Quintessence International, 09/1995

The combination of intracoronal and extracoronal bleaching represents a conservative treatment to restore esthetics to darkened or stained nonvital teeth. Notwithstanding the eventual risks and difficulties accompanying such technique, nonvital teeth often can be successfully lightened. This article presents a few guidelines for bleaching nonvital teeth as well as a clinical case to illustrate the indications and clinical protocol for the technique.

The functional and esthetic needs of the patient who is to receive an implant-retained prosthesis can be established with the help of a provisional restoration that is duplicated in a radiopaque radiographic template. The computer tomogram prepared with the aid of the template allows the evaluation of the implant sites in relation to the outline of the planned restoration. The radiographic template is converted into the surgical template, which contains information regarding the optimal position and angulation of implants. Because the surgical template is a modification of the radiographic template, which rests rigidly on the teeth during all procedures, implant placement is more predictable.

Interarch space is sometimes severly restricted, precluding the use of a conventional removable partial denture design. The treatment of a patient with posterior bilateral edentulous spaces and insufficient interarch space is described. A modified removable partial denture with metal bases and metal pontics covered with facial veneers of tooth-colored resin was used to provide a functional and esthetic restoration.

Two techniques for incorporating bonded porcelain facings within metal partial dentures are described. In the first technique, procelain is bonded to a metal framework constructed of bonding alloy. In the second technique, separate components are combined in a cast-on procedure to incorporate the mechanical properties of both bonding and framework alloys in one prosthesis. These techniques have enabled the successful treatment of patients in whom limited interocclusal space or parafunctional activity had led to failure of previous prostheses.

Removable partial denture production in western Germany was studied by analyzing 1,082 photographs taken in consecutive series at five large dental laboratories. The photographic technique was standardized, enabling evaluation of the casts as well as the design of the dentures. Of the casts, 47.2% were maxillary and 52.8% were mandibular. The mean number of teeth present was 6.29 in the maxilla and 6.57 in the mandible. In the maxilla, 52.9% of the molar regions were edentulous; ie, they had distal-extension free-end spaces. The corresponding figure for the mandibles was 72.7%. Most of the maxillary removable partial dentures had a palatal strap or a palatal plate, and most of the mandibular dentures had a lingual bar. Of the removable partial dentures, 53.1% had precision attachments, and 36.1% were retained by clasps only.

Electrolytic corrosion is part of a broader electrochemical phenomenon that is responsible for oral galvanism. Because several physiopathologic manifestations are associated with the electrochemical phenomenon of galvanism, making the differential diagnosis can be difficult. In endodontically treated teeth, periapical electrolytic corrosion phenomena with associated symptoms can easily be misinterpreted, and the clinical presentation may be accepted as a diagnosis rather than a symptom. The purpose of this paper is to describe two cases of symptomatic periapical electrolytic corrosion resulting from the creation of active bimetallic galvanic cells involving silver points. The treatment involved the placement of a retrograde seal into the apical part of the root canal, which controlled the unwanted effect of leakage into the canal space. With the electrochemical activity attenuated, periapical healing and remission of symptoms occurred.

Six cases of squamous cell carcinoma arising in the head and neck of patients infected with the human immunodeficiency virus described. This article reports the first two cases of primary intraosseous squamous cell carcinoma associated with infection with human immunodeficiency virus. Clinical presentation, results of imaging studies, histologic characteristics, therapies applied, and the clinical follow-up are described in detail for each of the six cases. These data are evaluated through a review of the current literature.

Three lining materials, Life, Ketac-Bond, and IRM, were investigared for their antibacterialeffects within dentinal tubules. Sterile saline served as control. Sixty standardized bovine root specimens were infected with Enteroccoccus faecalis following smear layer removal. The materials were mixed according to manufacturer's directions and inserted in the canal lumina; additional IRM specimens received a softer than normal mix. Specimens were incubated for 24 hours or 7 days, after which dentinal samples were taken from within the limina and the numbers of bacteria present were assessed. All the materials had a significant antibacterial effect after 7 days. Life demonstrated a more marked effect at 7 days than at 24 hours. The strongest antibacterial effect at 24 hours was shown by a soft mix of IRM. Ketac-Bond demonstrated an increase in antibacterial activity during the experimental period.