Hemostasis is an integral and very important aspect of surgical practice. As a rule, most bleedin... more Hemostasis is an integral and very important aspect of surgical practice. As a rule, most bleeding from dental surgery can be controlled by pressure. When the application of pressure does not yield satisfactory results, or where more effective hemostasis is required, hemostatic agents are used. These agents act to stop bleeding either mechanically or by augmenting the coagulation cascade. Some of the newer agents that are available to the dental profession have been presented.
Bisphosphonates are commonly prescribed for the treatment of osteoporosis and bone cancers. These... more Bisphosphonates are commonly prescribed for the treatment of osteoporosis and bone cancers. These drugs come in both intravenous and oral forms. Because these drugs have become more prevalent, there have been increased reports of bisphosphonate-related osteonecrosis of the jaws (BRONJ). This case presentation focuses on a 50-year-old woman with a 10-year history of monthly Zometa (zoledronic acid) use for treatment of multiple myeloma, resulting in BRONJ with a very unfavorable outcome. Its purpose is to depict how the chronic use of intravenous (i.v.) bisphosphonates can lead to bisphosphonate-related osteonecrosis of the jaw (BRONJ), and to present treatment options, including conservative measures, the dentist may be able to employ in the early phases of the disease, along with the indications for jaw resection. Osteonecrosis of the jaws in association with bisphosphonate therapy is a very serious condition with which all dentists should be familiar. When the osteonecrosis begins, it can be very painful to the patient, difficult to treat, and can lead to very deleterious sequelae.
Odontogenic tumors are a group of neoplastic growths that originate from the tissues responsible ... more Odontogenic tumors are a group of neoplastic growths that originate from the tissues responsible for tooth formation and the periodontal apparatus of the jaw. Odontogenic tumors usually present as radiolucent defect, which makes diagnosis somewhat confusing while differentiating them from cysts. Although cystic lesions are surrounded by sclerotic borders, few odontogenic tumors share similar features. This article reviews clinical concepts of several odontogenic tumors that occur in the proximity or in association with teeth and not merely focusing on relatively common conditions.
A variety of diseases ranging from obstructions, infections, to benign and malignant tumors occur... more A variety of diseases ranging from obstructions, infections, to benign and malignant tumors occur in salivary glands. The most common problem is painful blockage of ducts by stones that prevents drainage of saliva. Sialadenitis can be due to either infectious or noninfectious factors. Bacterial or viral infections are the most common causes of acute sialadenitis. Staphylococcus is the usual bacterial cause, whereas paramyxovirus (mumps) is the common viral cause. Eighty percent of salivary tumors are benign, whereas about 20% are malignant. Most tumors occur in the parotid gland and on the hard palate. Classifications, imaging, and suggested treatment are described.
Credentialing is the administrative process for validating the qualifications of licensed profess... more Credentialing is the administrative process for validating the qualifications of licensed professionals and appraising their background. It is used by hospitals and other health care facilities, educational institutions, and insurance companies to ensure the qualification of their clinicians and to grant privileges to provide specific services and perform different medical or dental procedures. This article familiarizes the reader with the credentialing process and the documentation that is needed to be credentialed by certain organizations.
Local pain management is the most critical aspect of patient care in dentistry. The improvements ... more Local pain management is the most critical aspect of patient care in dentistry. The improvements in agents and techniques for local anesthesia are probably the most significant advances that have occurred in dental science. This article provides an update on the most recently introduced local anesthetic agents along with new technologies used to deliver local anesthetics. Safety devices are also discussed, along with an innovative method for reducing the annoying numbness of the lip and tongue following local anesthesia.
The pathogenesis of odontogenic infection is polymicrobial, consisting of various facultative and... more The pathogenesis of odontogenic infection is polymicrobial, consisting of various facultative and strict anaerobes. The dominant isolates are strictly anaerobic gram-negative rods and gram-positive cocci. The periapical infection is the most common form of odontogenic infection. Although odontogenic infections are usually confined to the alveolar ridge vicinity, they can spread into deep fascial spaces. Cavernous sinus thrombosis, brain abscess, airway obstruction, and mediastinitis are possible complications of dental infections. The most important element in treating odontogenic infections is elimination of the primary source of the infection with antibiotics as adjunctive therapy.
Oral sedation with benzodiazepines and anxiolysis with nitrous oxide are 2 effective methods to h... more Oral sedation with benzodiazepines and anxiolysis with nitrous oxide are 2 effective methods to help alleviate anxiety and fear of dental procedures. Many patients would prefer to have their dentistry performed with sedation if it were offered to them. This article presents a detailed discussion on minimal sedation that should give the reader a good understanding of this valuable aspect of clinical care.
Hemostasis is an integral and very important aspect of surgical practice. As a rule, most bleedin... more Hemostasis is an integral and very important aspect of surgical practice. As a rule, most bleeding from dental surgery can be controlled by pressure. When the application of pressure does not yield satisfactory results, or where more effective hemostasis is required, hemostatic agents are used. These agents act to stop bleeding either mechanically or by augmenting the coagulation cascade. Some of the newer agents that are available to the dental profession have been presented.
Bisphosphonates are commonly prescribed for the treatment of osteoporosis and bone cancers. These... more Bisphosphonates are commonly prescribed for the treatment of osteoporosis and bone cancers. These drugs come in both intravenous and oral forms. Because these drugs have become more prevalent, there have been increased reports of bisphosphonate-related osteonecrosis of the jaws (BRONJ). This case presentation focuses on a 50-year-old woman with a 10-year history of monthly Zometa (zoledronic acid) use for treatment of multiple myeloma, resulting in BRONJ with a very unfavorable outcome. Its purpose is to depict how the chronic use of intravenous (i.v.) bisphosphonates can lead to bisphosphonate-related osteonecrosis of the jaw (BRONJ), and to present treatment options, including conservative measures, the dentist may be able to employ in the early phases of the disease, along with the indications for jaw resection. Osteonecrosis of the jaws in association with bisphosphonate therapy is a very serious condition with which all dentists should be familiar. When the osteonecrosis begins, it can be very painful to the patient, difficult to treat, and can lead to very deleterious sequelae.
Odontogenic tumors are a group of neoplastic growths that originate from the tissues responsible ... more Odontogenic tumors are a group of neoplastic growths that originate from the tissues responsible for tooth formation and the periodontal apparatus of the jaw. Odontogenic tumors usually present as radiolucent defect, which makes diagnosis somewhat confusing while differentiating them from cysts. Although cystic lesions are surrounded by sclerotic borders, few odontogenic tumors share similar features. This article reviews clinical concepts of several odontogenic tumors that occur in the proximity or in association with teeth and not merely focusing on relatively common conditions.
A variety of diseases ranging from obstructions, infections, to benign and malignant tumors occur... more A variety of diseases ranging from obstructions, infections, to benign and malignant tumors occur in salivary glands. The most common problem is painful blockage of ducts by stones that prevents drainage of saliva. Sialadenitis can be due to either infectious or noninfectious factors. Bacterial or viral infections are the most common causes of acute sialadenitis. Staphylococcus is the usual bacterial cause, whereas paramyxovirus (mumps) is the common viral cause. Eighty percent of salivary tumors are benign, whereas about 20% are malignant. Most tumors occur in the parotid gland and on the hard palate. Classifications, imaging, and suggested treatment are described.
Credentialing is the administrative process for validating the qualifications of licensed profess... more Credentialing is the administrative process for validating the qualifications of licensed professionals and appraising their background. It is used by hospitals and other health care facilities, educational institutions, and insurance companies to ensure the qualification of their clinicians and to grant privileges to provide specific services and perform different medical or dental procedures. This article familiarizes the reader with the credentialing process and the documentation that is needed to be credentialed by certain organizations.
Local pain management is the most critical aspect of patient care in dentistry. The improvements ... more Local pain management is the most critical aspect of patient care in dentistry. The improvements in agents and techniques for local anesthesia are probably the most significant advances that have occurred in dental science. This article provides an update on the most recently introduced local anesthetic agents along with new technologies used to deliver local anesthetics. Safety devices are also discussed, along with an innovative method for reducing the annoying numbness of the lip and tongue following local anesthesia.
The pathogenesis of odontogenic infection is polymicrobial, consisting of various facultative and... more The pathogenesis of odontogenic infection is polymicrobial, consisting of various facultative and strict anaerobes. The dominant isolates are strictly anaerobic gram-negative rods and gram-positive cocci. The periapical infection is the most common form of odontogenic infection. Although odontogenic infections are usually confined to the alveolar ridge vicinity, they can spread into deep fascial spaces. Cavernous sinus thrombosis, brain abscess, airway obstruction, and mediastinitis are possible complications of dental infections. The most important element in treating odontogenic infections is elimination of the primary source of the infection with antibiotics as adjunctive therapy.
Oral sedation with benzodiazepines and anxiolysis with nitrous oxide are 2 effective methods to h... more Oral sedation with benzodiazepines and anxiolysis with nitrous oxide are 2 effective methods to help alleviate anxiety and fear of dental procedures. Many patients would prefer to have their dentistry performed with sedation if it were offered to them. This article presents a detailed discussion on minimal sedation that should give the reader a good understanding of this valuable aspect of clinical care.
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