In a letter to the Compendium editor dated March 1, 2013, from Eric T. Stoopler, DMD, FDS RCSEd, Associate Professor of Oral Medicine, Director, Postdoctoral Oral Medicine Program, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, and Thomas P. Sollecito, DMD, FDS RCSEd, Professor and Chairman of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, it was brought to our attention that an update should be noted regarding an article published online by Compendium. The article, "Antibiotic Prophylaxis: A Literature Review," pp e33-e37, was part of the Compendium March Online Only issue.

Dens invaginatus, also known as dens in dente, is a rare anomaly affecting human dentition. The condition results in invagination of an amelodental structure within the pulp. This case report discusses the current management protocol of dens invaginatus as demonstrated in an adolescent female and describes treatment options. As with most conditions, early diagnosis and preventive measures help minimize complications in dens invaginatus cases.

Background:

This study investigated postoperative hypersensitivity at 1, 4, and 13 weeks following resin-based composite (RBC) restorations of occlusal caries and its relationship with prepreparation (baseline) sensitivity and preparation-related variables, including dentin caries activity, cavity dimension and volume, and lesion radiographic visibility.

Methods:

Investigators in a practice-based research network enrolled patients with occlusal caries deemed to require operative treatment. The 45 dental practitioners then placed restorations using their preferred techniques. Complete baseline data on 665 restorations from 602 patients included patient-reported sensitivity (pre-preparation); dentists' ranking of dentin caries on opening the enamel; measurements of preparation depth, width, and length; and patient demographics. At 1, 4, and 13 weeks post-treatment, patients anonymously reported any sensitivity to hot and cold stimuli, sweets, clenching, and chewing, as well as quality-of-life indicators related to the restorations.

Results:

At baseline, 30% of teeth had reported sensitivities of ≥3 on an anchored scale from 0 to 10 points and were designated as appreciable hypersensitivity (AH). Appreciable hypersensitivity at baseline was related to lesion radiographic visibility and patient age but not to dentin caries activity ranking, type of posterior tooth, gender, or race/ethnicity. Patients reported on 491 restorations at 4 weeks post-treatment-18% had AH. Of those who had AH, 39% (34 of 87) had no baseline AH. With restoration, 63% of teeth with baseline AH no longer had AH. Changes in AH were not associated with preparation depth, length, width, or volume.

Conclusion:

Patient-reported occlusal caries tooth sensitivity was high at baseline and eliminated by RBC restoration in 63% of cases; however, new sensitivity after restoration was reported in 10% of lesions that had none at pretreatment. Sensitivity was not related to preparation dimensions, volume, tooth type, or patient demographics (other than age) in these early lesions.

The purpose of this two-part series is to review the composition, properties, and products of mineral trioxide aggregate (MTA) materials. PubMed and MedLine electronic databases were used to identify scientific papers from January 1991 to May 2010. Based on the selected inclusion criteria, citations were referenced from the scientific peer-reviewed dental literature. Mineral trioxide aggregate is a refined form of the parent compound, Portland cement (PC), and demonstrates a strong biocompatibility due to the high pH level and the material's ability to form hydroxyapatite. Mineral trioxide aggregate materials provide better microleakage protection than traditional endodontic materials as observed in findings from dye-leakage, fluid-filtration, protein-leakage, and bacterial penetration-leakage studies and has been recognized as a bioactive material. Various MTA commercial products are available, including gray mineral trioxide aggregate (GMTA), white mineral trioxide aggregate (WMTA), and mineral trioxide aggregate-Angelus (AMTA). Although these materials are indicated for various dental uses and applications, long-term in-vivo clinical studies are needed. Part 1 of this article highlighted and discussed the composition and characteristics of the material. Part 2 provides an overview of commercially available MTA materials.

Antibiotic prophylaxis has been a matter of great interest and has been discussed by researchers and clinicians over the years. Changes and recommendations have been made in order to clarify protocol and make it safer for patients. Various organizations such as the American Heart Association, American Academy of Oral Surgeons, American Dental Association, and American Academy of Oral Medicine have played vital roles in formulating guidelines for antibiotic prophylaxis. These recommendations for prevention of infective endocarditis have been based on clinical experiences and research as well as expert opinion. This paper summarizes the most recent guidelines for general readers so that informed decisions may be made that are in the interest of patients and practitioners.

BACKGROUND:

The prevalence of latex allergy among dental patients is not known, although it has been increasing in the population since 1982, when the use of gloves was expanded to prevent the transmission of infectious diseases.

METHODS:

A retrospective cross-sectional study was undertaken of 1,798 electronic health records (EHRs) of new clinic patients who registered at the University of Pittsburgh School of Dental Medicine (SDM) dental clinic between January and June 2010. Data extracted from the EHRs included age, gender, and a history of a previous latex reaction, asthma, or allergy to penicillin.

RESULTS:

A previous reaction to latex was reported by 59 patients (3.3%). Women were almost three times more likely to report this (4.7% versus 1.6%, P = 0.0005). Histories of asthma or penicillin allergy in women were significantly associated with latex allergy (P = 0.0005 and P = 0.0001, respectively).

CONCLUSIONS:

The reported rate of a previous reaction to latex in this patient sample was higher than that of the general population. This may, in part, be related to repeated exposures to latex-containing gloves.

CLINICAL IMPLICATIONS:

Practitioners are increasingly likely to encounter patients who have had a reaction to latex. Non-latex products must be available for these patients, who are more likely to be women and individuals with asthma or an allergy to penicillin.

Peri-implantitis treatment is often surgical; however, in this case report, an alternative approach has been documented using a combination of nonsurgical debridement with the local controlled release of doxycycline by bioresorbable nanospheres in the peri-implant defect. After 15 months, remission on clinical inflammatory parameters of bleeding and suppuration on probing, as well as reduction of probing depths, was observed. This alternative approach may enhance clinical parameter improvements in some cases of peri-implantitis without the need for a surgical approach for implant decontamination.

There has been a rise in incidence of dental trauma and crown fractures as reported in the literature. Children and teenagers are the most affected age groups, and the maxillary central incisors are the teeth most often affected. This article discusses reattachment techniques for the restoration of fractured teeth when the tooth fragment is recovered after a traumatic dental injury. This particular case study reports re-reattachment of a previously fractured and reattached tooth fragment.

The new era of dentistry works on the principle of conservation and minimal intervention for treatment of any dental pathology. Thus, there is greater emphasis on repair procedures than on replacement protocols required. The following article outlines a common conservative repair protocol for fractured ceramic facings of ceramic-fused-to-metal (CFM) crowns. It also includes brief descriptions of several patients treated using the same basic protocol along with modifications as per the case requirement.

The key to appropriate treatment of odontogenic osteomyelitis or bisphosphonate-related osteonecrosis of the mandible in patients with autoimmune diseases lies in making the correct diagnosis based on meticulous review of signs and symptoms. As this complex case involving a patient with multiple comorbidities illustrates, diagnosis can be difficult, because these conditions may overlap or be mistaken for other conditions. However, prompt treatment is essential to limit the progression, which can be devastating for these medically complex patients. It is, therefore, important to understand local and systemic conditions that can weaken the immune system and predispose patients to chronic bone infection, meticulously go through signs and symptoms, and have a complete medical history, including patient medications.