Issue 1, 2010

Issue 1, 2010

Welcome to the first issue of JCDA Express, an e-newsletter that brings you concise information about important developments in the dental and biomedical literature pertinent to Canadian dental practitioners.

With each issue, you will receive a list of clinically oriented articles selected by members of our broad community of expertise. We’ll include links to either the abstracts or the full-text articles, and our contributors will briefly explain why, in their view, these are must-read papers.

Our goal with this member service is to minimize your research efforts so you can maximize your reading time.

Yours sincerely,

Dr. John P. O’Keefe
Editor in chief
[email protected]

Cone beam computed tomography

Dr. Ernest Lam is head of oral and maxillofacial radiology, faculty of dentistry, University of Toronto. Dr. Lam, a JCDA editorial consultant, recommends:

Radiation protection: cone beam CT for dental and maxillofacial radiology; provisional guidelines (v1.1 May 2009), by SEDENTEXCT, the European consortium tasked with developing guidelines for the use of cone beam computed tomography in dentistry.

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Full-text access to this article has expired.

 
Key points:

NOTES AND NEWS

MARK YOUR CALENDAR!
JDIQ in conjunction with CDA
May 29 to June 1
Montreal, QC
View the scientific program and register online at www.odq.qc.ca

SUBMIT AN ABSTRACT
The MASCC and ISOO 2010 International Symposium on Supportive Care in Cancer
June 24 to 26
Vancouver, BC
Abstracts: February 15
www.mascc.org

VIEW FINDINGS ON EDENTULISM
6.6% of Canadian adults aged 20 to 79 reported having no teeth of their own. View preliminary data from the Canada Health Measures Survey (CHMS) oral health component.

SPREAD THE WORD
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• Although medical CT imaging has been the imaging method of choice for examining hard-tissue abnormalities of the craniofacial skeleton and jaws, cone beam CT (CBCT) imaging may now be the preferred method because of reduced radiation dose.
• CBCT should not be routinely used for the diagnosis of dental caries, periodontal disease, periapical inflammatory disease, the assessment of the craniofacial skeleton, or when an assessment of soft tissues is required. For orthodontics in particular, large volume CBCT should not be used routinely for diagnosis or monitoring of treatment.
• CBCT should be used when conventional projection radiography does not provide adequate information for treatment planning. Such clinical situations may include the evaluation of persistent disease, the localization of unerupted or impacted teeth, the evaluation of palatal clefts, dentoalveolar trauma and in selected implant cases.
• To keep radiation doses to patients as low as reasonably achievable, the smallest volumes should be used for a particular imaging task.
• CBCT machines should be optimized by the operator for dose reduction before use. Consideration should be given to technical factors, voxel size and the number of acquired projections.

Reasons for recommending this article:

The guidelines are evidence-based. In fact, this is the first and currently only evidence-supported document guiding the use of CBCT in dentistry. I also like that the guidelines do not represent the opinion and experience of just one clinician with this technology.

Enamel matrix derivative for periodontal tissue regeneration

Dr. Debora Matthews is head of the division of periodontics at Dalhousie’s faculty of dentistry. Dr. Matthews, a JCDA editorial consultant, recommends:

Esposito M, Grusovin MG, Papanikolaou N, Coulthard P, Worthington HV. Enamel matrix derivative (Emdogain®) for periodontal tissue regeneration in intrabony defects. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD003875. DOI: 10.1002/14651858.CD003875.pub3.

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Full-text access to this article has expired.

Key points:

• Enamel matrix derivative (EMD) contains proteins (derived from developing pig teeth) believed to regenerate periodontal tissues lost due to disease. This systematic review and meta-analysis found that after 1 year, application of EMD in addition to surgical debridement significantly improved periodontal attachment levels (1.1 mm) and reduced probing depths (0.9 mm) when compared to a placebo or a control.
• However, there was no evidence that more compromised teeth could be saved using EMD, that the amount of tissue regeneration was clinically significant, or that patients preferred the EMD treatment for esthetic reasons.
• Further, the authors report that the use of barrier membranes (guided tissue regeneration, GTR) produced a statistically significant increase in recession compared to EMD and that the GTR group had significantly more postoperative complications.

Reasons for recommending this article:

The ideal treatment for tissue lost due to periodontal disease would be one that restored tissue to its original form and function. Many surgical techniques have shown the potential to regenerate periodontal tissues, including GTR, bone grafting and the use of EMD. Other Cochrane reviews have shown that GTR and bone grafting are only slightly more effective than open flap debridement. While progress has been made in the field of regenerative therapy, the magic bullet has yet to be found.

Dental materials

Dr. N. Dorin Ruse is chair of the division of biomaterials at the faculty of dentistry, University of British Columbia. Dr. Ruse, a JCDA editorial consultant, recommends 2 review articles:

Article 1: Hickel R. Trends in materials science from the point of view of a practicing dentist. J Eur Ceram Soc. 2009;29(7):1283-9.

View Abstract
Full-text access to this article has expired.

Reasons for recommending this article:

• Dr. Hickel is a well-known dentist and researcher with a proven publishing record (>100 papers, ~1600 citations). I found his review article, which focuses mainly on dental resin composites and dental ceramics, well-written, well-referenced, and containing a wealth of information useful for a practising dentist.
• The discussion and illustrations pertaining to the longevity and cause of failure of amalgams, composites and ceramic inlays can be very helpful in treatment planning. The review briefly addresses biocompatibility issues, dental cements, dental adhesive systems, endodontic materials and CAD/CAM ceramics. The importance of the “art of dentistry,” i.e., the role played by the dentist in the success or failure of the materials, is also highlighted.
• Finally, I liked the fact that the author emphasizes the importance of educating not only students but also dentists and educators.

Article 2: Breschi L, Mazzoni A, Dorigo ED, Ferrari M. Adhesion to intraradicular dentin: a review. J Adh Sci Tech. 2009;23(7-8):1053-83.

View Abstract
Full-text access to this article has expired.

Reasons for recommending this article:

I found this review paper excellent, with ample and pertinent discussion of all the aspects involved in the clinically challenging procedure of bonding fibre posts to intraradicular dentin. The review is systematically organized, well-referenced and well-illustrated—a great resource for anyone interested in this aspect of dentistry.

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