AIDS and Infection Control: Amsterdam Dentists Surveyed

In March 1988 all Amsterdam dentists (N = 470) were sent a questionnaire to assess the extent of compliance with guidelines from the Health Council to prevent HIV transmission in dental practice. Response rate was 62 percent. Gloves, masks, and other protective garments were widely used. Other infection control procedures, like sterilizing instruments, were often not followed in ways recommended by the Health Council. To date, 60 percent of the respondents did not spend more than US$2,500 for protective garments or special equipment. Planned expenditure is substantially higher. One-quarter of the respondents were certain to have one or more HIV-seropositive patients, and 35 percent believed they did. When taking the medical history, almost one-third of the dentists ask questions to assess whether a patient is possibly HIV seropositive. Forty percent of the dentists hold the opinion that it is necessary for a dentist to know whether a patient is HIV seropositive. This is against Health Council views. Thirty percent of the respondents are definitely fearful of AIDS infection and want additional information or training on this topic.     

Mandibulofacial dysostosis. Case report

A case of mandibulofacial dysostosis (Treacher Collins syndrome) is presented. Clinical features and skull radiographs revealed typical anomalies associated with the syndrome. Cleft of the soft palate and unerupted multiple supernumerary teeth were present in this case. No haematological, biochemical or immunological abnormalities could be detected in the patient. Pedigree analysis showed an autosomal dominant mode of transmission of the disease. Chromosomal studies did not reveal any structural or numerical discrepancies.     

The Validity of Self-reported Oral Health Status in the Elderly

The validity of self-reported number of teeth was assessed in a random sample of 50 individuals aged 70+ by comparing self-reports in a telephone interview with results of a subsequent in-home examination by a dentist. There were no significant differences between self-report and examination data, nor was there any systematic under- or over-counting of teeth as the actual number of teeth increased. These data support the validity of self-reported dentition.     

The Oral Health Status, Treatment Needs, and Dental Utilization Patterns of Native American Elders

The purpose of this study was to evaluate the oral health status, treatment needs, and dental care utilization patterns of a Native American population aged 65-74 years. A random sample of 688 individuals was chosen and approached regarding participation in the study. Data were gathered through an interviewer-administered questionnaire and an oral examination. A total of 204 individuals completed all aspects of the study. Only one participant had all 28 natural teeth, while 58.3 percent were totally endentulous. Of the 85 dentate participants, almost 53 percent required at least one extraction. The average number of required extractions in the dentate subjects was three. Although 94 percent of the sample stated they had a usual source of dental care, 40.7 percent had not visited a dentist within the last five years. Multiple regression analyses were used to determine the factors associated with total number of teeth present among the dentate participants. Years of education and time since last dental visit were the two significant predictors (P less than .05) of number of teeth present. The higher the level of education, the greater the number of teeth in later life. The number of teeth present was inversely related to years since dental treatment. Compared to the results of the National Survey of Oral Health in US Employed Adults and Seniors, this Native American sample had a higher prevalence of endentulism and utilized dental services less often than a comparable age group in the US population as a whole.     

Modified Hygienic Epitec System Abutment for Magnetic Retention of Orbital Prostheses

Maintenance of healthy periimplant soft tissue is a significant problem for orbital prosthesis wearers. Two female patients with orbital defects after malignant tumor resection were treated using custom‐made retentive components of an individual magnet for an Epitec System orbital prosthesis. Freestanding hygienic retentive components for an individual magnet were fabricated. An abutment replica was trimmed and modified, and using pattern resin, a magnetic keeper was cast and soldered to the abutment. The patients could maintain good hygiene and healthy periimplant soft tissue. This type of freestanding retentive component may be advantageous for the hygiene maintenance of periimplant soft tissue.     

Periodontal Attachment Loss in Independently Living Older Adults in Ontario, Canada

This paper describes the periodontal disease experience of a community-dwelling population aged 50 years and older, living in four communities in Ontario, Canada. The periodontal status of this population was assessed using attachment loss and the extent and severity index. Attachment loss was measured at two sites on each tooth using a pressure-sensitive periodontal probe. Complete periodontal data were obtained on 624 subjects. The mean number of sites per subject was 37.9. In line with recent US studies, the diagnostic threshold for a diseased or previously diseased site was set at 2 mm of loss. The overall mean attachment loss was 2.95 mm, with 19.7 percent of subjects having an overall mean attachment loss of 4.00 mm or more. The proportion of sites examined with loss of attachment of 2 mm or more was 77 percent. The severity of disease, defined as the average distance between the base of the sulcus or pocket and a point 1.00 mm apical to the cemento-enamel junction in sites with loss of 2 mm or more was 2.44 mm. These data indicate that the extent and severity of disease in this population were greater than that reported by some recent studies in the US. Taken together, the results of these studies suggest that there is some variation in the periodontal disease experience of population subgroups across North America.     

Terminology of facial morphology in the vertical dimension

Consideration of facial type plays an important role in the formulation of an orthodontic treatment plan and prognosis of treatment. Of particular importance is the vertical relationship, that is, whether an individual is long-faced (dolichofacial), or short-faced (brachyfacial). The vertical facial type provides a clue regarding the growth direction of the facial complex, and should be used with an anteroposterior classification to describe a patient's face. The potential for confusion in communicating vertical facial types exists due to the nature of the terminology in use. For example, the term dolichoprosopic as used in the Bimler analysis has an opposite meaning to the term dolichofacial. It would seem prudent that if such terminology is to be employed there should be some attempt at standardization, and at least an appreciation of the derivations of the terms, and their differences.     

Drug-induced palatal pigmentation

A bstract — Palatal pigmentations are rare in children. Four cases of palatal pigmentation associated with the prescribed use of the drug amodiaquine are tabulated and two are reported in detail. The wider clinical application of this anti-malarial drug and the potential for drug-induced palatal pigmentations are of dental interest. The pigmentation persists for an indefinite period after withdrawal of the drug.     

Effect of Compromised Cortical Bone on Implant Load Distribution

Purpose: To investigate photoelastically the difference in load distribution of dental implants with different implant neck designs in intact and compromised bone. Materials and Methods: Composite photoelastic models were fabricated using two different resins to simulate trabecular bone and a 1‐mm thick layer of cortical bone. The following parallel‐sided, threaded implants were centrally located in individual models representing intact and compromised cortical bone: Straumann (4.1‐mm diameter × 12‐mm length), AstraTech (4.0‐mm diameter × 13‐mm length), and 3i (3.75‐mm diameter × 13‐mm length). The compromised cortical bone condition was simulated by contaminating a 1‐mm neck portion with Vaseline to impair the implant–resin interface. Vertical and oblique static loads were applied on the abutments, and the resulting stresses were monitored photoelastically and recorded photograhphically. Results: For the fully intact condition, the highest stresses were observed around the crest and apical region for all implant designs under vertical and inclined loads. There were no appreciable differences in magnitude or distribution between implant types. With compromised cortical bone, for all designs and load directions, higher stresses in the supporting structures were observed. Increased stresses were noted especially at the cortical bone–trabecular bone interface. Somewhat lower stress levels were observed with the 3i implant. Conclusions: The condition of implant–cortical bone contact has considerable influence on stress distribution. A compromised cortical bone condition caused higher level stresses for all implant designs tested.