Why Clinical Pathology Should Matter in Your Clinic

When patients notice something strange in their mouths, they will probably schedule an appointment with their general dentist. Even for potentially serious symptoms, most dental or health insurers require referrals before approving specialist visits. General dentists are and will always be the gatekeepers of patient access to oral health care—and that position carries with it a significant burden.

When Robert E. Marx decided to write a book on oral pathology for general dentists, the need was clear. “One of the obstacles preventing dentists from recognizing oral diseases in their patients is the de-emphasis of clinical pathology in many dental schools today. Pathology courses may not even require or use a textbook for more than ‘suggested supplemental reading.’ This de-emphasis creates dentists who are not trained on how to refer a patient to a specialist for treatment—or even which specialist is best for any particular finding.”

Sometimes the best education comes from hands-on experience. But when it comes to clinical pathology, the stakes can be high. Dr Marx describes some successes and failures of referring dentists.

Successful Diagnoses

A 5-year-old girl presented to a restorative dentist with a mass at the base of her tongue. The mass was difficult to see and required a thorough examination. A radioactive iodine scan confirmed the suspicion that the mass was a persistent lingual thyroid; further, it was the only thyroid the patient had. Had her doctors preemptively biopsied/excised the mass, the patient would have been sentenced to a permanent hypothyroid condition at a critical point in her growth and development.

Persistent lingual thyroid as the entire thyroid gland with no presence in the neck.

In another case, a pediatric dentist noted redness and puffiness of the gingiva on the lingual side of a first molar in an 11-year-old girl. During exploration of the lesion, the dentist provoked a small but pulsatile bleeding that required 5 minutes of pressure to stop. When Dr Marx and his team evaluated the lesion, angiograms identified a large arteriovenous hemangioma where, in his words, “the gingiva represented the crown of a volcano of a potential exsanguinating bleed.” The early identification allowed Dr Marx to embolize the lesion and remove it before it grew any larger; had the lesion gone unnoticed and untreated, the hemangioma could have ruptured and resulted in massive bleeding.

Angiogram of an arteriovenous hemangioma showing large vascular networks.

Young girl in hypovolemic shock from an arteriovenous hemangioma bleed.

 

Squamous cell carcinoma of the lateral border of the tongue.

Dental hygienists are also capable of making these critical finds. One hygienist noticed an area of redness and firmness while performing a dental prophylaxis on the left lateral border of the tongue in a 61-year-old woman. Both the hygienist and dentist were suspicious enough of the lesion to refer the patient to Dr Marx, despite the fact that two physicians had previously identified it as a hypertrophied lingual tonsil. When Dr Marx biopsied the lesion, the results identified a squamous cell carcinoma. With a depth of invasion of 9 mm, the cancer required excision of the lesion as well as selective neck dissection. Thanks in part to the vigilance of the dental hygienist, the now–79-year-old patient is alive and well and continues to enjoy normal speech and eating.

Missed Diagnoses

But if every story had a happy ending, we wouldn’t need to be concerned about the status quo. Sometimes the find doesn’t come soon enough—other times, it comes far, far too late.

In one particularly frustrating case, a 45-year-old restorative dentist on the faculty of a major dental school presented with persistent redness of the anterior maxillary gingiva and frenulum. Despite impeccable plaque control—remember, the patient herself was a dentist—and her request for a biopsy, this squamous cell carcinoma was ignored and local periodontal care and topical antibiotic therapy continued for 2 years. When she was finally referred to Dr Marx, his biopsy identified the cancer that had by then invaded bone. An anterior maxillectomy was required.

A pyogenic granuloma.

In a similar case, though one in which the patient did not have the advantage of a dental degree, a 42-year-old woman was diagnosed with a pregnancy tumor when a small, red, friable lesion emerged between her maxillary lateral and central incisors. After it was confirmed that the patient was in fact not pregnant, the working diagnosis was changed to a pyogenic granuloma. Over the course of treatment, the so-called pyogenic granuloma was removed twice but not sent for biopsy. By 20 months after her first presentation, the lesion had grown to the size of a tennis ball, and the patient had bilateral lymphadenopathy from squamous cell carcinoma. The required treatment included an anterior maxillectomy and bilateral neck dissections followed by chemotherapy and radiation therapy. The patient remains disease-free a decade later but has undergone five reconstructive surgeries so far.

A final case demonstrates the many levels of care at which patients are vulnerable to misdiagnosis. An 18-year-old girl with a hard mass at the left angle of the mandible was diagnosed by her primary care physician as having mumps, even though the mass was attached to the angle of the mandible, not the parotid gland, and the patient had no fever, malaise, or anything else that would suggest mumps. After 9 months, the physician referred her to a dentist with the complaint of “numb lip.” The numb lip was incorrectly attributed to impacted third molars, and another 6 months transpired before a referral was made to an oral and maxillofacial surgeon. The surgeon recognized the irregular bony mass as a probable osteosarcoma, which Dr Marx’s biopsy later confirmed. Despite surgery and chemotherapy, the patient died from diffuse metastasis shortly before her 21st birthday.

Osteosarcoma of the mandible as seen on a panoramic radiograph.

How to Move Forward

No one can go back in time and change a mistake that was made. What we can do is arm ourselves with the knowledge and tools necessary to do better the next time around. Dr Marx had the stories above in mind when he wrote his book Oral Pathology in Clinical Dental Practice. His goal in writing this book was not to produce a 700-page textbook for oral pathologists on every possible finding, with detailed protocols for their management. Instead, his intent was to put potentially life-saving information into a format that would be accessible for the dental hygienist performing a routine cleaning who is in an ideal position to track changes in a patient’s oral health over time; for the general dentist whose gut instinct may be saying that a patient’s lesion doesn’t quite fit the textbook definition for a common condition and warrants a second opinion for ease of mind; and for the specialist who receives a referral for a prosthodontic rehabilitation that has already been cleared by the general dentist, but notices a potential issue that had not been previously managed and is now responsible for addressing it. This book empowers dental professionals across the spectrum of disciplines by giving them the information they need to recognize when something is wrong and to know what to do next.

“Dentists and their dental hygiene team historically have been the great identifiers of oral diseases,” Dr Marx emphasizes. “This book is dedicated to those practitioners who have picked up on diseases and conditions early, thus saving their patients from disease progression, deformity, and at times, even death. But it is also dedicated to those dentists who may have missed the early signs or obvious diseases while focusing exclusively on the dentition. It is hoped that this book will provide examples and guidance as well as the encouragement to be a diagnostician before being a treatment provider.”

Dr Marx’s aim is for his book to help each dentist, dental hygienist, and specialist become a more complete oral health care professional and, in doing so, maybe save a life or two.


Robert E. Marx, DDS, is Professor of Surgery and Chief of the Division of Oral and Maxillofacial Surgery at the University of Miami Miller School of Medicine. He is a well-known educator, researcher, and innovative surgeon who has pioneered new concepts and treatments for pathologies of the oral and maxillofacial area as well as new techniques in reconstructive surgery. The first edition of his textbook Oral and Maxillofacial Pathology: A Rationale for Diagnosis and Treatment (Quintessence, 2012) won the American Medical Writers Associations Prestigious Book of the Year award, and two of his other textbooks, Oral and Intravenous Bisphosphonate–Induced Osteonecrosis of the Jaws: History, Etiology, Prevention, and Treatment, Second Edition (Quintessence, 2011) and Atlas of Oral and Extraoral Bone Harvesting (Quintessence, 2009), have both been bestsellers. His many prestigious awards, including the Harry S. Archer Award, the William J. Giles Award, the Paul Bert Award, the Donald B. Osbon Award, and the Daniel Laskin Award, attest to his dedication and commitment to the field of oral and maxillofacial surgery.

 

Oral Pathology in Clinical Dental Practice

Robert E. Marx

While most dentists do not perform their own histologic testing, all dentists must be able to recognize conditions that may require biopsy or further treatment outside the dentist office. This book does not pretend to be an exhaustive resource on oral pathology; instead, it seeks to provide the practicing clinician with enough information to help identify or at least narrow down the differential for every common lesion or oral manifestation of disease seen in daily practice as well as what to do about them. Organized by type of lesion, mass, or disease, each pathologic entity presented includes the nature of the disease; its predilections, clinical features, radiographic presentation, differential diagnosis, and microscopic features; and the suggested course of action for the dental practitioner as well as the standard treatment regimen. In keeping with the concise nature of the text, all but the rarest disease entities include at least one photograph to illustrate the clinical condition. This book distills the comprehensive information from Dr Marx and Dr Diane Stern’s award-winning pathology reference text (Oral and Maxillofacial Pathology: A Rationale for Diagnosis and Treatment, Second Edition [Quintessence, 2012]) into practical guidelines for restorative and general dentists everywhere.

376 pp; 425 illus; ©2017; ISBN 978-0-86715-764-2 (B7642); US $98

Posted in Books, Feature, Misc, Multidisciplinary, Oral and Maxillofacial Surgery | Tagged , , , | Leave a comment

Quintessence Roundup: September

Quintessence 2017 Catalog

Monthly Special


Oral and Intravenous Bisphosphonate–Induced Osteonecrosis of the Jaws: History, Etiology, Prevention, and Treatment, Second Edition

Robert E. Marx

While many clinicians currently recognize that bisphosphonate usage is associated with ONJ, this book establishes the causal relationship between the two. It presents definitive treatment protocols for patients who present at each stage in the progression of ONJ as well as a simplified staging system and information about the serum CTX test for oral bisphosphonate cases. The book offers a simple method for predicting risk as well as crucial recommendations for preventing the disease from developing when bisphosphonate therapy is indicated. Comprehensive case histories provide direct guidance in managing patients spanning the full presentation spectrum.

160 pp (softcover); 211 illus; ©2011; ISBN 978-0-86715-510-5 (B5105); Special price! $9

 

New Titles in Books


Oral Pathology in Clinical Dental Practice

Robert E. Marx

While most dentists do not perform their own histologic testing, all dentists must be able to recognize conditions that may require biopsy or further treatment outside the dentist office. This book does not pretend to be an exhaustive resource on oral pathology; instead, it seeks to provide the practicing clinician with enough information to help identify or at least narrow down the differential for every common lesion or oral manifestation of disease seen in daily practice as well as what to do about them. Organized by type of lesion, mass, or disease, each pathologic entity presented includes the nature of the disease; its predilections, clinical features, radiographic presentation, differential diagnosis, and microscopic features; and the suggested course of action for the dental practitioner as well as the standard treatment regimen. In keeping with the concise nature of the text, all but the rarest disease entities include at least one photograph to illustrate the clinical condition. This book distills the comprehensive information from Dr Marx and Dr Diane Stern’s award-winning pathology reference text (Oral and Maxillofacial Pathology: A Rationale for Diagnosis and Treatment, ed 2 [Quintessence, 2012]) into practical guidelines for restorative and general dentists everywhere.

376 pp; 425 illus; ISBN 978-0-86715-764-2 (B7642); Now available! $98

 

Anesthesia Considerations for the Oral and Maxillofacial Surgeon

Edited by Matthew Mizukawa, Samuel J. McKenna, and Luis G. Vega

Although office-based anesthesia administration has been essential in the evolution of outpatient surgery, it is becoming more complex as people live longer and with more comorbid diseases. The purpose of this book is to strengthen the margin of safety of office-based anesthesia administration by helping practitioners determine whether the patients they treat are good candidates for office-based anesthesia. This book is organized into three sections. The first section provides a review of the principles of anesthesia, including the pharmacology of anesthetic agents, local anesthesia, patient monitoring, preoperative evaluation, the airway, and management of emergencies and complications. The major organ systems of the body are reviewed in section two, and the most common comorbid conditions that affect these systems are described in terms of their pathophysiology, diagnosis, management, and anesthesia-related considerations. Section three reviews patient groups that warrant special consideration in the administration of office-based anesthesia, such as geriatric, pediatric, pregnant, and obese patients. Spiral-bound and featuring tabs for quick and easy reference, this important book belongs on the shelf of every clinician who provides anesthesia in the office setting.

482 pp; 101 illus; ISBN 978-0- 86715-713- 0 (B7130); Now available! $168

 

The Bicon Short Implant: A Thirty-Year Perspective

Edited by Vincent Morgan

This book is a succinct and accessible compilation of over 30 years of knowledge concerning the Bicon system. It offers not only a history of dental implants and the science of osseointegration but also a vast collection of clinical examples that demonstrate Bicon’s capabilities. Bicon implants provide versatile, reliable treatment for a wide variety of clinical situations; they can successfully be placed in atrophic jaws, in sites that would require extensive bone grafting with longer implants, in tissue that has been compromised by medical conditions, and even in adolescent jaws that are still developing. With its proven track record of success, the Bicon system provides treatment opportunities for the benefit of clinicians, technicians, and patients by offering simple, predictable, and effective techniques. With everything from historical and theoretical origins to detailed step-by-step surgical and restorative guides, this book is a must-read for anyone interested in implantology.

336 pp; 1,800 illus; ISBN 978-0-86715-728-4 (B7284); Now available! US $192

Why the Owner of a Small Dental Practice Decided to Buy His Favorite Implant Line

 

New Issues in Journals


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Featured article: Prognosis of Dental Implants Immediately Placed in Sockets Affected by Peri-implantitis: A Retrospective Pilot Study
Eduardo Anitua, Laura Piņas, DDS, MPhil/Leire Begoņa, MSc/Mohammad Hamdan Alkhraisat

Principles for Vertical Ridge Augmentation in the Atrophic Posterior Mandible: A Technical Review
István A. Urbán, Alberto Monje, Jaime Lozada, and Hom-Lay Wang

Ten-Year Nonsurgical Periodontal Treatment Protocol with Adjunctive Use of Diode Laser Monitoring Clinical Outcomes in ≥ 6 mm Pockets: A Retrospective Controlled Case Series
Marisa Roncati, Annalisa Gariffo, Cinzia Barbieri, and Paolo Vescovi

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Comparison of Fixed Dental Prostheses with Zirconia and Metal Frameworks: Five-Year Results of a Randomized Controlled Clinical Trial
Irena Sailer, Marc Balmer, Jürg Hüsler, Christoph Hans Franz Hämmerle, Sarah Känel, and Daniel Stefan Thoma

Post-and-Core Restoration of Severely Damaged Permanent Posterior Teeth in Young Adolescents
Nili Tickotsky, Roy Petel, Yael Haim, Maysa Ghrayeb, and Moti Moskovitz

Additive Manufacturing Techniques in Prosthodontics: Where Do We Currently Stand? A Critical Review
Nawal Alharbi, Daniel Wismeijer, and Reham B. Osman

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Clinical Performance of Dental Implants with a Moderately Rough (TiUnite) Surface: A Meta-Analysis of Prospective Clinical Studies
Matthias Karl and Tomas Albrektsson

Thematic Abstract Review: Implantoplasty: A Valuable Method for the Management of Peri-implantitis?
Jan-Eirik Ellingsen

Local Application of Growth Hormone to Enhance Osseointegration in Osteoporotic Bones: A Morphometric and Densitometric Study
Elena Martin-Monge, Isabel F. Tresguerres, Celia Clemente, and Jesús A. F. Tresguerres

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Psychosocial Profiles of Temporomandibular Disorder Pain Patients: Proposal of a New Approach to Present Complex Data
Simple Futarmal Kothari, Lene Baad-Hansen, and Peter Svensson

Psychosocial and Behavioral Aspects of Pain and Perception of Oral Health
Miriane Lucindo Zucoloto, João Maroco, and Juliana Alvares Duarte Bonini Campos

Prevalence, Course, and Associated Factors of Pain in the Temporomandibular Joint in Early Rheumatoid Arthritis: Results of a Longitudinal Cohort Study
Jessica P.S. Chin Jen Sem, Marike van der Leeden, Corine M. Visscher, Karin Britsemmer, Samina A. Turk, Joost Dekker, Dirkjan van Schaardenburg, and Frank Lobbezoo

Dental Meetings Quintessence Will Attend in September


17th Biennial Meeting of the ICP
hosted by the International College of Prosthodontists, September 7–9 in Santiago, Chile

Congreso Internacional: Rockin’ Dentistry 3
hosted by the Colegio Mexicano de Prostodoncia de Nuevo León A. C., September 8–9 in Monterrey, Mexico

AAP 103rd Annual Meeting: Booth #311
hosted by the American Academy of Periodontology, September 9–12 in Boston, Massachusetts

Oral Design International Symposium
hosted by the Oral Design International Foundation, September 13–15 in Los Angeles, California

Spear Annual Summit
hosted by Spear Education, September 14–16 in Scottsdale, Arizona

UMKC Dental Implant Symposium
hosted by the University of Missouri-Kansas City School of Dentistry, September 22–23 in Kansas City, Missouri

 

Posted in Books, Dental Technology, Esthetic Dentistry, Implant Dentistry, Journal of Oral & Facial Pain and Headache, Misc, Multidisciplinary, Oral and Maxillofacial Surgery, Periodontics, Prosthodontics, Research, Restorative Dentistry, Roundup, Special Offer, The International Journal of Oral & Maxillofacial Implants, The International Journal of Periodontics & Restorative Dentistry, The International Journal of Prosthodontics, What's New | Tagged , , , , , , , , , , , , , , , | Leave a comment

Why the Owner of a Small Dental Practice Decided to Buy His Favorite Implant Line

Contributed by Dr Vincent Morgan, Jeffrey Lehrberg, and Kristina Pisarik of Bicon Dental Implants

We all have our favorite brands and products that we rely on; however, how many of us believe so strongly in a product that we are willing to dedicate our lives to it? This is the Bicon story.

The Shortest Implant with the Longest History

Dr Morgan’s implant journey began shortly after graduating from dental school in 1970 when he treated a young Irish girl who refused his treatment plan to fabricate two fixed bridges. She held out the hope that one day a dentist would be able to insert two prosthetic posts for her congenitally missing maxillary lateral incisors, but he advised her to abandon this wishful thinking and prepare for bridges instead.

Several weeks after his conversation with the young patient, the dentist with whom Dr Morgan shared his practice lost the last of his posterior maxillary teeth. If he had been a patient rather than a colleague, they would have extracted his remaining anterior teeth and fabricated a denture. However, since he was more than a patient, they decided to purchase two newly marketed Miter titanium blade implants. With no training of any sort and only common sense and logic as their guides, they successfully inserted the two blade implants into his posterior maxilla. Beginner’s luck being what it is, these blade implants remained functional some 20 years later.

Those two successful implants inspired Dr Morgan to become more involved with implant dentistry. His first experience with an implant designed by Thomas Driskell was in the mid-1970s with the Synthodont (Miter) implant. Dr Morgan would encounter another of Dr Driskell’s implants in 1992, and that implant would become the antecedent of all modern Bicon implants.

Thomas Driskell’s Discovery

Mr Driskell’s first PRF implant.

One of Mr Driskell’s early smooth implant designs with a very literal reproduction of the roots of a human molar.

In 1968, the conflict in Vietnam was beginning to escalate. As a result, Thomas Driskell and his team at the Battelle Memorial Institute in Columbus, Ohio, were tasked by the United States Army to develop a rapid and effective solution for replacing missing teeth in a combat or field situation. Driskell’s initial implant designs were smooth and closely mimicked the structure of mammalian teeth, but since they were not consistently successful, he began testing a variety of designs. He discovered that a bifurcated and grooved or finned design resulted in greater bone-to-implant contact than other designs—including screw-root form (SRF) implants. The finned design, referred to as plateau-root form (PRF), permitted occlusal loads to be transferred onto the bone that infiltrated the space between grooves.

After Battelle, Mr Driskell took his PRF implant design to Miter, where it became the Synthodont implant that Dr Morgan would later use. Mr Driskell revised his design further and created a submergible titanium implant with a removable abutment, the Titanodont (Miter). Subsequently, he formed a company called DB Bioengineering and received premarket notification for the DB Precision Fin Implant System in 1985. This implant had a PRF design, locking-taper implant-abutment interface, sloping shoulder, and—most importantly—no screws. Two years after its entry to the market, DB Bioengineering was sold to Stryker Corporation, and the implant was renamed the Stryker Precision Fin Implant.

The Synthodont, a freestanding, nonsubmergible implant made from high-density alumina.

The Titanodont, a submergible titanium implant with a removable abutment.

The DB Precision Fin implant, which later became the Stryker Precision Fin implant.

The Beginning and Future of Bicon

By 1992, Dr Morgan and his colleagues had placed over 2,500 SRF implants and had become frustrated with their inherent shortcomings. When they were introduced to the Stryker implant, it was a perfect fit. At last, they found what they were looking for—a design characterized by logic and simplicity. They soon became the most experienced clinicians using the Stryker implant; however, even they could not have predicted that 2 years later, in 1994, they would become the owners of the implant.

It all started when Dr Morgan attended a dinner meeting with Stryker’s product manager and discovered that he appeared to lack enthusiasm for the implant. At the advice of a patient who had been the CEO of a publicly traded company, Dr Morgan got into contact with Ron Ellenbass, one of Stryker’s presidents. Mr Ellenbass listened to his concerns and later complimented Dr Morgan for recognizing that the product manager was no longer enthusiastic about their implant. In fact, Stryker had decided to sell their implant line. He knew that whoever purchased it would have to work with Dr Morgan because he was their most knowledgeable user. After asking Mr Ellenbass to consider his patients while he would be cashing in his stock options, they politely ended their conversation. Subsequently, Mr Ellenbass called again and encouraged Dr Morgan to purchase the implant. As improbable as it seemed at the time, he did.

Fortunately, Dr Morgan had an attorney friend who provided the startup capital to purchase the implant. “We were dentists, not businessmen,” Dr Morgan explains. “But we knew firsthand the unmatched clinical capabilities and merits of Thomas Driskell’s implant. We knew the implant itself would make up for and overcome our inexperience and shortcomings, and it turns out that we were correct. We started as dabblers in implantology in a small dental practice; we are now an international medical device company in 90 countries.”

A selection of Bicon SHORT implants.

Despite the industry’s preference for screw-retained implants, Bicon continues to thrive with their PRF implants. A professor in Zurich recently greeted Dr Morgan by saying, “I know Bicon is a viable organization, for dead fish cannot swim against the stream. You have been going against the collective beliefs of the profession for decades, and now they are copying your ideas.”

When asked whether we are approaching the ceiling for innovation in implant dentistry, Dr Morgan has this to say: “History tends to mock those who make definitive statements regarding technology or innovation—there is always room for improvement and further innovation. That being said, the Bicon implant is the culmination of almost half a century of innovation and ingenuity. The Bicon implant is currently at a pinnacle; however, we have plans for it to be even better.”

One example of further innovation at Bicon is the implementation of milled telescopic copings used with TRINIA, a metal-free, fiber-reinforced resin material that is lightweight, flexible, durable, and readily modified. The combination of the TRINIA material with the retentiveness of the copings is providing revolutionary clinical treatments for both dentists and laboratory technicians and, most importantly, a stronger, more manageable denture for patients.

As for the future of Bicon and its implants, Dr Morgan says they will continue looking and moving in the best direction they know: forward.


Vincent J. Morgan, DMD, graduated from the Tufts University School of Dental Medicine in 1970. In 1994, he was part of a group that purchased the Bicon Implant System from Stryker Implants. He currently serves as president of Bicon, LLC and as honorary professor at Tver State Medical University in Tver, Russia. He also leads the prosthetic team at the Implant Dentistry Centre located at the Bicon headquarters in Boston, Massachusetts, where he is responsible in part for the development of many of the restorative techniques of the Bicon Dental Implant System.

 

The Bicon Short Implant: A Thirty-Year Perspective

Edited by Vincent Morgan

This book is a succinct and accessible compilation of over 30 years of knowledge concerning the Bicon system. It offers not only a history of dental implants and the science of osseointegration but also a vast collection of clinical examples that demonstrate Bicon’s capabilities. Bicon implants provide versatile, reliable treatment for a wide variety of clinical situations; they can successfully be placed in atrophic jaws, in sites that would require extensive bone grafting with longer implants, in tissue that has been compromised by medical conditions, and even in adolescent jaws that are still developing. With its proven track record of success, the Bicon system provides treatment opportunities for the benefit of clinicians, technicians, and patients by offering simple, predictable, and effective techniques. With everything from historical and theoretical origins to detailed step-by-step surgical and restorative guides, this book is a must-read for anyone interested in implantology.

336 pp; 1,800 illus; ©2017; ISBN 978-0-86715-728-4 (B7284); US $192

Posted in Books, Feature, Implant Dentistry, Prosthodontics, Restorative Dentistry | Tagged , , | Leave a comment

Hurricane Harvey Devastates Southeast Texas: How You Can Help

Rainfall from Hurricane Harvey as of Friday morning, August 25. (Source: the Houston Press.)

The Quintessence staff would like to extend our thoughts to all those affected by Hurricane Harvey.

Hurricane Harvey made landfall in southeast Texas as a Category 4 Hurricane in the early hours of the morning on Friday, August 25. Communities have been devastated by damage from high winds and flooding, and thousands of people have been displaced. Residents who evacuated may not be able to return until floodwaters have receded. Several people have lost their lives due to the storm, and many more are missing.

If you would like to help, donations can be made in many ways. The American Red Cross has mobilized disaster relief efforts in the area and accepts monetary donations online. Just select “Hurricane Harvey” in the drop-down menu under “I Want to Support.” If you are physically in the area, the South Texas Blood & Tissue Center is in dire need of blood donations. Visit their website for information on how and where you can donate. The Texas Diaper Bank is also collecting money and diapers to provide emergency diaper kits for families who have been displaced.

Our hearts go out to the members of the Quintessence family, both authors and readers, who have been affected by this disaster.

Posted in Misc | Leave a comment

Quintessence Roundup: August

Quintessence 2017 Catalog

Monthly Special


Seltzer and Bender’s Dental Pulp, Second Edition

Edited by Kenneth M. Hargreaves, Harold E. Goodis, and Franklin R. Tay

This comprehensive update of a classic text presents the latest research on the dental pulp and its interaction with other tissues, highlighting its central role in both local and systemic health. The second edition has been completely revised to incorporate new chapters featuring the most topical issues in research and clinical practice, including developments in stem cell research and pulpodentin regeneration, the effects of the aging process on the pulp, and the interdependent relationship of the pulp and restorative dental procedures. New contributors bring fresh perspective to topics such as pulpal infections, odontalgia, and the relationship between the pulp and periodontal disease. Each chapter provides an introduction to its major themes for the busy clinician or dental student as well as up-to-date, biologically based clinical recommendations for restorative and endodontic procedures. Practicing clinicians will find this information to be essential to providing accurate diagnoses and effective treatment.

512 pp; 707 illus; ©2012; ISBN 978-0-86715-480-1 (B4801); Special price! $75

New Titles in Books


Oral Pathology in Clinical Dental Practice

Robert E. Marx

While most dentists do not perform their own histologic testing, all dentists must be able to recognize conditions that may require biopsy or further treatment outside the dentist office. This book does not pretend to be an exhaustive resource on oral pathology; instead, it seeks to provide the practicing clinician with enough information to help identify or at least narrow down the differential for every common lesion or oral manifestation of disease seen in daily practice as well as what to do about them. Organized by type of lesion, mass, or disease, each pathologic entity presented includes the nature of the disease; its predilections, clinical features, radiographic presentation, differential diagnosis, and microscopic features; and the suggested course of action for the dental practitioner as well as the standard treatment regimen. In keeping with the concise nature of the text, all but the rarest disease entities include at least one photograph to illustrate the clinical condition. This book distills the comprehensive information from Dr Marx and Dr Diane Stern’s award-winning pathology reference text (Oral and Maxillofacial Pathology: A Rationale for Diagnosis and Treatment, ed 2 [Quintessence, 2012]) into practical guidelines for restorative and general dentists everywhere.

376 pp; 425 illus; ISBN 978-0-86715-764-2 (B7642); Special preorder price! $78

 

Anesthesia Considerations for the Oral and Maxillofacial Surgeon

Edited by Matthew Mizukawa, Samuel J. McKenna, and Luis G. Vega

Although office-based anesthesia administration has been essential in the evolution of outpatient surgery, it is becoming more complex as people live longer and with more comorbid diseases. The purpose of this book is to strengthen the margin of safety of office-based anesthesia administration by helping practitioners determine whether the patients they treat are good candidates for office-based anesthesia. This book is organized into three sections. The first section provides a review of the principles of anesthesia, including the pharmacology of anesthetic agents, local anesthesia, patient monitoring, preoperative evaluation, the airway, and management of emergencies and complications. The major organ systems of the body are reviewed in section two, and the most common comorbid conditions that affect these systems are described in terms of their pathophysiology, diagnosis, management, and anesthesia-related considerations. Section three reviews patient groups that warrant special consideration in the administration of office-based anesthesia, such as geriatric, pediatric, pregnant, and obese patients. Spiral-bound and featuring tabs for quick and easy reference, this important book belongs on the shelf of every clinician who provides anesthesia in the office setting.

482 pp; 101 illus; ISBN 978-0- 86715-713- 0 (B7130); Special preorder price! $134

 

Color in Dentistry:
A Clinical Guide to Predictable Esthetics

Stephen J. Chu, Rade D. Paravina, Irena Sailer, and Adam J. Mieleszko

Predictable shade matching in dentistry remains a significant challenge for clinicians in daily practice. Color is an important aspect in the esthetics of teeth and dental restoration fabrication, and color discrepancy can mar restorative results, even when other aspects (marginal fit, occlusion, and morphology) are adequate. This book provides step-by-step protocols to help dental professionals accurately match, communicate, and reproduce the color of teeth and gingiva. These authors demonstrate how to implement color science in simple problem-solving instructions for predictable esthetics in both clinical protocols and laboratory techniques. An extensive presentation of clinical cases is included to illustrate the use of recommended protocols in general practice. An outstanding contribution to the practice and theory of color management in contemporary dentistry.

256 pp; 890 illus; ISBN 978-0-86715-745-1 (B7451); Now available! US $108

Current Challenges in Color

 

The Bicon Short Implant: A Thirty-Year Perspective

Edited by Vincent Morgan

This book is a succinct and accessible compilation of over 30 years of knowledge concerning the Bicon system. It offers not only a history of dental implants and the science of osseointegration but also a vast collection of clinical examples that demonstrate Bicon’s capabilities. Bicon implants provide versatile, reliable treatment for a wide variety of clinical situations; they can successfully be placed in atrophic jaws, in sites that would require extensive bone grafting with longer implants, in tissue that has been compromised by medical conditions, and even in adolescent jaws that are still developing. With its proven track record of success, the Bicon system provides treatment opportunities for the benefit of clinicians, technicians, and patients by offering simple, predictable, and effective techniques. With everything from historical and theoretical origins to detailed step-by-step surgical and restorative guides, this book is a must-read for anyone interested in implantology.

336 pp; 1,800 illus; ISBN 978-0-86715-728-4 (B7284); Now available! US $192

 

ITI Treatment Guide Series
Volume 10: Implant Therapy in the Esthetic Zone: Current Treatment Modalities and Materials for Single-Tooth Replacements

Edited by Vivianne Chappuis and William Martin

This latest volume in the ITI Treatment Guide series starts out with the most recent statements and recommendations from the 5th ITI Consensus Conference, followed by a detailed protocol for the evaluation and treatment planning of patients with esthetic demands requiring single-tooth replacement with a dental implant. Various surgical situations commonly encountered in the esthetic zone are presented along with recommended treatment protocols. In addition, the many aspects of clinical management of the planned implant site (before and after placement) are discussed including the use of provisional prostheses, laboratory communication, abutment design, restorative material selection, and delivery of the definitive restoration. Fourteen complex case presentations form the core of this volume with step-by-step descriptions of procedures for achieving stable long-term esthetic outcomes. This volume provides a comprehensive, evidence-based approach to single-tooth replacement in the esthetic zone, from consultation to follow-up, with a focus on current treatment modalities and the materials that present-day implant dentistry has to offer in order to support clinicians in their decision-making processes.

444 pp; 1,386 illus; ISBN 978-3-86867-343-2 (B9097); US $98

 

Stability, Retention, and Relapse in Orthodontics

Christos Katsaros and Theodore Eliades

This book offers a thorough analysis of the retention and stability of orthodontic treatment results and outlines the keys to effective intervention. Tendencies for stability and relapse of orthodontic treatment are covered for incisor irregularity and Class I, Class II, transverse, and vertical problems, as well as orthognathic surgery outcomes. In addition to cautioning against tooth and jaw movements that have been associated with an increased risk of relapse, the authors discuss the use of fixed and removable retention appliances and outline treatment principles to minimize relapse and the development of potential unwanted effects at the retention stage. The end result is an understanding of how to develop targeted retention plans for individual patients and how to treatment plan long-term stability with strategic insight.

226 pp; 403 illus; ISBN 978-1-78698-019-9 (B9100); US $128

New Issues in Journals


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Featured article: Interpositional Augmentation Technique in the Treatment of Posterior Mandibular Atrophies: A Retrospective Study Comparing 129 Autogenous and Heterologous Bone Blocks with 2 to 7 Years Follow-Up
Pietro Felice, Carlo Barausse, Antonio Barone, Giovanni Zucchelli, Maurizio Piattelli, Roberto Pistilli, Daniela Rita Ippolito, and Massimo Simion

Human Histologic Evidence of Reosseointegration Around an Implant Affected with Peri-implantitis Following Decontamination with Sterile Saline and Antiseptics: A Case History Report
Paul Fletcher, Daniel Deluiz, Eduardo M.B. Tinoco, John L. Ricci, Dennis P. Tarnow, and Justine Monnerat Tinoco

Combining Esthetic Layering and Lithium Disilicate Sintering Technique on Zirconia Frameworks: A Veneering Option to Prevent Ceramic Chipping
Reza Saeidi Pour, Daniel Edelhoff, Caroline Freitas Rafael, Otto Prandtner, Stefan Frei, Claudia Angela Maziero Volpato, and Anja Liebermann

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Economic Evaluation of Implant-Supported Overdentures in Edentulous Patients: A Systematic Review
Qi Zhang, Xin Jin, Mengliu Yu, Guoming Ou, Hiroyuki Matsui, and Xing Liang

Preliminary Clinical Application of Removable Partial Denture Frameworks Fabricated Using Computer-Aided Design and Rapid Prototyping Techniques
Hongqiang Ye, Jing Ning, Man Li, Li Niu, Jian Yang, Yuchun Sun, and Yongsheng Zhou

Reliability of a CAD/CAM Surgical Guide for Implant Placement: An In Vitro Comparison of Surgeons’ Experience Levels and Implant Sites
Su-Jung Park, Richard Leesungbok, Taixing Cui, Suk Won Lee, and Su-Jin Ahn

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Clinical Performance of Dental Implants with a Moderately Rough (TiUnite) Surface: A Meta-Analysis of Prospective Clinical Studies
Matthias Karl and Tomas Albrektsson

Thematic Abstract Review: Implantoplasty: A Valuable Method for the Management of Peri-implantitis?
Jan-Eirik Ellingsen

Local Application of Growth Hormone to Enhance Osseointegration in Osteoporotic Bones: A Morphometric and Densitometric Study
Elena Martin-Monge, Isabel F. Tresguerres, Celia Clemente, and Jesús A. F. Tresguerres

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What Can Epigenetics Tell Us About Periodontitis?
Pamela Leong, Yuk Jing Loke, and Jeffrey M. Craig

Does Use of Alcohol-Containing Mouthrinse Increase Risk for Oral Cancer?
Ann Eshenaur Spolarich

Gingival Trauma: Tooth Brushing and Oral Piercings
Nienke L. Hennequin-Hoenderdos, Fridus A. van der Weijden, and Dagmar E. Slot

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A Retrospective Study on Possible Predictive Factors for Long-term Temporomandibular Joint Degeneration and Impaired Mobility in Juvenile Arthritis Patients
Stanimira I. Kalaykova, Adriaan T. Klitsie, Corine M. Visscher, Machiel Naeije, and Frank Lobbezoo

Prevalence of Temporomandibular Disorders in the Northern Finland Birth Cohort 1966
Päivi Jussila, Heikki Kiviahde, Ritva Näpänkangas, Jari Päkkilä, Paula Pesonen, Kirsi Sipilä, Pertti Pirttiniemi, and Aune Raustia

A Rare Case of Misdiagnosed Silent Lung Cancer with Solitary Metastasis to the Temporomandibular Joint Condyle
Luca Guarda-Nardini, Edoardo Stellini, Adolfo Di Fiore, and Daniele Manfredini

Dental Meetings Quintessence Will Attend in August


ICOI World Congress: Booth #109
hosted by the International Congress of Oral Implantologists, August 17–19 in Vancouver, Canada

Seminario XXII: Booth #E3
hosted by Ivoclar Vivadent México, August 18–18 in Mexico City, Mexico

CDA Presents the Art and Science of Dentistry: Booth #612
hosted by the California Dental Association, August 24–26 in San Francisco, CA

Posted in Books, Dental Technology, Endodontics, Esthetic Dentistry, Implant Dentistry, International Journal of Evidence-Based Practice for the Dental Hygienist, Journal of Oral & Facial Pain and Headache, Journals, Multidisciplinary, Oral and Maxillofacial Surgery, Orthodontics, Pediatric Dentistry, Periodontics, Promotions, Prosthodontics, Research, Restorative Dentistry, Roundup, Special Offer, The International Journal of Oral & Maxillofacial Implants, The International Journal of Periodontics & Restorative Dentistry, The International Journal of Prosthodontics, What's New | Tagged , , , , , , , , , , , , , , , , , , , , , | Leave a comment