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October 2021
Volume 42, Issue 9

First, Find the Problem

It all begins with the diagnosis. When patients present with dental pain, the diagnosis must be correct in order for the treatment to be successful. The treatment, in fact, is dependent on an accurate diagnosis.

Obtaining such a diagnosis, however, is not always easy. As endodontists know, despite there being a plethora of ways to identify endodontic pain-cold, heat, pressure-not every patient has easily recognizable symptoms, and sometimes clinicians have to resort to less conventional tactics. As discussed in our first continuing education (CE) article in this issue, this is where the use of selective anesthesia may come in. As the authors explain, when patients have pain that is poorly localized, local anesthetics can be effectively used to not only relieve pain but serve as a diagnostic tool. This review describes how selective anesthesia works, with cases illustrating its usefulness.

While there is more than one way to diagnose endodontic pain, there certainly is more than one way to treat the replacement of a missing maxillary lateral incisor, one of the more challenging tasks for clinicians. Dental implants have become fairly common as a treatment option in these cases, yet implant placement may not always be well-suited for every patient, particularly in a younger patient where continued alveolar bone growth and eruption of adjacent teeth may still be factors. In our second CE article, the authors present various treatment options to replace a missing maxillary lateral incisor, including the economical, esthetic, and durable bonded zirconia bridge.

Speaking of bonding, our roundtable discussion this month focuses on the use of universal adhesives as a bonding strategy, and our Special Report provides a "state-of-the-industry" overview on adhesive dentistry. Other articles in this issue range from treatment of recurrent "gummy" smile, to fabrication of a prosthetically guided cast post-and-core, to use of a novel volume-stable collagen matrix for peri-implant support, to a review of the significance of facial bone thickness following implant therapy. Be sure to also see our "online only" offerings (p.490).

We trust that you will find this issue useful in your quest to not only detect the problems but also provide the solutions.


Markus B. Blatz, DMD, PhD

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