Co-ordinated treatment of secondary cleft deformities

Secondary cleft deformities result from the cumulative effects of functional and morphological abnormalities. Treatment choices should be based on a comprehensive plan which is designed to minimize treatment time and iatrogenic effects and which is based on sound physical and psychosocial objectives. Conventional orthodontic and orthognathic surgical principles can be modified and applied to a variety of facial cleft problems. Direct surgical correction of secondary deformities instead of prosthetic or orthodontic compensation expands treatment possibilities and optimizes treatment results.     

Dental Fluorosis and Caries Prevalence in Children Residing in Communities with Different Levels of Fluoride in the Water

Objectives: This study investigated the prevalence of dental fluorosis and caries in 7–14-year-old children residing in communities with negligible (NF: 0.2 ppm), optimal (OPF: 1.0 ppm), and four-times optimal (4X OPF: 4.0 ppm) naturally occurring fluoride in their water systems. Methods : Examinations were performed on 344 children who were lifetime residents of their communities. Results : Whether using the tooth surface index of fluorosis or Dean's index, children examined in the 4X OPF community had the highest prevalence of dental fluorosis. While the severity of fluorosis seen in the OPF and NF communities was mild in appearance, the results indicate that fluorosis does occur in optimally and negligibly fluoridated communities. Compared to the NF community, DMFT and DMFS scores in the OPF community were 9.2 percent and 21.2 percent lower, respectively. Conclusions : The ingestion of water containing 1 ppm or less fluoride during the time of tooth development may result in dental fluorosis, albeit in its milder forms. However, in these times of numerous products containing fluoride being available, children ingesting water containing 1 ppm fluoride continue to derive caries protection compared to children ingesting water with negligible amounts of fluoride. Thus, the potential for developing a relatively minor unesthetic condition must be weighed against the potential for reducing dental disease.     

Open mandibular condylotomy (osteotomy) with precision scaphoid staple osteosynthesis and meniscopexy. A description of the operation

The technical minutiae of the operation of open mandibular condylotomy and precision scaphoid staple osteosynthesis with meniscoplasty or meniscopexy is described and illustrated. The operation is regarded as an evolution of closed condylotomy described by Ward in 1961 and is indicated for those cases of severe and persistent temporomandibular joint pain and crepitus unresponsive to skilled conservative treatment over a reasonable time. The success of the procedure is probably the sequel of a partial denervation of the joint capsule associated with arthrotomy, the interruption of venous hypertension, the relocation of the mandibular condyle and enlargement of the joint space. The operation is also applicable to cases of active (and inactive) mandibular condylar hyperplasia wherein a condylar neck ostectomy and staple is used to ablate an active growth centre or correct a lesser degree of mandibular asymmetry.     

Internal derangements of the temporomandibular joint. III. Anterior repositioning splint therapy

A bstract — Over a four-year period, anterior repositioning (REPO) splint therapy was used to treat 241 temporomandibular joint pain patients for whom a clinical diagnosis of anterior disc displacement had been made. Following an initial six months of active REPO therapy, the response to treatment over the ensuing twelve months was generally encouraging, control of joint noise and discomfort being achieved in 70 per cent of the treated sample. This figure had decreased to 53 per cent at the two-year follow-up and, by the end of three years, only 36 per cent were considered successfully treated.
It is suggested that REPO splint therapy for anterior disc displacement should not be lightly undertaken by the general dental practitioner but that a more conservative approach should be adopted for the vast majority of TMJ pain patients.     

Severe and fatal mass attacks by 'killer' bees (Africanized honey bees--Apis mellifera scutellata) in Brazil: clinicopathological studies with measurement of serum venom concentrations

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