Extreme Practice Makeover

Extreme Practice Makeover Let’s play a game and learn the new products and technology we need in our clinics.

Few industries in the world have a day to day experience with such a unique combination of healthcare, technical expertise, and even art the way dentistry does. Just when things seem to become mundane, a new technology emerges to make things easier for a patient, more profitable for the practice, and more exciting for the practitioner. At times it is hard to keep up with all the changes, but it is those changes that keeps our competitive edge and makes better practitioners.Looking around most offices, there is an amalgamation of new and old equipment. Sitting next to the CAD/CAM machine in the lab is a belt driven handpiece. A twenty year old dental chair sits up to view digital x-rays on a high-resolution LCD monitor. Most offices are due for an upgrade, and it’s hard to tell where to start the process. At Dentalcompare, we strive to bring you the latest information on products and technology to keep your office improving rather than decaying with time. We will show how to regain excitement at your office, streamline your day, and help you with your own Extreme Practice Makeover. http://www.dentalcompare.com/epm/

Dentsectortv

http://www.steps365.com/haber_detay.php?haber_id=590

Introduction of normal and para functions of TMS

 INTRODUCTION OF NORMAL AND PARA FUNCTIONS OF

 TEMPORO MANDIBULAR SYSTEM

 

(3 “chews” per side, then a functional shift)

The image to the left is demonstrating normal reciprocal functioning of the Lateral Pterygoids and Masseters/Med.Pteygoids/Temporalis’.
The Lateral Pterygoids advance the condyles, thereby opening the mouth (depressing the mandible), with the assistance of the Digastric (next webpage).

The oblique orientation of the Masseters and Medial Pterygoids create a sling. The non-working side Medial Pterygoid contacts simultaneously with the opposide side working Masseter.

It is this oblique orientation of the Med.Pterygoids and Masseters that create the functional “shift” of the mandible, not an unilateral contraction of a Lateral Pterygoid.

In normal chewing function, the mandible opens, and then, while initiating closing, there is a shift slightly to the side of the bolus, due to the orientation of the masseter and medial pterygoid. There is no “canine rise” during normal chewing fuction. Canine rise is mechanism to combat parafunction.

The moving yellow dot in the jaw tracing to the left shows the tracking of the gingival margin of a lower incisor during the left “working” movement of chewing. The red lines are jaw movements with the teeth in contact (excursive grinding to each side). The outter most line is the envelop of maximum movements.

Notice how the during normal masticatory function, the teeth do not contact, but may occasionall glance off each other.
(From Lindeen and Gibbs: Advances in occlusion, Boston, 1982, John Wright PSG, p.19)

The animations above show the effect of the contractions of the lateral pterygoids: the advancement (translation) of the condyles. A voluntary opening of the mandible requires the LPs to contract, thus the immediate translation upon attempted opening.
However, a voluntary attempt at closing requires the immediate retrusion of the condyles by the posterior temporalis, thereby “un-translating” the condyles. At the final arc of closure, the condyle is braced against the eminance, while the anterior temporalis rotates the mandible closed.

The animation above and to upper demonstrate how the condyle immediately translates upon opening during masticatory function, due to the contraction of the lateral pterygoid. As closing ensues, the LPs relax, and the elevators contract. The tension of the posterior segment of the temporalis “un-translates” the condyle. During last portion of closing, the anterior temporalis and masseters brace the condyles against the eminance (seating to “CR”), referred to as “rotation”.

The blue dot is the position of the gingival margin of the central incisor. The condyle translates immediately upon opening, and is rotating during the final phase of closure. The superior head of the lateral pterygoid is bracing the disc against the eminance as the elevators rotate the mandible closed against the resistance of the bolus.

Just as the anterior temporalis can sustain considerable contaction intensities over extended periods, so it may be with the posterior temporalis. The result would not be the clenching of the teeth, but of the blockage of the airway. It is this possiblity that makes for the varying reports of tooth soreness from the use of anit-snoring/anti-apnea devices, that attempt to hold the jaw forward. The reason why there is difficulty in holding the jaw forward for some patients is their intensity of retrusion by the posterior temporalis.

Bruxism can not be casually described as “hyperactivity of the lateral pterygoid”. Each of the graphics below displays identical degreess of LP “hyperactivity”:

Only the graphic to the far left can be considered to NOT be bruxism, although there IS hyperactivity of the LPs. The definitive component of bruxism is the degree of parafunctional elevation, that is, the clenching component. An accurated definition of bruxism is: Jaw clenching, with or without forcible excursive movements, where the intensity of the clenching dictates the severity (or lack of) grinding (neither the graphic at the far left or the far right would display tooth wear, yet the graphic at the far right is the most extreme form of bruxism).

Above: “Protusive Clenching”
In the event the Temporalis’ do not cease their active contractions, scenarios of varying degrees of parafunction result, as the Lateral Pterygoids encounter resistance to their attempts at condylar advancement, thereby increasing their intensity of contraction and strain on their origins and insertions: the pterygoid plates of the sphenoid bone, and the condylar neck and disc.
The degree of frequency, duration and intensity of the contractions of a Lateral Pterygoid is a function of the resistance provided by the parafunction ipsilateral and/or contralateral Temporalis. For example, in the animation to the left, as a Lateral Pterygoid attempts to translate its condyle, it is met with resistance provided by the contralateral Temporalis, thereby causing the Lateral Pterygoid to pull its condyle in a medial direction toward the contralateral contact.

Dentistry has stipulated that an elevated mandible
is a presentation of a “functional” position.However,
the duration and frequency of elevation is rarely taken into consideration. Just as elevating one’s arm from its rest position to an elevated position with enough frequency and duration will present symptoms of parafucntion, the same applies to a mandible.
Once the mandible (or an arm) has been elevated, the resistance to the elevation will dictate the intensity of contaction and degree of symptoms. Whereas skeletal muscle needs a foreign resistance to contract with maximal intensity, the temporalis has built in resistance, the maxilla. Sleeps studies have recorded clenching intensities above voluntary maximum

James P. Boyd, DDS

A Succes Story of A Dentist

Dr. Tamara L. Bailey moved to a new town, knew nobody, but turned her practice into a local success in two years

 
This month, we paid a visit to Dr. Tamara L. Bailey’s two-year-old practice in Weston, Wisconsin. Dr. Bailey discusses the challenges of opening up and marketing a brand new practice, how new technology has aided in her care for patients and her patients’ perceptions of female dentists.

 Why did you move to Wausau, Wisconsin? Where were you practicing before you moved?

I moved to Wausau because my husband (a physician) was recruited for the newly constructed hospital in town. My office is about two miles from the new hospital. The hospital opened about six months after my office opened. They are doing a lot of recruiting to the area and a lot of young professionals are moving to this end of town because of the hospital. I practiced in the Cleveland, Ohio, area before I moved here.

What process did you go through to select your location and start your practice from scratch? Did you consider purchasing an existing practice?

I met with the president of the local dental society before I moved up here and talked with him about practice opportunities in town. He told me that there really weren’t any existing practices currently for sale; they were usually absorbed/purchased by a dental group practice in town. He also told me that there were plenty of patients in town for everyone and they welcomed a new dentist! What a refreshing concept! Many of the more established docs in town had closed their practices to new patients. We moved here at the end of August 2004. I got my kids settled in their new schools the following week. I got a map of the area and spent every day driving up and down the streets in Wausau and surrounding towns. I looked for good visibility and location. If I got lost finding the street, I didn’t think it would be a good location. I also looked in the surrounding neighborhoods for new home construction. I found four locations that fit the bill and called the management companies and went from there.

Continues at this link, plz. read…
http://www.docere.com/Dentaltown/Article.aspx?aid=1406

Vision, Mission and Action in dentistry

Hi my dentist colleagues and dear student friends,

 

Your first target is trusting yourself and your abilities…

And your first duty is,to know your talents and to

perform them in usefull places…

You have to be number one and it must be the reality for you.

Don’t think to be stay casually.

We are all talent and have responsibilities otherwise we didn’t

choose dentistry which is difficult and full stress job…

Our job is like to climb a mountain…

If we dont have necessary equipments, only we can walk on

the foot of the mountains…

We can find a sample or samples who are succesful and we

have to learn to imagine to be like them…

All things begin with us and they all finish with us too…

Yesim Kale, DMD Istanbul-Turkiye