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Introduction: Mammography as a screening tool can reduce mortality from breast cancer. Nevertheless, it has disadvantages such as false positive results, false negative, impaired sensitivity in women with dense breast over-diagnosis and radiation. Due to the different weight given to the advantages versus the disadvantages of mammography, different approaches to screening have developed. These range from annual screening starting at the age of 40 years, to biannual screening starting at the age of 50. The official screening program in Israel is biannual screening between the ages of 50 and 74.

Introduction: Partial resections of the breast are more than 50% of breast oncological surgery. The resulting defect can be substantial and cause meaningful deformity that leads to reduced body image satisfaction of the patients, affecting their ability to cope with the cancer. Parallel to the development of breast oncology techniques, an evolution of breast reconstruction techniques occurred. During the last decade, by using techniques from cosmetic breast surgery (such as breast reductions, augmentations and mastopexies), we can reconstruct extensive partial defects of the breasts at the immediate and delayed setting and achieve symmetrical aesthetic results. Of the 350 oncological breast surgeries a year performed in our center, 70% undergo partial breast resection and only 10% of those surgeries exhibit a defect necessitating reconstruction. The recovery and post-operative complications, especially in the immediate setting, are significantly reduced in comparison to total breast reconstruction. Our experience shows that by using plastic surgery techniques in those operations, we can overcome the deformity created by large partial resection of the breast and improve the mental recovery from breast cancer.

Composites are a large family of materials composed of polymer matrices imbedded with different types of fillers. The specific properties achievable with diverse chemical combinations provide for a wide range of implications in many industrial fields. Materials designed for medical use must not only efficiently serve the purpose of their use, but also be biocompatible to the tissues they contact and the body as a whole. Dental composites and their components have been studied intensely to assess their potential local and systemic side effects, to establish biocompatibility, in order to receive the proper conformation allowing their safe clinical use. The purpose of the following paper is to summarize several aspects of research focused on determining cytotoxicity, genotoxicity, carcinogenicity, hypersensitivity, and microbial effects of composite components, in order to ascertain in fact how biocompatible dental composite materials are. Research shows that several chemical components may be released from different types of composites, and are able to cause toxic, allergic, mutagenic and other biological effects. However, because of the small amounts applied and the unique conditions in the oral cavity, the clinical relevance of these findings is questionable. Nevertheless, caution should be taken when using these materials, to avoid possible negative outcomes. Future studies should focus on targeting most toxic components and finding biocompatible alternatives and development of materials with high polymerization efficiency in order to reduce the amount of leachable components.

The common use of dental implants in the daily practice led to a profound change in the available treatment strategies. The option of replacing a diagnosed doubtful tooth with an implant has become widely accepted and often used. The prognosis systems in use today are based on the three major disciplines: endodontics, periodontics and prosthodontics. Combining these three may impair and bias the decision making process and increase the tendency to base it on subjective clinical experience and personal preference. Reading and reviewing the relevant literature gives no clear tool for use. Root canal treatment is considered a highly predictable treatment procedure and a treated tooth is affected mainly by the quality and type of the fabricated restoration and the risk of caries. Periodontal treatment followed by a suitable maintenance regimen will likely allow long term tooth survival. When comparing the success rates of natural teeth rehabilitation versus implant supported restorations, it appears that with implants an additional treatment is demanded along the years. This coincides with the fact that to date there is no consensus regarding the extent of perimplantitis and perimucositis that is to be expected around a restored implant. In addition, a peri implant tissue problem or a failure of a dental implant may prove to be more challenging than a failure of a tooth. It is important to remember that a dental implant is made to substitute a missing tooth and it is a treatment modality with known and clear indications for rehabilitation of an edentulous space. The aim of this paper is to review and discuss the various aspects of whether to maintain a compromised or a doubtful tooth or to prefer a treatment modality using dental implants. In conclusion it is advised here, to incorporate the discussed issues in the decision making process towards the most suitable treatment plan.

One of the reasons for immediate or late failure of restorations is the detachment of the restoration from the tooth. Retention for the restoration could be achieved from axial walls (macromechanical retention) or from adhesion of the restoration to the remaining tooth structure. Adhesion relies on bonding of resin cement to enamel or dentin on one side and to the restorative material on the other side. Bonding to enamel is predictable. Good bonding to dentin is more of a challenge especially with indirect restorations. In those cases the restoration is delivered usually a few days after the tooth was prepared during this time the exposed dentin might be contaminated or damaged. The question is whether you can rely on adhesion when cementing indirect restorations? In order to achieve the maximal bonding strength to dentin, the hybrid layer on the dentin must be built immediately after tooth preparation. This procedure is called Immediate Dentin Sealing. In vitro and clinical studies have shown better performance of restorations cemented following the IDS procedure. The article discusses the rational and the protocol of this procedure. A clinical case is presented as an example for the possibilities following this philosophy.

The majority of benign and malignant breast diseases originate in the ductal system. Breast ductoscopy (BD) allows direct access to this ductal system and thus holds great promise in the diagnosis and surgical management of a number of breast diseases. BD was first developed over 20 years ago to investigate nipple discharge. Indeed, till now, this remains the most common indication. However, BD technology has been further developed for a variety of new clinical applications. For example, BD-guided ductal ravage combined with molecular and genetic analysis can be a powerful screening tool for women at high-risk of breast cancer. BD can also be used during lumpectomy to identify additional radiographically occult disease. This refined intraoperative margin assessment can help surgeons to achieve clear margins at the first excision while optimizing the extent of resection. In the future, this same precise intraoperative margin assessment may facilitate a variety of local ablative techniques including laser Over time, BD is likely to evolve beyond its current technological limitations to realize its full diagnostic and therapeutic potential. The article describes the technique of BD, reviews its evolution and discusses current and future applications.

Diabetic mastopathy is an uncommon disorder of the breast seen mostly in young women suffering from type 1 diabetes mellitus. The presenting symptom is a rapidly growing breast lump that may simulate breast cancer. Clinically and radiologically it can be indistinguishable from breast carcinoma. Recognizing this clinical entity, in addition to close collaboration between the clinician and the pathologist can facilitate its early diagnosis, avoiding unnecessary alarm for the patient. A 36 years old patient with a long-standing type 1 diabetes mellitus was admitted to surgery for a rapidly growing left breast lump. Excisional biopsy of the lump revealed diabetic mastopathy.

Wear of materials is a complex and unpredictable phenomenon. The variables affecting the mechanism of wear include the properties of the two contacting materials and the surrounding and interfacial media. This paper reviews the dental wear of different restorative materials and their counter effect on the tooth structure. It presents the updated classifications for tooth surface lesions termed dental wear, and discusses the wear behavior of various restorative materials. Some guidelines for restorative material selection are given. Clinical wear bears a multifactorial etiology, understanding the mechanism of action is an important step in an appropriate restoration material selection. Each material selected should meet the individual wear behavior and needs. Individual factors may enhance the wear rates: aggressive tooth brushing, parafunctions, diet, acidic/aqueous environment, surface geometry, and diminished tooth support. Supportive treatment following restoration is important to monitor wear rates.