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Dental India Newsletter dated  11th September 2005... Choice of 22000 dentists
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This week
Meet Dr Liviu Steier DDM - Mayen, Germany
Root canal therapy of an acute cystic apical periodontitis - Part 1
Dental Tips
Preventing and treating Dry Skin 
Disinfecting High-tech Equipment in the Dental Setting
New Product - TempoSIL , New temporary Cement
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The opinions and photographs within this newsletters are not ours. Authors have been credited for the individual posts where they are.

Liviu Steier DDM /Mayen / Germany
Dr Liviu Steier is an Associate Prof.(Endodontics) in University of Witten Herdecke and University of Cologne and Visiting Professor, Restorative dentistry in University of Florence, Italy. A PhD student of Queens University Belfast and he has won KaVo Award for Geriatiric oral research - 1st Prize in IADR General Session held in Baltimore in 2005. He is Fellow of the “International Academy of Gnathology”. Fellow of the “International Congress of Oral Implantology”, Member of the American Academy of Periodontology“, European Society of Esthetic Dentistry and Diplomat of the Misch Implant Institute. He is running his private practice in Mayen, Germany since 1985.  He will be regularly  sharing his cases and clinical tips , answer questions - exclusively for the benefit of Dental India members. Efforts are being made   for his visit to India in later half of 2006 to give lectures and hands on courses  tentatively in Chennai / Bangalore , Hyderabad / Kochi
Root canal therapy of an acute cystic apical periodontitis

First lower molar with cystic apical periodontitis present at the mesial root. The tooth was covered with a gold onlay. It is obviuosly that at the moment of the decay removal an insuccessful direct
pulp capping was performed.



 X ray showing fistula tracing. Guttapercha point introduced into the fistula exit. The fistula canal did not allow a to deep penetration of the Guttapercha point.

- to be continued next week

Dental Tips
Sodium ascorbate significantly improves bond strengths on NaOCl treated dentin.....I heard this from Liviu 2 years ago. - available in the pharmacy.Ask for a Aqueous Solution - Fred
I started using a topical called "Profound" . It is a gel and is 10% lido, prilo and 4% tetracaine I deliver it on the perio probe into the pocket and the results are really
amazing. Easier, cheaper and more predictable than oraqix. $65 for a 30 gm tube
you can probably get 100-200 pea sized doses. we put in a 3cc syringe cap, left over from the povidone iodine syringes we preload  - Lynne H. Slim
Power Brushes and Periodontitis Clients
I instruct my patients to orient their brushes (sonicare, or manual) vertically all around the mouth, and to brush each tooth one at a time, distal, lingual-or-buccal, mesial; and to press the bristles against the teeth and slip the bristles below the gums.   It's asking a lot in the dexterity department, but sometimes they come back looking pretty good. - Paula Smith

Preventing and Treating Dry Skin
(Originally published in the Jan 2003 issue of InCONTROL)

Question: Are there recommendations for preventing and treating dry skin that is common during the winter months?

Answer: With the cooler temperatures, many of us are experiencing dry skin and subsequent dermatitis most likely resulting from frequent handwashing and glove use. Dental health-care personnel (DHCP) have the potential to wash their hands over 30 times during a typical workday. This can contribute to irritant contact dermatitis, which usually appears as reddened, dry, or chapped skin. Factors such as cold weather and low humidity may also contribute to the problem. Prevention is the key, because dry, irritated skin discourages proper hand hygiene and may harbor potentially pathogenic organisms. Also, if the problem is allowed to become chronic, the irritation may progress to hypersensitivity.

Lotions are recommended to ease the dryness resulting from frequent handwashing and, more recently, to prevent dermatitis resulting from glove use. Petroleum-based lotion formulations, however, can weaken latex gloves and cause increased permeability. For that reason, lotions containing petroleum or other oil emollients may affect the integrity of gloves and should not be used. At the time of product selection, information should be obtained from the manufacturer regarding interaction between gloves and lotions.

DHCP with open sores or weeping dermatitis must refrain from direct patient contact and handling of patient care equipment until the condition has resolved. Evaluation by a qualified health-care professional is necessary if DHCP experience repeated or unresolved hand irritation.

Some preventive measures include:

-Washing with cool or tepid water
-Wetting hands thoroughly before applying the handwashing agent
-Thoroughly rinsing off all handwashing agents with cool water
-Gently drying hands (vs. rubbing) with disposable soft materials
-Drying hands completely before donning gloves
-Wearing protective gloves when cleaning or handling chemicals
-Using water-based skin care products

References and Additional Resources:

CDC. Guideline for hand hygiene in health-care settings: recommendations of the healthcare infection control practices advisory committee and the HICPAC/SHEA/APIC/IDSA hand hygiene task force. MMWR 2002;51 (No. RR-16): 1-45.

Larson EL, 1992, 1993, and 1994 Association for Professionals in Infection Control and Epidemiology Guidelines Committee. APIC guideline for hand washing and hand antisepsis in health-care settings. Am J Infect Control 1995;23:251-69.

Molinari JA, Rosen S, Runnells RR. Chemical sterilization, disinfection, and antisepsis. In: Cottone JA, Terezhalmy GT, Molinari JA, eds. Practical infection control in dentistry, 2nd ed. Baltimore: Williams & Wilkins, 1996: 161-75.

Disinfecting High-tech Equipment in the Dental Setting
(Updated September 2004)

Question: Are there special considerations for disinfecting computer equipment in the dental operatory?

Answer: The introduction of high-tech equipment in dentistry (e.g., digital x-ray sensors, cameras, and computers) presents unique infection control challenges. The best results with the least damage to the equipment are obtained by following manufacturer's directions. Avoiding contamination is important because many items cannot be properly cleaned and disinfected or sterilized. Before touching any office equipment, ensure your hands are clean, and if wearing gloves select a powder-free brand. A computer keyboard and the mouse are excellent examples of difficult, if not impossible, equipment to clean. Items should be covered with a plastic barrier when contamination is likely, and the barrier changed between patients. If a reusable form-fitted barrier is used, it should be cleaned and disinfected between patients.

Some questions to consider prior to purchasing expensive high-tech equipment include:

-Can it be adequately decontaminated?
-Can it be cleaned with soap and water?
-Can it be heat sterilized?
-Will barrier covers interfere with its function?
-Do you have to disassemble it before cleaning?
-Is there more than one approach to decontamination?
-Will the approach you choose affect the life of the equipment?

(Lt Col Harte)

TempoSIL is a new temporary cement by Coltene/Whaledent. The addition-cured, silicon-based, zinc-oxide cement with silane reportedly provides optimal adhesion and superior marginal integrity. TempoSIL purportedly is a firm, yet elastic temporary cement that can easily be removed from the tissue and the restoration. The cement reportedly has a working time of 50 seconds and a setting time of 2 minutes. The Intro Kit (item #C6720), packaged with two 5-mL syringes of TempoSIL material, 20 mixing tips, and 20 intraoral tips.-  Col Vandewalle

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