The Umgeni bridge, a resin bonded pontic using a preformed fibre post an aesthetic procedure of low biological and fiscal cost.

A missing anterior tooth or open embrasures destroys the aesthetics of a smile. The replacement of a missing anterior tooth is one of the most rewarding and challenging aspects of restorative dentistry. There are a number of techniques to do this, however, most involve the use of a technician, which means additional cost to the patient and multiple visits. In today's financial climate with practice expenses climbing and medical aid remuneration dwindling, one must seek methods to reduce costs and provide patients with more affordable dentistry. In addition, in crisis situations such as the traumatic loss of a tooth an immediate replacement technique albeit temporary is necessary. To replace a missing anterior tooth directly and immediately presents a rewarding challenge to the clinician. The Umgeni bridge named after the river that flows on the north side of Durban, is particularly useful in replacing congenitally missing laterals after completion of orthodontic treatment in the case of congenitally missing laterals and cleft palates.     

Flexible casts used in making indirect interim restorations.

This article describes a procedure for making indirect interim restorations from a cast and dies made of polyvinyl siloxane impression material. The use of these flexible casts and dies facilitates the removal of the polymerized resin from the cast and the rapid set of the polyvinyl materials reduces the time involved in making the indirect interim restorations.     

Longevity of occlusally-stressed restorations in posterior primary teeth

PURPOSE: To compile a survey of the longevity and reasons for failure of stainless steel crowns, amalgam, glass-ionomer, composite and compomer restorations in stress-bearing cavities of primary molars. METHODS: This work reviewed the dental literature of 1971 up to July 2003 for longitudinal, controlled clinical studies and retrospective cross-sectional studies. Only studies investigating the clinical performance of restorations in primary teeth with an observation period of at least 2 years were included. Annual failure rates of stainless steel crowns, amalgam, glass-ionomer, composite and compomer restorations were determined and failure reasons were discussed. RESULTS: Annual failure rates in stress-bearing cavities of primary molars were determined to be: 0-14% for stainless steel crowns, 0-35.3% for amalgam restorations, 0-25.8% for glass-ionomer restorations, 2-29.1% for atraumatic restorative treatments, 0-15% for composite restorations, and 0-11 for compomer restorations. Main reasons for failure were secondary caries, marginal deficiencies, fracture, and wear.     

The power of children over adults when obtaining sweet snacks

Summary. Background. There is evidence to suggest that the family is becoming a more democratic unit and that children are spending more on sweet snack items than ever before. A study was thus undertaken to investigate the influence of children on parental decision‐making in relation to the use of sugary snacks. Methods. A cross sectional interview study; children aged 7–8 years from 20 inner‐city Manchester primary schools were asked about their sweet eating, their pocket money and their perceived levels of influence or autonomy within the household. The parents of these children were also asked to fill in a questionnaire that mirrored the children's questions. Results. There was a moderate but significant correlation between the opinion of the parents and that of the children on the extent of influence (Pearson coefficient r = 0·25, P = 0·001). When the adults (n = 181) were split into age groups, ≤ 29 years (n = 33), 30–35 years (n = 61) and ≥ 36 years (n = 87), the study showed that the older the adult, the less the child seemed to get his or her own way. Spearman's rho = 0·16, P = 0·03 (children's view) and rho = 0·17, P = 0·02 (adult's view). The dominant factors were related to money in the children's opinion, although the adults’ data suggested that older mothers (≥ 36 years) may be trying to limit their children's access to sweet snacks. Conclusions. Adults’ efforts to limit their children's intake of sweet snacks and drinks are being undermined by earlier and earlier influences in the child's life and by access to money, which allows the child to out‐manoeuvre his or her parents. This is compounded by the provision of additional income, mostly from grandparents.     

Motivation, Acceptance and Problems of Invisalign® Patients

Abstract Aim: This study examined how well patients accepted and to what extent they were impaired by Invisalign^® treatment. Patients and Methods: Fifty-four consecutive patients received a questionnaire with 12 questions after 3 to 6 months of Invisalign^® treatment. They were given a choice of three responses for each question. Apart from personal data, the questionnaire covered the following parameters: adaptation time, occurrence and duration of pain, possible speech impairment, lingual and mucosal irritations, temporomandibular joint (TMJ) problems and subjective assessment of the success of therapy thus far and the quality of information initially provided. Results: 78% of those interviewed were females. The highest percentage of patients (44%) were between 20 and 30 years of age. 83% got used to their aligners within one week. 35% had no pain and 54% mild pain while wearing them. This pain usually lasted for 2 to 3 days following insertion of a new aligner. 46% of the patients experienced no speech impairment. 93% felt so secure with their aligners that they felt not at all inhibited about speaking. The majority noticed no narrowing of the lingual space (76%) or irritation of the lingual or buccal mucosa (70%). However, 6% had strong irritations. 44% of the patients had difficulty chewing, mainly because the teeth were sensitive to pressure or had food particles caught between them due to temporary gaps. TMJ problems in terms of clicking were reported by 8% of the patients, although the clicking had existed before therapy initiation. None of the patients had TMJ pain. At the time of the interview, 89% of the patients were satisfied with the progress of therapy. All patients considered themselves well or very well informed about the treatment. Conclusions: Invisalign^® therapy seems particularly attractive to a clientele comparable to that for the lingual technique. Patients show high acceptance, since they become accustomed to the aligners very quickly and do not suffer much impairment. If indicated, Invisalign^® therapy should thus be considered an alternative to the lingual technique for esthetically-demanding patients. This applies especially to patients who cannot be treated by the lingual technique because of the inevitable speech impairment.     

Bone tissue interface

High resolution microradiography and multiple fluorochrome labeling are definitive histological methods for assessing the mechanism and timing of osseous healing, maturation, and adaptation. Two fundamental types of bone interface have been described for endosseous dental implants: (1) fibro-osseous integration ("pseudo-periodontal ligament") and (2) rigid osseous fixation ("osseointegration"). No definitive bone interface studies with modern physiological methods have been reported for fibro-osseous integration. Rigid osseous fixation has been investigated in cortical bone implantation sites. The initial healing reaction involves predominantly bone modeling at the periosteal and endosteal surfaces, i.e., a woven bone callus fills with lamellae by the process of lamellar compaction. Nonvital osseous interface and adjacent compacta are replaced by bone remodeling (turnover). As assessed with high resolution microradiography, "clinically successful" specimens had less than half of the intraosseous interface in direct contact with bone. Extrapolation from animal data suggests that endosseous implants can be provisionally loaded at about 18 weeks, but full maturation of the interface requires approximately one year.