bluuebunny/crossref_metadata_2025 huggingface dataset:
Methicillin‐resistant Staphylococcus aureus and infection control for restorative dental treatment in nursing homes
Authors: Hall David L.
Published: March 2008

The prevalence of methicillin‐resistant Staphylococcus aureus (MRSA) in nursing home residents now averages 20–35%. This includes both numerous asymptomatic mostly unidentified carriers, and the occasional patient with an active infection. Among the most common sites for positive MRSA colonization are the nares and mouth (saliva). Ohio State University (OSU) dental students perform routine restorative dental care onsite in local nursing homes using portable equipment including handpieces that can generate aerosols. Using a series of cultured test swabs and plates, this pilot study suggests that protection for both dental health care personnel and patients are provided by the following: I. universal barrier precautions (for example, gloves, gowns, masks, hats, facial shields, glasses), 2. surface disinfectants, 3. pre‐op 0.12% chlorhexidene mouth rinses, 4. high volume evacuation, 5. perioral skin scrubs. Additional infection control methods, techniques and equipment were evaluated and compared including rubber dam isolation, hand excavation and bond technique, high‐speed air turbine and electric “high” speed handpiece. There was no indication of a special tendency or heightened ability of MRSA to aerosolize.
Priorities for oral health goals in a sample of older adults
Authors: Stoller Eleanor Palo , Pyle Marsha A. , Perzynski Adam T.
Published: March 2008

This study was conducted to identify oral health factors that are important to people who are elderly. By identifying factors valued by patients who are older, dental professionals can gain better insights into the preferences and priorities that patients use in making dental treatment decisions. To determine which factors are important to this population, we compiled a list of oral health goals identified through a literature review. To supplement this initial list, we undertook line‐by‐line (open) coding of transcripts of two sets of semi‐structured interviews. The first set of interviews explored the decision of older adults to seek treatment in response tooth pain. The second set of interviews elicited anticipated responses to three scenarios involving extensive restoration and one scenario involving extraction and prosthetic replacement among older patients at a dental school.
Dental characteristics of the Wolf‐Hirschhorn Syndrome: a case report
Authors: Babich Sara B. , Banducci Carla , Teplitsky Paul
Published: March 2008

Little attention in the dental literature has been given to the dental characteristics of patients with the Wolf‐Hirschhorn Syndrome (WHS). The syndrome is caused by deletions of the terminal portion of the short arm of chromosome 4. This case report provides information on dental anomalies noted in a child with WHS. The dental findings include agenesis of multiple permanent teeth, particularly premolars and molars, taurodontism, and over‐retained primary teeth. This syndrome exhibits variable clinical expressivity, possibly due to the extent and the specific locus of the chromosomal deletion. Further studies are required to obtain a clearer view of the clinical oral/dental manifestations of this syndrome.
Use of cryotherapy to enhance mouth opening in patients with cerebral palsy
Authors: dos Santos Maria Teresa Botti Rodrigues , de Oliveira Leda Magalhaes
Published: March 2008

This study was conducted to assess the effect of cryotherapy on masseter spasticity on mouth opening, which is required for oral hygiene and dental treatment. The inter‐incisal distance was measured before cryotherapy in 24 patients with cerebral palsy who had spasticity of the tetraparesis type. Ice was then applied on the skin surface with sliding movements over the masseter, bilaterally for one minute. Interincisal distance was then measured again. The results showed a significant increase of the inter‐incisal distance after the application of cold to the masseter. We conclude that the action of cryotherapy on the masseter muscle produced a temporary reduction of spasticity, facilitating access to the occlusal and palatal surfaces of the maxillary molars. This improved access can be useful during dental treatment as well as preventive dental care such as oral hygiene.
Prosthodontic management of older severe hypodontia patients in general dental practice: A case series
Authors: Yip K. H‐K , Smales R.J.
Published: March 2008

Although a detailed understanding of the etiology of hypodontia is lacking, there is a need for awareness among dental professionals of the social and psychological consequences of severe hypodontia, as well as knowledge of those affected by hypodontia have ongoing dental treatment needs. Although, there may be a need for immediate referral of children to different specialists for optimal multidisciplinary treatment planning, most older patients with severe hypodontia can be treated by general practitioners. Practitioners therefore need to be aware of the ramifications of the condition and be capable of providing adequate oral health care for these patients and referring them for additional services when necessary. A case‐report series is used to illustrate routine prosthodontic treatments that can be offered to older patients in general dental practice.
Chronic craniofacial dematiaceous fungal infection: A case report
Authors: Shetty Kishore , Giannini Peter , Achong Ronald
Published: March 2008

Curvularia is a saprobic dematiaceous mold that has been associated with a wide spectrum of human infection. In non‐immunosuppressed patients, infections frequently involve the paranasal sinus, skin, and soft tissue, whereas systemic dissemination and endocarditis are extremely rare. The optimal antifungal therapy for Curvularia infection is not known, and responses to treatment with amphotericin B, miconazole, ketoconazole, terbinafine, and itraconazole have been reported. We describe a patient with an invasive dematiaceous fungal sinusitis who was immunocompetent and was infected with Curvularia. The patient was successfully treated with oral itraconazole by otolaryngology and the infectious disease service.
Reduction in caries rate among patients with xerostomia using a power toothbrush
Authors: Papas Athena S. , Singh Mabi , Harrington Dorothy , Ortblad Katherine , de Jager Marco , Nunn M.
Published: March 2008

The purpose of this study was to evaluate whether the use of a Sonicare*** toothbrush could be beneficiai in reducing coronal and/or root caries among patients with medication‐induced xerostomia.

Eighty subjects with drug‐induced xerostomia using either a Sonicare toothbrush (SC) or a manual toothbrush (MTB) were included in the study. Control subjects using a MTB were frequency‐matched to 40 subjects using a SC, based on age, gender, number of teeth at baseline, and salivary flow rates. Subjects were individually matched according to the type of xerostomic medication they were taking. Caries were assessed at baseline, and subjects were instructed to have carious teeth restored. Summary statistics were assessed and computed by treatment group for incipient and frank coronal and root caries after one year. Statistical comparisons of the number of frank and incipient coronal and root caries between treatment groups were conducted using paired t‐tests.

After one year of use, the numbers of incipient and frank root caries were significantly lower among subjects using SC compared to subjects using MTB. Subjects using SC also exhibited somewhat lower incipient and frank coronal caries than subjects using MTB, although their differences were not statistically significant.

The authors concluded that the Sonicare toothbrush may be beneficial in reducing root caries among older adults with medication‐induced xerostomia.
The influence of valproic acid on salivary pH in children with cerebral palsy
Authors: Siqueira Walter Luiz , Santos Maria Teresa Botti Rodrigues , Elangovan Satheesh , Simoes Alyne , Nicolau José
Published: March 2008

The purpose of this open‐label, crossover study was to measure salivary pH after the oral administration of distilled water, a 10% sucrose solution, and valproic acid to a population of 10 children with cerebral palsy. Salivary pH was measured just prior to giving the solutions and then every five minutes for 60 minutes. The criticai pH was defined at 5.5, below which dental demineralization occurs. In this population, valproic acid decreased salivary pH to below the criticai pH for an extended period of time (mean ‐ 4.32 at 20 minutes) when compared to mean salivary pH after administration of distilled water (7.11 at 20 minutes) and a 10% sucrose solution (5.96 at 20 minutes). Recovery from this low pH to above the criticai level did not occur until after 50 minutes and furthermore did not recover to baseline, neutral levels, for the duration of this study (60 minutes). Our results suggest that children with cerebral palsy, a population with a tendency toward reduced salivary function, have a compromised ability to buffer the oral administration of an exogenous acid. This can result in an increased susceptibility to demineralization and caries of the teeth.
Oral health status of adults with Down syndrome in Hong Kong
Authors: Cheng Ronald H. W. , Leung W. Keung , Corbet Esmonde F. , King Nigel M.
Published: March 2008

ARSTRACT

The aim of this survey was to study the oral health status of Hong Kong Chinese adults with Down syndrome (DS). Sixty‐five community‐dwelling adults with DS (aged 17 to 42 years, 26.8±6.4) and age‐and gender‐matched contrais attending a dental hospital were included in a cross‐sectional survey. The subjects with DS had fewer filled (2.4±4.6 vs. 2.7±3.1, p=0.017) and fewer decayed (1.1±2.5 vs. 1.7±2.4, p=0.007) teeth than the control subjects. Significantly more peg‐shaped maxillary lateral incisors and retained primary teeth (p<0.001) were observed in subjects with DS, compared to the control subjects. Adults who had DS had a significantly higher percentage of surfaces with detectable plaque (81.5±19.1 vs. 61.9±16.0. p<0.001) and a higher percentage of sites with bleeding on probing (76.3±25.8 vs. 55.6±21.4, p<0.001). A higher proportion of subjects with DS showed one or more occurrences where probing pocket depth was ≥6mm than control subjects (49%vs. 24.5%, p<0.021). In conclusion, while having fewer caries, Hong Kong Chinese adults with DS had poorer periodontal health than age‐ and gender‐matched control subjects.
The impact of providing dental services to frail older adults: Perceptions of elders in adult day health centers*
Authors: Walker Ryan J. , Kiyak H. Asuman
Published: March 2008

ARSTRACT

Very little is known about the oral health of, and access to, dental services among frail elders who live in the community and use an adult day health center (ADHC) for respite care. This pilot study evaluated the perceived oral health quality of life (OHQOL) of elders who used a mobile dental program in urban, suburban, and rural ADHC settings. Pre‐ and post‐treatment interviews were conducted to evaluate OHQOL using the Geriatric Oral Health Assessment Index (GOHAI). ADHC records were used to obtain demographic, medicai history and medication data. Following initial dental examinations and consent, dental treatment was provided at each ADHC. Of the 138 elders screened at three ADHCs, pre‐ and post‐treatment data were obtained on 76 subjects following their treatment (mean four months later). The groups members were mostly female (64.5%) and Caucasian (71.6%). Their mean age was 76.8 (+/‐ 9.8), with an average of 12.4 teeth (34.2% edentulous); 67.7% were on Medicaid. On average they had 5.5 chronic diseases, hypertension being the most common (67.1%); 44.8% had a neurological disorder or dementia. GOHAI scores were generally high both pre‐ and post‐treatment, reflecting high physical and psychosocial OHQOL and low leveis of worry. GOHAI scores were correlated with chronic diseases; the more chronic diseases an individual had, the lower his or her total score pre‐ and post‐treatment (r=‐.24, r=‐.26 respectively, p<.04). The more dental treatment needs an elder had, the lower his or her GOHAI (r=‐.23, p<.05). Elders with more teeth reported higher GOHAI pre‐ and post‐treatment (r=.36, r=.37 respectively, p<.002). Paired t‐tests comparing pre‐ and post‐treatment GOHAI scores revealed significant improvements in overall GOHAI (p<.001), and on two dimensions: physical (p<.005) and psychosocial (p<.002). The findings support the importance of providing on‐site access to dental services in order to maintain the general OHQOL of frail elders, more specifically in the areas of physical and psychosocial well‐being.
Effectiveness of a triclosan/copolymer dentifrice on dental plaque and gingivitis in Brazilian individuais with cerebral palsy
Authors: Feng Hsu Shao , Pinheiro Isabella Cristina Mendes , Grande Sabrina Rosa , Pannuti Cláudio Mendes , Barros Fernando Jos Nunes , Lotufo Roberto Fraga Moreira
Published: March 2008

This randomized clinicai trial investigated the effect of a dentifrice containing triclosan on the reduction of dental plaque and gingivitis in institutionalized individuais with cerebral palsy. Fifty‐seven residents were randomly allocated to a test group (n=28, dentifrice with triclosan) and a control group (n=29. conventional dentifrice). A single calibrated investigator performed examinations at baseline and after three months. The amount of dental plaque was assessed, and gingivitis was meas‐ured. The caretakers performed brushing with dentifrice. After three months, there was a significant reduction in the plaque index in both groups, but there was no difference between the two groups. There was a significant reduction in gingivitis only in the test group, and the difference between groups was significant after three months. The authors concluded that the dentifrice with triclosan reduced interdental bleeding in the studied population.
Receipt of dental care, dental status and workforce in U.S. nursing homes: 1997 National Nursing Home Survey
Authors: Dye Bruce A. , Fisher Monica A. , Yellowitz Janet A. , Fryar Cheryl D. , Vargas Clemencia M.
Published: March 2008

The goal of this paper was to report the prevalence of dental care — a Healthy People 2010 objective — for nursing home residents 65 years and older, and to assess the association between receipt of dental care with other oral status and workforce measures. Data from 7,363 residents aged 65 years and older with information in the 1997 National Nursing Home Survey (NNHS) were used.

Overall, 18.2% of elderly nursing home residents had received dental care in the last month. Multivariable modeling found residents were more likely to receive dental care in the past month if they lived in the Northeast (OR=3.32, 95% CI 2.51‐4.39); were dentate (OR=1.46, 95% CI 1.26‐1.69); had a length of stay 12 months or longer (OR=1.37, 95% CI 1.17‐1.62); or resided in facilities with dental professional services (OR=2.05, 95% CI 1.60‐2.62).

The results showed that disparities in receipt of dental care existed by region, length of stay, dentate status, and availability of dental services in nursing homes. Additionally, current oral health surveillance measures for nursing homes may have been inadequate.
Unacceptably high levels of fluoride in commercial preparations of silver fluoride
Authors: Gotjamanos Theo , Afonso Fernando
Published: March 2008

Instead of expected fluoride ion concentrations of around 60 000 ppm, commercial preparations of 40 per cent aqueous silver fluoride were found to contain 120 000–127 000 ppm. Information received from the Western Australian Chemistry Centre which provided independent confirmation of the higher than expected [F] indicates that the currently available commercial preparations contain silver difluoride rather than silver fluoride.

In view of the potential of fluoride‐containing products such as dentifrices (1000–1500 ppm F) and topical fluoride gels and solutions (6000‐12 000 ppm F) to cause adverse effects if excessive quantities are ingested, any product that contains 120 000 ppm [F] should be regarded as carrying a high risk of toxicity when used on young children.
Palatal rugae patterns in Australian Aborigines and Caucasians
Authors: Kapali Sunita , Townsend Grant , Richards Lindsay , Parish Tracey
Published: March 2008

The purpose of this study was to determine whether rugae patterns change with age and to compare the number and pattern of rugae in Australian Aborigines with those of Caucasians. For the longitudinal part of the study, serial dental casts of ten Aborigines, from 6 to 20 years of age, were examined and rugae patterns were recorded. To enable comparisons to be made between different ethnic groups an additional 100 dental casts of Australian Aborigines and 200 casts of Caucasians, ranging in age from 13 to 17 years, were examined. Characteristics observed were number, length, shape, direction and unification of rugae.

The length of rugae increased significantly with age but the total number of rugae remained constant. Thirty‐two per cent of rugae showed changes in shape, while 28 per cent displayed a change in orientation. In contrast to studies suggesting that rugae move forward with age, the majority of Aboriginal rugae that changed direction moved posteriorly. Changes in rugae patterns have been assumed to result from pala al growth but alterations in pattern were observed in the Aboriginal sample even after palatal growth had ceased. The mean number of primary rugae in Aborigines was higher than in Caucasians, although more primary rugae in Caucasians exceeded 10 mm in length than in Aborigines. The most common shapes in both ethnic groups were wavy and curved forms, whereas straight and circular types were least common. There was a statistically significant association between rugae forms and ethnicity, straight forms being more common in Caucasians whereas wavy forms were more common in Aborigines.
Inferior alveolar nerve demage following removal of mandibular third molar teeth. A prospective study using panoramic radiography
Authors: Smith Andrew C. , Barry Susan E. , Chiong Allan Y. , Hadzakis Despina , Kha Sung‐Lac , Mok Steven C. , Sable Daniel L.
Published: March 2008

Permanent alteration of sensation in the lip after the removal of mandibular third molar teeth is an unusual but important complication. Studies have been performed to assess the risk of nerve damage but most of these have been retrospective and poorly controlled.

This prospective trial predicted the outcome of altered sensation prior to surgery based on assessment of a panoramic radiograph and correlated this with the result postoperatively in the consecutive removal of 479 third molar teeth.

Result indicated that 5.2 per cent had transient alteration in sensation but only one patient (0.2 per cent) had prolonged anaesthesia. As 94.8 per cent of teeth extracted had no neurological sequelae the figures for prediction were skewed and a kappa statistical analysis of 0.27 illustrated a fair level of agreement between prediction and outcome.

This study supports previously reported levels of neurological damage and confirms that panoramic radiography is the optimum method for radiological assessment for mandibular third molar teeth prior to their removal.
Safety issues related to the use of silver fluoride in paediatric dentistry
Authors: Gotjamanos Theo
Published: March 2008

Due to its exceedingly high fluoride content, 40% silver fluoride solution has the potential to cause flurorosis when used in young children. In vitro testing conducted in the present investigation indicates that application of 40% silver fluoride to deep carious lesions or its use as a ‘spot’ application agent could result in 3 to 4 mg of fluoride reaching the systemic circulation.

As scientifically‐based clinical trials on the safety of 40% silver fluoride have not been conducted, it would be appropriate for it to be withdrawn from further clincal use until proper testing and evalution have been carried out. In view of the possibility that lower strength solutions of silver fluoride (1–4%) may be just as effective as 40% in ‘arresting’ deep caries, testing should focus on such solutions, particularly as the potential for toxicity from their fluoride content would be reduced by a factor of 10–40.
The retention of pit and fissure sealants placed in primary school children by Dentl Health Services, Victoria
Authors: Messer Louise Brearley , Calache Hanny , Morgan Michael V.
Published: March 2008

The benefit of a public sector sealant programme for children in Australia is yet to be established. This study evaluated sealants placed by therapists of the School Dental Service in Victoria, between 1989 and 1994, on permanent teeth of children in 15 primary schools in Melbourne. Seven hundred and seventy four children aged 6–12 years were examined in school dental clinics by six calibrated examiners. A total of 5363 sealants placed on 2875 permanent teeth (including 2616 first molars, 91 per cent of sample) up to four and a half years previously was examined. Values for complete and partial sealant retention were highest for premolars (86 per cent, 9 per cent respectively, total 95 per cent); similar for occlusal surfaces of maxillary and mandibular first molars (63 per cent, 30 per cent; 62 per cent, 32 per cent respectively) and buccal pits of mandibular molars (66 per cent); and low for pits/fissures of Carabelli's cusps of maxillary molars (44 per cent). Cross‐sectional examination up to 24 months for both maxillary and mandibular first molars indicated average values of 67 per cent complete retention, 27 per cent partial retention, 6 per cent missing; thereafter complete retention decreased and partial retention increased. Sealant failures in the six months post‐placement were attributed to technique failure. Regardless of sealant retention, caries experience was low under partially retained or missing sealants (4.5 per cent) and completely retained sealants (0.4 per cent). It is concluded that the SDS sealant programme is a sound preventive dental public health approach.
Social profile of first‐year dentistry students at the University of Sydney
Authors: Gietzelt Dale
Published: March 2008

There has been constant interest in the background of dentistry students over the years. This paper, based on the data amassed by surveying the firstyear dentistry students of 1994 and 1995, builds on previous questionnaires and publications, and shows that certain trends in student make‐up, predicted earlier, have been checked. The article examines such features as the gender breakdown of first‐year students, age at the end of their first year, their own and their parents' countries of origin, English and non‐English language proficiency, type of school attended, parents' occupations, parents' highest level of education, motivations for choosing dentistry as a career, aptitude for a career in dentistry, and previous studies and employment. The data are analysed with the view to determining changes over time in the social composition of dentistry students.
The analgesic efficacy of ibuprofen in periodontal surgery: A multicentre study
Authors: Pearlman B. , Boyatzis S. , Daly C. , Evans R. , Gouvoussis J. , Highfield J. , Kitchings S. , Liew V. , Parsons S. , Serb P. , Tseng P. , Wallis C.
Published: March 2008

The efficacy of a non‐steroidal anti‐inflammatory agent, ibuprofen, was evaluated in pain control following periodotal surgery. This type of agent acts peripherally by inhibiting the release of prostaglandins and minimizing the local inflammatory response. Thus there may be an advantage in pre‐treatment administration of the drug so as to delay or even prevent postoperative pain.

The study was multicentre, involving a Public Hospital Periodontal Unit, two specialist periodontal practices in Sydney, NSW, ad two in Canberra, ACT. One hundred and twenty‐seven pateints who were to undergo periodontal surgery were randomly given either two 200 mg tablets of ibuprofen or two matching placebo tablets at least 30 minutes before administration of local anaesthesia. The procedure was double blind: neither the patient nor the colinical was aware of the tablet identity.

Postoperatively, all patients were given labelled ibuprofen for pain relief, but were randomly divided into two groups: As directed who were instructed to take the drug regularly for two days postoperatively, and As required, who were to take the drug only if needed for pain relief. All patients completed a diary recording quantity and time of medication, and regular assessment of pain experience utilizing a viaual analogue scale.

The As directed group showed no significant difference in pain experience between pre‐operative and post‐operative only medication, but the As required group experienced significantly less pain and requirement for medication if the ibuprofen was administered pre‐operatively.
Growth inhibition of oral bacteria related to denture stomatitis by anti‐candidal chalcones
Authors: Sato Masaru , Tsuchiya Hironori , Akagiri Mioko , Takagi Nobuhiko , Iinuma Munekazu
Published: March 2008

In the antimicrobial therapy of denture stomatitis, it is desirable to inhibit the growth of not only the primary causative organism, Candida albicans, but also other oral bacteria closely associated with the condition. Three synthetic anti‐candidal chalcones were characterized and compared for their additional activity in inhibiting these causative bacteria. Among the tested chalcones, 2,4,2′‐trihydroxy‐5′‐methylchalcone showed the highest activity for different Gram‐positive bacteria. It inhibited the growth of streptococci, staphylococci and lactobacilli at 25.0–50.0 μg/mL which was lower than or comparable to its minimum inhibitory concentration for candida. It functioned with a bactericidal action and leaked 260 nm‐absorbing substances from the streptococcal cells. The antimicrobial activity of 2,4,2′‐trihydroxy‐5′‐methylchalcone against both primary and secondary causative agents suggests it could be useful as a potent therapeutic agent in denture stomatitis.
Gap measurement and bond strength of five selected adhesive systems bonded to tooth structure
Authors: Arbabzadeh F. , Gage J. P. , Young W. G. , Shahabi S. , Swenson S. M.
Published: March 2008

The ability of a restorative material to bond and seal the interface with tooth structure is perhaps the most significant factor in determining resistance to marginal caries. Thus, the quality and durability of marginal seal and bond strength are major considerations in the selection of restorative materials. The purpose of this study was to compare the bond strength and marginal discrepancies of five adhesive systems: All‐Bond 2, Clearfil Liner Bond, KB 200, ProBond and AELITE Bond. Twenty‐five buccal and 25 lingual cavities were prepared in 25 caries‐free extracted molar teeth, giving 10 cavities for each of the 5 adhesive systems. All teeth were restored with the resin composite Pertac Hybrid, or PRISMA Total Performance Hybrid with their appropriate adhesive systems. After restoration, the teeth were thermocycled, were stained with a 1.5% aqueous solution of a procion dye (reactive orange 14) and sectioned coronally with a saw microtome. Three sections of 200 μm thickness were prepared from each restoration which were then examined microscopically to measure marginal gap widths using a confocal tandem microscope. Shear bond strength measurements were carried out on the dentine bond using a universal testing machine. The All‐Bond 2 adhesive system was found to have higher shear bond strength and to have the least gap with at the cementodentinal margin.
Langerhans' cell histiocytosis of the jaw bones. Report of 11 cases
Authors: Schepman K. P. , Raddent B. G. , van der Waal I.
Published: March 2008

Eleven cases of Langerhans' cell histocytosis of the jaw bones are reported. The clinial and radiographical features are described, and the role of the dentist in the diagnosis and management of this disorder is discussed.
Post‐extraction bleeding—An aid to diagnosis? Case report
Authors: Songra A. K. , Darbar U. R.
Published: March 2008

Haemophilia A, the most common of bleeding disorders is characterzed by bruishing and spontaneous bleeding into the joints but may remain undiagnosed if present in the mild form. A case is discussed where episodes of bruising and joint sweelling as a child were misdiagnosed as rheumatic fever and the bleeding disorder was diagnosed following recurrent episodes of bleeding after extraction of an upper molar tooth.
An in vitro study of apical and coronal microleakage of laterally condensed gutta percha with Ketac‐Endo and AH‐26
Authors: Oliver Christopher M. , Abbott Paul V.
Published: March 2008

The purpose of this in vitro study was to compare both apical and coronal dye penetration when Ketac‐Endo and AH‐26 sealers were user with laterally condensed gutta percha. Crowns were removed from 28 teeth and the root canals were biomechanically prepared. The teeth were divided into two groups of 12 teeth. each and a control group of 4 teeth. Root canals in the two experimental groups were filled with laterally condensed gutta percha and either Ketac‐Endo or AH‐26 sealer. The ketac‐Endo group had the coronal 3 mm of gutta percha and sealer removed and the resultant cavity was filled with Ketc‐Endo alone. After the sealers had set, the root surfaces were coated with nail varnish except at the apex and at the coronal end. Positive control had no root fillings and were coated with nail varnish in the same manner while the negative controls were sealed apically and coronally with Cavit prior to apically and coronally with Cavit prior to sealing the entire external root surface with nail varnish. Specimens were placed in 2% methylene blue dye in a vacuum of 660 mm of mercury for five minutes and than left immersed for a further two days. The roots were vertically sectioned to determine the following mean levels of dye penetration: keta‐Endo, 1.08 mm apically and 6.29 mm coronally; AH‐26, 0.75 mm apically and 6.67 mm coronally. Positive controls had total leakage and negative controlls had no leakage. This study demonstrated that the apical and coronal seals obtained with Ketac‐Endo and AH‐26 were not significantly different although the apical seal obtained with each material was significantly better than the corresponding coronal seal.
Focal epithelial hyperplasia in an HIV positive man. An illustrated case and review of the literature.
Authors: Marvan Elishka , Firth Norman
Published: March 2008

Focal epithelial hyperplasia (FEH) is a rare but distinctive entity of viral aetiology with characteristic clinical and histopathological features. It is usually seen in children and adolescents of American Indian and Eskimo background; however, it has recently been described in adults who are HIV positive. Suppression of the immune system leaves the individual vulnerable to opportunistic infections. With improved management of immuno‐compromised patients it is increasingly possible that the general dental practitioner will encounter secondary oral infections such as FEH and must therefore be able to recognize, diagnose and treat these lesions. The following report presents a case of FEH in an HIV‐infected man, and is followed by a review of the literature.
Idiopathic swelling of the lower lip associated with topical anaesthesia. Report of the three case
Authors: Yaman Zekai , Kişnişci Reha S.
Published: March 2008

Three cases of idiopathic swelling of the lower lip are presented. Each developed following administration of a topical anaesthetic agent with unusual clinical manifestations closely resembling allergic angio‐oedema. The possibility of psychogenically mediated reactions was considered the contributing aetiological factor which showed as a somatic manifestation in the lower lips.
Handpiece degradation associated with performance testing of diamond rotary cutting instruments.
Authors: Gegauff A. G. , Rosenstiel S. F. , Johnston W. M. , Gangji R. K.
Published: March 2008

Reliable standardized testing of dental rotary cutting instruments remains a problem because of the many significant parameters that require identifying and quantifying. In a previous study, handpiece wear or degradation was identified as a potentially significant confounding variable leading to the suggestion that the use of industrial handpieces might be necessary. Therefore, the objective of this investigation was to measure and compare industrial and dental air rotor degradation during a simulated diamond rotary cutting instrument test. Two dental and two industrial products were tested in a random sequence using three replicate samples of each air rotor. The simulated test consisted of 10 diamond instruments each making 90 passes through a float glass substrate. The testing apparatus comprised a computer‐interfaced device that controlled the contact force between the cutting diamond and the substrate. Air rotor performance was based on the time required to cut a standardized path through the substrate. The performance change that occurred from diamond instrument to instrument during the simulated test was attributed to air rotor degradation. Multiple regression analyses showed significant differences between replicate samples of the same type and between regression intercepts for different air rotor types. Surprisingly, four air rotors exhibited improving performance during the simulated test. Changing air rotor performance must be considered to achieve reliability for the testing of diamond rotary cutting instruments.
Primary malignant melanoma of the oral cavity Report of an unusual case
Authors: Dimitrakopoulos I. , Lazaridis N. , Skordalaki A.
Published: March 2008

Primary malignant melanoma is only rarely found in the oral cavity (estimated at between 0.2 and 8 per cent of all melanomas) and occurs approximately four times more frequently in the oral mucosa of the upper jaw, usually on the palate or alveolar gingivae. A case is reported of a malignant melanoma in the mouth of a 74 year old male, which was originally diagnosed as reactive denture hyperplasia caused by a ill‐fitting upper denture. Correction of the denture fault failed to stop the growth of the mass, which was therefore removed surgically. Histological examination revealed a melanin‐producing tumour. A partial maxillectomy was performed and there was no evidence of recurrence over a three year follow‐up period.
Postoperative bleeding with factor VII deficiency: Case report
Authors: Cheng Jason C. F. , Wong Ricky W. K. , Yan Bill S. W.
Published: March 2008

Factor VII deficiency was diagnosed during haematological investigation of a patient with multiple occurrences of postoperative bleeding after surgical extraction of an impacted upper left canine. The bleeding was eventutally stopped with local measures without resorting to blood product transfusion which may have been necessary if local measures had failed to control bleeding. Abnormalities were also found in subsequent blood profiles and coagulation tests in other members of the patient's family.
Determination of gold alloy loss during the production of cast dental restorations
Authors: Fitzpatrick Brian J. , Brockhurst Peter , Gullotta Edward
Published: March 2008

Values for the loss of high gold content dental alloy during the fabrication of three types of cast dental restorations were determined. The mass changes measured were for the melting, casting and cleaning processes and the docking and laboratory finishing procedures involved in producing the final restoration. The casting yield from the alloy cast was also determined.

Five Brisbane dental laboratories participated and 407 cast restorations were assessed. The mean mass loss for the melting and casting process was 0.109 g (SD 0.326) per cast restoration, and 0.827 per cent (SD 1.805) of the total mass of alloy melted.

The data were analysed in four categories: alloy crowns, metal‐ceramic crowns, metal‐ceramic bridges, and combined. The mean total mass loss per restoration from docking and finishing for each of the four groups of cast dental restorations examined was 0.329 g, 0.350 g, 0.927 g and 0.363 g; 13.11, 28.30, 22.07 and 22.18 as a per cent of the mass of the docked casting respectively. The yield of casting masses from the alloy cast were 19.97, 9.11, 29.10 and 13.71 per cent respectively, with all differences significant at the 0.001 level. These values indicate that the recommendation for 50 per cent addition of new alloy for each cast is impractical.

The wide spread of the data precludes the establishment of a precise agreed value between dentists and technicians for expected loss. However, the use of the median or mean would provide a value which might be an equitable indicator in the long term. Alternatively, working values can be developed for individual dentist/technician partnerships.
Diagnosis and management of teeth with vertical root fractures
Authors: Moule Alex J. , Kahler Bill
Published: March 2008

Vertical fractures in teeth can present difficulties in diagnosis. There are, however, many specific clinical and radiographical signs which, when present, can alert clinicians to the existence of a fracture. In this review, the diagnosis of vertical root fractures is discussed in detail, and examples are presented of clinical and radiographic signs associated with these fractured teeth. Treatment alternatives are discussed for both posterior and anterior teeth.
Root resorption of mandibular second molar teeth associated with the presence of the third molars
Authors: Yamaoka Minoru , Furusawa Kiyofumi , Ikeda Masakimi , Hasegawa Takafumi
Published: March 2008

Although pressure resorption of second molars is associated with impacted and/or erupting third molars, the relationship between pressure resorption and age is unclear. In order to investigate this relationship, 3883 dental rediographs were studied in 3174 individuals of various ages.

The incidence of superimposition of the second molar on the third molar was not elevated in any subgroup except that of women of 16–40 years of age. There were no age or sex differences for the incidence of second molar root resorption. In older individuals, root resorption associated with a completely impacted third molar was more frequent than with apartially impacted third molar, and root resorption at the apex was mainly seen in individuals over 50 years of age. There was a higher incidence of superimposition and root resorption in men than women. Apical root resorption may be seen long after the formation of completely impacted third molars in both genders.
The effects of extracellular citric acid acidosis on the viability, cellular adhesion capacity and protein synthesis of cultured human gingival fibroblasts
Authors: Lan W. C. , Lan W. H. , Chan C. P. , Hsieh C. C. , Chang M. C. , Jeng J. H.
Published: March 2008

Root surface demineralization is widely used as an adjunct to periodontal treatment. To clarify the influence of citric acid root conditioning on periodontal wound healing, the effects of citric acid and associated extracellular acidosis on the viability (MTT assay), attachment and protein synthesis ([3H]‐proline incorporation into tirchloroacetic acid‐precipitated proteins) of human gingival fibroblasts (GF) were investigated. A concentration of 47.6 mmol/L of citric acid (pH 2.3) in water led to total cell death within three minutes of incubation. Media containing 23.8 mmol/L and 47.6 mmol/L of citric acid exerted strong cytotoxicity (47 to 90 per cent of cell death) and inhibited protein synthesis (IC50=0.28 per cent) of GF within three hours of incubation. Incubation of cells in a medium containing 11.9 mmol/L of citric acid also suppressed the attachment and spreading of fibroblasts on culture plates and Type I collagen, with 58 per cent and 22 per cent of inhibition, respectively. Culture medium supplemented with 11.9, 23.8 and 47.6 mmol/L of citric acid also led to extracellular acidosis by decreasing the pH value from 7.5 to 6.3, 5.2 and 3.8, respectively. In addition, it was confirmed that the toxic effect of media containing citric acid was due to their acidity rather than the citrate content. Most of the citric acid‐induced cell death could be prevented by adjusting the pH value of the culture medium to pH 7.5. Sodium citrate, at a concentration of 47.6 mmol/L, also exerted little cytotoxicity. The results suggested that toxicity of citric acid in specific stages of the healing process must be considered prior to its clinical application. Careful management of citric acid in order to avoid contact with tissue or the development of other demineralizing agents is important in enhancing periodontal wound healing.
Hyperbaric oxygen in the prevention of osteoradionecrosis of the jaws
Authors: Vudiniabola S. , Pirone C. , Williamson J. , Goss A. N.
Published: March 2008

Patients who have had their jaws irradiated as part of management of head and neck malignancy are at risk of osteoradionecrosis (ORN) following tooth extraction. Thirty‐seven patients with a history of irradiation to the jaws were managed during a four year period. Twenty‐nine patients received hyperbaric oxygen therapy (HBO) consisting of 20 treatments after. Only one (4 per cent) developed ORN. Seven patients who did not have HBO and one who did (15 per cent) developed ORN. The need for prophylactic treatment with HBO is discussed. It is recommended that prophylactic HBO is used prior to surgery for irradiated facial bones.
Facial burns in children: A series analysis with implications for resuscitation and forensic odontology
Authors: Acton Caroline , Nixon James , Pearn John , Williams David , Leditschke Fred
Published: March 2008

This study comprises a continuous (1981–1995) unselected series of all children who died from thermal injuries in teh state of Queensland, Australia. One hundred and six children, so identified, died from incineration (35 per cent), respiratory burns with smoke or carbon monoxide inhalaton (33 per cent), body surface area burns comprising greater than 60 per cent (9 per cent) and electrocution (20 per cent). The burn fatality rate electrocution (20 percent). The burn fatality rate was 0.98 per hundred thousand children (0–14 years) per year, with no secular trend and, specifically, no reduction in the annual rate of such fatalities. Eighty‐two children (49 males) had concomitant facial injuries, both thermal and nonthermal; of whom 55 per cent were under the age of five years. Sixty (73 per cent) child burn victims died in house fires. Forensic odontology is important in confirming the age of such victims in single incinerations but is of limited value wen larger numbers of children are incinerte, because of the relative lack of dental restorations in teh infant and pre‐school age group. Of the 82 children with facial and airway injuries, 12 per cent had only mild or superficial facial damage and only seven (8 per cent) were alive or resuscitatable at teh time of rescue from teh conflagration or burning injury. Child deaths from burns contributed an annual loss rate of 506 years of potential life lost (YPLL) in a population of 3 milllion of whom 21.5 per cent were children under the age of 15 years. Airway management and resuscitation, in the context of managing surviving burn victims of any age with facial injuries, pose special difficulties. Inhalational burns (smoke and the grass of conflagration) result in a mortality greater than 60 per cent. Although 81 per cent of children showed evidence of airway obstruction, analysis of current data indicates that a maximum of 8 per cent could have survived with airway maintenance and protection. Inhalational burns (to both upper and lower airway) grossly reduce survivability. Primary prevention would seem vital and thus remains a major challenge to reduce the incidence of such deaths. Some strategies include advocacy to promote the compulsory installation of smoke alarms, family drills to practise escape and the teaching of ‘first aid for all’.
Dentists' attitudes and practice regarding smoking
Authors: Clover Kerrie , Hazell Trevor , Stanbridge Vicki , Fisher Rob Sanson
Published: March 2008

Dentists are a potentially valuable source of community education about the health effects surrounding tobacco use. The aims of this study were to provide Australian data on dentists' current practice regarding discussing smoking with patients, dentists' perceptions of the barriers to discussing smoking with patients and dentists' interest in discussing smoking with patients. A postal survey of all dentists who were members of the Hunter Branch of the Australian Dental Association in New South Wales was conducted. Dentists generally reported quite high levels of current activity reported quite high levels of current activity regarding smoking. The majority of dentists reported asking at least some of their patients whether or not they smoked. Dentists reported that they discussed the possible oral effects of smoking with at least some of their smoking patients. Furthermore, they told at least some of their patients with smoking related disease that smoking may have contributed to their problems. Dentists identified a number of difficulties involved in helping patients quit smoking. These findings may be used to help guide future research and practice in involving dentists further in discussing smoking with patients.
Ameloblastoma of the maxilla. Case report
Authors: Iordanidis S. , Makos Ch. , Dimitrakopoulos J. , Kariki H.
Published: March 2008

A basal cell maxillary ameloblastoma became obvious as an asymptomatic swelling of the left buccal sulcus and alveolar process, although a large extension into the maxillary sinus up to the nasal conchae and the orbital floor had already occurred. The painless and slow growth of the lesion, the thin bone of the upper jaws, the adjacent cavities and the vital structures are the main factors for delay in recognition and thus the potentially lethal result of a maxillary ameloblastoma.

A review of location, age, sex and race predilection, clinical course, radiographic appearance, histological types and treatment methods is made.
Epidemiology of dental trauma: A review of the literature
Authors: Bastone Elisa B. , Freer Terry J. , McNamara John R.
Published: March 2008

This article reviews recent reports describing the aetiology of dental trauma from national and international studies as well as the different classifications currently used to report dental injuries. It also discusses possible preventive measures to reduce the increasing frequency of dental trauma. Reported studies demonstrate that males tend to experience more dental trauma in the permanent dentition than females, however, there does not appear to be a difference between the sexes in the primary dentition. Accidents within and around the home were the major sources of injury to the primary dentition, while accidents at home and school accounted for most of the injuries to the permanent dentition. The most frequent type of injury was a simple crown fracture of the maxillary central incisors in the permanent dentition while injuries to the periodontal tissues were more common in the primary dentition.

When preventive measures are being planned, knowledge of aetiology is important. More prospective studies from representative populations are required to understand the complexities of dental trauma epidemiology and to allow implementation of preventive strategies to reduce the increasing frequency of dental trauma.