The Dynamics and Function of the Masticatory System: The Multiple (Inter)forces of Occlusion
Dr. Henry Gremillion
The masticatory system functions in a complex, integrated, orthopedic manner. Many different philosophies regarding occlusal function are espoused. It is recognized that long-term orthopedic stability is dependent on the harmonious function of the dentition, hard and soft tissue supporting structures, temporomandibular joint complexes, and the neuromuscular system of the head and neck. A detailed analysis of the various components with an understanding of anatomy, physiology, and neural pathways facilitates case-specific diagnosis and management. Physiologic occlusal function is recognized to be a key component of orthopedic stability of the masticatory system. A causal relationship between mechanical stresses such as those associated with occlusal parafunction (clenching/bruxing) has been suggested by many. As forces enter the masticatory system they are dissipated through many structures including the temporomandibular joint complex , in some cases resulting in maladaptation and/or pathology. This presentation will include a recommended protocol for patient evaluation. Molecular biological factors currently recognized to result from excessive mechanical stresses applied to these structures will be highlighted. Oroposed etiologic and maintaining factors of subgroups temporomandibular disorders and their management will be discussed.
- Understand the basic principles of anatomy and function of the masticatory system.
- Recognize the clinical signs/symptoms of maladaptive occlusion.
- Understand the dentist’s role in the diagnosis and management of sleep disturbances, specifically nocturnal bruxism.
- Better appreciate the role of occlusal orthoses in patient care.
Operative Dentistry, Inc. designates this activity for 1 continuing education credit. Dr. Gremillion reports no proprietary, financial or other personal interest of any nature or kind in any product, service and or company that will be presented.
Common and Sometimes Invisible Ethical Issues in the Care of Dental Patients
Dr. Larry Garetto
An ethical dimension in the care environment is present each and every time an oral health provider interacts with a patient. There is never a scenario when it does not exist. Being willing and able to recognize ethical issues is the first and most important step in addressing them. The presentation will discuss common and sometimes invisible ethical issues in the care of dental patients and present a decision making framework for dealing with them.
- Describe the ethical dimension present in the clinical care of patients.
- Distinguish the similarities and differences between clinical ethical and professional ethical issues.
- Understand the four-box framework for identifying ethical issues in the clinical care of patients.
Operative Dentistry, Inc. designates this activity for 1 continuing education credit. Dr. Garetto reports no proprietary, financial or other personal interest of any nature or kind in any product, service and or company that will be presented.
The 36th Buonocore Memorial Lecture
To Crown or Not to Crown – Are the Traditional Treatment Concepts Outdated?
Dr. Irena Sailer
The prosthetic rehabilitation of patients with fixed restorations traditionally encompassed single crowns and/or bridges, cemented onto prepared abutment teeth with aid of conventional cements. In case of a lack of tooth substance the abutment teeth had to be built- up in order to deliver the geometrically desired shape, conicity and size to retain the restorations. The preparation requirements were mostly material- related, based on the needs of metal- ceramic restorations and later also adapted to the needs of all- ceramic restorations. These traditional treatment concepts are supported by a strong body of evidence, numerous studies were published over the last 20 to 30 years on the outcomes of full crown and bridgework. Recent systematic reviews of the literature demonstrate excellent survival rates of both metal- ceramic and all- ceramic restorations.
Yet, the reviews also highlight that loss of abutment tooth vitality is one predominant biologic complication of the traditional fixed restorations mostly caused by the invasive tooth preparation, hence iatrogenic. Yet, significant improvements of the adhesive cementation technology and the restorative materials composite and ceramics open- up a new less invasive treatment approach. Instead of preparing teeth to deliver retention to restorations, the current minimally- invasive treatment concepts focus on adhesively bonding them to the substrate and enabling defect- oriented restorations. New restoration types such as additional / non- prep veneers, onlays, overlays, overlay- veneers are increasingly being used for prosthetic rehabilitation today.
- Elaborate the actual possibilities of the non- and minimally- invasive restorations.
- Discuss their indications and current limitations for the rehabilitation of vital and non-vital teeth.
Operative Dentistry, Inc. designates this activity for 1 continuing education credit. Dr. Sailer reports no proprietary, financial or other personal interest of any nature or kind in any product, service and or company that will be presented.
Current Trends in Caries Detection and Diagnosis
Dr. Kim Diefenderfer
The treatment of dental caries remains a fundamental aspect of restorative practice. Dental caries is a rather complex, site-specific disease process. Accurate diagnosis is paramount to clinical success. Yet, many practitioners may still equate the caries lesion with the caries process, paying little attention to causative or mitigating factors. This presentation will discuss several strategies, including the use of new diagnostic technologies, to maximize clinical success in caries detection and diagnosis.
- Understand the difference between caries detection and caries diagnosis.
- Describe the characteristics of active and inactive/arrested caries lesions.
- Describe the advantages and disadvantages of current technology-based caries detection methods.
- Understand the importance of caries risk assessment in caries diagnosis and treatment planning.
Operative Dentistry, Inc. designates this activity for 1 continuing education credit. Dr. Diefenderfer reports no proprietary, financial or other personal interest of any nature or kind in any product, service and or company that will be presented.
Operative Dentistry from a Pediatric Dentistry Perspective: Managing the Deep Carious Lesions
Dr. Daniela Silva
Los Angeles, California
With the modern philosophy of caries management, the use of preventive therapies and remineralization as well as the scientific progress in dental adhesives and restorative materials, dental professionals have options to deliver conservative minimally invasive, functional and esthetic treatments to their patients. The clinical application of conservative treatment of deep carious lesions requires a paradigm shift from the conventional caries removal concepts and practices of removing all soft and leathery dentin until a hard dentin surface is achieved. This approach might lead to unwanted pulp exposure and subsequently could decrease the life span of the tooth. To minimize this risk, conservative carious tissue removal techniques have been proposed, including partial removal and stepwise excavation.
- Review the evidence based knowledge behind our understanding of the diagnosis and treatment of deep carious lesions in young permanent teeth.
- Understand the biologic evidence behind the type of carious dentin that needs to be removed, focusing on changing and active lesion into an arrested lesion without performing an excavation close to the pulp.
Operative Dentistry, Inc. designates this activity for 1 continuing education credit. Dr. Silva reports no proprietary, financial or other personal interest of any nature or kind in any product, service and or company that will be presented
Insights from a Navy Operative Dentist
Dr. Jeffrey Nordin
North Chicago, Illinois
This course will look at how information that is passed at the Academy of Operative Dentistry Annual Meeting is incorporated into the everyday practice of a Navy Dentist. Over the past several years the Academy Program has addressed several topics that are very pertinent to our practice in the Navy, in particular with respect to patients we treat in the Navy/Military.
- Caries Risk Management/Preventive Dentistry.
- What is the Navy’s current policy on Caries Risk Management?
- Some of the materials and methods we us and our rationale for using them.
- What exactly is going on with amalgam?
- Is composite resin the answer in all cases?
- How do we restore the “bombed-out” tooth?
- How has the Navy integrated CAD/CAM dentistry?
Operative Dentistry, Inc. designates this activity for 1 continuing education credit. Dr. Nordin reports no proprietary, financial or other personal interest of any nature or kind in any product, service and or company that will be presented.
Richard V. Tucker Lecture of Excellence, Part 1
Minimally Invasive Management of Complex Dental Problems
Dr. Frank Spear
Dr. Bob Barkley, the famous American preventive dentist of the 1960’s and 70’s, stated that the “goal of dentistry is to make the patient worse at the slowest possible rate.” Often times, in the recent history of our profession, the treatments provided appear to reverse that concept and accelerate the rate of destruction. This presentation will focus on a fundamental concept, the least invasive treatment is no treatment. Yet we know that there are situations in which doing nothing is not an acceptable option due to the predictable and negative consequences of the condition. But there are also times when in fact no treatment, or minimal treatment is acceptable. The presentation will identify commonly seen conditions related to esthetics, occlusion, tooth replacement, and restorative dentistry, and discuss the concept of acceptable compromise, as well as look at what treatment options may be considered in place of more traditional prosthodontic approaches. The focus will be on the Management of Problems over the course of a patient’s life-time, as opposed to thinking one course of treatment will provide a permanent cure.
- The concept of management vs cureHow to systematically address the prognosis of tooth removal and replacement prior to performing it.
- How staging treatment over several decades may be preferential to acting now.
- When action must be taken, how the concept of, “what is next”, may help in the decision process of how to act.
Operative Dentistry, Inc. designates this activity for 3 continuing education credits. Dr. Spear reports no proprietary, financial or other personal interest of any nature or kind in any product, service and or company that will be presented.
Richard V. Tucker Lecture of Excellence, Part 2
Dr. Spear’s presentation on Minimally invasive management of complex dental problems continues.
From 11:30 – Noon: Question and Answer Session of Dr. Spear’s Lecture
Moderated by Dr. Richard Vinci and Dr. Fred Eichmiller
Creating Natural Smiles with Minimally Invasive Dentistry
Dr. Rodrigo Maia
Iowa City, Iowa
The purpose of this course is to present direct bonded restorative approaches for anterior teeth based on a minimally invasive principles, planning, materials (adhesive systems and resin based composites) and clinical approaches (photo curing strategies and layering techniques). The focus of this lecture will help the dentist achieve excellent esthetics, function and affordable solutions while preserving natural tooth structure.
- Understand minimally invasive concepts and their influence in esthetic dentistry.
- Understand the keys to be able to achieve long term and aesthetic direct restorations.
- Incorporate new concepts of light curing, dental adhesives and resin based composite materials into their practice.
The Academy is grateful to Dr. Rodrigo Maia, who is serving as stand-by clinician this year in the event that another essayist cannot be present.
Operative Dentistry, Inc. designates this activity for 1 continuing education credit. Dr. Maia reports no proprietary, financial or other personal interest of any nature or kind in any product, service and or company that will be presented.