Restorative Dentistry

Worn down by toothwear? aetiology, diagnosis and management revisited

Toothwear can be defined as ‘the loss of tooth substance by means other than caries or dental trauma’. Tooth surface loss (TSL) is an alternative term used which can confuse dentists and patients, and...

Minimally invasive long-term management of direct restorations: the ‘5 rs’

A failing restoration can be described as one that has suffered biomechanical defect or damage resulting in immediate or subsequent detrimental clinical consequences to the patient. This may affect...

Rehabilitation of oncology patients with hard palate defects part 2: principles of obturator design

Defects have been successfully managed with obturators (Latin: ‘obturare’ meaning ‘to block up’) for many years. Ambroise Pare was probably the first individual to close a palatal defect artificially...

Rehabilitation of oncology patients with hard palate defects part 1: the surgical planning phase

The number of individuals undertaking surgical reconstructions has increased from 38% to 91% from 1995 to 2009,4 with the use of microvascular free flaps becoming more common. Surgically...

Fibre-reinforced composite (FRC) bridge – a minimally destructive approach

The conventional design for an anterior bridge will consist of an everStick C&B (GC) (or other) fibre bonded from the palatal side of the first retainer tooth bridging the space of the missing tooth...

An update on crown lengthening part 2: increasing clinical crown height to facilitate predictable restorations

The ‘biologic width’ concept was first described by Gargiulo et al in 1961, following a histological study in human autopsy specimens, examining the relationship between the various components...

Seventeen years of using flowable resin restoratives – a dental practitioner's personal clinical review

Flowable composites can be traced back to the pioneering product, Revolution, offered on the dental market in 1992 by SDS/Kerr. The name of that first flowable resin restorative was well timed since,...

The value of cone beam CT in assessing and managing a dilated odontome of a maxillary canine

A fit and healthy 14-year-old school boy was referred to King's Dental Institute by his general dental practitioner who had started root canal treatment on the UL3, but this was aborted as a result of...

An update on crown lengthening part 1: gingival tissue excess

The management of gingival tissue excess is dependent on the aetiology, and the type of intervention undertaken will be determined by the patient's presenting complaint, clinical presentation and...

Prosthetic rehabilitation of the gagging patient using acrylic training plates

Gagging is a normal protective mechanism which acts to maintain airway patency. It prevents foreign bodies from entering the trachea and can be evoked by stimulating numerous oral structures. In the...

Swallowed and inhaled dentures – what's the problem?

The case series study that focused exclusively on impacted dentures revealed that the incidence of swallowed dentures was greater in males (72.7%) than females (27.3%).2.

Hypodontia: aesthetics and function part 2: management

In order to provide patients with the most aesthetically pleasing and functional outcome, an interdisciplinary approach to management may be required. The role and aims of the team has been previously...

Precision attachments in partial removable prosthodontics: an update for the practitioner part 2

Careful treatment planning is essential. Errors at this early stage may result in failure of the case. A clinical examination to assess for caries, periodontal disease, peri-apical disease, tooth...

Hypodontia: aesthetics and functions part 1: aetiology and the problems

Absence of primary or permanent teeth can have a significant effect on facial aesthetics, which may have a negative psychological impact in some cases. A study of 451 patients reported that...