• Thursday, May 26, 2011

    Scope of Dental Forensic

    Human identification is the forensic odontologist's primary duty: Who is the victim? This involves the dentist as a team member working along with law enforcement agencies. This team is charged with the responsibility of investigating the evidence from cases involving violent crime, child abuse, elder abuse, missing persons, and mass disaster scenarios. In each cases, dental evidence produce compelling associations to aid victim and suspect identity and to establish facts that can affect the direction and ultimate outcome of investigative casework. Dental evidence can be used to identify both the people who were present during the commission of a crime or witnesses to an accident. The forensic dentist interacts with other forensic and medical disciplines like anthropology, pathology, human anatomy, and biological science. The best international source for forensic dental information and international forensic certification is available at Forensic Dentistry Online.

    Forensic dentistry (aka forensic odontology in Europe) has a two-and-one-half century history in the United States. It is the science and practice of dentistry and its role in modern society. Dental injuries from accidents or assaults must be assessed and treated. Occasionally, the treating dentist or attending
    forensic dental expert testifies in court proceedings for parties involved in civil litigation. Criminal cases use dentists to testify on dental evidence obtained from a crime scene or crime victims. Occasionally, a perpetrator of a crime leaves evidence at a scene. Bitten food, gum, or chewed objects may be recovered by law enforcement. Autopsy investigations may notice bite marks on the skin of a deceased victim. Dental experts also testify regarding the quality of dental care  (professional negligence) and in cases where dental fraud is an issue.

    Wednesday, May 18, 2011

    Management of Missing Teeth

    The teeth are usually absent from the dental arch congenital or as a result of the disease, including tooth decay and periodontal breakdown are the most common. While it is not axiomatic that a missing tooth must always be replaced, there are many occasions it is desirable to improve the appearance, chewing or speech function, or sometimes to avoid damaging changes in the dental arches, as overeruption or tilt / drifting of the teeth. Tooth loss is also followed by alveolar bone resorption, which aggravates resulting tissue deficits.

    In most countries with an oral care services is considerable component of the work of the dental team directed toward the prevention of tooth loss, repair damaged teeth, and replacing those missing, along with its supporting tissues. When patients are toothless, treatment for teeth loss has been largely restricted to the use of complete dentures, however, the timing, the potential treatments are more numerous, since a large variety of techniques can be used to stabilize prosthesis linking them to natural teeth. Removable partial dentures (DPR) are widely used due to
    versatility and can yield long-term effective appropriate circumstances. They do, however, suffer from still relatively bulky, often require metal components can be difficult to hide are patient removable, and are inherently less stable than a fixed bridge that is secured permanently to one or more teeth. These can be both traditional designs on the extensive preparation pillars, or more modern and less destructive adhesive techniques. In general, DPR are used to management of missing teeth or alveolar significantly extended resorption and where there are advantages in relative simplicity of manufacture and replacement. Fixed restorations are usually less versatile and more expensive to provide, but have advantages related to stability and reduced volume.

    Doctors have long sought to provide their patients with an artificial analogue of natural teeth and variety of materials and techniques have been used to it. However, it was not possible to replicate the periodontal tissues and alternatively strategies have therefore been adopted. These have was based on the principles of the creation and maintenance an interface between the implant and the surrounding bone, which is capable of transmitting the load, associated with healthy tissue adjacent predictable results and high success rate. This result proved elusive until the discovery of the phenomenon of osseointegration.As i will discuss osseointegration in my next blog post.

    Saturday, May 14, 2011

    Work Equipments in Dentistry

    In dentistry, the range of equipment is vast; however, it can be consolidated into two groups, namely equipment and instruments. Equipment is fixed or portable and manually or power operated. Examples of both groups appear below:

    . Decontamination equipment
    . Dental chair, unit and light
    . Disposables
    . Gas cylinders
    . Hand-held dental instruments
    . Office equipment
    . Portable electrical appliances
    . Pressure vessels
    . Radiography equipment
    . Rotary or air-driven instruments
    . Suction units

    The above is not an exhaustive list as it is impractical to list everything. However, the requirements of the Provision and Use of Work Equipment Regulations and other associated legislation must be applied to everything that comes under the definition of work equipment.

    Hazards associated with work Equipment

    An appreciation of the hazards presented by work equipment is important in order to effectively implement the safety precautions. The hazards range from relatively minor consequences to more serious and, in some cases, potentially fatal ones. The following list provides an overview of the more generic hazards:

    . Electric shock
    . Fire
    . Faulty design or installation
    . Entanglement with moving parts
    . Entrapment from equipment falling over
    . Impact from the release of particles ejecting
    . Biological, chemical or radioactive contamination
    . Noise or vibration
    . Dusts, vapours or fumes
    . Burns or scalds from contact with heating
    . Transmission of infectious disease through
    . Upper limb disorder from poor posture
    . Uncontrollable release of stored energy under pressure resulting in explosion

    Everyone is exposed to the above hazards; therefore, the safety of users, operators, others in the immediate vicinity and the outcome of instrument malfunction or failure which may adversely affect patient care must be addressed.

    Tuesday, May 10, 2011


    Extensive work by the Swedish orthopaedic surgeon P.-I. Brånemark led to the discovery that commercially
    pure titanium (CPTi), when placed in a suitably prepared site in the bone, could become fixed in place
    due to a close bond that developed between the two, a phenomenon that he later described osseointegration (OI). This state has anatomical and functional dimensions, as it requires both a close contact between the implant and surrounding healthy bone and the ability to transmit functional loads over an extended period without deleterious effects either systemically or in the adjacent tissues. OI is defined in terms of the extent of the bone-implant contact, provided that functional requirements met and the tissues are healthy. Many of the factors that predispose to the development of OI are now known, and where these exist a successful outcome will probably follow the placing of a suitable implant. Similarly, failure is more likely where factors known to predispose to an unsuccessful outcome exist. 

    Occasionally,implants fail for no apparent reason, sometimes in groups in one patient - the so-called 'cluster phenomenon'. It is therefore important to advise patients that a satisfactory outcome cannot be
    guaranteed.OI is currently viewed as the optimum implantbone interface, without which success cannot be
    obtained, and great emphasis has been placed on its production and maintenance. Nevertheless, it is only
    one component of successful dental implant treatment and does not in itself prevent that treatment from
    failing. While the absence of OI is equated with treatment failure, its achievement does not guarantee
    success, which is dependent on the design and performance of the final prosthesis. This may be
    precluded by an inappropriately placed implant, even if it is integrated.

    While the osseointegrated interface and associated soft-tissue cuff where the implant penetrates the oral
    mucosa are often thought of as dental analogues, they have a number of important differences. In particular, the interface is more rigid and less displaceable than the periodontal ligament, and behaves essentially elastically as opposed to the viscoelasticity of the periodontal ligament. The stability of the interface also precludes implant repositioning by orthodontic manoeuvres, but may permit dental implants to be used as anchorage for fixed orthodontic appliances. The osseointegrated interface is also associated with a slow rate of loss of crestal alveolar bone, typically less than 0.1 mm per annum after the first year of implantation. As a result, most implants can be expected to be functional throughout adult life.

    Inflammation of the tissues around an endosseous implant is sometimes observed; it is described as
    peri-implant mucositis when it involves only the soft tissues and peri-implantitis where loss of the bone
    interface occurs. While the microorganisms associated with these lesions are similar to those seen in periodontal disease, it is currently unclear whether they cause the lesion or colonize the region subsequently.

    Wednesday, May 4, 2011

    Partial Dentate case scenario

    Partial Dentate case scenario
    The major benefits achieved with implant treatment the edentulous patients transferred early partially solve specific problems dentate patients, where shown to be very effective in appropriate cases. The situation, However, more complex than in the case of edentulous, since there are often several treatment modalities
    could be used, and the status of existing teeth and additional support structures
    difficulties. Dental implants are not an alternative oral hygiene or inadequate treatment of poor planning, and if improperly inserted in Patients can present a major problem partially dentate when extra teeth are lost.

    Missing teeth are single, especially because of trauma, with Not an uncommon problem, which can in many cases easily solved using traditional restorative techniques. However, there are some cases where this is not it produces technically feasible or fewer results. Recognizing these cases, planning and implementation implant-based treatment to discuss.

    The ability to develop interfaces in osseointegrated various locations resulted in a wide range  of potential applications for dental and skull implants.

    A treatment with dental implants can be very complex procedure for planning enforcement, and management of subsequent problems. Despite the high success rate of the technique, not the unknown and managed by avoiding the best place than corrected after the event. Emphasis on this approach from the front consultation on, and covering different techniques may need to be employed when difficulties arise.

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