Quintessence International, 03/1998

This article describes a build-up technique that uses a customized acrylic resin shell for restoring endontically treated molars that are involved in three-unit fixed partial denture design. The shell confines the amalgam without impinging on the peridontium to ensure a proper core foundation, an ideal tooth preparation, and a more predictable final restoration.

The antibiotic era begain in the early 1940s with the clinical use of penicillin. Subsequent discovery, develoment, and clinical use of othe rantibiotics resulted in effective therapy against major bacterial pathogens. These drugs were so effective that bacterial infectious diseases were considered by many experts to be under complete therapeutic control. However, the scientific community grossly underestimated the remakrable genetic plasticity of these organisms and their ability, through mutations and genetic transfer, to develop resistance to antibiotics. Infectious diseases are now the worlds' major cause of death. The cause of bacterial reemergence as a threat to human health and life is the abuse of the miracle d rugs. The ubiquitous nature of antibiotics in the human ecosystem foments bacterial resistance and threatens to eliminate antibiotics as effective drugs for human therapeutic use.

For each patient who requires removal of anterior teeth, there are a multitude of treatment considerations. Cosmetic demands, functional needs, treatment sequencing, timeliness, and affordability are some primary concerns that must be addressed on an individual basis. A patient will generally want a cosmetic and functional prosthesis at the earliest possible opportunity. Providing the most apprp riate interim prosthesis for a given patient is both challenging and rewarding. The numerous clinical techniques for immediate interim tooth replacement are reviewed, and previously unreported methods are presented to assist the clinician in the selection of interim prosthesis design.

The development of resin cements for use in fixed prostheses has suggested the possibility of a new direct restorative technique, the bonded amalgam. This restoration te chnique reportedly reduces microleakage and increases adhesion to dental structure compared to conventional amalgam restoratie techniques. Factors such as to oth conservation, occlusion, patient age, and the time required for the execution of this type of restoration should also be considered. An amalgam restoration was placed with the adhesive technique in a 13-yea r-old patient with a nonvital mandibular left second molar and limited interocclusal space. After 3 years of observation, the restoration shows excellent function, suggesting its appropriateness for special clinical situations.

Objective: Recent studies have demonstrated that acid etching of vital dentin and pulpal tissue does not retard pulpal healing, odontoblastoid cell differentiation, or dentinal bridge formation when the pulp is capped with adhesive resins. The purpose of this study was to evaluate the pulpal response in nonexposed and exposed monkey pulps to treatment with the Clearfil Liner Bond 2 and Clearfil AP-X system. Method and materials: Class V and Class I cavities in nonexposed and exposed pulps were observed at 7 or 8, 27, and 97 days. Results: There were no differences in pulpal inflammation between the Clearfil Liner Bond 2/Clearfil AP-X specimens and calcium hydroxide controls in either Class V or Class I cavities at the various time periods. Conclusion: Clearfil Liner Bond 2 and Clearfil AP-X system is not toxic to either nonexposed or exposed pulpal tissues when placed according to manufacturer's directions.

The maxillary tuberosity can fracture during extraction of a molar tooth. If a small bony fragment is affected, the extraction of the tooth and tuberosity continues; however, a conservative approach is advised if the bony fragment is large. In a modified blind surgical technique, the tooth is removed without the fractured bone.

Oligodontia is defined as the congenital absence of six or more teeth, excluding the third molars. Genetic factors play an important role in oligodontia, which can occur as an isolated fining or as part of a syndrome. Characteristic dental symptoms are a reduced number of teeth, a reduction in tooth size, anomalies of tooth form, and delayed eruption. This article describes treatment of a 6-year-old girl with congential absence of 16 permanent teeth. Her malocclusion was corrected by orthodontic therapy, and removable partial dentures were made to improve esthetics and chewing function.

Hand, foot, and mouth disease is a viral infection related to coxsackieviruses A5, A6, A9, and A10, coxsackieviruses B2 and B5, and echovirus 11. It generally affects children, b ut this article presents a clinical case of a young woman with hand, foot, and mouth disease. Patients with this disease have oral and skin lesions that may be confused with other diseases. The differential diagnosis is very important because both dental and medical professionals may misdiagnose the disease and sometimes perscribe an inappropriate medication

The effect of Sensodyne dentifrice, which contains strontium chloride hexahydrate, on the occlusion of dentinal tubules was studied in vivo and in vitro. Eight premolar teeth schedule for extraction for orthodontic purposes were used. Four of the teeth were extracted before Sensodyne application (in vitro). The other four teeth were treated in vivo and then extracted. A patch of enamel was removed from all the teth toe xpose the dentinal surfaces, and the smear layer over the exposed area was removed. In the in vivo test, the patients were instructed to brush their teeth for 1 minute, twice a day, for 2 weeks. The teeth were thene xtracted and kept in distilled water until examined by scanning electron microscope . The in vitro teeth were brushed in the same manner and kept in distilled water between brushings. Most of teh in vitro dentinal tubules were found to be open, whereas most of the in vivo dentinal tubules were occluded.