Quintessence International, 04/1998

Objective: The overall clinical performance of porcelain veneers was evaluated at 5 years. Method and materials: Porcelain veneers were placed on 87 maxillary anterior teeth in 25 patients (19 to 69 years) by a single operator following a standardized clinical procedure. At the 5-year recall, esthetics, marginal performance, vitality, fracture rate, and patient satisfaction were recorded. Results: At recall, 93% of the veneers were satisfactory without intervention. The remaining 7% presented clinically unacceptable problems such as recurrent caries, porcelain fracture, severe clinical microleakage, or pulpal reaction. The retnetion rate of the porcelain veneers was 100%, and the maintenance of esthetics was perfect . Only 14% of the veneers presented excellent marginal adaptation over the entire outline of the restoration; however, the impact of the slight marginal defects on the clinical performance was negligible. Conclusion: Labial porcelain veneers offer a reliable and effective procedure for the conservative treatment of discolored, malformed, and malaligned anterior teeth.

The bacteria causing diseases that are now becoming serious public health threats are neither strange nor exotic, but rather shockingly familiar. Tuberculosis, typhoid fever, meningitis, pneumonia, and septicemias are emerging global threats. The infectious agents causing these serious threats are the same bacteria identified many decades ago. The only difference is that these and other microorganisms are no longer killed by the miracle drugs that have kept them at bay for the past six decades. Antibiotic resistance has made potential killers out of bacteria that previously posed little threat to mankind. The indiscriminate and reckless use of antibiotics has led to a fast-appraoching crisis in which human dominance of the planet is threatened by single, elementary cells of the microbial world. Part I of this article detailed the causes of the crisis. Part II addresses the solutions that are recommended by national and international authorities and organizations.

Objective: It is essential that the dental surgery autoclave be tested regularly to ensure that it is operating at a temperature and pressure that will kill all microorganisms. The aims of this study were to investigate the knowledge of general dental practitioners on aspects of autoclave use, to examine their autoclaving routines, and to test the effectiveness of the sterilization cycle of their practice's autoclave. Method and materials: A 35-question questionnaire was distributed to 840 dental practitioners in the United Kingdom. They were also sent three spore test ampules with details of their function and instructions on their use. The practitioners were asked to use the spore test ampules in their own practice's autoclave and to return these for testing. Results: Four hundred one questionnaires and associated spore test ampules were returned for analysis, a 47.7% response rate. Eight practice autoclaves (2.0%) failed to sterilize the spores. These practices were offered a retest following counseling. A total of 77.8% of respondents had received formal training in infection control. Of the 71.3% of respondents who stated that they check the performance of their autoclave routinely, 31.5% use a chemical strip every cycle, 17.5% use it once per day, and 30.4% use it once per week. However, only five respondents (1.2%) use a spore test; two of these respondents use it every cycle, one once per day, and two once per week. Conclusion: Further education of practitioners may be necessary to enhance their awareness of the need for routine checking of autoclave effectiveness.

Bilateral fenestration of the labial gingival tissue of the permanent mandibular central incisors is described. The situation was followed over a 2-year period with no treatment other than prophylaxis and oral hygiene instruction. The final outcome was an apical positioning of the gingival margin, which was lower than that of the adjacent uninvolved teeth.

A case of incomplete fractures occurring bilaterally in intact maxillary first molars is described. The etiology, diagnosis, and treatment of incomplete tooth fractures are dis cussed. The clinical results in this case showed that early diagnosis and treatment can prevent further extension of the crack into the pulp and subsequent complete tooth fracture.