Comparison of the occlusal vertical dimension after processing complete dentures made with lingualized balanced occlusion and conventional balanced occlusion

STATEMENT OF PROBLEM: An increase in occlusal vertical dimension (OVD) may occur after processing complete dentures. Although many factors that generate this change are known, no information is available in the dental literature regarding the effect that the occlusal scheme may have on the change in OVD. PURPOSE: This in vitro study compared the increase in OVD, after processing, between complete dentures with teeth arranged in lingualized balanced occlusion and conventional balanced occlusion. MATERIAL AND METHODS: Thirty sets of complete dentures were evaluated as follows: 15 sets of complete dentures were arranged in conventional balanced occlusion (control) and 15 sets of complete dentures were arranged in lingualized balanced occlusion. All dentures were compression molded with a long polymerization cycle. The occlusal vertical dimension was measured with a micrometer (mm) before and after processing each set of dentures. Data were analyzed using an independent t test (alpha=.05). RESULTS: The mean increase in the OVD, after processing, was 0.87 +/- 0.21 mm for the control group and 0.90 +/- 0.27 mm for the experimental group. There was no significant difference between the groups. CONCLUSION: After processing, dentures set in lingualized balanced occlusion showed an increase in OVD similar to those set in conventional balanced occlusion. CLINICAL IMPLICATIONS: Although the 2 occlusal concepts resulted in similar increases in the OVD after processing, the lingualized balanced occlusion may result in easier occlusal adjustments, as the less complicated occlusal scheme uses a smaller number of centric occlusion contact points.     

The phenotypic characterization of lymphoid cell subpopulations in gingivitis in children

Phenotypic characterization of lymphoid cell subpopulations in gingivitis associated with the deciduous dentition in children was carried out. Biopsies were obtained from 10 children aged between 5 and 9 years. The tissues were processed for either histochemistry or for immunofluorescence. T-cells were identified by their T-enzyme staining pattern and lack of immunoglobulin. B-cells on the other hand were identified by their lack of T-cell enzymes and presence of surface or cytoplasmic immunoglobulin. Morphologically the lesions consisted of approximately 70 % lymphocytes, between 11 and 26 % macrophages and fewer numbers of polymorphonuclear leukocytes and plasma cells. The majority of lymphocytes (approximately 70 %) were T-enzyme positive/Ig negative indicative of a Tcell population. Approximately 12 % of the infiltrating cells were immunoglobulin positive. These results showed that gingivitis in children is essentially a T-cell lesion and supports the hypothesis that the conversion from a stable to a progressive lesion involves shifts in cell populations.     

A feeding obturator for a preterm baby with Pierre Robin sequence

The article describes a clinical and laboratory technique for the fabrication of a feeding obturator for a baby with Pierre Robin sequence. Emphasis is placed on the direct fabrication of a preliminary custom tray, preventing thermal trauma to the tissues, and overcoming the danger of airway obstruction or foreign body aspiration. The functional problems associated with a cleft palate and various methods to overcome them are also discussed.     

The antimicrobial activity of a dentin conditioner combined with antibacterial agents

Dental hand instruments are not efficient in removing all infected dentin when performing carious removal for minimal intervention techniques. The use of an antibacterial dentin conditioner may therefore be useful when restoring cavities that have residual carious dentin. Antibacterial agents--chlorhexidine hydrochloride, cetylpyridinium chloride, cetrimide, benzaIkonium chloride and sodium hypochlorite, were added either to a dentin conditioner used for glass ionomer cements or distilled water at 1% concentration. Dentin conditioning solutions at pH 2.5, 4.9 and 7.7 were also prepared, along with 1% aqueous thymol. Using an agar diffusion test, 25 microl aliquots were examined for their inhibitory effects on three cariogenic bacteria. After 24 hours, an agar pellet was extracted adjacent to the agar well and placed on a second inoculated agar plate to observe sustained inhibitory effects, after which this procedure was repeated one more time. Antibacterial dentin conditioners showed significant inhibitory effect compared to the control over the three test periods (p<0.016). The combination of dentin conditioners with antibacterial agents significantly reduced the inhibitory effect compared to the antibacterial aqueous solutions (p<0.016). One-percent aqueous thymol showed no inhibitory effect against the test bacteria. The cetrimide-dentin conditioner showed the greatest inhibitory effect against all three test bacteria over the three experimental periods (p<0.016). The inhibitory effect of antibacterial agents was significantly reduced when combined with a dentin conditioner. Only the cetrimide-dentin conditioner combination produced significant inhibitory effects against all three test organisms.     

Serum cytokine levels in periodontitis patients in relation to the bacterial load

Background: Periodontitis is a local inflammatory disease that also has some systemic effects. We investigated the levels of interferon (IFN)‐γ, tumor necrosis factor (TNF)‐α, and interleukin (IL)‐2, ‐4, ‐5, and ‐10 in the serum of patients with periodontitis in relation to the bacterial load in the dental plaques. Methods: Serum cytokine levels in patients with generalized periodontitis and healthy control groups were determined using the cytometric bead array kit. Bacterial load in the dental plaque was determined semiquantitatively by real‐time polymerase chain reaction. The proportions of different lymphocyte subsets were determined in the peripheral blood of patients with periodontitis by flow cytometry. Finally, relationships between the bacterial load in the subgingival plaques of patients with periodontitis and levels of cytokines and counts of lymphocyte subsets were established. Results: Serum levels of IFN‐γ, TNF‐α, and IL‐10 were significantly increased, whereas those of IL‐2 were significantly decreased in patients with periodontitis compared to healthy controls. Increased serum levels of IFN‐γ and TNF‐α in patients with periodontitis were associated with the enhanced dental plaque load with Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) and Porphyromonas gingivalis, respectively. Finally, as revealed by analysis of lymphocyte populations, the presence of A. actinomycetemcomitans and Trepomena denticola was associated with an increased population of CD3^?/CD16⁺ and CD3⁺/CD8⁺ cells, respectively. Conclusion: Certain periodontal pathogens could be associated with an increased level of proinflammatory cytokines in the peripheral blood and thus increased risk of systemic diseases.     

Replacement of a fixed partial denture secondary to abutment fracture

BACKGROUND: The authors present a case that demonstrates the efficient replacement of a fixed prosthesis after a patient's abutment tooth fractured and required extraction. The fractured tooth had a local infection, and the maxillary bone was low-density and limited in height. CASE DESCRIPTION: The authors removed the tooth and grafted the site with particulate bone, while concurrently placing two implants in the edentulous region. After four months, they placed one additional implant and secured a fixed provisional prosthesis within one week. CLINICAL IMPLICATIONS: The patient wanted to minimize the time that she would have to be without a fixed prosthesis. The authors met her expectations by using an accelerated treatment plan.     

TRPM8 Axonal expression is decreased in painful human teeth with irreversible pulpitis and cold hyperalgesia

Pulpitis pain might be triggered by a cold stimulus, yet the cellular mechanisms responsible for this phenomenon are largely unknown. One possible mechanism involves the direct activation of cold-responsive thermoreceptors. The purpose of this study was to evaluate the possible role of the TRPM8 thermoreceptor in cold-mediated noxious pulpal pain mechanisms by comparing expression patterns in pulpal nerves from healthy control molars to cold-sensitive painful molars with irreversible pulpitis. Samples were identically processed with the indirect immunofluorescence method, and images were obtained with confocal microscopy. The immunofluorescence intensity and area occupied by TRPM8 within N52/PGP9.5-identified nerve fibers were quantified. Results showed that relative to normal samples, TRPM8 nerve area expression was significantly less in the cold-sensitive painful samples (34.9% vs 8%, P <0.03), but with no significant difference in immunofluorescence intensity between the 2 groups. These results suggest that TRPM8 is most likely not involved in cold-mediated noxious pulpal pain mechanisms.     

The effect of clenching on condylar position: A vector analysis model

STATEMENT OF THE PROBLEM: Clinicians often disagree about the acceptable position of the condyle in the articular fossa. Agreement as to what position the condyle-disk assembly assumes on the articular eminence while subjected to the forces of the elevator muscles of the mandible is important. PURPOSE: This simulation study investigated the position of the condyle-disk assembly on the articular eminence while subjected to the forces of the elevator muscles of the mandible during clenching. MATERIAL AND METHODS: Using the 2 conditions of static equilibrium, a vector analysis of a 2-dimensional model of the temporomandibular joint was developed. The dynamics of the condyle-disk assembly during muscle loading were analyzed. The vector sum of the masticatory muscle forces was determined by assuming that the maximum force developed by each contributing muscle was proportional with the physiologic cross section of the muscle. The effect of the resultant force vector of the combined muscle action applied to the condyle was analyzed for the orthogonal and acute angle situations. RESULTS: When the vector sum was orthogonal on the eminence, the condyle was in stable equilibrium. The stable equilibrium was found in the anterior-superior position in the fossa. When the vector sum was at an acute angle to the eminence, the condyle was subject to a translation force that displaced it into the anterior-superior equilibrium position. CONCLUSION: Within the limitation of this study, vector analysis suggested that the anterior-superior position of the condyle-disk assembly on the eminence was the most stable equilibrium position. All other tested positions of the condyle were less stable and maintained at the expense of other structures.