Diseases and Conditions in Dentistry

The author Keyvan Moharamzadeh, BSc, DDS, PhD, FHEA, FDSRCS, is a Senior Clinical Lecturer and Honorary Consultant in Restorative Dentistry and Specialist in Prosthodontics, Periodontics, Endodontics and Restorative Dentistry, at the University of Sheffield, UK.

"In order to make each chapter easier to read, the author uses the same format, including definitions, etiology, classifications, epidemiology, relevant history and special investigations, diagnosis, prognosis, treatment challenges, management options, maintenance issues, and relevant evidence from the literature […] The book is an excellent guide for under- and post-graduate students, and for those preparing for the ORE,"MFDS, MSc, MRD, ISFE, MClinDent, and DClinDent specialty exams.

• ContentsPreface xxiAcknowledgements xxiiiImage Contributors xxvAbbreviations xxviiAbout the Companion Webstite xxix1 Aggressive Periodontitis 11.1 Definition  11.1.1 Primary Features 11.1.2 Secondary Features 11.2 Classification  11.3 Prevalence 11.4 Aetiology and Pathogenesis 11.4.1 Bacteria 21.4.2 Genetic Susceptibility  21.4.3 Smoking 21.5 Screening  21.6 Diagnosis 21.7 Prognosis 21.8 Treatment 21.8.1 Systemic Antibiotics  31.8.2 Local Antimicrobials  3References  82 Amelogenesis Imperfecta 112.1 Definition  112.2 Aetiology 112.3 Epidemiology 112.4 Classification  112.5 Diagnostic Clinical Features 112.5.1 Hypoplastic Type 112.5.2 Hypocalcified Type 112.5.3 Hypomaturation Type 112.6 Relevant History 122.7 Relevant Investigations 122.8 Prognosis  122.9 Treatment Considerations  122.9.1 Management of Children  122.9.2 Mixed Dentition  132.9.3 Permanent Dentition  132.9.4 Adulthood 132.10 Survival of Restorations 13References  183 Apical Periodontitis 193.1 Definitions and Classification 193.2 Relevant Anatomy 193.3 Immunopathology 193.4 Aetiology 203.5 Microbiology  203.6 Radiology 213.7 Diagnosis 213.8 Epidemiology 233.9 Endodontic Treatment Considerations  233.9.1 Local Anaesthesia  233.9.2 Isolation and Disinfection  233.9.3 Access Cavity Preparation 233.9.4 Magnification  233.9.5 Working Length Determination  233.9.6 Root Canal Preparation Techniques  243.9.7 Irrigation and Debridement 243.9.8 Interappointment Medication  243.9.9 Obturation Techniques  243.9.10 Coronal Restoration  253.9.11 Review 253.9.12 Exacerbation  253.10 Endodontic Retreatment  253.11 Prognosis and Outcome of Non-Surgical Endodontic Treatment  263.11.1 Preoperative Factors  263.11.2 Intraoperative Factors  263.11.3 Post-Treatment Factors 263.12 Surgical Endodontic Treatment  263.12.1 Indications  263.12.2 Contraindications  263.12.3 Flap Design 273.12.4 Specific Anatomy  273.12.5 Bone Removal  273.12.6 Root End Preparation  273.12.7 Root End Filling 273.12.8 Prognosis and Outcomes  273.12.8.1 Preoperative Factors  283.12.8.2 Intraoperative Factors  28References  294 Bisphosphonates and Medication-Related Osteonecrosis of the Jaw 334.1 Definition and Staging 334.2 Pathogenesis 334.3 Prevalence 334.4 Prevention  344.5 Assessment and Investigations 344.6 Treatment Considerations  34References  365 Caries 375.1 Definition and Aetiology 375.2 Pathogenesis 375.3 Epidemiology 375.4 Classification  375.5 Relevant History 385.6 Clinical Examination of Caries 385.7 Differential Diagnosis 385.8 Prevention  385.8.1 Tooth Brushing and Mechanical Plaque Control  385.8.2 Diet 385.8.3 Fluoride 385.8.4 Fissure Sealing 395.9 Treatment Considerations  395.9.1 Primary Teeth  395.9.2 Permanent Teeth 395.9.2.1 Minimally Invasive Techniques 395.9.2.2 Treatment of Exposed Pulp in Permanent Teeth  40References  416 Chronic Periodontitis  456.1 Definition and Classification 456.2 Clinical Features and Characteristics  456.3 Periodontal Indices  456.4 Epidemiology 476.5 Risk Factors  476.5.1 Local Risk Factors  476.5.2 Systemic Risk Factors  476.5.2.1 Smoking Tobacco  476.5.2.2 Diabetes  476.5.2.3 Genetics 486.5.2.4 Osteoporosis  486.5.2.5 Psychosocial Factors  486.5.2.6 Other Considerations  486.6 Microbiology  486.7 Pathogenesis 496.8 Role of Occlusal Trauma  496.9 Treatment 506.9.1 Treatment Goals  506.9.2 Treatment Phases  506.9.2.1 Systemic Phase  506.9.2.2 Initial Hygiene Phase 506.9.2.2.1 Mechanical Supragingival Plaque Control 506.9.2.2.2 Chemical Supragingival Plaque Control 516.9.2.3 Non-Surgical Therapy  516.9.2.3.1 Management of Tooth Mobility  526.9.2.4 Corrective Phase (Additional Therapy) 526.9.2.4.1 Periodontal Surgery 526.9.2.4.2 Outcome of Periodontal Surgery  536.9.2.4.3 Treatment of Teeth with Furcation Involvement  536.9.2.4.4 Periodontal Regeneration 546.9.2.5 Maintenance Phase  55References  587 Cleft Lip and Palate 637.1 Introduction  637.2 Complications  637.3 Dental Abnormalities  637.4 Management of Patients with CLP  637.4.1 Infancy and Primary Dentition Stage 647.4.2 Mixed Dentition  647.4.3 Permanent Dentition  647.4.3.1 Orthodontic Treatment  647.4.3.2 Orthognathic Surgery  647.4.3.3 Distraction Osteogenesis (DO)  647.4.3.4 Restorative Treatment  65References  678 Combination Syndrome 698.1 Defining Features 698.2 Pathogenesis 698.3 Clinical Assessment  698.4 Prevention  708.5 Treatment Considerations  708.6 Management of Flabby Ridge 708.7 Management of Denture-Induced Stomatitis  71References  729 Complete Edentulism 759.1 Introduction  759.2 Treatment Stages  759.3 Denture Support  759.4 Challenging Conditions 759.5 Complete Denture Occlusion  769.5.1 Measuring Occlusal Vertical Dimension (OVD) 769.5.2 Registration of Centric Relation (CR)  769.5.3 Complete Denture Occlusal Schemes  769.5.3.1 Bilateral Balanced Occlusion  769.5.3.2 Monoplane Scheme of Occlusion  779.5.3.3 Linear Occlusion Scheme  779.5.4 Occlusal Adjustment  779.6 Setting Up the Teeth in Complete Denture  779.7 Tooth Size and Shape  789.8 Soft Liners and Tissue Conditioners 789.9 Copy Denture 789.10 Complete Denture Troubleshooting  79References  8110 Deep Overbite 8310.1 Definition and Prevalence 8310.2 Aetiology 8310.3 Classification  8310.4 Treatment Options  8310.4.1 Orthodontic Treatment  8310.4.2 Orthognathic Surgery  8410.4.3 Prosthodontic and Restorative Treatment  84References  8611 Dens Invaginatus  8711.1 Definition and Terminology 8711.2 Aetiology and Prevalence 8711.3 Classification  8711.4 Clinical Examination and Investigations 8711.5 Treatment Considerations  88References  9012 Dentine Hypersensitivity 9312.1 Definition  9312.2 Prevalence 9312.3 Aetiology and Pathogenesis 9312.4 History and Examination 9312.5 Management  9412.5.1 Management of DHS in Patients with Gingival Recession and/or Periodontal Disease 9412.5.2 Management of DHS in Patients with Tooth Surface Loss  94References  9613 Dentinogenesis Imperfecta and Dentine Dysplasia 9913.1 Definition  9913.2 Classification and Clinical Features 9913.3 Aetiology and Pathogenesis 9913.4 Epidemiology 10013.5 Differential Diagnoses 10013.6 Relevant History and Special Investigations 10013.7 Treatment Considerations  10013.7.1 Primary Dentition  10013.7.2 Permanent Dentition  101References  10414 Dentoalveolar Trauma 10514.1 Introduction  10514.2 Displaced and Malpositioned Teeth 10514.3 Loss of Vitality and Discolouration 10514.4 Ankylosis and Root Resorption 10614.5 Lost Teeth 10614.5.1 Exodontia Considerations  10614.5.2 Role of Orthodontists  10614.5.3 Autotransplantation  10614.5.4 Prosthetic Tooth Replacement  107References  11315 Discolouration 11515.1 Introduction  11515.2 Intrinsic Discolouration  11515.2.1 Alkaptonuria 11515.2.2 Congenital Hyperbilirubinaemia 11515.2.3 Congenital Erythropoietic Porphyria 11515.2.4 Tetracycline Staining  11515.2.5 Pulpal Disease 11515.2.6 Root Resorption  11615.2.7 Amelogenesis Imperfecta (AI) 11615.2.8 Dentinogenesis Imperfecta (DI)  11615.2.9 Fluorosis  11615.2.10 Ageing 11615.2.11 Other Conditions Associated with Enamel Defects 11615.3 Extrinsic Discolouration  11615.4 Treatment Options  11615.5 Tooth Bleaching  11715.5.1 Bleaching Techniques  11715.5.1.1 Vital Bleaching (External Bleaching)  11715.5.1.2 Non‐Vital Bleaching (Internal Bleaching)  11715.5.1.3 Inside/Outside Bleaching  11715.5.2 Bleaching Products  11715.5.2.1 Whitening Gels  11715.5.2.2 Whitening Strips  117References  11816 Ectodermal Dysplasia 12116.1 Definition and Prevalence 12116.2 Classification  12116.3 Aetiology 12116.4 Diagnosis and Clinical Features 12116.5 Management Considerations  12216.6 Restorative Treatment  12216.6.1 Direct Restorations  12216.6.2 Indirect Restorations  12216.6.3 Removable Dentures 12216.6.4 Implants  122References  12417 External Root Resorption 12717.1 Introduction  12717.2 Aetiology and Pathogenesis 12717.3 External Invasive Cervical Root Resorption 12717.4 History and Examination 12817.5 Differential Diagnosis 12817.6 Treatment Considerations  12817.6.1 Non‐Surgical Management  12817.6.2 Surgical Management  12917.6.3 Endodontic Treatment  130References  13118 Failed Restoration and Compromised Tooth 13318.1 Introduction  13318.2 Direct Restorations  13318.2.1 Amalgam Restorations 13318.2.2 Composite Restorations  13318.2.3 GIC, Resin‐Modified GIC and Compomers  13418.3 Indirect Restorations  13418.3.1 Crowns  13418.3.1.1 Porcelain Fused to Metal (PFM) Crowns  13518.3.1.2 All‐Ceramic Crowns  13518.3.1.3 Full Gold Crowns (FGG)  13518.3.2 Inlays and Onlays 13518.3.3 Veneers  13618.4 Restoration of Root‐Treated Teeth  136References  14019 Fluorosis 14319.1 Definition  14319.2 Aetiology and Pathogenesis 14319.3 Prevalence  14319.4 Clinical Features and Classifications 14319.5 Diagnosis 14319.6 Treatment Considerations  144References  14620 Fractured Endodontic Instrument  14720.1 Incidence 14720.2 Causative Factors and Prevention 14720.3 Impact on Outcome of Endodontic Treatment  14720.4 Management Strategies  14820.5 Factors Affecting Removal of Fractured Instruments 14820.6 Fragment Removal 149References  15121 Fractured or Failed Post  15321.1 Introduction  15321.2 Reasons for Failure of Post‐Retained Restorations 15321.3 Factors to Consider  15321.4 Risks of Post Removal 15321.5 Post Removal Techniques  154References  15722 Gingival Enlargement and Gingivitis 15922.1 Introduction  15922.2 Aetiology and Clinical Features 15922.3 Diagnosis 16022.4 Management  160References  16423 Gingival Recession 16523.1 Introduction  16523.2 Aetiology and Risk Factors 16523.3 Classification  16623.4 Diagnosis 16623.5 Prevention and Non‐Surgical Management 16623.5.1 Monitoring and Maintenance  16623.5.2 Adhesive Restorations 16623.5.3 Gingival Prosthesis 16623.5.4 Orthodontic Space Closure  16723.6 Surgical Treatment  16723.6.1 Gingival Augmentation 16723.6.2 Surgical Root Coverage 16823.6.2.1 Pedicle Soft Tissue Grafts  16823.6.2.2 Free Soft Tissue Grafts  16923.6.2.3 Prognostic Factors  16923.6.2.4 Clinical Outcome of Various Root Coverage Procedures 17023.6.3 Surgical Reconstruction of Interdental Papillae 17023.6.4 Periodontal Microsurgery 170References  17324 Halitosis 17724.1 Terminology  17724.2 Aetiology 17724.3 Epidemiology 17724.4 Classification  17724.5 Diagnosis 17724.6 Management Strategies  178References  17925 Hypodontia  18125.1 Definition and Classification 18125.2 Aetiology 18125.3 Epidemiology 18125.4 Clinical Features  18125.5 History and Examination 18225.6 Relevant Investigations 18225.7 Care Pathway 18225.8 Multidisciplinary Team 18225.9 Restorative Considerations 18325.10 Treatment Considerations  18325.10.1 Preventive Care 18325.10.2 Treatment Options for Missing Teeth  18325.10.3 Missing Maxillary Lateral Incisors 18325.10.3.1 Space Closure  18325.10.3.2 Space Opening  18425.10.4 Missing Mandibular Incisor Teeth  18425.10.5 Maxillary Midline Diastema 18425.10.6 Management of Retained Primary Teeth  18425.10.7 Prosthetic Options to Replace the Missing Teeth 18525.10.7.1 Resin-bonded Bridge (RBB)  18525.10.7.2 Conventional Bridge 18625.10.7.3 Removable Partial Denture (RPD) and Overdenture 18625.10.7.4 Implant‐Retained Prosthesis  18625.10.8 General Maintenance Requirements  187References  19126 Internal Root Resorption 19326.1 Definition  19326.2 Pathogenesis  19326.3 Predisposing Factors 19326.4 Epidemiology 19326.5 Classification  19326.6 Diagnosis 19326.6.1 Clinical Features  19426.6.2 Radiographic Features 19426.7 Treatment Considerations  194References  19627 Irrigation Accidents 19727.1 Introduction  19727.2 Types of Incidents and Common Causes 19727.3 Signs and Symptoms 19727.4 Prevention  19727.5 Management  198References  20028 Low Maxillary Sinus Floor 20128.1 Introduction  20128.2 Sinus Floor Elevation Techniques  20128.2.1 Lateral Approach  20128.2.1.1 Indications and Contraindications  20128.2.1.2 Preoperative Assessment 20128.2.1.3 Surgical Approach 20228.2.1.4 Bone Grafting  20228.2.1.5 Postoperative Care and Complications 20328.2.2 Crestal Approach  20328.3 Implant Survival 203References  20429 Microdontia  20729.1 Definition, Prevalence and Classification 20729.2 Aetiology 20729.3 Examination and Diagnosis 20729.4 Management  207References  21030 Necrotising Periodontal Diseases 21130.1 Introduction  21130.2 Epidemiology 21130.3 Predisposing Factors 21130.4 Clinical Features and Diagnosis 21130.5 Microbiology and Histology 21130.6 Management  21230.6.1 Acute Phase Treatment  21230.6.2 Treatment of Chronic Periodontal Disease  21230.6.3 Corrective Phase Treatment  21230.4 Maintenance  212References  21331 Occlusal Issues and Occlusion 21531.1 Definitions  21531.2 Occlusal Philosophies 21531.3 Assessment and Recording of Occlusion 21631.4 Articulators  21631.5 Face‐bow  21631.6 Conformative Approach 21731.7 Reorganisation of Occlusion  21731.8 Determinants of Posterior Occlusal Morphology 217References  21932 Oncology‐Related Defects in Mandible 22132.1 Introduction  22132.2 Roles of the Multidisciplinary Team in Head and Neck Cancer Management 22132.3 Consequences of Cancer Surgery in Mandible 22232.4 Classification of Mandibular Defects 22232.5 Rehabilitation of Mandibular Defects 22232.5.1 Surgical Reconstruction of Mandibular Defects 22232.5.2 Prosthetic Rehabilitation of Mandibular Defects  22332.5.2.1 Pretherapy Dental Screening  22332.5.2.2 Prosthetic Challenges  22332.5.2.3 Conventional Prosthetic Management  22432.5.2.4 Implants in Oncology Patients  22432.5.2.4.1 Indications and Limitations  22432.5.2.4.2 Relevant History and Preoperative Examination 22432.5.2.4.3 Planning, Timing and Design Considerations 22532.5.2.4.4 Primary Implants  22532.5.2.4.5 Implants in Irradiated Bone  22532.5.2.4.6 Implants in Grafted Bone Flaps  225References  22933 Oncology‐Related Defects in Maxillae 23333.1 Maxillary Tumours  23333.2 Surgical Resection  23333.3 Classification of Maxillary Defects 23333.4 Surgical Reconstruction  23433.4.1 Local and Regional Flaps 23433.4.2 Soft Tissue Free Flaps  23433.4.3 Hard Tissue or Composite Free Flaps 23433.5 Prosthetic Treatment 23433.6 Alterations at Surgery to Facilitate Prosthetic Treatment  23433.7 Prosthetic Treatment Phases  23533.7.1 Surgical Obturator  23533.7.2 Interim Obturator  23533.7.3 Definitive Obturator  23633.8 Soft Palate Defects  23633.9 Osseointegrated Implants  236References  23834 Open Apex (Immature Non‐Vital Teeth) 24134.1 Definition  24134.2 Aetiology 24134.3 Classification  24134.4 Management Strategies  24134.4.1 Working Length Determination in Teeth with Open Apices  24134.4.2 Irrigation Considerations  24134.4.3 Calcium Hydroxide Apexification 24234.4.4 Placement of an Apical Plug to Create an Artificial Apical Barrier 24234.4.4.1 Mineral Trioxide Aggregate 24234.4.4.2 Biodentine®  24234.4.5 Regenerative Endodontic Treatment  242References  24435 Open Bite 24735.1 Definition and Classification 24735.2 Aetiology 24735.3 Incidence 24735.4 Indications for Treatment  24735.5 Treatment Options  24735.5.1 Prevention  24735.5.2 Orthodontic Treatment  24735.5.3 Orthognathic Surgery  24835.5.4 Restorative Treatment  248References  25036 Osteoradionecrosis 25136.1 Definition and Pathogenesis 25136.2 Prevalence  25136.3 Risk Factors  25136.4 Classification of ORN  25136.5 Diagnosis 25236.6 Prevention  25236.6.1 Pre‐Radiotherapy Dental Assessment and Extractions 25236.6.2 Patient Education  25236.6.3 Minimising Trauma  25236.6.4 Prophylactic Hyperbaric Oxygen Therapy and Antibiotics 25236.7 Management  253References  25437 Partial Edentulism – Implant Treatment 25737.1 Introduction  25737.2 Preoperative Patient Assessment 25737.2.1 History  25737.2.2 Clinical Examination  25737.2.3 Special Investigations 25737.3 Risk Factors  25837.3.1 Local Risk Factors  25837.3.2 Systemic Risk Factors  25837.3.3 Behavioural Risk Factors 25937.4 Risk Assessment and Patient Consent 25937.5 Treatment Considerations  25937.5.1 Planning Stage 25937.5.2 Surgical Stage  26037.5.3 Prosthetic Treatment 26037.5.4 Replacement of the Anterior Teeth with Implants  26137.5.5 Replacement of the Posterior Teeth with Implants  26137.5.6 Considerations in Bruxist Patients  26137.5.7 Maintenance  26237.5.8 Implant Complications  26237.5.8.1 Biological Complications  26237.5.8.1 Mechanical Complications  26237.5.8.1 Aesthetic Complications  26337.5.8.1 Evidence  26337.6 Implant Survival 26337.6.1 Implant‐Retained Single Crowns 26337.6.2 Implant‐Retained Bridge  26337.7 Timing of Implant Placement after Tooth Extraction  26337.8 Timing of Implant Loading 264References  26938 Partial Edentulism – Partial Denture Treatment  27338.1 Introduction  27338.2 Removable Partial Denture Types 27338.2.1 Acrylic Dentures  27338.2.2 Cobalt-Chromium RPDs  27338.2.3 Flexible Dentures  27438.2.4 Hypoallergenic Dentures 27438.2.5 PEEK‐based RPDs 27438.3 Classification of Partially Dentate Arches 27438.4 General Guidelines  27438.5 RPD Design  27438.5.1 Surveying 27438.5.2 Occlusal Analysis 27438.5.3 Replacing Anterior Teeth  27438.5.4 Milled Crowns 27538.5.5 Components of RPD Design 27538.5.6 Saddle Areas 27538.5.7 Rests  27538.5.8 Retentive Clasps 27538.5.9 Indirect Retainer  27538.5.10 Mandibular Major Connectors  27538.5.11 Maxillary Major Connectors  27638.5.12 Minor Connectors  27638.6 Swing‐Lock RPD  276References  27839 Perforation 28139.1 Definition 28139.2 Causes  28139.3 Pathogenesis  28139.4 Epidemiology 28139.5 Classification  28139.6 Diagnosis 28139.7 Prognosis  28239.8 Management  28239.8.1 Extraction 28239.8.2 Non‐Surgical Treatment  28239.8.3 Surgical Treatment  28239.9 Treatment Outcomes 283References  28540 Peri‐Implant Diseases 28740.1 Definitions  28740.2 Aetiology 28740.3 Risk Factors  28740.4 Prevalence  28740.5 Diagnostic Criteria  28740.6 Patient Assessment  28840.6.1 Implant Identification  28840.6.2 Relevant History 28840.6.3 Assessment of Suprastructure 28840.6.4 Assessment of Individual Fixtures 28840.6.5 Assessment of Peri‐Implant Soft Tissue  28840.6.6 Radiographic Assessment 28840.7 Management of Peri‐Implant Mucositis  28840.8 Management of Peri‐Implantitis  288References  29141 Periodontal Abscess 29341.1 Definition and Classification 29341.2 Pathogenesis  29341.3 Prevalence  29341.4 Microbiology  29341.5 Diagnosis 29341.6 Differential Diagnosis 29441.7 Treatment 294References  29642 Periodontic‐Endodontic Lesion 29742.1 Definition and Classification 29742.2 Diagnosis 29742.3 Prognosis  29742.4 Management  298References  30043 Periodontitis as a Manifestation of Systemic Disease 30143.1 Introduction  30143.2 Periodontitis Associated with Haematological Disorders 30143.3 Periodontitis Associated with Genetic Disorders 30143.4 Periodontitis Associated with Other Conditions (Not OtherwiseSpecified Group)  303References  30544 Radiotherapy Side Effects 30744.1 Introduction  30744.2 Radiation‐Induced Oral Mucositis  30744.3 Xerostomia 30844.3.1 Organ‐Sparing Radiotherapy 30844.3.2 Salivary Gland Tissue Transfer 30844.3.3 Preventive Medication 30844.3.4 Salivary Stimulation 30844.3.5 Saliva Substitution 30844.4 Oral Infections  30844.5 Trismus (Restricted Mouth Opening)  309References  31145 Ridge Defects (Generalised) 31345.1 Introduction  31345.2 Classifications  31345.3 Neutral Zone Impression Technique for Resorbed Ridges 31345.4 Magnet‐Retained Conventional Overdenture 31445.5 Implant‐Supported Overdentures 31445.6 Full‐Arch Implant‐Retained Fixed Prosthesis 315References  31746 Ridge Defects (Localised) 31946.1 Introduction  31946.2 Ridge Augmentation by Soft Tissue Grafts 31946.3 Ridge Augmentation with Hard Tissue Surgery 32046.3.1 Anatomical Repositioning Techniques 32046.3.2 Bone Grafting  320References  32447 Shortened Dental Arch (SDA) 32547.1 Definition  32547.2 History  32547.3 Effect of SDA on Oral Health‐Related Quality of Life 32547.4 Effect of Tooth Loss on Masticatory Function  32547.5 Effect of SDA on Occlusal Stability  32547.6 Effect of SDA on Temporomandibular Joint  32647.7 Alternative Treatment Options  326References  32748 Supernumerary, Fusion and Gemination 32948.1 Supernumerary (Hyperdontia) 32948.1.1 Prevalence  32948.1.2 Classification  32948.1.3 Aetiology 32948.1.4 Oral and Dental Complications  32948.1.5 Examination and Diagnosis 32948.1.6 Management  33048.2 Fusion  33048.2.1 Classification  33048.2.2 Aetiology 33048.2.3 Incidence 33048.2.4 Relevant Investigations 33048.2.5 Treatment Options  33048.3 Gemination  331References  33249 Temporomandibular Disorders 33549.1 Definition  33549.2 Prevalence  33549.3 Classification  33549.4 Aetiology 33549.5 Diagnosis 33649.6 Special Investigations 33649.7 Management  33649.7.1 Patient Education  33649.7.2 Jaw Exercise and Manual Therapy 33649.7.3 Acupuncture  33649.7.4 Pharmacotherapy  33749.7.5 Occlusal Stabilising Splint Therapy  33749.7.6 Anterior Repositioning Splint 33749.7.7 Occlusal Adjustment  33749.7.8 TMJ Lavage  33749.7.9 Surgery 337References  33850 Tooth Wear 34150.1 Definitions and Clinical Features 34150.2 Aetiology 34150.2.1 Parafunction and Occlusion  34150.2.2 Intrinsic Acids  34150.2.3 Extrinsic Acids  34250.3 Prevalence  34250.4 Classification  34250.5 History and Examination 34350.6 Prevention  34350.7 Management of Worn Teeth  34350.7.1 Conformative Approach 34350.7.2 Reorganisation Approach 34350.7.3 Occlusal Splint Therapy Prior to VD Increase  34450.7.4 Fixed Restorations  34450.7.4.1 Direct Fixed Restorations  34450.7.4.2 Indirect Fixed Restorations  34450.7.5 Crown Lengthening 34550.7.6 Removable Treatment Options  34550.7.7 Maintenance  346References  350Index 355