Upholding parameters of care in a service-provision constrained time period

Advances in technology necessitate constant changes in all aspects of medical education and patient care. This requires educators and clinicians to merge traditional practices with new innovations, materials and techniques. We are also aware that rapid and dramatic changes are taking place in the world with respect to urbanisation and migration, science and technology and the future of the earth

Isolate in unison, wear your mask in unity

In keeping with the cover theme of masks, it seems that the dreaded Corona virus (SARS-CoV-2) has made manypeople weary and even rebellious towards wearing protective facemasks. This brought back memories of a patient who had been treated at one of the government hospitals many years before airborne epidemics made mask-wearing in public an observable occurrence. His story will be related in the hopes that its childlike innocence will be a reminder to us all that if we unselfishly unite in our struggles against this, and any of life’s adversities, we WILL all winin the end

International Earth Day - 22 April

In the 1969 UNESCO Conference in San Francisco, peace activist John McConnell proposed a day to honour the Earth and the concept of peace. The first such event was celebrated on March 21, 1970 to coincide with the first day of spring in the northern hemisphere. A month later the United States Senator Gaylord Nelson proposed the idea to hold a nationwide environmental teach-in on April 22, 1970

Overview of Lithium Disilicate as a restorative material in dentistry

Lithium disilicate was first introduced to the dental field as an indirect restorative material in 1998. It was marketed under the name IPS Empress 2, and was intended for use with press technology. It was later replaced by modified versions including IPS e.max® Press and IPS e.max® CAD. Newer versions have since emerged,namely Amber Mill GC Initial and CEREC Tesseratwo.The latter has part crystal composition of lithium disilicate,embedded in a glassy zirconia matrix. The CAD versionis provided in a meta-silicate state, characterised by40% platelet-shaped lithium meta-silicate crystals and aglassy matrix that is bluish in colour. To obtain the desired lithium disilicate structure and tooth shades, a process ofcrystallization is required. This involves firing at 840 °C,for 25 minutes. The resulting glass-ceramic material has the benefit of providing maximum aesthetic translucency along with good fracture resistance of about 2MPa, and mechanical strength of 360MPa. Developments in the all-ceramic dental materials have led to improvements in their physical properties and aesthetic appeal, leading to a substantial increase in their clinical use. This paper present a review of lithium disilicate with particular reference to its chemical composition, aesthetic versatility, and durability for use in crowns, veneers, and implant retained restorations. It also covers the recommended techniques prescribed to ensure predictable bonding and cementation. An electronic literature search on the use of lithium disilicate in dentistry was carried out using EBSCOhost search engine. This included all papers relating to its use for conventional veneers, crowns and bridge work, for CAD/CAM restorations, dentine bonding procedures and luting agents. It covered all papers published in peer reviewed journals from 1988 to 2021. The review indicates that lithium disilicate can be a useful and versatile material in dentistry providing it is handled correctly and the recommended tooth and restoration surface preparations and bonding procedures are carried out. The latter involves tooth etching and silane treatment of the fitting surfaces of restorations prior to cementation to improve adhesion and fracture resistance

Restorative considerations in children with congenital dental anomalies

Children with congenital dental manifestations may have to endure challenges due to their abnormal tooth development, altered skeletal growth, compromised masticatory and speech function and poor aesthetics. This may further lead to psychosocial problems. These children may have deficient ridge height and volume in edentulous areas, missing teeth, malformed or malpositioned teeth and often the added complication of xerostomia. These anomalies complicate conventional treatment and have led clinicians to consider alternative restorative treatment options. Recent literature suggests that Osseo integrated implant therapy may be a viable option for children with congenital dental defects. However, studies are scarce, with no standardization of success or survival criteria, and little long-term follow-up results. This paper explores the various restorative options and highlights the need for a multidisciplinary team. approach

Embracing new technology, with caution

Dental manufacturers frequently present clinicians with new “cutting edge” materials, devices or technology. These usually come with great promise for bettering the status quo in their practices, and of putting them ahead of their colleagues in the market place. However before succumbing to the advertorial hype, and abandoning their old practices, materials or equipment, practitioners need to evaluate the new offering against the “gold standard” if one exists. This entails comparing it to “the benchmark” practice/ product that is routinely used under reasonable conditions, and answering a number of clinically and scientifically pertinent questions. If they are then confident it has beenthrough extensive trials, the results have been analysed with appropriate tests by independent investigators, and the reporting thereof is accurate, reliable, repeatable, sensitive, specific and clinically applicable, they may consider making practice changes. While it is admirable for clinicians to be open minded and willing to embrace and adapt to modern technology, this should only be done if the change has been proven superior to reliable routine practices. It is incumbent on all practitioners to keep abreast of current trends through the many platforms available. They should also strive towards being life-long learners who are curious, open minded, flexible, willing to learn new skills, and open to adapting their work to embrace advances. This will hopefully lead to practitioners having more fruitful careers, and equip them to provide the best possible service and care to their patients

South Africa’s contribution in the field of Forensic Odontology - A textbook review

This textbook represents an up-to-date, comprehensive compilation of the field of Forensic Odontology. The chapters have been uniquely structured to take the reader through all aspects of this discipline in a methodical and logical approach. Authors for each section were carefully selected as being internationally recognised experts and renowned amongst their peers in their particular field of Forensic Odontology. The material in this textbook is presented in a manner that is both interesting and clear for novices in the discipline, while at the same time offering highly informative, cutting-edge information for experts practising Forensic Odontology. The book begins with a chronology of the origin of Forensic Odontology dating back to 1477, using intriguing real-life cases to set the theme for the rest of the book

Proteus Syndrome – A one in a million occurrence

The syndrome is named after the Greek sea-god Proteus, who could change his shape. Proteus Syndrome (PS) is a rare condition with an incidence of less than 1 in 1 million people. It is characterized by variable, multifocal overgrowth of bones, skin, or other tissue derived from any of the three germinal layers. It is generally not apparent at birth, but signs develop rapidly from as early as 6 months and get more severe with age. Craniofacial deformities are less frequent but overgrowth of facial bones leads to disfigurement, malocclusion and a number of other oral and dental anomalies. The following case report of a young boy with PS was written for three reasons. Firstly, it will describe this unusual condition to colleagues who have never encountered patients with the syndrome. It then stresses the importance of a holistic approach to treatment planning. This entails addressing the immediate needs, and then basing the definitive treatment on considerations of possible short- and longterm, patient-related developments. Finally, it illustrates how a complex case was treated successfully with conservative management using modifications of standard clinical procedures

The ethical debate between what patients want, need and can afford, and what treatment clinicians think they should receive

Endodontic emergencies are common procedures in dental practice, and need to be addressed as soon as possible. The initial treatment is usually extirpation of the pulp –also known as emergency root canal treatment (ERCT), –followed by complete cleaning, shaping and obturation ofthe root canal system. Root canal therapy (RCT) needs to be completed with a definitive restoration to increase long term prognosis of the tooth. Both of these carry additional costs. Patients treated in government facilities often have limited access to follow-up care due to long waiting lists, financial constraints or logistical challenges

Misleading advertising – What is our duty as dental professionals towards our patients and the public?

There are currently several media adverts on radio and television in which “experts” confidently inform the public of their unique kinds of toothpaste which not only strengthen but can rebuild enamel and lost tooth substance.The concerns raised in this paper relate to pharmaceutical companies preying on uninformed, concerned, and often-compromised consumers to promote their products. To this end, some make fallacious claims, misrepresent or overinflate their products' therapeutic potential, which all overtly or covertly create false hopes and unrealistic expectations. The profession needs to collectively identify a body that will monitor the information presented to the public by dental manufacturers, advertising bodies, and social media websites. If we stand by and say nothing, we agree with the data and legitimize the product. Dental clinicians need to be more accountable, active, and visible on television, social media sites and in popular publications providing educational information and, if necessary, dispelling false perceptions. We have a duty to the publi