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Zirconia – The Truth



Open Discussion Forum / Q&A


Thursday 13 May, 2010


at the CAD/CAM & Computerized Dentistry Int’l Conference 13-14 May 2010, Dubai UAE


Researchers, Clinicians, Manufacturers will answer all your questions.

Post your questions here or visit:

http://www.cappmea.com/cadcam4/pages/zirconia.htm


The aim of this Open forum is to evaluate the effect of different surface treatment methods and in particular the effect of
the quality of “fake” CAD/CAM zirconia blocks on the market, the flexure strength
of zirconia frameworks, proper preparation and proper bonding.




Delegates will interact with the panel participant (all on stage) and post their questions and comments. They will have the answers from
the researchers’, clinical and industry point of view.


AGENDA:


1. Truth of the product? 10 min – research presentation.


2. Truth of the preparation? 10 min – clinical presentation.


3. Truth of the result? 10 min – manufacturer presentation.



Q/A interactive session following the above topics with equally active
participation.



PANEL PARTICIPANTS: Dr. Nadim Aboujaoude, Lebanon; Dr. Andreas Kurbad, Germany; Dr. Peter
Gehrke
, Germany; Dr. Atef Shaker,
Egypt; Ralph
Riquier, Germany; Dr. Ilan Preiss, UK


MODERATOR: Dr. Munir Silwadi


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As a Dental professional you need to be certain of the specific exclusions on your Professional Liability policy.Botox and Dermal Fillers are a "hot topic" amoungst Dentists and Insurance companies over the past few years. Some insurance companies have adapted to allow a minimal amount of procedures however, even more companies have opted to exclude any type procedures outside of the tyical scope of dentistry.All policies are not the same, be sure you know what your coverage offers!
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How Dental Care Will Be Changed by Healthcare Reform - Dental Health Magazine.pdf

This is of course particularly of importance now. It seems to be good news! What's your view???

The new healthcare reform bill will "appreciate" dental education toward the public and one of the main focus' being on children. This is such a proactive measure. Children need good hygiene habits early on and can carry it through generations thereafter. Educating the public is also key and should be rewarded. Reaching out to the public should always be a high priority.

Of course the flip side is that their are insurance capping issues that has some worried. Like many other congressional bills, there is still much to work out. Either way the bill would "change dentistry forever".

I am happy to say that the time I do spend in the dental office since cutting back, is spent speaking to school classes and even pre-schoolers! I enjoy it and it feels good to be hands on and stepping into the educational side of dentistry. In turn, if the children have a good experience outside of the dental office , they will be more inclined to go home and tell their parents...thus perhaps reminding the adult that dental care is crucial.
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Medical Billing In Dentistry

When treating patients with medical issues we can begin the process of medical billing. This increases your referrals with MD's, the referrals that keep on giving. Patients who understand the difference on treatment and the need for collaboration with their MD"S will also be great referrals. Understanding that you are different working with their medical insurance will increase the accepted treatment in your office.. Practices that are including testing for diabetics,working with sleep labs, OBGYN doctors will increase production and collection for the upcoming months.

I am so impressed with the focus on medical inclusion with Web Dental.

Thanks,
Christine Taxin
ctaxin@links2success.biz
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Obesity and Periodontal Disease

Obesity and Periodontal Disease.pdf

This is of interest in todays society. More people are overweight and unhealthy than ever, hence my wellness business as a branch of dentistry I suppose ! This article states a study providing this point. You know that there are many risks with being overweight, but some may not know that gum disease is one of them.

This article points to the inflammatory chemicals secreted by fatty tissue. This leads to increased production of cytokines, promoting periodontal disease. Very interesting how the body WARNS you in many ways that being overweight is not good for our health! I would be interested to know if you all have noticed this in your patients? Or have you made the link ?

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Perio and Pre-term birth

Periodontal Disease and Preterm Birth.pdf

This article (complete article link to Medical News) is really amazing to me, particularly as a woman. In fact, I hear many women tell me that their dental maintenance declined during pregnancy, and even afterwards. In this respect, the importance of oral care is profound. This article provides an eye-opening, perhaps surprising, fact of that point exactly.
I know personally I am more aware of oral care and keeping dental recall appointments during the time I will be pregnant. I value this information and the study mentioned in the article. If more women knew of this periodontal link to pre-term birth, they would take note. Again, it is amazing that we are in such a revolutionary field !
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While the concept and capability to offer same day restorations with a
chairside CAD CAM system has been around for nearly 25 years, it
hasn't been until the new generations of systems (E4D Dentist System, CEREC
AC Bluecam) that the true potential and ease of use have been realized for
the clinician and dental assistant. Creating metal-free restorations with
no compromise in form, fit and function in a single appointment or even two
appointments provides every dental professional and dental practice
incredible benefits. I use the E4D Dentist system in my practice for a
variety of indications selecting from a variety of high strength ceramic
materials (IPS Empress, IPS e.max CAD) to provide my patients with unequaled
service and convenience. Patients are amazed at the change in dentistry
that is taking place and no longer dread the long temporary phase or making
another appointment weeks from the first.

Once you have become confident in your use of the technology and proficiency
in the system, you can offer your patients beautiful restorations on
anterior and posterior teeth. Taking time to custom stain and glaze can provide
the results shown here in as little as 2 hours.

If you haven't looked at chairside CAD CAM dentistry firsthand in the last
few months you haven't looked at chairside CAD CAM dentistry. Do yourself,
your patients and your bottom line a favor and check them out. It isn't a
matter of if you will incoporate it but simply when.

James M. Stein D.M.D.


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Sleeping Issues and the Dental Office

Sleep Apnea_ Dentists Help Patients Breathe Easier and Sleep Better | Colgate Dental Health Articles.pdf

This article is interesting because it touches on the possiblity of cone-beam computerized tomography helping patients pinpoint sleep issues. This is not commonly thought about in dental offices. Snoring or sleep apnea is rarely asked by your own dentist, true? But in reality, in a profession that completely deals only with the oral cavity, it perhaps should be part of a routine dental visit.

If an x-ray, or cone-beam computerized image could at all predict a patient that may develop sleep apnea, as suggested in this articel, it could broaden the spectrum.






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Arthritis and Treating Gum Disease

Arthritis Pain and Treating Active Gum Disease | Colgate Dental Health Articles.pdf

Many times I have to remind myself of the world of general dentistry! I have been in pediatrics for 12 years now. Many issues with older patients must be addressed when dealing with the oral cavity. The whole body must be considered, including medications patients take. Gum disease is very common and many medications make it all the more difficult to treat and provide ways to maintain care. Adding to this is the dexterity and range of motion patients with arthritis. This poses difficulty for the patient as well.

This article touches on home remedies as well, which can be communicated to patients. People really do appreciate those recommendations before surgery, coming from a health care provider they trust. Even if the time comes for surgery, they will appreciate the concern to try all options first.

In my work with general dentists with Wellness, "Flexibility" approaches this subject in dealing with joint issues. Depending on the patient, they seem to appreciate a natural approach as well, as opposed to common drug treatment. Given many options, patients value your professionalism and thus the patient/doctor relationship is strengthened.


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Here are two blog posts I wrote about Mayo Clinic's use of social medai, including an interview with the person in charge....

http://www.gandolfsmarketingmagic.com/2010/03/05/the-mayo-clinic-social-media-powerhouse/

http://www.gandolfsmarketingmagic.com/2010/03/12/mayo-clinic-interview-reveals-how-to-win-with-social-media/
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Orthodontic extraction are sometimes difficult with rotated ormultirooted teeth when the teeth or root fractures and you have toremove quite a lot of alveolar bone for extracting the fracturedsegments. An easy way out is to bond the teeth to be extracted with aBegg bracket and use a 0.012 NiTi wire to engage this bracket with therest of the bracketed dentition. After 2 weeks, you can extract theteeth easily. Remove the bracket and when you place the forceps andapply apical pressure the teeth will just pop out of the socket due tothe orthodontic movement it has undergone as it was bracketed andligated.


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Esterified hyaluronic acid for use as a bone grafting material in periodiontal defects and also to regenerate bone for implant placement and stabilization.
Int.J Periodontics Resorative Dent. 2009; 29:315-323,
produced by Fidia Advanced Biopolymers Srl in Italy, more info at www.Fidiapharma.com.

An interesting concept using a polymer of polysaccaharide which is the principal component of the extra-cellular matrix which is involved in cell division and tissue formation. HyA is osteoconductive and favours bone formation in tissue healing. It also has bacteriostatic effects on common periodontal pathogens and has an anti-inflammatory role in periodontal/ bone healing.
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Texting in the office......

flyer_jointhealth_english.pdf

I have attached an article that seems to be an issue in the office at times....many times! This mainly observes tecxting as a joint issue, but I also see texting invading the dental professionals workspace and becoming deangerous.

Do you experience "texters" in your practice? Texting has become an issue in legal matters, traffic rules, and saftey issues these days. It does now, have a place in the office. There are more and more lobby signs to "turn off cell phone" ! But should we have a "no texting " rule in the dental chair?

An even bigger issue is not only the distraction of actually texting in the dental chair, but joint issues in the hands. As I have said before, whole body health is key to the new age of dentistry. The texting issue is two-fold in this way. Countless times a patient will ansewer a text and even try to text while being treated in the dental chair! I kid you not. This can of course pose quite a danger.

Not only should we think of these issues for the sake of the patients saftey, but overall health as well.
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People who are stressed by daily problems or trouble at work seem to be more likely to grind their teeth at night. Researchers writing in BioMed Central's open access journal Head & Face Medicine studied the causes of 'sleep bruxism', gnashing teeth during the night, finding that it was especially common in those who try to cope with stress by escaping from difficult situations. Maria Giraki, from Heinrich-Heine-University, Düsseldorf, Germany, worked with a team of researchers to study the condition in 69 people, of whom 48 were 'bruxers'. She said, "Bruxing can lead to abrasive tooth wear, looseness and sensitivity of teeth, and growth and pain in the muscles responsible for chewing. Its causes are still relatively unknown, but stress has been implicated. We aimed to investigate whether different stress-factors, and different coping strategies, were more or less associated with these bruxism symptoms."


Bruxing was not associated with age, sex or education level, but was more common in people who claimed to experience daily stress and trouble at work.

Giraki adds, "Our data support the assumption that people with the most problematic grinding do not seem to be able to deal with stress in an adequate way. They seem to prefer negative coping strategies like 'escape'. This, in general, increases the feeling of stress, instead of looking at the stressor in a positive way."

This article seems to confirm what already know. In our private practice of periodontics, dental implants and bone regeneration in Framingham and Newton, it seems as though we see occlusal wear, cervical abfraction, myofacial pain and other related issues in increasing numbers. Perhaps we can blame this on another phenomenon - the poor economy! What is your experience?

Source: Science Daily

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flyer_healthcare.pdf

More and more has come to light on this subject. All health care professionals are becoming more aware of whole body wellness as an approach to dentsitry (along with many other avenues in health care). Connecting the body with oral care is essential, as demonstrating in the article presented by WebDental about "Pancreatic Cancer and Saliva".

I know in Pediatrics, we constantly strive to get pediatricians involved with the MOUTH. They seem to stop at the mouth and hand over complete responsibility to us. For example, educating parents about the dangers and risk of breast/ bottle feeding in length (ie, baby-bottle decay). It should always be a joint effort in health care. Referring, but still educating the patient as a whole.

This leads to the effects of the health care crisis as well. Cutting costs has come to cutting corners! Are you practicing any wellness in your office? It may increase receivables within the practice, but it is also key to linking the body to the mouth !



Cherie Tschudi
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Website review!

I have to say after 12 + years in the dental profession, this site is the most interactive by far. It is managed well, very user friendly, and savvy! Events are easily posted and discussions easily followed for a busy professional. I continue to be active on my other sites, but very seldom due to the lack of upkeep and interaction between the members. Thanks WebDental !
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Several genes affect tooth development in the first year of life, according to the findings of a study conducted at Imperial College London, the University of Bristol in the UK and the University of Oulu in Finland. The research, published February 26 in the open-access journal PLoS Genetics, shows that the teeth of babies with certain genetic variants tend to appear later and that these children have a lower number of teeth by age one. Additionally, those children whose teeth develop later are more likely to need orthodontic treatment. Abnormal tooth development may lead to dental problems that demand challenging and costly orthodontic treatment. The discovery of genes influencing tooth growth may lead to innovations in the early treatment and prevention of congenital dental and occlusion problems. Professor Marjo-Riitta Jarvelin said: "The discoveries of genetic and environmental determinants of human development will help us to understand the development of many disorders which appear later in life. We hope also that these discoveries will increase knowledge about why foetal growth seems to be such an important factor in the development of many chronic diseases." Do any of our orthodontic colleagues feel that this article has merit? Has this been your experience in practice?

Source: Science Daily
Journal Reference: Pillas D, Hoggart CJ, Evans DM, O'Reilly PF, Sipilä K, et al. Genome-Wide Association Study Reveals Multiple Loci Associated with Primary Tooth Development during Infancy. PLoS Genet, 6(2): e1000856 DOI: 10.1371/journal.pgen.1000856
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Polligrip being pulled from the market!!

February 18, 2010
Consumer Advisory
GlaxoSmithKline (GSK) warns about a potential health risk associated with
long-term, excessive use of GSK’s zinc-containing denture adhesives
Super Poligrip ‘Original’, ‘Ultra Fresh’ and ‘Extra Care’.
This communication is to alert consumers to a potential health risk from long-term excessive use of zinccontaining
denture adhesives Super Poligrip ‘Original’, ‘Ultra Fresh’ and ’Extra Care’.
While zinc is an essential part of the diet, recent publications suggest that an excessive intake of zinccontaining
denture adhesives over several years may lead to the development of neurological symptoms
and blood problems such as anemia. Neurological symptoms may include numbness, tingling or
weakness in the arms and legs and difficulties with walking and balance.
Super Poligrip is safe to use as directed in the product label (see below). The majority of consumers
follow these directions. However, some consumers apply more adhesive than directed and use it more
than once per day. Therefore, as a precautionary measure to minimize any potential risks to these
consumers, GSK has voluntarily stopped the manufacture, distribution and advertising of these products.
GSK has discussed this situation with the FDA and no further action is required.
What consumers should do
If you have been using zinc-containing Super Poligrip ‘Original’, ‘Ultra Fresh’ or ’Extra Care’ for several
years in greater amounts than directed on the package or more than once per day, or have concerns
about your health, you must:
1. Stop using the product.
2. Talk to your doctor.
3. Use a zinc-free alternative such as Super Poligrip ‘Free,’ Super Poligrip ‘Comfort Seal Strips’, or
Super Poligrip ‘Powder’.
People with ill-fitting dentures should seek help from their dental care professional, rather than
compensate for poorly fitting dentures by using excessive adhesive.
Polident Denture Cleanser tablets contain no zinc and are not affected by this announcement.
GSK will soon be introducing zinc-free versions of Super Poligrip ‘Original’, ‘Ultra Fresh’ and ’Extra Care’.
Zinc Free Formula will be clearly shown on the new packaging.
Consumers with questions may call GSK toll free on 1-866-640-1017.
Original Ultra Fresh Extra Care
Comfort Seal Strips
Contains no zinc
Free Powder
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A multidisciplinary group of investigators from the UCLA School of Dentistry, the David Geffen School of Medicine at UCLA, the UCLA School of Public Health and UCLA's Jonsson Comprehensive Cancer Center has demonstrated the usefulness of salivary diagnostics in the effort to find and fight the disease. Their results are published by the journal Gastroenterology.

Pancreatic ductal adenocarcinoma, the most common type of cancer of the pancreas, is also the most lethal of all cancers, with a mortality rate that is approximately the same as the rate of incidence. A "silent killer," pancreatic cancer produces its typical symptoms -- abdominal pain and jaundice -- only in the advanced stage of the disease, making it difficult to fight. Fewer than 5 percent of those diagnosed with the disease live for five years, and full remission is very rare, according to the World Health Organization.

"Worldwide, the prevalence of pancreatic cancer is so high, and the disease is so deadly, that it calls out for a reliable means of early diagnosis," said the study's senior investigator, Dr. David Wong, D.M.D., D.M.Sc., UCLA's Felix and Mildred Yip Professor of Dentistry and associate dean of research at the dental school. "The ability to implement safe, cost-effective, widespread screening could be the answer to saving thousands of lives each year -- and that is what we are after."

"David Wong and his team at the dental school have demonstrated the usefulness of saliva in detecting oral cancer," said co-first author Dr. James Farrell, M.D., an associate professor in the UCLA Division of Digestive Diseases and director of the Pancreatic Diseases Program at UCLA. "As a clinician-scientist who manages patients with all stages of pancreatic cancer, I was eager to work with them to explore the possibilities it could yield in diagnosing this disease."

In the study, the researchers successfully linked changes in the molecular signatures found in human saliva to the presence of early-stage pancreatic cancer.

"Our recent findings underscore the potential for salivary diagnostics to play a pivotal role in the detection of systemic cancers and diseases," said Lei Zhang, Ph.D., an assistant researcher at the UCLA School of Dentistry Dental Research Institute and co-first author of the study. In addition to Wong, Farrell and Zhang, the research team included Hui Zhou, David Akin and No-Hee Park of the UCLA School of Dentistry; David Elashoff of the UCLA School of Public Health; and David Chia of the David Geffen School of Medicine at UCLA. Wong, Chia and Park are also members of UCLA's Jonsson Comprehensive Cancer Center.

Source: Science Daily
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