bluuebunny/crossref_metadata_2025 huggingface dataset:
Periodontal health status and treatment needs among the elderly
Authors: Ajwani Shilpi , Tervonen Tellervo , Närhi Timo O. , Ainamo Anja
Published: March 2008

The numbers of dentate elderly are growing rapidly in all industrialized countries, and epidemiological information about their oral health is urgently needed. Our study is part of the population‐based Helsinki Ageing Study (HAS), and this paper describes the periodontal health status as well as the need for periodontal treatment among the dentate elderly born in 1904, 1909, and 1914 and living in January, 1989, in Helsinki, Finland (n = 175). The dental examinations were carried out during 1990 and 1991 at the Institute of Dentistry, University of Helsinki, Finland. The subjects' periodontal health was recorded by the CPITN (Community Periodontal Index of Treatment Needs) method. The mean number of remaining teeth was 15.1 among men and 14.0 among women, with the mean number of remaining sextants 3.7 and 3.5, respectively. Healthy periodontal tissues (CPI = 0) were found in 7% of the subjects. Bleeding on probing (CPI = 1) was recorded in 6%, and calculus and/or overhanging margins of restorations (CPI = 2) in 41% of the subjects, as the worst finding. Altogether, 46% of the subjects had deep periodontal pockets, 35% with at least one 4‐ to 5‐mm pocket (CPI = 3), and 11% with at least one ≥ 6‐mm pocket (CPI = 4). Overall, 93% of the subjects required oral hygiene instruction, 87% scaling and root planing, and 11% complex periodontal treatment. The periodontal treatment need was significantly higher in men than in women; however, no significant differences were observed among the three age cohorts. The need for complex periodontal treatment was unexpectedly low, probably explained by the fact that there were many missing teeth, especially molars, perhaps lost due to poor periodontal health.
Managing patients on warfarin therapy: a case report
Authors: Aldous Jay A. , Olson Craige J.
Published: March 2008

Coagulotherapy is a common therapeutic regimen most frequently utilizing warfarin. This therapy may have important dental ramifications. An understanding of the mechanisms of action and drug interactions may help avoid problems. Questions commonly arise as to what dental procedures may be safely considered when a patient is on anticoagulant therapy. The coagutherapy level is measured in values of the International Normalized Ratio (INR). Any question about the appropriateness of dental procedures should be referred to the physician prescriber of the anticoagulant therapy. Generally, controlling bleeding is less of a problem than the management of thrombi and vascular occlusion from decreased coagutherapy. A case is presented in which the INR reached a critical value as the result of drug interactions and miscommunication.
A longitudinal study of the association between tooth loss and age‐related hearing loss
Authors: Lawrence Herenia P. , Garcia Raul I. , Essick Gregory K. , Hawkins Robert , Krall Elizabeth A. , III Avron Spiro , Vokonas Pantel S. , Kong Lan , King Tonya , Koch Gary G.
Published: March 2008

The purpose of this study was to investigate cross‐sectional and longitudinal associations between hearing acuity and tooth loss in 1156 US veterans taking part in the Veterans Affairs' Normative Aging (NAS) and Dental Longitudinal (DLS) Studies in the Boston, MA, area. The mean age was 48 years (SD = 8.9), 5.3% were edentulous, and 15.4% had < 17 teeth at baseline. Hearing acuity was determined by puretone, air‐ and bone‐conduction audiometry, and speech discrimination tests at triennial examinations over a 20‐year follow‐up period. Hearing decline was defined as a change from baseline in the average puretone air‐conduction thresholds of ≥ 20 dB at 0.25, 0.5, 1, 2, 3, 4, 6, and 8 kHz. The explanatory variables of interest were change since baseline in dentate status (cut points at < 1, < 17, and < 20 teeth), and in the number of teeth lost (linear). Linear and logistic regression models—which controlled for baseline audiological status, age, air‐bone gap, and otoscopic examination at current visit—showed that subjects who went from having ≥ 17 to < 17 teeth had 1.64 times (95% CI, 1.24‐2.17) as high odds of having hearing decline as those with no change in their dentate status. For every tooth lost since baseline, there was a 1.04 times as high odds (95% CI, 1.02‐1.06) for hearing decline, when additional baseline and time‐varying covariates were taken into account in the model.
The oral health of psychiatric in‐patients in South Wales
Authors: Lewis Susan , Jagger Robert G. , Treasure Elizabeth
Published: March 2008

Little information is available regarding the oral health of hospitalized psychiatric patients. The aims of the study were:

to quantify the oral health status and identify dental treatment needs of hospitalized psychiatric patients in South Wales; and

to compare the oral health of subgroups within the population by their age, psychiatric diagnosis, psychotropic medication use, and length of stay.

The total patient population of the hospitals involved in the study was 469, and 326 subjects (70%) took part in the study. The mean age of the subjects was 71.1 years, with 265 long‐stay and 61 short‐stay patients. Forty‐seven percent of patients had a psychiatric diagnosis of dementia, 23% of schizophrenia, and 19% of depressive illness. The examination included assessment of oral hygiene, periodontal condition, and prevalence of caries. The treatment needs of the population were also determined. It was found that 63% of the population was edentulous. The mean DMFT score was 19.1 ± 7.9 (SD). Comparison with the DMFT of the general population showed a similar level of decay, fewer filled teeth, and more missing teeth in the study population. The oral hygiene of the dentate population was poor, and there was little periodontal disease. Treatment needs were mainly for scaling and polishing. There were no significant differences found between subgroups within the population.
Selection of restorative materials for the atraumatic restorative treatment (ART) approach: a review
Authors: Yip Hak‐Kong , Smales Roger J. , Ngo Hien C. , Tay Franklin R. , Chu Frederick C.S.
Published: March 2008

The atraumatic restorative treatment (ART) technique or approach for the restoration of primary and permanent teeth has been widely adopted in, but not limited to, developing countries. However, the requirement for the placement of the restorative materials under often less‐than‐ideal conditions imposes significant restrictions on their selection; and there have been very few randomized clinical trials or reports comparing different types of restorative materials and treatments. Although conventional glass‐ionomer cements (GICs) have relatively poor mechanical and adhesive strengths, their satisfactory biological features, ease of use, and low costs are distinct advantages. Most of the published reports of the clinical performance of the newer, high‐strength esthetic conventional GICs specifically marketed for the ART approach have been from short‐term studies. Satisfactory clinical performance has been demonstrated for single‐surface posterior restorations only, over three years. Findings indicate that further improvements in restorative materials are still required for their use with the ART approach, together with further clinical investigations of the remineralization of shallow open caries lesions, as an alternative to placing definitive restorations.
Infectious hepatitis C, hepatitis G, and TT virus: review and implications for dentists
Authors: Lodi Giovanni , Bez Cristina , Porter Stephen R. , Scully Crispian , Epstein Joel B.
Published: March 2008

In the past 10 years, hepatitis C and G viruses have been identified, and in the last two years a further parenterally transmitted agent, termed TT virus (TTV), has been discovered. These viruses have a worldwide distribution and frequently cause chronic infection. The purpose of this article was to promote an understanding of these viral agents and their relevance in dental practice. Infected patients may develop a chronic carrier state without clinical disease or may develop liver disease, and may have related oral conditions. Dental providers will see a growing number of patients with HCV/HGV and possibly TTV infection. All of these patients require appropriate infection control measures during dental treatment.
Dental fear in a special needs clinic population of persons with disabilities
Authors: Martin Michael D. , Kinoshita‐Byrne Jamie , Getz Tracy
Published: March 2008

This study reports findings from a survey of dental fear in a special needs dental clinic population. Subjects were recruited from the University of Washington's Dental Education in Care of Persons With Disabilities (DECOD) clinical program (n = 132). Dental fears were assessed using the Kleinknecht Dental Report. Fear levels were examined among patients with differing categories of primary disabilities and between genders, races and educational levels. Some level of dental fear was reported by 43.2% of the respondents, indicating that dental fear may be an important factor in dental care for this population. Gender and educational level were significantly associated with fear levels (both p < 0.05). Significant differences in fear levels were found between individuals with differing classes of disability. Accompanying caregivers also were interviewed (n=72) to allow for a comparison of patient and caregiver perceptions. Both patient and caregiver were interviewed whenever possible to create paired reports. Generally, caregivers significantly overestimated fear levels compared with patients (p < 0.01). However, when scores were compared in matched caregiver‐patient analyses, the fear scores were not significantly different, indicating that caregivers accurately estimated their client's level of dental fear. A regression model including disability group, gender, and years of education was significant for predicting fear level as measured by the Kleinknecht survey (p= 0.02). We conclude that dental fear may be a significant, though little understood problem for a population of persons with disabilities as well as for their oral care providers, and that further investigation is needed.
Diet medications and valvular hearl disease: the current evidence
Authors: Barasch Andrei , Safford Monika M.
Published: March 2008

Since 1997, the appetite suppressant drugs fenfluramine‐phentermine (fen‐phen) and dexfenfluramine have been associated with the development of valvular heart disease. As a result, the drugs have been withdrawn from the market and interim recommendations for evaluation and treatment of exposed patients were issued. However, subsequent studies showed lower prevalence rates for valve abnormalities than were initially reported, and the possibility of such drug‐induced lesions resolving has been raised. This article reviews relevant evidence and discusses concerns for the dental practitioner.
Oral disorders and chronic systemic diseases in very old adults living in institutions
Authors: Maupomé Gerardo , Gullion Christina M. , White B. Alex , Wyatt Christopher C.L. , Williams P. Michele
Published: March 2008

This study evaluated whether oral disorders were associated with chronic systemic diseases in 532 Canadian adults who are old and very old and living in institutions. A brief oral examination documented tooth retention, caries, and periodontal and gingival health. Medical records provided information about chronic systemic conditions. A history of stroke was associated with a higher experience of caries, a higher ratio of decayed‐to‐present teeth, and more gingival and periodontal problems. Participants with high blood pressure, osteoporosis, or diabetes were more likely to be edentulous or to have fewer teeth than participants who did not have these conditions. Participants who had arthritis retained more teeth with age. Participants who had more diseases also tended to have poorer gingival or periodontal conditions, fewer teeth, and higher risk of edentulousness. The associations between systemic diseases and more severe oral disorders may be direct or may be mediated by underlying factors such as health behaviors.
Oral and nutritional status in frail elderly
Authors: Soini Helena , Routasalo Pirkko , Lauri Sirkka , Ainamo Anja
Published: March 2008

This article describes associations between oral health and nutritional status among chronically ill older adults who were living at home and receiving regular professional home care services. A structured questionnaire, oral examination, and Mini‐Nutritional Assessment were completed for 51 subjects (mean age 83.7 years). Two‐thirds of the sample were edentulous, and one‐third had between 2 and 23 teeth (mean 10.59, SD ± 6.92). Sixty percent of subjects complained of xerostomia, while dentists found only 48% to have clinical signs of dry mouth. More than half of the subjects had stimulated saliva rates of < 0.8 ml/min. Stimulated saliva secretion rates were lower for persons with no functional natural dentition or prostheses (p= 0.012). Subjects assessed their dentures to be more functional than did the dentist (Kappa 0.338). No one was considered malnourished, 47% were at risk of malnutrition, and 52% were well nourished. The dentist's estimation of dry mouth and eating problems were significantly associated to lower MNA scores (p= 0.049 and p = 0.015, respectively). Subjects with a natural functioning dentition had higher BMI scores (p= 0.0485).
Oral health for people with intellectual disability and high support needs: positive outcomes
Authors: Grant Ellen , Carlson Glenys , Cullen‐Erickson Margaret
Published: March 2008

This qualitative study, based on phe‐nomenological approaches, explored and documented four situations in which positive oral health outcomes occurred for people with mental retardation and moderate to high support needs. Strategies and environmental factors that contributed to these oral health outcomes were identified through 10 semi‐structured interviews conducted with ‘key‐players’ supporting the oral health of the people with disabilities. Participants included dental professionals, direct support workers, and other professionals who cared for their four people with disabilities.

Common strategies expressed in the interviews included “giving it a go”; maintaining consistency; facilitating positive experiences; taking as much time as needed; respecting and encouraging choice making; timeliness and frequency of dental appointments; communication between support workers, dental professionals and the person with mental retardation; problem solving; assisting the person with disability to learn skills; and desensitisation. Contributing factors in the physical, social, and organizational environment also were identified.
Antibiotic prophylaxis in a patient with penicillin allergy and recurrent bacterial endocarditis: A case report
Authors: Wang Linda , Lopes Lawrence Gonzaga , Oliveira Gianne Cerqueira Leite Rodrigues , Navarro Maria Fidela de Lima , Santos Carlos Ferreira
Published: March 2008

Bacterial endocarditis (BE) is a rare and life‐threatening heart infection that can be caused by oral microorganisms. Patients with specific cardiac valvular abnormalities as well as those with a history of recurrent episodes of endocarditis are considered to be at high‐risk for developing BE. Antibiotic prophylaxis is recommended for high‐risk individuals when bleeding is anticipated during dental procedures. Penicillins are the antibiotics of choice in preventing endocarditis, while other medications are indicated for patients with penicillin allergies. This case presentation outlines antibiotic prophylaxis prior to restorative care for a 44‐year‐old man who had a prosthetic heart valve, history of recurrent infective endocarditis and penicillin allergy. Intravenously administered van‐comycin and gentamicin were prescribed due to the patients' level of risk and bleeding propensity. This article was written to raise the awareness of dental practitioners to the antibiotic prophylaxis options available for the treatment of patients with cardiac and associated systemic conditions.
Paraneoplastic epidermolysis bullosa acquisita associated with multiple myeloma
Authors: Radfar Lida , Fatahzadeh Mahnaz , Shahamat Yasaman , Sirois David
Published: March 2008

Epidermolysis bullosa acquisita is a rare acquired autoimmune subepidermal blistering disease that clinically resembles other vesiculobullous lesions such as pemphigus vulgaris and cicatricial pemphigoid. Multiple myeloma is the most common plasma cell malignant disorder characterized by a single clonal expansion and increased level of a single immunoglobulin. Epidermolysis bullosa acquisita has been reported with other systemic diseases such as lymphoma. In this case report, we present a patient with paraneoplastic epidermolysis bullosa acquisita associated with multiple myeloma.
Assessment of the use of sialogogues in the clinical management of patients with xerostomia
Authors: Chainani‐Wu Nita , Gorsky Meir , Mayer Priscilla , Bostrom Alan , Epstein Joel B. , Jr. Sol Silverman
Published: March 2008

This study was conducted to assess the clinical efficacy and adverse effects of pilocarpine, bethanechol and cevimeline In patients with xerostomia. In this open‐label crossover assessment in 20 patients with xerostomia, a one‐ to two‐week course of each medication with a one‐week washout period was prescribed. Side effects, symptoms, whole stimulated and unstimulated saliva were measured. Each sialogogue was found to increase saliva and decrease symptoms. A mixed‐effects analysis showed a greater increase in stimulated saliva on bethanechol compared to pilocarpine (0.106, p=0.0272). Increased sweating was the most common side effect, experienced more frequently with pilocarpine as compared to bethanechol (p=0.0588) or cevimeline (p= 0.0143). A carryover effect beyond the washout period was seen. Effects on saliva and side effects vary between sialogogues, suggesting a benefit of trials with different sialogogues to determine individual patient preference. The observed carryover effect suggests that intermittent treatment may be an alternative to continuous treatment with sialogogues.
What influences dental students to serve special care patients?
Authors: Baumeister Sebastian E. , Davidson Pamela L. , Carreon Daisy C. , Nakazono Terry T. , Gutierrez John J. , Andersen Ronald M.
Published: March 2008

This study examines factors associated with graduating dental students' motivation to deliver services to special care patients. We investigated community context and student characteristics, which would influence potential behavior. Higher percentages of older adults and low‐income residents in the community were positively correlated with interest in serving special care populations. Factors which correlated with individual student characteristics included having a father with at least a college education, a higher number of weeks spent in extramural clinical rotations, preparedness to provide care to disabled patients, and service orientation and socially conscious attitudes. Frail elderly and disabled persons have limited access to dental care, which is compounded by a shortage of skilled dental professionals who are willing to treat these populations. Our findings suggest that interest in special care dentistry is partly conditioned by the dental school's demographic and dental market context. This study is important to dental educators and poli‐cymakers because the challenge of providing care to the “special patient” will increase in the future.
Occurrence of bruxism in a sample of Brazilian children with cerebral palsy
Authors: Peres Ana Claudia Darré , Ribeiro Mariana Ortiz , Juliano Yara , César Marcelo Furia , Santos Rachel Cesar de Almeida
Published: March 2008

Bruxism has been reported to exist in many children with cerebral palsy; however, only a few studies confirm this fact. The objective of this study was to determine the rate of bruxism in children with cerebral palsy and to relate its presence to the following factors: kind of cerebral palsy, gender, age, dentition, degree of malocclusion. oral mucous membrane trauma, trismus, and number of wear facets on specific teeth. The guardians of 121 children with cerebral palsy between the ages of 4 and 9 years were interviewed and the children were clinically examined. Bruxism was detected in 69.4% of the children and reported by 57% of the guardians. In 4‐and 5‐year‐old children, the rate of wear facets was small. Children with athetosis and spastic tetraplegia had a higher rate of bruxism than all others.
Health benefits and reductions in bacteria from enhanced oral care
Authors: Ferozali Fozia , Johnson Gary , Cavagnaro Andrew
Published: March 2008

ARSTRACT

This investigation assessed the oral cavity and microbiological status of 36 non‐verbal persons with developmental disabilities. The authors examined oral hygiene interventions aimed at reducing risk factors linked to bacterial colonization and aspiration pneumonia. The findings indicated a statistically significant decrease of potentially pathogenic bacteria and a reduction in total bacteria counts for people receiving oral care via intermittent suction.
Why is periodontal disease more prevalent and more severe in people with Down syndrome?
Authors: Morgan James
Published: March 2008

Periodontal disease has been found to be significantly more prevalent and more severe in people with Down syndrome. A series of studies have reported a prevalence of between 58% and 96% for persons younger than 35 years of age. This phenomenon cannot simply be attributed to poor oral hygiene. The etiology of periodontal disease in persons with Down syndrome is complex. In recent years, much focus has been placed on the altered immune response resulting from the underlying genetic disorder. This paper presents an overview of contemporary knowledge on periodontal disease in patients with Down syndrome.
Recessive dystrophic Epidermolysis bullosa. Two case reports with 20‐year follow‐up
Authors: Olsen Christopher B. , Bourke Laurence F.
Published: March 2008

These two case reports highlight the enormous clinical difficulties faced by dentists in providing satisfactory long‐term dental care to patients who suffer from Epidermolysis bullosa. Problems of bullae formation in oral soft tissues and subsequent scarring are outlined in relation to the difficulty of maintaining satisfactory oral hygiene and a diet leading to minimal dental caries experience. The behavioural problems of maintaining patient compliance for preventive and restorative dentistry in this painful and debilitating disease are illustrated in these case reports. Difficulties in providing restorative care, either under local anaesthesia or general anaesthesia are discussed, and a novel replacement of non‐viable carious anterior teeth using a nine‐unit porcelain fused to metal Rochette type bridge is presented. Dental management of patients with Epidermolysis bullosa should commence at birth, and non‐compliance in dental attendances should be followed up by social workers to prevent the disastrous oral morbidity that frequently occurs in such patients.
Human immunodeficiency virus infection: A review of the mode of infection, pathogenesis, disease course, and the general and clinical manifestations
Authors: McCullough M. J. , Firth N. A. , Reade P. C.
Published: March 2008

Acquired immunodeficiency syndrome (AIDS) was first recognized in 1981 and in 1983 the virus responsible for this syndrome, the human immunodeficiency virus, was first isolated. There has been an increasing understanding of the many aspects related to infection with this virus and this review discusses the historical as well as the more recent findings related to infection with this virus. In particular, the pathogenesis, mode and course of infection are discussed followed by an overview of the general and oral manifestations of infection with this virus.
Surgically‐assisted maxillary expansion
Authors: Woods Michael , Wiesenfeld David , Probert Timothy
Published: March 2008

A combined surgical and orthodontic technique for management of transverse maxillary deficiencies in mature patients is described and discussed. Special references are made to the surgical release of several circummaxillary articulations to facilitate the use of a fixed expansion device, and to the authors' addition of an osteotomy below the nasal spine, to ensure that the nasal septum remains independent of the maxillary segments. Indications for the use of this surgically‐assisted maxillary expansion technique, and its advantages when compared with segmented surgical expansion, are also presented.
Efficacy of a dentifrice and oral rinse containing sanguinaria extract in conjunction with initial periodontal therapy
Authors: Cullinan Mary P. , Powell Robin N. , Faddy Malcolm J. , Seymour Gregory J.
Published: March 2008

In the treatment of periodontal disease initial therapy aims at reducing marginal inflammation so allowing assessment of residual disease and further treatment options. The aim of the present study was to determine whether the use of a dentifrice and oral rinse containing sanguinaria extract led to a more rapid resolution of gingival inflammation following initial therapy. Thirty‐four subjects, randomly assigned to one of two treatment groups, took part in this randomized double‐blind parallel study. All subjects received initial therapy including oral hygiene instruction and scaling and root planing as required. One group also received an active dentifrice and oral rinse containing sanguinaria extract (an antiplaque agent) and zinc chloride. The other group received a placebo dentifrice and oral rinse. The gingival index (GI), plaque index (PLI) and probing pocket depths (PD) were recorded at six sites per tooth at baseline, two weeks after initial therapy and six weeks after initial therapy. There was no significant difference between the groups for any of the parameters at the baseline examination. Two weeks following initial therapy both groups showed a statistically significant increase in the number of sites with PLI of 0 or 1 (p<0.0001) and a statistically significant increase in the number of sites with a GI of 0 or 1 (that is, no bleeding on probing), (p<0.0001). Also there was a statistically significant increase in the number of sites with probing depths 3 mm (p<0.0001) compared with baseline. These changes were maintained through to six weeks post therapy. There was no significant advantage to the sanguinaria group. Results demonstrate that initial therapy in the form of oral hygiene instruction, scaling and root planing leads to a significant improvement in periodontal status which is maintained at least in the short term. Further, use of a dentifrice and oral rinse containing sanguinaria did not improve the efficacy of initial therapy.
Infant and child feeding practices: A preliminary investigation
Authors: Wyne Amjad H. , Spencer A. John , Szuster Fearnley S.
Published: March 2008

The objective of this preliminary investigation was to examine the feeding practices of infants and pre‐school children in Adelaide, and thereby contribute to the development of appropriate preventive dental strategies. A stratified random sample of 160 two year old and three year old pre‐school children in the Adelaide Statistical District was obtained. Information about feeding practices and use of comforters or ‘dummies’ was obtained through a self‐administered questionnaire completed by parents of the selected children. Information was collected for the age periods of 0–3 months, 4–6 months, 7–12 months, 13–24 months and 25–36 months. Most of the children (81.8 per cent) were breast‐fed at some stage. However the percentage of children being breast‐fed decreased markedly across age periods, particularly to 13–24 months, when only 15.9 per cent of children were being breast‐fed. Over half of the children had been bottle‐fed with infant formula at some stage. The highest percentage of children being bottle‐fed with infant formula occurred in the 4–6 months (42.6 per cent) closely followed by the 7–12 months age period (37.4 per cent). Nearly two‐thirds of children were bottle‐fed with cow's milk at some stage. The highest percentage of children being bottle‐fed with cow's milk occurred in the 13–24 months age period (49.6 per cent). A quarter (24.5 per cent) of the children were put to bed at some stage with a bottle containing cariogenic fluids. The majority of children used a ‘dummy’ at some stage during both day‐time and night‐time. Parents are in need of advice on appropriate feeding patterns for infants and young children.
Audit of waste collected over one week from ten dental practices. A pilot study
Authors: Farmer Glenda M. , Stankiewicz N. , Michael B. , Wojcik A. , Lim Y. , Ivkovic D. , Rajakulendran J.
Published: March 2008

An audit of the waste practices of ten general dental surgeries identified problems that have occurred due to the lack of specific dental guidelines or codes of practice in this area. Occupational health and safety requirements for types and locations of sharps containers, and lack of consensus on what constitutes a sharp, were identified as areas needing attention. Cross‐infection control items, such as gloves, masks, single‐use cups, and protective coverings, were found to constitute up to 91 per cent of total waste. When infectious waste was reclassified by the audit team as ‘that waste which was visibly blood stained,’ a reduction in waste in this category was made, during the audit, at each practice. The practice of disposing of radiographic fixer and developer into the sewerage system occurred in three out of the ten practices, even though the Australian Dental Association Inc. has discouraged this practice.
Cell surface structures of Actinomyces israelii
Authors: Figdor David , Davies John
Published: March 2008

Actinomyces israelii is the most common cause of human actinomycosis, a chronic granulomatous infection. Periapical actinomycosis involving A. israelii has been identified as an important cause of failure of conventional endodontic treatment. Structures on the bacterial cell surface have been implicated in the pathogenicity of Actinomyces. In this study the ultrastructure of A. israelii was investigated by electron microscopy. Negatively stained preparations revealed the presence of hairlike fimbriae protruding through a thick surface coat on some species, whilst thin sectioning disclosed a Gram‐positive cell wall surrounded by a fuzzy outer coat. These structures may be important for the pathogenicity of A. israelii.
Distribution of coronal and root caries experience among persons aged 60+ in South Australia
Authors: Slade Gary D. , Spencer A. John
Published: March 2008

This report provides epidemiological data describing caries experience among the population of noninstitutionalized older adults in Adelaide and Mt Gambier. Subjects were selected in a stratified random sample of persons aged 60+ who were listed on the South Australian Electoral Database. Oral examinations were conducted by four calibrated dentists among 853 dentate persons aged 60 years and over. There was an average of 14.7 missing teeth, 8.3 filled teeth and 0.3 decayed teeth, and a further 0.2 teeth were present as retained roots. The mean number of missing teeth was higher (p<0.05) in older compared with younger age groups, and in Mt Gambier compared with Adelaide. The mean DFS of 22.1 was significantly higher (p<0.05) among younger persons, females and in Adelaide. Root surface caries affected an average of 3.1 surfaces, and was greater (p<0.05) among persons aged 70–79 years, males and Adelaide residents. However, when root caries was expressed as an attack rate per 100 exposed surfaces, differences were statistically significant only among age groups. Analysis of specific teeth revealed that no more than 40 per cent of molars were retained, and between 30 and 58 per cent of retained molars had coronal fillings.
Coronal displacement of cementum: Correlation between age and coronal movement of cementum in impacted teeth
Authors: Bocutog Önder , Yakan Birkan
Published: March 2008

This study was conducted on 48 impacted and 51 erupted mailary permanent canine teeth exteracted from healthy patients aged 13–73 years. Longitudinal buccolingual ground sections were prepared. The distance between the edges of cementum and enamel in each specimen was measured with an eyepiece micrometer. A correlation test was applied between age and the distance between enamel and cementum measurements. In impacted teeth, depending age, cementum ahd a tendency to overlap the enamel; there was a linear correlation betwen age and coronal displacement of cementum (n‐2 = 46, r = 0.69, distance (μm) = 21.7* age (years)‐440, p<0.001). No correlation between age and coronal displacement was found in erupted teeth (n‐2 = 49, r = ‐0.23, p>0.05). Resutlts of the study indicated that the cementum in impacted teeth migrated coronally during the ageing process. This may affect the impacted teeth and may be a mechanism by which the teeth are protected at the cemento‐enamel junction (CEJ). This phenomenon could be used in forensic dentistry to determine could be used in forensic dentistry to determine age. The absence of correlation in erupted teeth could be attributed to the masking effects of extrinsic factors.
Tissue radiation dosages using the RVG‐S with and without niobium filtration
Authors: Scarfe William c. , Farman Allan G. , Brand John W. , Kelly Michael S.
Published: March 2008

Tissue doses for a modified Rando head‐and‐neck phantom were measured for imaging with speed group E film with standardized aluminium filtration and the RVG‐S both with and without added niobium filtration. Cylindrical holes drilled into the phantom's tissue‐equivalent material permitted the placement of a small ionization chamber into anatomically correct sites representing the thyroid, parotid, submandibular and sublingual glands. To establish the necessary cone positions, angulations and time settings for each exposure, diagostically acceptable images of six teeth, representative of different intraoral regions, were made for a DXXTR mannequin. Entrance and exit points were marked and transferred to the phantom to allow reproducible repeat exposures. The RVG‐S provided reductions in average skin entrance dose of 31 per cent to 39 per cent with standard aluminium filtration and 51 per cent to 60 per cent with the addition of niobium filtration to attenuate the beam. While dose reductions relative to E‐speed film usage were found for deep tissue sites, these were site and projection specific. The cumulative reduction from use of the RVG‐S without niobium filtration was 32 per cent. It was 42 per cent with additional niobium filtration. It should be noted, however, that adding niobium filtration resulted in increased dosages to the deeper soft tissues such as the thyroid gland.
Gingival crevicular fluid lactoferrin levels in adult per iodontitis patients
Authors: Tsai C‐C. , Kao C. C. , Chen C. C.
Published: March 2008

The present study was designed to determine in a cross‐sectional study whether there was any relationship between the levels of lactoferrin in gingival crevicular fluid and clinical periodontal parameters. Crevicular fluid was collected from individual sites using standardized filter paper strips (clinically healthy sites, N=23; periodontitis sites, n=66) and evaluated for lactoferrin by enzyme‐linked immunosorbent assay. The data showed that: (1) the total amounts of lactoferrin were 0.003‐0.021 ng (30 second sample) (average 0.009±0.005 ng) in a clinically healthy periodontium group and 0.016‐3.847 ng (30 second sample) (average 0.575±0.069 ng) in adult periodontitis patients (statistically significantly higher in adult periodontitis patients); and (2) the total amounts of lactoferrin were significantly correlated with clinical parameters,
A new intermaxillary fixation method using adhesive cast splints for a voiding skin puncture
Authors: Yamada Takehisa , Sumi Yasunori , Okazaki Yasuhiro , Ueda Minoru
Published: March 2008

Intermaxillary fixation using arch bars is performed for mandibular and fractures. They are applied to the respective maxillary and mandibular arches with circumdental stainless steel wires. Skin puncture may pose a risk for the surgeon. Therefore, the authors have developed and tested a method for using intermaxillary fixation using an adhesive cast splint. The resulting strength was found to be generally superior to that achieved with arch bars. Despite some problems, this technique is considered a useful method for avoiding skin puncture.
Anaphylactic reaction following administration of lignocaine hydrochloride infiltration. Case report
Authors: Ogunsalu Christopher O.
Published: March 2008

A case of progressive anaphylactoid reaction complicating a local anaesthetic agent administered to a dental patient is described. The management of the condition is discussed.
The use of titanium mesh sheet in the frontozygma tico‐orbital region. Case reports
Authors: Lazaridis N. , Makos Ch. , Iordanidis S. , Zouloumis L.
Published: March 2008

Six cases reconstructed in the zygomatico‐frontoorbital region with titanium mesh are reported and a discussion of the use of theis material in oral and maxillofacial surgery is presented.
Sublingual hypoglossal neurilemmoma. Case report
Authors: Drevelengas Antonios , Kalaitzoglou Ioannis , Lazaridis Nikolaos
Published: March 2008

Neurilemmomas of the peripheral segment of the hypoglossal nerve are extremely uncommon neoplasms. A rare case of hypoglossal neurilemmoma located in the sublingual space is reported and the differential diagnosis of sublingual mass lesions is discussed.
An assessment of attitudes to, and extent of, the practice of denture marking in South Australia
Authors: Alexander P. M. V. , Taylor J. A. , Szuster F. S. P. , Brown K. A.
Published: March 2008

Denture marking or labelling is not a new concept in either prosthetic or forensic dentistry and its routine practice has been urged by forensic odontologists internationally for many years. In the general community it is often recommended for institutionalized persons to prevent confusion of ownership of dentures. In Australia, the Nursing Home Standards require that dentures of residents be ‘discreetly labelled’ and marking of all dentures is recommended by the Australian Dental Association. In some countries the marking of dentures is regulated by legislation, but elsewhere there seems to be a reluctance to effect this practice.

Various methods which have been proposed include the insertion of an identifying label during the fabrication of the dentures with the utilization of a number of materials and coding systems. This study reports the results of a survey undertaken to determine the extent of the practice of denture marking in South Australia, the methods in use, and the attitudes of dentists, dental technicians and institutions to it.

The results indicated that 24.5 per cent of all practitioners providing removable prostheses to their patients include an identifying label as part of the service on some occasions. This included 19.9 per cent of general dental practitioners, 25 per cent of specialist prosthodontists, 57.1 per cent of practitioners with training in forensic odontology, and 43.5 per cent of clinical dental technicians.

No practitioner labelled dentures routinely. Reasons cited for not labelling dentures included cost, lack of awareness of standards and recommendations and a belief that it was of little importance.
Service‐mix in general dental practice in Japan: A survey in a suburban area
Authors: Kawamura Makoto , Sasaki Takehiko , Imai‐Tanaka Takako , Yamasaki Yukiko , Iwamoto Yoshifumi
Published: March 2008

Overseas investigations have reported the amount and variety of dental services provided. An understanding of the current service‐mix in private general practice is important in the anticipation of the future practice of dentistry. The main purpose of this study was to describe the service‐mix of private general practitioners in Japan, which was recorded using the Australian Dental Association Dental Procedure Code. Some comparisons with previous studies were offered. The youngest age group and adolescents formed only a small percentage of the total patients, while the greatest percentage of patients occurred in the 45–64 year age group. The services provided were mainly restorative, diagnostic, advanced restorative and endodontic services. Preventive services represented a minority of dental activity, especially for young patients. Periodontic and orthodontic services were also remarkable for their low percentage in all age groups. In comparison with an Australian study, the percentage of preventive services was considerably lower. Movement toward a preventive emphasis in Japanese dentistry requires a change in the clinical model, de‐emphasizing biomedical and aetiological approaches and placing greater emphasis on the patient and factors affecting dental practice.
A brief review of indigenous Australian health as it impacts on oral health
Authors: Martin‐Iverson Nicole , Phatouros Andrea , Tennant Marc
Published: March 2008

The indigenous population of Australia constitutes approximately 2 per cent of the total population. This group has faced significant cultural, economic and health changes since European settlement some 200 years ago. In this brief review some of the health changes that have influenced the oral health status of this community have been examined. Of major importance is the dietary change that the once nomadic indigenous community has undergone. Today's Western diet, high in sugar, low in proteins and vitamins, has resultd in a significant increse in the risk (and prevalence) of caries and periodontal disease. In addition, the high prevalence of diabetes also exacerbates the periodontal problem. The remoteness of a significant proportion of Australian indigenous communities from modern health care services and limited access to fluoridation increases the incidence of oral disease. It is also noted that the incidence of rheumatic heart disease is one of the highest in the world, thereby increasing the risk of bacterial endocarditis. It is clear that indigenous communities have unique oral health needs but the extent of these needs is not well documented. It is important that more research be undertaken to assess these needs so that appropriate oral health programmes can be developed.
The outcome of arthroscopic treatment of temporomandibular joint arthropathy
Authors: Rosenburg I. , Goss A. N.
Published: March 2008

Ninety patients underwent arthroscopic temporomandibular joint surgery to 124 joints for arthropathy which had failed to respond to at least six months of non‐surgical treatment. They were surveyed at between 6 months and 5 years (mean 2.5 years) after surgery and 63 per cent responded to the survey. They reported an 82 per cent improvement for pain (50 to 100 per cent better), 80 per cent for clicking and 82 per cent for locking. There was no morbidity following the treatment. Arthroscopic surgery sould be considered for advanced temporomandibular joint arthropathy which is refractory to non‐surgical treatment.
Radiographic appearance of alveolar osseous defects in relation to their anatomic location
Authors: Nicopoulou‐Karayianni Kety , Diamanti‐Kipioti Anthoula
Published: March 2008

Radiographs are of limited value in the diagnosis of osseous defects. Anatomic and technical factors affect the radiographic appearance of bone lesions. This study was undertaken in order to determine whether the radiographic appearance of alveolar osseous defects depends on their location, and particularly whether there are any differences in radiographic detection between bone defects located in the maxilla or the mandible, and on the buccal or lingual aspects of the alveolar crest. Experimental bone lesions were created in the alveolar crest of a skull. Standardized periapical radiographs were obtained before and after the defects were made. After processing, pairs of radiographs were randomly mounted. Five dentists acted as observers in order to determine whether or not a change in alveolar bone was detectable at each of the five possible locations. The unpaired t test was applied for the assessment of statistically significant differences with respect to sensitivity, specificity, and positive diagnostic value in the diagnosis of bone lesions depending on their location. The results showed that the anatomic location of a lesion in the alveolar bone affected its radiographic appearance. Moreover, experimental defects were detected more often in the mandible and on the lingual surfaces of the alveolar crest.
The Clinical performance of ceramic inlays: A review
Authors: Bergman Mark A.
Published: March 2008

The availability of improved ceramic materials, bonding techniques, new technology and issues of amalgam safety have led to a revival of interest in ceramic inlays in density over the past ten years. Clinical studies have been carried out during this time using various evaluation technique to assess the clinical performance of these restorations.

In this paper, recent clinical studies are examined and a review of the current state of knowledge regarding the clinical performance and survival statistics of ceramic inlays in presented. The major problems associated with ceramic inlay therapy appear to be fracture, hepersensitivity, degree of fit, maintenance of marginal integrity, microleakage, bond failure and cement wear. Other areas which also effect the clinical performance of ceramic inlays are ceramic wear, opposing tooth wear, plaque accumulation, gingivitis, secondary caries, colour stability, anatomic form and radiopacity.

Recommendations based on the findings of clinical studies are also preseneted and whilst no specific material or technique has been shown to be clearly superior, certain principles which predispose to success can be identified.

When compared with other forms of aesthetic intra‐coronal restorations, ceramic inlays perform well. However, their high cost and extreme technique sensitivity would appear to restrict their use to certain limited clinical situations.
Integrating the surgical and prosthodontic stages of implant therapy with a sterile implant position registration
Authors: Chan Richard W.
Published: March 2008

A new implant position registration technique utilizing an autoclavable thermoplastic material is described. This technique, which has been in use sine 1994, allows the clinician to fabricate a provisional restoration for insertion at stage II surgery to enhance the soft tissue contour and the aesthetics of the final restoration.
Resin‐ionomer restorative materials for children: A review
Authors: Hes K. M. Y. , Leung S. K. , Wei S. H. Y.
Published: March 2008

Hybrid restorative materials comprising resins and components of conventional glass ionomers have been widely introduced and accepted by the dental profession in recent years. These include the resinmodified glass ionomer cements and the polyacidmodified resin composites or compomers. They are developed in an attempt to overcome the problems of traditional restoratives, such as moisture sensitivity and reduced early strength, while at the same time maintaining their clinical advantages of command setting, adhesion to tooth structures, adequate strength to occlusal load, fluoride release and aesthetics. This paper reviews the development, composition and properties, of these new materials. Their clinical performance appears to be promising and they should be considered as good alternatives to amalgam and other conventional restorative materials in the future.