bluuebunny/crossref_metadata_2025_split huggingface dataset:
An interdisciplinary approach to the management of complex medical and dental conditions
Authors: Rogers JPH , Stewart PR , Stapleton JV , Hribar DL , Adams P. , Gale AE 
Published: March 2008

AbstractDental and medical practice often requires an interdisciplinary approach integrating the knowledge, skills and experience of all the disciplines of dentistry, medicine and its associated fields into comprehensive treatment to maximize results. Rapid and comprehensive scientific and technological advances have made it difficult for dental and medical practitioners to keep up to date in their fields; thus, to decrease practitioner frustration and increase patient benefits, an interdisciplinary approach has become essential. This report illustrates how therapy was coordinated for a young medically compromised patient with dental phobia and significant dental problems. The latest advances in dental techniques and materials, medical technology and pharmacology are highlighted. The communication and cooperation of team members with each other and with the patient and guardians is illustrated. The astute observation by a medical practitioner in an unrelated discipline led to the improvement in the quality of life for a patient.
Quinine induced coagulopathy ‐ a near fatal experience
Authors: Hawthorne M. , Sim R. , Acton C.H.C. 
Published: March 2008

AbstractA 67 year old man presented to his local dentist for restorative treatment. He stated he was fit and well and denied taking any medications. When he was given an inferior alveolar nerve block, excessive bleeding was noted at the injection site and the dentist advised the patient see an oral land maxillofacial surgeon. An appointment was made for the patient but he did not attend. Three days later, he presented with evidence of massive deep haemorrhage to the point of airway compromise. He underwent hospital admission, early intubation, intensive care for nine days and hospitalization for six weeks. The cause of his bleening was a severe thrombocytopoaenia, induced by chronic ingestion of quinine. He was self‐medicating with this to relieve muscular cramps. Despite this experience, the patient continued to deny that quinine was the cause of his problem and that he had failed in his obligations to advise the dentist of his drug history. Dentists need to be alert to the risk that patients may not reveal their true medical history. There are, however, obligations on the dentist to ensure the accuracy of information the patient gives and to ensure that patients whom they believe are at risk follow their advice. Teamwork and skilful airway management prevented this patient's demise.
Tooth loss and implant replacement
Authors: Henry P. J. 
Published: March 2008

AbstractOsseointegrated dental implants are increasingly used to replace missing teeth in a variety of situations ranging from the missing single tooth to complete edentulism. The implant possibility must be carefully considered because treatment involves extended time frames, considerable expense and is not without risk. Accordingly, treatment‐planning decisions should have an evidence‐based strategy with appropriate risk assessment. Implant systems need to be adequately tested before they are released for general use and success rates should be assessed from peer review scientific publication data and not commercial promotional literature. It is the responsibility of the dentist to ensure the patient is educated so an informed decision can be made on difficult treatment alternatives. The clinical decision making process must respect the issues to assure quality of care and reduction of liability for negligent care. Today, the three‐unit fixed bridge can no longer be considered as the standard of care for restoration of a single missing tooth. The evidence has accumulated that the single tooth implant supported replacement is more conservative, more cost‐effective and more predictable with respect to longterm outcome in uncomplicated cases.
Analysis of fluoride levels retained intraorally or ingested following routine clinical applications of topical fluoride products
Authors: Heath K. , Singh V. , Logan R. , McIntyre J. 
Published: March 2008

AbstractA variety of topical fluorides is now used clinically for the prevention and control of dental caries. It is essential for the dental profession to be fully aware of the relative retention rates of fluoride in saliva and thus its contact with the teeth. These may vary following the use of the different categories and concentrations of agents available and with different methods of use. It is also important to be aware of the amounts of fluoride ion ingested following use of the more concentrated forms and of the resultant elevation in total blood fluoride levels.These parameters were investigated in a series of experiments invlolving human volunteer subjects using a variety of topical fluoride materials commercially available in Australia. Fluoride commercially available in Australia. Fluoride mouthrineses appeared to provide the highest salivary retention rates per dose of all forms of topical fluoride. Ingestion rates from concentrated gels were acceptable when effective evacuation methods were applied. The use of custom‐made trays resulted in a reduction in amounts of fluoride ion ingested, though simple self‐application by toothbrush of smaller quantities proved to be an effective alternative in terms of amount of fluoride ion retained in saliva per amount applied and ingested. None of the concentrated gels used resulted in elevations in total blood fluoride levels which were of concern in adults.It is acknowledged that salivary retention rates of fluoride ion do not necessarily reflect the caries inhibitory effects of topical fluorides. However, these data provide some indication of possible advantages of some products and methods of application over others.
A protocol for the dental management of von Willebrand's disease, haemophilia A and haemophilia B
Authors: Stubbs M. , Lloyd J. 
Published: March 2008

AbstractA guide for the dental management of the three inherited bleeding disorders, von Willebrand's disease, haemophilia A and haemophilia B, was established jointly by the Institute of Medical and Veterinary Science Transfusion and Haemostasis Unit in conjunction with the Medically Compromised Dental Unit at the Adelaide Dental Hospital. This protocol was subjected to a successful trial for 24 months.
A study of the dental treatment needs of children with disabilities in Melbourne, Australia
Authors: Desai Mala , Messer Louise Brearley , Calache Hanny 
Published: March 2008

AbstractA selected population of children with disabilities in Melbourne, Australia, was studied with reference to their oral disease and treatment needs. A total of 300 children (aged 9–13 years), 150 attending special developmental schools (SDS) and 150 attending special schools (SS), received an oral examination and the parent/guardian completed a questionnaire. Six levels of function were defined, based on the child's independence for five selfcare activities (brushing teeth, feeding self, dressing self, walking and performing toilet). The caries experience of children in the SS was lower than in SDS (d+D: 1.3±1.6 versus 1.5±2.4; dmft+DMFT: 2.0±2.3 versus 2.5±3.1); those attending SDS had higher unmet preventive and restorative needs. Significant associations were seen between the number of decayed teeth, the dmft+DMFT index, and the level of function (p<0.005). Periodontal disease was prevalent; significant associations were seen between periodontal status, the need for periodontal therapy, and the level of function (p±0.005). Assessment of the level of function by staff could assist in triaging individuals for urgent dental examination. Despite 41 per cent of children requiring simple treatment, the preventive and treatment needs of many remained unmet. Following examination, diagnosis and treatment planning by a dentist, much of the preventive, simple treatment and oral health promotion could be performed by trained dental auxiliaries. An epidemiological survey followed by the implementation and evaluation of a long‐range public dental health care plan for children and adolescents with disabilities is needed urgently.
Concepts for the Prophylaxis of Infective Endocarditis in Dentistry
Authors: Tetsas Angelo , Ferguson Martin M. 
Published: March 2008

AbstractOral commensal microorganisms are commonly associated with the pathogenesis of infective endocarditis. Despite modern antimicrobial and surgical treatment, infective endocarditis continues to cause substantial morbidity and mortality. Although dentistry is no longer considered a major risk factor for infective endocarditis, it is current standard of practice that dental procedures likely to produce significant bacteraemia in patients who are susceptible to this disease be prophylactically covered with an antimicrobial agent. The concepts of antimicrobial prophylaxis prior to invasive dental procedures are outlined in this review, with particular reference to the latest recommendations of the Australian Dental Association.
Pits and Fissures: Etch Resistance in Prismless Enamel Walls
Authors: Burrow MF , Burrow JF , Makinson OF 
Published: March 2008

Background: In a previous study to examine the nature of etching on the walls of fissures, there was a consistent result of resistance to deep etching on parts of the walls and a zone of lesser etching on part of the walls as evidenced by the uptake of stain. The staining had been used to examine the nature of the etch pattern. The aims of this study were to define the nature of this etch resistant area.Methods: A sample of 55 teeth, both molars and premolars, were divided into three groups. In the first group the wetting of fissures by the etchant was examined; the second group tested for the effects of pellicle‐cuticle‐debris or air entrapment on the etching process. The final group looked at alternative mechanical treatments of the fissure prior to etching.Results: The specimens split along the fissures showed clearly that the etch resistant zone was not due to lack of contact with the etchant or the presence of a pellicle‐cuticle‐debris covering, but to the presence of a prismless enamel structure. This study showed that this zone inhibited tag development on the fissure walls.Conclusions: The mechanical removal of this prismless layer of enamel within the fissure system should result in an improved bonding of a fissure sealant through better tag development, in turn leading to a reduction in the failure rate of a sealant used to prevent caries.
The Shelf‐Life of Sodium Hypochlorite Irrigating Solutions
Authors: Clarkson RM , Moule AJ , Podlich HM 
Published: March 2008

Background: Sodium hypochlorite (bleach) solutions are widely used as irrigants in endodontics. Their tendency to deteriorate is worsened by environmental influences which could cause loss of available chlorine content.Methods: This study measured the loss of available chlorine concentration in a range of sodium hypochlorite solutions under conditions which mimic clinical usage and storage. Domestic bleach, both undiluted and diluted with demineralised water or hard water, was tested, along with Milton, for initial concentration of available chlorine, and then retested after varying periods and modes of storage to measure loss of chlorine concentration. The types of storage were: (1) in closed plastic bottles which were opened daily and agitated; (2) in open plastic bottles; (3) in syringes exposed to sunlight; (4) in syringes kept in the dark; (5) in open stainless steel bowls; (6) in closed stainless steel bowls; and (7) when heated to 50øC. Not all solutions were tested under all storage conditions.Results: Of the solutions opened daily, undiluted domestic bleach was the most stable and Milton was the least stable. Initially, diluted bleach left open deteriorated rapidly but deterioration slowed with time. Solutions in syringes exposed to sunlight showed the most rapid loss of chlorine content. Heated bleach lost nearly 5 per cent of its strength in six hours. Diluted bleach surprisingly, increased its chlorine concentration in open bowls probably due to evaporation of water. Dilution of bleach with hard tap water did not significantly affect shelf‐life. Preloading of diluted bleach into syringes appears to be a sound technique if the syringes are stored away from light.Conclusions: This study reinforces the need for sodium hypochlorite to be stored in closed opaque containers. Constant opening of containers appears to cause greater loss in chlorine concentration of diluted bleach solutions, perhaps because a lower concentration of sodium hydroxide allows the pH to drop more rapidly.
A Comparison of Stainless Steel Hand and Rotary Nickel‐Titanium Instrumentation Using a Silicone Impression Technique
Authors: Chen JL , Messer HH 
Published: March 2008

Abstract Background: Root canal preparation using rotary nickel‐titanium instruments has been reported to be superior to hand instrumentation in terms of root canal shape, centring and frequency of procedural errors. The purpose of this study was to evaluate canal preparations using a sequential silicone impression technique to assess root canal morphology. Methods: Pre‐operative canal impressions were obtained from 24 extracted single‐rooted premolars. Canals were randomly assigned to be firstly, instrumented with stainless steel K‐type files or rotary nickel‐titanium instruments (Profile), then further apically enlarged with rotary nickel‐titanium instruments (Profile or Lightspeed). Post instrumentation impressions were taken and digitally photographed in a bucco‐lingual and mesio‐distal orientation at low‐power magnification. Images were evaluated for procedural defects, changes in canal curvature, canal enlargement and canal rounding at 1, 3 and 7mm from the working length. Results: Silicone impressions could accurately reproduce the detailed root canal morphology of single‐canal premolars. Repeated impressions of each canal using a standardized procedure allowed a detailed comparison of instrumentation techniques at various stages. Hand instrumentation incurred more errors than rotary nickel‐titanium instrumentation (Profile). Further apical enlargement using Lightspeed instruments incurred fewer errors than with Profile instruments. Differences among techniques were highly significant (p<0.005). All techniques resulted in slight canal straightening, as well as rounder and enlarged canals particularly in the apical third. Conclusions: Rotary nickel‐titanium instrumentation, especially Lightspeed, may produce better canal shape by reducing procedural errors.
A Comparison of Kodak Ultraspeed and Ektaspeed Plus Dental X‐ray Films for the Detection of Dental Caries
Authors: Wong A. , Monsour PA , Moule AJ , Basford KE 
Published: March 2008

Abstract Background: Using the fastest dental X‐ray film available is an easy way of reducing exposure to ionizing radiation. However, the diagnostic ability of fast films for the detection of proximal surface caries must be demonstrated before these films will become universally accepted.Methods: Extracted premolar and molar teeth were arranged to simulate a bitewing examination and radiographed using Ultraspeed and Ektaspeed Plus dental X‐ray films. Three different exposure times were used for each film type. Six general dentists were used to determine the presence and depth of the decay in the proximal surfaces of the teeth radiographed. The actual extent of the decay in the teeth was determined by sectioning the teeth and examining them under a microscope.Results: There was no significant difference between the two films for the mean correct diagnosis. However, there was a significant difference between the means for the three exposure times used for Ultraspeed film. The practitioners used were not consistent in their ability to make a correct diagnosis, or for the film for which they got the highest correct diagnosis.Conclusions: Ektaspeed Plus dental X‐ray film is just as reliable as Ultraspeed dental X‐ray film for the detection of proximal surface decay. The effect of underexposure was significant for Ultraspeed, but not for Ektaspeed Plus. Patient exposure can be reduced significantly with no loss of diagnostic ability by changing from Ultraspeed X‐ray film to Ektaspeed Plus X‐ray film.
Tooth Wear in Children with Down Syndrome
Authors: Bell EJ , Kaidonis J. , Townsend GC 
Published: March 2008

AbstractBackground: Several studies have described the impact that dental caries and periodontitis may have on the dentitions of individuals with Down syndrome, but there are few reports about the effects of tooth wear. This investigation aimed to compare the aetiology, prevalence and severity of tooth wear in 49 cytogenetically confirmed Down syndrome children with 49 non‐Down syndrome controls.Methods: This study involved three aspects: an oral examination, including obtaining dental impressions; a dietary analysis spanning three days; and a questionnaire seeking information about habits, medical problems and medications. Tooth wear severity was scored on a 4‐grade scale (none‐to‐little; moderate; severe; very severe), while aetiology was classified as being due to attrition mainly, erosion mainly, or a combination of both. Double determinations established scoring method reliability and chi‐square tests assessed associations between samples.Results: Tooth wear was significantly more frequent (p<0.01) in the Down syndrome than the non‐Down syndrome sample (67.4 per cent cf 34.7 per cent), with more of the Down syndrome children showing severe to very severe wear (59.2 per cent cf 8.2 per cent). Significantly more Down syndrome children (p<0.05) displayed a multifactorial aetiology of tooth wear, i.e., both attrition and erosion (46.7 per cent cf 28.6 per cent), although no particular dietary link was established. Gastric reflux and vomiting were reported in over 20 per cent of the Down syndrome sample.Conclusions: Given the potential consequences of high levels of tooth wear, associated with tooth grinding and an acidic oral environment in Down syndrome children, educational programmes aimed at increasing awareness of carers and health professionals are needed urgently.
Oral Health of Children with Gastro‐Esophageal Reflux Disease: A Controlled Study
Authors: Linnett V. , Seow WK , Connor F. , Shepherd R. 
Published: March 2008

Background: The aim of this study was to compare the dental health of children with gastro‐esophageal reflux disease (GERD) with a healthy control group. Methods: Dental examinations were conducted for 52 children (31 boys and 21 girls) with a definitive history of GERD. For every subject enrolled in the study, a healthy control sibling without the condition was recruited. Medical histories were obtained from medical records, and dental and dietary histories were obtained from parents. The teeth were examined for erosion, dental caries, and enamel hypoplasia, and sampled for Streptococcus mutans. Results: The prevalence of erosion by teeth was found to be statistically significant between GERD patients (14 per cent) and controls (10 per cent) (p<0.05). GERD patients had erosion in more permanent teeth compared to controls (4 per cent vs 0.8 per cent, p<0.05), and more severe erosion (p<0.05). Caries experience was also higher in GERD patients compared to controls (p<0.05). Although there were more subjects with Streptococcus mutans in the GERD group compared to the control group (42 per cent vs 25 per cent), the difference was not statistically significant. Conclusions: Children with GERD have more erosion and dental caries compared to healthy controls and should be targeted for increased preventive and restorative care.
Adhesions in the Temporomandibular Joint: Formation and Significance
Authors: Hase M. 
Published: March 2008

Background: Adhesions are frequently seen in the deranged temporomandibular joint (TMJ). In the early stage of the degenerative process the adhesion does not seem to be a significant factor in reduced mandibular movement. This is reversed in advanced degenerative joint disease where the adhesion requires release to achieve a satisfactory clinical result. Correlation of clinical history and findings within the joint should increase understanding of limited jaw movement. Methods: Arthroscopic examination of deranged TMJs was performed on 75 patients with limited jaw opening and correlated with the history of the derangement. Results: A progressive maturation of adhesion formation was observed with longer standing symptoms. A different adhesion pattern was noted with derangement caused by direct trauma on the joint. Conclusions: Internal derangement of the TMJ is associated with formation of intra‐articular adhesions. These are unlikely to be associated with reduced condyle movement in the early phase of the derangement. Later stage adhesions are more substantial and require release to achieve a satisfactory clinical outcome.
Ethical Dilemmas Confronting Dentists in Queensland, Australia
Authors: Porter SAT , Grey WL 
Published: March 2008

AbstractBackground: This paper details contemporary ethical dilemmas encountered by Queensland dentists.Methods: An age‐stratified sample of 499 dentists resident in Queensland was surveyed. The questionnaire contained scenarios of five common ethical dilemmas. In addition, open‐ended questions sought the respondent's most frequent, difficult and recent ethical dilemmas, and where they would seek guidance in dealing with ethical problems.Results: Respondents acknowledged the patient's rights in treatment decisions and the dentist's right to refuse demands for inappropriate treatment. However, responses varied in the extent to which dentists may influence treatment decisions. Few respondents would ignore evidence of poor dental treatment but they are evenly divided in choosing to inform the patient, the dentist or both. Poor quality treatment is the most frequent and difficult dilemma, and half have experienced this problem recently. Requests by patients for fraudulent receipts occur in a third of responses. Dentists develop ethical values from multiple sources but for help with dental ethical problems, 90 per cent of respondents would consult another dentist.Conclusions: Of the ethical dilemmas discussed in this survey, those relating to poor quality treatment confronted most respondents. Also the actions of dentists in dealing with these dilemmas were most varied.
An Investigation into the Use of Pilocarpine as a Sialagogue in Patients With Radiation Induced Xerostomia
Authors: Frydrych AM , Davies GR , Slack‐Smith LM , Heywood J. 
Published: March 2008

AbstractBackground: Radiation therapy to the head and neck region can be an effective form of treatment for malignancies. Unfortunately damage to salivary glands may occur. Treatment of resultant dry mouth is at present very poor. The purpose of this pilot study was to investigate whether pilocarpine dissolved in artificial saliva and administered in a mouth spray would be effective in relieving such symptoms.Methods: Twenty‐three patients with radiation induced hyposalivation were recruited for this randomized, double‐blind investigation. Subjects were randomly allocated to placebo or control medicaments used for eight weeks. All subjects were evaluated for the severity of their xerostomia associated symptoms prior to administration of the spray and again eight weeks later.Results: The questionnaire and the visual analogue scale did not reveal any improvements in the dry mouth symptoms between cases and controls. Sideeffects were reported among cases, mostly mild and tolerable. All patients taking pilocarpine (with base salivary flow rates > Om1/min) demonstrated improvement in stimulated and unstimulated salivary flow rates. Candida counts decreased among the cases and controls although decrease among the cases was much greater.Conclusions: The results obtained indicate that provided residual functioning salivary tissue exists, pilocarpine used as formulated is effective and warrants further investigation.