Archive for October, 2013

Debridement

Sunday, October 20th, 2013

It is important to thoroughly debride and degranulate an infected (acute or chronic) extraction site prior to placement of a bone replacement graft or growth factor enhanced matrix. It is imperative to transfer the diseased site to a healthy site for future implant treatment. Teeth that present with unresolved endodontic infections, vertical root fracture, non-restorable caries associated with endodontic infection, or advanced periodontal bone loss have inflamed or infected granulation tissue surrounding or apical to the extraction socket. These lesions must be completely debrided to optimize the osseous healing and prevent intraosseous areas of inflamed tissue, which would pose a risk for short-term infection or to the long-term healing and future implant placement. Failure to thoroughly debride may lead to compromised healing and possible infection and loss of the preservation graft.

 

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Dr. Marc Nevins is in the private practice of Periodontics and Implant Dentistry in Boston, Massachusetts. He is Assistant Clinical Professor of Periodontology at the Harvard School of Dental Medicine and is a Diplomate of the American Board of Periodontology. Dr. Nevins is the Associate Editor of The International Journal of Periodontics and Restorative Dentistry.
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To access this article in its entirety please click HERE

Budget for Technology

Tuesday, October 15th, 2013

Without a budget, the cash outlay for technology can quickly become overwhelming for the doctor and the practice. But how much is enough? The truth is that every practice and every practitioner has different needs and wants. While the numbers may vary, there are some guidelines that you should factor into the budget:

 

1. New computer hardware every 36 to 48 months.

2. Practice management software, regular updates, and unlimited support.

3. On-site professional technical hardware and network installation and maintenance, unless you are using a Cloud-based system.

4. A minimum of 16 hours of on-site software training annually.

 

On the clinical side, the typical annual budget would include expenses for both operations and clinical information management and purchases, such as the following:

 

1. New computer hardware every 36 to 48 months.

2. Practice management software, regular updates, and unlimited telephone support.

3. All clinical software upgrades to the practice management software.

4. Digital X-rays, digital imaging (camera), imaging software, periodontal probing, etc.

5. On-site professional technical hardware and network installation and maintenance.

6. A minimum of 32 hours of on-site training each year.

 

Next to dental school, practice technology is probably the biggest investment you will make in your career. And like virtually any other product on the market, you get what you pay for, so prepare and invest your dollars wisely. Develop a plan, establish a budget, and arrange to professionally train your team.

Perio – Ridge Preservation

Saturday, October 5th, 2013

Procedures provided at the time of extraction combined with atraumatic extraction techniques will preserve ridge form. These procedures are generally less invasive than augmentation procedures provided after the ridge resorption has occurred. During the resorption process there is loss of 3-dimensional volume and scar tissue may form and this may make the future surgical procedures more challenging in regards to soft tissue management and primary closure.

 

Multiple biomaterials including autogenous bone, bone allograft, xenograft, and synthetic biomaterials have been advocated for ridge preservation. Allogenic and xenogenic bone replacement grafts are favorable as they are osteoconductive and are obtained without the need for harvesting bone from the patient. Human growth factors generated through recombinant biotechnology such as rhBMP-2 and rhPDGF-BB are commercially available and have been reported to be successful in ridge preservation procedures. rhPDGF-BB is FDA approved for periodontal therapy, but there are preclinical and clinical reports focused on dental implant site development utilizing this growth factor for bone regeneration.

 

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Dr. Marc Nevins is in the private practice of Periodontics and Implant Dentistry in Boston, Massachusetts. He is Assistant Clinical Professor of Periodontology at the Harvard School of Dental Medicine and is a Diplomate of the American Board of Periodontology. Dr. Nevins is the Associate Editor of The International Journal of Periodontics and Restorative Dentistry.
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To access this article in its entirety please click HERE