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Diseases and Conditions in Dentistry - An Evidence-Based Reference

Diseases and Conditions in Dentistry - An Evidence-Based Reference

Authors
Publisher John Wiley and Sons Ltd
Year 2018
Pages 392
Version hardback
Readership level Professional and scholarly
Language English
ISBN 9781119312031
Categories Dentistry
$125.18 (with VAT)
556.50 PLN / €119.31 / £103.58
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Book description

Diseases and Conditions in Dentistry: An Evidence-Based Reference is the ideal, one-stop guide for dentistry clinicians to keep at their side.





Provides a quick reference for the busy clinician covering diseases and conditions in endodontics, periodontics, prosthodontics and restorative dentistry

Offers identically formatted chapters following the same clear and concise layout with detailed clinical cases and evidence-based discussions

Features a companion website with additional clinical photographs, radiographs, and case notes "In order to make each chapter easier to read, the author uses the same format, including definitions, etiology, classifications, epidemiology, relevant history and special investigations, diagnosis, prognosis, treatment challenges, management options, maintenance issues, and relevant evidence from the literature [...] The book is an excellent guide for under- and post-graduate students, and for those preparing for the ORE,"MFDS, MSc, MRD, ISFE, MClinDent, and DClinDent specialty exams.

Diseases and Conditions in Dentistry - An Evidence-Based Reference

Table of contents

Contents





Preface xxi





Acknowledgements xxiii





Image Contributors xxv





Abbreviations xxvii





About the Companion Webstite xxix





1 Aggressive Periodontitis 1





1.1 Definition 1





1.1.1 Primary Features 1





1.1.2 Secondary Features 1





1.2 Classification 1





1.3 Prevalence 1





1.4 Aetiology and Pathogenesis 1





1.4.1 Bacteria 2





1.4.2 Genetic Susceptibility 2





1.4.3 Smoking 2





1.5 Screening 2





1.6 Diagnosis 2





1.7 Prognosis 2





1.8 Treatment 2





1.8.1 Systemic Antibiotics 3





1.8.2 Local Antimicrobials 3





References 8





2 Amelogenesis Imperfecta 11





2.1 Definition 11





2.2 Aetiology 11





2.3 Epidemiology 11





2.4 Classification 11





2.5 Diagnostic Clinical Features 11





2.5.1 Hypoplastic Type 11





2.5.2 Hypocalcified Type 11





2.5.3 Hypomaturation Type 11





2.6 Relevant History 12





2.7 Relevant Investigations 12





2.8 Prognosis 12





2.9 Treatment Considerations 12





2.9.1 Management of Children 12





2.9.2 Mixed Dentition 13





2.9.3 Permanent Dentition 13





2.9.4 Adulthood 13





2.10 Survival of Restorations 13





References 18





3 Apical Periodontitis 19





3.1 Definitions and Classification 19





3.2 Relevant Anatomy 19





3.3 Immunopathology 19





3.4 Aetiology 20





3.5 Microbiology 20





3.6 Radiology 21





3.7 Diagnosis 21





3.8 Epidemiology 23





3.9 Endodontic Treatment Considerations 23





3.9.1 Local Anaesthesia 23





3.9.2 Isolation and Disinfection 23





3.9.3 Access Cavity Preparation 23





3.9.4 Magnification 23





3.9.5 Working Length Determination 23





3.9.6 Root Canal Preparation Techniques 24





3.9.7 Irrigation and Debridement 24





3.9.8 Interappointment Medication 24





3.9.9 Obturation Techniques 24





3.9.10 Coronal Restoration 25





3.9.11 Review 25





3.9.12 Exacerbation 25





3.10 Endodontic Retreatment 25





3.11 Prognosis and Outcome of Non-Surgical Endodontic Treatment 26





3.11.1 Preoperative Factors 26





3.11.2 Intraoperative Factors 26





3.11.3 Post-Treatment Factors 26





3.12 Surgical Endodontic Treatment 26





3.12.1 Indications 26





3.12.2 Contraindications 26





3.12.3 Flap Design 27





3.12.4 Specific Anatomy 27





3.12.5 Bone Removal 27





3.12.6 Root End Preparation 27





3.12.7 Root End Filling 27





3.12.8 Prognosis and Outcomes 27





3.12.8.1 Preoperative Factors 28





3.12.8.2 Intraoperative Factors 28





References 29





4 Bisphosphonates and Medication-Related Osteonecrosis of the Jaw 33





4.1 Definition and Staging 33





4.2 Pathogenesis 33





4.3 Prevalence 33





4.4 Prevention 34





4.5 Assessment and Investigations 34





4.6 Treatment Considerations 34





References 36





5 Caries 37





5.1 Definition and Aetiology 37





5.2 Pathogenesis 37





5.3 Epidemiology 37





5.4 Classification 37





5.5 Relevant History 38





5.6 Clinical Examination of Caries 38





5.7 Differential Diagnosis 38





5.8 Prevention 38





5.8.1 Tooth Brushing and Mechanical Plaque Control 38





5.8.2 Diet 38





5.8.3 Fluoride 38





5.8.4 Fissure Sealing 39





5.9 Treatment Considerations 39





5.9.1 Primary Teeth 39





5.9.2 Permanent Teeth 39





5.9.2.1 Minimally Invasive Techniques 39





5.9.2.2 Treatment of Exposed Pulp in Permanent Teeth 40





References 41





6 Chronic Periodontitis 45





6.1 Definition and Classification 45





6.2 Clinical Features and Characteristics 45





6.3 Periodontal Indices 45





6.4 Epidemiology 47





6.5 Risk Factors 47





6.5.1 Local Risk Factors 47





6.5.2 Systemic Risk Factors 47





6.5.2.1 Smoking Tobacco 47





6.5.2.2 Diabetes 47





6.5.2.3 Genetics 48





6.5.2.4 Osteoporosis 48





6.5.2.5 Psychosocial Factors 48





6.5.2.6 Other Considerations 48





6.6 Microbiology 48





6.7 Pathogenesis 49





6.8 Role of Occlusal Trauma 49





6.9 Treatment 50





6.9.1 Treatment Goals 50





6.9.2 Treatment Phases 50





6.9.2.1 Systemic Phase 50





6.9.2.2 Initial Hygiene Phase 50





6.9.2.2.1 Mechanical Supragingival Plaque Control 50





6.9.2.2.2 Chemical Supragingival Plaque Control 51





6.9.2.3 Non-Surgical Therapy 51





6.9.2.3.1 Management of Tooth Mobility 52





6.9.2.4 Corrective Phase (Additional Therapy) 52





6.9.2.4.1 Periodontal Surgery 52





6.9.2.4.2 Outcome of Periodontal Surgery 53





6.9.2.4.3 Treatment of Teeth with Furcation Involvement 53





6.9.2.4.4 Periodontal Regeneration 54





6.9.2.5 Maintenance Phase 55





References 58





7 Cleft Lip and Palate 63





7.1 Introduction 63





7.2 Complications 63





7.3 Dental Abnormalities 63





7.4 Management of Patients with CLP 63





7.4.1 Infancy and Primary Dentition Stage 64





7.4.2 Mixed Dentition 64





7.4.3 Permanent Dentition 64





7.4.3.1 Orthodontic Treatment 64





7.4.3.2 Orthognathic Surgery 64





7.4.3.3 Distraction Osteogenesis (DO) 64





7.4.3.4 Restorative Treatment 65





References 67





8 Combination Syndrome 69





8.1 Defining Features 69





8.2 Pathogenesis 69





8.3 Clinical Assessment 69





8.4 Prevention 70





8.5 Treatment Considerations 70





8.6 Management of Flabby Ridge 70





8.7 Management of Denture-Induced Stomatitis 71





References 72





9 Complete Edentulism 75





9.1 Introduction 75





9.2 Treatment Stages 75





9.3 Denture Support 75





9.4 Challenging Conditions 75





9.5 Complete Denture Occlusion 76





9.5.1 Measuring Occlusal Vertical Dimension (OVD) 76





9.5.2 Registration of Centric Relation (CR) 76





9.5.3 Complete Denture Occlusal Schemes 76





9.5.3.1 Bilateral Balanced Occlusion 76





9.5.3.2 Monoplane Scheme of Occlusion 77





9.5.3.3 Linear Occlusion Scheme 77





9.5.4 Occlusal Adjustment 77





9.6 Setting Up the Teeth in Complete Denture 77





9.7 Tooth Size and Shape 78





9.8 Soft Liners and Tissue Conditioners 78





9.9 Copy Denture 78





9.10 Complete Denture Troubleshooting 79





References 81





10 Deep Overbite 83





10.1 Definition and Prevalence 83





10.2 Aetiology 83





10.3 Classification 83





10.4 Treatment Options 83





10.4.1 Orthodontic Treatment 83





10.4.2 Orthognathic Surgery 84





10.4.3 Prosthodontic and Restorative Treatment 84





References 86





11 Dens Invaginatus 87





11.1 Definition and Terminology 87





11.2 Aetiology and Prevalence 87





11.3 Classification 87





11.4 Clinical Examination and Investigations 87





11.5 Treatment Considerations 88





References 90





12 Dentine Hypersensitivity 93





12.1 Definition 93





12.2 Prevalence 93





12.3 Aetiology and Pathogenesis 93





12.4 History and Examination 93





12.5 Management 94





12.5.1 Management of DHS in Patients with Gingival Recession and/or Periodontal Disease 94





12.5.2 Management of DHS in Patients with Tooth Surface Loss 94





References 96





13 Dentinogenesis Imperfecta and Dentine Dysplasia 99





13.1 Definition 99





13.2 Classification and Clinical Features 99





13.3 Aetiology and Pathogenesis 99





13.4 Epidemiology 100





13.5 Differential Diagnoses 100





13.6 Relevant History and Special Investigations 100





13.7 Treatment Considerations 100





13.7.1 Primary Dentition 100





13.7.2 Permanent Dentition 101





References 104





14 Dentoalveolar Trauma 105





14.1 Introduction 105





14.2 Displaced and Malpositioned Teeth 105





14.3 Loss of Vitality and Discolouration 105





14.4 Ankylosis and Root Resorption 106





14.5 Lost Teeth 106





14.5.1 Exodontia Considerations 106





14.5.2 Role of Orthodontists 106





14.5.3 Autotransplantation 106





14.5.4 Prosthetic Tooth Replacement 107





References 113





15 Discolouration 115





15.1 Introduction 115





15.2 Intrinsic Discolouration 115





15.2.1 Alkaptonuria 115





15.2.2 Congenital Hyperbilirubinaemia 115





15.2.3 Congenital Erythropoietic Porphyria 115





15.2.4 Tetracycline Staining 115





15.2.5 Pulpal Disease 115





15.2.6 Root Resorption 116





15.2.7 Amelogenesis Imperfecta (AI) 116





15.2.8 Dentinogenesis Imperfecta (DI) 116





15.2.9 Fluorosis 116





15.2.10 Ageing 116





15.2.11 Other Conditions Associated with Enamel Defects 116





15.3 Extrinsic Discolouration 116





15.4 Treatment Options 116





15.5 Tooth Bleaching 117





15.5.1 Bleaching Techniques 117





15.5.1.1 Vital Bleaching (External Bleaching) 117





15.5.1.2 Non?Vital Bleaching (Internal Bleaching) 117





15.5.1.3 Inside/Outside Bleaching 117





15.5.2 Bleaching Products 117





15.5.2.1 Whitening Gels 117





15.5.2.2 Whitening Strips 117





References 118





16 Ectodermal Dysplasia 121





16.1 Definition and Prevalence 121





16.2 Classification 121





16.3 Aetiology 121





16.4 Diagnosis and Clinical Features 121





16.5 Management Considerations 122





16.6 Restorative Treatment 122





16.6.1 Direct Restorations 122





16.6.2 Indirect Restorations 122





16.6.3 Removable Dentures 122





16.6.4 Implants 122





References 124





17 External Root Resorption 127





17.1 Introduction 127





17.2 Aetiology and Pathogenesis 127





17.3 External Invasive Cervical Root Resorption 127





17.4 History and Examination 128





17.5 Differential Diagnosis 128





17.6 Treatment Considerations 128





17.6.1 Non?Surgical Management 128





17.6.2 Surgical Management 129





17.6.3 Endodontic Treatment 130





References 131





18 Failed Restoration and Compromised Tooth 133





18.1 Introduction 133





18.2 Direct Restorations 133





18.2.1 Amalgam Restorations 133





18.2.2 Composite Restorations 133





18.2.3 GIC, Resin?Modified GIC and Compomers 134





18.3 Indirect Restorations 134





18.3.1 Crowns 134





18.3.1.1 Porcelain Fused to Metal (PFM) Crowns 135





18.3.1.2 All?Ceramic Crowns 135





18.3.1.3 Full Gold Crowns (FGG) 135





18.3.2 Inlays and Onlays 135





18.3.3 Veneers 136





18.4 Restoration of Root?Treated Teeth 136





References 140





19 Fluorosis 143





19.1 Definition 143





19.2 Aetiology and Pathogenesis 143





19.3 Prevalence 143





19.4 Clinical Features and Classifications 143





19.5 Diagnosis 143





19.6 Treatment Considerations 144





References 146





20 Fractured Endodontic Instrument 147





20.1 Incidence 147





20.2 Causative Factors and Prevention 147





20.3 Impact on Outcome of Endodontic Treatment 147





20.4 Management Strategies 148





20.5 Factors Affecting Removal of Fractured Instruments 148





20.6 Fragment Removal 149





References 151





21 Fractured or Failed Post 153





21.1 Introduction 153





21.2 Reasons for Failure of Post?Retained Restorations 153





21.3 Factors to Consider 153





21.4 Risks of Post Removal 153





21.5 Post Removal Techniques 154





References 157





22 Gingival Enlargement and Gingivitis 159





22.1 Introduction 159





22.2 Aetiology and Clinical Features 159





22.3 Diagnosis 160





22.4 Management 160





References 164





23 Gingival Recession 165





23.1 Introduction 165





23.2 Aetiology and Risk Factors 165





23.3 Classification 166





23.4 Diagnosis 166





23.5 Prevention and Non?Surgical Management 166





23.5.1 Monitoring and Maintenance 166





23.5.2 Adhesive Restorations 166





23.5.3 Gingival Prosthesis 166





23.5.4 Orthodontic Space Closure 167





23.6 Surgical Treatment 167





23.6.1 Gingival Augmentation 167





23.6.2 Surgical Root Coverage 168





23.6.2.1 Pedicle Soft Tissue Grafts 168





23.6.2.2 Free Soft Tissue Grafts 169





23.6.2.3 Prognostic Factors 169





23.6.2.4 Clinical Outcome of Various Root Coverage Procedures 170





23.6.3 Surgical Reconstruction of Interdental Papillae 170





23.6.4 Periodontal Microsurgery 170





References 173





24 Halitosis 177





24.1 Terminology 177





24.2 Aetiology 177





24.3 Epidemiology 177





24.4 Classification 177





24.5 Diagnosis 177





24.6 Management Strategies 178





References 179





25 Hypodontia 181





25.1 Definition and Classification 181





25.2 Aetiology 181





25.3 Epidemiology 181





25.4 Clinical Features 181





25.5 History and Examination 182





25.6 Relevant Investigations 182





25.7 Care Pathway 182





25.8 Multidisciplinary Team 182





25.9 Restorative Considerations 183





25.10 Treatment Considerations 183





25.10.1 Preventive Care 183





25.10.2 Treatment Options for Missing Teeth 183





25.10.3 Missing Maxillary Lateral Incisors 183





25.10.3.1 Space Closure 183





25.10.3.2 Space Opening 184





25.10.4 Missing Mandibular Incisor Teeth 184





25.10.5 Maxillary Midline Diastema 184





25.10.6 Management of Retained Primary Teeth 184





25.10.7 Prosthetic Options to Replace the Missing Teeth 185





25.10.7.1 Resin-bonded Bridge (RBB) 185





25.10.7.2 Conventional Bridge 186





25.10.7.3 Removable Partial Denture (RPD) and Overdenture 186





25.10.7.4 Implant?Retained Prosthesis 186





25.10.8 General Maintenance Requirements 187





References 191





26 Internal Root Resorption 193





26.1 Definition 193





26.2 Pathogenesis 193





26.3 Predisposing Factors 193





26.4 Epidemiology 193





26.5 Classification 193





26.6 Diagnosis 193





26.6.1 Clinical Features 194





26.6.2 Radiographic Features 194





26.7 Treatment Considerations 194





References 196





27 Irrigation Accidents 197





27.1 Introduction 197





27.2 Types of Incidents and Common Causes 197





27.3 Signs and Symptoms 197





27.4 Prevention 197





27.5 Management 198





References 200





28 Low Maxillary Sinus Floor 201





28.1 Introduction 201





28.2 Sinus Floor Elevation Techniques 201





28.2.1 Lateral Approach 201





28.2.1.1 Indications and Contraindications 201





28.2.1.2 Preoperative Assessment 201





28.2.1.3 Surgical Approach 202





28.2.1.4 Bone Grafting 202





28.2.1.5 Postoperative Care and Complications 203





28.2.2 Crestal Approach 203





28.3 Implant Survival 203





References 204





29 Microdontia 207





29.1 Definition, Prevalence and Classification 207





29.2 Aetiology 207





29.3 Examination and Diagnosis 207





29.4 Management 207





References 210





30 Necrotising Periodontal Diseases 211





30.1 Introduction 211





30.2 Epidemiology 211





30.3 Predisposing Factors 211





30.4 Clinical Features and Diagnosis 211





30.5 Microbiology and Histology 211





30.6 Management 212





30.6.1 Acute Phase Treatment 212





30.6.2 Treatment of Chronic Periodontal Disease 212





30.6.3 Corrective Phase Treatment 212





30.4 Maintenance 212





References 213





31 Occlusal Issues and Occlusion 215





31.1 Definitions 215





31.2 Occlusal Philosophies 215





31.3 Assessment and Recording of Occlusion 216





31.4 Articulators 216





31.5 Face?bow 216





31.6 Conformative Approach 217





31.7 Reorganisation of Occlusion 217





31.8 Determinants of Posterior Occlusal Morphology 217





References 219





32 Oncology?Related Defects in Mandible 221





32.1 Introduction 221





32.2 Roles of the Multidisciplinary Team in Head and Neck Cancer Management 221





32.3 Consequences of Cancer Surgery in Mandible 222





32.4 Classification of Mandibular Defects 222





32.5 Rehabilitation of Mandibular Defects 222





32.5.1 Surgical Reconstruction of Mandibular Defects 222





32.5.2 Prosthetic Rehabilitation of Mandibular Defects 223





32.5.2.1 Pretherapy Dental Screening 223





32.5.2.2 Prosthetic Challenges 223





32.5.2.3 Conventional Prosthetic Management 224





32.5.2.4 Implants in Oncology Patients 224





32.5.2.4.1 Indications and Limitations 224





32.5.2.4.2 Relevant History and Preoperative Examination 224





32.5.2.4.3 Planning, Timing and Design Considerations 225





32.5.2.4.4 Primary Implants 225





32.5.2.4.5 Implants in Irradiated Bone 225





32.5.2.4.6 Implants in Grafted Bone Flaps 225





References 229





33 Oncology?Related Defects in Maxillae 233





33.1 Maxillary Tumours 233





33.2 Surgical Resection 233





33.3 Classification of Maxillary Defects 233





33.4 Surgical Reconstruction 234





33.4.1 Local and Regional Flaps 234





33.4.2 Soft Tissue Free Flaps 234





33.4.3 Hard Tissue or Composite Free Flaps 234





33.5 Prosthetic Treatment 234





33.6 Alterations at Surgery to Facilitate Prosthetic Treatment 234





33.7 Prosthetic Treatment Phases 235





33.7.1 Surgical Obturator 235





33.7.2 Interim Obturator 235





33.7.3 Definitive Obturator 236





33.8 Soft Palate Defects 236





33.9 Osseointegrated Implants 236





References 238





34 Open Apex (Immature Non?Vital Teeth) 241





34.1 Definition 241





34.2 Aetiology 241





34.3 Classification 241





34.4 Management Strategies 241





34.4.1 Working Length Determination in Teeth with Open Apices 241





34.4.2 Irrigation Considerations 241





34.4.3 Calcium Hydroxide Apexification 242





34.4.4 Placement of an Apical Plug to Create an Artificial Apical Barrier 242





34.4.4.1 Mineral Trioxide Aggregate 242





34.4.4.2 Biodentine (R) 242





34.4.5 Regenerative Endodontic Treatment 242





References 244





35 Open Bite 247





35.1 Definition and Classification 247





35.2 Aetiology 247





35.3 Incidence 247





35.4 Indications for Treatment 247





35.5 Treatment Options 247





35.5.1 Prevention 247





35.5.2 Orthodontic Treatment 247





35.5.3 Orthognathic Surgery 248





35.5.4 Restorative Treatment 248





References 250





36 Osteoradionecrosis 251





36.1 Definition and Pathogenesis 251





36.2 Prevalence 251





36.3 Risk Factors 251





36.4 Classification of ORN 251





36.5 Diagnosis 252





36.6 Prevention 252





36.6.1 Pre?Radiotherapy Dental Assessment and Extractions 252





36.6.2 Patient Education 252





36.6.3 Minimising Trauma 252





36.6.4 Prophylactic Hyperbaric Oxygen Therapy and Antibiotics 252





36.7 Management 253





References 254





37 Partial Edentulism - Implant Treatment 257





37.1 Introduction 257





37.2 Preoperative Patient Assessment 257





37.2.1 History 257





37.2.2 Clinical Examination 257





37.2.3 Special Investigations 257





37.3 Risk Factors 258





37.3.1 Local Risk Factors 258





37.3.2 Systemic Risk Factors 258





37.3.3 Behavioural Risk Factors 259





37.4 Risk Assessment and Patient Consent 259





37.5 Treatment Considerations 259





37.5.1 Planning Stage 259





37.5.2 Surgical Stage 260





37.5.3 Prosthetic Treatment 260





37.5.4 Replacement of the Anterior Teeth with Implants 261





37.5.5 Replacement of the Posterior Teeth with Implants 261





37.5.6 Considerations in Bruxist Patients 261





37.5.7 Maintenance 262





37.5.8 Implant Complications 262





37.5.8.1 Biological Complications 262





37.5.8.1 Mechanical Complications 262





37.5.8.1 Aesthetic Complications 263





37.5.8.1 Evidence 263





37.6 Implant Survival 263





37.6.1 Implant?Retained Single Crowns 263





37.6.2 Implant?Retained Bridge 263





37.7 Timing of Implant Placement after Tooth Extraction 263





37.8 Timing of Implant Loading 264





References 269





38 Partial Edentulism - Partial Denture Treatment 273





38.1 Introduction 273





38.2 Removable Partial Denture Types 273





38.2.1 Acrylic Dentures 273





38.2.2 Cobalt-Chromium RPDs 273





38.2.3 Flexible Dentures 274





38.2.4 Hypoallergenic Dentures 274





38.2.5 PEEK?based RPDs 274





38.3 Classification of Partially Dentate Arches 274





38.4 General Guidelines 274





38.5 RPD Design 274





38.5.1 Surveying 274





38.5.2 Occlusal Analysis 274





38.5.3 Replacing Anterior Teeth 274





38.5.4 Milled Crowns 275





38.5.5 Components of RPD Design 275





38.5.6 Saddle Areas 275





38.5.7 Rests 275





38.5.8 Retentive Clasps 275





38.5.9 Indirect Retainer 275





38.5.10 Mandibular Major Connectors 275





38.5.11 Maxillary Major Connectors 276





38.5.12 Minor Connectors 276





38.6 Swing?Lock RPD 276





References 278





39 Perforation 281





39.1 Definition 281





39.2 Causes 281





39.3 Pathogenesis 281





39.4 Epidemiology 281





39.5 Classification 281





39.6 Diagnosis 281





39.7 Prognosis 282





39.8 Management 282





39.8.1 Extraction 282





39.8.2 Non?Surgical Treatment 282





39.8.3 Surgical Treatment 282





39.9 Treatment Outcomes 283





References 285





40 Peri?Implant Diseases 287





40.1 Definitions 287





40.2 Aetiology 287





40.3 Risk Factors 287





40.4 Prevalence 287





40.5 Diagnostic Criteria 287





40.6 Patient Assessment 288





40.6.1 Implant Identification 288





40.6.2 Relevant History 288





40.6.3 Assessment of Suprastructure 288





40.6.4 Assessment of Individual Fixtures 288





40.6.5 Assessment of Peri?Implant Soft Tissue 288





40.6.6 Radiographic Assessment 288





40.7 Management of Peri?Implant Mucositis 288





40.8 Management of Peri?Implantitis 288





References 291





41 Periodontal Abscess 293





41.1 Definition and Classification 293





41.2 Pathogenesis 293





41.3 Prevalence 293





41.4 Microbiology 293





41.5 Diagnosis 293





41.6 Differential Diagnosis 294





41.7 Treatment 294





References 296





42 Periodontic?Endodontic Lesion 297





42.1 Definition and Classification 297





42.2 Diagnosis 297





42.3 Prognosis 297





42.4 Management 298





References 300





43 Periodontitis as a Manifestation of Systemic Disease 301





43.1 Introduction 301





43.2 Periodontitis Associated with Haematological Disorders 301





43.3 Periodontitis Associated with Genetic Disorders 301





43.4 Periodontitis Associated with Other Conditions (Not Otherwise





Specified Group) 303





References 305





44 Radiotherapy Side Effects 307





44.1 Introduction 307





44.2 Radiation?Induced Oral Mucositis 307





44.3 Xerostomia 308





44.3.1 Organ?Sparing Radiotherapy 308





44.3.2 Salivary Gland Tissue Transfer 308





44.3.3 Preventive Medication 308





44.3.4 Salivary Stimulation 308





44.3.5 Saliva Substitution 308





44.4 Oral Infections 308





44.5 Trismus (Restricted Mouth Opening) 309





References 311





45 Ridge Defects (Generalised) 313





45.1 Introduction 313





45.2 Classifications 313





45.3 Neutral Zone Impression Technique for Resorbed Ridges 313





45.4 Magnet?Retained Conventional Overdenture 314





45.5 Implant?Supported Overdentures 314





45.6 Full?Arch Implant?Retained Fixed Prosthesis 315





References 317





46 Ridge Defects (Localised) 319





46.1 Introduction 319





46.2 Ridge Augmentation by Soft Tissue Grafts 319





46.3 Ridge Augmentation with Hard Tissue Surgery 320





46.3.1 Anatomical Repositioning Techniques 320





46.3.2 Bone Grafting 320





References 324





47 Shortened Dental Arch (SDA) 325





47.1 Definition 325





47.2 History 325





47.3 Effect of SDA on Oral Health?Related Quality of Life 325





47.4 Effect of Tooth Loss on Masticatory Function 325





47.5 Effect of SDA on Occlusal Stability 325





47.6 Effect of SDA on Temporomandibular Joint 326





47.7 Alternative Treatment Options 326





References 327





48 Supernumerary, Fusion and Gemination 329





48.1 Supernumerary (Hyperdontia) 329





48.1.1 Prevalence 329





48.1.2 Classification 329





48.1.3 Aetiology 329





48.1.4 Oral and Dental Complications 329





48.1.5 Examination and Diagnosis 329





48.1.6 Management 330





48.2 Fusion 330





48.2.1 Classification 330





48.2.2 Aetiology 330





48.2.3 Incidence 330





48.2.4 Relevant Investigations 330





48.2.5 Treatment Options 330





48.3 Gemination 331





References 332





49 Temporomandibular Disorders 335





49.1 Definition 335





49.2 Prevalence 335





49.3 Classification 335





49.4 Aetiology 335





49.5 Diagnosis 336





49.6 Special Investigations 336





49.7 Management 336





49.7.1 Patient Education 336





49.7.2 Jaw Exercise and Manual Therapy 336





49.7.3 Acupuncture 336





49.7.4 Pharmacotherapy 337





49.7.5 Occlusal Stabilising Splint Therapy 337





49.7.6 Anterior Repositioning Splint 337





49.7.7 Occlusal Adjustment 337





49.7.8 TMJ Lavage 337





49.7.9 Surgery 337





References 338





50 Tooth Wear 341





50.1 Definitions and Clinical Features 341





50.2 Aetiology 341





50.2.1 Parafunction and Occlusion 341





50.2.2 Intrinsic Acids 341





50.2.3 Extrinsic Acids 342





50.3 Prevalence 342





50.4 Classification 342





50.5 History and Examination 343





50.6 Prevention 343





50.7 Management of Worn Teeth 343





50.7.1 Conformative Approach 343





50.7.2 Reorganisation Approach 343





50.7.3 Occlusal Splint Therapy Prior to VD Increase 344





50.7.4 Fixed Restorations 344





50.7.4.1 Direct Fixed Restorations 344





50.7.4.2 Indirect Fixed Restorations 344





50.7.5 Crown Lengthening 345





50.7.6 Removable Treatment Options 345





50.7.7 Maintenance 346





References 350





Index 355

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