Glass inserts. A new dimension in restorative dentistry.

Pediatric restorative dentistry has traditionally involved the placement of a stainless steel crown following a pulpotomy in primary molars. The increased exposure to systemic and topical fluorides has significantly decreased smooth surface caries, yet occlusal pit and fissure caries remains a problem. Occlusal caries involving the pulp of primary molars, leaving the supporting walls intact, may be restored conservatively with the use of glass inserts. The glass inserts provide the major volume of the restoration, therefore a minimal amount of posterior composite resin is necessary. The glass inserts bond to composite resin, increase restoration strength, and reduce polymerization shrinkage which may cause cuspal deflection or marginal microleakage. A case is presented to describe a new material and the conceptual protocol for clinical use.

Indirect composite resin crowns as an esthetic approach to treating ectodermal dysplasia: a case report.

This article presents a case report describing the indirect fabrication of composite resin crowns for the restoration of primary anterior teeth. A 3-year-old with a confirmed diagnosis of hypohidrotic ectodermal dysplasia was provided with composite resin crowns that were both esthetic and functional. The indirect method decreases clinical time, provides a durable restoration, and allows treatment of patients who lack the cooperative ability to endure prolonged direct bonding appointments. The indirect technique may be feasible for the restoration of carious teeth as well as the presented case.

The role of flexor tenolysis in the palm and digits.

Seventy-seven digitis in 70 patients undergoing a technique of thorough flexor tenolysis, with instillation of local triamcinolone, and immediate motion were studied. Classification of the results utilized a method which determined the percentage of passive joint flexion potential actively achieved and by a second system which graded the results in the finger as a whole. A further categorization into three patient groups, depending on the etiology of the tendon adhesions, was carried out. Using these classifications 84% or the proximal interphalangeal joints, 86% of the distal interphalangeal joints, and 80% of the fingers as a whole were improved by this procedure. These results were comparable or superior to those of other published reports. Improvement in digital flexion was consistent, often with restoration of near-normal function. The incidence of tendon rupture, infection, and delayed wound healing have not been great.

Subjective signs of efficacious inferior alveolar nerve block in children.

This study is designed to examine the clinical signs relating to profound anesthesia of the primary dentition using the inferior alveolar nerve block (IANB) injection. The IANB injection has been used for many years for both adults and children to anesthetize the mandibular teeth. Most dentists are quite familiar with the signs of profound intraoral anesthesia in the adult. Because of infrequent exposure, they might not be as aware of the signs of adequate anesthesia on the child patient. Additionally, the dentist may not be able to differentiate apprehensive behavior from behavior elicited with inadequate pulpal anesthesia. The study consisted of forty male and female children. The subjects who ranged in age from 3 years to 12 years, with a mean age of 7 years, were scheduled for routine restorative care of mandibular primary teeth. Each subject was injected with 1.8 ml of 2 percent xylocaine, 1:100,000 epinephrine using the mandibular-block technique. Anesthesia was evaluated using direct ice placement, lip reaction, tongue reaction and gingival reaction at intervals of 0, 1, 2, and 5 minutes. The results showed a correlation of lip and tongue anesthesia and pulpal anesthesia over time. A stronger correlation existed with gingival anesthesia and pulpal anesthesia over time. There was no statistical relationship between the subject response to ice and pulpal anesthesia.