New Gel May Mean No More Dental Anesthesia Shots - Science News - redOrbit

This seems exciting. It would definitelymake treatment more acceptable to many of our patients !

New Gel May Mean No More Dental Anesthesia Shots - Science News - redOrbit:

Anesthetic gel made from a rare plant found deep in the Peruvian rainforest has been found to be so potent that it could potentially replace the uncomfortable anesthetic injections used prior to dental procedures — and provide a natural remedy for aching teeth, scientists say.

The remarkable painkilling properties of the Acmella oleracea plant, commonly referred to as Spilanthes Extract, have been used for centuries if not millennia by Incas to treat toothache, ulcers, abscesses and to even clean teeth.

Indigenous tribes revealed the secrets of the plant to Cambridge University researcher Dr. Françoise Barbira Freedman, who has spent more than 30 years visiting and living with the Keshwa Lamas tribe of Peru. Freedman said the plant could literally transform western dental practice.

Freedman became the first westerner to be accepted into the secretive society in 1975. During one of her trips to the rainforest, she suffered severe pain in her wisdom teeth. She was given the remedy by the tribe‘s medicine men and the pain subsided “immediately,” she said. more

Source: redOrbit (http://s.tt/17lS9)

'via Blog this'

Membrane Perforation in Sinus Floor Elevation – Piezoelectric Device versus Conventional Rotary Instruments for Osteotomy: An Experimental Study

It seems NOTHING , nothing is a substitute for knowledge, experience and expertise !

A piezosurgery device is a very useful adjunct for doing sinus floor elevations. But it is not a magic wand that will make membrane perforations go away !

Membrane Perforation in Sinus Floor Elevation – Piezoelectric Device versus Conventional Rotary Instruments for Osteotomy: An Experimental Study:

ABSTRACT

Purpose: Sinus membrane perforation is the most common intraoperative complication of maxillary sinus floor elevation (MSFE) procedures and frequently causes postoperative problems. Piezoelectric devices have been claimed to reduce the frequency of membrane perforations although no clear evidence supports this view.

Materials and Methods: Ten surgeons with different expertise levels performed 80 MSFEs in selected lamb heads, with rotary and piezoelectric instruments following standard protocols. After the procedures, specimens were coded and perforations or tears determined through a microscope.

Results: No significant differences in terms of thickness either of the sinus lateral wall (x_i-x_j = 73.2; 95% confidence interval [CI] = 45.3–191.8) or the membrane (x_i-x_j = 24.2; 95% CI = −29.4 to 77.9) were identified between the specimens allocated to each group. Nine membrane perforations (11.2%) occurred during the study, all within the lower expertise group. Membrane elevation by hand instruments caused five perforations (40%) in the rotary instrument group and one in the piezoelectric group. Expert surgeons produced no membrane perforations, the size of the antrostomy that was smaller in the piezoelectric group being the only significant difference between the rotary and piezoelectric groups.

Conclusions: The use of piezoelectric material for MSFE reduces the frequency of membrane perforation among surgeons with a limited experience.

Soft Tissue Preservation and Pink Aesthetics around Single Immediate Implant Restorations: A 1-Year Prospective Study

As one can see from the abstract below , even when the biotype is thick and buccal bone is intact achieving esthetic success with immediate implant placement in the esthetic zone is fraught with uncertainty. The protocol suggested by Buser and Belser for early placement after soft tissue healing is probably a safer protocol for most of us in clinical practice where predictability is key.

Soft Tissue Preservation and Pink Aesthetics around Single Immediate Implant Restorations: A 1-Year Prospective Study:

ABSTRACT

Purpose: (1) To document soft tissue aspects using a specific protocol for immediate implant treatment (IIT) following single-tooth removal; (2) to evaluate whether this protocol allows preservation of pink aesthetics as objectively assessed.

Materials and Methods: Patients with a thick gingival biotype and intact buccal bone wall upon extraction of a single tooth in the aesthetic zone (15–25) were consecutively treated. The protocol included flapless extraction and implant surgery, socket grafting, immediate nonocclusal loading with a screw-retained provisional crown, and replacement by a permanent crown 6 months thereafter. The outcome was assessed after 3, 6, and 12 months. Cases demonstrating major alveolar process remodeling and/or advanced midfacial recession (>1 mm) at 3 months were additionally treated with a connective tissue graft (CTG). The emergence profile of the provisional crown was replicated for all permanent crowns.

Results: Twenty-two patients (12 men, 10 women; mean age 50) were treated after tooth extraction for nonperiodontal reasons using a novel bone condensing implant with variable-thread design, conical connection, and platform switch (NobelActive®, Nobel Biocare, Göteborg, Sweden). One implant failed and mean marginal bone loss was 0.1 mm (p = .059). Temporary mesial papilla reduction occurred, whereas distal papilla reduction was permanent (mean 0.5 mm; p = .001). At 3 months, five cases demonstrated major alveolar process remodeling and two advanced midfacial recession. Hence, slight initial decline in the pink esthetic score (PES) (p = .053) was observed. CTG resulted in a steady improvement of the PES after 3 months (p ≤ .037). At 12 months, pink aesthetics (mean PES 12.15) was comparable to the preoperative status (mean PES 11.86; p = .293). Distal papillae had significantly deteriorated (p = .020) in this time span, whereas midfacial contour had significantly improved (p = .005).

Conclusions: Preservation of pink aesthetics is possible following IIT. However, to achieve that, CTG may be necessary in about one-third of the patients. Major alveolar process remodeling is the main reason for additional treatment.