Rehabilitation of a cystic mixed dentition mandible following marsupialization with a multipurpose acrylic splint acting as a space maintainer and an obturator.

Radicular cysts are the most common odontogenic cystic lesions of inflammatory origin which can be managed by marsupialisation specially if the cyst is large and is in relation to the vital structures. This article presents a case in which a radicular cyst was present in association with grossly carious deciduous molars and has been treated by marsupialisation. Postoperatively a surgical splint was inserted to maintain the patency of the bone cavity. This obturator splint also acts as a space maintainer to prevent space loss and ensure unimpeded eruption of permanent premolars.

Functional adaptability to changes in lower denture shape.

Forces exerted on the right and left lingual and buccal flanges of Kennedy Type I mandibular dentures were studied using an 8 channel recording technique, during resting, swallowing, talking, reading and simulated mastication. The effects of adaptation, head position and incremental thickening of the flanges were determined. Highest forces were recorded when swallowing, with smaller differences between the other activities. Lingual forces were higher than buccal, and posterior forces higher than anterior ones. There was a highly significant relationship between increases in flange thickness of 2 and 3mm and increases in peak forces. Evidence for adaptation and effects related to head position was weaker.

Inequalities in access to education and healthcare.

The burden of disease is borne by those who suffer as patients but also by society at large, including health service providers. That burden is felt most severely in parts of the world where there is no infrastructure, or foreseeable prospects of any, to change the status quo without external support. Poverty, disease and inequality pervade all the activities of daily living in low-income regions and are inextricably linked. External interventions may not be the most appropriate way to impact on this positively in all circumstances, but targeted programmes to build social capital, within and by countries, are more likely to be sustainable. By these means, basic oral healthcare, underpinned by the primary healthcare approach, can be delivered to more equitably address needs and demands. Education is fundamental to building knowledge-based economies but is often lacking in such regions even at primary and secondary level. Provision of private education at tertiary level may also introduce its own inequities. Access to distance learning and community-based practice opens opportunities and is more likely to encourage graduates to work in similar areas. Recruitment of faculty from minority groups provides role models for students from similar backgrounds but all faculty staff must be involved in supporting and mentoring students from marginalized groups to ensure their retention. The developed world has to act responsibly in two crucial areas: first, not to exacerbate the shortage of skilled educators and healthcare workers in emerging economies by recruiting their staff; second, they must offer educational opportunities at an economic rate. Governments need to lead on developing initiatives to attract, support and retain a competent workforce.

Periodontal status and IOTN interventions among young hemophiliacs.

Fifty-two young individuals suffering from severe haemophilia A and B volunteered to be compared with school- and college-going students for oral health status description and subsequent management. A total of 244 students (84.42% boys and 15.58% girls) with the age group of 13-23 years were divided into two groups, A and B (controls). The purpose of this study was to increase awareness about evidence-based dental practices by oral examinations followed by comparisons of periodontal health and prevalence of malocclusions among medically compromised students and healthy controls. Results described the oral health in severe haemophilic population to be compromised with combined simplified health index score of 0.50 and Decayed/Modified/Filled Teeth (DMFT) index score of 2.07 when compared with 0.42 and 0.95, respectively, among group B. Although prevalence of malocclusion and orthodontic treatment needs among group A were higher, yet it was not confirmed as a reason for degraded dental and periodontal status. However, spontaneous and/or toothbrush (trauma)-induced gingival bleeding episodes among group A could be explained as factors discouraging oral hygiene maintenance, particularly self-administered measures. Four haemophiliacs presented with symptoms of Temporomandibular Joint Dysfunction Syndrome (TMPDS). Evidence-based oral medicine and clinical practices need to be encouraged and applied to enhance the quality of life among haemophiliacs, particularly in developing world. Dental treatment needs of haemophilic population appear to be greater and maybe incorporated in routine dental practices, at institutional and individual levels.

Prosthetic management and rehabilitation of an extensive intraoral and facial defect.

As with all maxillofacial prostheses, the management of large combined oral and facial prostheses require preoperative planning and cooperation between the surgeon, prosthodontist, and dental technician. Improvisation is particularly necessary during the early phases of treatment. Treatment objectives are to restore the skeletal defect, teeth, masticatory function, and appearance--all of which contribute to the patient's morale. Clinical care for a patient with a large intraoral and facial defect is presented.