A simple splint for the radial forearm donor site

A simple splint for the radial forearm donor site is described. It can be constructed preoperatively and provides for unlimited re-applications and has been used successfully in 15 consecutive cases.     

Valiant-PhD and Lojic N amalgam alloys: four-year clinical results

From 1984 to 1986, 97 similar pairs of Valiant-PhD and Lojic N amalgam restorations were placed at random by one dentist in Class II cavities prepared in 105 molar and 89 premolar permanent teeth of 73 patients treated in a private practice. Assessments were made of the different handling properties of the two alloys and of the effects of polishing, or otherwise, on the clinical behaviour of the restorations. Valiant-PhD alloy had more 'body' for condensing and was easier to carve and polish than was Lojic N alloy. After periods of up to four years, there was only one restoration failure (from bulk fracture) for each alloy although both materials deteriorated over time. Both the polished and the unpolished restorations showed similar deterioration for marginal fracture and staining, and for surface tarnish, and their initially-different surface textures became more similar during the study. Statistically, Lojic N restorations showed significantly more surface tarnish, but less marginal fracture than did Valiant-PhD restorations, and the tarnishing did not appear to be related to the effects of corrosion.     

Effects of splint therapy in TMJ dysfunction: A study using magnetic resonance imaging

This pilot study was undertaken to correlate clinical and MRI diagnoses in seven symptomatic TMJ dysfunction patients and to account, if possible, for the clinical improvement in the signs and symptoms after the use of a maxillary stabilizing splint. The symptomatic TMJs were evaluated by means of MRI prior to splint insertion. Sagittal open/closed, and coronal closed images were obtained with a 0.3 T Fonar MR Scanner. A follow-up MRI was taken after three months of splint therapy for the purposes of a comparative study.
All subjects responded positively even at the early phase of splint treatment. By the end of the three month period, six subjects experienced full remission of pain in the TMJ and associated masticatory muscles with one subject experiencing only partial remission following therapy. Baseline MRI study revealed that only three subjects had anterior disc displacement while the other four subjects had normal disc/condyle relationships and morphology. In the follow-up MRI study, there were no signs of recapture of the three anteriorly displaced discs despite there being evidence of improved jaw movement and remission of pain symptoms.
The use of MRI in this preliminary study indicates that some but not all TMJ pain dysfunction syndromes are caused by internal derangements of the joint. A larger MRI study using the same clinical parameters is indicated for future research.     

Local complications following intravenous benzodiazepines in the dorsum of the hand. A comparison between midazolam and Diazemuls in sedation for dentistry

Two hundred patients requiring sedation for minor oral surgery were randomly allocated to receive either midazolam or diazepam as Diazemuls intravenously through a 23-gauge indwelling needle in the dorsum of the hand. The site of injection was inspected at 7 days and 14 days post injection and assessed for pain, tenderness, redness, induration, painless thrombosis, and thrombophlebitis. The mean dose administered was 0.119 mg/kg of midazolam and 0.298 mg/kg of Diazemuls. At 7 days there was no significant difference in venous complications. At the 14 day follow up, the midazolam group had a significantly greater incidence of tenderness and redness (p less than 0.001 and p less than 0.05 respectively using Chi squared test). The incidence of thrombophlebitis in the midazolam group was 2% at 7 days and 1% at 14 days, the corresponding figures in those given Diazemuls being none and 1% respectively. We conclude that the dorsum of the hand is a satisfactory site of injection for administration of these drugs. The higher incidence of minor complications at 14 days following midazolam was offset by its more reliable amnesic properties.     

Temporomandibular disorders. 2. Non-surgical treatment

There are many treatment modalities for temporomandibular disorders (TMD), most of which are effective in controlling symptoms, at least in the short term. The non-surgical treatment of temporomandibular disorders continues to be the most effective way of managing over 80 per cent of patients who present with symptoms of temporomandibular pain and dysfunction. In this, the second article in the series, a general overview of the current non-surgical treatment strategies for TMD will be presented.     

A maxillary buccal tip

A method for the delivery of the average fractured upper buccal root apex, for which no reference can be found in the exodontic literature, is presented.     

DDAVP and EACA used for minor oral surgery in von Willebrand disease

A therapeutic approach to the management of mild von Willebrand disease in four patients requiring minor oral surgery is reported, using a combination of 1-deamino-8 d-arginine vasopressin (DDAVP) and epsilon-aminocaproic acid (EACA).     

Long-term Clinical Performance of Resin-Bonded Fixed Partial Dentures Placed in a Developing Country

Purpose This study assesses the clinical performance of 92 resin-bonded fixed partial dentures (FPDs) placed at four private practices in Karachi, Pakistan, between 1982 and 1991. Materials and Methods The distribution of the FPDs was 9 perforated, 45 electrolytically etched, and 38 silicoated. Twenty-five FPDs replaced anterior teeth and 67 replaced posterior teeth. There were 66 FPDs with single pontics and 26 with multiple pontics. The perforated designs used a restorative composite for cementation, whereas the electrolytically etched and silicoated designs used a composite luting cement. The observation periods for the perforated, electrolytically etched, and silicoated FPDs were 114,99, and 30 months respectively. Results During the evaluation period, 27 FPDs (29%) failed; of these, 4 were perforated, 18 were electrolytically etched, and 5 were silicoated. The mean (±SD) duration of the successful clinical service for all FPDs was 41 ± 26 months. The mean time to failure for the FPDs that did not survive was 35 ± 23 months. The silicoated FPDs tended to have early failure, as did the FPDs with multiple pontics and those in the mandibular arch. Anterior and posterior FPDs performed equally well. Conclusions These findings, in conjunction with those from Europe and North American, show that resin-bonded FPD technology is as successful in a developing country as in industrialized areas of the world.     

The effect of cement thickness on the fracture strength of all-ceramic crowns

The effect of increasing cement thickness on the fracture strength of aluminous porcelain jacket crowns was investigated in this study. Thirty-three aluminous porcelain jacket crowns were divided into three groups. In Group 1, only platinum foil was used to provide cement space. In Group 2 two layers and Group 3 four layers of die spacer were painted onto the metal die before impression taking. Each crown was cemented onto a metal die with zinc phosphate cement and loaded until fracture. The maximum force to break each crown was recorded. The average fracture load was 408 N for Group 1,365 N for Group 2 and 324 N for Group 3. ANOVA (SPSS) found a significant difference (p < 0.05) between groups. A Scheffe Test revealed a significant difference between Groups 1 and 3. It was concluded that increasing the cement thickness above 70 μm reduced the fracture strength of porcelain jacket crowns.