bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimal intervention dentistry and older patients part 2: minimally invasive operative interventions
Authors: Hayes Martina , Allen Edith , da Mata Cristiane , McKenna Gerald , Burke Francis 
Published: August 2017

As described in the first paper of this two part series, the expansion of our older population and the concomitant reduction in levels of edentulism will result in an increase in the number of patients presenting in general practice with complex restorative challenges. The application of the concepts of minimal intervention dentistry and minimally invasive operative techniques may offer a powerful armamentarium to the general dentist to provide ethical and conservative treatment to older patients. Clinical Relevance: When it is unavoidable, operative intervention should be as minimally invasive as practicable in older patients to preserve the longevity of their natural dentition.
Oral health and the provision of care to panjabi patients in the UK
Authors: Farrukh Affifa , Sayeed Saad , Mayberry John 
Published: August 2017

There is a substantial Panjabi community in the UK and its language is the second most common to be used in the country. As a result, it is critical that all practitioners concerned with oral health are aware of the dental practices of this community and of the increased risk of conditions such as head and neck cancer. This review assesses work published in the UK as well as in India and Pakistan. It emphasizes the need for a better understanding of cultural aspects of our care. Of course many aspects are not unique to this community but a better understanding will help with approaches to other communities. Social practices, such as paan use, can occur with greater frequencies amongst others, such as the Bangladeshi community. However, the purpose of this review is to concentrate attention on the largest minority community in the UK and, through this mechanism, to encourage interest in other groups. This interest should lead to practical approaches, such as: the development of relevant focus groups to improve clinical care; to develop outreach programmes to schools and community associations, including temples, gurdwaras and mosques; the production of appropriate literature and other media. Clinical Relevance: This review should ensure that the reader is aware of attitudes towards dental care in the Panjabi community and of the increased frequency of a range of clinical conditions.
Precision attachments in partial removable prosthodontics: an update for the practitioner part 1
Authors: Williams Gareth , Thomas Matthew BM , Addy Liam D 
Published: August 2017

Precision attachments can be used in removable prosthodontics to improve the retention, stability and aesthetics of a prosthesis. Their use is not commonplace. However, when used appropriately, it is possible to construct a more satisfactory prosthesis where conventional partial dentures have previously been unsuccessful. The first of two articles will describe the different types of precision attachments, including intracoronal, extracoronal and radicular. Their relative indications, advantages and disadvantages will also be discussed. Clinical Relevance: Precision attachments are an option to increase retention in challenging prosthetic cases.
An overview of preformed metal crowns part 1: conventional technique
Authors: Rogers Helen J , Batley Haris A , Deery Chris 
Published: August 2017

This article details the clinical techniques for conventional preformed metal crown placement. It aims to increase the readers' awareness of the clinical advantages of preformed metal crowns and the indications for their use. The second part will discuss the Hall Technique. CPD/Clinical Relevance: This two-part article aims to guide the reader through the conventional and alternative techniques available for placement of a preformed metal crown whilst providing an update of the evidence for each.
An update on crown lengthening part 1: gingival tissue excess
Authors: Kalsi Harpoonam Jeet , Hussain Zahra , Darbar Ulpee 
Published: August 2017

This is the first article in a two-part series which aims to provide an overview of the different techniques used to increase clinical crown height. In the first paper, the focus will be on the management of patients who present with gingival tissue excess. The different aetiologies are discussed and illustrated with clinical cases, following which a range of procedures that may be employed in the management of these patients are presented. With an increasingly ageing population, more patients are taking regular medications prescribed from their general medical practitioner, and so having a working knowledge of the specific drugs that may cause gingival enlargement is essential. Clinical Relevance: When patients with gingival tissue excess present in primary or secondary care, a clinician must have a good knowledge of the possible causes of the condition, as well as an idea of how the patient may be managed.
Aesthetic treatment related to clinical need – an illustrated case report
Authors: Worskett Paul 
Published: August 2017

Aesthetic treatment may be patient driven and usually by a ‘want’, rather than a ‘need’. This paper describes the management of a patient who presented with aesthetic wants and clinical needs, both of which were caused as a result of unsuccessful aesthetic treatment which the patient had received previously. The diagnostic process, discussion of the treatment plan and clinical procedures, which produced a satisfactory result, are described and illustrated. Clinical Relevance: This case demonstrates that aesthetic treatment may commit the patient to future dental treatment needs, particularly if treatment provided is poorly planned and carried out to an unsatisfactory standard.
The francis report – implications for the regulator
Authors: Gilvarry Evlynne 
Published: August 2017

The professional regulators were identified in the Francis Report as having a central role in maintaining fundamental standards of care. This paper describes the key themes in the Report and the importance of regulatory powers to ensure that the serious failings in patient care highlighted by the Mid-Staffs Inquiry cannot be repeated. The central role of the GDC Standards in the profession's response to the Francis Report is stressed. Clinical Relevance: The importance of our professional regulator in ensuring adherence to fundamental standards of care is a central tenet of clinical dentistry.
Infraoccluded upper deciduous second molars leading to caries in the permanent dentition
Authors: Rooney Claire , Suida Imran , Spencer Richard James 
Published: August 2017

Infraocclusion of primary teeth is a problem that can be recognized early by the general dental practitioner. Allowing affected teeth to deteriorate beyond a point where active intervention would be recommended can make treatment of the condition more complex or may lead to unexpected sequelae. The case described in this report of infraoccluded primary teeth, suffered pathology in adjacent teeth, leading to multiple extractions and fixed orthodontic treatment post surgery. This case highlights the need for early recognition of infraocclusion by the GDP and will suggest interceptive treatment options. CPD/Clinical Relevance: To highlight the need of interceptive orthodontics in primary care when required.
Facial skin lesions dentists should know
Authors: Sibai Louna , Kudsi Zaki 
Published: August 2017

Facial skin lesions are common; patients may present with a nodule, crack, ulcer or abnormal discoloration of the skin that is not normally present. Ideally, dentists should include face examination in their routine clinical examination. Any suspicious lesion should be referred to a dermatologist as an early diagnosis and treatment could be life-saving. This article will discuss the diagnosis and treatment of common lesions of the face. Clinical Relevance: Dentists should recognize facial lesions, understand the differential diagnosis and refer suspicious lesions for treatment.
Mouth cancer for clinicians part 4: risk factors (traditional: alcohol, betel and others)
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 the main cancer risk factors, namely tobacco and alcohol, betel and other chewing habits, and environmental factors.
Pain part 5b: non-odontogenic dysfunctional pain
Authors: Renton Tara , Egbuniwe Obi 
Published: August 2017

Orofacial chronic pain provides a significant challenge to all clinicians and the patients seeking treatment for it. Due to the anatomical and regional complexities, diagnosis can be extremely difficult, and due to the lack of cross specialty training, patients will undergo a variety of treatment under different disciplines. Dysfunctional pain provides a unique challenge for patient management and requires a multidisciplinary team. Clinical Relevance: Lack of recognition of dysfunctional chronic pain can result in inappropriate dental treatment and further damage. to the patient. Appropriate patient reassurance and referral to an orofacial pain multidisciplinary team is recommended as most of these conditions require medical management.
Warfarin and drug interactions: prescribing vigilance
Authors: Hook J , Millsopp Lynne , Field E Anne 
Published: August 2017

A patient taking warfarin presented to the Oral Medicine Clinic at Liverpool University Dental Hospital, having been prescribed metronidazole and miconazole by his general dental practitioner (GDP) for his oral mucosal problem. He subsequently developed bruising on his torso following mild trauma. Having read the drug information leaflet provided with his metronidazole and miconazole, he noted the potential drug interactions between these and warfarin. He therefore stopped his warfarin. The details of this case are outlined, and the potential for significant drug interactions with warfarin are highlighted. The need for dental practitioners to be vigilant concerning drug interactions is emphasized, together with the importance of CPD in relation to drug prescribing. CPD/Clinical Relevance: This case report, which is of relevance to all dental practitioners, highlights the importance of up-to-date medical and drug histories and the continuing awareness of potential drug interactions. In this case, patient intervention after checking drug information leaflets prevented serious consequences. The importance and potentially serious consequences of significant drug interactions needs to be understood.
Flexible and sectional complete dentures with magnetic retention for a patient with microstomia – a case report
Authors: King Elizabeth , Owens James 
Published: August 2017

This case report describes treatment for a patient with microstomia and the development of the index of oral access for restorative dental treatment (IOA). CPD/Clinical Relevance: An understanding of the causes of microstomia and challenges encountered when treating microstomia patients with an index to aid diagnosis and treatment planning.
Modern endodontic principles part 7: the restorative interface
Authors: Martin Warren , Taylor Carly , Jawad Sarra , Roudsari Reza Vahid , Darcey James , Qualtrough Alison 
Published: August 2017

The restoration of endodontically-treated teeth is a topic that has been extensively studied and yet remains controversial. The endodontically-treated tooth can be restored with a wide range of techniques of varying complexity. This article reviews the literature on this topic. Consideration is given to the ferrule and its importance in achieving success. Furthermore, consideration will be given to the use of endodontically-treated teeth as abutments for fixed and removable prostheses and the challenges this presents. Clinical recommendations are presented as guidelines to improve the predictability and outcome of treatment when restoring structurally compromised root-filled teeth. CPD/Clinical Relevance: The prognosis of endodontically-treated teeth depends not only on the success of the endodontic treatment, but also on the type of reconstruction.
The prosthodontic pathway for patients with anomalies affecting tooth structure
Authors: Laverty Dominic P , Thomas Matthew BM 
Published: August 2017

There are a number of anomalies that affect the structure of the dental hard tissues which impact upon the form, function and aesthetics of the dentition. Understanding the challenges these conditions pose will enable dentists to manage the functional and aesthetic problems with restorative techniques better. This article will present cases that demonstrate the different conditions, the restorative challenges experienced and a variety of restorative treatments in the management of these conditions. CPD/Clinical Relevance: Awareness of different anomalies affecting tooth structure that may present to the dental practitioner is necessary. Clinicians should appreciate the specific restorative challenges that may arise in treating such patients and the possible treatment options that may be available.
Mouthwashes: do they work and should we use them? part 3: safety of mouthwashes
Authors: Hodge Penny 
Published: August 2017

There have been numerous reports in the scientific literature investigating the possible association between alcohol-containing mouthwashes and oral cancer but relatively few epidemiological surveys have taken place and the findings have been equivocal. This article will address the controversial issue of the safety of mouthwashes and provide an objective assessment of the latest scientific evidence. CPD/Clinical Relevance: The evidence surrounding the safety of ‘over the counter’ alcohol-containing mouthwashes is evaluated. This provides guidance for dentists and dental care professionals of when it is appropriate to recommend mouthwash use to their patients.
Hypercoagulopathy and dento-alveolar surgery: a case of exodontia in a patient with hughes' syndrome
Authors: Petrosyan Vahe , Carr Richard WF , Milton Tim , Revington Peter J 
Published: August 2017

Antiphospholipid syndrome is a thrombophilic disorder in which the presence of serum autoantibodies to phospholipid causes disruption of the protein C antithrombotic pathway. Deposition of these autoantibodies in small blood vessels can lead to intimal hyperplasia and acute thromboses. The associated hypercoagulopathy is problematic in dentistry since, if proper haemostasis is not achieved prior to discharge of exodontia patients, excessive haematoma formation may result. This case report and review of the literature discusses the condition in the context of hypercoagulation with reference to a patient undergoing a simple extraction, and suffering post-operative complications amounting to a large haematoma requiring evacuation. CPD/Clinical Relevance: Post-operative bleeding is one of the most common complications of exodontia. This case report and review of the literature provides the reader with a concise summary of the clotting cascade in parallel with an unusual case of post-operative bleeding.
Case report: metastatic infratemporal soft tissue myeloma presenting as a numb lower lip
Authors: Rice Niamh , Srinivasan Badrinarayanan , Macpherson David 
Published: August 2017

This is a case of a patient presenting to his general dental practitioner (GDP) with altered sensation in his lower lip with no obvious cause. Due to a prompt referral, the patient was investigated and diagnosed with an extramedullary presentation of multiple myeloma. A numb lip can present in general dental practice, although this is not common. There are several causes, for example, dental infection or fractured mandible. CPD/Clinical Relevance: It is very important for the dental practitioner to recognize when there could be a potential sinister underlying cause and prompt referral, under the two week rule referral system, is indicated.
What's new in molar incisor hypomineralization?
Authors: Silva Mihiri J , Kilpatrick Nicky , Crombie Felicity , Ghanim Aghareed , Manton David 
Published: August 2017

Molar Incisor Hypomineralization (MIH) poses a significant challenge to clinicians worldwide. Since its description in 2001, extensive research has provided some insight into the condition, its aetiology, natural history and management. An appreciation of the unique clinical features and management considerations of MIH is essential to maximize patient outcomes. Early diagnosis is the first of several key steps in developing an appropriate management plan, which must account for short- and long-term needs of the patient. While traditional caries preventive approaches are important, more proactive restorative strategies may also be useful.CPD/Clinical Relevance: This review provides clinicians with an update of the recent literature and discusses the contemporary management of MIH.
Facial palsy masquerading as an acute dental abscess
Authors: Razzak Arif , O'Leary Frances , Ahmed Nabeela 
Published: August 2017

Facial nerve palsy has specific symptomology, but varied aetiology. Prompt and thorough assessment is required to ascertain if upper or lower motor neurone damage has occurred. This report discusses a 6-year-old female, presenting in the Emergency Department with unilateral facial weakness. Initially thought to be facial swelling relating to her carious dentition, clinical assessment from the maxillofacial team identified that the patient had a unilateral facial palsy, later diagnosed as Bell's palsy. Her delayed presentation was due to initial misdiagnoses in primary care. This case report aims to highlight its aetiology, clinical features and appropriate management. CPD/Clinical Relevance: To make the general dental practitioner aware of different causes of facial paralysis, and to provide GDPs with an algorithm to follow in the presentation of a facial palsy in the primary care setting.
Early tooth loss in children: a warning sign of childhood hypophosphatasia
Authors: Hughes Sara L , Parkes Rachel C , Drage Nicholas , Collard Mechelle 
Published: August 2017

Premature exfoliation of primary teeth may be the first manifestation of this serious condition and the general dental practitioner plays an important role in recognizing dental anomalies and referring patients at an appropriate time. This is imperative to ensuring early diagnosis and good quality patient care. This article describes the case of a 4-year-old boy affected by childhood hypophosphatasia, who presented with premature exfoliation of his primary teeth as the first manifestation of this condition. An overview of the condition is outlined including a discussion of the likelihood of permanent dentition involvement. CPD/Clinical Relevance: Oral manifestations of hypophosphatasia may be the first and the only signs of this condition and may be the basis upon which a diagnosis is made.
Arteriovenous malformation of the jaws: a black hole for the GDP – a case report
Authors: Shah Kunal , Srinivasan Badrinarayan , Ethunandan Madanagopalan , Pratt Clive 
Published: August 2017

We report a case of a mandibular arteriovenous malformation in a 3-year-old child, who attended our department, and have carried out a literature review. CPD/Clinical Relevance: Arteriovenous malformation (AVM) is a rare condition but clinicians need to be aware of it as this lesion can have potentially life-threatening complications due to massive haemorrhage.
Dual role of subepithelial connective tissue grafting in regeneration of periodontal attachment apparatus
Authors: Kumar Nettemu Sunil , Sowmya Nettem , Singh Vijendra Pal , Verma Madhu B 
Published: August 2017

Periodontal plastic and aesthetic surgery are gaining significant momentum owing to the increasing aesthetic demands by patients. Along with the fulfilment of aesthetic needs, it is imperative that clinicians also enhance function. From these two important viewpoints, subepithelial connective tissue grafting remains an optimum treatment choice for periodontists when treating gingival recession defects accompanied by periodontal attachment apparatus breakdown. CPD/Clinical Relevance: Subepithelial connective tissue grafting is a successful procedure in its dual role of gingival recession coverage and predictable periodontal regeneration.
Tooth wear: screening, diagnosis and management in general dental practice
Authors: Yim Victor Ka Cheong 
Published: August 2017

Recent epidemiological data shows that the prevalence of tooth wear (TW) is increasing. Current available assessment tools are either too complicated to carry out on every patient or inadequate in identifying the nature of the condition. Moreover, early onset or localized lesions may be overlooked. This article describes a screening tool which may overcome these problems. This tool involves using the existing Basic Erosive Wear Examination scoring system and a proposed age-related grid. This will lead to an associated pathway, which indicates the recommended level of further investigations and management. CPD/Clinical Relevance: Early identification and prevention of pathological tooth wear in the primary care setting is the key to slowing down the disease progression.
’Educating the educated’: a report of an undergraduate medical student with multiple carious lesions and poor dietary habits
Authors: Dhadwal Amardeep Singh , Baysa Aylin 
Published: August 2017

It is evident in the undergraduate dental curriculum that competent dental students are expected to have a broad knowledge of the intricacies of the human body and its relationship with the oral cavity, but the same cannot be guaranteed for medical students. This case report of a medical undergraduate student who presented with multiple carious lesions and a poor knowledge of the impact of her habits on her oral heath illustrates the importance of using a well-formulated and holistic treatment plan with a focus on oral health promotion and education. The review appointment proved promising with an improved plaque score and dietary analysis. This article provides a brief introduction to the topics and discusses potential future developments that aim to reduce the subjectivity in the analysis process and simplify presentation of evidence to non-dental parties. CPD/Clinical Relevance: This case re-iterates the need to encompass education and prevention to stabilize and prevent dental caries and teach other future healthcare professionals so that they can utilize and consider this knowledge in the management of their own patients. Moreover, it demonstrates that there may be scope for raising dental awareness and education within the medical profession.
A review of the literature relating to transmigrating canines. An illustrated case report
Authors: Sarode Gargi S , Sarode Sachin C , Patil Anuprita 
Published: August 2017

Canine impaction is not an uncommon finding in the dental literature, but transmigration of mandibular canines is a rare phenomenon, and some of them are far more extreme than others. We report an extremely rare case of bilateral transmigration of impacted permanent canines crossing the midline of the mandible. Clinical Relevance: To understand the role of early interception so that the patient can be treated before canines transmigrate in order to avoid surgical extraction, as well as complex orthodontic and restorative therapies.