Using PRF By: Dr. Nekky Jamal
This week we have the pleasure of learning from Dr. Nekky Jamal, on the basics of PRF and how to incorporate it in your daily practice. Dr. Nekky Jamal is a faculty member at the…
This week we have the pleasure of learning from Dr. Nekky Jamal, on the basics of PRF and how to incorporate it in your daily practice. Dr. Nekky Jamal is a faculty member at the…
After practicing dentistry for a few years we are bound to come across different populations of patients, some of whom present with rare genetic disorders that requires unique management and careful planning in order to…
The best new implant system may have arrived! Scientists at Japan’s Kyoto University and the University of Fukui developed a monoclonal antibody treatment that seems to trigger the body to grow new teeth, according to research published…
There are many things to consider when performing a fixed prosthodontics procedure such as a crown, bridge or a veneer that require preparation of the natural dentition to provide retention and support to the prosthetic.…
Dental wear is the loss of hard tooth structure, from any etiology, other than caries or trauma. Usually it arises from erosion, abrasion, abfraction, or attrition. Although tooth wear is a normal physiological process, its…
A common screening that occurs at the dental office, for our female patients, is whether they are an expectant mother. With that in mind let’s explore some of the common dental/oral events and current recommendations in treating…
Case Presentation An otherwise healthy 27-year-old woman presented to the Oral and Maxillofacial Surgery outpatient clinic at the Montreal General Hospital five hours after having had tooth 2.8 extracted by her general dentist. She complained…
Patients being treated with anti-resorptive and anti-angiogenic medications have a risk of developing medication related osteonecrosis of the jaw (MRONJ). This condition can be more prevalent as a result of dental procedures which impact bone,…
Occlusal splints have become common practice in the dental office. They can predictably manage TMJ pain, the severe wear of enamel, or the long-term effects of bruxism and parafunction. However, choosing the right occlusal splint…
A very common finding in patients is the “spontaneous” enlargement of fungiform papillae, called transient lingual papulosis. These enlargements are erythematous and develop 1-4 hours following a source of trauma, such as heat, spicy foods, or mechanical trauma.…
For today’s morninghuddle, we’ll back track to some information that you learned in dental school. Our hot topic: recurrent herpes labialis or more commonly known as cold sores. Caused by HSV-1 (herpes simplex virus type-1 and…
Successful management of pain is a critical aspect of dentistry. This becomes a great challenge when patients present to clinic with a painful endodontic emergency. Management of acute symptoms of irreversible pulpitis can be difficult to manage…
Recurrent aphthous stomatitis (RAS) is of the most common and debilitating oral pathologies. Some studies show up to 25% of the population being affected by RAS. The disease has three clinical variants: minor, major and herpetiform aphthous.…
We got what you’ve been missing… Third molars, otherwise known as wisdom teeth are the most commonly missing teeth in the human dentition. What’s more is that 40% of agenesisof third molars often occurs unilaterally. Teeth development…
Pediatric endodontics can be confusing and challenging. Choosing the right treatment plan is dependent on a multitude of factors: primary vs. permanent tooth, pulpal state, open vs. closed apex, estimated retention time for the tooth, and a variety…
Even the most experienced dentists have a hard time achieving inferior alveolar nerve (IAN) anesthesia 100% of the time. Although the numbers can vary with every study, it’s reported that IAN anesthesia failure can be…
The following is the third and final presentation on the management of ectopic eruption of teeth. Part 3 As we’ve seen so far, autotransplantation can be used with great success in treating ectopic and/ or transmigration of teeth. This…
It’s Friday afternoon. You’re ready to go home. You’ve extracted a tooth on the maxilla, and now you see an itty-bitty hole in bottom of the tooth socket. Could it be…a sinus perforation? This can lead to a lot of…
Pediatrics Refresher: Pulpotomy Pulpotomy of the primary tooth is indicated when caries has infiltrated the pulp or there has been a traumatic exposure of the pulp. The coronal tissue of the pulp is first amputated…
The following presentation is a sequel case series on the management of ectopic eruption of teeth. Part 2 As we’ve discovered, autotransplantation can be an efficient means in treatment of ectopic eruption of a tooth in an…
Platelet Rich Fibrin also known as PRF Platelet rich fibrin also known as PRF has gained popularity for use in surgical procedures to help heal the site more rapidly and effectively through it’s potential ability…
When practicing dentistry everyday, we can loose track of the foundational knowledge underlying routine procedures. Today, we hope to refresh your knowledge, by presenting a case that shows percise and clean dentistry. An endodontically treated tooth…
The following presentation is the first part of our case series on the management of ectopic eruption of teeth. Part 1 As we’ve discovered in our previous article, autotransplantation can be a viable means of replacing…
Bioactive bioceramics are materials that react with the tissue components. The “bioactivity” of the materials refers to its ability to create a hydroxyapatite layer when in contact with tissue fluid rich in calcium and phosphate.…
“Theorizing on the influence of covid-19 and oral health.” Coronavirus Disease-2019 (COVID-19) is caused by a novel coronavirus namely severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which utilizes cell surface angiotensin-converting enzyme 2 (ACE2) as…
Case Report:18 months after the initial cementation of a 3 unit fixed partial denture (FPD), a 48-year old woman returned to the office due to fracturing of the same FPD. Records showed that the FPD…
Pulpal necrosis in permanent teeth that have not completed their root development may lead to short root length, thin root walls and inadequate crown-root ratio, compromising their long term prognosis. The apex is wide open……
Dentists who have removed a fixed orthodontic appliance, at some point, have asked themselves…did I remove the entire composite? Am I shaving away the enamel now? If you leave too much bonding material, you are risking…
Amalgam tattoos in the esthetic zone is a tricky problem to solve. Recent research shows that superficial pigmentations can be treated easily with lasers. However, deeper tattoos can involve soft-tissue, bones and periosteum – as can…
The following presentation is the third and final case series on the management of macrodontia of fused anterior maxillary incisors. Part 3 As part of continued discussion on anterior maxillary tooth fusion we’ll be presenting…
“The gingival flap distal to an erupting molar, an operculum, can cause a lot of havoc.” An operculum can lead either to pain caused by the occlusion of the opposing maxillary molar or by local…
The following presentation is part of three case series on management of macrodontia of fused anterior maxillary incisors. Tune in each week as we discuss each unique scenario. Part 2 As we discussed in our…
As shown by Professor Heitor Cosenza, the surgical visit begins with local infiltration of anesthesia in the vestibule and in the palate. Care is taken not to inject intrapapillary or intrasulcularly, especially because of the…
The following presentation is part of three case series on management of macrodontia of fused anterior maxillary incisors. Tune in each week as we discuss each unique scenario. Part 1 Macrodontia of anterior teeth may…
Conventional extraction techniques, using only elevators and forceps cause immediate and long-term changes to ridge integrity. Immediately following extraction, we see buccal plate fracture in 10% of cases, dehiscence in 28% of cases, and even…
Did you know? During mandibular implant placement the most frequently injured nerve is the IAN at 64.4% follow by the Lingual nerve at 28.8%. Implant placement can effectively improve patient quality of life by restoring aesthetics, form, function. Some cases…
The primary goal of any dental treatment is to preserve the pulp or reverse any damage to it. In mature teeth, when there is a carious pulp exposure, the usual treatment is pulpectomy or root…
For the treatment of areas of missing teeth dental implants have become the golden standard of care. Hygienic and comfort factors contribute to its popularity amongst patients and practitioners alike. Similar to most other treatments…
Case Presentation A 19-year-old man presented to the dental office with pain and swelling around tooth 4.6. The tooth had a history of an initial root canal treatment, 5 years ago, due to a diagnosis of…
During the initial work up assessment of dealing with an orthodontic case, considerations must be made for physiologic growth status of patient in order to adequately manipulate bone and tooth structures to bring about a…
How do you answer your patient when they ask you why their TMJ clicks? The truth is that the answer is not very clear, and there hasn’t been any consistent research to tell us why.…
The twice a year routine is the hallmark of modern day prevention in dentistry. Despite its origins, the 6-month interval has become a timeline for care, which is adjusted by the dentists depending on the patient’s caries…
Going to work in oral healthcare can make a lot of us anxious these days. The global pandemic is still evolving and there are still many unknowns about the behavior of the COVID-19 virus. Dental…
“Brace yourself, a 5-year old is coming for a filling.” Treating a pediatric patient can go one of two ways: a) average without any special events, or b) horribly wrong. There is no in-between. When…
When placing implants in the esthetic zone, the response of the peri-implant soft tissue is just as important as the final restoration. What creates a pleasing smile is not only the size and shape of…
Clinical Case Report A 30-year-old woman presented to the dental clinic to improve her smile, because of multiple spaces between her anterior teeth. The patient is a heavy grinder, leading to generalized attrition and uneven…
The most common indication for the removal of third molars is pericoronitis, non-restorable caries or internal resorption. Yet, when a third molar is close to the inferior alveolar nerve, the risk of nerve injury is…
Dealing with dental fluorosis is tricky. Depending on the severity of the hypomineralization, there are many different treatment options. Sometimes the issue is solved with simple bleaching, yet sometimes veneers/ or crowns are needed to…
Ectodermal dysplasia can present with a variety of manifestations. 1/10,000 people are affected in different ways. Patients can show up with signs of sparse hair, malformed sweat glands, abnormally developing nails, skin diseases, vision disturbances,…
Case Presentation A 19-year-old woman was referred to the clinic with acute pain on the upper left central incisor, as she experienced a sports injury the day prior. The patient had fractured the coronal aspect the…
A 16-year-old girl presented to the clinic with a fistula on the apical third of her upper left central incisor. During clinical examination, a tubercle was seen on the buccal cervical third of the tooth.…
The market for e-cigarettes and vapes has boomed. First developed in China in 2003, e-cigarettes made their way to Europe and North America in 2006. They gained popularity by being branded as a safer alternative to…
A patient comes to your office for crown or veneer preparations of multiple teeth. You have spent many hours perfecting the preparations. You’ve looked at them at every possible angle, and your neck/back pain is…
Following the extraction of a tooth, we can expect short-term and long-term resorption of the hard and soft tissues. Even with bone grafting of the extraction socket, there is still 1-2 mm loss of volume. This…
As endodontic systems and methods of disinfection advance, most endodontic failures are due to root or crown fractures, instead of re-infections. As clinicians we tend to make a significant compromise when doing root canal treatments.…
Immediate implant placement following tooth extraction is a predictable treatment with a high success rate. However, when it is done in the anterior esthetic zone, bone and gingival recession can be expected following extraction of…
Case Presentation A 35-year-old woman presents to the office due to a spontaneous avulsion of her upper left central incisor. Her chief concern is to replace the missing tooth. Medical history shows that the patient…
Case Presentation A 65-year-old woman presents to the clinic for periodontal treatment and during the routine intraoral exam, a firm nodule is noticed in the right buccal mucosa. The nodule is well circumscribed in the…
You will always remember the day you found hair growing in someone’s mouth. The oral cavity is derived from the stomodeum, and ectodermal derivatives like sebaceous glands are not unheard of. However, the presence of sebaceous…
Clinical Presentation 44-year-old woman presents to the clinic due to a lesion on the left lateral border of her tongue (17x10mm). The lesion shows a soft nodular swelling, circumscribed, with white irregular papillary projections. The…
Much has been uncovered regarding the risk factors for contracting Covid-19 and for being harshly effected by its symptoms. Yet, little is known regarding any protective factors that could possibly improve outcomes once the virus is contracted. It…
The final esthetic outcome and longevity of veneers depends on the tooth preparation. Excessive reduction can compromise bond strength (due to exposed dentin), cause sensitivity and limit possible treatment options for the patient in the…
Amelogenesis Imperfecta (AI) disrupts the composition of enamel in teeth. The condition can be x–linked, autosomal recessive or dominant. AI can affect both permanent and primary teeth. Clinical presentations of AI can include sensitivity, surface…
Extraction is the only treatment option for a hopeless tooth caused by severe periodontitis. Once extracted, we are left with the options of implant restoration, fixed prosthesis, or removable prosthesis. All of these options involve…
In 1917, Walter Hess first showed the presence of the MB2 canal. 90%-95% of first maxillary molars have been shown to have a MB2 canal. The identification and treatment of the MB2 canal is particularly…
Patient Presentation A patient presents to the orthodontic office with a chief complaint of straightening her upper and lower front teeth. She is particularly concerned about the vertical height of the two upper central incisors,…
According to OSHA, dental health care providers have one of the highest risks of being exposed to Covid-19. This is mainly due to the fact that a large proportion of the procedures that dentists perform…
Periodontal disease has a strong correlation with the aging of an individual. As a person’s biological age progresses, so does risk of gum inflammation, periodontal bone loss, and transition of the oral bacteria from good…
At-home teeth whitening systems are the new craze. A scroll through your social media shows everything from “laser activated” gels to charcoal toothpastes. With the flood of new whitening systems into the market, clinicians have…
TMJ dislocations can be horrifying for our patients. A full TMJ luxation is when the condyle translates anteriorly of the articular eminence, and does not return to the fossa. This can occur after excessive mouth…
For the majority of dentists, inferior alveolar nerve blocks (IANB) are the only way to achieve anesthesia for mandibular teeth. Periapical infiltrations are blocked by the dense buccal cortical bone, so injection into the pterygomandibular…
Oral ulcerations are a very common sight within the oral cavity. Luckily, due to the high reparative nature of the oral mucosa, many oral ulceration cases can be resolved with minimal or no intervention at…
International governing bodies of dentistry have actively recommended measuring patient blood pressure, since at least 1998. This practice has allowed uncovering undetected hypertension and possibly safeguarding against cardiac events during outpatient surgeries. This recommendation is…
Class V lesions and root decays are very common. However, the durability of the restorations of these lesions is not promising. Once restored, we can expect a loss of retention, marginal excess, secondary caries and…
Once you notice that the primary lateral incisors aren’t present in a child, you can almost be sure that the permanent later incisor is not going to erupt either. This is a situation that has…
Standard diameter implant have become the gold standard, particularly because of the high success rate of the procedure. However, in cases where atrophic alveolar bone is present, predictable success rates can only be achieved with…
Medical emergencies in the dental office are a relatively rare event. However, due to the increased age of the general population, increase morbidities, and increased number of dental visits, medical emergencies are something we should…
Clear aligners are simply the fastest growing component of the orthodontic market globally. Players in this market include the likes of 3M, Align Co. and ClearCorrect, with Invisalign currently dominating the market, hovering around 80%…
The emergence of zirconia has advanced dentistry. A crystalline ceramic, zirconia can give great esthetic qualities to the patient. In addition, with its high metal oxide concentration, zirconia shows great mechanical strength. However, bonding to…
CAD/CAM technologies have been around since the 1950s. CAD/CAM’s introduction into dentistry came in 1987, when CEREC was first launched. Years later and many improvements to the foundational CAD/CAM technology, we are still seeing a…
The benefits of probiotics have been widely known for the general human health. Probiotics can alter the existing flora; enhance beneficial host-microbial function, leading to prevention of inflammation or other systemic conditions. Recently, it was…
Bad breath or halitosis is one of the most common complaints patients have. In fact, about ¼ of people suffer from halitosis. Whether it is a transient or a chronic condition, halitosis usually has some…
The etiology of a cracked tooth is multivariable. We must consider several factors such as parafunction, excessive wear, trauma and any restorations present (their size and materials used). Even the proximity of the tooth to…
“9/10 recommend an electric tooth brush – are you the 10th?” In 2014, it was shown through a systematic review, that power/ electric toothbrushes are better than manual toothbrushes. This was measured in their efficacy…
With every new patient and re-call exam, a head/ neck exam is recommended. This gives our profession a chance to detect irregularities that are usually not checked for by the patient’s regular physician. In fact,…
Systemic chronic graft-versus-host disease (cGVHD) is an immune condition that happens after a transplant, when the immune cells of the graft attack the host’s tissues. This condition can happen after bone marrow transplants, even when…
Many US states and Canada have legalized the personal use and research of Cannabis. With full legalization, we have seen a surge of such use, in its variety of forms (smoking or eating). In fact,…
An endodontically treated tooth most often has a lot of missing tooth structure. The downfalls of cast posts to replace this structure are widely known – usually showing a higher incidence of horizontal and vertical…
Not every shadow or stain should be drilled and filled. Seeing a radiographic shadow under a restoration can make you doubt your own skills, or judge another dentist’s – depending on if the shadow belongs…
No patient has ever wanted a root canal. For one reason or another, in the mind of the patient, it is always associated with pain during and after the procedure. In fact, one study showed…
At this point, everyone on Earth (except maybe Sweden) is itching for the Covid-19 lockdown to be over. Over the past few days, the glimmer of hope has come from the idea of antibody testing…
Nitrous oxide is seen as the “safest” form of sedation given in the dental setting. Since almost all of the nitrous oxide ingested is expelled unchanged, its delivery has become routine, due to its relative…
Direct restorations can be a relatively low cost and a minimally invasive treatment option for the esthetic case. However, in a case aiming to restore anterior teeth involving a bonded lingual wire, our options of…
What is tougher for patients other than endodontic treatment? Having endodontic treatment done again! Considering that the failure rate of root canals are somewhere around 5% to 22%, its astonishing to think that the US…
With progress in dental materials manufacturing, the demand for esthetics is increasing – both with the patient and the practitioner. For decades, the gold standard for fixed prostheses was the metal-ceramic crown. However, zirconia crowns…
Any treatment performed should stand the test of time. When dealing with the esthetic restoration of teeth, what you see during the time of insertion is expected to remain stable for years going forward. There…
Fluorosis can be seen in varying degrees of severity. Regardless of the severity, it can produce a very un-esthetic condition, especially on anterior teeth. This condition can have a profound effect on the psychosocial state…
The Angiotensin Converting Enzyme 2 (ACE-2) has been at the center of uncovering the pathogenesis of Covid-19. ACE-2 decreases the production of angiotensin II in the body. Angiotensin II is a vasoconstrictor, and logically angiotensin…
Case Presentation – Full report can be accessed here. 76-year-old male. Presents to the hospital due to headache and drainage of purulent discharge on right side of his face. Patient’s medical history indicated hypertension, alcoholism,…
In ancient societies most tooth wear was linked to a coarser diet. Today most tooth wear is linked to bruxism. More than 42% of US population has reported some sort of bruxism in their adult…
Denture fabrication doesn’t come without its headaches. From reduced function, new sensations, new phonetics, and altered hygiene; getting comfortable with a new set of dentures is always tough for the patient. Adding denture stomatitis as…
Over the past two decades, benzodiazepine prescriptions have increased by almost 70%. Not surprisingly, overdose deaths involving benzodiazepines have increased 10 fold. How can we use these medications to aid our patients, while curbing the…
As we write this piece, Covid-19 as a virus and our understanding of it, is at its infancy. The first case has been hypothesized to be transmitted somewhere in the third week of November 2019.…
Condensed sodium vs. coffee Makino et al. studied this hypothesis in a double-blind randomized clinical trial, with 30 participants. Each subject held (with an appliance) a hydroxyapatite pellet on the lingual side of the mandible…
There are only a few things that can make a dentist’s heart skip a beat. Perforations are one of them. Furcation perforations can cause your heart to skip two beats, and want to cancel the…
The Covid-19 pandemic has mobilized the global scientific community. New discoveries about the characteristics and management strategies of the covid-19 disease are being uncovered by the hour. Here we cover the current accepted knowledge by…
As more information is uncovered about the Covid-19 virus, methods of diagnosis leading to prevention are uncovered as well. Since it’s initial detection, Covid-19 has been observed in the saliva of infected individuals. This leads…
Until now it has been observed that younger patients, especially children are only mildly affected by Covid-19. As the scientific community continues to try and understand this virus, understanding the variety and severity of the…
Due to Covid-19, most oral health providers globally are mandated to perform emergency treatments only. It has been recommended that if odontogenic symptoms can be managed with prescriptions, it should be done so, in an…
When most of us come across the term “Artificial Intelligence,” we instantly revert back to Stanley Kubrick’s Space Odyssey, or some variation of it. However, we are far from the dystopian world we think “AI”…