Clinical experience, misunderstood concepts and frequently asked questions. Notes from many years of practice.
Across 25 All-on-4 studies, mean cumulative implant survival was 94 to 98 percent over follow-up of 72 to 132 months, with mean marginal bone loss of 1.3 plus or minus 0.4 mm, and axial and tilted implants showed no significant survival difference. What a package covers and what it does not.
Tongue-tie is present in 4% to 11% of newborns, and the evidence is narrower than the debate: the Cochrane review pooled 5 randomised trials covering 302 infants, finding reduced maternal nipple pain but inconsistent feeding outcomes, while 16 studies found no clear link with speech articulation.
Fill with warm water, start on low pressure, place the tip before switching on and trace the gumline at 90 degrees. Water flossing, step by step.
Laser teeth whitening is in-office bleaching with light-activated peroxide gel; it lifts coffee, tea and tobacco stains but cannot change crowns or veneers.
In a systematic review of 25 studies using the All-on-4 concept, cumulative implant survival was 94% to 98% over 72 to 132 months and prosthesis survival was 99% to 100% at 12 months. What the treatment involves, how packages are priced, and which questions to ask first.
The association is strong and measured: in a meta-analysis of 33 studies, daily pacifier use carried an odds ratio of 10.22 for anterior open bite. The reassuring half is that in 5 studies of children aged 4 to 12, open bite self-corrected by 50% to 100% once the habit ended.
A “perfect smile” is a set of decisions with published lifespans: pooled clinical evidence across 29 studies gives ceramic laminate veneer survival of 96.13% for feldspathic, 93.70% for leucite-reinforced and 96.81% for lithium disilicate at 10.4 years. Which treatments, in which order.
Reshaping the ridge matters because the ridge changes on its own: human re-entry studies pooled in a systematic review found 3.79 mm of horizontal and 1.24 mm of buccal vertical bone reduction after extraction. Technique matters too, with piezosurgery giving lower pain scores on day 2.
Early lesions can be arrested rather than drilled: a network meta-analysis of 31 trials with 1,906 participants ranked resin infiltration and self-assembling peptide P11-4 with fluoride varnish above varnish alone, while sealants cut the odds of occlusal decay in permanent molars to 0.15 over seven years or more.
