Estimating the need for dental sedation. 1. The Indicator of Sedation Need (IOSN) - a novel assessment tool

While the control of pain and anxiety is fundamental to the practice of dentistry, the use of conscious sedation in dentistry is very variable among dentists. The need for conscious sedation could be considered by assessing and ranking a combination of information on patient anxiety, medical history and the complexity of the anticipated clinical treatment. By undertaking this systemtic assessment an indication of sedation need may be developed which would act as an aide to decision making and, potentially, referral management. Such a tool could also be used by commissioners who need to identify patients who need conscious sedation for dental treatment in order to plan, commission and deliver appropriate sedation services.     

Virulence factors of the oral spirochete Treponema denticola

There is compelling evidence that treponemes are involved in the etiology of several chronic diseases, including chronic periodontitis as well as other forms of periodontal disease. There are interesting parallels with other chronic diseases caused by treponemes that may indicate similar virulence characteristics. Chronic periodontitis is a polymicrobial disease, and recent animal studies indicate that co-infection of Treponema denticola with other periodontal pathogens can enhance alveolar bone resorption. The bacterium has a suite of molecular determinants that could enable it to cause tissue damage and subvert the host immune response. In addition to this, it has several non-classic virulence determinants that enable it to interact with other pathogenic bacteria and the host in ways that are likely to promote disease progression. Recent advances, especially in molecular-based methodologies, have greatly improved our knowledge of this bacterium and its role in disease.     

Preliminary study of the impact of loss of part of the face and its prosthetic restoration

STATEMENT OF PROBLEM: Loss of a part of the face or having a congenitally missing ear, nose, or eye is likely to have both a social and a psychologic impact on those affected. The nature and extent of this impact has not been explored previously. The provision of facial prostheses is an increasingly viable and beneficial treatment option, but the psychologic and social adjustment to the prosthesis has not been described. PURPOSE: This study performed a preliminary investigation of patients' responses to loss of part of the face, and their perceptions of the prosthetic restoration of their missing facial part. METHODS: Nine individuals who had experienced prosthetic replacement of an ear, nose, or eye were interviewed. Interviews were semistructured, each respondent was interviewed individually and the interviewer followed a predetermined interview schedule. Themes emerging in the interviews were identified. RESULTS: The main themes relating to the loss of the facial part were the importance of the story of the loss, coping through bargaining, and the impact of the loss on relationships. The important themes identified in regard to the prosthesis were issues in the maintenance of the prosthesis and the reactions of other people to the prosthesis. CONCLUSION: Loss of part of the face requires great adjustment. The reactions of other people were marked. Provision of a facial prosthesis can assist in the process of adjustment.     

Dental findings in Lowe syndrome

This paper presents the dental findings of a child with the oculocerebrorenal syndrome of Lowe. The genetic abnormality in this condition results in an inborn error of inositol phosphate metabolism. Renal tubular dysfunction leads to metabolic acidosis and phosphaturia. At 4 years, generalised mobility of all primary teeth was noted. It is postulated that a defective inositol phosphate metabolism was responsible for the periodontal pathology found in this case. This is in direct contrast with previous reports of prolonged retention of primary teeth in children with this condition. Histology of extracted primary incisors demonstrated enlarged pulp chambers and mildly dysplastic dentin formation. This is consistent with a chronic subrachitic state, a known feature of Lowe syndrome, but no prominent interglobular dentin was present.     

Cytotoxicity of a trial resin composite liner containing TiK2F6 on rat dental pulp cells

The aim of this study was to assess the toxicological responses of a resin composite containing TiK2F6 and NaF in rat dental pulp cells. Trial resin composite liners were made, containing 3 wt% fluorides (TiK2F6 or NaF). These specimens were immersed in 5 ml of cell culture medium supplemented at 37 degrees C for 24 hours. The eluates were used for the experiments. We judged the cytotoxicity of the samples by the cell viability. The original elute solution was serially diluted and then the medium was exchanged for the dilute medium. The cell viability at 1, 2 or 5 days after commencement of re-culturing was calculated. The viability of cells in the eluate from the resin composite liners containing TiK2F6 and NaF decreased with time. The cytotoxicity of TiK2F6 was weaker than that of NaF at all times.