Dentinal tubule occlusion and root hypersensitivity.

Previous studies have established that root sensitivity is due in part to open dentinal tubules at the root surface. The purpose of this study was to longitudinally evaluate the occlusion of dentinal tubules by various clinical procedures including scaling and root planing and the application of potassium oxalate. A model was developed to evaluate dentinal surfaces in vivo. Six 2 mm x 3 mm sections were taken from the roots of extracted teeth immediately below the CEJ. One half of the treated dentin samples from each donor was incorporated into the removable denture worn by the donor and the other half served as baseline. The dentin samples were evaluated at 1 week by scanning electron microscopy. At day zero no open tubules were observed in any of the samples due to the presence of a smear layer or oxalate crystals. Evaluation of root planed samples revealed that by 7 days the tubules had re-opened. The samples which had been treated with potassium oxalate showed few oxalate crystals by 7 days revealing open tubules. Control samples were etched with EDTA and evaluated in the same manner. Although the number of tubules did not significantly change in the EDTA etched control samples, the diameter of the tubules dramatically decreased by 4 weeks. It can be concluded that the creation of a smear layer or application of oxalates to occlude dentinal tubules to reduce sensitivity are relatively short-lived. These procedures may provide patient comfort prior to natural occlusion of the tubules.

Root trunk dimensions of 5 different tooth types.

The primary purpose of this study was to document mean, standard deviation, and range of root trunk dimensions of multirooted tooth types. A total of 412 extracted teeth were examined and classified as: maxillary first molars, maxillary second molars, maxillary first premolars, mandibular first molars, and mandibular second molars. The distance from the cementoenamel junction (CEJ) to the root groove and from the CEJ to the root division was measured. Mean CEJ to root groove distances ranged from 1.35 to 1.65 mm for maxillary first molars, from 1.49 to 1.89 mm for maxillary second molars, from 1.71 to 1.73 mm for maxillary first premolars, from 1.16 to 1.22 mm for mandibular first molars, and from 1.53 to 1.76 mm for mandibular second molars.

Twenty commonly dispensed medications at a United States military installation and their significance to dentists.

Understanding the clinical pharmacology of medications commonly used by dental patients is necessary when providing dental care. A significant number of patients may be taking medications that have the potential for adverse effects. The purpose of this paper is to familiarize dental practitioners with the clinical pharmacology of medications most likely to be encountered in a current military dental practice. Product activity reports (records of medications usage) were obtained from the main pharmacy at a United States Army Community Hospital. The product activity reports covered a 1-year period from December 31, 1992, to December 30, 1993. These reports were analyzed according to the number of medications dispensed to determine the 20 most commonly used medications.

Acute necrotizing ulcerative gingivitis-periodontitis: a literature review.

Acute necrotizing ulcerative gingivitis-periodontitis (ANUG/NUP) is a relatively uncommon periodontal disease characterized by gingival necrosis and ulceration, pain, and bleeding. The purpose of this paper is to provide a review of current knowledge on ANUG/NUP. Current literature on the epidemiology, pathogenesis, immunology, predisposing factors, and treatment of ANUG/NUP is reviewed.

Assessing hyperanticoagulation of dental patients undergoing warfarin therapy.

Patients often undergo a number of dental procedures that may cause bleeding. Usually these procedures can be performed with little risk to the patient. However, patients on medications such as warfarin (Coumadin) have an altered ability to control, bleeding and may develop bleeding problems subsequent to treatment. Once this potential problem has been recognized, measures can be taken to minimize the risks. Patients on warfarin are on specific medication protocols and often exhibit episodes of hyperanticoagulation. The purpose of this study was to assess patients on warfarin protocols for episodes of hyperanticoagulation. Sixty-two patients undergoing anticoagulation therapy with warfarin were assessed for episodes of hyperanticoagulation with the prothrombin test. Based on these results, it can be concluded that patients taking warfarin had an approximately 42% chance of at least one episode of hyperanticoagulation. No specific warfarin protocol demonstrated any statistical significance for an increased chance of hyperanticoagulation.

The incidence of known diabetics among U.S. Army active duty dental patients.

Diabetes affects an estimated 16 million Americans. The purpose of this study was to determine the incidence of known diabetes among active duty soldiers by reviewing medications dispensed for diabetes at a large military installation. This study was conducted from July 31, 1997, through August 1, 1998. Fifty-eight (0.18%) members of the total active duty male population of 32,593 had been dispensed diabetes medications, whereas 43 (0.48%) members of the total female active duty population of 8,898 had been dispensed medications for diabetes. Gestational diabetes was the cause for 88.37% of the total active duty females dispensed diabetic medication at Fort Hood, Texas. The female-to-male ratio for diabetes was 2.7:1. Diabetics made up 0.27% of the total population.

Periodontal indices of patients taking isoniazid and rifampin: a pilot study.

A significant reduction in the incidence of tuberculosis (TB) has resulted from the use of medications such as isoniazid (INH) and rifampin. Unfortunately, there has been a resurgence of TB since the mid 1980s. The purpose of this pilot study was to evaluate the effects of INH and rifampin on periodontal indices of patients with positive tuberculin skin tests (PPD). The gingival index, plaque index, and periodontal scoring and recording were recorded in PPD-positive patients at baseline and 1 month. Control patients received no medications during the study and were evaluated at baseline and 1 month. Mean values for each patient were obtained and analyzed using unpaired t tests (N = 8). Statistically, within the limits of this study, it was found that patients taking INH and/or rifampin had a significant decreased (p < 0.05) in gingival inflammation from baseline.

A review of applications of recombinant DNA techniques in diagnosis and treatment of dental diseases.

The goal of regeneration in oral maxillofacial reconstruction is replacing the previous goal of repair. Many advances in treatment and diagnosis have taken place in medicine and dentistry with the advent of DNA technology. The purpose of this paper is to provide the dental practitioner an overview of some of the medical research using recombinant DNA technology and its potential use in dentistry.

Prevalence of periodontal disease in an active duty military population as indicated by an experimental periodontal index.

An experimental periodontal screening examination and index was used to measure the prevalence of gingivitis and periodontitis among 1,334 soldiers at Fort Knox, Kentucky. Although 12.1% of the subjects demonstrated no disease, 40.3% were found to have gingivitis. In this sample group, the occurrence of gingivitis decreased with increasing age. Early periodontitis (probing depths of 3-5 mm) was detected in 35.7% of the subjects, and subjects with moderate to advanced periodontitis (probing depths greater than 5 mm) comprised 11.9% of the sample. The screening exam used is suggested for use as part of each soldier's annual dental examination.

The incidence of active duty dental patients taking antihypertensive medications.

Hypertension affects 58 million Americans. Dentists frequently encounter patients who are using one or more antihypertensive medications. This study evaluates the incidence of active duty soldiers dispensed antihypertensive medications at a large military installation. Lisinopril was the most frequently prescribed antihypertensive medication during a 2-month period in 1997 and was followed by hydrochlorothiazide, amlodipine, propranolol, felodipine, verapamil, atenolol, diltiazem, terazosin, clonidine, nifedipine, and metoprolol. These 12 drugs accounted for 93.46% of all antihypertensive medications dispensed. In this study, the percentage of active duty soldiers dispensed any antihypertensive medication was 1.51% (30 different medications were dispensed); 0.16% of all soldiers younger than age 30 and 1.25% of all soldiers older than age 30 were prescribed 1 of the 12 most commonly prescribed antihypertensive agents. Considering the same top-12 antihypertensive agents, the percentage of male soldiers younger than 30 who received a prescription was 0.24% and the percentage of male soldiers older than 30 who received a prescription was 4.3%. The percentage for males older than 40 receiving 1 of the 12 medications listed above was 12.05%. Similarly, the percentages for females were 0.27% for younger than 30, 1.87% for older than 30, and 3.51% for older than 40. Active duty males older than age 30 were more than twice as likely to be prescribed an antihypertensive agent than females in the same age group. Male active duty soldiers older than age 40 were more than 50 times more likely to be prescribed an antihypertensive agent than active duty males younger than 30.

The circumferential supracrestal fiberotomy.

This article addresses the advantages and shortcomings of circumferential supracrestal fiberotomy procedures from the pragmatic perspective of practicing clinicians. The first part of this article reviews the anatomy, surgical techniques, and timing of the procedure. The significance of individual techniques and studies are discussed.

Esthetic preference of the frontal and profile views of the same smile.

This study has shown that orthodontists and their patients share a common pool of diffuse esthetic values of the same smile. Profile and frontal views of the same smile were not similarly rated for esthetic pleasantness: the profile views were rated higher than the frontal views of the same smile. This finding suggests that orthodontists should consider both frontal and lateral views during evaluation of their patient when planning and assessing orthodontic treatment. More research is needed to determine the generalizability of the finding that orthodontists and patients have similar facial esthetic preferences. Future studies should expand the range of smiles that are evaluated by including both genders, people of different ethnic backgrounds, and people of a variety of ages. Research is also needed to evaluate facial esthetics and smiles in dynamic motion.