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Root Fracture During Insertion of Prefabricated Posts

Root Fracture During Insertion of Prefabricated Posts
The consequence of inappropriate post selection and/ or hasty insertion can result in tooth fracture and/or loss. It has been demonstrated that conical or parallel sided post design has a direct effect on root fracture during post insertion. However, during experimentation it became apparent that root size and its relationship to post size had a direct effect on root fracture. This article correlates root size, post size, and fracture rate during insertion of prefabricated posts.

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Allan S. Deutsch, DMD, Barry Lee Musikant, DMD, John Cavallari, MS (EE), James Lepley, DDS, Karen Ohlen, BA, Martin Lesser, PhD
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Mental Neuropathy Associated with Malignant Disease

Mental Neuropathy Associated with Malignant Disease
In the current report, we emphasize that mental neuropathy is often a sign of progressive or recurrent malignant disease, despite normal results of a mandibular radiograph in a diagnostic evaluation.

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Michael Szikman, DDS, Roger Melkonain, DDS, Daniel Dubovsky, MD
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Maintaining Dental Implants

Maintaining Dental Implants
Implant dentistry has become an important treatment regimen in restorative dentistry since outcome predictability became very well-established and recognized for long-term dental implant and restoration success. The increasing number of patients selecting dental implants as a treatment option presents the dental team with the challenge of maintaining these sometimes complex restorations. This article will help the reader to understand the similarity and differences in the periodontal structure…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Gregori M. Kurtzman, DDS, MAGD, DICOI
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Bipolar Soft Tissue Management &amp; Functional Mock-Ups

Bipolar Soft Tissue Management & Functional Mock-Ups
Patients desiring a cosmetic smile improvement can present challenges to the dentist when treatment planning. An excessive display of gingiva due to a high lip line often complicates treatment planning and can compromise the final esthetic result when proper planning is not considered prior to finalizing the case. We often have to ask ourselves as we evaluate the patient, do we “lower the river” (increase tooth length incisally), “raise the bridge” (increase tooth length gingivally) or a combination…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Gregori M. Kurtzman, DDS
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Linear Tomography in Conjuction with Pantomography in Implant Assessmnet Sites

Linear Tomography in Conjuction with Pantomography in Implant Assessmnet Sites
Tomography provides a three-dimensional unobstructed and anatomically accurate picture of the region being viewed. Tomography is a radiographic technique in which a "slice" or section of a given internal body structure is imaged in a pre-determined plane. The advantage of utilizing a tomographic evaluation along with a pan tomographic survey is that the clinician may examine the exact position or depth in all three planes of visualization. This radiographic modality can also reveal the quality and…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Roger W. Melkonian, DDS, David Kurtzman, DDS, Jerry J. Garnick, DDS, Michael D. Lefkove, DDS
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Laboratory Technology

Laboratory Technology
Prosthodontic treatment ofthe edentulous cleft palate patient presents the dentist with numerous challenges for achieving a satisfactory result for the patient. A technique is described for prosthodontic rehabilitation of a completely edentulous cleft palate patient using bone augmentation procedures, root-form dental implants, and a removable maxillofacial prosthesis. Dental implants may improve prosthesis retention, stability, and occlusal function when used in carefully selected cases.

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Michael D. Lefkove, DDS, Bill Matheny, CDT
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Instrumentation for Modern Day Implant Surgery

Instrumentation for Modern Day Implant Surgery
Public awareness of the aesthetic possibilities through the replacement of missing or nonsalvageable teeth has been elevated with advances in dental implant therapy and related hard and soft tissue regenerative therapies. This has led to an increase in the fabrication of fixed prostheses supported by either natural teeth, dental implants, or removable prostheses anchored by implants rather than conventional tissue- or tooth-supported partial dentures.

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Peter C. Shatz, DDS
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Improving Diagnosis Through the Use of Digital Radiography

Improving Diagnosis Through the Use of Digital Radiography
As aesthetic dentistry has gained in popularity among. consumers, who are mare aware of the potential it has to correct deficiencies in their smiles, practitioners are challenged to improve the nature of their treatment. Often, this entails providing treatment with a smaller associated expense, reduced treatment duration or expense, and w ith increased comfort to the patient throughout the procedure. Facing these imperatives, greater numbers of practitioners have opted to incorporote digital communications…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD
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Implant Therapy-Sequence of Surgical &amp; Restorative Phases

Implant Therapy-Sequence of Surgical & Restorative Phases
Failure of the natural dentition due to periodontal- or endodontic-related osseous infections may complicate implant therapy. Sequencing (ie, staging) of the surgical aspects of the treatment is essential to achieve the desired restorative objectives. Additionally, for indications in which the adjacent natural teeth require cosmetic enhancement as part of the overall treatment plan, proper sequencing will influence the definitive results. The following article discusses the surgical and restorative…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Gregori M. Kurtzman, DDS, Peter C. Shatz, DDS
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Implant Prosthodontic Procedures for a Completely Edentulous Patient with a Cleft Palate

Implant Prosthodontic Procedures for a Completely Edentulous Patient with a Cleft Palate
Cleft lip and palate maxillofacial prosthodontics is evolving and re-defining treatment approaches via the use of dental implants. A case report is presented demonstrating the use of the sinus lift procedure originally described by Tatum, the placement of osseointegrated root-form implants, and an implant-supported and -retained maxillofacial prosthesis.

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Michael D. Lefkove, DDS, Bill Matheny, CDT
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Guide to Diagnosing &amp; Treating Endodontic &amp; Periodontal Lesions

Guide to Diagnosing & Treating Endodontic & Periodontal Lesions
The gathering of diagnostic information using radiographs and conventional pulp vitality testing serves as the current foundation for milking uncomplicated endodontic diagnoses. Acquiring and investigating diagnostic information can be analogous to piecing together a puzzle. As each piece fits, a picture begins to emerge. but if the puzzle contains too many pieces and inherently becomes more complex, frustration mounts and elucidating the pIcture becomes more difficult. Therefore, the practitioner must…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Peter C. Shatz, DDS, Albert L. Amato, DDS, David Kurtzman, DDS
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Clinical and Microbiological Effects of Local Tetracycline Irrigation on Periodontitis

Clinical and Microbiological Effects of Local Tetracycline Irrigation on Periodontitis
This investigation was conducted on seven individuals referred for treatment of moderate adult periodontitis. Twenty-eight sites with an average probing depth of 5.6 ± 0.9 mm were evaluated. One tooth per jaw quadrant was randomly assigned to receive one of the following treatments: (I) no treatment, i.e., control; (II) saline irrigation; (III) tetracycline irrigation and (IV) scaling and root planing (SC/RP). A plaque control program was instituted one week prior to the experimental period and reinforced…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Nabil Bissada, M. Manouchehr-Pour, Henry Greenwell
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Orthodontic Treatment as a Prelude to Dental Implant-Supported Restorations

Orthodontic Treatment as a Prelude to Dental Implant-Supported Restorations
Adjunctive orthodontic therapy is tooth movement that either facilitates other dental procedures necessary to control periodontal disease, or changes tooth positions that are not conducive to long-term oral health. Such therapy restores proper occlusal function and provides a healthy foundation for an aesthetic smile. When adjunctive orthodontic therapy is utilized. as part of a multidisciplinary dental team treating complex restorative cases, such as those involving the use of prosthetically guided…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Marc E. Moskowitz, DDS, David Kurtzman, DDS
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Using Cross-Sectional Tomography to Perform Exploratory Radiography

Using Cross-Sectional Tomography to Perform Exploratory Radiography
Since osseointegration was first introduced by Branemark, dental implants have been used increasingly to replace missing teeth. The high predictability of implant success has been well documented. Unfortunately, there are numerous failures in implant dentistry. The primary failure on endosseous dental implants include improper diagnosis, treatment planning, and/or sequenceing; poor periodontal tissue management and/or maintenance; improper implant position at surgery; and aesthetic requirements…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Donald Callan, DDS, David Kurtzman, DDS
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Bisphosphonates and Their Impact on Patient Treatment

Bisphosphonates and Their Impact on Patient Treatment
There has been increasing discussion concerning a variety of implications for patients who have been administered bisphosphonates, which are FDA-approved chemical agents used in the treatment of osteoporosis, metastatic cancer involving the bone, and Paget's disease. I The first report of the biological characteristics of bisphosphonates was published in 1968, when scientists discovered that bisphosphonates have a marked ability to inhibit bone resorption. Bisphosphonates suppress or reduce bone…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Gregori M. Kurtzman, DDS, John Peden, DDS
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Barriers in the Surgical Suite: Standards Required

Barriers in the Surgical Suite: Standards Required
Dental implant, periodontal , and oral surgical procedures or any potentially hemorrhagic procedures put the practitioner and staff at risk for exposure to blood-borne viruses (eg, AIDS, Hepatitis B, Hepatitis C), as well as saliva and blood-transmitted pathogens (eg, Mycobacterium tuberculosis, Staphyloccus, Streptococcus, cytomegalovirus). There are also a number of viruses that may infect the upper respiratory tract. In these cases, infections may be transmitted through direct contact with blood…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Gregori M. Kurtzman, DDS
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Aesthetic Enhancement of Pontic Sites for Fixed Partial Dentures

Aesthetic Enhancement of Pontic Sites for Fixed Partial Dentures
An adequate alveolar bone base is the prerequisite for functional and aesthetically optimal reconstruction of the soft tissue architecture for a fixed partial denture pontic site or dental implant site. If the horizontal and vertical dimensions of the ridge deficiency are within 3 mm of their original contour, acceptable results can he achieved by soft tissue augmentation procedure only, ie, connective tissue grafts, onlay grafts, or an inlay rolled graft. These procedures are usually performed…

Author(s): Jack A. Hahn, DDS;Lee H. Silverstein, DDS, MS, FACD, FICD;David Kurtzman, DDS, Scott Harden, DMD, Peter C. Shatz, DDS
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Aesthetic Enhancement of Anterior Dental Implants with the Use of Tapered Osteotomes &amp; Soft Tissue Manipluation

Aesthetic Enhancement of Anterior Dental Implants with the Use of Tapered Osteotomes & Soft Tissue Manipluation
An adequate bone base is usually a prerequisite for functionally and aesthetically optimal reconstruction of the soft tissue architecture around a dental implant. In patients with sufficient bone height but insufficient bone width as a result of tooth loss, a jaw enlargement technique with osteotomes combined with soft tissue manipulation may be utilized to facilitate proper implant placement while concomitantly optimizing the aes thetics of the final implant prosthesis. The learning objective of…

Author(s): Jack A. Hahn, DDS;Lee H. Silverstein, DDS, MS, FACD, FICD;Gregori M. Kurtzman, DDS, Marc E. Moskowitz, DDS, David Kurtzman, DDS
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Using an Acellular Dermal Matrix for Increasing Keratinized Tissue Around Dental Implants

Using an Acellular Dermal Matrix for Increasing Keratinized Tissue Around Dental Implants
In previously published articles, investigators concluded that gingival recession may affect up to 90% of the population. Gingival recession ranges from one to three millimeters and is predominantly noted on the buccal surfaces of molar, premolar, and lower incisor teeth. Although surgical grafting techniques have traditionally been used to restore these recession sites, an acellular allograft material has recently been developed for increasing the zone of keratinized tissue surrounding teeth and…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD
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Alloplastic Bone Substitutes Around Dental Implants

Alloplastic Bone Substitutes Around Dental Implants
The repair of osseous defects has been a goal in dentistry for many decades. Subsequently, within the last several years, there has been an emergence of a new class of materials in dentistry referred to as synthetic bone. Finding the ideal bone substitute material has been the goal of researchers for many years. In attempting to achieve this ideal material, dental practitioners have tried with varying degrees of success: autogenous and demineralized freeze-dried bone, allografts of plastic, carbon…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Lee M. Whitesides, DMD, MMSC
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