Dental INTERACTIVE

Editorial: Who does implantology belong to anyway?

SADJ July 2010, Vol 65 No 6 p238
H Gluckman: Specialist in Oral Medicine and Periodontics, in private practice in Gardens, Cape Town. Part Time private practice in London UK, Founder member and director of the Implant and Aesthetic Academy, E-mail: docg@theimplantclinic.co.za Implantology has shown massive growth over the last 30 years. It has been the fastest growing branch of dentistry for the last 10 years. More research and development comes from implantology than any other branch of dentistry. Patients� knowledge of implants has grown at a similar rate and as a result the demand for affordable implantology has risen dramatically.

SADA Communique: SADA snapshots

SADJ July 2010, Vol 65 No 6 p240
J Michelson: Senior Manager, SADA. E-mail: jeffm@sada.co.za

Clinical: Consequences of tooth loss (part 1): The patient perspective - aesthet

SADJ July 2010, Vol 65 No 6 p242 - p245
H L Craddock: PhD, MDent Sci, BDS, FDS(Rest Dent), MRD(Pros), MFDS RCS(Edin), MGDSRCS(Eng), DGDP(UK), Senior Lecturer, Honorary Consultant, Leeds Dental Institute, Leeds LS2 9LU, UK.

This article is re-printed with permission from Dental Update 2009; 36: 616�619 Abstract
Tooth loss in adults is becoming less common, and the attitudes of patients and professionals towards it have changed dramatically over the last quarter of a century. This paper explores these changes, from the patient�s perspective, in terms of psychological perspectives, aesthetics, function and the need or desire for tooth replacement. A second paper will examine the evidence available on the positional and functional changes following tooth loss.
Clinical Relevance
Clinicians need to have an awareness of changes in disease patterns, trends in patient expectations and the demand for restorative interventions.

Case study: An alternative surgical flap design for impacted third molars: A com

SADJ July 2010, Vol 65 No 6 p246 - p251
G J Roode: BChD, MSc (Odont), DipOdont (Oral Surg), DipOdont (Radiol), Department of Maxillo-Facial- and Oral Surgery, Faculty of Health Sciences, University of Pretoria, South Africa
K Bütow: MChD (MFO Surg), Dr Med Dent, PhD, DSc (Odont), FCMFOS, Department of Maxillo-Facial- and Oral Surgery, Faculty of Health Sciences, University of Pretoria, South Africa

Corresponding author
G J Roode: Department of Maxillo-Facial- and Oral Surgery, Faculty of Health Sciences, P O Box 1266, Pretoria, 0001. Tel: 012 319 2654, Fax: +2786 693 8067. E-mail: giel.roode@up.ac.za Abstract
Introduction: A major concern of patients who need surgery for impacted third molars is the occurrence of pain and swelling. The damage done during the incision and retraction of soft tissue to expose the impacted teeth, contribute to the above-mentioned.
Aims and objectives: The study was done to prove a hypothesis that an alternative surgical flap (ASF) is effective in limiting pain and swelling when compared to the standard reverse L-flap (RLF).
Method: A prospective randomized cross-over study was done, which included 33 healthy patients. Patients with mirror-image impacted mandibular third molars were selected. Evaluation of pain and swelling was done by Visual Analogue Scale (VAS), implemented for the first seven days after surgery.
Results: The results indicated on average that patients experience less pain with the ASF, although this was not statistically significant. The patients also indicated that they experienced a significant reduction (p Conclusions: The hypothesis that the ASF will result in less swelling, has been proven. It is therefore recommended that surgeons use this flap method for removal of impacted third molars to enhance post-operative patient comfort.

Clinical: Is coronal restoration more important than root filling for ultimate e

SADJ July 2010, Vol 65 No 6 p252 - p256
J V Williams: BDS(Bris) MFDS RCS(Eng), Senior Lecturer, Honorary Consultant, Senior House Officer in Oral and Maxillofacial Surgery, Frenchay and Southmead Hospitals, Bristol and General Dental Practitioner, Bristol
L R Williams: BDS(Bris) MFDS RCS(Eng), Specialist Registrar in Paediatric Dentistry, Bristol Dental Hospital, Lower Maudlin Street, Bristol, UK.
This article is re-printed with permission from Dental Update 2010; 37: 187�193 Abstract
The importance of a good coronal seal and restoration of the endodontically treated tooth has been hotly debated over recent years. This article reviews the evidence in the literature that exists to demonstrate which techniques can be used for optimal results, and whether the root filling or coronal seal is more relevant.
Clinical Relevance
Evidence from both in vitro and in vivo studies supports the findings that both coronal seal and root filling in combination are essential for successful and predictable endodontics.

Communication: Strategy for teaching communication skills in dentistry

SADJ July 2010, Vol 65 No 6 p260 - p265
Prof. JG White: Head: Department of Dental Management Sciences, School of Dentistry, University of Pretoria, E-mail: George.White@up.ac.za. ABSTRACT
Aim: To develop and evaluate a teaching strategy for teaching communication skills in dentistry.
Methodology:

Phase I: Development and implementation of a course in communication skills.
Phase II: Implementation of a teaching strategy by means of an experiential learning strategy complemented by a didactic teaching strategy.

Subjects: Third year dental students (n = 67). The instruments included the following:

Study guide;
Case study;
Assessment rubric;
Two questionnaires: �Patient�s and �Dentist�s feedback;
Standardised patient.

Results: The class as a whole scored significantly higher after training compared to before training (p Conclusion: The teaching strategy employed for teaching third year dental students communication skills, proved to be effective and was perceived by the students as a valuable and appropriate strategy.
Key words: Communication skills teaching; dentist-patient relationship; standardised patient.

Communication corner: HPV modulation of host immune responses

SADJ July 2010, Vol 65 no 6 p266 - p268
L Feller: DMD, MDent(OMP). Head of Department of Periodontology and Oral Medicine, School of Oral Health Sciences, University of Limpopo, Medunsa Campus, South Africa.
NH Wood: BChD, DipOdont(MFP), MDent(PeOM). Department of Periodontology and Oral Medicine, School of Oral Health Sciences, University of Limpopo, Medunsa Campus, South Africa.
RAG Khammissa: BChD, PDD, MSc(Dent). Department of Periodontology and Oral Medicine, University of Limpopo, School of Oral Health Sciences, Medunsa Campus, South Africa.
UME Chikte: BChD, DHSM, MDent, MSc, PhD. Department of Interdisciplinary Health Sciences, Faculty of Health Sciences, University of Stellenbosch, South Africa.
R Meyerov: BSc, BDS, MDent (OMP). Department of Periodontology and Oral Medicine, School of Oral Health Sciences, University of Limpopo, Medunsa Campus, South Africa.
J Lemmer: BDS, HDipDent, FCD(SA)OMP, FCMSAae, Hon.FCMSA. Department of Periodontology and Oral Medicine; School of Oral Health Sciences, University of Limpopo, Medunsa Campus, South Africa. Professor Emeritus: Periodontology and Oral Medicine, University of Witwatersrand, Johannesburg, South Africa.
Corresponding Author:
L Feller: Box D27, Department of Periodontology and Oral Medicine, School of Oral Health Sciences, Faculty of Health Sciences, University of Limpopo, Medunsa Campus 0204, South Africa. E-mail: lfeller@ul.ac.za Tel: +27 12 521 4834 Abstract
Host immune responses to HPV are generally low-level because the virus, being confined to basal epithelial cells is shielded from the circulating immune cells during initial stages of infection. In this location there is only a limited expression of viral proteins. Other factors contributing to the low level of host immunity are that HPV infection is non-lytic (does not cause death of the infected cell); that a functionally active immune response is generated only at later stages of HPV infection, in post-mitotic suprabasal keratinocytes where all viral genes are expressed; and that only in suprabasal keratinocytes has the HPV DNA been sufficiently amplified to be detected by the host immune-surveillance cells.
In addition to the natural low-level immune responses towards HPV, HPV also employs several mechanisms to down-regulate innate and cell-mediated immunity, thus facilitating host immune evasion and persistent infection. The environment, lifestyle, the genetic make-up of the host, and the viral genomic characteristics can also influence the persistence of HPV infection, and consequential diseases. Persistent infection with high-risk HPV is associated with increased risk of developing HPV-mediated premalignancy and malignancy.
It is not clear if the natural humoral immune response as opposed to vaccination is effective in eliminating primary HPV infection or in preventing progression of infection; but after initial infection, the host develops HPV-specific T cell immune responses that appear to be capable of clearing established infection, of protecting against progression of early HPV-associated intraepithelial neoplastic lesions to squamous cell carcinoma, and of preventing reinfection.

Dental Ethics case 3: Informed consent:risks and benefits of treatment

SADJ July 2010, Vol 65 No 6 p270 - p271
Prof S Naidoo: BDS(Lon), LDS.RCS (Eng), MDPH (Lon), DDPH.RCS (Eng), MChD (Comm Dent), PhD (US). Professor and Principal Specialist, Department of Community Oral Health, University of the Western Cape, Private Bag X1, Tygerberg, 7505. Tel: +27 21 937 3148. Fax: +27 21 931 2287. E-mail: suenaidoo@uwc.ac.za

Obituary: Barry Leon Cohen 1 Oct 1929 - 2 June 2010

Barry grew up in Piketberg in the Western Cape and was educated at Wynberg Boys High and the University of the Witwatersrand. After spending a year in London he returned to Cape Town and opened a practice in Parow where he spent the next 40 years, before retiring in 2005.

Implant terminology (part 3)

SADJ July 2010, Vol 65 No 6 p272
H Gluckman: Specialist in Oral Medicine and Periodontics, in private practice in Gardens, Cape Town. Part Time private practice in London UK, Founder member and director of the Implant and Aesthetic Academy, E-mail: docg@theimplantclinic.co.za