Clinical, Cosmetic and Investigational Dentistry 

About: Clinical, Cosmetic and Investigational Dentistry is an academic journal published by Dove Medical Press. The journal publishes majorly in the area(s): Medicine & Internal medicine. It has an ISSN identifier of 1179-1357. It is also open access. Over the lifetime, 361 publications have been published receiving 4599 citations.

Strategies to manage patients with dental anxiety and dental phobia: literature review.

Abstract: Dental anxiety and phobia result in avoidance of dental care. It is a frequently encountered problem in dental offices. Formulating acceptable evidence-based therapies for such patients is essential, or else they can be a considerable source of stress for the dentist. These patients need to be identified at the earliest opportunity and their concerns addressed. The initial interaction between the dentist and the patient can reveal the presence of anxiety, fear, and phobia. In such situations, subjective evaluation by interviews and self-reporting on fear and anxiety scales and objective assessment of blood pressure, pulse rate, pulse oximetry, finger temperature, and galvanic skin response can greatly enhance the diagnosis and enable categorization of these individuals as mildly, moderately, or highly anxious or dental phobics. Broadly, dental anxiety can be managed by psychotherapeutic interventions, pharmacological interventions, or a combination of both, depending on the level of dental anxiety, patient characteristics, and clinical situations. Psychotherapeutic interventions are either behaviorally or cognitively oriented. Pharmacologically, these patients can be managed using either sedation or general anesthesia. Behavior-modification therapies aim to change unacceptable behaviors through learning, and involve muscle relaxation and relaxation breathing, along with guided imagery and physiological monitoring using biofeedback, hypnosis, acupuncture, distraction, positive reinforcement, stop-signaling, and exposure-based treatments, such as systematic desensitization, "tell-show-do", and modeling. Cognitive strategies aim to alter and restructure the content of negative cognitions and enhance control over the negative thoughts. Cognitive behavior therapy is a combination of behavior therapy and cognitive therapy, and is currently the most accepted and successful psychological treatment for anxiety and phobia. In certain situations, where the patient is not able to respond to and cooperate well with psychotherapeutic interventions, is not willing to undergo these types of treatment, or is considered dental-phobic, pharmacological therapies such as sedation or general anesthesia should be sought.

Oral biofilms: molecular analysis, challenges, and future prospects in dental diagnostics.

Abstract: Oral biofilms are functionally and structurally organized polymicrobial communities that are embedded in an extracellular matrix of exopolymers on mucosal and dental surfaces. These biofilms are found naturally in health, and provide benefits to the host. However, this relationship can break down, and disease can occur; disease is associated with a shift in the balance of the species within these biofilms. Simple diagnostic tests have been developed that involve the culture of selected bacteria, eg, those implicated in dental caries, facilitating an assessment of risk of further disease in individual patients. However, oral diseases have a complex etiology, and because only around 50% of oral biofilm can be grown at present, culture-independent molecular-based approaches are being developed that give a more comprehensive assessment of the presence of a range of putative pathogens in samples. The diversity of these biofilms creates challenges in the interpretation of findings, and future work is investigating the ability of novel techniques to detect biological activity and function in oral biofilms, rather than simply providing a catalogue of microbial names.

Current knowledge about the hydrophilic and nanostructured SLActive surface

Abstract: This review summarizes the present documentation for the SLActive surface, a hydrophilic and nanostructured surface produced by Straumann Company in Switzerland, and covers the results from 15 in vitro, 17 in vivo, and 16 clinical studies. The SLActive surface is a development of the large grit-blasted and acid-etched SLA surface, and is further processed to a high degree of hydrophilicity. In general, the in vitro and in vivo studies of the SLActive surface demonstrate a stronger cell and bone tissue response than for the predecessor, the SLA surface, produced by the same company. However, in most studies, this difference disappears after 6–8 weeks. In the clinical studies, a stronger bone response was reported for the SLActive surface during the early healing phase when compared with the SLA surface. However, the later biological response was quite similar for the two surfaces and both demonstrated very good clinical results.

Pattern of third molar impaction in a Saudi population.

Abstract: Objective To evaluate the current pattern of third molar impaction in a sample of Saudi patients. Methods One thousand thirty-nine orthopantomograms (OPG) of patients ranging in age from 19 to 46 years (536 males and 503 females) were evaluated to determine the frequency of impacted third molars, their levels of eruption, and their angulations. Results Four hundred twenty-two (40.5%) of the 1039 OPG showed at least one impacted third molar, with no significant difference between males (222; 52.6%) and females (200; 47.4%) (P = 0.284). The most common number of impacted third molars per OPG was one (72.5%). Impacted third molars were 1.64 times more likely to occur in the mandible than in the maxilla. The most common angulation of impaction in the mandible was the mesial (33.4%), while the most common angulation in the maxilla, was the vertical (49.6%). Level B impaction was the most common in both maxilla (48.2%) and mandible (67.7%). There was no significant difference in the frequency of impaction between the right and left sides in both jaws. Conclusion The pattern of third molar impaction in the western region of Saudi Arabia is characterized by a high prevalence of impaction that is greater in the mandibles and with no sex predilection.

Treating chronic periodontitis: current status, challenges, and future directions.

Abstract: Periodontitis affects roughly one-third of the US population. A timely diagnosis of chronic periodontitis at its earliest stage is essential to avoid more challenging severe stages of the disease. Most cases of slight and moderate chronic periodontitis can be successfully managed by mechanical removal and/or reduction of subgingival bacterial biofilms and calculus. However, any factor that affects either the local environment or the host response may contribute to progression of the disease and a poor treatment response. Thus, it is essential that clinicians are aware of etiologic and risk factors associated with disease development and progression in order to plan and execute a successful treatment. This paper reviews a variety of risk factors, both local and systemic, that can impact the successful treatment of chronic periodontitis.