(ii) Spondylolysis & spondylolisthesis

Spondylolysis and spondylolisthesis are not uncommon findings in the patient presenting with back pain. A full understanding of the natural progression of this disorder is important to guide correct management. Typically, non-surgical treatment modalities are the mainstay of treatment; however, careful assessment is required to allow identification of the patients for whom surgical intervention would be beneficial.A review of the aetiology, natural progression, clinical findings and radiological appearances is presented below, along with a consideration of management strategies that can be utilized in this condition.     

The efficacy of oral lumenoscopy™ (ViziLite®) in visualizing oral mucosal lesions

Early diagnosis of oral mucosal lesions has been advocated as a means of improving outcomes of cancer therapy. Improved visualization of mucosal lesion* may aid in diagnosis by guiding tinue sampling or referral. This multi‐center study reports the effect of chemiluminescent light (ViziLite) upon visualization of mucosal lesions. The cftemiluminescent light did not appear to improve visualization of red lesions, but white lesions and lesions that were both red and white showed enhanced brightness and sharpness.     

Effect of a fluoride varnish (Duraphat®) in preschool children

The caries-preventive effect of semiannual applications of a fluoride varnish (Duraphat) was tested for 2 years in 225 3-year-old children; 113 children served as a control group. At the baseline examination, 69% of the children in the test group and 75% in the control group were caries-free. The results after 2 years showed an average caries increment of 2.1 surfaces in the test group and 3.7 in the control group. The difference is statistically significant. Thirty-eight percent of the children in the test group and 27% in the control group were still caries-free. The caries reduction was 44%.     

Nicotine modulates gelatinase B (MMP‐9) and epilysin (MMP‐28) expression in reconstituted human oral epithelium

J Oral Pathol Med (2011) 40 : 33–36 Oral epithelial keratinocytes express nicotinic cholinergic receptors which activation modulates keratinocytes differentiation and migration through different metabolic pathways. Matrix metalloproteinases (MMPs) are Zn‐dependent enzyme involved in cell migration. Among them, gelatinase B (MMP‐9) and epilysin (MMP‐28) are two MMPs expressed by human keratinocytes during both wound healing and proliferation. Their expression has been investigated in a reconstituted human oral epithelium (HOE) exposed to nicotine (Nic, 1–50 μM) for 72 h both in the absence and presence of the nicotinic antagonist mecamylamine (Mec), H7, a PKC inhibitor and PD98059, a MAPK inhibitor (PD). At the end of treatment, MMP‐28 expression has been analyzed in epithelium sections using an anti‐MMP‐28 antibody, whereas MMP‐9 presence and activity has been measured in cell‐conditioned medium analyzed by gelatine zymography. The expression of MMP‐9 was reduced by Nic in a dose‐dependent fashion and this effect was antagonized by Mec, H7 and PD. On the other hand, Nic increased the expression of MMP‐28, and this effect was blocked both by H7 and PD, whereas Mec even enforced it. Nic effects on MMP‐9 and MMP‐28 expression by oral keratinocytes were not previously reported and these data suggest MMPs expression mediated by PKC and MAPK as a possible target for Nic toxicity in oral epithelium.     

Primary tooth injuries in Norwegian children (1–8 years)

Abstract –  This prospective study examined the yearly incidence of traumatic injuries to primary teeth. The aim of the study was to find out more about dental injuries to primary teeth in Norwegian children. The study was performed in one county of Norway involving approximately 20 000 children in the age group 1–8 years. Twenty-seven public dental clinics and 42 dentists participated. The dentists attended information and calibration meetings and received illustrations of the classification of dental trauma as well as examples of how to fill in the forms correctly. Two hundred and sixty-six children were involved, including 447 primary teeth, recorded during a 1-year registration period (2003). The dental trauma incidence was 1.3% with 3.5-year old being the most accident-prone. Boys were significantly more often injured than girls, 164 versus 102 ( P  < 0.001). The upper central incisors were most involved (92%), with a non-significant difference between the right and left side. The minor periodontal injuries dominated (59%). Hard tissue injuries were far less frequent (13%). Avulsions were observed in 6.5% and intrusions in 7.5% of the injured children, being 5.5% and 5% of the injured teeth. Most of the injuries occurred either at home (38%) or at kindergarten (32%). Sixty-two percentage were falling accidents often sustained during children's play, and 25% were pure playing accidents.
Conclusion:  In Norwegian children aged 1–8 years, with a predominance of boys, the most common primary tooth injuries were minor luxations of the maxillary central incisors, sustained at an age of 3.5 years. As the traumas often occurred during children's play and/or were the consequence of falls, these are difficult to prevent. However, follow ups should be carried out to disclose pulpal or periodontal complications and/or developmental disturbances of the permanent successors.     

Front tooth replacement with Tübingen (Frialit®) implants

127 Tübingen (Frialit®) implants have been clinically evaluated for a 10 year period. The implants were placed in the anterior region of the maxillae of 101 patients to replace lost incisors, cuspids and premolars. Seventy-seven implants were placed within 3 months after loss of a natural anterior tooth, resulting in the preservation of the volume of the alveolar ridge and the contour of the surrounding soft tissues. This preservation of the volume of the alveolar ridge was due to the fact that the Tübingen implants have conical shapes and sizes, equal to those of the roots of natural teeth.
The dentine-like colour and the biological properties of the bio-inert Al₂O₃ implant-material, in most of the cases was an advantage to the aesthetics of the prosthetic restorations and to the condition of the soft tissues in the permucosal area. The Tübingen implant is placed with a one-phase technique implying special care for the temporary restorations to avoid premature loading. Also prevention of overloading the ceramic material by the fixed restoration needs special attention in the construction of posts, cores and crowns. The overall survival-rate in this study with a mean follow-up of 4–5 years was 87%. Patient and dentist satisfaction was high.     

Comparison of platelet-rich fibrin (PRF) produced using 3 commercially available centrifuges at both high (~ 700 g) and low (~ 200 g) relative centrifugation forces

Clinical Oral Investigations - Platelet-rich fibrin (PRF) has gained tremendous momentum in recent years as a natural autologous growth factor derived from blood capable of stimulating tissue...