bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
Evolution of surgical guidance in implant dentistry
Authors: Kalra Manav , IN Aparna , B Dhanasekar 
Published: August 2017

The optimal positioning of oral implants ensures good biomechanical, functional, aesthetic and phonetic results. The concept of surgical guidance in implant dentistry has been developed to bridge the gap between pre-operative treatment planning and surgical site preparation. This article discusses its evolution, from the early surgical guide systems which used only diagnostic casts as reference, to the latest in computer-assisted navigation. Clinical Relevance: Surgical guidance allows the accurate transfer of information from the pre-operative treatment planning phase to the surgical field. It assists the operator in placing the implant in the most ideal position and angulations, with regards to the final prosthesis.
Taking the trauma out of trauma: an easy to follow guide for the management of trauma to the permanent dentition
Authors: White Ian , Spiers Gareth 
Published: August 2017

Treatment of dental trauma can be an infrequent, unpredictable and stressful experience for a dental practitioner. Correct diagnosis and management of such cases is of primary importance in the prognosis of the affected dentition. We have therefore constructed a number of easy to follow algorithms in management, both short and long term, for the range of traumatic injuries that can affect the permanent dentition.Clinical Relevance: Immediate as well as longer term management of dental trauma cases can be difficult, therefore a clear treatment plan is of great importance in successful results.
The characteristics of bisphosphonate patients developing bisphosphonate-related osteonecrosis of the jaw attending an OMFS department
Authors: Serrant Paul S , Clark Stuart 
Published: August 2017

This case series considers the incidence of patients taking bisphosphonate medication that suffer with bisphosphonate-related osteonecrosis of the jaw (BRONJ) following an exodontia procedure. Forty five such patients who attended the Wigan Royal Albert Edward Infirmary (RAEI) Oral and Maxillofacial Surgery (OMFS) department for an exodontia procedure were examined. A patient's age, gender, exodontia technique, bisphosphonate route (Oral/IV), smoking status and reason for taking the bisphosphonates, eg osteoporosis/cancer/arthritis was considered. All of the patients that experienced BRONJ were smokers. Clinical Relevance: Bisphosphonates are now widely accepted for the management of medical conditions, including arthritis, osteoporosis and various forms of cancer. Such patients are regularly referred to OMFS departments for dental extractions.