The Patients Keep It Interesting
As we've noted many times in Compendium over the years, no two dental patients are exactly the same. Although general rules apply in every situation, as most clinicians have discovered-hopefully not the hard way-often there are exceptions to the rules. Even within general rules, there may be gray areas. Through experience we learn the nuances of dentistry and discover that what may be appropriate for one patient might not be optimal for another.
Take the question of tooth extraction, for example, which is the subject of our first continuing education (CE) article. Some schools of thought, particularly in this day and age where implant dentistry is thriving, advocate extraction, especially when it may benefit bone preservation. While this may be so in some cases, the authors argue that extraction usually should be considered a last resort, that patients should understand the finality of it, and it should be indicated primarily only when restoration is not an option.
Our second CE also demonstrates differences among patients-in this instance the disparity between children and adults. Clearly, there is a world of dissimilarity when treating pediatric patients versus adult patients with regard to pharmacological principles. This article discusses pharmacokinetics and pharmacodynamics, highlighting the many variances that exist between these two groups of patients.
This month's featured case report focuses on the prosthetic and surgical management of atypical tooth spacing caused by congenitally missing teeth. The authors describe two cases in which interdisciplinary therapy involving multiple specialists resulted in successful outcomes, both functionally and esthetically. Again, although restorative principles are fairly universal, as this article attests, each case is different.
Additionally, a clinical research study examines the use of computer-guided placement of zygomatic implants, which have shown to be a predictable and safe implant treatment modality in the maxillary jaw. This article describes a novel protocol that utilizes 3D computerized implant planning and a specific surgical guide for enhanced operator visualization and control.
The fact that every patient is different-even if just a little bit-makes dentistry fun and keeps it interesting. At Compendium, we'll keep you informed of the principles; you just keep finding those rare and unusual patients.
Louis F. Rose, DDS, MD