Archive
Abfraction lesion under gingival tissue – final proof?
Loss of cervical tissue around teeth has been linked to the presence of excessive occlusal loading.
These are known as abfraction lesions, defined as “Loss of tooth structure, usually in a wedge-shaped pattern in the cervical area of the tooth, attributed to flexure and fatigue in an area away from the point of loading (usually cervical).” The true aetiology of these has been called into question, with some recent research purporting to show that a toothbrush and abrasive dentifrice are required for them to develop.
A case I saw this week seems to contradict such an assertion – this aesthetic case need a little gingival recontouring around the anteriors:
…. so I started to work on the lateral first and look what has appeared! This photo was taken moments after removing the gingival tissue, and it hasn’t been touched by a bur:
Now, this looks suspiciously like an abfraction lesion to me, and it has has been subjected to significant occlusal loading palatally from a deep overbite Class II div 2 situation for many years. Is this final proof that such things really do exist – it can’t possibly be toothbrush abrasion since this is the first time it’s ever seen the light of day. Any other ideas, or do you think I have found something significant?
Survey on oral and dental considerations with eating disorders
I think we’re all aware that bulimia in particular can be a major factor in the development of occlusal changes and wear, so I’d be very grateful if members of the dental team could complete this survey on oral and dental considerations with eating disorders for a project being organised by Alexandra Day (Sheffield) with support from Dr N Martin (Sheffield), Dr A Milosevic (Liverpool) and Prof A Eder (UCL Eastman).
https://www.surveymonkey.com/s/CXW9BBR
Should take no more than a few minutes and will help highlight possible need for better support and education in this increasingly important field.
Many thanks.
_________________
Andy Lane
Feedback from the POISE Course
We get great feedback from our courses, and it’s great to hear how we are changing lives, but here is one that I felt we had to share with you:
I’m amazed what a difference having extra knowledge of occlusion has made. I have treated many hundreds of patients since finishing the course but one in particular jumped out at me. The patient in question has had undiagnosed occlusal problems for years. The SDS questionnaire flagged up the problem. Past dental history revealed a bridge which had failed four times in ten years and numerous broken teeth. On examination he has very large bony exostosis, abfractions, Masseteric hypertorphy and classic violin strings through his Temporalis which were excrutiating to touch. Absolute barn door case, straight out of the notes. Amazingly he’s been a patient at the practice for 20 years and it had never been picked up. As you said on the course, you can only see what you know. After a stabilization splint and a decent bridge made in CR he’s got no pain and is pleased as punch with me as a dentist. He is a GMP for a living and values the holistic approach that we’ve taken to his treatment. He has since recommended other patients to the practice.
It frustrates me that there is such a big black whole in undergraduate occlusion teaching. I now don’t like looking at work that I’ve done before the course as I can see my own mistakes even though I considered myself a good dentist. I have older dentists who’ve been qualified for years telling me that occlusion is a waste of time. I truly believe it is not and am very grateful to you and Higgy for changing my career. CM
If you’d like to change your career in a similar way please book on our next POISE course, 12th/13th November 2012 at ACE in Wakefield, you won’t regret it! Call Jemma on 01457 821800 or email: jemma@sds-ipso.com
Bruxism Awareness Week Lecture Special Offer
This year’s Bruxism Awareness Week lecture entitled “NTI-tss Therapeutic Protocol – Traumatic Occlusion and Bruxism” will be delivered by Dr Barry Glassman one of the world’s leading authorities in the management of TMD, Migraine and dental sleep medicine and very popular speaker in the USA.
This prestigious event will be held at the Royal College of Physicians in London on 24th October 2011.
S4S are sponsoring the event and have agreed to provide all our SDS Occlusion Blog subcribers with a special booking package which includes your place at the event and a Kit of 5 NTI splints (worth £105.00) all for a 20% discounted rate of £280.00 (normally £350).
To take advantage of this offer book online HERE, select the “special offer booking package”, use discount code “CWK” and mention which kit you would like in the “order notes”. Alternatively you can call S4S on 0114 250 0176.
Hands-on Endodontic Courses for GDPs
Alyn Morgan is an endodontist we work closely with at my practice. He not only does great endo, but is also prepared to share his knowledge and skills with fellow-GDPs through his hands-on courses, to be held at Optident Ltd’s HQ in Ilkley.
Forthcoming dates are: 7/8th October 2011 and 4/5th November 2011 Read more…
New POISE course dates announced
The Practical Occlusal Instrumentation, Splints and Equilibration (POISE) Course
Speakers: Roy Higson and Andy Lane
This laboratory based, intensive 2-day course is the ideal introduction to essential occlusal principles and practical skills.
Roy and Andy, as general practitioners who know what works in practice, will pass on dozens of practical tips for how to make your dentistry more predictable, better looking and longer lasting, and make your patients think you are amazing!
Next Course: Saturday/Sunday 12th/13th November 2011 at the Academy of Clinical Excellence, Wakefield
Call us on 01457 821800 to book NOW! Or email: jemma@sds-ipso.com
Cost: £800 + vat – course notes, refreshments and loan of equipment included
- PRACTICAL – the only way to learn a skill you can take back to your practice and use on Monday morning
- OCCLUSION – a subject that forms an essential consideration in every aspect of dentistry, yet is often poorly taught in the undergraduate curriculum
- INSTRUMENTATION – unlock the mysteries of face-bows, articulators, leaf gauges, centric relation records and cast-mounting
- SPLINTS – the why, when, how, on whom and for how long of the whole range of occlusal appliances – make anterior jigs and stabilsation splints on another participant and experience having them made on yourself
- EQUILIBRATION – what is it and why do we do it – experience the effects of wearing a fully equilibrated stabilisation splint on yourself and others
- DIAGNOSIS – recognising the 80% of your patients that clench or brux, and working out which 20% actually need some form of intervention from you to unlock a whole new income stream without needing any new patients
Comments:
Invaluable knowledge gained over the weekend. Would be very interested in future courses. KF
Enjoyable, extremely well delivered and faultless presentation. DT
Great to refresh and relearn, many thank. AR
Excellent course very well presented, thank you. KG
Excellent! CT
Thanks, excellent course and extremely relevant subject matter! RF
The revision was very good for helping me to organise occlusal concepts in mind. I feel like I reall do understand occlusion now! Thanks Roy and Andy. HS
15 hours CPD
Feedback from the 3 most recent courses at LonDEC and ACE
(Scale of 1 – 5, 1 = “poor”, 5 = “excellent”)
- DAY 1: 4.9
- DAY 2: 4.9
- Roy Higson: 5.0
- Andy Lane: 5.0
- Venue (ACE): 4.9
- Would you recommend this course to a colleague? – YES – 100%
- VERY STRONGLY (100%)
MORE COMMENTS:
Thank you for a great weekend. Learned a whole lot – tip of the iceberg though! A.N.
+
A fantastic weekend with plenty of practical and theory. Thanks to Roy and Andy. M.C.
+
Excellent and enjoyable, I feel I have gained a lot of relevant information by attending. Location was easy to find and well equipped. D.T.
+
One of the BEST courses I have ever been on! S.P.
Mandibular Movements Videos
Here are some great videos for anyone struggling with some of the more 3 dimensional aspects of occlusion and the relationship between jaw movements and occlusal anatomy.
3D Head and Neck Anatomy DVD offer
Primal Pictures have just renewed their special offer for £20 off the usual price of this fantastic DVD (usually £180, SDS price £160).
Alongside a huge amount of anatomical content this DVD also includes all the videos we use on our courses (and more!) to help you understand complex 3D relationships, how each muscle controls head and jaw position and what can go wrong in the TMJs. The ideal revision for all our courses and the closest we have to a “must have”, way more useful than any text book!
Click Here for the order page, or quote “SDS” if you call 0207 637 1010 by phone.
Reminder – Mike Melkers’ Webinar this Wednesday
Don’t forget to register for Mike Melkers’ next webinar, Wednesday 8th June at 8pm in the UK.
Subject: Intention Based Orthotic Therapy … Listening & Communicating for Treatment Success!
Register here: https://www3.gotomeeting.com/register/422253262
This will be a very valuable session, no matter what level you are at in occlusal appliances, full of practical hints and tips about communicating with patients. The webinar will be followed by a question and answer session, which always proves very popular. You type in your questions and Mike answers them in order, so don’t be shy – make sure you take part!
SDS Instructors
Roy Higson and Andy Lane
SDS Occlusion Blog 