Central nervous system tuberculosis (CNS-TB) is a manifestation of Mycobacterium tuberculosis infection that poses significant diagnostic and therapeutic challenges. This article reports an unusual case of CNS-TB in a patient who presented to the oral surgery department following referral from a general dental practitioner. The patient's primary complaint was pain involving the palate that extended across the midline. CNS-TB is rare, and early recognition and timely intervention through a multidisciplinary approach are essential to achieve favourable outcomes and prevent unnecessary dental procedures. This case highlights the importance of including CNS-TB in the differential diagnosis of orofacial pain, particularly in patients from regions with a high prevalence of tuberculosis. The clinical presentation, diagnostic work up and management strategy adopted in this case are described, highlighting the need for heightened clinical vigilance among dental health professionals. CPD/Clinical Relevance: Central nervous system tuberculosis, although rare, should be considered in the differential diagnosis of atypical orofacial pain.

This three-part series provides a comprehensive commentary on the positive and negative aspects of the dental dam system. This first part gives an overview of dental dams and gives the methodology and key findings of a literature review on their use, advantages and drawbacks. A search of the literature, including peer-reviewed studies and grey literature, was carried out and the results analysed. Dental dam application was found to provide significant clinical benefits as well as having various limitations. Part 2 examines the advantages of rubber dam use in more detail and Part 3 will comprehensively consider the disadvantages and limitations and make practical recommendations to address these. CPD/Clinical Relevance: This critical analysis of rubber dam outlines its possible uses, highlights gaps in the scientific data and the need for more research.

Silver diamine fluoride is a topical technique licensed for sensitivity but which can be used for caries arrest off label. There is a long history of its use internationally, but relatively recent licensing arrangements in North America and Europe have led to a renewed interest and an evolving evidence base. This includes evidence of its efficacy in the arrest of caries in primary teeth and root caries in permanent teeth. These updates have implications for clinical indications and techniques employed when using SDF. SDF is listed as a World Health Organization essential medicine. It was recently included in the Scottish Dental Clinical Effectiveness Programme guideline on caries management and prevention in children. CPD/Clinical Relevance: This article gives an overview of the updated evidence base for silver diamine fluoride.

Molar–incisor hypomineralization (MIH) is a common enamel developmental condition affecting one or more first permanent molars. This article presents a practical, evidence-based summary of current management approaches for MIH-affected posterior teeth, with an emphasis on hypersensitivity management, preventive strategies and restorative interventions. CPD/Clinical Relevance: This article presents a practical, evidence-based summary of current management approaches for MIH-affected posterior teeth, with an emphasis on hypersensitivity management, preventive strategies and restorative interventions.

A chronic apical abscess is an endodontic condition commonly characterized by the presence of a notable sinus tract through which pus periodically discharges. In general, these cases can be considered ‘straight forward’ to diagnose but on some occasions, diagnosis can be challenging. Any misdiagnosis can compromise the treatment approach for the patient and lead to adverse outcomes such as unnecessary biopsies or referrals. Therefore, clinicians should follow a meticulous treatment approach consisting of appropriate diagnostic measures to establish the correct diagnosis and treatment pathway. CPD/Clinical Relevance: Misdiagnosis of challenging cases can result in inappropriate treatment, especially where odontogenic infections mimic precancerous/cancerous skin lesions.

Zirconia has undergone significant modifications to enhance its optical properties, with the percentage of yttria being a crucial determinant. Surface treatment techniques, such as air abrasion, primer application and resin cement application, play critical roles in achieving reliable zirconia restorations. This review explores the critical factors of transformation toughening and low-temperature degradation, interpreting their impact on zirconia's mechanical properties. It provides a brief explanation of the computer-aided design and computer-aided manufacturing process for fabricating zirconia restorations and explores the classification of zirconia variations. Additionally, it briefly discusses essential clinical aspects, such as tooth preparation and cementation techniques, specific to zirconia restorations. The review highlights the importance of carefully selecting zirconia owing to the diverse types available in the market. Factors such as yttria concentration and tooth preparation significantly influence the outcome of zirconia restorations. A comprehensive understanding of these factors is essential for making informed decisions in restorative dentistry. CPD/Clinical Relevance: This review offers dental professionals comprehensive insights into zirconia as a restorative material.