Cement

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What do u think??Which cement would you use to glue an aluminia core ceramic ?Panavia Zinc phosphateResin modified glass ionomer Poly carboxylate BalsamSent from my iPadOn 18 Dec 2011, at 17:18, Irfan Salim <irfansalim85@...> wrote:

hmm .. well I dont exactly know what happened. But if patient opts to have the tooth edxtracted knowing that we have explained the procedure then its patient who has to decide the final procedure based on the pros n cons of the procedure. We can give alternatives and patient can decide. Because we do take consent from patient before extraction so necrosis would be one of the side effects of the procedure mentioned in the consent form. From: Sana Puremel <sanapuremel@...> " " < > Sent: Sunday,

December 18, 2011 9:18 PM Subject: Re: Again bisphosphonates-new guidance..?

The way i handle and communication was fine and i passed that(they grade you on that as well),but the answer abt pulpotomy i guess was wrong...i told everything as it was in MJDF RCS osces..Nothing to do with other osces..because I have fedback from the exam on every osces-passed/failedi feel that i shouldnt refer pt to extract the tooth,i should extract it From: Irfan Salim <irfansalim85@...> To:

" " < > Sent: Sunday, 18 December 2011, 15:12 Subject: Re: Again bisphosphonates-new guidance..?

I dont think that this exact question can be the cause of failure. In OSCE the way you handle the patient is also important. Its about communication skills as well . So I think it might have to do with other osces. With bisphosphonates I would always tell the patient that he pain can be relieved easily by pulpotomy. There is no need to go into problems. Immediate pain relief is via pulpotomy. From: Sana Puremel <sanapuremel@...> " " < > Sent: Sunday, December 18, 2011 8:08 PM Subject: Re: Again bisphosphonates-new guidance..?

Hi guysI offered to my Pt RCT in the exam mfds-I failed this osce,I guess I should say extract the tooth...pt was suffering from a pain,and kept asking me to pull the tooth out...and said you may have the osteonecrosis,,,well i explained everything abt bisphosph.-but i failed the osce.... From: Lyudmyla Huhley <huhley2006@...> " " < > Sent: Sunday, 18 December 2011, 9:52 Subject: Re: Again bisphosphonates-new guidance..?

thank you irfan for confirmation of my thoughts)) SincerelyLyudmyla From: Irfan Salim <irfansalim85@...> " " < > Sent: Sunday, 18 December 2011, 4:13 Subject: Re: Again bisphosphonates-new guidance..?

But I think lyuda you already answered this in your question lol .. From: Lyudmyla Huhley <huhley2006@...> " " < > Sent: Saturday, December 17, 2011 1:29 AM Subject: Again bisphosphonates-new guidance..?

Hi guysI am confused abt bisphosphonates-if Pt has a toothache what shall we do?Extract or RCTIt looks like we can extract tooth but before you need to assess pt if they are at low risk...If any extraction or any oral surgery or procedure which may impact on bone is necessary,assess whether the patient is at low, or higher risk of BONJ as follows:• the patient is at low risk before they have started taking bisphosphonates for any condition,or are taking bisphosphonates for the prevention or management of osteoporosis.• the patient is at higher risk if any of the following factors is present:−−previous diagnosis of

BONJ;−−taking a bisphosphonate as part of the management of a malignant condition;−−other non-malignant systemic condition affecting bone (e.g. Paget’s disease);−−under the care of a specialist for a rare medical condition (e.g. osteogenesis imperfecta);−−concurrent use of systemic corticosteroids or other immunosuppressants;−−coagulopathy, chemotherapy or radiotherapy.Advise the patient that there may be BONJ risk to enable informed consent, but ensure that theyunderstand that it is an extremely rare condition. It is very important that a patient is not discouragedfrom taking medication or undergoing dental treatment. Record that this advice has been given.Follow the management strategies described in Sections 3.2.1 and 3.2.2.Note: There is no supporting evidence that BONJ risk will be reduced if the patient temporarily, or evenpermanently, stops taking bisphosphonates prior to invasive

dental procedures since the drugs maypersist in the skeletal tissue for years. If a patient has taken bisphosphonates in the past but is nolonger taking them for whatever reason (i.e. completed or discontinued the course, taking a drugholiday), allocate them to a risk group as if they are still taking them. SincerelyLyudmyla