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Dental treatment may require osseous grafting. Pathologic voids may require grafting to restore osseous anatomy. Various osseous grafting materials have been used and reported. These include autografts, allografts, xenografts, and nonbiological products. Osseous grafts act as a scaffold, maintaining volume while allowing bone formation. Calcium sulfate has been used as an osseous void filler, binder, and grafting material. It possesses many characteristics of an ideal material for bone regeneration. It provides an effective cement for maxillofacial and dental augmentation that is easy to use and cost effective, while not requiring complete soft tissue coverage or a membrane at placement. Many soft-tissue grafting solutions are available for reconstruction and restoration of volume and esthetics of keratinized attached mucosa at compromised periodontal and peri-implant interfaces. Presence of healthy soft tissues is crucial for functional and esthetic implant success as well as longevity of natural dentition. The options available each provide unique characteristics with different indications. This article is intended to provide an efficient and comprehensive overview of this topic, covering the essentials of periodontal anatomy and physiology, indications for soft-tissue grafting, and keys in recipient and donor-site preparation, and exploring the available procedural arsenal in soft-tissue grafting. The oral health care provider sees a significant number of patients in his or her practice who suffer from systemic diseases affecting the ability to clot. These medical issues can be acquired or inherited bleeding dyscrasias requiring pharmacologic therapy during the perioperative period. Patients with inherited or acquired bleeding disorders require careful attention with respect to the assessment of bleeding risk. This article develops algorithms to manage acquired and inherited bleeding dyscrasias. These approaches include a discussion of the epidemiology of bleeding disorders in surgical patients, mechanism of hemostasis, and strategies for patient management based on the etiology of bleeding disorder. Even with the great strides made in the techniques for placement of traditional endosseous dental implants, restoration of the dentition in patients with a severely resorbed or resected maxilla can prove challenging. For many decades, significant bone grafting was the mainstay of treatment for these patients. However, zygomatic implants have been shown to provide a stable and predictable alternative for the restoration of the dentition for patients with severe bone loss of the maxilla. Burning mouth syndrome/glossodynia and trigeminal neuropathic conditions can have serious negative impact on a patient's overall quality of life. These conditions are often hard to diagnose and even harder to fully treat and manage, but it is important for dentists/oral and maxillofacial surgeons to be aware of these conditions and modalities of their treatment. Often the only method for arriving at the proper diagnosis is for patients to undergo traditional approaches for treatment of presenting signs and symptoms, and it is the unexpected failure of interventional therapies that leads ultimately to a proper diagnosis. The use of 3-dimensional (3D) cone-beam computed tomography (CBCT) imaging in the dental office has become a common imaging modality. The authors present an overview of multiple treatments that would benefit from the use of this technology. From preoperative, intraoperative, to postoperative patient management, 3D technology plays a vital role in the dental practice. With the incorporation of 3D CBCT, intraoral scanners, and 3D printing, a dental provider can accurately plan and execute the treatment with greater confidence. The contemporary dentist, however, has many options for incorporating the digital workflow based on the specific practice needs. Surgical adjunctive instruments and devices are now available for the up-to-date dental/oral surgical office to help mitigate possible surgical complications. Both the laser and Piezo instruments are unique devices that can offer the clinician certain advantages that may prove beneficial in the treatment of his or her patients. Excessive gingival display or "gummy smile" is a growing concern to dental patients and often considered detrimental to an esthetic smile. Gingival display of more than 4 mm of gingiva is considered by many to be unattractive. The cause of the gummy smile can be multifactorial and must be accurately diagnosed to render appropriate treatment. Factors that contribute to the gummy smile include altered passive eruption, lip length, lip hypermobility, incisal wear/crown length, and vertical maxillary excess and gingival hyperplasia. The purpose of this article is to review the etiology, diagnosis, and surgical approaches in treating the gummy smile. For the general dentist, the use of BTA and dermal fillers confers the ability to exert control over the soft tissues surrounding the mouth to better create a harmonious smile. The injection of BTA and fillers into the facial musculature and dermis requires a level of finesse to achieve the desired outcomes. A sound understanding of the mechanisms of action and the ability to manage potential complications are also necessary, because the dentist administering BTA and dermal fillers must be competent to the same level as other providers who have traditionally been the gatekeepers of such agents. Opioid addiction has reached epidemic proportions in the United States and it is thought that the problem started with the prescription for legal pain medications by health care professionals, particularly for treating patients who had undergone surgery. To reduce the reliance on opioids in dental pain management, increase use of nonsteroidal anti-inflammatory drugs (NSAIDs) and other adjunctive techniques have emerged. The use of NSAIDs, transdermal and transmucosal patches are presented. Understanding the rational for these different approaches requires a basic knowledge of the molecular biology of dental pain. With a very large number of endosseous dental implants placed by generalists and specialists, complications are to be expected. Among them are problems with the soft tissue interface and the hard tissue attachment. Peri-implant mucositis and peri-implantitis are not uncommon, but their prevalence and impact may be reduced with diagnosis and appropriate management, as can the likelihood of progression from mucositis to peri-implantitis. Successful implant dentistry does not end with integration and restoration, and both patient and professionally administered modalities are important for long-term implant maintenance. CC-90011 solubility dmso Published by Elsevier Inc.

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