Nevoid basal cell carcinoma syndrome: a 17‐year study of 19 cases in Iranian population (1991–2008)

J Oral Pathol Med (2010) 39 : 677–680 Background: Nevoid basal cell carcinoma syndrome (NBCCS) is a hereditary autosomal dominant disorder with a wide range of clinical signs and symptoms. The major criteria are more than two basal cell carcinoma, keratocystic odontogenic tumor, three or more palmar pits, and calcification of the falx cerebri, spine and rib anomalies, and a family history of the syndrome. Methods: This study reports 19 cases in an Iranian population and presents this rare syndrome as a differential diagnosis of skeletal anomalies. Between 1991 and 2008, the demographic, clinical, radiologic and histologic data of 19 patients with NBCCS were analyzed. Results: The average age at the time of diagnosis of NBCCS was 35.12 years. All patients had a minimum of two major criteria. The major criteria with the most frequency were the keratocysts odontogenic tumor (19 patients), and the average number was 6.2. Basal cell carcinoma (8 patients), and the average number was 14.7 calcification of the falx cerebri (17 patients), palmo‐plantar pits (14 patients), mild hypertelorism (10 patients), and bilateral cleft lip and palate (1 patient). Only one patient was affected with an unusual case of NBCCS in a 30‐year‐old man with an associated squamous cell carcinoma of the maxillary sinus. Only two cases of this unusual association have been reported. This case is one of a large family including 14 NBCCS‐affected patients.     

Learned and unlearned concepts in periodontal diagnostics: a 50‐year perspective

In the past 50 years, conceptual changes in the field of periodontal diagnostics have paralleled those associated with a better scientific understanding of the full spectrum of processes that affect periodontal health and disease. Fifty years ago, concepts regarding the diagnosis of periodontal diseases followed the classical pathology paradigm. It was believed that the two basic forms of destructive periodontal disease were chronic inflammatory periodontitis and ‘periodontosis’– a degenerative condition. In the subsequent 25 years it was shown that periodontosis was an infection. By 1987, major new concepts regarding the diagnosis and pathogenesis of periodontitis included: (i) all cases of untreated gingivitis do not inevitably progress to periodontitis; (ii) progression of untreated periodontitis is often episodic; (iii) some sites with untreated periodontitis do not progress; (iv) a rather small population of specific bacteria (‘periodontal pathogens’) appear to be the main etiologic agents of chronic inflammatory periodontitis; and (v) tissue damage in periodontitis is primarily caused by inflammatory and immunologic host responses to infecting agents. The concepts that were in place by 1987 are still largely intact in 2012. However, in the decades to come, it is likely that new information on the human microbiome will change our current concepts concerning the prevention, diagnosis and treatment of periodontal diseases.     

A logbook for continuous self-assessment during 1 year in paediatric dentistry.

AIM: The present study was designed to investigate whether a logbook helps undergraduate students to develop the ability to self-reflect and to increase their self-awareness. METHODS: A logbook was introduced to 54 dental students in their fourth year of education at the beginning of the paediatric dentistry course. The students filled in a questionnaire on learning styles at the start of the course and after 12 months. RESULTS: The results showed that at the end of the course significantly fewer students wished to be given detailed instructions to solve problems. Significantly more students felt able to expose both their weaknesses and strengths in clinical competence in the presence of their teachers. Students who reported a good knowledge of their own clinical skills found feedback from instructors more constructive compared with those who reported less good knowledge. CONCLUSION: For a large group of students, the logbook stimulated self-reflection, learning from personal clinical experience, and an increase in knowledge about their weaknesses and strengths in clinical competence.     

Efficacy of stabilisation splint treatment on facial pain – 1‐year follow‐up

The aim of this randomised controlled trial was to assess the efficacy of stabilisation splint treatment on TMD‐related facial pain during a 1‐year follow‐up. Eighty patients were randomly assigned to two groups: splint group (n = 39) and control group (n = 41). The patients in the splint group were treated with a stabilisation splint and received counselling and instructions for masticatory muscle exercises. The controls received only counselling and instructions for masticatory muscles exercises. The outcome variables were the change in the intensity of facial pain (as measured with visual analogue scale, VAS) as well as the patients' subjective estimate of treatment outcome. The differences in VAS changes between the groups were analysed using variance analysis and linear regression models. The VAS decreased in both groups, the difference between the groups being not statistically significant. The group status did not significantly associate with the decrease in VAS after adjustment for baseline VAS, gender, age, length of treatment and general health status. The only statistically significant predicting factor was the baseline VAS, which was also confirmed by the mixed‐effect linear model. After 1‐year follow‐up, 27·6% of the patients in the splint group and 37·5% of the patients in the control group reported ‘very good' treatment effects. The findings of this study did not show stabilisation splint treatment to be more effective in decreasing facial pain than masticatory muscle exercises and counselling alone in the treatment of TMD‐related facial pain over a 1‐year follow‐up.     

Minimal intervention dentistry for managing dental caries – a review

This publication describes the history of minimal intervention dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non‐restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow‐up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the ‘surgical’ care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI's policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing.     

Student self‐confidence in coping with uncooperative behaviours in paediatric dentistry

During paediatric dental treatment, non‐collaboration and fearful reactions are frequently observed in the child client. The dentistry student must be prepared to cope with these reactions, particularly considering the importance of the relationship between dentists and patients in the promotion of oral health. The present study aimed to assess undergraduate dentistry students’ perceptions of their ability to cope with non‐collaboration situations in paediatric dentistry. A Likert‐style questionnaire was used to analyse students’ self‐confidence levels, and proposed solutions to 10 problem situations the students would be likely to encounter were recorded. The questionnaire was administered to two undergraduate dentistry student groups from two different Brazilian Public Faculties, comprising 122 respondents. The self‐confidence analysis indicated that it varied according to the extent of the child’s reaction and the invasiveness of the procedure. Responses to the open‐ended questions were categorised by solution proposed, and the analysis indicated that the most frequent responses were categorised as follows: tranquilising, explanation and restriction. Significant differences were found in tranquilising (with higher values for Faculty 2 than 1, and higher values for female students than male students at Faculty 2) and restriction (with higher values for female students compared with male student at both Faculties). The results and discussion focused on the aspects of training dentistry students’ social and behavioural management skills.     

Management of a 9‐year‐old boy experiencing severe dental injury – a 21‐year follow‐up of three autotransplants: a case report

Abstract – The replacement of missing anterior teeth is a particular challenge in children and adolescents. This report describes the management of a 9‐year‐old boy suffering a severe dental injury. The treatment included three autotransplantations and orthodontic space closure to replace four maxillary teeth. A follow‐up period of 21 years demonstrated a successful outcome. Autotransplantation of premolars in growing individuals is a predictable method for replacement of missing teeth and for re‐establishment of the alveolar process after traumatic bone loss. This case report shows that a multidisciplinary approach is essential for the management and outcome of severe dental injuries in children.     

Long‐term implant survival and success: a 10–16‐year follow‐up of non‐submerged dental implants

Objectives: The aim of the present study was to evaluate the long‐term results of dental implants using implant survival and implant success as outcome variables. Methods: Of the 76 patients who received 162 implants of the Straumann Dental Implant System during the years 1990–1997, 55 patients with 131 implants were recalled 10–16 years after implant placement for a complete clinical and radiographic examination, followed by a questionnaire that examined the degree of satisfaction. The incidence of biological and technical complications has been carefully analysed for each implant. Success was defined as being free of all these complications over the entire observation period. Associated factors related to peri‐implant lesions were analysed for each implant. Results: The long‐term implant cumulative survival rate up to 16 years was 82.94%. The prevalence of biological complications was 16.94% and the prevalence of technical complications was 31.09%. The cumulative complication rate after an observation period of 10–16 years was 48.03%, which meant that substantial amounts of chair time were necessary following implant placement. The majority of implant losses and biological complications were concentrated in a relatively small number of patients. Conclusion: Despite a relatively high long‐term survival rate, biological and technical complications were frequent. Patients with a history of periodontitis may have lower implant survival rates than patients without a history of periodontitis and were more prone to biological complications such as peri‐implant mucositis and peri‐implantitis. To cite this article :
Simonis P, Dufour T, Tenenbaum H. Long‐term implant survival and success: a 10–16‐year follow‐up of non‐submerged dental implants.
Clin. Oral Impl. Res. 21 , 2010; 772–777
doi: 10.1111/j.1600‐0501.2010.01912.x