CBCT has gained broad acceptance in dentistry in the last 5 years, although its roots go back about 2 decades. The major innovation compared with intraoral and panoramic imaging is that it provides high-quality, thin-slice images. Cone-beam machines emit an x-ray beam shaped liked a cone, rather than a fan, as in conventional CT machines. Because the beam covers the entire region of interest, it is only necessary for the x-ray source to make one pass or less around the patient's head, when acquiring images. CBCT is capable of providing sub-millimetre resolution in images of high diagnostic quality, with short scanning times (10-70 seconds) and radiation dosages reportedly up to 15 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a 3-dimensional representation of the maxillofacial skeleton with minimal distortion.
As dentistry moved into the twenty- first century the attention to ethics would have to be even greater. Nowadays ethical standards in modern dentistry are in a tempo with rapid advance. Learning to handle practical ethics issues and developing one's professional identity are essential steps in becoming a good dentist. The core issues in dental ethics are the ethics of the dentist patient relationship, patient's confidentiality, and the need to obtain informed consent. Although law and ethics have similarities, law may be better defined as the sum total of rules and regulations by which a society is governed. Healthcare malpractice can be challenged under two main categories in the court of law, that is, civil and criminal depending on the nature of offence. A third category lies under Consumer Protection Act (CPA), 1986, where professional services provided by the dentist can be challenged. Records are the most important factors needed to prevail in the lawsuit. Therefore, there is a need for oral health professionals to update their understanding on Ethics, informed consent, CPA and its amendments and professional indemnity insurance.
Dental caries has been a highly prevalent and costly disease in the world, representing the most common infectious disease in the paediatric population. Caries risk is greater in children from rural setting, poor and from ethnic background or who have limited access to care. Restorative treatment shall be based upon the results of an appropriate clinical examination and ideally should be an integral part of a comprehensive treatment plan which should consider developmental status of the dentition, caries-risk assessment, the patient's oral hygiene, anticipated parental compliance and likelihood of timely recall and the patient's ability to cooperate for treatment. Materials such as glass-ionomers, resin ionomers, resin ionomer products, and improved resin-based composite systems have been developed which are having profound impact on the restoration of primary teeth.
A debilitating dental condition affecting millions of individuals across the globe is complete edentulism. The introduction of implantolgy has revolutionized dentistry including the overdenture treatment modality with attachments. Dental practitioners and technicians select attachment systems based on their experience and training.The selection of the attaching mechanism for an implant retained over denture depend on : cost effectiveness, amount of retention needed, expected level of oral hygiene, amount of available bone, patient's social status, patient's expectation, maxilla mandibular relationship, inter-implant distance, and status of the antagonistic jaw.
A number of conditions can lead to aesthetically unacceptable dentitions like dental caries, discoloration, trauma, early loss of teeth, misalignment and any abnormality of shape and size. Today there are many solutions available for aesthetic problems in Pediatric Dentistry. But the biggest dilemma is choosing the best treatment modality for a particular patient and situation. Dental esthetics is an integral part of facial esthetics. With the growing awareness of the esthetic options available, there is a greater demand for solutions to unsightly problems. The principle goal of paediatric restorative dentistry is to restore the damaged teeth to its normal function as well as to retain its aesthetic. In the past, the only treatment option for pulpally involved primary teeth would have been to extract the teeth and replace them with prosthetic substitutes, until the permanent teeth erupted. However, the availability of natural crowns and roots would allow the use of biologic restorations to preserve the integrity of patient's natural dentition.
Functional orthopedic treatment seeks to correct malocclusions and harmonize the shape of the dental arch and oro-facial function. Functional appliance intended to alter mandibular growth, play a major role in growth modification treatment. Unfortunately due to the bulk and inconvenience, removable functional appliance fails to attract the patient's cooperation. In addition, their intermittent wear does not elicit continuous muscle activity, a factor that is very essential for promoting skeletal change. Patient cooperation has long been recognized as an important factor in the outcome of orthodontic treatment. Failure to adhere to prescribed schedules of removable appliance wear will result in slow treatment response or no response at all. To reduce these factors the fixed functional appliances were developed.
Extractions in orthodontics remain a relatively controversial area. It is not possible to treat all malocclusions without taking out any teeth. The factors which affect the decision to extract include the patient's medical history, the attitude to treatment, oral hygiene, caries rates and the quality of teeth. Extractions of specific teeth are required in the various presentations of malocclusion. Any decision regarding the need for extraction of teeth during orthodontic therapy is not only dependent on the presence or absence of space in the dental arches. Other issues should be evaluated in order to achieve proper malocclusion correction, maintenance or improvement of facial aesthetics and result stability.