A 4‐year follow‐up case of extrusive luxation in a patient with cerebral palsy

Cerebral palsy (CP) is a condition caused by brain damage before, during, or shortly after birth. Communication can be a challenge when treating patients with CP. Some patients can communicate verbally, while others use augmentative alternative communication tools or have individualized means of communication. Therefore, professional dental treatment in individuals with CP is challenging, especially if the patient is affected by dental trauma and requires emergency treatment. This report shows how individualized communication skills assessment allowed us to successfully manage a 9‐year‐old patient with CP, who suffered extrusive luxation of the permanent lower incisor. In the present case, the teeth were repositioned briefly after the trauma had occurred and then stabilized with a flexible splint according to international guidelines. The teeth remained vital and periodontal repair was observed during the 4‐year follow‐up.     

钛瓷瓷裂的临床研究和原因分析

目的：分析钛-瓷修复体失败的原因。方法：对38例瓷裂的钛-瓷修复体进行分析：①肉眼观察烤瓷崩瓷部铸件的表面颜色并用便携式厚度测试仪测量其厚度，与未发生瓷裂的正常镰铬合金烤瓷比较；②观察烤瓷崩瓷的部位；③X-ray检测铸件内部气孔。结果：本组崩瓷的钛-瓷修复体，其断层或有气泡，或金属表面氧化层明显增厚（P〈0．05）。而且，所有发生崩瓷的部位均在受力点或因技工本身操作不当引起。结论：钛-瓷修复体失败的原因与加工过程中工艺、瓷的受力点以及与钛元素化学性能有关。     

Introducing dental students to clinical patient care: The complete denture prosthodontics transition clinic

Using complete denture treatment as an introduction to clinical patient care for dental students, the purposes of the Complete Denture Prosthodontics Transition Clinic at the University of Colorado School of Dentistry are to reduce the time lapse between the preclinical complete denture prosthodontics course and the first denture patient experience, and to encourage development of student self-confidence and skills. In the 2002 spring semester, faculty at the University of Colorado School of Dentistry initiated the Complete Denture Prosthodontics Transition Clinic for DS-II (second-year) dental students, as an introduction to clinical patient care. Each patient was assigned to a team of two dental students. Three Division of Prosthodontics faculty members staffed each clinic session, providing a student-to-faculty ratio of approximately 6.6:1 and a patient-to-faculty ratio of approximately 3.3:1. All DS-II students in the Class of 2004 delivered their first complete dentures no later than 8 months (average, 184 days) after the last day of the preclinical complete denture prosthodontics course. The time from the diagnostic appointment through the denture placement appointment averaged 39 days for patients treated in this program, compared with an average of 98 days or more for previous classes. The program was successful in achieving the goal of reducing the time lapse between the preclinical complete denture prosthodontics course and the first denture patient experience.     

Association between commensal bacteria and opportunistic pathogens in the dental plaque of elderly individuals

Opportunistic infections in the oral cavity of the elderly may increase the incidence of systemic disease. The objective of this study was to investigate the differences in the oral bacterial flora between dependent elderly (inpatients) and independent elderly (community-dwelling residents). After multiple variables were taken into account, inpatients had significantly lower detection rates than community-dwelling residents for alpha-streptococci (p < 0.001) and Neisseria (p 0.004), and higher detection rates for Pseudomonas aeruginosa (p 0.024), methicillin-resistant Staphylococcus aureus (MRSA) (p 0.011) and Actinomyces spp. (p 0.005). Among inpatients, the requirement for a high degree of care was related negatively to detection of alpha-streptococci, but was related significantly to detection of P. aeruginosa (p 0.018) or MRSA (p 0.004). Tube-fed inpatients had a significantly lower detection rate for alpha-streptococci (p 0.041) and a higher detection rate for P. aeruginosa (p 0.004) than those who did not require tube feeding. Inpatients with a history of antibiotic use had a significantly lower detection rate for alpha-streptococci (p 0.049) and a higher detection rate for MRSA (p 0.007) than those without a history of antibiotic use. The detection rates for P. aeruginosa or MRSA in inpatients without alpha-streptococci were higher than in inpatients with alpha-streptococci after controlling for age and gender (P. aeruginosa, p 0.006; MRSA, p 0.001). Overall, detection of alpha-streptococci had an inverse correlation with the detection of P. aeruginosa and MRSA in the oral cavity and is likely to be an indicator of pathogenic bacterial infection.     

A clinical and radiological two‐year follow‐up study of maxillary overdentures on osseointegrated implants

In order to satisfy the need to restore the aesthetics, phonetics and comfort and to facilitate optimal hygiene procedures, 20 edentulous patients were treated with a new concept of overdenture therapy on implants ad modum Brånemark. After 24±3.5 months the patients were re‐examined. They were asked to answer a questionnaire and use a Visual Analogue Scale (VAS) to give their opinion on the prosthetic treatment. The results indicate that an implant‐retained overdenture in the maxilla with this design can satisfy the patients needs in aesthetics, phonetics and comfort and can 1 facilitate oral hygiene measures.     

复合树脂充填物与酸蚀牙齿间密合度的扫描电镜观察

用SEM观察6种复合树脂充填物与酸蚀牙齿间密合度。结果表明6种复合树脂充填物与牙齿间均有微缝隙,其宽度多数在5μm内,最宽为10～15μm。1月后再观察,清晰见到从酸蚀牙本质小管曳出的树脂突,其曳出方向与缝隙形成可能有关。     

Dental fear treatment: comparison of a video training procedure and clinical rehearsals

Abstract – Two types of fear desensitization, video training, and clinical rehearsals, were evaluated using psychometric tests, behavioral measures, and interviews for a group of 68 dental fear patients with high and low general trait anxiety. After treatment, a visual analogue scale (VAS) also tested the degree of perceived anxiety before going off to an unknown dentist. Results indicated no significant differences in dental fear reduction effects of the two types of desensitization. However, both treatments showed significant and meaningful effects when compared with a group of 75 dental fear patients on a waiting list who were also tested once at the beginning of the waiting period and again after 6 months. Only high general anxiety subjects resisted desensitization and failed standardized dental treatment tests. Exit interviews revealed that both groups named securing/accepting personnel, conversations about their fears and relaxation, in that order, as the most important factors in their dental fear reduction. Psychometric trust scores confirmed this. VAS scores showed a significant increase in fear level about the next dentist, also indicating trust as a major factor in reducing dental fear. Suggestions are made about which patient conditions can affect the choice of either of these training methods.     

Disposition and hypoglycaemic action of glipizide in diabetic patients given a single dose of nifedipine

Summary Adrenaline, when administered in dental local anaesthetic solutions, significantly reduces the plasma potassium concentration in young healthy adults. This effect occurs within 10 min of extravascular injections into the maxillary buccal sulcus and may influence the choice of local anaesthetic solution for patients receiving kaliuretic diuretics.     

Scanning electron-microscopic study of pellicle and plaque formation on tetracyclineimpregnated dentin

Abstract — Previous experiments have shown that tetracyclinecs may react with hydrosyapatite, e.g. in enamel and dentin, without losing their antimicrobial capacity. The present paper examines the pattern of pellicle and plaque formation on doxycycline-treated dentin by the use of scanning electron microscopy (SEM). From newly extracted human teeth were prepared standardized dentin slabs, half of which were soaked in aqueous solutions of doxycycline HC1, 10 mg/ml (pH 2.5) for 10 min. Seven volunteers carried doxycycline-impregnated specimens ligated to the buccal surface of a maxillary molar for 2 h, 8 h, 24 h and 120 h, respectively. Untreated control specimens were ligated to the contralateral teeth. After removal from the oral cavity, the dentin slabs were briefly rinsed in water, allowed to air dry and processed for SEM. SEM assessment of the specimens showed that doxycycline-impregnation resulted in a superficial etching of the dentin, a reduced rate of pellicle formation as well as an impairment of pellicle adhesion, and a retarded bacterial plaque formation on the dentin surfaces.