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.     

Testing responsiveness to change for the early childhood oral health impact scale (ECOHIS)

Abstract – Objectives: The Early Childhood Oral Health Impact Scale (ECOHIS) is a recently developed oral health‐related quality of life instrument designed to assess the impact of oral health problems in 0–5‐year‐old children. It has previously been validated as discriminative instrument. The goal of this study was to investigate the responsiveness to change of the ECOHIS. Methods: Data were collected from a convenience sample of 101 parents of 0–5‐year‐old children attending a hospital dental clinic for dental treatment. The ECOHIS was completed by parents prior to dental treatment and 2 weeks later. Subjects were also asked a global transition judgement concerning change between the second and first completion of the ECOHIS instrument. Responsiveness to change of the ECOHIS was analysed through: (i) a comparison of ECOHIS change scores with a global transition judgment by study subjects; (ii) an assessment of the statistical significance of within‐group change in scores over time for groups reporting improvement, stability and deterioration; (iii) an estimation of the ECOHIS’s sensitivity; and (iv) an investigation the effect size of the ECOHIS. Results: Of the 101 subjects recruited, 94 had full datasets. Their data were used for the analyses reported in this paper. Pre‐ and post‐treatment distributions of ECOHIS scores were strongly distributed towards no oral health impacts. Among the 94 subjects, 51.1% reported improvement, 42.6% reported no change and 6.4% reported deterioration following treatment, using the global transition judgement. The mean ECOHIS change scores for these three groups were ?0/9, +0.7 and +6.5 respectively, although none of the within‐group changes were statistically significant. The effect size for those reporting improvement was small (0.15) but for those reporting deterioration was moderate‐to‐large (0.69). Sensitivity ranged from 0.61–0.79 depending on the size of the cut‐off point, with a change of 3 points demonstrating the best sensitivity to false positive ratio (0.79 versus 0.41 respectively). Conclusion: In this sample with low levels of problems, the ECOHIS has demonstrated some limited ability to respond to change. Further work in a larger sample with higher levels of problems is needed to investigate the instrument’s ability to respond to change when it has occurred.     

Endoscope-assisted reduction of long-standing condylar dislocation

Endoscopy is widely used in the diagnosis and treatment of temporomandibular joint disorders. This paper introduces arthro-endoscopy as a new method of treatment for temporomandibular joint dislocation. As this method is minimally invasive, it is suitable for medically compromised patients who cannot tolerate open surgery.     

Using NHANES oral health examination protocols as part of an esophageal cancer screening study conducted in a high-risk region of China

Background

The oral health status of rural residents in the People's Republic of China has not been extensively studied and the relationship between poor oral health and esophageal cancer (EC) is unclear. We aim to report the oral health status of adults participating in an EC screening study conducted in a rural high-risk EC area of China and to explore the relationship between oral health and esophageal dysplasia.

Methods

National Health and Nutrition Examination Survey (NHANES) oral health examination procedures and the Modified Gingival Index (MGI) were used in a clinical study designed to examine risk factors for esophageal cancer and to test a new esophageal cytology sampling device. This study was conducted in three rural villages in China with high rates of EC in 2002 and was a collaborative effort involving investigators from the National Institutes of Health and the Cancer Institute of the Chinese Academy of Medical Sciences.

Results

Nearly 17% of the study participants aged 40–67 years old were edentulous. Overall, the mean number of adjusted missing teeth (including third molars and retained dental roots) was 13.8 and 35% had 7 contacts or less. Women were more likely to experience greater tooth loss than men. The average age at the time of first tooth loss for those with no posterior functional contacts was approximately 41 years for men and 36 years for women. The mean DMFT (decayed, missing, and filled teeth) score for the study population was 8.5. Older persons, females, and individuals having lower educational attainment had higher DMFT scores. The prevalence of periodontal disease (defined as at least one site with 3 mm of attachment loss and 4 mm of pocket depth) was 44.7%, and 36.7% of the study participants had at least one site with 6 mm or more of attachment loss. Results from a parsimonious multivariate model indicate that participants with poor oral health wemore likely to have esophageal dysplasia (OR = 1.59; 95% CI 1.06, 2.39).

Conclusion

This report describes the first use of NHANES oral health protocols employed in a clinical study conducted outside of the United States. The extent and severity of poor oral health in this Chinese study group may be an important health problem and contributing factor to the prevalence of EC.     

Adhesive solutions: report of a case using multiple adhesive techniques in the management of enamel hypoplasia

Enamel hypoplasia is a common condition that may present a severe aesthetic problem. Although the teeth affected may not be particularly susceptible to caries, patients may request cosmetic improvement. Adhesive techniques may be useful in such situations. This paper discusses the management of a patient with enamel hypoplasia using a combination of adhesive systems including enamel- and dentine-bonded veneers, dentine-bonded crowns, a cantilever resin-retained bridge, bonded amalgam restorations and chairside tin plating. Where adhesion was contraindicated, conventionally retained crowns were used.     

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.