Fluoride in saliva and plaque following use of fluoride-containing mouthwashes

The sensitivity of methodology for measuring the concentration of fluorine species in saliva and in plaque has been tested. Human subjects mouth-rinsed daily with aqueous solutions of NaF and Na2FPO3. Samples of unstimulated whole saliva and of plaque were collected twice weekly at least 18 hr after treatment application. Oral fluoride concentrations rose from placebo values for approximately two weeks before attaining equilibrium and returned to baseline when daily mouthrinsing was stopped. Mean elevated oral fluoride concentrations increased significantly with increasing applied NaF concentration in the range 0-1000 ppm F (0-0.053 mol/L). There appeared to be a linear relationship between saliva and plaque fluoride. The ability of fluoride treatments to sustain elevated oral fluoride levels between daily applications may be of major importance in caries control.     

Blue-black macule on the maxillary palate

A cellular blue nevus located on the palate of a 72-year-old female is reported. This intraoral finding is uncommon and should be distinguished from clinical entities it closely resembles. Practitioners should be aware that a pigmented palatal lesion in fact may be a malignant melanoma. Surgical excision with microscopic examination is the only means by which an accurate diagnosis can be made.     

The effect on the composition of subgingival plaque of a simplified oral hygiene system including pulsating jet subgingival irrigation

The aim of this study was to investigate the effect on subgingival plaque of a simplified oral hygiene regime consisting of instruction in Bass brushing without stress on interdental cleaning, scaling and root planing, in combination with subgingival pulsated jet irrigation with dilute solutions of chlorhexidine, metronidazole or placebos. Twenty-five patients, 14 women and 11 men, each with periodontal pockets ≥ 4 mm, participated in a randomized, double-blind, placebo-controlled study. The patients were assigned to 4 groups: 2 test groups (0.02% chlorhexidine and 0.05% metronidazole) and 2 placebo groups (0.01% quinine sulphate and 0.09% sodium chloride). Subgingival plaque samples were obtained from at least 4 sites in each subject on days 0 (prior to scaling and root planing), 7, 28, 56 and 84. Subgingival irrigation was terminated on d 28. Darkfield microscopy was used to assess the effects of treatment on the subgingival microflora by observing 4 morphologic groups: cocci, motile organisms, spirochetes and others (i.e. non-motile rods and filaments). All the groups showed marked beneficial changes at the end of the 28-d irrigation period, with increases in cocci and decreases in motile forms and spirochetes to less than baseline values. These beneficial effects were maintained for at least 8 weeks after irrigation was stopped. Metronidazole was more effective in reducing motile forms, but the reduction was not significant at d 84. It was concluded that pulsating monojet subgingival irrigation as part of a simplified oral hygiene program, with or without an active antimicrobial agent at low concentration, is effective in reducing the motile and spirochete portions of the subgingival microflora. These effects might be enhanced and prolonged if suitable antimicrobial solutions of higher concentration were used.     

Pacinian neuroma in adipose herniation of the buccal mucosa

An interesting case of a trauma-induced tender mass of the buccal mucosa in a 45-year-old man was presented. Following surgery, the patient was relieved from pain. Microscopically, the mature adipose tissue is unique in that it contained a single enlarged Pacinian corpuscle near the deep margin. This is the hitherto undescribed intraoral lesion of Pacinian neuroma in the herniated buccal fat pad.     

Trans-sinusal maxillary distraction for correction of midfacial hypoplasia: long-term clinical results

Maxillary distraction osteogenesis is indicated in severe angle class III malocclusions, and severe maxillary hypoplasia among some cleft patients and other craniofacial deformities. Twenty patients, aged 8-48 years (mean 17.8+/-10.5 SD) with maxillary and midfacial hypoplasia were treated. The follow-up period was 13-65 months (mean 35+/-16.3 SD). A trans-sinusal maxillary distractor was placed intraorally at each side of the maxilla. The distraction vector was predicted using specialist software, and was transferred to the patients using stereolithographic models and individual templates. A (high) Le Fort I type osteotomy was performed. The amount of activation varied from 8 to 17.5 mm (mean 13.1+/-2.9 SD). Soft and hard tissue formation resulted in complete healing across the distraction gaps. The distractors are almost completely submerged, and can be left in place as long as necessary to avoid relapse. Wit's appraisal was used to measure the stability of the long-term distraction results. Results up to 5 years after distraction showed considerable maxillary advancement with long-term stability. Ongoing growth of the facial skeleton must be considered when distraction osteogenesis is chosen in growing patients.     

Effects of systemic fluoride and in vitro fluoride treatment on enamel crystals

Systemically administered fluoride at a concentration of 75 ppm increases the surface roughness of developing enamel crystals in rats, which may be significant in advancing our understanding of the biological mechanism of fluorosis. Thus, the aim of this study was to investigate whether the increased surface roughness may be a result of surface restructuring by the direct action of fluoride at the crystal surface. We examined the fluoride dose-dependent roughening of enamel crystal surfaces in vivo, in the rat, and whether this roughening could be mimicked by the in vitro treatment of rat enamel crystals with neutral pH fluoride solutions. Our results showed that enamel crystal surface roughness increased after treatment with increasing fluoride ion concentrations, whether applied in vitro or administered systemically. This suggests a mechanism, alongside others, for the increased surface roughness of crystals in fluorotic enamel.