Quintessence International, 09/1997

This case report describes the treatment of an adult patient with a combination of fixed and removable prosthodontics. The treatment involved increasing the patient's vertical dimension of occlusion, placing two osseointegrated implants, making six surveyed crowns, fabricating a maxilalry partial denture, and using magnets to help retain the mandibular partial denture. The clinical st eps for using a type of intraoral magnet are described.

The new generation of manual and powered toothbrushes that have been tested in recent years exhibit better plaque removal than do older brushes. Differences are most significant when individuals have been instructed in proper brushing technique. Comparisons of powered and manual brushes show the clear superiority of newer powered brushes, but there is no such effect with older powered brushes, which stop when force is applied. Newer powered brushes reduce gingivitis and gingival abrasions. In a limited 18-month trial, a powered oscillating toothbrush improved existing periodontal conditions, thus effecting a considerable savings in treatment costs. At present, under optimal conditions, improved designs of both manual and powered toothbrushes, which do not stop or break down in use, produce more significant plaque removal in critical sites. Long-term trials are needed to confirm these results.

Ectodermal dysplasia is a hereditary disease characterized by a congenital dysplasia of one or more ectodermal structures and their accessory appendages. Common manifestations include defective hair follicles and eyebrows, frontal bossing with prominent supraorbital ridges, nasal bridge depression, and protuberant lips. Intraorally, common findings are anodontia or hypodontia, conical teeth, and, consequently, generalized spacing. The patient may suffer from dry skin, hyperthermia, and unexplained high fever as a result of the deficiency of sweat glands. The present review focuses on the clinical manifestations, classifications, and diagnosis of ectodermal dysplasia. A 6-year-old girl, described in the case report, exhibited many of the manifestations of ectodermal dysplasia as well as behavioral problems and a severe gag reflex. The treatment to improve her appearance and oral function included a removable prosthesis, acid-etch-retained indirect resin composite veneers, and a fixed partial denture.

The purpose of this study was to evaluate the effectiveness of a transcutanous electrical nerve stimulation unit. The effects of electronic dental anesthesia and local anesthesia for deep cavity preparations i n primary molars were compared in children aged 7 to 9 years by using the Eland Color Scale. The patients had symmetric teeth requiring Class I cavity preparation. One of the teeth was treated with electronic anesthesia and the other with local anesthesia. The tooth and method were selected randomly. Both restorations were finished at the same visit. There was no statistically significant difference between the groups in the perception of pain. Fifty-six percent of the children preferred transcutanous electrical nerve stimulation, while 36% of them preferred local anesthesia.

Questionnaires were used to evaluate operators' and patients' attitudes to a recently introduced electronic dental analgesia system. Five participating dentists were given 30 minutes; instruction in the use of the system and asked to offer the use of the system to patients who expressed an interest in using the system or anxiety to administration of local anesthesia. The system, used for 113 patients, was considered most useful for placement of Class I and Class V restorations and procedures such as crown or prosthesis insertion. The system was considered most suitable for patients who disliked needles or numbness. P rincipal difficulties encountered were the time-consuming nature of the system and the differing electrode sites required for different patients. Major benefits identified were the absence of drugs, needles, residual numbness, and invasiveness and a reduction in anxiety in needle phobics. Forty-one percent of patients indicated that the system controlled discomfort more effectively than did local anesthesia. Seventy-two percent of respondent patients stated that they would request its use for future treatment.