MetLife MetDental Accreditation Information

Dentists always faced the challenge of making good decisions regarding the incorporation of new technology into their practice. Questions of reliability, relative effectiveness, predictability, effect on outcomes of care, and cost all need to be answered based on objective, non-biased assessments. The sixth edition of this Guide provides the practitioner information about newer diagnostic instruments including cone beam and digital imaging, electronic apex locators, rotary instrumentation, disinfection and root canal filling in a concise format. The newest science is reviewed with regard to instrumentation and filling materials. The extensive references provide the reader with the basis for the author’s evaluation of the various technologies. This Guide can serve as a fundamental resource for the practitioner initiating or expanding the delivery of endodontic therapy within their practice.

The term ‘cracked tooth’ has been used to describe many types of fractures in teeth. One type of dental fracture is the Crown-originating fracture (COF). A COF typically originates in the tooth crown and is not related to previous root canal treatment. A COF is often extremely difficult to diagnose because symptoms vary widely and may mimic other pathologic conditions. This Quality Resource Guide (QRG) provides an evidence-based discussion of the COF, including characteristics, symptoms, diagnosis (using radiographic information, clinical/tactile findings, pulp testing, percussion and periodontal probing), treatment options and prognosis. A section also discusses appropriate methods of communicating with the patient through the sometimes very difficult processes of determining a diagnosis and selecting a treatment option. The QRG is an important reference for the clinician assessing a patient presenting with pain that is suspected of being from a tooth. It also provides background information for the dental office team to answer patients’ questions regarding a potential COF and the options they face regarding therapy.

Symptoms of a Vertical Root Fracture (VRF) are often lacking or mild in nature, complicating its diagnosis and management. In addition, the clinical presentation of a VRF can be confused with other dental conditions and lead to misdiagnosis. This QRG describes the clinical and radiographic aspects of a VRF and discusses management of these dental problems. It provides an evidence-based discussion of the VRF, including characteristics, symptoms, diagnosis, treatment options and prognosis. A section also discusses appropriate methods of communicating with the patient through the sometimes very difficult processes of determining a diagnosis and selecting a treatment option. Multiple well-documented clinical cases are presented to demonstrate the descriptions and findings discussed in the narrative. The QRG is an important reference for the clinician assessing a patient presenting “soreness” in a tooth,that is difficult to differentiate. It also provides background information for the dental office team to answer patients’ questions regarding a potential VRF and the options they face regarding therapy.

Pathologic root resorption of permanent teeth, sometimes leading to premature tooth loss is a very frustrating clinical situation for the practicing dentist. This guide presents an overview of the various types of tooth root resorption, describes suspected resorptive mechanisms, and discusses diagnosis, management and associated prognoses of teeth with root resorption. Detailed sets of radiographs, several with post-therapy follow-up, demonstrate the clinical resorptive conditions.  An easy to understand table differentiates the clinical, radiographic and recommended treatment differences between “Internal Resorption” and “External Resorption”. The fourth edition of this guide discusses the use of cone beam computed tomography as a definitive diagnostic tool in difficult cases.

Traumatic dental injuries are often the result of facial trauma and affect individuals of all ages. More than one billion individuals and an average of one in four ages 6-50 have experienced dental trauma. There are several types of traumatic dental injuries involving soft and hard tissues, ranging from simple crown fractures to more complex types associated with damage to the soft tissues and facial bones. The type and severity of the injury will influence its prognosis and determine the best treatment approaches. This Quality Resource Guide (QRG) provides an evidence-based review of: the classification of traumatic dental injuries associated with dislocation of teeth; proper management of traumatic dental injuries; timing and chronology of treatment procedures for traumatic dental injuries, and; expected prognosis and treatment outcomes. The QRG, in narrative and table formats, supplemented by high-quality photos documenting therapy and follow-up, presents the clinical findings and treatment guidelines for concussion/subluxation, extrusive luxation, lateral luxation, intrusive luxation and avulsion. It will serve as an essential reference when a patient presents with an oral traumatic injury and a resource for practitioners and staff members as they discuss treatment, follow-up, and prognosis with a patient having a traumatic dental injury.