Ronald E. Goldstein

Esthetics in Dentistry

In the authors opinion, the subject of esthetics should be offered as a comprehensive course and should be included in the dental school curriculum.

Study of need for esthetics in dentistry.

T he literature contains numerous documented articles showing the need for treatment of caries and missing teeth. l-l5 However, it is apparent that people cannot enjoy complete social and mental well-being if their mouths are esthetically displeasing. I6 Nevertheless, there is an absence of material related to patient attitudes and desires for esthetic treatment. For this reason, a preliminary two-year study on esthetic motivation was undertaken. The group that was chosen for the study might be more conscious of esthetics than the average population. Sixty young ladies, ages 17 to 25, who were finalists for the 1966 and 1967 Miss Atlanta Pageants were surveyed. The girls were not given advance notice of the purpose or method of doing the survey.

The clinical management of awake bruxism

BACKGROUND Awake bruxism is a common clinical condition that often goes undetected, often leading to pain or damaged teeth and restorations. METHODS The authors searched electronic databases regarding the treatment and effects of awake bruxism compared with those of sleep bruxism. The authors used the search terms diurnal bruxism and oral parafunction. The authors combined information from relevant literature with clinical experience to establish a recommended protocol for diagnosis and treatment. RESULTS The authors found articles regarding the diagnosis and treatment of bruxism. The authors combined information from the articles with a review of clinical cases to establish a treatment protocol for awake bruxism. CONCLUSIONS Literature and clinical experience indicate a lack of patient awareness and, thus, underreporting of awake bruxism. As a result, myriad dental consequences can occur from bruxism. The authors propose a need for increased awareness, for both patients and professionals, particularly of the number of conditions related to awake bruxism. PRACTICAL IMPLICATIONS Clinicians should look for clinical signs and symptoms of awake bruxism and use minimally invasive treatment modalities.

Microleakage around Class V Composite Restorations after Ultrasonic Scaling and Sonic Toothbrushing around their Margin.

ABSTRACT Objectives To measure microleakage around class V composite restorations after piezoelectric ultrasonic scaling and sonic toothbrushing. Methods 3 mm × 2 mm × 1.5 mm boxes were prepared on buccal and lingual surfaces of extracted molars centered on the cementum‐enamel junction. Half the preparations were beveled (0.5 mm). Preparations were restored with composite and polished. Restorations on one side of the teeth were either traced with an ultrasonic scaler (60 seconds, n = 16) or brushed in a sonic toothbrushing machine (2 hours, n = 16). After thermocycling (10,000 cycles/5–55°C), specimens were immersed in 5 wt% Fuchsine solution (24 hours). Samples were sectioned and evaluated for percentage of dye penetration. Data were analyzed with an exact Wilcoxon rank‐sum test and exact Wilcoxon signed‐rank test (alpha = 0.05). Results Microleakage was observed at the cementum‐composite interface but not the enamel‐composite interface. There was not a statistically significant effect of the bevel for ultrasonic scaling or for sonic toothbrushing. Data obtained with and without a bevel were combined and a statistically significant difference in microleakage between the treatment and control sides of the tooth were found for ultrasonic scaling (32.5%±44.9%, n = 16; p = 0.016) but not sonic toothbrushing (2.5% ± 41.2%, n = 16; p = 1.0). Conclusions Piezoelectric ultrasonic scaling increased microleakage at cementum‐composite interface and there was no difference in microleakage with the use of a bevel. Clinical Significance Piezoelectric sonic scaling around Class V composite restorations with margins in cementum should be avoided. Beveled margins will not reduce the incidence of microleakge resulting from ultrasonic scaling in Class V restorations. Placing the apical margin of the restoration in enamel should be attempted whenever possible to prevent future microleakage. (J Esthet Restor Dent 29:41–48, 2017)