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The Klippel-Feil Syndrome: a Case Report JCDAJournal of the Canadian Dental Association Vol. 70, No. 10 November 2004 Painting by Dr. Kris Row Nonsurgical Decompression of Large Periapical Lesions Pigmented Lesions of the Oral Cavity Klippel-Feil Syndrome Diet and Dentin Hypersensitivity Canada’s Peer-Reviewed Dental Journal PM40064661 R09961 • www.cda-adc.ca/jcda • Dental technology is changing fast and Ash Temple keeps me up to date The people of Ash Temple are experienced and motivated. Their knowledge of what’s new in the market, combined with their understanding of your practice and your style, can help you to achieve the highest standards of performance. Ash Temple is your all-Canadian source for unmatched value on supplies and equipment and for answers to the challenges of a busy dental office. Our dedication to Canadian dentistry shows in our extra value Equity purchasing program, in our advanced ordering and delivery systems, and in our financial support for practice development and for professional organizations. Supplies ● Equipment ● Design We are ready to help. Call 1-800-268-6497, or visit ashtemple.com Repairs ● Financing ● Transitions JCDAJournal of the Canadian Dental Association CDA Executive Director George Weber Editor-In-Chief Mission statement Dr. John P. O’Keefe Writer/Editor CDA is the authoritative national voice of dentistry, dedicated to the Sean McNamara representation and advancement of the profession, nationally and Assistant Editor internationally, and to the achievement of optimal oral health. Natalie Blais Coordinator, French Translation Nathalie Upton Coordinator, Publications Rachel Galipeau Editorial consultants Writer, Electronic Media Dr. Catalena Birek Dr. Ernest W. Lam Melany Hall Manager, Design & Production Dr. Gary A. Clark Dr. James L. Leake Barry Sabourin Dr. Jeff Coil Dr. William H. Liebenberg Graphic Designer Dr. Pierre C. Desautels Janet Cadeau-Simpson Dr. Kevin E. Lung Associate Editors Dr. Terry Donovan Dr. Debora C. Matthews Dr. Michael J. Casas Dr. Robert Dorion Dr. Anne Charbonneau Dr. David S. Precious Dr. Robert V. Elia Dr. Mary E. McNally Dr. Richard B. Price Dr. Sebastian Saba Dr. Joel B. Epstein All statements of opinion and supposed fact Dr. N. Dorin Ruse are published on the authority of the author Dr. Kenneth E. Glover who submits them and do not necessarily Dr. George K.B. Sándor express the views of the Canadian Dental Dr. Daniel Haas Association. The editor reserves the right to Dr. Benoit Soucy edit all copy submitted to the Journal. Publica- Dr. Felicity Hardwick tion of an advertisement does not necessarily Dr. Gordon W. Thompson imply that the Canadian Dental Association Dr. Robert J. Hawkins agrees with or supports the claims therein. Dr. Aleksandra Jokovic Dr. Robert S. Turnbull The Journal of the Canadian Dental Associa- tion is published in both official languages — Dr. Asbjørn Jokstad Dr. David W. Tyler except scientific articles which are published in the language in which they are Dr. Richard Komorowski Dr. Peter T. Williams received. Readers may request the Journal in the language of their choice. The Journal of the Canadian Dental Association is published 11 times per year (July-August combined) by the Canadian Dental Association. Copyright 1982 by the CDA Board of Directors Canadian Dental Association. Publications Mail Agreement No. 40064661. Registration President Dr. Gordon Johnson No. 09961. Return undeliverable Canadian Dr. Alfred Dean North Battleford, Saskatchewan addresses to: Canadian Dental Association at 1815 Alta Vista Drive, Ottawa, ON K1G 3Y6. Sydney, Nova Scotia Postage paid at Ottawa, Ont. Subscriptions Dr. Robert MacGregor are for 11 issues, conforming with the calen- President-Elect Kentville, Nova Scotia dar year. All 2005 subscriptions are payable Dr. Jack Cottrell in advance in Canadian funds. In Canada — Port Perry, Ontario $81 ($75.70 + GST, #R106845209); United Dr. Jack Scott States — $110; all other — $136. Notice of Vice-President change of address should be received before Edmonton, Alberta the 10th of the month to become effective the Dr. Wayne Halstrom following month. Member: American Associat- Vancouver, British Columbia ion of Dental Editors and Canadian Circulations Dr. Robert Sexton Audit Board • Call CDA for information and Dr. Michael Connolly Corner Brook, Newfoundland and Labrador assistance toll-free (Canada) at: 1-800-267-6354 Charlottetown, Prince Edward Island • Outside Canada: (613) 523-1770 • CDA Fax: (613) 523-7736 • CDA E-mail: reception@ Dr. Darryl Smith cda-adc.ca • Web site: www.cda-adc.ca Dr. Craig Fedorowich Valleyview, Alberta Hamiota, Manitoba ISSN 0709 8936 Printed in Canada Dr. Don Friedlander Dr. Deborah Stymiest Ottawa, Ontario Fredericton, New Brunswick Journal of the Canadian Dental Association November 2004, Vol. 70, No. 10 655 Trusted strength Trusted esthetics Trusted fit Before After ™ ava Zirconia Crowns and Bridges by 3M ESPE combine superior ™ Lstrength and durability coupled with excellent esthetics to meet Lava the demands of your patients. Now the Lava system is available in 8 shades for natural shade matching. Lava zirconia crowns and bridges All-Ceramic System utilize an innovative CAD/CAM technology to produce all-ceramic crowns and bridges on a zirconium-oxide glass-free polycrystalline base that result in high-strength, reliable restorations with excellent esthetics and an outstanding marginal fit. Preparations require minimal Crown. removal of tooth structure and conventional cementation techniques. TM Prescribe Lava crowns and bridges for your next restoration. The strength of 100% zirconia Excellent esthetics Authorized LavaTM Milling Centre STRENGTH Mechanical Properties ISO 6872* and translucency 1300 Lava™ zirconia crowns and 1200 8 shades of zirconia framework bridges are now available to 1000 for natural shade matching you through your lab. Have 800 your lab contact an Authorized 600 4-year clinical history Strength (MPa) Lava Milling Centre by visiting 400 www.3MESPE.com/labproducts 200 Conventional cementation or by calling 1-800-265-1840 0 ZrO2(Lava) Procera** InCeram InCeram Empress I Empress II Alumina Alumina Zirconia Ideal for 3- and 4-unit bridges ext. 6229. * 3M ESPE ** Wagner et al. J. Prost. Dent. 76 (2) 1996. Visit www.3MESPE.com/labproducts, contact your lab or call 1-800-265-1840 ext. 6229 to learn more about how the Lava™All-Ceramic System can help enhance your dental practice. Dentistry and clinical photography courtesy of Ariel Raigrodski, DMD, MS; Ceramics, Mr Andreas Saltzer, CDT. #8 restored with a porcelain feldspathic veneer, #9 Lava © 3M 2004. 3M, ESPE and Lava are trademarks of or AG. Used under licence in Canada. 0405MG19801 CONTENTS Journal of the Canadian Dental Association D EPARTMENTS P ROFESSIONAL I SSUES Editorial . 659 Is Dentistry a Profession? Part 3. Future Challenges . 675 Jos V.M. Welie, MMedS, JD, PhD President’s Column . 661 Regional Variation in Dental Procedures among People Letters . 663 with an Intellectual Disability, Ontario, 1995–2001 . 681 Robert S. Balogh, MSc News. 667 Hélène Ouellette-Kuntz, MSc Duncan J.W. Hunter, PhD FDI Statements . 670 The Dental Advisor . 672 C LINICAL P RACTICE Point of Care . 704 Pigmented Lesions of the Oral Cavity: Advertisers’ Index . 709 Review, Differential Diagnosis, and Case Presentations . 682 Clinical Showcase . 711 Adel Kauzman, BDS, DMD, MSc Marisa Pavone, DDS Classified Ads . 721 Nick Blanas, BSc, DDS, FRCD(C) Grace Bradley, DDS, MSc, FRCD(C) The Klippel-Feil Syndrome: A Case Report . 685 Manuel O. Lagravère, DDS, MSc All matters pertaining to the Journal should María I. Barriga, DDS be directed to: Editor-in-chief, Journal of the Carla Valdizán, DDS Canadian Dental Association, 1815 Alta Vista Augusto Saldarriaga, DDS Drive, Ottawa, ON, K1G 3Y6. E-mail: Juan F. Pardo, DDS [email protected]. Martha Flores, DDS • Toll-free: 1-800-267-6354 • • Tel.: (613) 523-1770 • Active Nonsurgical Decompression of Large • Fax: (613) 523-7736 • Periapical Lesions — 3 Case Reports . 691 Jose L. Mejia, DDS, Dip Endo All matters pertaining to classified advertising Jaime E. Donado, DDS, Dip Endo should be directed to: Ms. Beverley Kirk- Bettina Basrani DDS, Dip Endo, PhD patrick c/o Canadian Medical Association, 1867 Alta Vista Dr., Ottawa, ON K1G 3Y6 • Toll-free: 1-800-663-7336 , ext. 2127 • • Tel.: (613) 731-9331• A PPLIED R ESEARCH • Fax: (613) 565-7488 • All matters pertaining to display advertising Influence of Natural Fruit Juices in Removing the Smear should be directed to: Mr. Peter Greenhough Layer from Root Surfaces — An In Vitro Study . 697 c/o Keith Communications Inc., Fernanda Oliveira Bello Corrêa, DDS, MS 104-1599 Hurontario St., Mississauga, ON L5G 4S1 José Eduardo Cezar Sampaio, DDS, MS, PhD • Toll-free: 1-800-661-5004 • Carlos Rossa Júnior, DDS, MS, PhD • Tel.: (905) 278-6700 • Silvana Regina Perez Orrico, DDS, MS, PhD • Fax: (905) 278-4850 • Publication of an advertisement does not necessarily imply that the Canadian Dental Association agrees with or supports the claims therein. An independent review* has concluded that oscillating- “We acknowledge the financial support rotating technology, pioneered by Oral-B, is the most of the Government of Canada through effective at reducing plaque and gingivitis. the Publications Assistance Program *For more information, and to read the published abstract, visit the Cochrane Collaboration website at towards our mailing costs.” www.update-software.com/toothbrush. Please see our advertisement opposite the Editorial page. Journal of the Canadian Dental Association November 2004, Vol.
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