The effects of phenytoin and sodium valproate on the periodontal health of adult epileptic patients

The periodontal health of 30 adult epileptic patients treated with either sodium valproate or phenytoin was compared with a control group (n = 15) of otherwise healthy patients. The 3 groups were matched for age and sex. Patients on phenytoin therapy showed significantly higher plaque scores (P less than 0.05), gingival index (P less than 0.05) and pocketing (P less than 0.05) than patients in the control group. The % of gingival hyperplasia was significantly higher (P less than 0.05) in the phenytoin-treated patients than those on sodium valproate or in the control group. However, patients on phenytoin therapy had significantly less bone loss than those on sodium valproate (P less than 0.05) or in the control group (P less than 0.01). No significant differences were observed between the sodium valproate group and the control group on any of the parameters assessed. The results from this study would suggest that sodium valproate has no unwanted effects on periodontal health and may be considered a safe alternative, regarding the periodontal aspects, to phenytoin for the treatment of adult onset epilepsy.     

Microstructure and strength properties of silicate and glass ionomer cements

Microstructure characterization of silicate and glass ionomer cements has been carried out using, SEM, EDAX and ion microprobe techniques. The distribution of aluminum, calcium, fluorine, phosphorus or silicon was measured in the set cement surfaces. Cracks in the cement specimens produced by mechanical breaking, in contraction during setting, or as a result of SEM preparation were observed to occur mainly in the matrix and in the interface between matrix and particle. Powders of silicate and glass ionomer cements were separated into various fractions using sieves or cyclone separation technique. Compressive strength measurements of specimens made of powders with various size distributions have been assessed. The fractionation did not reveal any strong effect on the compressive strength properties either for the silicate or the glass ionomer cement.     

Distribution of the EDTA-soluble non-collagenous organic matrix components of rabbit incisor dentine

EDTA-soluble fractions were obtained from serial sections of rabbit incisor dentine. The amounts of protein in each extract were measured and their amino acid composition determined. Changes in composition and amount of protein were found and 3 zones could be differentiated. Zone 1, from the immature end of the root to approx. $\text{1}\text{3rd}$ of the way along the incisor, contained low levels of protein, predominantly of the anionic glycoprotein type. Zone 2, from zone 1 to approx. $\text{1}\text{2}$ way along the incisor near an opaque boundary, contained higher levels of protein with a much greater proportion of the less-acidic glycoproteins. The 3rd zone, from zone 2 to the incisive edge, appeared to consist of a mixture of non-collagenous matrix protein together with further protein material, possibly of pulpal origin.     

Postoperative pulpal and repair responses

BACKGROUND: Each year in the United States, the success of 10 million surgically restored carious lesions depends on a favorable tertiary dentin repair response to preparation, restoration and patient factor variables. The authors investigated the relationship between these variables and dentinal response. METHODS: Standardized rectangular Class V restoration preparations were cut into the buccal dentin of intact first or second premolars of 27 patients without exposing the pulp and were restored. The patients were between 9 and 17 years of age. The treated teeth were scheduled for extraction for orthodontic reasons. After tooth extraction, the tertiary dentin was analyzed histomorphometrically. RESULTS: The area of tertiary reactionary dentin was found to be correlated using linear regression analysis of variance with restoration residual dentin thickness (P = .0024), age of the patient (P = .0045), restoration floor surface area (P = .0266) and restoration width (P = .0415). The authors did not find a correlation with the premolar position (P = .0594), sex of the patient (P = .650), pulpal inflammatory reaction (P = .613) or the time elapsed since surgery (P = .531). Restoration with zinc oxide eugenol was found to negatively influence tertiary dentin matrix secretion (post hoc analysis of variance, P = .030). CONCLUSIONS: The age of a patient at treatment, the choice of restorative material and the size of the restoration preparation are all factors that can positively or negatively affect the pulpal repair response. CLINICAL IMPLICATIONS: Age of the patient affects dentin repair capacity and may be a factor in treatment planning decisions. Minimizing the cutting of dentin, especially the width and base of the preparation, reduces the probability of recurrent pulpal complications.     

The myelodysplastic syndromes. Case report and review

The myelodysplastic syndromes are a heterogenous group of hematologic disorders of myeloid progenitor cells. Oral manifestations may be among the first signs and often reflect degrees of neutropenia or neutrophil dysfunction. A patient with persistent herpes labialis and severe oral mucosal ulceration in myelodysplastic syndrome is reported. The features of myelodysplasia are reviewed and their oral manifestations and significance to dental management outlined.