Formulating a Global Prognosis and Treatment Plan for the Periodontally Compromised Patient: A Reconstructive Vs. an Adaptive Approach
Weiqiang Loke, BDS; Angela M. Coomes, DDS; Adam Eskow, DDS; Matthew Vierra, DDS; Brian L. Mealey, DDS, MS; and Guy Huynh-Ba, DDS, MS

Two approaches for treatment of chronic periodontitis are discussed—a reconstructive approach versus an adaptive one. Both aim at achieving periodontal health and occlusal stability, and each has its own advantages and disadvantages. Utilizing a global prognostic approach will assist clinicians in prescribing customized periodontal and restorative therapies that best address patients' needs.

Evaluating the Advances and Use of Hypodermic Needles in Dentistry
Sean G. Boynes, DMD

Different injection techniques and patient management methodologies have been proposed to decrease the fear patients may have concerning dental needles. This article provides an overview of the pain perception process associated with dental injections and reviews the two main sensory nerve fibers associated with injection pain. Needle properties as well as complications and adverse occurrences are discussed.

Probiotics for Bacterial Disease Treatment in the Oral Environment
Suellan Go Yao, DMD; and James Burke Fine, DMD

Because both periodontal disease and dental caries are bacterial diseases, a probiotics approach to treating these maladies is currently being evaluated. Several over-the-counter products claim to be formulated with probiotics and suitable for use for oral care. In this article, the authors define probiotics, review research that explores probiotics in relation to periodontal disease and caries, and identify available probiotics products aimed at promoting oral health.

Custom Abutments Alone Will Not Eliminate the Clinical Effects of Poor Cementation Techniques Around Dental Implants
Alfonso Piñeyro, DDS; and Jeffrey Ganeles, DMD

When placing cement-retained implant restorations clinicians should be aware of the potential and sometimes irreversible biological complications associated with residual excess cement. Use of various alternative practices may reduce this problem. The cases in this report describe the use of custom abutments to restore deeply placed implants with the intent of minimizing residual excess cement.

Achieving Esthetic and Functional Objectives with Additive Equilibration
Amanda Seay, DDS

In a case involving a patient with high esthetic demands who wanted to keep treatment conservative, minimal direct bonding was used to enhance anterior esthetics while creating acceptable function. Primary treatment goals in the case, in which the patient was diagnosed with a constricted chewing pattern, were to improve esthetics by lengthening the maxillary anterior teeth and to stop continued loss of anterior tooth structure.

Effectiveness of a Combined In-Office and Take-Home Whitening System for Teeth Shades A3.5 to A4
Gary M. Radz, DDS

Although research is available regarding several aspects of the whitening process, the use of a combination technique, including both in-office and at-home, as well as specific whitening gels, had not been investigated to verify a successfully combined professional whitening system until now.

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