Palatal neurofibroma associated with localized periodontitis

BACKGROUND: Neurofibromatosis type 1 (NF1) is the most common form of neurofibromatosis. While typically considered a dermatologic disorder, intraoral signs of neurofibromatosis occur quite commonly. This clinical entity can be confused with periodontitis because of the presence of periodontal pockets. In this report, we present the case of a palatal neurofibroma with radiographic involvement in a patient with NF1. METHODS: A 40-year-old female patient was referred from her general dentist to evaluate advanced periodontitis in the maxillary left quadrant. The patient's medical history was significant for a soft tissue lesion excised from her back 11 years previously and diagnosed as a neurofibroma. Subsequent medical examination at that time confirmed a systemic diagnosis of NF1. A comprehensive periodontal evaluation was performed, and panoramic and periapical radiographs were taken. Teeth were tested for vitality. An incisional biopsy was completed for histopathologic examination. RESULTS: The periodontal evaluation revealed the presence of 6 to 9 mm probing depths adjacent to teeth #14 and #15. Panoramic and periapical radiographs showed a circumscribed 0.8x0.9-cm unilocular radiolucency superimposed over the root of tooth #13 and extensive horizontal bone loss on the distal side of #15. Incisional biopsy confirmed the presence of a neurofibroma, and because of the extent of the lesion, the patient was referred to the Oral and Maxillofacial Surgery service for complete excision. CONCLUSIONS: Neurofibromas can cause extensive destruction of alveolar bone, mimicking periodontitis. Due to the potential systemic and genetic implications, the diagnosis of neurofibroma requires appropriate medical referral.     

Characteristics of domestically produced siloxane elastomer for making elastic gingival prosthetic device

Gingival prosthetics effectively eliminates esthetic and phonetic disturbances in cases of pronounced gingival recession. Technology for making elastic gingival prosthetic devices of domestically produced siloxane elastomer composition with microwave siloxane vulcanization is described as well as the technique for making combined gingival prosthetics of siloxane composition and colorless plastic.     

Tooth loss in treated periodontitis patients responsible for their supportive care arrangements

AIM: To identify risk indicators associated with tooth loss and periodontitis in treated patients responsible for arranging supportive periodontal care (SPC). MATERIALS AND METHODS: Ninety-seven Chinese subjects (34-77 years) who showed favourable responses to periodontal therapy provided in a teaching hospital 5-12 years previously were recalled. They were advised to seek regular SPC on discharge. Background information, general health status, smoking, oral hygiene habits, follow-up dental care, tooth loss, and periodontal parameters were investigated. Multiple regression analysis was performed. RESULTS: Two hundred and fifty-six teeth had been lost, 195 because of self-reported periodontal reasons. Up to 26.8% sites were with pockets > or =6 mm. Positive correlations were found between total/periodontal tooth loss and (i) smoking pack-years, (ii) time spent on oral hygiene, (iii) years since therapy's conclusion, (iv) age, and negative correlations with (v) inter-dental brush use, and (vi) education levels. Tooth loss by arch was correlated with wearing of removable partial denture in that arch. Percentage sites with pockets > or =6 mm were significantly negatively correlated with percentage sites without bleeding on probing. CONCLUSIONS: Smokers, more elderly patients, removable partial denture wearers, and patients with lower education levels or not using inter-dental brushes ought to be targeted for clinic-based SPC.     

A longitudinal controlled study of factors associated with mutans streptococci infection and caries lesion initiation in children 21 to 72 months old

PURPOSE: The purpose of this longitudinal study was to determine factors associated with mutans streptococci (MS) infection and development of caries lesions in a group of children 21 to 72 months old. METHODS: The 63 caries-free children, recruited since birth, were divided into: (1) a study group of 24 children who were colonized with MS; and (2) a control group of 39 children without MS. The children were recalled every 3 months for approximately 24 months, and their social, medical, and dental histories were updated. At each recall, the teeth were checked for presence or absence of plaque, enamel hypoplasia, and caries lesions, and their MS status was assessed using a commercial test kit. RESULTS: MS infection was associated with: (1) visible plaque (P < .01); (2) enamel hypoplasia (P < .05); (3) commencement of tooth-brushing after 12 months of age (P < .05); (4) lack of parental assistance with tooth-brushing (P < .025); and (5) increased hours of child care/school (P < .05). Four children (20%) were colonized at an age range of 21 to 36 months, 9 (45%) at 37 to 48 months, and 7 (35%) at 49 to 72 months (P < .001). Eight children who developed caries lesions: (1) had more hypoplastic teeth (P < .001); (2) ate sugar-containing snacks (P < .05); and (3) did not brush regularly with chlorhexidine gel (P < .01) compared to those who remained free of caries lesions. CONCLUSIONS: Lack of oral hygiene, consumption of sugar-containing snacks, and enamel hypoplasia are significant factors for both MS infection and caries lesion initiation.     

Risk factors for endosseous dental implant failure

Failures of endosseous dental implants are rare and tend to cluster in patients with common profiles or risk factors. Clinical trials indicate that factors related to implant devices, anatomy, occlusion,systemic health or exposures, microbial biofilm, host immuno-inflammatory responses, and genetics may increase the risk for im-plant complications or loss. In general, factors associated with the patient appear more critical in determining risk for implant failure than those associated with the implant itself. Several risk factors can be modified. For example, the patient can modify smoking and the clinician can modify implant selection, site preparation,and loading strategy. In identifying these factors and making appropriate interventions, clinicians can enhance success rates while improving oral function, esthetics, and patient well-being.     

Student occupational exposure incidence: perception versus reality

Reports of clinical injuries made to a dental school Office of Occupational Health and Safety at the time of their occurrence were compared to self-reports on a survey for dental students in five classes at various times over their educational careers. The majority of injuries were from needlesticks and mishaps with hand instruments. Underreporting at the time of injury was approximately one-third in the first clinical year and one-half in the final clinical year of the three-year program. Students reported a greater perceived likelihood of injury later in their education than at the beginning but a decreased fear of such injuries. Female students reported more needlesticks and a greater fear of injury than did male students. It is hypothesized that a personal interpretation of the meaning of clinical injuries influences reporting behavior.     

The hyoid bone in malay infants with cleft lip and palate.

OBJECTIVE: To compare morphological and positional variations of the hyoid bone in unoperated infants with cleft lip and palate (CL/P) with those in noncleft infants. DESIGN: Retrospective, cross sectional. PATIENTS AND METHODS: Three-dimensional computed tomography scans were obtained from 29 unoperated CL/P infants of Malay origin aged between 0 and 12 months and from 12 noncleft infants in the same age range. Observations were made and measurements were obtained with a software package developed at the Australian Craniofacial Unit. The sizes of the hyoid bones and the position of the hyoid body and epiglottis in relation to the cervical spine were measured. Anatomical anomalies of the hyoid and prevalence of aspiration pneumonia were also documented. RESULTS: The hyoid bones and epiglottis were found to be located more inferiorly in CL/P infants compared with the noncleft infants. Also, 17% (5/29) of the CL/P infants had nonossified hyoid bodies. CONCLUSION: The results suggest that there are differences in the location and genesis of the hyoid bone in infants with CL/P that warrant further investigation.     

Do patients have a preference for major connector designs?

AIM: The aim of this research was to evaluate patients' preferences for resin analogs of four major connector designs formulated to have equal rigidity once fabricated in the same alloy. METHODS AND MATERIALS: Nineteen Kennedy Class I or II partially edentulous patients participated at two centers. The four major connector analogs (MCAs) were fabricated for each subject using light-polymerizing acrylic resin. The subjects were asked to wear each of them in the mouth for 30 seconds in six pairs in random order, and to report their preference for each pair. Based on these data, the four analogs were ranked in a descending preference order for each patient. Within-subject comparisons preferences were performed with the Friedman test, and the multiple comparisons were performed with the Wilcoxon Signed Ranks test for data of each sample independently. RESULTS: Statistically significant and consistent preference orders were revealed for both samples, and the thin and wide design was significantly preferred to the thick and narrow design. However, a higher variation was observed for the first preference of each subject. CONCLUSIONS: Subjects demonstrated a tendency to prefer thinner MCAs. However, the individual predilections of patients may not be an appropriate basis for an attempt to find a 'best design' applicable to all patients.     

"All I want for Christmas is my two front teeth" (the story behind the song)

During his long and productive career, Donald Yetter Gardner (1913-2004) played various musical instruments, directed church choirs, wrote contemporary church anthems and led many community-sponsored choral events. Additionally, he penned a number of popular spirituals, including "Man Shall Not Live By Bread Alone," and "O Give Thanks Unto the Lord". He was noted for his varied musical accomplishments, but he was best known for composing what was to become an international childrens holiday favorite, "All I Want For Christmas Is My Two Front Teeth".