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June 2017
Volume 38, Issue 6

Proceed With Caution

As in every field of medicine, dentistry has witnessed a barrage of technological advances over the years. From digital imaging, to implant improvements, to restorative material innovations, technology has forged a path to enhanced techniques and greater predictability. Yet, despite the availability of the best tools, instruments, and products, when clinicians treat patients, great care and caution must remain at the top of their armamentarium list.

This mentality is pervasive throughout this issue of Compendium. The first continuing education (CE) article discusses challenges in dental implant placement in the anterior maxilla, where the nasopalatine canal can be an impediment. The authors write that the position and size of the canal and its foramen with respect to the teeth, buccal plate of bone, and type of planned prosthesis are key factors to consider, and that, if managed appropriately, placing an implant into the nasopalatine canal is viable when alternate sites are inaccessible.

Another treatment that requires careful case selection is immediate implant placement and provisionalization. In a case report involving a severely reduced periodontium for a tooth planned for extraction, the authors discuss the importance of exercising caution when dealing with a compromised soft- and hard-tissue architecture. As shown, immediate implant placement and provisionalization with a technique using the extracted tooth with simultaneous tissue augmentation was successfully performed in one visit.

Our other CE addresses the complexity of the pulp root canal and the difficulty in achieving complete disinfection, shaping, and filling to prevent bacterial infiltration. Newer biomaterials for use in endodontics, such as mineral trioxide aggregate (MTA)- and calcium phosphate-based materials, promote pulpal and periapical healing. This article examines these bioactive materials, including the potential of injectable bone substitutes.

Additionally, we report on the use of bloodborne pathogens exposure control plans (ECPs) in private dental practices. A survey conducted by NIOSH and OSAP revealed that many practices are unaware of or lacking required elements of an ECP. This article reveals the survey results.

While dentists are encouraged to try new techniques and utilize innovative methods, they should always proceed with caution and put patient well-being and safety first. Visit for resources that will aid in your decision making.

Louis F. Rose, DDS, MD

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