Replacement of a single anterior tooth is an extremely challenging procedure. The interdisciplinary team must evaluate numerous objective and subjective factors when determining the appropriate restorative method. This article reviews different treatment modalities when dealing with the provisionalization of a tooth requiring extraction. A fixed provisional technique is described using the patient’s natural extracted tooth.

Dual-cure composite resins have been traditionally used only for fabrication of core build-ups and restoration of endodontically treated teeth prior to crown placement. This article will review other clinical uses for these materials and discuss reasons for selection of self-etch adhesives vs total-etch adhesives when bonding dual-cure composite resins.

One of the most critical aspects to the success of implant dentistry is the precise location of the implant fixture relative to the depth of the bone and the surrounding anatomical structures. Fixture angulation also is important and proper placement simplifies the restorative phase of treatment. Surgical guides have been shown to provide an aid to implant fixture placement. The literature has described fabrication techniques of variations of surgical guides that range from visual estimation to verification of implant positioning with 3-dimensional radiography data. A new clear polyvinyl material has been introduced to be used solely and in conjunction with other materials in the fabrication of surgical guides for the positioning of implant fixtures.

Considerable controversy exists in the dental literature regarding cantilevered pontics. This article discusses basic concepts of the cantilever fixed partial denture (CFPD) in which one cantilevered pontic is supported by only one or two abutment teeth. Three primary factors should be considered carefully to optimize the prognosis for a CFPD: abutment selection, control of functional forces, and rigidity/strength of connectors. Abutments should have a root surface area greater than the tooth being replaced and a crown-to-root ratio of 2:3. They also should exhibit minimal mobility and be vital and periodontally sound. Contact on cantilevered pontics should be light in centric position and nonexistent in excursions. CFPDs ideally should be metal or metal-ceramic, and connectors, which are high-stress areas, require bulk for strength. A cantilevered prosthesis may require more consideration and planning than a conventional fixed partial denture, but when kept within the patient’s biological limitations and executed properly, can provide a restorative option with many advantages.

There are many clinical procedures where the dentist must either modify or control the gingival tissues to successfully complete a restorative procedure. Electrosurgery has been available as a soft tissue surgical device for many years and is still an excellent tool to deal with soft tissue issues in dentistry. Two of the more common procedures that electrosurgery is used for in clinical practice are for esthetic gingival recontouring and troughing around preparations to expose the margins prior to master impressions. This article will discuss both of these procedures in detail and outline certain parameters and techniques to ensure a good clinical result.

Ultrasonic instrumentation has become integral to the practice of dental hygiene during the last few decades. While the benefits of utilizing ultrasonic debridement procedures are numerous and well documented, today’s dental hygienist must be able to understand the differences between ultrasonic units and how various power scalers work in order to maximize clinical outcomes. It is the author’s desire to familiarize the dental practitioner with basic concepts, descriptive terminology, instrumentation strategies, and practical approaches to increase desired dental hygiene results. An historical perspective of how ultrasonics entered the field of dentistry and became a staple in dental hygiene therapy is included as a tribute for their tremendous impact and contributions to patient care.

The increasing use of all-ceramic and laboratory-processed indirect polymer restorations has brought postoperative sensitivity back to the forefront. Most monolithic all-ceramic and indirect polymer restorations are inserted with composite resin cements. With the increased use of resin cement systems, numerous reports of postoperative sensitivity have surfaced. The following article will discuss reducing postoperative sensitivity by sealing exposed dentinal tubules during indirect restorative procedures. Indications, variations of the technique, and the different materials used will also be discussed.

In recent years, there has been a trend away from the use of dental amalgam for the placement of posterior restorations to the use of adhesive composite resin. A major challenge when placing any Class II restoration is the establishment of an anatomically shaped and positioned proximal contact.1 For composite resins, this challenge is greater because of the handling characteristics and physical properties of composite resin. Development of an anatomically correct proximal contact is critical to success of a Class II composite resin restoration. This article discusses a technique for achieving predictable proximal contacts and illustrates the technique in a clinical case report.

Cavity liners have traditionally been used in direct and indirect restorations for purposes such as promoting reparative dentin and neutralizing acids.1 Today, liners are used when resin composites are used as the restorative materials on the posterior teeth, but for a different reason. Clinically, liners are considered to decrease sensitivity and wet the cavity better than restorative composites because of their flowability, adaptation to the dentinal surface, and adhesion. As bonding systems and composite materials continue to improve and become better understood, so do the techniques for placing composites. This has led to the reassessment of the clinical relevance and function of liners. Some clinicians don’t use cavity liners, assuming they are a thing of the past; some use composite liners, and others use resin-modified glass ionomer liners. Additionally, there is not a clear agreement over the function of liners, such as when and why they should be used or what type of liner material would provide the best performance for a particular clinical situation. This article attempts to clarify some of the confusion surrounding the use of liners by reviewing the available literature on the subject and attempting to give evidence-based rationale for the use and protocol for the clinician.

This article provides an analysis of pediatric systemic disease and the corresponding prescribed medications for selected physical and mental health conditions. The focus is on pediatric oral health, specifically the drugassociated side effect of gingival enlargement. A simple and logical analysis of current pediatric health trends reveals that gingival overgrowth is evident in societies worldwide as a serious epidemic. This article describes the morbidity and risks that are related to drug-associated gingival overgrowth, and proposes a framework of action for treating the side effects of chronic diseases and conditions in pediatric patients.