The Prevalence of Dental Sealants in North Carolina Schoolchildren

Objectives: This study reports the prevalence of dental sealants derived from a survey of schoolchildren in North Carolina, and its variation according to several sociodemographic characteristics. Methods : A single-stage, stratified probability sample of grade K–12 classrooms in the state yielded a sample of 8,026 students. Clinical examinations were performed on 83 percent of the sample. Estimates for sealant prevalence and their variation according to seven sociodemographic variables were determined. Results : About 117,000 children in the state, or 12 percent of those 6–17 years of age, have sealants. The prevalence of sealants varied according to geographic region of residence and the socioeconomic status of whites. Prevalence was affected little by age, sex, degree of urbanism, or socioeconomic status of those with races other than white. Conclusions : While underutilized, there are indications in these data that sealant use is increasing, thus having the potential to contribute to further declines in the prevalence of dental caries in the state. Those factors included in this study and associated with the prevalence of sealants suggest that major gains in sealant use will need to address not only those specific barriers preventing their use by the profession or public, but broader issues preventing the utilization of dental services in general.     

Multiple endocrine neoplasia syndrome, Type III: Review and case report

Successful treatment of the multiple endocrine neoplasia type III (MEN III) syndrome requires early diagnosis. It is highly possible that the patient's dentist may be the first practitioner with the opportunity to diagnose this potentially fatal syndrome. Additionally, patients with this syndrome having a pheochromocytoma and needing invasive dental treatment pose a life-threatening dental management risk. This article presents a review of the MEN III syndrome and a case report on the surgical management of a MEN III patient with a pheochromocytoma.     

Progressive systemic sclerosis – oro-facial manifestations. Case report

Progressive systemic sclerosis is a chronic disease characterized by diffuse sclerosis of connective tissue. Cutaneous and visceral tissues may be involved and there are oro-facial manifestations of which dental practitioners should be aware. Facial skin rigidity and microstomia are features of the disorder which may compromise effective oral hygiene practices and render routine dental treatment more difficult. Radiographically there may be widening of the periodontal ligament spaces and loss of mandibular bone associated with muscular attachments.
A case of scleroderma is presented which illustrates a typical presentation of the disease. The need for regular dental care in these patients is discussed.     

The Surface-Specific Caries Pattern of Participants in a School-Based Fluoride Mouthrinsing Program with Implications for the Use of Sealants

This paper describes the surface-specific changes in the DMFS after seven years of a school-based mouthrinsing program occurring in the elementary schools of the fluoride-deficient Three Village Central School District, Long Island, New York. The effectiveness of mouthrinsing was evaluated annually by comparing the caries prevalence of a random sample of participants to that of Three Village elementary schoolchildren examined in 1975, prior to the beginning of the program. Because sixth-grade children rinsed the longest and had the longest exposure to the caries challenge, only sixth-grade children who participated in the program are included in the analysis. Overall, they experienced a 50 percent reduction in dental caries; the reduction was not uniformly experienced by all surfaces. Proximal surface caries showed the greatest rate of change but the least absolute change, because the amount of proximal carious lesions was low initially. Occlusal surfaces showed the greatest absolute reduction in dental caries, whereas buccolingual surfaces had the lowest percentage reduction. The majority of the decayed or filled surfaces, 94 percent, involved pits or fissures. Therefore, it was concluded that the combined use of sealants and weekly fluoride rinsing could produce a virtual elimination of dental decay in elementary schoolchildren.     

Silicone-induced foreign-body reaction after temporomandibular joint arthroplasty. Case report

Dacron-reinforced Silastic sheets were removed from two patients who had previously undergone surgery for internal derangements of the temporomandibular joint. Excised tissue from around the joints was submitted for histological analysis, revealing a diagnosis of detritus synovitis. The significance of these findings with respect to the insertion of foreign material into the jaw joint is discussed in the light of recent research.     

Plasma‐derived human antithrombin attenuates ventilator‐induced coagulopathy but not inflammation in a Streptococcus pneumoniae pneumonia model in rats

Summary. Background: Mechanical ventilation exaggerates pneumonia‐associated pulmonary coagulopathy and inflammation. We hypothesized that the administration of plasma‐derived human antithrombin (AT), one of the natural inhibitors of coagulation, prevents ventilator‐induced pulmonary coagulopathy, inflammation and bacterial outgrowth in a Streptococcus pneumoniae pneumonia model in rats. Methods: Forty‐eight hours after induction of S. pneumoniae pneumonia rats were subjected to mechanical ventilation (tidal volume 12 mL kg^?1, positive end‐expiratory pressure 0 cmH₂O and inspired oxygen fraction 40%). Rats were randomized to systemic treatment with AT (250 IU administered intravenously (i.v.) before the start of mechanical ventilation) or placebo (saline). Non‐ventilated, non‐infected rats and non‐ventilated rats with pneumonia served as controls. The primary endpoints were pulmonary coagulation and inflammation in bronchoalveolar lavage fluid (BALF). Results: Pneumonia was characterized by local activation of coagulation and inhibition of fibrinolysis, resulting in increased levels of fibrin degradation products and fibrin deposition in the lung. Mechanical ventilation exaggerated pulmonary coagulopathy and inflammation. Systemic administration of AT led to supra‐normal BALF levels of AT and decreased ventilator‐associated activation of coagulation. AT neither affected pulmonary inflammation nor bacterial outgrowth from the lungs or blood.Conclusions: Plasma‐derived human AT attenuates ventilator‐induced coagulopathy, but not inflammation and bacterial outgrowth in a S. pneumoniae pneumonia model in rats.     

Evaluation of erythrocyte morphology in the urinary sediment for the differential diagnosis of haematurias using standard light microscopy

Summary: The glomerular or non-glomerular origin of haematuria can be identified by the morphologic study of red blood cells in the urine. In the present study, we report the results obtained by the morphologic study of red blood cells in the urine of 39 patients: 22 with glomerular diseases and 17 with extra-glomerular diseases. In a blind study, we used conventional light microscopy, lowering the condenser lens to obtain a picture similar to that provided by phase contrast microscopy, an original strategy not previously reported in the literature. the highest specificity (100%) while maintaining good sensitivity (90%) was obtained when 70% or more dysmorphic erythrocytes were adopted as a criterion of dysmorphism.