen Christopher , Bhatia Krishnakant , Ibbetson Professor Richard
Published: August 2017

Zirconia restorations are now accepted and commonly prescribed in dentistry. However, these materials undergo hydrothermal ageing which can reduce their clinical performance. Appropriate handling is essential to limit the restorations’ susceptibility to low temperature degradation/ageing. Through appropriate clinical prescribing and laboratory manufacture, an aesthetic, strong and long-lasting restoration can be fabricated.

Clinical Relevance: This article will inform the reader about zirconia as a dental material as well as how best to handle a zirconia restoration.
Management of bleeding disorders in the dental practice: managing patients on anticoagulants
Authors: Kudsi Zaki , Dalati Mohamad Hani Nouri , Sibai Louna , Koussayer Lara Taher
Published: August 2017

Patients with bleeding disorders pose a challenge for dentists. Most of these conditions can be safely treated in the general dental practice. Patients who are on anticoagulants represent a large group of bleeding disorders. This article reviews the latest evidence in regard to managing those patients. Most of the articles reviewed seem to agree on the negligible risk of modification or interruption of oral anticoagulants when performing most dental treatments because a decreased risk of excessive bleeding might be associated with an increased risk of thrombo-embolic complications. However, extensive pre-operative assessment is essential to reduce the risk of serious complications.

Clinical Relevance: Patients with bleeding disorders pose a challenge for dentists. Adequate understanding of the underlying medical condition is essential to reduce the risk of dangerous complications.
Ethical marketing in ‘aesthetic’ (‘esthetic’) or ‘cosmetic dentistry’ part 2
Authors: Kelleher Martin G D , Djemal Serpil , Lewis Nicholas
Published: August 2017

This is the second article in a series of three. It is essential to find out from patients what it is that they hope to achieve when requesting an improvement in their dental appearance. Their expectations, hopes and fears need to be explored in detail. The long-term biologic costs of some invasive procedures need to be explained to patients in advance so that they can make properly informed decisions. Failure to do so renders the practitioner vulnerable to a charge of behaving unethically. The differences between ethical marketing and selling are explained including the historic development of marketing.

Clinical Relevance: A practical approach, using a modification of the Edward de Bono Six Thinking Hats model is described to help ethical practitioners to develop sound treatment plans when dealing with complex aesthetic problems.
Aesthetic preview: a novel approach
Authors: Seymour DW , Patel M , Chan M F W-Y
Published: August 2017

Planning the final aesthetic result of restorative treatment is a key skill needed by the clinician to ensure predictable success. This paper aims to review current techniques that may be used by clinicians for an aesthetic preview, whilst also highlighting a simple technique that may be readily utilized in practice.

Clinical Relevance: It is considered good practice to give patients an aesthetic preview of the end result prior to commencing active treatment. This article demonstrates the different techniques available and those that are easily utilized in general practice. The aesthetic preview is of benefit to both the clinician and technician in defining treatment goals and improving communication.
Root fracture and its management
Authors: Ranka Meena , Shah Jinesh , Youngson Callum
Published: August 2017

Root fractures are uncommon following dental trauma but are mostly diagnosed shortly after the injury, although occasionally at routine dental appointments. This paper presents the management of the different types of root fractures and the types of healing response suggesting the appropriate follow-up of these injuries.

Clinical Relevance: A thorough clinical examination supplemented with radiographs, vitality tests, appropriate treatment planning and subsequent follow-up of root fractured teeth can improve the prognosis for these teeth and also minimize the need for subsequent extractions. Immature teeth with root fractures have a better chance of healing compared to teeth with fully formed roots.
Revalidation in primary care – a personal view
Authors: Miller Alasdair G
Published: August 2017

This article explores an approach to Revalidation based on the principles of quality assurance.

Clinical Relevance: The delivery of safe, effective clinical care is the goal of every practitioner and the use of appropriate quality assurance processes can promote this and, at the same time, meet the General Dental Council's likely requirements for Revalidation.
The non-operative resin treatment of proximal caries lesions
Authors: Ekstrand Kim , Martignon Stefania , Bakhshandeh Azam , Ricketts David NJ
Published: August 2017

Epidemiological data show that the prevalence of caries on proximal surfaces in need of operative treatment is very high around the world, both in the primary and the permanent dentition. This article presents two new treatment methods: proximal sealing and proximal infiltration. The indications are progressing proximal caries lesions, radiographically with a depth around the enamel-dentine junction. A small number of studies regarding the effect of sealing and infiltration on proximal caries versus the use of fluoride varnish, placebo treatment and flossing instructions have been carried out. About half of the studies disclose a not significant difference between test and control treatment. In the other half, the therapeutic effect is significant and corresponds to about 30% reduction in lesion progression. However, longitudinal studies of longer duration are lacking.

Clinical Relevance: Proximal sealing and proximal infiltration may have a place in the treatment of non-cavitated proximal lesions. Proximal caries is a problem in both primary and permanent dentitions. Proximal sealants or lesion infiltration are possible treatments.
Macrodont management
Authors: Pace Audrey , Sandler Paul Jonathan , Murray Alison
Published: August 2017

Macrodontia is an uncommon dental anomaly that can present in both primary and permanent dentition. It has often been reported to occur concomitantly with other dental anomalies and has also been an established clinical characteristic of numerous systemic conditions and syndromes.

The following case reports illustrate the challenges of managing macrodont teeth in view of the various treatment options available, as well as the multiple factors that tend to influence each case individually.

Clinical Relevance: This article highlights the importance of early referral and a multidisciplinary approach to treating patients with dental anomalies.
Training and the dental team – or how to get the best from your staff
Authors: Miller Alasdair G , Kemp Tim
Published: August 2017

This article explores the benefits and methods of training in dental practice based on current accepted educational theories.

Clinical Relevance: Effective delivery of any service or clinical activity is dependent on having the right resources delivered at the right time, in the right place and in the right way. This can only happen if every person involved in the delivery knows what to do, when and how; this requires training.
Abstract
Authors: Morgan Anne
Published: August 2017

Dentists are expected to raise their concerns about possible neglect or abuse in children. The finding of this study would suggest that reporting levels are low, although awareness of child protection issues has increased.

Children identified a need for better information, and a desire to be involved in decision-making. However, there are considerable challenges to overcome in trying to engage with children without increasing their anxiety levels, or conflicting with parents' views about what is best for their child.
Internal and external root resorption: aetiology, diagnosis and treatment options
Authors: Al-Momani Zaid , Nixon Peter J
Published: August 2017

Root resorption is a pathological process that may occur after surgical, mechanical, chemical or thermal insult. Generally, it can be classified as internal and external root resorption. Depending on the diagnosis, an orthograde, surgical or a combined approach is used in management of these cases.

Clinical Relevance: General dental practitioners can face difficulties in diagnosis and treatment planning for cases with root resorption. An understanding of the aetiology and pathogenesis of root resorption is critical for diagnosis, effective management and improves outcome.
An update on the clinical pathology of oral precancer and cancer
Authors: Hunter Keith D , Yeoman Christine M
Published: August 2017

The identification of oral precancerous and cancerous lesions at an early stage allows for early intervention and minimizes mortality and morbidity. A combination of risk reduction and early detection should further reduce the incidence and improve outcomes. A clear understanding of the aetiology and clinical presentation of these lesions is key to effective management of these patients in primary dental care. We present a timely update on these issues, with an emphasis on the importance of early detection.

Clinical Relevance: The identification of lesions at precancerous stages or, at worst, early malignancy, is the key to better outcomes for our oral cancer patients.
Are friends electric?: a review of the electric handpiece in clinical dental practice
Authors: Campbell Stuart C
Published: August 2017

Contemporary restorative procedures demand precise detail in tooth preparation to achieve optimal results. Inadequate tooth preparation is a frequent cause of failure. This review considers the electric high-speed, high-torque handpiece and how it may assist clinicians in achieving greater accuracy in tooth preparation.

Clinical Relevance: The electric handpiece provides a satisfactory alternative to the air-turbine and may be considered by clinicians who wish greater control with operative procedures.
Osteosarcoma of the mandible mimicking an odontogenic abscess: a case report and review of the literature
Authors: Bhadage Chetan J , Vaishampayan Sagar , Kolhe Swapnil , Umarji Hemant
Published: August 2017

Inflammatory lesions, like periapical/odontogenic abscesses, are by far the most common pathologic condition of the jaws. Radiographically, these lesions commonly manifest as widening of periodontal ligament space, discontinuity of lamina dura and ill-defined periapical radiolucency. There are some rare disorders which could cause similar radiographic changes in the jaw bone. With careful scrutiny of periapical radiolucency, regular periodic follow-up radiographs and histo-pathologic examination, the periapical abscess or infection can be differentiated from rare fatal disorders.

Clinical Relevance: This paper highlights the need for vigilant examination of even the commonest, innocuous-appearing periapical changes which sometimes are produced by some rare fatal disorders.
Parotid fistula – an extra-orally draining infected dentigerous cyst associated with a supernumerary fourth molar in ascending ramus
Authors: Sanghera Ripponjit Kaur , Jones Judith
Published: August 2017

An infected cyst, associated with a supernumerary fourth molar in the ascending ramus of the mandible, presented with parotid swelling, trismus and pain. It was managed as a parotid infection but recurred and a draining pre-auricular sinus developed, which was thought to be a parotid fistula. This was managed by cautery, followed by excision of the fistula, both of which were unsuccessful. Following this, further investigations revealed that the cause of the facial sinus was in fact a cyst associated with a mandibular fourth molar in the posterior ascending ramus. The tooth was extracted, via a pre-auricular extra-oral approach, under general anaesthetic.

Clinical Relevance: This case shows how a dental panoramic radiograph can be extremely helpful at ruling out certain pathology. It also demonstrates how the symptoms of an infection arising from a tooth in the ramus may be misdiagnosed as salivary gland pathology.
The orthodontic-restorative interface in patients with hypodontia: the patient's journey
Authors: Stevenson Brian , Patel Dipali , Ricketts David , Cord Alison
Published: August 2017

Abstract: Congenitally absent teeth may pose aesthetic and functional problems for patients. Treatment is often complex and involves a multidisciplinary team. Using retrospective data, the patient's pathway, when a combined orthodontic-restorative dentistry approach was used, will be summarized. It was found that the number of teeth missing ranged from 1 to 8 with a mean of 3.4 per patient. Combined treatment was found to take on average around 38 months, using over 20 appointments.

Clinical Relevance: Hypodontia is a relatively common condition. It is important that practitioners and patients are aware of the length of time treatment can take.
Invisible orthodontics part 2: lingual appliance treatment
Authors: McMullin Ailbhe , Waring David T , Malik Ovais H
Published: August 2017

Abstract: The aim of this second article of the three part series is to sum up the current developments in lingual orthodontics. This article attempts to review the development, advantages and disadvantages, bonding techniques, bracket mechanics, patient factors and types of lingual appliance systems available. In addition, the article shows examples of treated cases with lingual appliances.

Clinical Relevance: Lingual appliances are a useful addition to the armamentarium of invisible orthodontic appliances, with significant developments over the last few years. Clinicians need to be aware of the advances and predictable results achievable with lingual appliances.
Making sense of sensitivity
Authors: Beddis Hannah , Soneji Priya , Welford Susan , Ashley Martin
Published: August 2017

Abstract: Our professional understanding of the causes and treatment options for dentine hypersensitivity should now allow the dental profession to manage this condition reliably. This paper reviews the aetiology and explains the scientific basis for what has become a confusing number of products and methods available to patients and dental clinicians.

Clinical Relevance: Dentine hypersensitivity appears to be an increasing problem for patients and the dental profession alike. Clinicians need to have up-to-date knowledge of this condition and the products available to treat patients presenting with this troublesome complaint.
Top tips for child protection for the GDP
Authors: Harris Christine M , Welbury Richard
Published: August 2017

Knowledge of child protection is essential in everyday practice for the whole dental team as they are well placed to take part in the shared responsibility of protecting children. Physical abuse, neglect, sexual abuse and emotional abuse may all present to the dental team in various ways. This article aims to provide some top tips for general dental practitioners who have concerns regarding possible child abuse/neglect and remind them of what observations to make and what questions to ask themselves when they are concerned about a child's welfare.

Clinical Relevance: Abuse and neglect are areas in child protection that the dental team can provide important information about to the local child protection team. All members of the dental team need to be aware of the signs and symptoms of child abuse/neglect and where to go for help.
The indicator of sedation need (IOSN)
Authors: Coulthard Paul
Published: August 2017

Conscious sedation in dentistry is usually indicated because a patient's anxiety can prohibit the necessary dental treatment being undertaken. It may also be indicated because of unpleasant or lengthy treatment or to prevent exacerbation of a patient's medical or behavioural condition by anxiety. The indicator of sedation need (IOSN) tool has been developed to help support dentists in their clinical decision-making and uses information about a patient's anxiety, medical and behavioural status and treatment complexity. The IOSN has been used to measure sedation need and has shown that 5.1% of patients attending general dental practices have a high need of conscious sedation. IOSN has also been used to investigate the need for conscious sedation in the general population among dental practice attenders and those who don't attend. The proportion was found to be 6.7%.

Clinical Relevance: Some patients require conscious sedation in order to access dental care. The indicator of sedation need (IOSN) tool helps in the decision-making process.
Factors to consider when treatment planning for patients seeking comprehensive aesthetic dental treatment
Authors: Ali Zaid , Ashley Martin , West Chris
Published: August 2017

Co-operation between specialties, improvements in dental materials, bonding technology, increase in public awareness of ‘cosmetic dentistry’ and patients' desires to improve their appearance, mean that, increasingly, dental practitioners are being asked how elective treatment may be used to improve their patients' smiles. Traditionally, a dentist's role has been to treat disease and promote oral health. Elective, invasive dental treatment needs careful consideration and, often, interdisciplinary planning. The issues dentists may need to consider and discuss with their patients are outlined with reference to dental literature.

Clinical Relevance: Requests to dentists to embark upon complex elective treatments to improve their patients' dental appearance are on the increase. It is important that clinicians appropriately assess cases prior to committing to a treatment plan. Considerations to be taken when assessing these patients are discussed.
Trauma to the primary dentition and its sequelae
Authors: Ranka Meena , Dhaliwal Harmeet , Albadri Sondos , Brown Catriona
Published: August 2017

Trauma to the primary dentition is common. This injury may have an impact on the child and his/her parents. The examining dentist should take appropriate factors into consideration before providing the required treatment. This paper discusses the management of trauma to the primary teeth and describes the sequelae of injury to both the primary and secondary dentitions.

Clinical Relevance: In cases of trauma to the primary teeth, diagnosis and appropriate management is necessary to alleviate the pain and discomfort for the child and to decrease the risk of damage to the permanent successor. It is important to prevent inducing fear and dental anxiety in children during the management of this injury.
Computerized tomography, stereolithography and dental implants in the rehabilitation of oral cancer patients
Authors: Patel Mital , Al-Momani Zaid , Hodson Nicholas , Nixon Peter J , Mitchell David
Published: August 2017

As survival rates improve it is important to consider the quality of life for oral cancer patients post-treatment. The primary goal is removal of the tumour, however, with a gradual increase in survival rates, post-operative rehabilitation is now becoming increasingly important. Specialists in restorative dentistry, along with oral and maxillofacial surgeons, general dental practitioners and other members of the multidisciplinary team play a vital role in planning treatment for, and rehabilitating, these patients. This paper presents a case series to show how recent advances in computerized tomography (CT) and the use of stereolithographic models can help in the rehabilitation of oral cancer patients.

Clinical Relevance: The principles discussed can also be applied to other patients undergoing dental implant treatment to help plan and carry out treatment and improve the quality of peri-implant tissues.