Quintessence International, 06/1994

Classic Kaposi's sarcoma is a rare malignant neoplasm of endothelial cell origin. Oral manifestation of Kaposi's sarcoma is even more uncommon. The purpose of this article is to describe two cases of classic Kaposi's sarcoma and to discuss the current knowledge regarding its pathogenesis, epid emiology, clinical characteristics, and therapy.

Various changes may occur in the gingiva and/or the periodontium as an expression of existing infection with human immunodeficiency virus. Thus, periodontal disease, characterized by unusual course, progress, and resistance to treatment, may occur with increased frequency. Clinically, pseudomembranous or erythematous (atrophic) forms of candidiasis or so-called papillary hyperplasia may be caused by ubiquitous fungi. Although Candida albicans infections arise frequently on the cheek, the palate, the dorsum of the tongue, and the corner of the mouth (angular cheilitis), gingivo-periodontal manifestation is more unusual. Because of the existing immune defect, infection with or reactivation of various viruses may occur. Recurrent, progressive destructive ulcerations may be caused by herpes simplex virus 1 or 2, but apparently limited ulcerations may be an expression of a disseminated cytomegalovirus infection. Oral Kaposi's sarcoma appears initially as bluish or reddish spots; these may transform during the course of the disease into blue, occasionally lymphoma-like or lymphangioma-like, exophytic tumors.

Overdenture bar attachment therapy is a rarely chosen treatment option in today's aggressive environment of implant treatment. However, overdenture therapy preserves the sensation of proprioception, preserves the edentulous ridge, maintains the border seal, and provides the patient with good speaking ability and chewing efficiency. The use of preformed components for impression posts, plastic burnout post patterns, plastic burnout bar patterns, attachable screw attachments, and nylon retention clips, which are quickly replaced clinically and induce minimal wear on the bar, have made the fabrication of the overdenture bar attachment easier, quicker, and more precise. This article details the fabrication of a canine splint bar for a bar and clip-retained mandibular overdenture that opposes a complete maxillary denture.

Correct planning of treatment is central to clinical dental practice, given that the skillful completion of an inappropriate procedure may be of little or no benefit to the patient. Effective treatment planning is dependent on a number of factors, including good communication with the patient, recognition of the problems that require and influence treatment, and an awreness of the prognosis of the potential alternatives.

In this limited clinical study, 30 posterior adhesive fine-particle hybrid composite resin inlays/onlays were placed. After 12 months in situ, 29 of the restorations were reexamined. The evaluation was carried out using clinical parameters and the scanning electron microscope. None of the restorations showed fractures, recurrent caries, or a clinically visible loss of substance. All restored teeth were vital. The radiopacity of the material was clinically sufficient. Only the color match, because of a suboptimal shade range, and the perfect removal of excess luting composite resin proved to be problematic. Furthermore, slight abrasion of the luting composite resin was observed, although the abrasion had no influence on the quality of the marginal adaptation. In the scanning electron microscope excellent marginal quality was observed initially (98.9% continuous margin) as well as after 12 months (94.9% continuous margin). The evaluated compo site resin inlay/onlay system has proved to be reliable during 12 months in situ.

Brain abscess is a rare, extremely aggressive, life-threatening infection. A mortality rate of between 36% and 90% has been reported as recently as 1990. It is resistant to antibiotics and is one of the few bacterial infections whose morbidity and mortality statistics remain unaffected by the development of antimicrobial medications. Su ccessful treatment appears to be dependent on early diagnosis, surgical intervention, and direct antibiotic irrigation of the surgical wound site, as well as intravenous administration of high doses of antibiotics throughout the crisis. It has been suggested that there is a relationship between dental infection or treatment and brain abscess. Dental infection and treatment have been found culpable in numerous cases reported in the literature. However, careful review of the articles reveals that dental infection or treatment has often been named as a causative factor (1) solely because an infection or treatment occurred within several months of brain abscess; (2) when nondental bacteria were cultured from the brain abscess; and (3) without culturing both the dental infection and the brain abscess to ascertain flora match.

Twenty children, presenting 66 proximal carious lesions in 60 primary molars, were selected to reveive composite resin tunnel restorations. Thirty of these teeth were expected to exfoliate within 6 months (group I); in the remaining 30 teeth exfoliation was expected within 1 year (group II). All teeth received tunnel preparations, which were then restored with a posterior composite resin. The restorations were evaluated after 6 months and after 1 year through each of the following methods: bitewing radiographic examination, clinical examination with a probe and mirror, and direct examination of proximal surfaces after tooth extraction. The occlusal portions of the restorations were considered to be excellent both after 6 months and 1 year. Radiographic examinations and direct examinations (performed after extraction of teeth) did not reveal the same percentages of secondary caries in the proximal portion of restorations. Fracture of the marginal crest reached 3% during the first 6 months, but fracture was absent during the subsequent 6 months.

The in vitro wear resistance of foru types of light-activated composite resins designed for crown and bridge veneers was determined by means of a three-body wear-testing device. After repeated cycles of loading, the wear values were measured with a profilometer, and surface textures were observed through a scanning electron microcscope. All of the composite resin veneering materials examined in this investigation exhibited greater wear resistance than an unfilled poly(methyl methacrylate)-based material. The worn surface of veneering materials demonstrated outlines of fillers, indicating the difference in wear resistance between the resin matrix and the filler.

Talon cusp is a rare phenomenon found on the lingual surfaces of anterior teeth. Five cases of talon cusp that were observed during routine clinical examination are described.

The aim of this study was to evaluate the level of aerosol pol lution following dental procedures performed in 15 sessions with an ultrasound scaler and a bicarbonate cleaner. The air contamination was measured by means of the Surface Air System method and the plate method (Air Microbial Index). Each colony-forming unitper cubic meter of air was allotted a unit value for statistical analysis. The data were then compared with the hygienic assessments made in previous studies. The results showed that the initial environmental conditions in a dental office initiated at the level of mediocre, then became very bad during dental procedures, and fell between mediocre and very bad at the end of the procedures.