Sound levels of the Piezosurgery®. Risk of permanent damage to hearing In the past, research has regularly been carried out concerning the sound levels of various drilling devices and the impact these have on those who regularly use these devices. The present research is concerned with the possible permanent damage to hearing which can occur during the use of a newly developed instrument, the Piezosurgery®. Measurements have been performed in a standardized set-up in which use is made of the lower jaws of pigs and a weight scale for measuring various degrees of pressure. The boundary values of the permissible exposure to noise were determined. The values of the Piezosurgery® were compared with conventional drilling machines. It was concluded that using the Piezosurgery® for less than 1.5 hours per day implies no risk of permanent damage to hearing. This means that the risk in the case of Piezosurgery® is somewhat lower than that of conventional drilling devices.

Maxillofacial prosthodontics is a specialization in dental health practiced in centers for special dental care in the Netherlands by a limited number of dentists and technicians. The necessary skills, which are largely unique in the field of dentistry, were described in 2001 in a training program by the Dutch Association for Gnathology and Prosthodontics. Multidisciplinary diagnostics, treatment planning, and care delivery are taught in a modular system. A shortage of maxillofacial prosthodontists and maxillofacial technicians calls for a structural training of young colleagues.

The surgical and prosthetic aftercare of craniofacial prostheses supported by endosseous implants were registered in patients treated with implant-retained craniofacial prostheses in a university clinic during the last two decades. Aftercare was registered during the period from implant placement until the last follow-up visit. Implant survival rate was 95,2% in non-irradiated and 78,8% in irradiated bone. Discoloration of the silicon material, becoming loose of the acrylic clip carrier from the silicone, rupture of the silicone, and ill-fitting of the prosthesis were main reasons for fabrication of a new craniofacial prosthesis.

An editorial by Professor Daniel Malamud, expert in the field of saliva research, on new developments in salivary diagnostics appeared in spring 2006 in The Journal of the American Dental Association (J Am Dent Assoc 2006; 137: 284-285). In this editorial it was emphasized that the introduction of emerging technologies such as nanotechnology, proteomics and genomics has significantly broadened the diagnostic potential of saliva. Malamud expects that it will become possible in the near future to determine, with the help of a few drops of saliva, whether a patient is suffering from a certain disease (for example, an oral tumour or a systemic disease like the Sjögren syndrome). With the help of nanotechnology it will be possible to miniaturize the necessary diagnostic equipment to hand-held size, and in a form appropiate for the dentist’s chair. Moreover, these new techniques might be applied for monitoring oral health status (e.g. whether a patient suffers from active periodontal disease). Much research still has to be performed regarding the sensitivity and specificity of proteomics and genomics for detecting diseases (in the mouth or elsewhere in the body) or monitoring oral health before these techniques will become available for application in general practice. Nevertheless, things are developing very rapidly.

A 34-year-old woman appeared at the office of a general dental practitioner after a bicycle accident. At first, the only injury seemed to be some small tooth enamel fractures. Several weeks later, she developed a swelling in the lower lip and was referred to an oral surgeon. A radiograph of the lower lip revealed some of the tooth enamel fragments. This case-report illustrates the importance of a meticulous examination in case of a patient with a dental trauma.

The Dutch government is watching on the health care, consistant with a special law, by registering all health care providers in a national record. Dentist also have the opportunity to demonstrate to patients their engagement in oral health care by registering in a national dental quality record voluntarily.Both the health care providers record and the dental quality record are running a website. The websites are supplying information to health care providers as well as their patients: www.ribiz.nl en www.kwaliteitsregistertandartsen.nl.