Quintessence International, 07/1998

Objective: This study evaluated the 2-year clinical performance of beta-quartz-resin composite restorations. Method and materials: Twenty-two glass insert-resin composite restorations were placed. Restorations were placed in 6 molars, 12 premolars, and 4 incisors. After 2 years, clinical assessment of the restorations was made by three oeprators according to the US Public Health Service criteria. Scanning electron microscopic evaluations were made by replica technique. Results: Nineteen restorations were graded Alfa and three restorations were graded Bravo for color match. Twenty-one restorations were graded Alfa and one restoration Charlie for proximal contact, marginal integrity, and anatomic form. None of the restorations showed marginal discoloration, tooth sensitivity, or caries. Conclusion: Glass-ceramic insert-resin composite restorations exhibited excellent performance after 2 years of clincial service.

Objective: The surface roughness caused by four implant scaler s (Premier/Hawe-Neos, Advanced Implant Technologies, Hu-Friedy, and Nobel Biocare) on a titanium abutment was assessed in a standardized in vitro situation, and operators were asked to evaluate the clinical usefulness of each instrument. Method and materials: Twenty-four evaluators scored scanning electron micrographs of abutment surfaces scaled for 15 minutes with each instrument. Twelve operators used each instrument on at least three implant recall patients and scored each for ease of access; efficacy in deposit removal; overall convenience; distance reached subgingivally; scaling time per abutment; and overall preference. Results: The Advanced Implant Technologies scaler created a significantly rougher surface than all other instruments. The Premier/Hawe-Neos and Advanced Implant Technologies instruments were significantly preferred in most categories by the operators. There was no statistically significant difference in scaling time per abutment. Conclusion: The Premier/Hawe-Neos instrument combines operator acceptance with less damage to the abutments, and, of the instruments tested, is the scaler of choice.

Cicatricial pemphigoid is a chronic mucocutaneous bullous condition. It is a heterogenous autoimmune diseas, chraracterized by the production of autoantibodies against basement membrane zone antigens. The target antigens in cicatricial pemphigoid appear to be lamina lucida proteins involved in human keratinocyte adhesion to extracellular matrix. Cicatricial pemphigoid primarily affects persons older than 40 years and appears to have a 2:1 predilection for women, without racial or geographic bias.

A 60-year-old woman with clinical features of desquamative gin givitis had a history of painful, blistering gingival lesions for more than 2 years. There were no other accompanying mucosal or skin lesions. Clinical examination revealed erythematous and edematous gingiva with ulcerated areas and evidence of intact and ruptured bullae. White plaquelike lesions were also noted. Gingival manipulation caused epithelial desquamation. Light microscopic examination of biopsy specimens from the perilesional gingival tissue shoed separation of the oral gingival epithelium and connective tissue at the margin of the collapsed bulla. A moderately intense inflammatory infiltrate was present in the connective tissue. Direct immunofluorescent microscopy revealed a continuous linear deposition of immunoglobulin G and C3 at the basement membrane zone. On the basis of clinical, histopathologic, and immunofluorescent findings, the diagnosis of mucous membrane pemphigoid was made.

Objective: The study compared two commercial chlorhexidine mouthrinses (Chlorhexamed 0.1% and Corsodyl 0.2%) for their effects on dental plaque and gingival inflammation, thei r side effects (eg, tooth staining and mucosal irritation), and patient acceptance. Method and materials: One hundred thirty halthy volunteers were randomly distributed into two groups of 65 each. Each volunteer had gingivitis or chronic marginal periodontitis and used the rinse two times a day for 4 weeks. The sulcular bleeding index, approximal plaque index, gingival index, and a discoloration index were taken at baseline and once a week thereafter. The patients were questioned about taste disturbances, mucosal irritation, and their perception of the taste of the mouthrinse. Results: In both groups, after 4 weeks, the mean sulcular bleeding index, approximal plaque index, and gingival index scores had decreased significantly. The discoloration index had increased significantly in both groups. There were no statistically significant differences between the two mouthrinses in any of these measurememts. There were no significant differences in side effects reported by the two groups. Conclusion: The increase in concentration of chlorhexidine provided no clinical advantages or disadvantages.

Nightguard vital bleaching with 10% carbamide peroxide was used to remove a brown stain from the maxillary central incisor of a 13-year old boy. After 7 years, during which there was no touch-up treatment, the discoloration had not returned. This conservative technique should be considered before more invasive procedures for the treatment of discolored vital teeth in young patients.