Developing and Adapting Systems for Your Dental Office

By William J. Moorhead, D.M.D.

Looking for ways to systematize your dental office? In the book “The Checklist Manifesto” by Atul Gawande, M.D., Dr. Gawande talks about the advantages of using discipline in our work day. Let’s face it, we’re human and prone to mistakes. Gawande reveals how systems and checklists can decrease mistakes, boost efficiency and reduce stress.

Even the Journal of the American Dental Association (JADA) agrees. In an article published in August 2010, Harold M. Pinsky, D.D.S., a part-time dentist and part-time pilot, states, “To enhance safety, practitioners must implement forward-thinking strategies. Because human error is inevitable, threat and error management techniques are needed to help identify and trap error before it develops into unexpected outcomes. Risk analysis heightens situational awareness for possible dental error. Efficiency increases with early error detection.” Continue reading

Implants and CBCT

It is no longer a debatable fact that three-dimensional imaging is standard of care when it comes to the surgical component of implant placement.1 The key here is to understand the value of achieving the three-dimensional view, simply phrased as the depth component of the visual anatomy. CBCT images are valuable to understand the topography and—more importantly—the inner component of the osseous structures.

Although all the image stacks are very critical to forming an opinion of the anatomical region in consideration, it is the cross-sectional view that are the most used when it comes to virtual planning of implants. Surgeons are better able to appreciate the buccal-lingual dimension of the bone when viewing the cross sectional reconstruction of the scanned anatomical area of the jaws. While viewing this reconstruction and other multiplanar images, there are some key anatomical markers to be evaluated as a part of the visual assessment of the bone.

It is expected that the morphology of the edentulous areas varies not only between individuals, but in an individual’s oral cavity. Age is a critical factor in the change noted in the osseous structures. Another critical factor is time; the longer a patient stays edentulous, the more the probability of resorption of the alveolar crest. This leads one to note the following three (not limited to) critical changes in the jaws:

Examples of lingual undercut, knife edge ridges and ridge angulation. Continue reading