bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential diagnosis of severe periodontal lesions
Authors: Hirsch Robert S. , Clarke Nigel G.
Published: May 2009

In current clinical practice, a differential diagnosis of severe localized periodontal lesions is rarely made; such lesions are considered to be manifestations of periodontitis caused by specific microbes from the commensal oral flora. However, deep seated lesions of the periodontium which are in communication with the alveolar crest, are well documented periodontal consequences of pulpal pathoses and can mimic the signs and symptoms of ‘periodontitis’. The very low incidence of tooth‐threatening periodontal disease in ancient and modern man is revealed when differential diagnoses are used in the examination of alveolar defects in anthropological materials and when epidemiological studies use more appropriate indices. However, no periodontal index to date has incorporated a differential diagnosis between gingival and pulpal causes of alveolar bone loss. The gingival and periodontal signs of severe localized periodontal lesions are reviewed and the imprecise nature of current clinical diagnostic tests (radiography, ‘pulp testing’, darkfield microscopy, bleeding on probing, periodontal probing) is discussed. None of these tests is able to detect disease activity and cannot be used to predict future patterns of disease behaviour. However, the commonly held belief that the tests are accurate has resulted in most severe periodontal lesions being falsely labelled as periodontitis. Failure to carry out differential diagnosis of severe periodontal lesions has resulted in the instigation of periodontal therapy for many lesions of non‐gingival origin. Whenever severe localized lesions of the periodontium are detected, the differential diagnosis between pulpal and periodontal origins should be made. The results of diagnostic tests in current use should be interpreted with extreme caution; clinicians are left to exercise their judgment based on consideration of all the available evidence.
Clinical evaluation of three dentine bonding agents
Authors: Tyas Martin J.
Published: May 2009

Three commercial dentine bonding agents were used with composite resin to restore non‐undercut Class V abrasion lesions without enamel etching. Patients were reviewed at 3, 6 and 12 months and the integrity and marginal staining of restorations was assessed.

The loss incidence of restorations ranged from 18 to 40 per cent at one year, and there was increasing evidence of marginal staining over the evaluation period.

Comparisons are made with other commercial dentine bonding agents from previous studies in this series.
Survey of dental practice/dental education in Victoria Part I. Questionnaire/general aspects
Authors: Stewart Barry L. , Ralph William J. , Macmillan Cleo H.
Published: May 2009

A questionnaire was designed to canvass the opinions of dentists registered with the Dental Board and resident in the State of Victoria, with a view to assessing the present undergraduate curriculum in relation to clinical dental practice. All respondents were requested to provide information about age, sex, registration, type/location of practice and qualifications. The questionnaire sought opinions from all respondents regarding the priority to be given to basic sciences and medical sciences as well as the introduction of topics not presently included in the undergraduate course. Questions were also posed in relation to physical assessment of applicants for the dental course, the timing of introduction to clinical procedures and the desirability of an intern year (Section A). Other sections were designed to ascertain the current trends and busyness of general dental practice (Sections B and C) and of restricted/specialist practice (Sections C and E), the views of recent graduates and postgraduates with respect to the appropriateness of their training for clinical practice (Sections D and F, respectively) and, in a separate questionnaire, the perceived views of graduating students with respect to their training for registration as dentists. The results of the survey were prepared in the form of four papers, namely, General aspects (Part I), Recent graduates/‐graduating students (Part II), Current trends in general dental practice (Part III) and Specialist dental practice (Part IV).

This paper deals with the results of Section A of the survey which, it is suggested, need to be considered in any review of the curriculum.
Does midazolam sedation in oral surgery affect the potency or duration of diflunisal analgesia?
Authors: Rodrigo M. R. C. , Rosenquist J. B.
Published: May 2009

A randomized cross‐over study was carried out to determine whether midazolam in doses used for conscious sedation had any effect on the potency or duration of diflunisal, a non‐narcotic analgesic used for postoperative pain in oral surgery. Thirty‐two Hong Kong Chinese patients of either sex, aged between 16 and 28 years, were given either midazolam to supplement local anaesthesia or local anaesthesia alone at one visit and the alternative at the other visit, for surgical removal of bilateral symmetrically impacted third molars. Surgery was carried out on one side only at each visit. Diflunisal was given for postoperative pain relief. Midazolam had no effect on the potency or duration of action of diflunisal. Independent of the method, more patients had better pain relief following the second procedure than following the first, probably due to a degree of adaptation to the pain, at the second visit.
The effect of etching on a number of glass ionomer cements
Authors: Fuss J. , Mount G. J. , Makinson O. F.
Published: May 2009

In view of the continuing interest in the use of glass ionomer cements as a dentine substitute or base under composite resins, further investigations were carried out on the effects of the length of time of etching of the surface of the cement prior to the placement of the resin. A number of cements are available on the Australian market which are advocated for use in this technique. Each of them was subjected to etching for periods of 15, 30, 45, or 60 seconds and then stored in water for one week. Examination under a dissecting microscope and a scanning electron microscope revealed some variation in results between the different cements.

It would appear that not all those materials presently marketed for this purpose are entirely suitable. Whilst 15 seconds is the preferred time for most cements, some require times up to 60 seconds to achieve the best result. Also, some of the cements showed signs of cracking, expansion and distortion after they had been stored in water for one week to allow for maturation before being prepared for viewing under the SEM. It is suggested that this group of cements is not suitable for the ‘sandwich’ technique.
Orofacial pain associated with an infected complex odontome. Case report
Authors: Tözöm M. şenol
Published: May 2009

Diagnosis and treatment of a case of complex odontome of the mandible is presented, together with a discussion of the condition.
Bruxism: A review of the literature. Part II
Authors: Faulkner Keith D. B.
Published: May 2009

A review of the literature on bruxism ‐ a condition which has been clinically recognized since the late nineteenth century ‐ is presented. It will be seen that there is not complete agreement on the definition of this activity, and its aetiology and treatment remain controversial.
Amyloidosis with oral involvement. Case report
Authors: Loh F. C. , Ravindranathan N. , Yeo J. F.
Published: May 2009

Abstract— A patient with chronic renal failure was investigated after complaining of oral discomfort which was found to be due to macroglossia and generalized involvement of the oral soft tissues by amyloidosis. A search for multiple myeloma proved to be positive. She also had a previous history of Carpal‐tunnel syndrome. Despite an initial good response to treatment with phenylalanine nitrogen mustard (melphalan hydrochloride), she finally succumbed to end‐stage renal failure.
Localized alveolar ridge augmentation using a connective tissue graft. Case report
Authors: Kitchings Sterling K.
Published: May 2009

Abstract— The restorative dentist is often faced with difficulties in overcoming functional, cosmetic, and cleansibility requirements when replacing teeth in areas of localized alveolar ridge resorption. A case report is presented highlighting a surgical technique to correct such an alveolar ridge deficit.
Medicaments: Aids to success in endodontics. Part 2. Clinical recommendations
Authors: Abbott Paul V.
Published: May 2009

In order to predictably achieve bacteria‐free root canal systems, especially in pulpless teeth, it is necessary to use intra‐canal medicaments. Medicaments can also be used to influence the peri‐radicular response to endodontic treatment. Consideration of a material's therapeutic action must be made when selecting a medicament for any pathological condition. In general, only two commercial preparations satisfy the general requirements for root canal medicaments. Guidelines and the rationale for the use of these preparations are presented.
The biocompatibility testing of some dental amalgams in vivo
Authors: Ellender Graham , Feik Sophie A. , Gaviria Claudia
Published: May 2009

The biological responses to some dental amalgams were determined in vivo and compared with those of dental porcelain. The technique of implantation employed in the study addressed some of the vagaries of the Recommended Standard Practices for Biological Evaluation of Dental Materials (RSP) and considered both cellular responses (inflammation, infiltration and fibrogenic cell activity) and the organizational status of the resultant encapsulation. The implantation sites for both the experimental and control were biogeometrically similar, unlike those currently recommended in RSP. At the end of the test period, all the dental amalgams tested caused minor responses reflected by the formation of thin capsules with an acceptable matrix organization. The Australian manufactured dental amalgams — Permite C®, Lojic, F400®, New Ultrafine® and GS80® all produced even capsules with quiescent cells. By one hundred days, the capsule around Dispersalloy®, although generally well formed, showed some areas of cellular activity and matrix variability. The biological responses to all the dental amalgams examined were mild and considered to be acceptable for clinical usage. The matrix organization of enveloping capsules must be considered in the determination of the biocompatibility of a dental restorative material.
A method of determining residual monomer in acrylic resin using methyl ethyl ketone
Authors: Sadamori Shinsuke , Shigeto Naofumi , Hamada Taizo , Okuda Kyuichiro
Published: May 2009

An improved method of extraction of residual monomer from acrylic resin has been described for determination of the concentration of residual monomer by gas chromatography. Four kinds of organic solvent selected according to their physico‐chemical properties (methanol, N,N‐dimethylformamide, ethyl acetate and methyl ethyl ketone) were tested for their capacity to extract residual monomer at varying temperatures and time periods. Extraction with methyl ethyl ketone at 4°C was found to be the most effective. The method is simpler and more effective than others reported so far, and therefore seems to be suitable for clinical laboratory use.
Odontogenic tumours. A series of 409 cases
Authors: Günhan Ömer , Erseven Gülçin , Ruacan Şevket , Celasun Bülent , Aydintug Yavuz , Ergun Ender , Demiriz Murat
Published: May 2009

Reports on the incidence of odontogenic tumours are infrequent with only a limited number of series having appeared in the literature. In this paper, the results of a multicentre retrospective study on the histologic types and relative frequencies of odontogenic tumours in Turkey are presented. The results indicated that the most frequent histologic type was ameloblastoma (36.5 per cent) and the area at greatest risk for the development of odontogenic tumours was the mandibular molar region. A Table showing the most likely type of tumour by location is also presented.
Enamel defects in a fluoridated South‐East Asian community
Authors: Chellappah N. K. , Vignehsa H. , Lo G. L.
Published: May 2009

The prevalence and distribution patterns of enamel defects in maxillary incisors was assessed in 194 Singaporean children aged 11–15 years and belonging to three different ethnic groups. All were born and continuously resident in Singapore, which has a tropical climate. The water supply was fluoridated in 1957 at a level of 0.7 ppm. The mouth prevalence of defects was 71.5 per cent and the tooth prevalence was 55.9 per cent; 82 per cent of all affected teeth demonstrated white lesions of various forms. Although there was no sex difference in the prevalence and distribution pattern of defects, some racial differences were observed. The results were compared with data from other studies where the same classification of defects was used.
Chairside evaluation of salivary parameters in patients with tooth surface loss: A pilot study
Authors: Bevenius Joan , L'Estrange Peter
Published: May 2009

In cases of tooth surface loss, the possibility of an erosive component should be considered, even when the lesions have the characteristic clinical appearance of abrasion or attrition. Individual susceptibility or resistance to erosive damage has been attributed to variations in the quality of saliva. Two recent studies have indicated that rate of flow of saliva and buffer capacity may be important determinants in erosion susceptibility. These parameters may be readily assessed using the chairside kits developed in Scandinavia for assessing caries susceptibility. In eight consecutive patients referred to the University of Queensland Dental School for investigation of tooth surface loss, six had no measurable quantities of resting whole saliva, four had low values for stimulated saliva flow rates, and only two patients had buffer capacities within the normal range. The results indicate the need for a larger scale study of salivary parameters in this patient group. The chairside kits provide a simple, rapid, hygienic means of assessing salivary values.
Acid etching of a glass ionomer cement base: SEM study
Authors: Smith E. Dell Kingsford , Martin F. Elizabeth
Published: May 2009

The effects of acid‐etching duration on the surface of a glass ionomer cement designed for use as an intermediary layer between composite resin and dentine were investigated. Cement topography changes occurred which could be related to etch duration. When compared with enamel etched for a similar period, undue loss of cement substance was not observed for any of the etch times used.
Computerized axial tomography in the diagnosis of internal derangements of the temporomandibular joint
Authors: Anker A. H. , D'Rozario R. H. , Li S.
Published: May 2009

Fourteen patients with a history of pain, clicking and locking of the temporomandibular joint were assessed clinically and by using computerized axial tomography (CAT). The findings of the clinical and CAT scan assessment were correlated and compared with surgical observations. Computerized axial tomography scanning proved to be a highly accurate method of assessing meniscal position. With the advent of more sophisticated methods of CAT scanning, it provides an accurate, non‐invasive method of assessing the temporomandibular joint and providing a basis for more effective treatment planning of problems related to internal derangements.
The natural tooth pontic — a compromise treatment for periodontally involved anterior teeth
Authors: Walsh L. J. , Liew V. P.
Published: May 2009

A technique which uses a natural tooth pontic to replace a periodontally compromised tooth is described. Following extraction and root resection of a maxillary central incisor, the crown was bonded to the adjacent teeth using acid‐etched composite resin located in proximal cavity preparations. Some advantages of the technique are discussed.
The partial denture over a fixed guide bar appliance: A technique for restoring partially edentulous quadrants. Case report
Authors: Poschelk Kevin K.
Published: May 2009

Replacement of a number of lost teeth in partially edentulous quadrants has been accomplished using a technically simple Tissue‐borne, Partial Denture over a Fixed Bar (PDOFB) Appliance. The appliance offers a similar degree of comfort and aesthetic appeal to that of a fixed bridge, but is specifically designed to reduce the high occlusal loads that normally are applied to the abutment teeth during mastication. It has been used where, because of the excessive distance between the abutment teeth, or because of the poor periodontal health of the abutment teeth, the construction of conventional crowns and bridges was contraindicated.

The indications for, and the construction of such an appliance are described.
Post‐insertion sensitivity with a bonded etched cast metal prosthesis. Case report
Authors: Berekally Thomas L.
Published: May 2009

An interesting case of post‐insertion sensitivity in a patient who had an etched cast metal prosthesis (Maryland Bridge) cemented with a recently marketed resin luting agent is discussed. This case report draws attention to the fact that despite the relative conservatism and simplicity commonly associated with abutment tooth preparation for resin bonded prostheses, dentine exposure should be avoided if possible to reduce the potential for chemical irritation of the pulp by components of the resin luting system.
Fermentable simple sugars in self‐administered medications as aetiologic agents in rampant caries. Case report
Authors: Walsh L. J. , Seow W. Kim
Published: May 2009

Sucrose is recognized as the most cariogenic carbohydrate. However, other simple sugars may act as substrates for cariogenic micro‐organisms. The clinical features of an adult patient suffering from rampant caries are described. It was considered that the predominant aetiologic factor was prolonged intake of mineral supplements which contained the disaccharide lactose. The principal caries risk factors included drug‐induced xerostomia and prolonged contact time with the substrate in a retentive form. Chemical analysis of the products revealed the presence of lactose together with starch or glucose. A strategy for preventive management prior to restorative therapy based on chlorhexidine and fluoride‐containing products was followed. Possible contributions of sugar‐containing medications to caries risk status are discussed.
Root formation by tooth germs following extraction of prematurely erupted upper first premolars. Case report
Authors: Mahomed Nazir A.
Published: May 2009

A case is described of a seven year‐old boy in whom root formation continued following the premature extraction of both maxillary first premolars.
Determination of adhesive bond strength to dentine. A new method
Authors: Stewart Barry L. , Harcourt John K. , Tyas Martin J.
Published: May 2009

Specimens for the determination of adhesive bond strength to dentine were prepared using suitable surfaces of freshly extracted teeth from 15 patients who were having immediate dentures fitted. As soon as possible after extraction, shallow cavities were cut into the dentine to a depth of 1 mm using a highspeed round bur (diameter 4.2 mm) under water coolant. The cavities were restored using dentine bonding agents and single increments of light activated composite resin. The restored teeth were cut down to approximately 5 mm in diameter and 3 mm thick and were either placed in previously prepared sites in the buccal or occlusal surfaces of their respective dentures or in containers of tap water. Patients were instructed to remove their dentures only for cleaning with a soft nylon brush and toilet soap, while the laboratory specimens were stored at ambient temperature. After one week, the tensile force needed to dislodge each restoration from its cavity was determined using a universal testing machine.

Previously reported laboratory methods for bond strength determination have usually employed a flat dentine surface. However, this study more closely resembled the clinical situation in that the smear layer was produced by a rotary cutting instrument, and the effects of polymerization shrinkage when curing the composite resin were simulated. Furthermore, it was easier to confine the bonding agent to the desired dentine surface.
Prosthetic management of hypohydrotic ectodermal dysplasia with anodontia. Case report
Authors: Shaw R. M.
Published: May 2009

The patient in this report is a young boy with hypohydrotic ectodermal dysplasia. His case is exceptional in that anodontia was complete in both deciduous and permanent dentitions. A brief review of this condition is presented along with the prosthetic management of the case which emphasizes the need for regular modification and replacement of dentures worn by a growing child.
Parental awareness of the emergency management of avulsed teeth in children
Authors: Raphael Sarah L. , Gregory Peter J.
Published: May 2009

Although public awareness campaigns on avulsed teeth have been mounted in the past, no study has investigated the knowledge parents possess of the protocol for the management of this dental emergency. The purpose of this investigation was to evaluate, by means of a questionnaire, the parental awareness of the emergency management of avulsed teeth in children.

Over 2000 parents were surveyed during a four‐week period at 20 suburban vacation swimming centres. The results indicated that almost two‐thirds of respondents would attempt replantation of an avulsed tooth but further questioning showed they did not know the correct procedures. Thirty‐three per cent of respondents were unaware of any after‐hours emergency dental services. Ninety‐two per cent felt they should seek professional help urgently following an avulsion injury, but their knowledge of transport media for the tooth was poor. Only 5 per cent knew that milk was the medium of choice for both washing and transporting an avulsed tooth. Ninety per cent of parents surveyed had never received advice on what to do in the event of an accident where a permanent tooth was avulsed.

This study revealed the need for educational campaigns aimed at parents to increase their knowledge of the emergency procedures required when a tooth is avulsed.
Aptitude testing and the selection of dental students
Authors: Spratley M. H.
Published: May 2009

This paper discusses the problems involved in the selection of dental students and the need for some form of aptitude testing. It describes the situation in the United Kingdom both in the past and the present, and then describes in detail the situation in North America (both in the United States and Canada). The Dental Admission Test, its history and the research into its development are described with particular emphasis on the dexterity, perceptual and aptitude components of the test. More recent research into dexterity and aptitude testing of dental students is also covered. However, it is apparent that many questions remain unanswered.
Survey of dental practice/dental education in Victoria. Part III. Trends in general dental practice
Authors: Stewart Barry L. , Macmillan Cleo H. , Ralph William J.
Published: May 2009

The responses of practising dentists in regard to clinical time spent and demand trends in dental practice were combined with recent graduates' views of the emphasis given to various disciplines during their undergraduate training in order to provide information which might assist the undergraduate curriculum review.

The greatest proportion of clinical time spent by general practitioners on various clinical disciplines was reported to be restorative, preventive, diagnostic and endodontic services. There was evidence to suggest that there is an increasing demand for a broad range of clinical services, particularly in country locations, and that general practitioners appear to be expanding their range of services, including those traditionally offered by specialists. Highest increasing demand over the past five years were for recent advances in ‘aesthetic dentistry’, endodontics, preventive services, orthodontics, periodontics and fixed prosthodontics. High rates of referral were reported only for fixed orthodontics and major oral surgery.

Almost twice as many practitioners overall reported an increase (44 per cent) rather than a decrease (26 per cent) in volume of patients over the last five years. This trend was much more evident in country practices, however, with 55 per cent and 22 per cent compared with Melbourne city, 37 per cent and 29 per cent, increasing and decreasing, respectively.

Although dental educators are challenged to ensure that graduates are adequately prepared clinically to meet the demands of dental practice there is mounting pressure to support the introduction of an intern year prior to full registration.
Connective tissues of the periodontium. Research and clinical implications
Authors: Bartold P. Mark
Published: May 2009

The periodontium is a complex anatomical site composed of a variety of hard and soft connective tissues. The site is subjected to enormous daily chemical and mechanical abuse, yet, for the most part remains relatively intact. Nonetheless, when breakdown does occur, the ability of the periodontium to regenerate is sometimes limited. This review considers the various components of the periodontium and how they might be involved in not only the pathology of periodontal diseases but also the various reparative and regenerative processes required during wound healing. In addition, the importance of external factors such as a variety of commonly prescribed medications on these events is discussed.
Limitations of rotational panoramic radiographs in the diagnosis of maxillary lesions. Case report
Authors: Lilienthal B. , Punnia‐Moorthy A.
Published: May 2009

This case report clearly demonstrates that mis‐diagnosis may result from failure to recognize the limitations dictated by the width of the focal trough in rotational panoramic radiographs. The patient's clinical signs and symptoms were at variance with the findings from the rotational panoramic radiograph. A subsequent radiographic view by the occipito‐mental (Water's) projection showed the extent and malignant features of the lesion.
The role of oral bacteria in the pathogenesis of infective endocarditis
Authors: Knox K. W. , Hunter N.
Published: May 2009

Various micro‐organisms have been implicated as causative agents for bacterial endocarditis, including lactobacilli and in particular the viridans streptococci which are more commonly associated with dental caries. Of these, the most frequently isolated one has the descriptive name Streptococcus sanguis. The disease is characterized by growth of microorganisms within a platelet‐fibrin thrombus protruding from a valve leaflet. An understanding of the pathogenesis involves knowledge of the mechanisms of conversion of the normal vascular surface to a thrombogenic one and the adhesion of micro‐organisms to such surfaces. Model systems to study this interaction include experimental animals, mammalian epithelial cells and platelets, and proteins such as fibronectin and fibrinogen. Microbial protein surface components (adhesins) and lipoteichoic acid have also been implicated. Capsular polysaccharides may be involved, but the role of dextrans formed from sucrose has been overemphasized as the polymers are not formed in situ.

Antibiotic prophylaxis for patients at risk is based on bacteriostatic or bactericidal action. However, bacterial cell surface components involved in adhesion may also be affected, and knowledge of such reactions could provide a more rational basis for antibiotic prophylaxis.
Three‐year clinical evaluation of dentine bonding agents
Authors: Tyas Martin J.
Published: May 2009

Eighty Class V non‐undercut cervical abrasion lesions were restored using four dentine bonding agents and composite resin. The restorations were examined over a three‐year period, and the cumulative loss rate calculated each year. Marginal staining at each year was assessed using a standardized photographic method. The loss rate of restorations increased generally over the three‐year period, reaching 30 to 60 per cent for the four products. Marginal staining also increased for all four products over the three‐year period.
Talon cusp in Malaysia
Authors: Meon Rusmah
Published: May 2009

Five hundred and thirty‐six patients were examined for the presence of talon cusps. The anomaly was observed in 28 patients (5.2 per cent). There was no sex predilection in the occurrence. Only two patients had a bilateral occurrence, with the maxillary lateral incisors being the most commonly affected. Radiographic evidence of pulpal extension into the cusp was observed in five patients. Many of the affected teeth presented with deep developmental grooves some of which were carious and/or occlusal interference leading to malocclusion.
A case of AIDS presenting as intra‐oral malignant lymphoma
Authors: Donkor P. , Punnia‐Moorthy A. , Painter D. M.
Published: May 2009

A range of oral manifestations in a patient who was subsequently confirmed as infected with the human immune deficiency virus are presented. Most of these lesions have been previously reported in the literature, and represent opportunistic infection changes resulting from immune deficiency. The rare occurrence of a malignant large cell lymphoma intraorally in this patient is also reported. The need for clinicians to treat all oral lesions as potentially infective and to wear gloves routinely is stressed.
Idiopathic coronal radiolucencies in unerupted permanent teeth. Case reports
Authors: Singer Steven , Abbott Paul V. , Booth David R.
Published: May 2009

The discovery of a radiolucency within an unerupted tooth is a rare occurrence. One cause is external resorption. The clinical features, the histology, and the management of three cases are described.
The scope of oral and maxillofacial surgery in Australia and New Zealand. A postal survey
Authors: Goss Alastair N. , Gerke Dale C.
Published: May 2009

The current scope of oral and maxillofacial surgery in Australia and New Zealand was explored with a survey of full members of the Australian and New Zealand Association of Oral and Maxillofacial Surgeons resident in the region. There was an 83 per cent usable response rate and the objectivity of the data was confirmed by check questions and material from other sources. The study showed that oral and maxillofacial surgery is the surgical speciality of dentistry with the core of referral and surgical services being dento‐alveolar. However, the essential knowledge of the anatomy, pathology, and surgery of the orofacial region forms the basis for the wider scope of modern oral and maxillofacial surgery. Current surgery includes management of trauma, pathology, dentofacial deformity, and a wide range of reconstructive surgery including grafts and implants.
Soft tissue calcifications in the differential diagnosis of opacities superimposed over the mandible by dental panoramic radiography
Authors: Monsour Paul A. , Romaniuk Kornel , Hutchings Roxanne D.
Published: May 2009

Not all opacities observed on panoramic dental radiographs are associated with the jaws. Two thousand six hundred and twenty‐eight panoramic radiographs obtained from a single dental health clinic were evaluated for the presence of opacities associated with the mandible. Opacities were observed in 4 per cent of cases. The radiographic features of these opacities are presented. The importance of including soft tissue calcifications which may be superimposed over the mandible on panoramic views in the differential diagnosis is discussed. Information on the various soft tissue calcifications which can occur in this region is presented.
Eosinophilic granuloma of the oral region: A potential diagnostic problem
Authors: Cronin A. J. , Stevenson A. R. L. , Austin B. W.
Published: May 2009

Eosinophilic granuloma is a condition which may initially present with oral symptoms. Its variable oral clinical manifestations can result in a potential diagnostic problem for the dental surgeon. Two cases are presented which illustrate the difficulties in making a definitive diagnosis. The importance of a biopsy in diagnosis and the use of a whole‐body skeletal scan in formulating a treatment plan are highlighted
The effect of cheese on dental caries: A review of the literature
Authors: Herod Edward L.
Published: May 2009

The relationship between nutrition and dental health has been a topic of interest for many years. Recently, the cariostatic properties of cheese have been the subject of intensive research. Most of these studies suggest that the use of cheese as the final food in a meal will help to reduce caries. Several mechanisms by which cheese may reduce enamel demineralization have been proposed.

Chewing cheese stimulates saliva flow. The alkaline nature of saliva buffers the acids formed in plaque. There is also an increased rate of sugar clearance due to the diluting action of cheese‐stimulated saliva. Research has also suggested that chewing cheese may reduce the levels of cariogenic bacteria. This may be secondary to the reduced incidence of caries as conditions within a carious lesion tend to promote the growth of these organisms. The high calcium and phosphorus content seems to be another factor in the cariostatic mechanism of cheese. Both casein and whey protein seem to be involved in the reduction of enamel demineralization. Casein phosphopeptides may also be responsible for some anticariogenicity by concentrating calcium and phosphate in plaque.

An overview of the effect of milk on dental caries is also presented in this review.
Accidental damage to teeth adjacent to crown‐prepared abutment teeth
Authors: Moopnar M. , Faulkner K. D. B.
Published: May 2009

Three hundred and seventy casts with 652 registrable proximal surfaces adjacent to crown preparations were examined for iatrogenic damage to hard tissue surfaces. The incidence of damage was high and recommendations for prevention and treatment of such damage are made.
Primitive neuroectodermal tumour in the oral cavity. Case report
Authors: Yeo J. F. , Loh H. S. , Sng I.
Published: May 2009

Primitive neuroectodermal tumour is regarded as a rarely seen lesion as it occurs mainly within the central nervous system. However, this neoplasm does occasionally occur elsewhere in the body. One such case which occurred in the posterior part of the palate in a child is reported. Following a combined therapeutic approach comprising surgery, radiotherapy and chemotherapy, the patient has been well for nine years since treatment.
Bony lid approach for apicoectomy of mandibular molars
Authors: Lasaridis N. , Zouloumis L. , Antoniadis K.
Published: May 2009

Apicoectomy in the lower molar region is indicated in many instances to avoid the need for prosthetic appliances. Nevertheless it is a method sometimes rejected by oral surgeons because of the thickness of the buccal compact bone in the lower molar area leading to extensive bone loss in addition to a restriction of vision and access during the operation.

The present study reports twenty‐four cases of apicoectomized mandibular molars treated with the bony lid approach which facilitates considerably the apicoectomy procedure. Once part of the buccal compact bone in the periapical area of the molars is removed, favourable conditions are created for the completion of the operation under direct vision of the operational field. The replacement of the buccal compact bone then minimizes the dimensions of the remaining bone cavity.
The hard tissue lesion revisited
Authors: Goodman John M.
Published: May 2009

Recent research indicates that the thorough removal of calculus is still a critical step in the treatment of periodontal disease. Surgical access facilitates this in deep pockets. Repair is mediated by a long junctional epithelium as microscopically total calculus removal is rarely achieved. In intrabony defects the apical portion of the root surface which has not attracted deposits of calculus has the potential for connective tissue reattachment and regeneration if care is taken to preserve collagen fibres still attached to the root.
A national survey of dentists' management of children with anxiety or behaviour problems
Authors: Wright F. A. C. , Giebartowski J. E. , McMurray N. E.
Published: May 2009

Seven‐hundred and sixty dentists, selected randomly from all States and Territories except Victoria, responded to a questionnaire survey on beliefs, attitudes and the techniques used in the management of children with anxiety or behaviour problems. The most common techniques used were permitting the child some degree of control over terminating treatment if difficulties were experienced, coaxing and reinforcing positive behaviours, and furnishing waiting areas with child‐oriented play materials. Most respondents never used TV or video‐tape distraction strategies, film or video‐modelling tape or hypnosis. More than half of the respondents believed there was insufficient information available to them on current anxiety/behaviour management techniques.

The use of particular management techniques varied by gender, age, university of graduation, State or Territory of residence, and membership of the Australian and New Zealand Society of Paediatric Dentistry. Patterns of use of particular techniques showed similarities and contrasts with other studies. Patterns of use in the national sample were almost identical to the frequency and pattern of use by Victorian dentists. In contrast, however, North American studies have reported a higher frequency of use of hand‐over‐mouth, and lower use of general anaesthesia within the armamentarium of techniques and strategies used by dentists to manage anxious or difficult children.
A laboratory study of glass ionomer cement as a retrograde root‐filling material
Authors: Roth Stephan
Published: May 2009

This laboratory study investigated the use of various glass ionomer cements for retrograde root filling from the point of view of sealing qualities, ion release and ease of application. The sealing qualities of the material were tested by dye penetration and microscopic and SEM examination. Fluoride and silver ion release tests showed an initial loss of these two ions from the glass ionomer cement. A modified system for mixing and application was developed. Dye penetration did not differ from that of controls using vertically condensed gutta‐percha. Glass ionomer cement is possibly a clinical alternative for the sealing of retrograde cavities; however, the silver‐reinforced materials may cause tissue irritation from release of silver ions and their corrosion products.
Large database management in clinical dental research
Authors: Webster David A. , Smales Roger J.
Published: May 2009

Previously the management and analysis of large databases for longitudinal clinical dental research has been severely restricted by the costs of custom‐made software and access to suitable computing equipment. However, the recent availabiity of powerful personal computers and the use of the Scientific Information Retrieval Database Management System (SIR/DBMS) in association with BMDP Statistical Software has now created an enormously powerful tool for extensive and fast data manipulation requiring relatively few commands and the capability to easily perform detailed statistical analyses.
Transmigration of permanent mandibular canines. Case report
Authors: Shanmuhasuntharam P. , Boon Lian Chin
Published: May 2009

Transmigration is the migration of a tooth across the midline of the jaw. This phenomenon is found only in relation to the permanent mandibular canines. Two cases are reported. In both, the cause of this deviation was an odontome found in the site normally occupied by the mandibular canine. The literature on transmigration is reviewed.
Effects of pulsing with xylitol on mixed continuous cultures of oral streptococci
Authors: Rogers A. H. , Pilowsky K. A. , Zilm P. S. , Gully N. J.
Published: May 2009

Continuous culture is a means whereby organisms can be grown at rates approaching those occurring naturally. Moreover, the effect of adding transient excesses of various nutrients to the culture vessel (‘pulsing’) simulates the effect of dietary challenge on dental plaque organisms. Mixed cultures of Streptococcus mutans T8 and Streptococcus milleri B448 were grown glucose‐limited in a chemically defined medium under an atmosphere of 5 per cent carbon dioxide in nitrogen, at a dilution rate of D = 0.1 h‐1 and controlled pH of 7.0. The level of arginine in the medium reservoir was adjusted so that Strep. milleri predominated over Strep. mutans in a stable co‐existence. After equilibration, the culture vessel was pulsed with various carbohydrates to a final concentration of 5 times 10‐2mol/L. Samples were then taken at regular intervals and differential viable counts of Strep. mutans and Strep. milleri were done on mitissalivarius agar. Results demonstrated that pulsing with glucose, fructose, ‘coupling sugar’, lactose, xylose and sorbitol gave Strep. mutans a clear ecological advantage. In direct contrast, pulsing with xylitol resulted in a marked antimicrobial effect on Strep. mutans while Strep. milleri was essentially unaffected. This supports recent findings by other workers that uptake of this pentitol by Strep. mutans in batch culture sets up a ‘futile cycle’, leading to depressed growth or even cell death.
Cariostatic effect of glass ionomer cement: a five‐year clinical study
Authors: Tyas Martin J.
Published: May 2009

Composite resin and glass ionomer cement were used to restore 67 and 65 Class V carious lesions, respectively. The restorations were assessed each year for recurrent caries and marginal staining. After five years, 1 per cent of glass ionomer and 6 per cent of composite restorations had become carious, and there was approximately twice as much marginal staining around the composite as around the glass ionomers. There appear to be significant benefits in using glass ionomer to restore Class V carious lesions.
Clinical evaluation of restoration margins by an endoscopic microscope
Authors: L'Estrange P. R. , Karlsson S. L. , Ödman P. , Stegersjö G. , Engström B.
Published: May 2009

A method is presented for high magnification, clinical examination and recording of the marginal fit of dental restorations. An endoscopic microscope used in conjunction with video recording facilities affords acceptable colour records of restorative procedures for monitoring purposes. The suggestion is made that the concept of ‘fit’ in the clinical context has not been adequately addressed. The technique described has other clinical and research implications.
Diet and feeding patterns in high risk pre‐school children
Authors: Stacey M. A. , Wright F. A. C.
Published: May 2009

A survey of 60 pre‐school children both from Anglo‐Saxon and Lebanese backgrounds collected detailed information on subjects' oral health status and dietary and feeding habits. Lebanese subjects had significantly higher caries experience (mean dmfs = 4.88) than Anglo‐Saxon subjects (mean dmfs = 0.56). Subjects from the different backgrounds varied significantly also in the frequency of exposure to cariogenic agents and health practices. In each situation Lebanese children were exposed to higher risk factors than Anglo‐Saxon children. Notwithstanding the association between variables, the best single predictor of variance in caries experience of subjects, explaining 23 per cent of the variance in dmfs, was the mother's level of education. Culturally relevant health education programmes need to address the specific requirements of high risk groups.
Clinical and microbiological investigations of anorexia nervosa
Authors: Liew V. P. , Frisken K. W. , Touyz S. W. , Beumont P. J. V. , Williams H.
Published: May 2009

Several studies have examined the relationship between anorexia nervosa and oral status. However, none has used control subjects. Furthermore, none has examined bacteriological data in these subjects to determine whether dietary restrictions, particularly of carbohydrates, change the levels of Streptococcus mutans and Lactobacillus species.

Fifteen female subjects recently hospitalized for anorexia were studied along with fifteen age‐ and sex‐matched control subjects. The parameters examined included salivary pH and flow rate, levels of S. mutans and Lactobacillus spp., DMFT scores, facial and palatal plaque scores, periodontal pocketing, gingival recession and bleeding following gentle probing.

Compared with control subjects, anorexics had significantly lower salivary pH (7.1 ± 0.4 vs 7.6 ± 0.3, p<0.01), more facial and lingual surfaces with plaque scores of 1 (facial plaque 38 per cent vs 18 per cent, p<0.01, lingual plaque 47 per cent vs 29 per cent, p<0.01), more surfaces with gingival recession (1 mm‐7.9 per cent vs 1.8 per cent, p<0.001; 2 mm‐1.7 per cent vs 0.2 per cent, p<0.001; >2 mm‐0.6 per cent vs 0.0 per cent, p<0.001), more surfaces with bleeding on probing (16.9 per cent vs 6.5 per cent, p<0.001) and fewer sextants with CPITN scores of 0 (1.9 ± 1.5 vs 3.2 ± 1.0, p<0.01).

The results of this study indicate that prolonged periods of dietary restriction did not result in changes to some bacteria implicated in caries and nor did it result in lower DMFT rates or salivary flow but did result in more acidic saliva. Furthermore, anorexics are more likely to show changes indicative of gingivitis and recession but not necessarily of periodontitis compared with control subjects.
Langerhans cell disease associated with pathological fracture of the mandible
Authors: MacMillan A. R. G. , Oliver A. J. , Radden B. G. , Lacy M. F.
Published: May 2009

A 27‐year‐old male suffered a fractured mandible following extraction of a tooth. It was subsequently found that the fracture occurred in an area pathologically weakened by a localized lesion of Langerhans cell disease. Since lesions of the jaws may be seen either as the first manifestation or as a complication of widespread Langerhans cell disease, the dentist has a major role in the diagnosis and management of such cases.
Ectopic tonsillar tissue in the mucosa of the floor of the mouth simulating a benign tumour. Case report
Authors: Mogi Kenji
Published: May 2009

Ectopic tonsillar tissue in the mucosa of the floor of the mouth is rare. A case of a 38‐year‐old man with ectopic tonsillar tissue in the mucosa of the floor of the mouth is described. The lesion was manifested as a small, painless tumour. There was difficulty in establishing a clinical diagnosis, but it was thought to be a benign tumour and was removed and then examined histopathologically to confirm the diagnosis.
Anterior maxillary supernumerary teeth: A clinical and radiographic study
Authors: von Arx Thomas
Published: May 2009

Clinical records and radiographs of 90 patients with 113 anterior maxillary supernumerary teeth (mesiodens) have been evaluated. Although uncommon, mesiodentes are the most frequent supernumerary teeth and may disturb the eruption and/or position of the adjacent permanent incisors. Clinical and radiographic examination may disclose the number, direction and location of mesiodentes and their effects on neighbouring teeth. In the present study the majority of the supernumerary teeth lay palatal to the central incisors. Complete or partial eruption of a mesiodens was rare, hence the importance of radiographs to locate supernumerary teeth in the premaxilla.

Pathological findings included the formation of dentigerous cysts in three patients and complete ossification of the pericoronal space with resorption of the crown of the mesiodentes in eight cases. Retention and malposition of the adjacent permanent incisors occurred in 39 and 24 cases, respectively.