Over the last decade, osseointegrated dental implants have become an integral part of the restorative dental armamentarium. Reproducible success rates approaching 100% further emphasize the importance and value of this treatment modality. Still, a significant waiting period is required between implant placement and prosthesis delivery, which necessitates a two-surgery approach for implant protection during healing. This article discusses the development of an animal model that is being used to investigate methods of manipulating the healing process of bone next to dental implants. Osseointegration has been shown to occur at 6 weeks in the rat tibia model, demonstrating many of the same characteristics seen in humans. The successful manipulation of bone next to the implant surface may ultimately lead to a surgical protocol for the placement of dental implants requiring only one surgery, significantly reducing the overall healing time.

For a variety of reasons, orthodontic intervention is often overlooked as a viable modality to correct occlusal, axial, rotational, and space discrepancies before undertaking fixed prosthetic rehabilitation. However, patient treatment is being enhanced as never before by such intervention. This valuable treatment option facilitates tooth preparation, path of insertion, optimum oral hygiene, and a better pontic and abutment design, while occlusal forces can be directed against the long axes of the teeth for a more predictable prognosis. Moreover, this interdisciplinary approach can be cost-effective to patients and their treating dentists from the standpoint of producing more stable, durable, and esthetic restorations.

The use of at least two biologic indicators to monitor a sterilization process greatly enhances failure detection. A retrospective study of a sterilization monitoring service's database revealed that 48.7% of tests using two test strips were single-strip positive. This indicates that there is a nonuniformity in the sterilization conditions within the sterilizer chamber and that there is a need for at least two test strips to detect this nonuniformity.

Sterilization in the dental office should be monitored to ascertain proper sterilizer function. Biologic monitoring with calibrated preparations of bacterial spores is the preferred, as well as the only method that actually measures sterilization. A dental school-based sterilization monitoring service for dental practices was established in 1978 at the University of Detroit. This service has grown from 20 participating dental offices to more than 1,500. In 1993, 18,137 biologic monitoring tests were performed. The participants in the service primarily use autoclaves (70%) for heat sterilization, while unsaturated chemical-vapor sterilizers (20%) and dry-heat units (10%) are less common. This article describes the history of sterilization monitoring in dental practices from 1978 to the present through a dental school-based service.

With the advent of regulatory requirements regarding infection-control procedures, the business of sterilization monitoring is becoming ever more popular across the country. Therefore, monitoring services, many of which are associated with an academic institution, are providing such services for dental practitioners. The relationship between the service and its clients, as well as the types of service the sterilization monitoring service provides, presents some interesting legal issues. The documentation of services provided, including record keeping, requires compliance with various state confidentiality and privacy laws. The service must also be concerned about potentially misrepresenting itself to its clients about the services it offers. Additionally, the service must avoid making warranties that its clients may detrimentally rely on to escape sanctions by applicable regulatory agencies. Finally, the service must concern itself with general business regulations, including those specific policies and rules that apply to the academic institution with which it is associated.

Many states now require dental offices to test their sterilizers on a regular basis for public health reasons. To perform this task, many offices choose to have the testing done by a third party. Many companies, small and large, now offer this service. To choose a monitoring service, the dental office should learn as much as possible about the variety of services available. This article will show the dental office how to choose a monitoring service.