Scaling and root planing effectiveness: the effect of root surface access and operator experience

This study investigated two variables associated with scaling and planning (S&RP): operator experience level and root surface access. One hundred and fourteen periodontally involved, single-rooted teeth designated for extraction were randomly distributed among four operators of various experience levels for either an open or closed session of S&RP. Immediately after treatment, the teeth were extracted, washed, and scored for residual calculus in a blind manner. Results showed that there was no difference in S&RP effectiveness for experience level or type of procedure in shallow (1-3 mm) pockets. However, in moderate (4-6 mm) and deep (greater than 6 mm) periodontal pockets, S&RP combined with an open flap procedure was more effective than S&RP alone for both experience levels. Also, the more experienced operators produced a significantly greater number of calculus-free root surfaces than the less experienced operators in periodontal pockets with moderate and deep probing depths. Clinical application of these results suggests that surgical access is associated with thorough surface debridement in periodontal pockets with moderate-to-advanced probing depths. However, more experienced operators could be expected to render more effective soft surface debridement.     

Electrotherapy and hyperbaric oxygen: promising treatments for postradiation complications

Electrotherapy and hyperbaric oxygen therapy have been added to physical therapy to treat patients with postsurgery and radiation sequelae. Problems of reduced oral opening and range of head movement, soft tissue necrosis, osteoradionecrosis, and delayed wound healing were addressed in 37 patients over a 3-year period. Of this group, 16 irradiated maxillary resection patients were specifically followed up to determine the effectiveness of the new modalities on improving reduced oral opening. Although healing and the quality of the soft tissues showed marked improvement there was no significant improvement in oral opening.     

A controlled study of the association of various dental anomalies with hypodontia of permanent teeth

Although hypodontia, or oligodontia, is one of the most common human dental anomalies observed, there have been few studies on the association of other anomalies occurring with it. The present investigation of 1032 patient records found that 65.7% of patients with hypodontia showed ankylosis of primary molars compared to only 1.5% of control children (P less than 0.001). In addition, taurodontism of the mandibular first permanent molar was observed in 34.3% of hypodontia cases compared to 7.1% in the controls (P less than 0.001). Other dental anomalies significantly associated with hypodontia include enamel hypoplasia (11.9%, P less than 0.01) and conical incisors (8.9%, P less than 0.01). In contrast, there were significantly more impacted teeth in control children compared to the hypodontia group. The results indicate that for patients with missing permanent teeth, clinicians should be alert to the possibility of these associated anomalies and their accompanying clinical implications.     

Effect of an acute maternal fluoride dose on fetal plasma fluoride levels and enamel fluoride uptake in guinea pigs

We conducted this study to measure maternal plasma, fetal plasma, and fetal enamel fluoride concentrations for four hours following an oral F dose to near-term pregnant guinea pigs. We placed female guinea pigs on de-ionized (Group I) or 3-ppm-F (Group II) drinking water prior to breeding and during gestation. On the 57th day of gestation, we administered a maternal dose of NaF solution (0.6 mg F/kg) by stomach tube. We collected samples of maternal plasma, fetal plasma, and fetal enamel at baseline, at 15 and 30 min, and at one, two, and four h after administration of the dose. We assayed samples for F using a modification of the micro-diffusion and ion-specific electrode method. Group I mean baseline F values were: maternal plasma, 0.016; fetal plasma, 0.002; and fetal enamel, 7.0 ppm. Group II mean values were: 0.055, 0.004, and 19.0 ppm. After the maternal fluoride dose, the mean maternal plasma [F] rose sharply for 30 to 60 min and declined to about 50% of peak values by four h. Fetal plasma [F] changed less in absolute values, but similarly to maternal changes relative to baseline. Fetal enamel mean [F] rose more in Group II than in Group I. Baseline F status had an important effect on F uptake in fetal enamel following an acute maternal fluoride dose.     

The relationship between oxide adherence and porcelain-metal bonding

The lack of a reliable bond test has hindered the elucidation of the mechanism for porcelain-metal bonding in dental systems, because a test capable of detecting differences among porcelain-metal bonds of various qualities is required before the reasons for these differences may be ascertained. A method was developed in the present study whereby specimens of alloys with differing physical properties may be deformed to a constant strain to yield a fracture surface suitable for measurement of the area fraction of retained porcelain by an x-ray spectrometric technique described previously. The method proved sufficiently discriminating that significant differences could be found in 48 of the possible 66 comparisons among alloys and treatments. Linear regression analysis revealed a strong correlation (r2 = 0.947) between the area fractions of retained porcelain measured in the present study and the oxide adherence strength values measured previously. This strong correlation, when considered in light of the literature evidence for the presence of an oxide layer at the porcelain-metal interface, provides compelling support for the oxide layer theory of porcelain-metal bonding in dental alloy systems.     

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.