Quintessence International, 05/1993

This article reviews some of the factors involved in shade selection for prosthetic teeth and suggests simple techniques for accurately transmitting information about the desired color to the laboratory technician.

A technique in which the custom-made anterior ceramometal pontics are securely attached to the metal framework of a Kennedy Class IV removable partial denture is described. This technique results in a more esthetic prosthesis with less palatal coverage.

The maxillary anterior region presents a difficult and uniqu therapeutic challenge in the treatment of periodontal disease. The periodontist should use therapeutic procedures to prevent or minimize esthetic problems, such as increased tooth length and loss of interdental papilla, without compromising the main goals of periodontal treatment. This article presents various periodontal treatment modalities that can be used in the anterior maxillary area with acceptable esthetic results. A better understanding of the problem, the treatment steps, and the various options available may improve the communication between the general practitioner and the periodontist, producing satisfactory long-term results.

Glass-ionomer cement and composite resin can be used in combination for restoration of an endodontic access preparation. Adhesive restorations using these materials avoid the problems of marginal leakage and tooth discoloration, characteristic of silver amalgam restorations, and preclude the need for complete-coronal restoration. A detailed clinical procedure for placement of a stratified glass-ionomer cement and composite resin restoration for an endodontically treated permanent incisor is described.

Children and adolescents, aged 2 to 18 years, from 300 poor families in Addis Ababa were examined to determine the prevalence of the traditional practice of primary canine tooth removal. Fifteen percent of the primary canine teeth were found to have been affected, and 7% of the permanent canines had been damaged by this practice. A questionnaire to a subset of 40 families revealed some of the reasons that this procedure is still carried out, in spite of the considerable associated morbidity.

One aspect of a rpevious retrospective radiographic study was an examination of diameter and length changes of root canals at various ages. It was found that root canal shrinkage increased with advancing age. In the present follow-up study, a larger population (500 subjects) was used and only mandibular anterior teeth were evaluated. Root canal shrinkage was calculated vertically and horizontally. Measurements taken were tooth length, coronal length, apical length, root canal length, cervical width, midroot width, and apical width. Six age groups were examined: 17 through 20; 30 through 39; 40 through 49; 50 through 59; 60 through 69; and 70 through 79. Root canals showed statistically significantly more shrinkage with advancing age; there were significant changes among all groups. These findings could prove useful in anthropology and forensics and as an aging biomarker.

The long-term durability of a photocured resin bond to groun bovine dentin with its smear layer retained was investigated. The bonding resin that was employed was composed of 5.0 wt% 2-(methacryloxy)ethyl phenyl hydrogen phosphate (phenyl-P) as a diffusion-promoting monomer, 0.5 wt% camphorquinone as a photosensitizer, and 0.5 wt% N-phenylglycine as a reducing agent in triethyleneglycol dimethacrylate. Following polymerization of the bonding resin, a composite resin was placed and photocured for 60 seconds. Prepared specimens were stored in 37 degrees C water for 1 day, 6 months, and 1 year. Measured tensile bond strengths were 6.7 MPa after 1 day of storage, 4.1 MPa after 6 months of storage, and 2.8 MPa after 1 year of storage. Examinations of the interfaces after fracture under tensile loading suggested that long-term water-immersion weakened the bonds between the photocured adhesive resin and the smear layer-retained dentin because there was insufficient diffusion of the adhesive resin through the retained smear layer.

A retrospective survey was performed to assess side effects of alloys used in fixed and removable partial prosthodontics. Nineteen clinicians reported the status of prosthodontic appliances that had up to 31 years of service and the reactions in the corresponding oral mucous membrane. Survey charts of 335 patients, who had a total of 915 fixed and 87 removable prosthodontic units, were received. Almost half of these prostheses were made from base metal alloys, mainly nickel-chromium alloys for the fixed partial dentures, and cobalt-chromium for the removable partial dentures. The rest were classified as gold and palladium-type alloys or as miscellaneous. There were no or only slight deviations from the normal uniform luster of the metal components in all groups. Only four unit were reported to have moderate reactions of severe tarnish and signs of corrosion. The gingiva and oral mucosa adjacent to the restorations were normal but showed slight changes in all groups. Twenty-three of the 335 patients were reported to have moderate reactions, and two patients had severe raactions. The soft tissue reactions were considered to be largely due to factors other than the metal components.

This two-part paper discusses treatment considerations for geriatric patients-a population that is on the rise. The first part of this paper examined the effects of aging on general health and on the oral environment. The second part discusses restorative treatment options for geriatric patients with caries, tooth wear, or missing teeth.

This paper describes a case of transmission of herpetic whitlow to the index finger of a dental student from a patient with herpes simplex virus. The recognition of intraoral viral infections in patients is important because thse viruses have serious implications for health care providers. Rubber gloves must be worn when patients with primary or secondary herpetic lesions are treated. Asymptomatic permanent herpes virus carriers must also be treated with appropriate precautions.