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.

Abstract In case of failure of initial root canal therapy, modern endodontics provides clinicians with different treatment options to save the natural tooth from extraction. This article reviews the reasons for conventional treatment failure and discusses guidelines and diagnostic criteria for conventional and surgical re-treatment. The decision-making process for choosing among conventional re-treatment, surgical microendodontics, or extraction of the tooth with subsequent placement of an endosseous implant is described, and indications are illustrated by case examples.

Recent years have seen a dramatic increase in the number of published articles on short-term complications of oral piercing, possibly reflecting an increase in the popularity of this practice. Long-term effects of oral piercing, however, have had minimal documentation. This case report of a 28-year-old woman with piercing of the tongue and lower lip demonstrated localized severe periodontitis as a destructive long-term outcome related to oral piercing. The patient reported that she had worn 2 tongue rings and a mandibular labrette (lip piercing) in the form of a bar for 12 years. Plaque and calculus accumulation, severe inflammation, tooth mobility, severe horizontal radiographic bone loss, and deep pocketing were observed in teeth affected by the jewelry.

The goal of this study was to evaluate head and neck posture in the rest position of patients with bruxism and patients without temporomandibular disorder signs or symptoms to further relate them with Angle's class of malocclusion. Fifty-six volunteers participated in this study, ages 18 to 27 years with an average age of 22.5 years. They were divided into 2 groups: Group B-28 subjects with parafunctions (teeth grinding or clenching); and Group C-28 subjects without parafunctional habits (control group). All participants were photographed, and their pictures were analyzed and compared with the software Alcimagem (Instrumental Concept and Movement Analysis Laboratory, Uberlândia, Minas Gerais, Brazil). The results demonstrated that variation of angular values did not present statistical difference for the studied groups. Regarding Angle's class of malocclusion, class I was predominant in Group C, and classes II and III were predominant in Group B. The mental-sternal angle calculated did not present statistical significance between the groups; however, there was a greater variation between the smaller angle and the higher angle in Group B, contrary to Group C.

In general dentistry, preventative and restorative care is usually the primary goal of a practice; however, prevention with protective mouthguards and treatment of orofacial trauma should also be a goal. Incorporating these into the practice would require a team effort involving the office staff, dental assistants, hygienists, and dentists. Dentistry has increasingly been recognized by various medical organizations such as the International Olympic Committee's Medical Commission and the International Ice Hockey Federation Medical Commission as an important component and partner in treating patients with orofacial injuries, which has increased the awareness and importance of sports dentistry. It is the role of a dental team to help educate patients, parents, coaches, trainers, and officials on the importance of having a dentist on the team for the prevention and treatment of orofacial injuries. One approach for the dental team is to establish a mouthguard program in their community to help the local teams. Athletic teams ideally should have a team dentist or at least have one available on-call to help with injured players.