Presence of periodontal data in patient records of general practitioners

It has been reported that little diagnostic information concerning periodontal conditions is entered in patient records of general practitioners, but actual rates for such chart entries are unknown. Records of regular patients, seen at least annually, were randomly selected from the offices of 36 general practitioners in two North Carolina counties. In each office 80 records were selected for audit. After adjustment, the final sample consisted of 2488 audited records. Entries noting the presence or absence of 14 diagnostic conditions were identified for the five previous years and for the patient's most recent examination. The presence of a periodontal diagnosis or periodontal treatment plan was noted. The number of radiographic sets exposed in the previous five years and the age of the most recent set were determined for complete series/panoramic films and for bitewings. Across practices, the most frequent notations (20.5% within the past five years) concerned the presence of probing depths and calculus. Gingival bleeding (13%) and plaque (12%) were noted less frequently. A periodontal diagnosis was recorded in only 16.3% of the records. Annualized rates for radiographic sets were 0.09 for complete series/panoramic films and 0.50 for bitewings. These data suggest that, except for radiographs, the majority of patient records do not contain sufficient diagnostic information to describe patients' periodontal health.     

Chondrosarcoma of the mandible. Report of case and a survey of 23 cases in the Japanese literature

A huge chondrosarcoma of the mandible (80 X 95 X 100 mm in size) with extension into the infratemporal fossa is described. The tumour was successfully treated by surgical removal and postoperative irradiation. A survey of the Japanese literature revealed 23 cases of chondrosarcoma with involvement of the mandible. The tumours occurred equally in males and females whose mean age was 38 years. The molar region was the site of predilection. The most common symptom was swelling and it was accompanied by pain in 7 cases and paraesthesia in 5 cases. Radiographically, the lesions were quite variable and with the exception of 3 cases in which information was not available, they consisted of a combination of irregular radiopacity and radiolucency in 9 cases, whereas the predominant feature was radiopacity in 6 cases and radiolucency in 4 cases. There was no radiographical abnormality in 2 cases. Root resorption of adjacent teeth was noted in 3 of 6 cases where information existed. Computed tomography was thought to be quite valuable in determining the nature and extent of the tumour. Although an elevation of serum alkaline phosphatase was observed in our case, results of laboratory tests were mostly of no diagnostic significance. Surgical removal was employed in 22 cases alone or in conjunction with irradiation and/or chemotherapy. Of 14 cases on whom information was available, local recurrence occurred in 6 cases in which radiotherapy was not given and distant metastasis in 2 of 10 cases on whom information was available. Of 20 patients on whom information was available on the postoperative course, 7 patients died 5 months to 6 years after the primary treatment.     

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 effect of porcelain laminate veneers on gingival health and bacterial plaque characteristics

Abstract. The aim of this study was to evaluate the response of microbial plaque and gingival inflammation to the placement of porcelain laminate veneers on anterior teeth. 9 patients, 7 female and 2 male (mean age of 30 years), with a total of 35 veneers were examined. The volume of gingival crevicular fluid (GCF), level of neutral proteolytic enzyme activity, gingival index (GI), plaque index (PII) and plaque bacteria vitality were measured at baseline and after the placement of veneers. The volume of GCF increased after the placement of veneers ( p =0.03). No statistically significant differences were found in proteolytic enzyme activity or GI ( p >0.05). There were statistically significant reductions in PII ( p =0.000) and plaque bacteria vitality ( p =0.018). Further research is required to assess the long-term influence of porcelain laminate veneers on gingival health and microbial plaque characteristics.     

Effect of autonomic nerve stimulation on bleb formation in striated duct cells of the rat submandibular gland

Several previous investigations have shown that blebs form on the apical surface of the striated duct cells of the rat submandibular gland on feeding after starvation. In the present report the influence of autonomic nerve stimulation on bleb formation was studied by electron microscopy. Both parasympathetic and sympathetic stimulation were performed, using electric nerve stimulation. In addition, sympathetic nerve stimulation in combination with alpha- or beta-adrenergic blockers was used. Massive bleb formation took place in response to sympathetic nerve stimulation. This response was almost completely abolished by the administration of alpha- but not by beta-adrenergic blocker. Bleb formation was not seen after parasympathetic nerve stimulation.     

Techniques for achieving realistic color distribution in large composite resin restorations

A technique of using macrofilled and microfilled composite resins in conjunction with tints and opaquers has been described. The technique achieves a more realistic color distribution in large composite resin restorations, such as Class IV restorations, diastema closures, veneers, and large Class III restorations. In placing more natural distributions of color in composite resin restorations, a more pleasing appearance can be achieved.