The Right and Wrong Ways to Brush

Most people start brushing their teeth as toddlers, so one might think that by the time we reached adulthood, we’d be professionals at it. Assuming one brushes twice a day for 20 years, that’s approximately 14,600 practice sessions. But each of us has probably seen our share of patients whose teeth make it evident that those 14,600 brushings have been done the wrong way. We are often asked about sensitive teeth and what can be done to manage the condition. Excessive tooth wear and gingival recession, which can lead to dentin hypersensitivity, are just a few of the problems we see resulting from overzealous brushing. How can such a seemingly simple act trip up so many people? How can we help our patients learn and maintain the proper technique?
We know there are multiple factors in brushing that can contribute to tooth wear, and it is not always evident which factor, or combination of factors, is responsible when we see a patient with obvious abrasion or recession. In these cases, hygienists should review the list of possible causes with the patient in order to identify the culprit(s). The list can be difficult to remember, but we can give our brains a helping hand with a simple mnemonic device: “Make Brushing Feel Truly Fantastic Again.” Each of these words corresponds to a factor in the proper toothbrushing checklist.
 

MOTION

The brushing motion most associated with tooth wear is the horizontal technique,¹ which seems to be the default setting for many patients. This can be a difficult factor

Plaque Formation and Marginal Gingivitis Associated with Restorative Materials

The presence of restorative materials on tooth surfaces is perceived to be a contributing factor to periodontal disease. This observation is a result of the increased accumulation of plaque on restorations adjacent to the gingiva, which may lead to gingivitis. Plaque is believed to adhere better to restorations than to enamel. This may be due to the surface characteristics of restorative materials such as surface roughness and surface-free energy inherent in the materials. This article reviews the experimental studies of plaque formation on different restorative materials. In addition, clinical studies analyzing and comparing restorative materials and the consequent formation of gingivitis are reviewed. While in vitro and in vivo studies show variations in plaque formation among restorative materials and enamel, clinical studies demonstrate that the progression of gingivitis can be prevented if patients maintain adequate oral hygiene and home care. Therefore, instructing the patient to maintain proper oral hygiene and home care is more important than the choice of restorative material.
Plaque-induced gingivitis is gingival inflammation caused by bacterial plaque at the gingival margin. Prevalent in all ages of the dentate population, it is the most common form of periodontal disease.¹ Plaque is a biofilm composed of various microbial species in a matrix of microbial byproducts and host-derived factors and attaches to the tooth.² Local factors such as crowded teeth, tooth anatomy, and restorative margin discrepancies may alter the formation of bacterial plaque.³ Throughout the years, studies have considered the effects of the integrity of the restorative surface, type of restorative materials, and location of the restorative margin placement on the periodontal tissues as factors that exacerbate gingival diseases.⁴ One concern of clinicians is the placement of restorative margins and its impact on the violation of the biologic width. This may lead to gingival inflammation, clinical attachment loss, and bone loss due to the inflammatory response to the microbial plaque situated in deeply placed restorative margins. It appears that a minimum distance of 3 mm between alveolar bone and restorative margins is a prudent dimension in restorative treatment planning.⁵ A review⁶ of several clinical studies has shown varying degrees of microbial colonization when comparing restorative materials or when comparing them to natural teeth.
The topic of how different restorative materials affect plaque formation is important. The clinician may choose a specific restorative material over another based on

Periodontal Probing Systems: A Review of Available Equipment

The periodontal pocket, one of the definitive signs of periodontal disease, is the most common parameter to be assessed by dental clinicians. Periodontal probes have been the instruments most commonly used to locate and measure these pockets. Regular use of periodontal probes in routine dental practice facilitates and increases the accuracy of the process of diagnosing the condition, formulating the treatment, and predicting the outcome of therapy. Advances in the field of periodontal probing have led to the development of probes that may help reduce errors in determining this parameter used to define the state of active periodontal disease. One such advance is the emergence of probes that purportedly assess periodontal disease activity noninvasively. The selection of periodontal probe depends on the type of dental practice: a general dental practitioner would require first- or second-generation probes, while third- through fifth-generation probes generally are used in academic and research institutions as well as specialty practices.
The periodontal pocket, one of the definitive signs of periodontal disease, is the most common parameter to be assessed by dental clinicians. One of the more reliable and convenient ways of detecting, measuring, and assessing the status of periodontal disease activity is through

PERIODONTICS (DENTAL UPDATE)

DOWNLOAD
http://uploading.com/files/a7f584e6/periodontics.rar/

PERIO-ENDO INTERFACE

download

HORMONAL FACTORS IN PERIO

Download