bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why, what and how: caries control for erupting molars
Authors: Rogers Helen J , Morgan Annie G , Batley Haris , Deery Chris 
Published: August 2017

This article aims to update the practitioner on the various techniques and interventions available to prevent or control caries during this high-risk period. The evidence to support provision of toothbrushing advice, placement of fissure sealants and fluoride varnish application is considered, along with more novel methods. An evidence-based protocol is suggested to help the practitioner determine when further intervention is required and what action to undertake. Clinical Relevance: This article aims to reinforce the need for rigorous caries prevention in an erupting permanent molar and provides an update on the evidence behind a range of clinical techniques used for this purpose.
Peri-implant diseases: an overview
Authors: Warreth Abdulhadi , Boggs Shane , Ibieyou Najia , El-Helali Ruaa , Hwang Soohyun 
Published: August 2017

The use of dental implants in replacing missing teeth is proven to be a valid treatment with a high success rate. To achieve the best treatment outcome in all implant systems, the implant has to be able to integrate with the surrounding tissue. However, dental implants are affected by peri-implant diseases and may fail as a result. As the number of implants placed continues to increase, the prevalence of peri-implant disease will also increase. This requires preventive measures to inhibit the development of the disease and stop its progression. Clinical Relevance: Understanding how to maintain healthy peri-implant tissue as well as diagnosis and treatment of disease are vital for every dentist and dental student.
The francis report – why it matters to the dental team
Authors: Bagg Jeremy , Welbury Richard 
Published: August 2017

The Francis Report into the deaths at Mid-Staffordshire NHS Trust highlighted the problems facing the NHS when patients, families, clinicians and nurses are not heard, and where the management, leadership and ensuing culture are focused on the system's business, not patient care. This paper, the first in a series based on the implications of the Francis Report, provides the background and context for the subsequent ‘perspective’ articles from a range of relevant stakeholders and care-providers. The overriding message is that in all areas of healthcare, dentistry included, the quality of patient care, especially patient safety, must be placed above all other aims. Clinical Relevance: The overriding importance of patient-centredness and quality of care, above all other aims, is the key message of clinical relevance from the Francis Report.
Assessment and management of halitosis
Authors: Singh Vijendra P , Malhotra Neeraj , Apratim Abhishek , Verma Madhu 
Published: August 2017

Halitosis is an unpleasant condition that may be the origin of concern not only for a possible health condition but also for frequent psychological alterations which may lead to social and personal isolation. The most frequent sources of halitosis that exist in the oral cavity include bacterial reservoirs such as the dorsum of the tongue, saliva and periodontal pockets. Volatile sulphur compounds (VSCs) are the prominent elements of oral malodour. Genuine halitosis and pseudo-halitosis should be in the treatment realm of dental practitioners.Clinical Relevance: Halitosis can be a symptom of underlying systemic disease, therefore the exact diagnosis and its source (oral or non-oral) is important in the proper approach to its management.
Pain part 3: acute orofacial pain
Authors: Khawaja Nadine , Renton Tara 
Published: August 2017

Acute trigeminal pain is a common presentation in the dental surgery, with a reported 22% of the US adult population experiencing orofacial pain more than once during a 6-month period. 1 This article discusses the mechanisms underlying the pain experience, diagnosis and subsequent management of acute trigeminal pain, encompassing pre-, peri- and post-operative analgesia. The dental team spend most of their working lives managing patients and acute pain. The patient may present to the clinician in existing pain, which may often provide a diagnostic challenge. Prevention and managing intra-operative and post-surgical pain are implicit in providing your patient with optimum care. CPD/Clinical Relevance: This paper aims to provide an overview of conditions that may present with acute orofacial pain and their management using the most recent evidence base. Intra-operative and post-surgical pain management are also scrutinized and evidence-based treatment is recommended.
Dementia and dentistry
Authors: Edwards Julie A , Ford Liz , Boyle Carole 
Published: August 2017

Dementia is increasing in prevalence: by 2025 it is estimated that there will be over a million people in the UK with this diagnosis. The condition is likely to affect us all as healthcare providers, whether in our patients, our relatives or ourselves. This article gives an overview of dementia: causes, treatment, how it affects people and provides advice on how to manage patients with dementia who require dental care. CPD/Clinical Relevance: By identifying the patient with dementia and being aware of the challenges in providing care the clinician can provide better treatment and reduce the chance of dental problems as the condition progresses.
Current applications and future prospects of stem cells in dentistry
Authors: Surendran Sharmila , Sivamurthy Gautham 
Published: August 2017

Stem cells are defined as clonogenic, unspecialized cells capable of both self-renewal and multi-lineage differentiation, contributing to regenerating specific tissues. For years, restorative treatments have exploited the lifelong regenerative potential of dental pulp stem cells to give rise to tertiary dentine, which is therapeutically employed for direct and indirect pulp capping. Current applications of stem cells in endodontic research have revealed their potential to continue root development in necrotic immature teeth and transplanted/replanted teeth. Successful application of pulp revascularization is highlighted here with support of a clinical case report. This article also discusses the role of dental stem cells as a promising tool for regeneration of individual tissue types like dentine, pulp and even an entire functional tooth. CPD/Clinical Relevance: This article will help practising dental surgeons understand the significance of stem cells in dentistry. Clinicians can harness the potential of stem cells using procedures like pulp regeneration/revascularization in endodontics and improve their knowledge on the recent advances in tissue engineering and future applications of dental-derived stem cells.
Management of recurrent aphthous stomatitis in children
Authors: Montgomery-Cranny Jodie A , Wallace Ann , Rogers Helen J , Hughes Sophie C , Hegarty Anne M , Zaitoun Halla 
Published: August 2017

Recurrent oral ulceration is common and may present in childhood. Causes of recurrent oral ulceration are numerous and there may be an association with underlying systemic disease. Recurrent aphthous stomatitis (RAS) is the most common underlying diagnosis in children. The discomfort of oral ulcers can impact negatively on quality of life of a child, interfering with eating, speaking and may result in missed school days. The role of the general dental practitioner is to identify patients who can be treated with simple measures in primary dental care and those who require assessment and treatment in secondary care. Management may include topical agents for symptomatic relief, topical corticosteroids and, in severe recalcitrant cases, systemic agents may be necessary. CPD/Clinical Relevance: Children and young people frequently suffer from recurrent oral ulceration; with recurrent aphthous stomatitis being the most common diagnosis.
An unusual allergic response to orthodontic treatment
Authors: Shargill Inderjit , Asher-McDade Catherine 
Published: August 2017

This paper describes a case of a 13-year-old patient with a systemic hypersensitivity reaction to orthodontic treatment. Her allergy was investigated resulting in a provisional diagnosis of pressure urticaria. The aetiology, diagnosis and clinical management of allergic reactions to dental procedures are discussed. CPD/Clinical Relevance: A significant underlying medical condition may be revealed by dental procedures. Appropriate liaison with medical professionals is essential so that appropriate diagnostic measures may be taken and treatment instigated. This paper shows the importance of patient safety both with regard to the taking of accurate medical and dental histories and the management of untoward reactions to dental procedures.
Class ii resin composites: restorative options
Authors: Patel Minesh , Mehta Shamir B , Banerji Subir 
Published: August 2017

Tooth-coloured, resin composite restorations are amongst the most frequently prescribed forms of dental restoration to manage defects in posterior teeth. The attainment of a desirable outcome when placing posterior resin composite restorations requires the clinician to have a good understanding of the benefits (as well as the limitations) posed by this material, together with a sound knowledge of placement technique. Numerous protocols and materials have evolved to assist the dental operator with this type of demanding posterior restoration. With the use of case examples, four techniques available are reported here. CPD/Clinical Relevance: This article explores varying techniques for the restoration of Class II cavities using resin composite.
Mouth cancer for clinicians part 5: risk factors (other)
Authors: Kalavrezos Nicholas , Scully Crispian 
Published: August 2017

A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team, in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family. Clinical Relevance: This article offers the dental team an overview of other cancer risk factors agents, such as human papilloma viruses (HPV) and irradiation.
Infected dentine revisited
Authors: Kidd Edwina , Fejerskov Ole , Nyvad Bente 
Published: August 2017

Dentine becomes infected as a result of caries lesion formation on root surfaces and when lesions progress following cavitation of enamel lesions. However, this infection is unimportant because the driving force for lesion formation and progression is the overlying biofilm. This explains why root surface caries can be controlled by mechanical plaque control and fluoride, and restorations are not needed to arrest these lesions. Similarly, the infected dentine in cavitated coronal lesions does not have to be removed to arrest the lesion. If the lesion is either accessible or opened for cleaning by the patient or parent, the lesion can be arrested. Sealing of infected dentine within the tooth, either by a Hall crown in the primary dentition or by partial caries removal prior to placing a well-sealed filling, will also arrest the lesion. When restoring deep lesions in symptomless, vital teeth, vigorous excavation of infected dentine is likely to expose the pulp and make root canal treatment necessary. Thus ‘complete excavation’ is not needed and should be avoided. CPD/Clinical Relevance: Root surface caries can be arrested by cleaning and fluoride application. Restorations are not essential. Vigorous excavation of softened dentine in deep cavities of symptomless, vital teeth is contra-indicated. It is not needed and increases the risk of pulp exposure.
Coronectomy; good or bad?
Authors: Sarwar Humera , Mahmood-Rao Sameer 
Published: August 2017

The removal of mandibular third molars can be complicated by injury to the inferior alveolar nerve (IAN). Coronectomy retains the tooth root; this method has been found to be preferable to extraction in the context of mandibular third molars. A failed coronectomy may cause mobilization of these roots, thereby requiring a subsequent extraction. Having undergone a previous coronectomy, extraction is then safer as the roots usually migrate away from the IAN. Computed tomography is more accurate than radiography when imaging mandibular third molars pre-operatively owing to its three-dimensional nature. Longer studies need to be conducted to evaluate the long term benefits of coronectomy. CPD/Clinical Relevance: The removal of mandibular third molars can be complicated by the presence of the close lying inferior alveolar nerve. Coronectomy can be useful in this setting and therefore it is important to be aware of the pros and cons of this technique.
Modern endodontic principles part 4: irrigation
Authors: Darcey James , Jawad Sarra , Taylor Carly , Roudsari Reza Vahid , Hunter Mark 
Published: August 2017

The complex anatomy of the tooth limits the ability to eradicate pathogens by mechanical means alone. Irrigation is the key to solving this problem. This paper highlights the importance of irrigation, the key irrigants available and methods of improving the performance of irrigants within the canal. CPD/Clinical Relevance: To provide advice on which irrigants to use, how to use them effectively and safely and what to do if irrigants are extruded beyond the apex.
Nutrition and periodontal disease
Authors: Raindi Devan 
Published: August 2017

The identification of inflammatory periodontal disease and education in local and systemic risk factors and their management forms the foundation of the treatment of this disease. Nutrition is potentially a modifiable risk factor that could drive or abrogate the underlying oxidative stress in periodontitis. As research in this area is still in its infancy, clinical guidance on the delivery of dietary advice for susceptible patients is scarce. This paper will explain the possible mechanisms linking nutrition and periodontal disease, as well as the guidelines currently available to the dental profession. CPD/Clinical Relevance: With a growing evidence base, an appreciation of the links between nutrition and inflammatory periodontal disease can help guide clinicians in educating patients on this potentially important modifiable risk factor.
Extra-oral appliances in orthodontic treatment
Authors: Almuzian Mohammed , Alharbi Fahad , McIntyre Grant 
Published: August 2017

Extra-oral appliances are used in orthodontics to apply forces to the jaws, dentition or both and the popularity of these appliances is cyclical. Although the use of retraction headgear for the management of Class II malocclusion has declined over the last 20 years with the refinement of non-compliance approaches, including temporary anchorage devices, headgear still has a useful role in orthodontics. The use of protraction headgear has increased as more evidence of its effectiveness for the treatment of Class III malocclusion has become available. This paper describes the mechanics and contemporary uses of headgear in orthodontics for primary care dentists and specialist orthodontists. CPD/Clinical Relevance: Extra-oral appliances have specific uses in orthodontic biomechanics. Clinicians using retraction headgear and protraction headgear should be familiar with their clinical indications, the potential problems and how these can be avoided.
The dental update readers' panel
Authors: Burke FJ Trevor 
Published: August 2017

Readers will be aware of the names of the Editorial Board of Dental Update, given that these appear in each issue, with the Board being responsible, along with myself, for the quality of the publication. Their other role is to suggest articles to be commissioned for future issues and authors who might write them. Given that the majority of published articles are written by dental academics (despite encouragement from me aimed at involving general dentists in the writing process), it is therefore not a surprise to note that the majority of the Editorial Board are academics. The Readers' Panel was formed by me in 1998, with a view to seeking the views of a representative sample of the varied readership on the appropriateness of the content of Dental Update to their needs and to suggest topics which they feel should be covered. Readers may therefore be interested to read the varied backgrounds of the members of the Readers' Panel, as this has changed over the years, but with this short piece hopefully demonstrating that the Panel represents the workplace within dentistry of the majority of readers. The most recent addition is a student member, given the popularity of Dental Update among dental students.
Provisional restorations – a permanent problem?
Authors: Keys William F , Keirby Naomi , Ricketts David 
Published: August 2017

Provisional restorations play an important role when providing indirect restorations. There are a number of materials and techniques available for their construction. Careful planning and construction can protect the prepared tooth surface, improve the periodontal condition and help plan for the definitive restoration. A good provisional restoration can save time, money and effort. CPD/Clinical Relevance: Provisional restoration construction is an integral part of the indirect restorative process for inlays, onlays, crowns and bridges.
The restorability assessment and endodontic access cavity interface
Authors: Quilligan Graham , McKenna Gerald , Allen P Finbarr 
Published: August 2017

Successful root canal treatment requires management of the bacterial infection within the root canal space and protection of residual tooth structure with direct/indirect restorations. Long-term success depends upon prevention of re-infection of the root canal space as well as ensuring favourable distribution of the occlusal forces throughout the residual tooth structure. Appropriate planning and design of the final restoration prior to initiating root canal treatment is paramount in achieving this objective. This article describes simultaneous restorability assessment and access cavity preparation to optimize outcome of both endodontic and prosthodontic treatment of the endodontically involved tooth. CPD/Clinical Relevance: This paper proposes a method to improve visibility and reduce iatrogenic errors whilst simultaneously facilitating effective design of the definitive restoration based on the quantity and distribution of residual tooth structure.
Aetiological, histopathological, clinical, diagnostic and therapeutical features of idiopathic cervical resorption
Authors: Gijón Virginia Robles , Martín Cristina Lucena , Encinas Rosa M Pulgar , Navajas José Manuel 
Published: August 2017

Root resorption is the loss of hard dental tissue as a result of odontoclastic action involving vital and pulpless teeth. Cervical root resorption (CRR) is a type of external resorption which usually occurs immediately below the epithelial attachment of the tooth in the cervical region. The idiopathic cervical resorption (ICR) refers to a clinical situation in which all other causes, whether local or systemic, have been ruled out as the origin of the disease. The early stage is asymptomatic and might be diagnosed by a routine radiograph or a clinical examination. In this study, the aetiological, histological, clinical and radiological analysis is undertaken; a review is made concerning the pathologies to which the differential diagnosis should be applied; and the different therapeutical options are discussed. This lesion sometimes demands the management of a broad field of multidisciplinary techniques such as restorative dentistry, endodontics, surgery, implants and prosthesis. CPD/Clinical Relevance: Cone-beam computed tomography (CBCT) may be a useful tool to determine the true extent of external cervical resorption lesions.
A pathological fracture of the mandible due to osteomyelitis following a full dental clearance
Authors: Jauhar Preeti , Handley Thomas , Hammersley Nicholas 
Published: August 2017

Orofacial infections following dental extractions are a common referral to an oral and maxillofacial department as an emergency, especially when combined with swelling and limited mouth opening. The case presented demonstrates a rare complication of chronic suppurative osteomyelitis with bilateral pathological fractures of the mandible, which occurred following a staged dental clearance. CPD/Clinical Relevance: Dental extractions are one of the most common treatments carried out by oral surgeons and general dental practitioners. This case highlights a rare but encountered complication of routine oral surgery and demonstrates when it is necessary to make an immediate referral to the local oral and maxillofacial surgery unit.
Mouth cancer for clinicians part 8: referral
Authors: Kalavrezos Nicholas , Scully Crispian 
Published: August 2017

A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family. Clinical Relevance: This article offers the dental team an overview of referral procedures; oral diagnosis is not always simple and a second opinion can be valuable to all concerned in cases of doubt.
Relevance of bisphosphonate therapy in osteoporosis and cancer – no cause for alarm in dentistry
Authors: Moore Amelia Elizabeth , Renton Tara , Taylor Talli , Popat Shina , Jasani Mukundrai Kris 
Published: August 2017

This report provides important background information on osteoporosis (OP) and bone complications of cancer for the dental team, and discusses why bisphosphonate (BP) therapy is vital for patients with the two conditions. It also addresses several questions, including in particular: ‘Is withholding BP therapy the best way to prevent osteonecrosis of the jaw (ONJ) occurrence?’ Also, ‘Of the two, which is more important: ONJ or OP fracture prevention?’ CPD/Clinical Relevance: BP therapy offers OP patients the promise of a fracture-free life and the prevention of fracture-related pain, disability, loss of qualify of life (QOL) and the shortening of life. Without BP therapy, the lifetime risk of fracture occurrence in OP patients is as high as 1 in 2 women and 1 in 5 men; whilst using it, the relative risk of ONJ occurrence is as low as between 1 in 10, 000 and 1 in 100, 000. To cancer patients with bone complications, it offers the much needed pain relief and improvement in QOL. In cancer patients, the risk of ONJ is almost 100 times higher but, despite that, oncologists advocate BP therapy for virtually all the patients. Therefore, when prescribed, BP therapy merits the whole-hearted support of the dental team.