Review of the Modern Dental Ceramic Restorative Materials for Esthetic Dentistry in the Minimally Invasive Age
This article is designed to provide the practitioner with up-to-date practical information on ceramic restorative materials and techniques in a clear, evidence-based, and unbiased manner. It also provides decision-making guides to help the practitioner determine the best ceramic material for various clinical scenarios. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - July 30, 2020 Category: Dentistry Authors: Alireza Moshaverinia Source Type: research

The Use of Botulinum Toxin and Dermal Fillers to Enhance Patients ’ Perceived Attractiveness
Physical appearance and attractiveness consciously and subconsciously, affect patients ’ quality of life. Traditionally, dentists were tasked with improving a patient’s smile, a central aspect of facial aesthetics and physical appearance. More recently, as the scope of practice of the aesthetic dentist has broadened to potentially include other components of facial cosmesis that g o hand-in-hand with a patient’s smile, new options have emerged with which modern aesthetic dentists should familiarize themselves. As laws surrounding their use in dental offices continue to evolve, Botox and dermal fillers rep...
Source: Dental Clinics of North America - July 30, 2020 Category: Dentistry Authors: Phong Tran Cao Source Type: research

Adhesive Dentistry
Successful adhesive dentistry begins with correct placement and polymerization of the bonding agent. Although numerous agents exist, all abide by certain key principles, including the newest group, the universal adhesives. Fundamental steps also exist in the application process that require the operator to understand the chemistry of the adhesive being used. Modalities exist that can help preserve the durability of the bond achieved, thus slowing down the degradation process. However, no material or agent can overcome poor technique. Thus, it is of the utmost importance that the practitioner respects the technique sensitiv...
Source: Dental Clinics of North America - July 15, 2020 Category: Dentistry Authors: Marc Hayashi Source Type: research

Preface
Dentists have been on the forefront of pain management for well over 4000 years.1 In fact, it was a dentist, William Morton, who pioneered the first public demonstration of anesthesia at Massachusetts General Hospital in 1843, an event that made possible the development of Surgery as we know it today. In the years that followed, a range of oral analgesics also was developed as a mainstay of acute pain management in dental care. With all of these efforts, the late nineteenth century brought a recognition that prescribed opioids for pain could pose addiction-related risks. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Authors: Ronald J. Kulich, David A. Keith, Michael E. Schatman Source Type: research

Introduction
Dental pain is real, and most dentists in practice were taught that the most effective way to alleviate severe pain was with opioid painkillers. That ’s what I was taught during my dental school experience and my residency in pediatric dentistry. During the early part of my career in dental education, I served as Dean for Clinical Affairs at the dental schools at Harvard University and the University of Connecticut. Students and residents faced with patients who presented complaining of pain were eager to address their symptoms, and opioids were often prescribed for them. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Authors: Richard W. Valachovic Source Type: research

Controlled Substance Risk Mitigation in the Dental Setting
DENTAL CLINICS OF NORTH AMERICA (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Authors: Ronald J. Kulich, David A. Keith, Michael E. Schatman Source Type: research

Copyright
ELSEVIER (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Source Type: research

Contributors
RONALD J. KULICH, PhD (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Source Type: research

Contents
Ronald J. Kulich, David A. Keith, and Michael E. Schatman (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Source Type: research

Dental Clinics of North America
The Journey to Excellence in Esthetic Dentistry (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - May 22, 2020 Category: Dentistry Source Type: research

Dentistry ’s Role in Assessing and Managing Controlled Substance Risk
Dentistry is in a unique position among the health care professions to assess and manage the patient with controlled substance risk. The concern over opioid risk is not new, and historically dentists have had to balance the critical need for adequate pain care with the importance of recognizing the consequences of using controlled substances for their patients. Barriers for providing adequate patient assessment and management may be greater in dentistry than other health care fields, although these barriers can be recognized and overcome. Collaboration with cotreating providers will improve patient outcomes and reduce pati...
Source: Dental Clinics of North America - April 29, 2020 Category: Dentistry Authors: Shuchi Dhadwal, Ronald J. Kulich, Priyanka Monga, Michael E. Schatman Source Type: research

Special Screening Resources
The prescription drug crisis has affected all sectors of the population, and so it is inevitable that dentists will increasingly see at-risk patients or those with substance use disorders in the course of their professional activities. Recognizing these patients and the special needs that they may have is now part of the standard of care for the profession. Screening for substance misuse involves a thorough history and review of the patient ’s medical record and, as appropriate, reviewing prior records and use of available screening tools. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 28, 2020 Category: Dentistry Authors: David A. Keith, Mar ía F. Hernández-Nuño de la Rosa Source Type: research

Opioid Prescribing in Dental Practice
Dentistry should be proud of its history of providing responsible pain relief, as well as becoming more cautious in prescribing opioid medications when other safer pharmacologic options exist. Our training directs us to first eliminate the source of dental pain and prescribe analgesics only as adjunctive relief. Prescriptions must be written for a legitimate dental purpose and for a patient of record. Through self-regulation, the dental profession must continue to establish pain management guidelines based on scientific evidence and clinical experience to avoid further regulatory action restricting our prescribing privileg...
Source: Dental Clinics of North America - April 28, 2020 Category: Dentistry Authors: David A. Keith, Ronald J. Kulich, Alexis A. Vasciannie, Richard S. Harold Source Type: research

Comorbid Conditions in Relation to Controlled Substance Abuse
Dental patients who experience comorbid psychiatric and medical conditions present an elevated risk of medication misuse, abuse, substance use disorders, and overdose. The authors review the role of notable comorbidities in predicting the development of substance use disorder, including medical, psychiatric, and other psychosocial factors that can be assessed in general dental practice. Psychiatric disorders commonly cooccur with substance abuse, and these typically include anxiety disorders, mood disorders (major depression, bipolar), posttraumatic stress, as well as sleep and eating disorders. Medical disorders commonly ...
Source: Dental Clinics of North America - April 24, 2020 Category: Dentistry Authors: Matthew Fortino, Ronald J. Kulich, Joshua A. Kaufman, Hudson Franca Source Type: research

Managing Acute Dental Pain
Pharmacotherapy forms an integral part of acute dental pain management. In a majority of cases, safe and effective management of acute dental pain can be accomplished with a non-opioid medication regimen. Nonetheless, in certain circumstances use of opioid medications may be needed. Furthermore, there are various pain management regimens, such as pre-emptive analgesia, post-procedural cold compression, use of long acting anesthetic, and compound drug therapy that can improve the efficacy of analgesics to achieve a desired therapeutic response without compromising patient safety. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 23, 2020 Category: Dentistry Authors: Shehryar Nasir Khawaja, Steven John Scrivani Source Type: research

Interprofessional Collaboration in the Assessment and Management of Substance Use Risk
Substance use disorder assessment strategies are increasingly being employed by dentistry, while adequate evaluation requires reaching out to other cotreating providers and collaborating on patient care. The field of dentistry has a range of barriers often not experienced in other professions, including limitations on e-record communication and clinical practice setting often isolated from the patient ’s general medical care. Barriers can be overcome if the dentist facilitates communication. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 20, 2020 Category: Dentistry Authors: Ronald J. Kulich, David A. Keith, Alexis A. Vasciannie, Huw F. Thomas Source Type: research

Assessment and Management of the High-Risk Dental Patient with Active Substance Use Disorder
Every dentist cares for patients with a history of substance use disorder (SUD), regardless of a patient ’s socioeconomic status, education, or ethnicity. SUD is a global epidemic, with approximately 8% of the general US population meeting diagnostic criteria for a SUD and more than 20% of the global population experiencing a SUD. The importance of understanding how to identify substance use, manage patients with a SUD, and offer appropriate referral is essential for all dental professionals. In 2005, the American Dental Association published, “Statement on Provision of Dental Treatment for Patients with Substa...
Source: Dental Clinics of North America - April 16, 2020 Category: Dentistry Authors: Archana Viswanath, Antje M. Barreveld, Matthew Fortino Source Type: research

Brief Motivational Interventions
Motivational interviewing (MI) is an evidence-based approach to resolving patient ambivalence to change. MI techniques can be effectively used by dentists in assessing and managing substance use risk and may add minimal time to the patient interview. Although MI ’s greatest utility has been in the area of improving general oral hygiene in order to reduce caries and other preventable conditions, its use in addressing controlled substance risk is well established in other health care disciplines. These techniques do not require special training in mental he alth assessment and can be effectively used by dentists and de...
Source: Dental Clinics of North America - April 16, 2020 Category: Dentistry Authors: Michael E. Schatman, Hannah Shapiro, Maria Hernandez, Vanak Huot Source Type: research

Special High-Risk Populations in Dentistry
Comprehensive and compassionate treatment of vulnerable patients is an important service to the community, although dental treatment of special populations can represent a challenge. The dental provider must be able to recognize the issues surrounding substance use and abuse, coordinate care with medical providers, and build a trusting provider –patient relationship to achieve success. Open conversations regarding expectations of pain, and the risks, benefits, and alternatives to opioids are important aspects of the best care of these patients. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 11, 2020 Category: Dentistry Authors: Jennifer Magee, Britta E. Magnuson, Donavon Khosrow K. Aroni Source Type: research

Patient Interviewing Strategies to Recognize Substance Use, Misuse, and Abuse in the Dental Setting
This article describes interviewing strategies that will help dental providers communicate effectively and empathically with their patients to collect relevant clinical information related to substance use, misuse, and abuse and provide better care for their patients. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 3, 2020 Category: Dentistry Authors: Michael E. Schatman, Ellen Patterson, Hannah Shapiro Source Type: research

Neuropathic Pain and Burning Mouth Syndrome
Burning mouth syndrome/glossodynia and trigeminal neuropathic conditions can have serious negative impact on a patient ’s overall quality of life. These conditions are often hard to diagnose and even harder to fully treat and manage, but it is important for dentists/oral and maxillofacial surgeons to be aware of these conditions and modalities of their treatment. Often the only method for arriving at the proper di agnosis is for patients to undergo traditional approaches for treatment of presenting signs and symptoms, and it is the unexpected failure of interventional therapies that leads ultimately to a proper diagn...
Source: Dental Clinics of North America - February 27, 2020 Category: Dentistry Authors: Harry Dym, Spencer Lin, Jaykrishna Thakkar Source Type: research

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As editor of this issue of Dental Clinics of North America, I have the duty and privilege to write a preface that is designed as an introduction to the issue, primarily stating its scope and aims, and I do so willingly now. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - February 27, 2020 Category: Dentistry Authors: Harry Dym Tags: Preface Source Type: research

Title Page
DENTAL CLINICS OF NORTH AMERICA (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - February 27, 2020 Category: Dentistry Authors: Harry Dym Source Type: research

Copyright Form
ELSEVIER (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - February 27, 2020 Category: Dentistry Source Type: research

Contributors List
HARRY DYM, DDS, FACS (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - February 27, 2020 Category: Dentistry Source Type: research

Table of Contents
Harry Dym (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - February 27, 2020 Category: Dentistry Source Type: research

Forthcoming Issues Page
Controlled Substance Risk Mitigation in the Dental Setting (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - February 27, 2020 Category: Dentistry Source Type: research

Clinical Uses of Platelet-Rich Fibrin in Oral and Maxillofacial Surgery
Platelet-rich fibrin (PRF) is an autogenous material that is derived from a person ’s own platelets and is used to enhance wound healing and tissue regeneration. Platelet concentrates have been applied in dermatology, pain management, sports medicine, plastic surgery, cardiac surgery, urology, and also dentistry. PRF has garnered significant interest in the dental community beca use of its proposed regenerative properties and its ability to aid in wound healing. PRF is proposed to have a direct effect on enhancing a patient’s wound healing by suprasaturating the wound with growth factors that promote tissue hea...
Source: Dental Clinics of North America - February 3, 2020 Category: Dentistry Authors: Yijao Fan, Karla Perez, Harry Dym Source Type: research

Maxillofacial Bone Grafting Materials
This article reviews the literature and summarizes the benefits and disadvantages of each respective graft and illustrates its use in clinical practice. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - February 1, 2020 Category: Dentistry Authors: Nabil Takahiro Moussa, Harry Dym Source Type: research

Treatment of the Dental Patient with Bleeding Dyscrasias
This article develops algorithms to manage acquired and inherited bleeding dyscrasias. These approaches include a discussion of the epidemiology of bleeding disorders in surgical patients, mechanism of hemostasis, and strategies for patient management based on the etiology of bleeding disorder. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - January 31, 2020 Category: Dentistry Authors: Leslie R. Halpern, David R. Adams, Earl Clarkson Source Type: research

Soft-Tissue Grafting Solutions
This article is intended to provide an efficient and comprehensive overview of this topic, covering the essentials of periodontal anatomy and physiology, indications for soft-tissue grafting, and keys in recipient and donor-site preparation, and exploring the available procedural arsenal in soft-tissue grafting. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - January 29, 2020 Category: Dentistry Authors: Romeo Minou Luo, David Chvartszaid, Sang Woo Kim, Jason Eli Portnof Source Type: research

Zygomatic Implants
Even with the great strides made in the techniques for placement of traditional endosseous dental implants, restoration of the dentition in patients with a severely resorbed or resected maxilla can prove challenging. For many decades, significant bone grafting was the mainstay of treatment for these patients. However, zygomatic implants have been shown to provide a stable and predictable alternative for the restoration of the dentition for patients with severe bone loss of the maxilla. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - January 25, 2020 Category: Dentistry Authors: Jonathan Rosenstein, Harry Dym Source Type: research

Diagnosis and Treatment Approaches to a "Gummy Smile"
Excessive gingival display or “gummy smile” is a growing concern to dental patients and often considered detrimental to an esthetic smile. Gingival display of more than 4 mm of gingiva is considered by many to be unattractive. The cause of the gummy smile can be multifactorial and must be accurately diagnosed to render appr opriate treatment. Factors that contribute to the gummy smile include altered passive eruption, lip length, lip hypermobility, incisal wear/crown length, and vertical maxillary excess and gingival hyperplasia. The purpose of this article is to review the etiology, diagnosis, and surgica...
Source: Dental Clinics of North America - January 24, 2020 Category: Dentistry Authors: Harry Dym, Robert Pierre Source Type: research

Role of Piezo Surgery and Lasers in the Oral Surgery Office
Surgical adjunctive instruments and devices are now available for the up-to-date dental/oral surgical office to help mitigate possible surgical complications. Both the laser and Piezo instruments are unique devices that can offer the clinician certain advantages that may prove beneficial in the treatment of his or her patients. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - January 22, 2020 Category: Dentistry Authors: Tarun Kirpalani, Harry Dym Source Type: research

Peri-implantitis
With a very large number of endosseous dental implants placed by generalists and specialists, complications are to be expected. Among them are problems with the soft tissue interface and the hard tissue attachment. Peri-implant mucositis and peri-implantitis are not uncommon, but their prevalence and impact may be reduced with diagnosis and appropriate management, as can the likelihood of progression from mucositis to peri-implantitis. Successful implant dentistry does not end with integration and restoration, and both patient and professionally administered modalities are important for long-term implant maintenance. (Sour...
Source: Dental Clinics of North America - January 18, 2020 Category: Dentistry Authors: Hillel Ephros, Shiwoo Kim, Robert DeFalco Source Type: research

Bone Regeneration
Dental treatment may require osseous grafting. Pathologic voids may require grafting to restore osseous anatomy. Various osseous grafting materials have been used and reported. These include autografts, allografts, xenografts, and nonbiological products. Osseous grafts act as a scaffold, maintaining volume while allowing bone formation. Calcium sulfate has been used as an osseous void filler, binder, and grafting material. It possesses many characteristics of an ideal material for bone regeneration. It provides an effective cement for maxillofacial and dental augmentation that is easy to use and cost effective, while not r...
Source: Dental Clinics of North America - January 18, 2020 Category: Dentistry Authors: Amos Yahav, Gregori M. Kurtzman, Michael Katzap, Damian Dudek, David Baranes Source Type: research

Botox and Dermal Fillers
For the general dentist, the use of BTA and dermal fillers confers the ability to exert control over the soft tissues surrounding the mouth to better create a harmonious smile. The injection of BTA and fillers into the facial musculature and dermis requires a level of finesse to achieve the desired outcomes. A sound understanding of the mechanisms of action and the ability to manage potential complications are also necessary, because the dentist administering BTA and dermal fillers must be competent to the same level as other providers who have traditionally been the gatekeepers of such agents. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - January 17, 2020 Category: Dentistry Authors: David Sheen, Earl Clarkson Source Type: research

New Approaches to Pain Management
Opioid addiction has reached epidemic proportions in the United States and it is thought that the problem started with the prescription for legal pain medications by health care professionals, particularly for treating patients who had undergone surgery. To reduce the reliance on opioids in dental pain management, increase use of nonsteroidal anti-inflammatory drugs (NSAIDs) and other adjunctive techniques have emerged. The use of NSAIDs, transdermal and transmucosal patches are presented. Understanding the rational for these different approaches requires a basic knowledge of the molecular biology of dental pain. (Source: ...
Source: Dental Clinics of North America - January 13, 2020 Category: Dentistry Authors: Orrett E. Ogle Source Type: research

Intraoral Scanner, Three-Dimensional Imaging, and Three-Dimensional Printing in the  Dental Office
The use of 3-dimensional (3D) cone-beam computed tomography (CBCT) imaging in the dental office has become a common imaging modality. The authors present an overview of multiple treatments that would benefit from the use of this technology. From preoperative, intraoperative, to postoperative patient management, 3D technology plays a vital role in the dental practice. With the incorporation of 3D CBCT, intraoral scanners, and 3D printing, a dental provider can accurately plan and execute the treatment with greater confidence. The contemporary dentist, however, has many options for incorporating the digital workflow based on...
Source: Dental Clinics of North America - January 13, 2020 Category: Dentistry Authors: Levon Nikoyan, Rinil Patel Source Type: research

Short Implants
The purpose of this article is not to discuss the success of short dental implants versus standard/long dental implants, but to compare short dental implants with standard/long dental implants in areas that necessitated adjunctive bone grafting or augmentation procedures and as a way to avoid the need for advanced surgical procedures and their associated risks. It can be concluded that short dental implants are a viable alternative in sites that would have required additional complex and costly augmentation procedures. Short dental implants resulted in comparable survival and success rates with faster, less expensive treat...
Source: Dental Clinics of North America - January 2, 2020 Category: Dentistry Authors: Steven R. Schwartz Source Type: research

Jaw and Dental Abnormalities
This article highlights a variety of developmental abnormalities that present with structural disharmony of the maxillomandibular complex and secondarily associated dental structures. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 15, 2019 Category: Dentistry Authors: Tibebu M. Tsegga, Cody J. Christensen Source Type: research

Oral Potentially Malignant Disorders
This article reviews the clinical appearance of OPMDs, associated risk factors, diagnosis and histologic appearance, and treatment. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 15, 2019 Category: Dentistry Authors: Stephanie L. Wetzel, Jessica Wollenberg Source Type: research

Oral Diseases for the General Dentist
DENTAL CLINICS OF NORTH AMERICA (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 15, 2019 Category: Dentistry Authors: Arvind Babu Rajendra Santosh, Orrett E. Ogle Source Type: research

Copyright
ELSEVIER (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 15, 2019 Category: Dentistry Source Type: research

Contributors
ARVIND BABU RAJENDRA SANTOSH, BDS, MDS (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 15, 2019 Category: Dentistry Source Type: research

Contents
Arvind Babu Rajendra Santosh and Orrett E. Ogle (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 15, 2019 Category: Dentistry Source Type: research

Forthcoming Issues
Surgical and Medical Management of Common Oral Problems (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - November 15, 2019 Category: Dentistry Source Type: research

Oral Manifestation of Systemic Diseases
The US Surgeon General ’s report Oral Health in America highlighted ways in which oral health and systemic conditions are associated with each other. An oral examination can reveal signs and symptoms associated with systemic diseases. In this article, multiple systemic diseases including but not limited to viral and imm une modulated conditions and associated oral symptoms are discussed. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 22, 2019 Category: Dentistry Authors: Natasha Bhalla, Yoav Nudell, Jaykrishna Thakkar, Harry Dym Source Type: research

Benign and Malignant Lesions of Jaw
Benign and malignant neoplasm of oral cavity is usually presented as swellings or ulcerations of affected tissue. The lesions are broadly categorized as potentially malignant disorders, benign and malignant neoplasm of epithelial and connective tissue origin for the convenience of learning. Neoplasm of oral cavity has a significantly lower incidence. Because of uncommon occurrence of oral neoplasm, retention of diagnostic skills is a challenging task. However, comprehensive understanding on clinical and pathologic details will help in correlating and presenting complaint and assisting in formulation of possible diagnosis. ...
Source: Dental Clinics of North America - October 21, 2019 Category: Dentistry Authors: B.V. Ramana Reddy, K. Kiran Kumar, Arvind Babu Rajendra Santosh Source Type: research

Mucocutaneous Diseases
Mucocutaneous diseases affecting the oral cavity are predominantly immune mediated or inflammatory. Three of the most common and clinically significant conditions are reviewed in this article: lichen planus, pemphigus vulgaris, and mucous membrane pemphigoid. Because oral manifestations may be the first or only manifestation of mucocutaneous diseases, oral health professionals play a critical role in the early diagnosis and multidisciplinary management of these conditions. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - October 21, 2019 Category: Dentistry Authors: Michal Kuten-Shorrer, Reshma S. Menon, Mark A. Lerman Source Type: research