bluuebunny/crossref_metadata_2025 huggingface dataset:
Dens evaginatus on a wisdom tooth: A diagnostic dilemma. Case report
Authors: Ngeow Wei Cheong , Chai Wen Lin
Published: March 2008

Pericoronitis is the most common odontogenic problem associated with the wisdom tooth in young men and women. Patients may present with problems associated with infection, swelling and pain. However, other associated pathology such as caries, periodontal disease and referred pain from the temporomandibular joint must be investigated when treating pain from the wisdom tooth. The authors wish to present a case in which the pain from a wisdom tooth was due to a fractured dens evaginatus. The importance of this dental anomaly should not be overlooked.
The effect of cleaning on blood contamination in the dental surgery following periodontal procedures
Authors: Edmunds Louise M. , Rawlinson Andrew
Published: March 2008

Blood contamination of 16 surfaces in the dental surgery was investigated using the Kastle‐Meyer test for haemoglobin, after three types of periodontal procedures had been performed on a total of 30 patients. The effect of cleaning surfaces contaminated by blood was investigated using the same test. Cleaning materials used in the dental surgery were tested to rule out the possibility of false positive outcomes and the sensitivity of the test was determined prior to the study. The results show a marked variation in the degree of contamination and efficacy of cleaning following treatment. Overall, root planing was associated with the most widespread and frequent blood contamination and gingival surgery the least. The surgery work surface, edge of the spittoon, aspirator tube and ultrasonic scaler handpiece into which the ultrasonic insert fits, were the most frequently contaminated surfaces. The work surface, dentist's pen, light switch and handle were cleaned most effectively. The least effectively cleaned surfaces were the water dispenser switch, aspirator tube, bracket table and ultrasonic scaler handpiece. Methods for reducing this potential source of crossinfection are discussed.
The effects of early orthodontic force application on pulp test responses
Authors: Hall C. J. , Freer T. J.
Published: March 2008

The effects of orthodontic tooth movement on pulpal responses are of interest to the clinician. Alterations to pulpal physiology may result in altered responses to external stimuli. This pilot project tested a small group of orthodontic patients during the early stages of treatment. Heat, cold and electrical stimuli were applied prior to treatment, after the placement of fixed appliances and after one month of force application. A smaller group was tested after two months of force application. One month after force application there was a lack of response to electrical stimulation but there was continued response to thermal stimulation. The lack of response to electrical stimulation continued in the smaller group up to two months. The results suggest that the outcome of electric pulp testing during orthodontic treatment should be interpreted cautiously. Thermal testing will offer more reliable data.
Comparison of exposed dentinal surfaces resulting from abrasion and erosion
Authors: Bell Emma Jane , Kaidonis John , Townsend Grant , Richards Lindsay
Published: March 2008

The aim of this study was to compare the shape of exposed dentinal surfaces caused by abrasion and erosion with a view to developing a diagnostic clinical test. The study material consisted of 80 natural teeth and 129 dental models obtained from Australian Aborigines known to display considerable dental abrasion due to their diet, and dental models of 37 Caucasians diagnosed with dental erosion through detailed history and dietary analysis. Polyvinyl siloxane impressions were obtained of all occlusal surfaces with dentinal scooping in both the ‘abrasion’ and ‘erosion’ groups. All impressions were sectioned buccolingually through the deepest point of the scooped dentine, and then the profiles were photocopied at X 2 magnification. The breadth and depth of dentinal profiles were measured to an accuracy of 0.1 mm, enabling ratios of depth:breadth to be determined, and the position of the deepest part of each scooped surface was recorded. The mean depth:breadth ratio of scooped dentine was significantly greater in the Aboriginal natural teeth (0. 19±60.06, mean±SE) than in the Aboriginal dental models (0.15±0.04). Both Aboriginal natural teeth and models with abrasion showed significantly smaller ratios (p<0.05) than the Caucasian models showing erosion (0.33±.07). Furthermore, in the abrasion samples, the deepest region of the scooped dentine tended to be lingually placed more often in maxillary teeth but buccally placed more often in mandibular teeth (p<0.05). These results indicate that scooped dentine on abraded occlusal surfaces of teeth displays significant differences in shape compared with that caused mainly by erosion.
Supernumerary tooth in the maxillary sinus: Case report
Authors: Erkmen Nilgün , Ölmez Seval , Önerci Metin
Published: March 2008

The ectopic development of teeth has been reported in many locations including the nasal cavity, maxillary sinus and the chin. Ectopic teeth may be permanent, deciduous or supernumerary. A case is presented in which a supernumerary tooth erupted into the maxillary sinus of an 11 year old boy.
Abnormally high fluoride levels in commercial preparations of 40 per cent silver fluoride solution: Contraindications for use in children
Authors: Gotjamanos Theo , Orton Vergil
Published: March 2008

Although a 40 per cent solution of silver fluoride would be expected to contain 6 per cent fluoride (60 000 ppm), F‐ levels of 100 000 ppm and 120 000 ppm were found in 14 commercial samples analysed at The University of Western Australia in 1993 and 1994. To determine whether F‐ levels in 40 per cent AgF preparations have remained high, the present investigation was aimed at analysing different batches of commercial preparations obtained more recently.

Fluoride ion analysis was carried out on 24 AgF samples using the Ion‐Selective Electrode technique. Independent analyses of the same samples were carried out by a private chemical testing laboratory (Genalysis). Ten samples supplied by Agson Chemical Export were found to contain between 75 000 and 100 000 ppm F‐; Genalysis reported 80 000 to 120 000 ppm. Fourteen samples supplied by Southern Dental Industries were found to contain between 70 000 and 120 000 ppm F‐; Genalysis reported 88 000 to 108 000 ppm F‐. These results confirm significantly higher than expected F‐ levels (ANOVA p<0.05) in commercial preparations of 40 per cent AgF.

The solutions tested were found to contain a mixturr of ammonium fluoride, sodium or potassium fluoride, and silver fluoride. The additional presence of silver difluoride and hydrofluoric acid resulting from the manufacturing process has been suggested as an explanation for the much higher than expected levels of fluoride ion. In view of possible toxicity of 40 per cent AgF in young children, it is concluded that such a highly concentrated solution should not be used clinically; instead, lower strength AgF solutions should be investigated for their efficacy in caries treatment.
p53 expression in oral precancer and cancer
Authors: Rich Alison M. , Kerdpon Duangporn , AM Peter C. Reade
Published: March 2008

Expression of the p53 tumour suppressor gene is a frequent finding in human malignancies, including oral cancer, and it has been detected in some potentially malignant lesions. The results of the present project showed that 35 of the 41 (85 per cent) oral mucosal lesions with histological evidence of epithelial dysplasia expressed p53, but the presence or absence of p53 staining could not be used to predict the outcome of potentially malignant oral mucosal lesions.
Adenomatoid hyperplasia in the mandibular retromolar area. Case report
Authors: Chen Y. K. , Lin C. C. , Lin L. M. , Yan Y. H.
Published: March 2008

This paper reports a case of adenomatoid hyperplasia of minor salivary glands in the retromolar area, with a unique symptom of painful swelling. This appears to be the first reported case in the Chinese population. It would be useful for clinical dentists to be aware of this tumour.
Dental cervical lesions associated with occlusal erosion and attrition
Authors: Khan F. , Young W. G. , Shahabi S. , Daley T. J.
Published: March 2008

Acid demineralization of teeth causes occlusal erosion and attrition, and shallow and wedge‐shaped cervical lesions putatively involving abfraction. From 250 patients with tooth wear, 122 with cervical lesions were identified. From epoxy resin replicas of their dentitions, associations of occlusal attrition or erosion or no wear with cervical lesions were recorded at 24 tooth sites (total 2928 sites). Criteria used to discriminate occlusal attrition from erosion, and shallow from grooved, wedge‐shaped or restored cervical lesions were delineated by scanning electron microscopy. A 96 per cent association was found between occlusa and cervical pathology. shallow cervical lesions were more commonly found in association with occlusal erosion. Wedge‐shaped lesions were found equally commonly in association with occlusal erosion, as with attrition. Grooved and restored cervical lesions were uncommon. Differences were appreciated in the associations within incisor, canine, premolar and molar tooth sites which related more to the site‐specificity of dental erosion than to attrition from occlusal forces. Non‐carious lesions on teeth then have multifactorial aetiology and pathogenesis in which erosion and salivary protection play central roles. Dentists should primarily consider erosion in the diagnosis, prevention and treatment of tooth wear.
Incidence of complicated healing and osteoradionecrosis following tooth extraction in patients receiving readiotherapy for treatment of nasopharyngeal carcinoma
Authors: Tong Antonio Chi‐Kit , Leung Albert Chun‐fung , Cheng Jason Chi‐fung , Sham Jonathan
Published: March 2008

A group of 43 patients requiring tooth extraction after radiotherapy for nasopharyngeal carcinoma (NPC) was studied retrospectively to determine the incidence of post‐extraction complications. It was found that because of the method used in the delivery of radiation, extraction of maxillary posterior teeth resulted in the greatest risk of complications (28.9 per cent), Including a 10.5 per cent risk of osteoradionecrosis (ORN). Based on the findings, a protocol was established for the dental care of such patients. It was concluded that when extraction of maxillary posterior teeth was necessary, prophylactic antibiotics were not sufficient to prevent the complication of delayed healing. The risk of ORN was 10.5 per cent within the field of maximal radiation does, Hyperbaric oxygen may be the better choice of preventive measures. However, in view of the low risk of ORN, wholesale prescription of hyperbaric oxygen therapy may no be indicated. An additional patient who had tooth extraction two weeks prior to radiotherapy was included to show that if adequate time for wound healing was not allowed, ORN could develop.
A clinical review of drug‐induced gingival overgrowths
Authors: Marshall Roderick I. , Bartold P. Mark
Published: March 2008

There is an increasing number of medications associated with gingival overgrowth. These medications are used to treat a number of common conditions in the Australian population and as such denitsts can expect to manage a number of patients with medication‐related gingival overgrowth. This review highlights the clinical features and management of the common overgrowths associated with anticonvulsants, immunosuppressants and the calcium channel blockers.
Cytotoxicity of polymerized commercial cyanoacrylate adhesive on cultured human oral fibroblasts
Authors: Thumwanit V. , Kedjarune U.
Published: March 2008

Cyanoacrylate (CA) has been used as both a commercial and tissue adhesive. Dentists may have had the experience of patients repairing their own acrylic‐based dentures using a cyanoacrylate (CA) adhesive known as ‘super glue’. This study evaluated the cytotoxicity of commercial CA adhesives when fully polymerized, as well as the toxicity of substances released from polymerized commercial CA adhesives after incubation of these materials for various periods of time. Toxicity was tested on cultured oral fibroblasts. Dead cells found around the various CA‐coated filter papers constituted inhibitory zones which varied from 200–1000 μm and which persited for two weeks. Control oral fibroblasts grew to approach the waxcoated filter paper. Cell viability testing using MTT and crystal violet staining methods supported the conculsion that polymerized CA‐coated filter paper released substances that are toxic to cells, while wax‐coated filter paper gave the same result as the control. The crystal violet staining method was also used to investigate the cytotoxicity of various CA materials after incubation for one, three, seven and 14 days and showed that CA continued to release cytotoxic substances at about the same level for at least two weeks. It can be concluded that, if CA adhesive is used for repair of broken dentures, it will release substances which are toxic to human oral fibroblast cells. This release of substances may persist for at least two weeks.
The use of glass ionomer in special needs patients
Authors: Gryst Mark E. I. , Mount Graham J.
Published: March 2008

Placement of restorations for patients who are physically or intellectually disabled or mentally ill can pose considerable difficulties for the general practitioner. Access to the oral environment is often limited and patient tolerance and concentration may be reduced to rather brief periods of time. Oral hygiene routines may be less than ideal leading to a high caries rate. Enamel surfaces which do not normally become carious can develop broad but shallow lesions with a poorly defined outline.

Selection of the most suitable restorative material will be important, with longevity of the restoration as the prime consideration. Other factors such as access, isolation of the lesion and patient co‐operation must also be taken into account. Also, forces acting on restorative materials may be less than usual due to poor occlusion, teeth opposing dentures or being completely unopposed. Restoration by indirect techniques will often not be possible so the choice will be limited to the three plastic restorative materials normally used in restorative dentistry: amalgam, resin composite and glass ionomer.

As a result of clinical experience it is suggested that glass ionomer will often be the material of choice. This paper describes five years experience with the resin‐modified glass ionomers in an institutional practice which is limited to patients with special needs.

Clinical significance

Placement of restorations, with a reasonable expectation of longevity, can pose considerable problems for the patient with special needs. Resin‐modified glass ionomer is a useful alternative material and has been placed with a high degree of success over a period of five years.
A prospective study of cantilever resin‐bonded bridges: An intial report
Authors: Chan A. W. K. , Barnes I. E.
Published: March 2008

A prospective study was undertaken in a dental teaching hospital to compare the clinical performance of cantilever resin‐bonded bridges with a fixed‐fixed design for the replacement of a maxillary permanent incisor. A total of 25 anterior resin‐bonded bridges was placed in 24 patients. The prostheses were evaluated over 14 to 45 months. During the evaluation period only one fixed‐fixed type debonded, which was subsequently rebonded successfully. There was no debond in the cantilever group. The short‐term, initial findings showed that cantilever resin‐bonded bridges performed as successfully as their fixed‐fixed counterparts and were considered to be an acceptable form of restoration.
Localised enamel hypoplasia of human deciduous canines: genotype or environment?
Authors: Taji Sue , Hughes Toby , Rogers Jim , Townsend Grant
Published: March 2008

A discrete area of defective enamel formation that appears on the labial surface of the crowns of deciduous canine teeth has been described in both recent and prehistoric human population, with reported frequencies varying from 1 to 45 per cent. Suggestions about the aetiology of this localized hypoplasia range from genotypic factors to environmental conditions and systemic effects. The major aims of this study were to describe the frequency of occurrence and pattern of expression of the lesion in Australian Aboriginal and Caucasian ethnic groups, and to clarify the role of genetic factors by examining a sample of twins.

The study sample consisted of dental casts of 181 pairs of Australian Caucasian twins, 215 Aborigines and 122 Caucasian singletons, together with 253 extracted deciduous canines. Examination of dental casts and extracted teeth was undertaken under 2X magnification with emphasis being placed upon location and expression of the lesion.

The defect was observed in 49 per cent of twins and 44 per cent of Aborigines, but only 36 per cent of singletons. The percentages of affected teeth in each group were: 18 per cent in twins, 17 per cent in Aborigines and 13 per cent in Caucasians. A significant proportion of the defects occurred on the mesial aspect of the labial surface, in the middle area incisocervically, with the majority in the lower jaw. Anumber of significant differences in frequency were observed between groups, sexes, arches and sides.

The results confirm some of the findings of previous studies, but also suggest that none of environmental, genetic or systemic factors can be ruled out as being involved in aetiology of the defect. The higher incidence of the lesion occurring on the mesial aspect of the labial surface is suggestive of physical trauma. Also, the vulnerability of the prominent developing mandibular canine, with its thin or missing labial covering of bone, would be expected to lead to higher prevalence of the lesion in the lower jaw. Although not definitive, the results of concordance analyses in twins were suggestive of a possible genetic predisposition in the formation of the lesion. Further research with a greater clinical orientation and emphasis on determing specific aetiological factors within any given environment in different ethnic groups may provide better insight into the ambiguous aetiology of the hypoplastic enamel defect.
Dental caries is a preventable infectious disease
Authors: Balakrishnan Mayooran , Simmonds Robin S. , Tagg John R.
Published: March 2008

Dental caries is the most common infectious disease affecting humans. the principal causative agents are a group of streptococcal species collectively referred to as the mutans streptococci of which Streptococcus mutans and Streptococcus sobrinus are the most important agents of human caries. This review outlines what is currently known about these ubiquitous pathogens and discusses novel methods for elimination of these bacteria from dental plaque.
A late developing mandibular premolar supernumerary tooth
Authors: Gibson Nova
Published: March 2008

This paper presents a case of a patient who developed a mandibular premolar supernumerary tooth between the age of 11 and 20 years. Evidence for the late development of the supernumerary tooth comes from consecutive panoramic radiographs. A review of the international literature concerning late developing supernumerary teeth is included.
Are dental; radiographs safe?
Authors: Abbott Paul
Published: March 2008

Dental patients are often aware that radiation has the potential to harm them but they do not usually understand how or why and what potential harmful effects may arise from dental radiographs. The potential for undesirable effects must be balanced against the benefits obtained from radiographs. Dentists should address the concerns of patients who question the need for radiographs and allow them to make an informed decision. Data are available that relate radiation exposure levels from medical and dental radiographs to normal background exposure levels and allow comparisons with everyday risks in life. Recognized radiation authorities publish guidelines to help dentists with their use of radiographs, although, due to the time lag associated with testing and the publication of results, some of the published data may not always be entirely relevant to currently used X‐ray machines and techniques. Dentists also have professional obligations not only to limit the use of radiographs to potentially beneficial situations but also to take good quality diagnostic radiographs, to limit the doses used, to use good radiation safety measures and to use modern equipment to achieve the best possible films. Radiographs must then be properly developed and viewed under appropriate conditions to gain the maximum possible diagnostic information from each exposure.
Outcomes of cleft care in Western Australia: A pilot study
Authors: Williams Alison C. , Johnson Nicola C. , Singer Steven , Southall Peter , Mildinhall Sue , Semb Gunvor , Sell Debbie , Thomas Steve , Sandy Jonathan R.
Published: March 2008

The purpose of this study was to compare outcomes and delivery of cleft care in Western Australia with the average standard of care in the United Kingdom (UK). This was achieved through a cross‐sectional study involving children born with unilateral cleft lip and palate between April 1983 and March 1985 (12 year olds) or between April 1990 and March 1992 (5 year olds). A total of 38 children born with unilateral cleft lip and palate were under the care of the cleft team based at Perth's Princess Margaret Hospital. Dental arch relations, facial skeletal pattern, speech, hearing, success of alveolar bone grafting and dental health were measured. It was found that fewer Princess Margaret Hospital children in both age cohorts had revision surgery and speech therapy compared with the UK average. The facial skeletal pattern, speech, hearing and alveolar bone grafting out‐comes from Princess Margaret Hospital were similar to the UK at age 12. Seventeen per cent of the Princess Margaret Hospital 12 year olds had a poor dental arch relationships compared with 39 percent in the UK. In the 5 year olds, most outcomes in Princess Margaret Hospital patients appeared better than the UK with lower residual treatment needs. While it is difficult to draw firm conclusions because of the small numbers involved, this study indicates standards need to be set and determined for Australia.
An Evaluation of the Changes in Malocclusion Index Scores Over a 25‐year Period
Authors: Hong S. , Freer TJ , Wood EB
Published: March 2008

Background: The measured values of specific traits of occlusion may be subject to significant change due to growth and maturation of the dentofacial structures. Some traits may show improvement while others may show deterioration. Rarely is there an opportunity to examine a sample of occlusions 25 years after the acquisition of the original set of records. This study examines the changes in traits of occlusion in a sample of 46 subjects who were originally examined between 1971–1973 and for whom records were again obtained in 1998.

Methods: The 46 patients were a sub‐group of a previously selected randomised school‐based sample and study models obtained in 1971–1973 were still available. New models for each patient were obtained in 1998. Of the 46 subjects, only eight had received orthodontic treatment.

Results: Assessments of the changes in specific traits were made using the methods proposed in the Harry L Draker, California Modification (HLD Cal Mod) index. This simple index was chosen because the main component traits were well defined and, when analysed separately, reflected changes with time. The total index score gave a broad indication of the global changes in the individual's occlusion. The five basic traits of the HLD index include overjet, overbite, openbite, mandibular protrusion and labio‐lingual spread. Three additional traits (ectopic eruption, anterior crowding and posterior crossbite) are used in the HLD Cal Mod index. These traits provided a useful reflection of occlusal changes with time. Measurements were made with reference to specifications and the details outlined in the HLD Cal Mod protocol. The results revealed an increase in total index scores over time with a significant increase in lower labio‐lingual spread associated with an increased score in anterior crowding. Overjet and overbite, however, displayed a significant decrease with time.

Conclusions: These findings are in keeping with previous studies and highlight the importance of time as a significant issue in the assessment of occlusion.
Practical Belief Scales Among Private General Dental Practitioners
Authors: Brennan DS , Spencer AJ
Published: March 2008

Background: Practice beliefs have been related to service rate variation. The aims of this study were to replicate practice belief scales in Australia and investigate associations with dentist and practice characteristics and services.

Method: A random sample of Australian dentists completed mailed questionnaires (response rate 60.3 per cent).

Results: Private general practitioners (n=345 provided service data from a typical day. Eight practice belief items were recorded on a five‐point Likert scale, yielding four factor‐based scales.

Approximately 85 per cent of responses were on the agreement side of the midpoint for the scales of Information giving and Patient influence, 45 per cent for Preventive orientation and approximately 10 per cent for Controlling active disease rather than developing better preventive advice.

Capital city dentists had higher agreement with the Preventive orientation scale, while males and older dentists showed less disagreement with the Controlling active disease item (Mann‐Whitney, Kruskal‐Wallis P<0.05).

Those agreeing with the scales (that is scores the median) showed (Poisson regression P<0.05): a higher rate of crown and bridge, a rate ratio (RR) of 1.31, but lower rates of extraction (RR=0.76) and prosthodontic services (RR=0.64) for the Information giving scale; a higher rate of restorative (RR=1.22) and total services per visit (RR=1.06) for the Preventive orientation scale; a higher rate of preventive services (RR=1.14), but a lower rate of crown and bridge services (0.78) for the Patient influence scale; and higher rates of crown and bridge (RR=1.40) and prosthodontic (RR=1.59) but lower rates of periodontic (RR=0.60) and extraction services (RR=0.62) for the Controlling active disease item.

Conclusions: These findings confirm the factor structure of practice beliefs and demonstrate small to moderate associations with variation in service rates.
Dental Needs of Elderly Hostel Residents in Inner Melbourne
Authors: Saub R. , Evans RW
Published: March 2008

Background: The purpose of this study was to determine the oral health status and treatment of elderly hostel residents in Melbourne. method: One hundred and seventy‐five subjects aged 65+ were selected from 20 hostels within a 10 m radius of Melbourne's central business district.

Result: Subjects were clinically examined and interviewed using a standard questionnaire. In the course of the clinical examination, coronal caries, root caries, periodontal disease, denture status and related treatment needs were assessed. The mean age of the subjects was 83.7, the majority of whom were female (80 per cent). About 35 per cent of the sample were dentate. The mean number of teeth present among dentate persons was 13.8, the mean coronal caries experience was 24.9 DMFT and mean root caries was 2.3 R‐DF. Of the dentate subjects, 46 per cent required at least one restoration for coronal caries and 30 per cent required at leas tone restoration for root caries. Most dentate subjects had calculus and none had deep pockets, therefore, indications for periodontal treatment did not include complex care. More than 50 per cent of lower full dentures were retained unsatisfactorily and about half of the total number of subjects required prosthetic treatment.

Conclusion: Although there was a high number of treatment needs, most requirements involved simple technologies that could be delivered by auxiliaries.
Salvage of a Blade‐Implant Bridge
Authors: Thomson David H.
Published: March 2008

This paper describes an aesthetic and functional treatment for the replacement of a failing bridge supported by blade implants where the patient refused further surgery
Oral Lesions in Scurvy
Authors: Firth N. , Marvan E.
Published: March 2008

Scurvy is the nutritional deficiency state associated with lowered levels of ascorbic acid (vitamin C). Lack of ascorbic acid leads to suppression of collagen synthesis and the synthesis of defective collagen among other metabolic derangements. Weakening of vascular walls results in signs and symptoms mimicking other diseases such as bleeding diatheses and deep vein thrombosis.

Scurvy is rarely encountered in Western countries where there is a broad community understanding of the importance of nutritional requirements and where foods containing ascorbic acid are readily available.

As a result of these factors early diagnosis may be hampered where it is not considered in the differential diagnosis, and consequently, prolonged suffering of the patient. Scurvy is easily treated with high doses of oral ascorbic acid, although recurrences may occur.

Education of health care providers in recognizing the signs and symptoms of scurvy therefore cannot be over emphasized, particularly in societies in which nutritional deficiencies are considered uncommon.

A case of scurvy presenting primarily with oral manifestations is reported here.
Digital Imaging for Dentists
Authors: Macdonald R.
Published: March 2008

This review of digital imaging and the technical aspects of radiographic equipment manufactured for dentists is designed to provide practical information to assist in the decision making process and purchase of radiographic digital imaging for clinical use.
Water fluoridation, osteoporosis, fractures—recent developments
Authors: Demos Lisa L. , Kazda Hana , Cicuttini Flavia M. , Sinclair Martha I. , Fairley Christopher K.
Published: March 2008

Background: Optimal (1 ppm) water fluoridation is seen as the most socially equitable way to prevent dental caries, however concerns about the safety of fluoridation are periodically raised.

Methods: Research on effects on bone published since the 1991 National Health and MedicalResearch Council report on water fluoridation was reviewed.

Results: Thirty‐three studies were identified. Adverse effects in animal feeding studies were only seen at doses much greater than those currently used in artificial water fluoridation. The majority of animal studies showed no effect or a beneficial effect of lowfluoride doses. The results of ecological studies were conflicting. One of the two cohort studies showed an increase in fracture incidence at fluoride levels four times greater than optimal water fluoridation and the other showed no effect after 20 years' optimal fluoridation. The cross‐sectional studies showed a favourable effect on bone mineral density. The clinical trials predominantly showed increased bone density in several sites associated with fluoride treatment of 9–22.6mg fluoride per day for one‐four years.

Conclusion: These studies provide a substantial body of evidence that fluoride at up to 1ppm does not have an adverse effect on bone strength, bone mineral density or fracture incidence.
A retrospective analysis of oral hairy leukoplakia in South Australia
Authors: Logan RM , Coates EA , Pierce AM , Wilson DF
Published: March 2008

Background: The features of oral hairy leukoplakia (OHL) have been widely reported in the literature. However, no studies have described this lesion in the Australian setting. This study retrospectively examines, with respect to specific clinical factors, the prevalence of OHL in a South Australian HIVinfected population.

Methods: Clinical data were collected from the records of 197 HIV‐infected patients who had attended the Adelaide Dental Hospital between January 1986 and February 1995. Data were analysed using the chi‐square test.

Results: The prevalence of OHL in South Australian HIV‐infected patients was 45.2 per cent. The study found the presence of OHL was not related to CD4+T‐lymphocyte count or AIDS‐defining illness nor did the length of time a patient had been infected with HIV relate to the presence of OHL. An association was observed between a reduced prevalence of OHL in patients who were taking antiviral medication.

Conclusion: The prevalence of OHL in South Australia is comparable with results of other studies. This study supports the notion that OHL is not an indicator of immunosuppression in South Australian HIV‐infected patients. Further longitudinal studies are required to ascertain the relationship of OHL to HIV disease progression.
Continuing education: The 1998 Survey of the Royal Australasian College of Dental Surgeons
Authors: Sambrook P. , Thomson D. , Bastiaan R. , Goss A.
Published: March 2008

Background: Continuing education (CE) is an essential professional activity. In the last decade, CE has been actively pursued by the medical profession in Australia and abroad. However, the uptake of CE in dentistry has been much slower and there is minimal Australian data on dental CE.

Methods: To determine the level of CE activity, in 1998, postal questionnaires were sent to all fellows of the Royal Australasian College of Dental Surgeons. The responses were analysed.

Results: There was a high reponse rate (90 per cent) but a moderate usable rate (54 per cent). The results show a biphasic distribution between high and low CE activity. The average amount of activity of those involved in CE was 116 hours per year, above the usually accepted minimum of 100 hours/year. Some groups, particularly members of the specialist divisions of oral and maxillofacial surgeons (215 hours) and periodontists (205 hours), have high levels of CE. However, approximately 25 per cent of college fellows reported little or no CE activity. The survey revealed that inactive fellows are more likely to be older and in general practice. Inactive fellows were also tardy in replying to the questionnaire.

Conclusion: The high activity CE group needs to be recognised and encouraged to continue. Specific plans to help the low CE activity group should be developed. Although these findings relate directly to the Royal Australasian College of Dental Surgeons, they are presented as they have implications for the dental profession at large.
Specific Orofacial Problems Experienced by Musicians
Authors: Yeo DKL , Pham TP , Baker J. , Porter SAT
Published: March 2008

Background: Patients who play musical instruments (especially wind and stringed instruments) and vocalists are prone to particular types of orofacial problems. Some problems are caused by playing and some are the result of dental treatment. This paper proposes to give an insight into these problems and practical guidance to general practice dentists.

Method: Information in this paper is gathered from studies published in dental, music and occupational health journals, and from discussions with career musicians and music teachers.

Results: Orthodontic problems, soft tissue trauma, focal dystonia, denture retention, herpes labialis, dry mouth and temporomandibular joint (TMJ) disorders were identified as orofacial problems of career musicians. Options available for prevention and palliative treatment as well as instrument selection are suggested to overcome these problems.

Conclusions: Career musicians express reluctance to attend dentists who are not sensitive to their specific needs. General practitioner dentists who understand how the instruments impact on the orofacial structures and are aware of potential problems faced by musicians are able to offer preventive advice and supportive treatment to these patients, especially those in the early stages of their career.
Comparison of Five Selective Media for the Growth and Enumeration of Streptococcus Mutans
Authors: Wan AKL , Seow WK , Walsh LJ , Bird PS
Published: March 2008

Background: Although a few growth media are available for selective isolation of the cariogenic bacteria, Streptococcus mutans (S. mutans), it is still unclear as to which is the most efficacious. This study compared the selectivity and sensitivity of five different media for growing a laboratory strain of S. mutans (NCTC 10449), and for enumerating S. mutans from teeth of a group of young children, aged 2–10 years.

Methods: The media tested in this study were mitis salivarius with bacitracin (MSB), mitis salivariuskanamycin‐bacitracin (MSKB), glucose‐sucrosetellurite‐bacitracin (GSTB), trypticase soy‐sucrosebacitracin (TYS20B) and tryptone‐yeast‐cysteinesucrose‐bacitracin (TYCSB) agars. These were prepared according to the respective manufacturer's instructions.

Results: The results showed that at concentrations of bacteria 1times103 to 1X1010/mL, the recovery of the laboratory S. mutans strain was highest in TYCSB agar, followed by in descending order by TYCSB, MSB, GSTB, and MSKB (p<0.01). Similar results were obtained using dental plaque samples collected from swabs of the teeth of a group of children. In the clinical samples, TYCSB again showed the highest recovery rates of S. mutans compared to the other four media. Results were reproduced at dilutions of the samples at 1:20times106 to 1:2times106, and S. mutans concentrations of 1.6 to 7.7 Log 10 CFU/mL. In addition, there were highest ratios of mutans to nonmutans bacteria in TYCSB compared to the other media, suggesting high selectivity of this media for mutans species.

Conclusion: The results of our study suggest that TYCSB is the most sensitive and selective media for culture of S. mutans for laboratory and clinical studies.
Reconstructive Techniques for the Repair of Oral and Maxillofacial Oncological Procedures: What are they, How do they Work and What do they Look Like?
Authors: Chandu A. , Bridgeman AM , Smith ACH , Flood SJ
Published: March 2008

Background: There are many different ways to reconsturct the oral and maxillofacial region post tumour ablation. In the past, the resection of oral tumours had been associated with significant disfigurement and loss of function. Modern techniques aim to restore function and improve cosmetics. This paper aims to describe the techniques used in patients treated at the Austin and Repatriation Medical Centre and to answer the more common questions associated with reconstructive techniques.

Methods: A review of techniques of oral reconstruction used by our unit over the last nine years and a review of the literature.

Results: Various techniques of reconstruction gained from our experience in treating patients with oral cancer are documented. There are a variety of techniques including grafts, local flaps, regional flaps and free vascularized flaps. Metallic implants such as osseointegrated dental implants may also be used for dental rehabilitation.

Conclusions: There are many different methods of reconstruction in patients who have had resection for oral tumours. It is important for general dental practitioners who may be involved with the care of such patients to have an understanding of the modern techniques of reconstruction that may be used.
Spontaneous Gingival Haemorrhage: Case Report
Authors: Gleeson P.
Published: March 2008

Clinical observation of our patients forms the basis of the dental examination, along with other more complex diagnostic tests. In this case, the gingival bleeding episode of one patient was initially diagnosed and treated as an acute periodontal episode. When simple therapy failed to resolve the bleeding, a full haematological investigation was ordered. This revealed the presence of a lifethreatening disease. The patient was immediately referred for medical management of acute myeloblastic leukaemia, but died some months later. Dentists should always be on guard to observe any unusual clinical signs that may lead to the early diagnosis of systemic disease processes.
Immediate Restoration of an Immediate Single‐Tooth Implant
Authors: Clausen GF , Chen ST
Published: March 2008

abstract

Traditional implant protocol specifies an unloaded healing period prior to restoration. Shorter healing times may be appropriate in some circumstances, and examples of early loading have been reported in the dental literature. This case report involves immediate implant placement at the time of tooth extraction, combined with construction of a restoration, inserted directly after implant surgery. The clinical procedures are described, and the specific indications which may permit this approach are presented.
A new era of dental education at the University of Sydney, Australia
Authors: Klineberg I. , Massey W. , Thomas M. , Cockrell D.
Published: March 2008

Dental education is currently under scrutiny in order to most appropriately address community needs for the new millennium. Educational outcomes need to include a commitment to life‐long learning, and an emphasis on professional ethics and moral responsibility. These needs are supported by new forms of information delivery with a focus on the electronic media, by student centred and selfdirected coursework, and by clinical stimulation. Additionally, at the University of Sydney, selection will follow a first degree. This will allow candidates time for an informed decision to be made for their future professional career and for a period of experience in the tertiary education system.
Strains in the Marginal Ridge During Occlusal Loading
Authors: Palamara JEA , Palamara D. , Messer HH
Published: March 2008

Background: The marginal ridge is considered fundamental to the ability of the tooth to resist functional and parafunctional occlusal loads without damage. Despite this role, very little is known of patterns of stress and strain in marginal ridges under load. This study investigated strains in proximal enamel of mandibular premolars using finite element analysis (FEA) and strain gauge measurements.

Methods: A three‐dimensional FEA model of a human mandibular premolar was developed using commercial FEA software, and strains were computed in response to loads simulating clenching and chewing functions. Strains were measured in extracted premolars using strain gauges mounted on the proximal surfaces, under similar occlusal loading conditions.

Results: Strains in the vicinity of contact areas and marginal ridges were lower than near the cementoenamel junction and on buccal and lingual surfaces. The magnitude of proximal strains increased with oblique loading on cuspal inclines. Finite element analysis results correlated well with strain gauge measurements and can be used to predict strain directions and magnitudes.

Conclusions: At least for mandibular premolars, the marginal ridges are not highly stressed areas during simulated occlusal loading.
Minimizing the Risks of Latex Allergy: The Effectivness of Written Information
Authors: Carrozzi FM , Katelaris CH , Burke TV , Widmer RP
Published: March 2008

Background: Latex allergy has been identified as an occupational risk for the dental profession. This study assessed whether identified latex‐allergic dental personnel changed their practices after receiving verbal and written information about the management of latex allergy.

Methods: A survey conducted at the 1998 Australian Dental Association Congress identified 157 dental personnel with clinical latex allergy, or at high risk from latex exposure. The workplace implications were then explained to them by a consultant allergist. Four weeks later, follow up written information on latex allergy was mailed out. The information sheet outlined possible symptoms and cross‐reactions, implications for the workplace, hand care advice and management strategies to reduce latex exposure in the workplace. After six weeks, a questionnaire, designed to assess whether appropriate steps to reduce latex exposure had been taken, was mailed out.

Results: Seventy per cent of the questionnaires were returned. All respondents felt the information was easy to understand and informative. While 50 per cent of respondents indicated that they had changed to powder‐free or non‐latex gloves, only five respondents were fully compliant with all instructions.

Conclusion: Compliance with instructions regarding minimizing exposure to latex in a group of latexallergic dental personnel was poor.
Dental erosion in asthma: A case‐control study from south east Queensland
Authors: Sivasitamparam K. , Young WG , Jirattanasopa V. , Priest J. , Khan F. , Harbrow D. , Daley TJ
Published: March 2008

Background: Asthma medication places patients at risk of dental erosion by reducing salivary protection against extrinsic or intrinsic acids. But patterns of lesions in asthmatics may differ from patterns in non‐asthmatics, because gastro‐oesophageal reflux (GOR) is found in 60 per cent of asthmatics

Methods: The lesions in 44 asthma cases were compared to those of age and sex match controls with no history of asthma or medications drawn from the dental records of 423 patients referred concerning excessive tooth wear. The subjects were 70 males age range 15 to 55 years and 18 females age range 18 to 45. Anamnestic clinical data were compared between the two groups. Models of all 88 subjects were examined by light microscopy, and wear patterns were recorded on permanent central incisor, canine, premolar and first molar teeth.

Results: Clinical differences were a higher incidence of tooth hypersensitivity, xerostomia, salivary gland abnormalities, gastric complaints, and self induced vomiting in the cases. No differences were found between the cases and controls on citrus fruit and acid soft drink consumption. More occlusal erosion sites were found in cases, whereas more attrition sites were found in the controls. There were no significant differences in palatal erosion on maxillary anterior teeth found between cases and controls. Lingual erosion of the mandibular incisors, found only in GOR patients, was not observed.

Conclusions: A higher incidence of erosion was found in asthmatics. Gastro‐oesophageal reflux symptoms were not associated with the sign of lingual mandibular incisor erosion. The clinical significance is that asthmatics are at risk of dental erosion from extrinsic acid, but GOR does not appear to contribute in a site‐specific manner.
Dental screening of older adults living in residential aged care facilities in Perth
Authors: Stubbs C. , Riordan PJ
Published: March 2008

Background: This study aimed to estimate the dental treatment needs and oral health status of a sample of older adults in residential aged care facilities in Perth.

Methods: The 348 participants (65 years) were interviewed and screened in 25 facilities. The screenings were carried out by one examiner using a mirror and a portable light.

Results: Over half (52 per cent) of the participants were edentulous and 45 per cent of those edentulous participants for whom a recording was made (n=174) had oral mucosal conditions. The 164 dentate participants had a mean of 12 disease‐free standing teeth, a mean decayed, missing or filled teeth (DMFT) of 24.7 (mean DT 0.8, mean FT 5.3) and half of them required the removal of supragingival calculus. Of those with root caries experience (n=127), a mean of 1.3 untreated decayed roots and a mean of 1.9 roots covered in plaque were recorded. The majority of the participants (83 per cent) were pensioners eligible for government subsidized dental care and 47 per cent were reported by the Directors of Nursing to have dementia.

Conclusions: The data collected here demonstrate poor oral health conditions and a substantial treatment need in a neglected population. More people in nursing homes and hostels are keeping their natural teeth compared with a similar population studied 13 years ago.