Osteopetrosis—Prosthodontic treatment

The general, physical, and dental findings of osteopetrosis were described. The diagnosis and treatment of a patient with this disease were discussed. The patient was successfully treated with maxillary and mandibular overlay dentures. The treatment improved the patient's appearance, morale, and general outlook on life.     

Dialogue—A treatment modality

The findings and philosophy as to why a purposeful interview conducted in the dental office is desirable for the problem patient have been presented. Rapport and meaningful dialogue between dentists and patients are the first steps necessary for successful treatment. Conducting the interview with problem patients in the dental operatory may lead to one-way communication, from the dentist to the patient. The finest clinical oral health procedures may be doomed to failure when patients see themselves more as spectators than as participants in their planned over-all health care.     

Intravenous sedation—a review*

Abstract — The intravenous injection of diazepam as an analgesic has limitations and there is an urgent need for reappraisal of the rationale for its use. Evidence presented by various writers on its value is criticized, particularly the absence in the literature of reports on the prevalence of complications which are known to occur. Supplementation of diazepam with methohexitone is not recommended.     

Vienna 2002—almost there

With the Vienna Congress just a few weeks away, arrangements are well in hand to make the 2002 Annual World Dental Congress one to remember. The Exhibition space is now sold out and this alone promises to be a highlight of what will be Europe's most prestigious dental meeting this year.     

Self‐Adhesive Resin Cements—Part II

This is the second part of a two‐part piece on self‐adhesive resin cements; Part I was presented in the previous issue of the Journal. Here in Part II, the specific topics concerning self‐adhesive cements are clinical performance, post‐cementation sensitivity, and cementation of endodontic posts.     

Self‐Adhesive Resin Cements—Part I

A recent Medline search revealed 214 publications related to the search term “self‐adhesive resin cements.” The Journal published a Critical Appraisal on these materials by Burgess and colleagues in late 2010 (J Esthet Restor Dent 2010;22:412–9). One hundred fifty‐eight of those were published in 2009 or later, so the knowledge base on this subject is growing rapidly. With that in mind, we thought it would be helpful to provide an update. The update will be presented in two parts. Here in Part I, the specific topics addressed are bonding to tooth structure, bonding to zirconia ceramics, and effects of curing mode.     

Elder neglect—Oral diseases and injuries

Elder neglect (EN) is the failure of a designated caregiver to meet the needs of a dependent older person. World EN prevalence, meta‐analyzed in this study, is 1.0% or 1.8% according to different statistical methods. Referring alleged EN cases to Adult Protective Services (APSs) by healthcare workers (HCWs) is mandatory in many countries. However, only few claims are substantiated, as EN could be confused with Self‐Neglect, and neglect could be unintentional or due to caregiver unawareness. Screening tools are inaccurate, and their use is discouraged by public health organizations, because they lead to too many false positives, which engulf the already overwhelmed APSs. HCWs need effective tools with objective judgments, which do not hamper the HCW–caregiver–patient rapport and prevent lawsuits when allegations are unfounded. Orofacial EN manifestations (poor oral/denture hygiene, lack of needed/improper dentures, dry mouth, skin/mucosal rashes) are essential Forensic Markers of EN. I classified EN‐associated oral diseases according to the unmet needs into four groups: (1) traumatic injuries due to lack of caregiver vigilance (e.g., maxillofacial fractures); (2) diseases due to oral hygiene deficiency (e.g., root caries); (3) diseases typical of the elderly with late/no diagnosis (e.g., oral cancer); and (4) diseases typical of the elderly exacerbated by psychological distress (e.g., oral lichen planus).     

Early childhood caries — a synopsis

All the papers presented at the conference are reviewed and comparisons are made with past beliefs on the topic. Early childhood caries (ECC) is a serious public health problem in disadvantaged communities in both developing and industrialized countries in which under-nutrition is common. ECC involves the maxillary primary incisors within months after their eruption and spreads rapidly to involve other primary teeth. The early implantation of mutans streptococci, the use of a feeding bottle containing sugary solutions and prolonged breast-feeding, especially at night, are important predisposing factors. Attention is drawn to the need for more research into the factors which determine the resistance of the enamel and particularly the elucidation of the relationship established in several countries between early enamel caries, enamel hypoplasia, and perinatal under- or malnutrition. Primary preventive measures should be applied during the ante- and immediate post-natal periods. Secondary preventive measures include the use of chemotherapeutic agents such as fluoride, and antimicrobials. The most appropriate tertiary preventive measure is the atraumatic restorative technique (ART). Broadly based committees should be established by governments to address the issues of caries risk in young children. Parents and all personnel involved in infant health and welfare should be shown how to recognize early signs of the condition, as well as to promote early intervention and referral.     

External Root Resorption — Part I

Root resorption is a pathological process initiated by specific clastic cells which remove the organic and mineral components of dental hard tissues. Clastic cell activity in teeth is associated with a number of factors which include biomechanical forces, mechanical, surgical and chemical trauma, endodontic microorganisms and their toxins, developmental defects, neoplasia, and hormonal disturbances. The therapeutic measures which can regulate clastic activity include endodontic treatment, the use of specific anticlastic agents such as Ledermix paste, non-specific necrobiotic agents such as calcium hydroxide and trichloracetic acid, surgery or root surface conditioners. Accurate diagnosis is essential to the correct application of therapy. While some resorptions are self-limiting, others such as inflammatory root resorption require active and prompt endodontic preparation and medication to allow the control of clastic activity. One treatment regimen of invasive cervical and related conditions involves careful and accurate application of a chemical cauterising agent, trichloracetic acid, followed by curettage and restoration.     

Urea cycle disorder—argininosuccinic lyase deficiency

An increased level of ammonia in the bloodstream, or hyperammonemia, is a symptom associated with metabolic disorders referred to as inborn errors of metabolism. Urea cycle disorder is a congenital abnormality or absence of one of the six enzymes involved in the elimination of ammonia. Administration of certain medications, high protein diet, excessive exercise, surgical procedures, or trauma can precipitate symptoms of mental confusion, seizure‐like activity, and ataxia. This paper reviews the literature with insight into current treatment and management options of the disorder and modification of treatment for the dental patient.