Automotive Technology Revolutionized Restorative Dentistry Discovery of Alpha-diketone/Amine Catalyst: Part II -Reflections on Photopolymerization from Conception to Development of Composite Resin and Activator Light.

A full account of the preceded early research tribulation that led to the development of the first visible light activated composite resin and the first visible light activator source is documented. The events took place over four years since early 1974 when a raw industrial composite resin that was radiolucent, stiff paste, universal optically opaque white color, polymerized by exposure to a prototype visible light for 120 seconds was given to developed. Four years later, the developed restorative composite resin ended up as a radiopaque, optically translucent, universal color with an additional three shades that possessed the biologic, esthetic, mechanical and physical characteristics with proven efficacy be used for esthetic zone. This conservative account of early development of a technology that must count as one of a small number of inventions during the seventies, over the years has revolutionized restorative dental practice. We were privileged and very lucky to be associated with developmental stages, stumbling blocks, and final success of the first LC Composite resin that ignited the thought process worldwide and laid the foundation for modern esthetic restoratives practiced today.

Automotive Technology Revolutionized Restorative Dentistry Discovery of Alpha-diketone/Amine Catalyst: Part I.

A full account of early research that led to the discovery of the Alpha-diketone and Amine systems by two Imperial Chemical Industries (ICI) researchers. UK Chemists in the mid-sixties marked the beginning in the early development of a composite resin cured with visible light spectrum into a solid mass. Its incorporation into the newly developed Urethane based resin, led to conceiving the idea of developing the first light-activated restorative composite resin, which formed the prototype of modern composite restorative materials. How all that came about, and the ideas that were conceived and pursued in the development of these systems are discussed in detail.

Oral health considerations in anorexia and bulimia nervosa. 1. Symptomatology and diagnosis.

Eating disorders have captured the attention of medical and dental professionals as well as the public for decades and continue to raise concern today. The literature devoted to anorexia and bulimia highlights myriad psychological, systemic, and dental health complications. Dental practitioners are in a unique position to discover early manifestations of these disorders. The present article reviews anorexia and bulimia, summarizing telltale behavioral traits, systemic manifestations, and dental features to facilitate recognition and enable accurate diagnosis.

Oral health considerations in anorexia and bulimia nervosa. 2. Multidisciplinary management and personalized dental care.

This article outlines a comprehensive, multidisciplinary strategy for treatment of patients with anorexia and bulimia nervosa. In this approach, primary medical intervention and emergency dental care are followed by the staging of treatment phases that integrate medical care, psychotherapy, nutritional counseling, and dental management, which may encompass various treatment options for repair of damaged dentition. Emphasis is placed on prevention of further tissue damage during all phases of management and following completion of the treatment course.

Clinical observations of dental erosion associated with citrus diet and intake methods.

Citrus fruits and juices are an integral part of daily diets the world over; however, excessive and frequent consumption can cause damage to the human dentition. This article describes the characteristics of destruction induced by citrus products. Related factors include the fruits' acidic nature, their inherent highly fibrous content, the method of intake, and the sites of the dentition exposed for prolonged durations. The various features of the defects resulting from the combined chemical and/or mechanical destructive potential of citrus products are demonstrated in relation to intake method. Mitigating and aggravating factors that affect the erosive process are discussed also.

Distinguishing and diagnosing contemporary and conventional features of dental erosion.

The vast number and variety of erosion lesions encountered today require reconsideration of the traditional definition. Dental erosion associated with modern dietary habits can exhibit unique features that symbolize a departure from the decades-old conventional image known as tooth surface loss. The extent and diversity of contemporary erosion lesions often cause conflicting diagnoses. Specific examples of these features are presented in this article. The etiologies, genesis, course of development, and characteristics of these erosion lesions are discussed. Contemporary and conventional erosion lesions are distinguished from similar defects, such as mechanically induced wear, carious lesions, and dental fluorosis, which affect the human dentition.

Dental erosion due to abuse of illicit drugs and acidic carbonated beverages.

Consumption of illicit drugs and the abusive intake of acidic carbonated beverages (particularly soda) often are associated with similar types of damage to the human dentition, the most common of which is dental erosion. The dentitions of individuals who are addicted to methamphetamines or crack cocaine can be misdiagnosed as dental caries rather than generalized dental erosion, a condition that also is associated with chronic excessive consumption of soda. Failing to identify the causative etiology could lead to a wrongful diagnosis that could in turn adversely affect treatment planning and misdirect a specified prevention protocol. This article seeks to identify the unique clinical features of each one of these conditions, highlight the resemblances between them, and recognize the unambiguous differences in their fundamental characteristics. Three representative cases-involving a methamphetamine user, a crack cocaine addict, and an avid consumer of diet soda-are presented. In each case, the patient has admitted to the cause of their poor oral health. The dental, oral, and paraoral manifestations of each case are documented and differentiated from one another, and the factors that contributed to the associated disease process are discussed.

Effect of sweetening agents in acidic beverages on associated erosion lesions.

Accurate diagnosis of erosion defects caused by acidic beverages is essential when designing a comprehensive management strategy that includes combating possible recurrence. The manifestations of erosion lesions associated with acidic beverages are diverse, as seen in the differences and similarities of lesions associated with various regular and diet varieties of beverages. Erosion lesions caused by regular sugar-sweetened beverages display signs similar to dental caries, while lesions resulting from diet, non-sugar-sweetened soft drinks have defects similar to mechanical wear of the dentition. Aggravating factors such as toothbrushing or compromised oral home care could influence the features of erosion lesions. These diverse characteristics of erosion lesions could make identification difficult. This article describes pertinent signs of erosion defects associated with the regular and diet varieties of acidic beverages and discusses their causative factors. This information is designed to avert an improper diagnosis that would derail any restorative intervention and alter a proper preventive management course.

Clinical features and differential diagnosis of erosion lesions: systemic etiologies.

An accurate diagnosis is essential for successful treatment, making it critical that dentists recognize the differences among erosion lesions and the numerous etiologies that cause them. Erosion lesions may result from various factors, including intrinsic etiologies. The similarities among the intrinsic types of lesions and those caused by noncarious destructive mechanisms in the oral cavity may lead to conflict over their etiologies; as a result, these lesions may be ignored, undiagnosed, or misdiagnosed. This article identifies the many systemic etiologies that propel stomach acid into the oral cavity, thereby causing dental erosion. Specific descriptions of the clinical characteristics of dental erosion lesions associated with the identified etiologies are provided and the differential diagnoses are outlined.

Effects of common beverages on the development of cervical erosion lesions.

Dental erosion is a demineralization process that affects hard dental tissues (such as enamel and dentin), independent of any microbial action. This study evaluated certain common beverages and their abilities to initiate cervical erosion lesions. The progression of these lesions was monitored in an accelerated test condition over the duration of 20 weeks. Morphotopographic and radiographic profile assessments of the disassociated human teeth in vitro illustrated the differences of each tested fluid's potential to cause erosion. The outcome of the erosion process was found to be acidic fluid-specific. Unlike caries, which progresses in a triangulated fashion, the erosion lesions in enamel and dentin both appeared to progress in a pattern characterized by incremental decalcification in a parallel plane. The disparity between the changes of the radiographic and photographic images of the involved tissues (enamel and dentin) reflected the differences in terms of the inorganic and organic contents of each one. Close examination of the dynamic changes in the cervical region of the disassociated human teeth revealed the mechanism of cervical erosion lesion formation that was a coincidental finding of this study's results.

Dental erosion linked to dysmenorrhea.

This article examines the case of a woman with hard dental tissue loss that was similar to perimolysis caused by bulimia nervosa; however, the patient's health history, signs and symptoms, and dietary habits refuted any eating disorder. All extrinsic causes and the majority of intrinsic causes were examined carefully and eliminated. The patient had undergone endometrial surgery 32 years earlier to remove a tumor, a procedure that was believed to be unrelated to the dental professionals' realm; however, a detailed patient history revealed severe pain associated with abdominal cramps that were in concert with the menstrual cycle. Over a period of nearly three decades, these cramps frequently caused forceful purging of stomach contents during episodes of dysmennorhea. The mechanism, force, direction, and frequency of purging closely resembled that of bulimia, producing similar (if not identical) consequential damage to the dental hard tissues. The process of identifying, differentially diagnosing, and finally determining the etiology of the erosion lesions was based on an in-depth knowledge of systemic disorders, recognition of various characteristics and causes of erosion lesions, and an accurately detailed systemic and dental health history.

Topographic and radiographic profile assessment of dental erosion. Part III: Effect of green and black tea on human dentition.

This study compared green and black tea to soda and orange juice in terms of their erosive effect on the human dentition. Vinegar and water were used as active and passive control fluids. An accelerated in vitro test was used to monitor how short- and long-term exposure to these fluids affected the topography and morphology of the coronal segments of the human dentition. This 20-week test was conducted under controlled conditions, independent of the influencing factors of the oral environment. The erosive effects of these fluids were categorized generally into three groups: highly erosive (vinegar), moderately erosive (soda and orange juice), and minimally erosive (black and green tea). The erosive effect of tea was similar to that of water, which has no erosion potential. Given the systemic and dental benefits of tea and the low potential for erosion, green and black tea should be highly encouraged for daily beverage consumption.

Topographic and radiographic profile assessment of dental erosion. Part II: effect of citrus fruit juices on human dentition.

This study sought to monitor changes in the topography, morphology, and radiographic profiles of human permanent teeth that had been exposed to citrus fruit juices. The effect of long-term exposure was monitored for a prolonged duration of 20 weeks according to set criteria. Topographic and morphologic changes were observed at weekly intervals following challenge by test fluids (orange, lemon, and grapefruit juices) and compared with control fluids (acetic acid and water). The qualitative changes in the specimens' topography and the morphology of citrus fruit juices and control fluids are described as a function of time, in specific details. The digitized radiographic images obtained at four-week intervals were analyzed and the changes were assessed. The results indicated that orange juice specimens demonstrated the mildest changes, while lemon juice specimens displayed the most severe damage to the coronal segments of the teeth. This damage manifested as loss of cusp height, cervical enamel, and coronal radius, as well as reduction of enamel cap height. Of the tested and control fluids, lemon juice displayed the most eros ion, followed by acetic acid, grapefruit juice, orange juice, and water, which had no effect. Continued immersion in the four acidic fluids led to varying degrees of enamel loss progression.

Topographic and radiographic profile assessment of dental erosion--Part I: Effect of acidulated carbonated beverages on human dentition.

Evidence-based case reports and epidemiologic surveys have indicated an association between dental erosion and high consumption of acidulated carbonated beverages (ACBs). This study sought to monitor the effect of exposure to ACBs on the topography and geometrical profile of disassociated human dentition. Two representatives of ACBs, caramelized (ACCB) and non-caramelized (AN-CCB), were evaluated along with control liquids. Following exposure to the fluids, qualitative assessment of topographic changes and quantitative analysis of digitized serial radiographic tracings were performed at four-week intervals for 20 weeks. Within the controlled perimeters of this in vitro test, the erosive effects of ACBs were closely similar but were lower than those caused by acetic acid (control fluid). These effects were indicated by changes in enamel topography (such as color, translucency, texture, and integrity) as well as reduction in specimen profile parameters. This amounted to an average weekly reduction in cusp tip height, a loss of cervical enamel, a reduction of enamel cap height, and reduction of crown radius for the ACBs and acetic acid.

Influence of drinking patterns of carbonated beverages on dental erosion.

As a hard tissue dental disease, dental erosion has a multifactorial etiology. The majority of dental erosion that originates from extrinsic sources is the result of dietary intake, particularly acidic beverages. Several preventive means have been proposed to minimize the damage to the dentition, including a reduction in the consumption of causative beverages and the adoption of a specific method of drinking, utilizing a straw instead of a cup. This article presents two cases involving the clinical and radiographic features of erosion lesions associated with chronic and excessive intake of acidic carbonated beverages. These examples embody how drinking patterns influence the formation of erosion lesions in various anatomic locations within the dentition. The clinical and radiographic evidence presented in this report cautions against the use of nonspecific terms, such as "cup versus straw," and instead suggests implementing a more precise description of the suggested method. In view of the extensive damage inflicted by the chronic, excessive intake of carbonated beverages, preventive measures are considered to be the only effective course of management. This article offers illustrative examples of erosion lesions associated with long-term excessive intake of carbonated beverages. The influence of the drinking method--that is, a straw positioned into the labial vestibule versus a cup--on the anatomic location of the erosion lesions will be demonstrated through clinical and radiographic evidence.

Rare and abnormal massive dental calculus deposit: an investigative report.

An unprecedented case is presented involving a massive calculus buildup on the mandibular incisors. The clinical and radiographic findings were reviewed, probable causes were investigated, and results were outlined and discussed. The composition, origin, and formation of dental calculus and its interrelationship with dental plaque and saliva were highlighted. The role of dental calculus in the pathogenicity of periodontal diseases, in view of epidemiological data, research, and clinical study findings, is discussed. Both the case management and the benefit of total calculus removal for resolving periodontal disease are underlined.

Effect of resilient liners on masticatory muscle activity of edentulous patients: clinical and electromyography studies.

This investigation evaluated how the soft lining of both maxillary and mandibular complete dentures influences the activity of the masseter and temporalis muscles. Electromyography was used to determine changes in muscle activity. The findings, expressed by Root Mean Square values, indicated an increase in muscle activity after insertion of dentures and prior to application of soft lining material. These activities decreased gradually throughout the 12-week evaluation period following the application of soft liner. Significant differences were noted between masseter and temporalis muscle activity during mastication of different types of food.

Combined aplasia of maxillary first molars and lateral incisors: a case report and management.

Congenital absence of teeth, as the most commonly known developmental dental anomaly in man, has a multitude of adverse affects that could be detrimental to normal function and esthetics. This report presents a rare case of combined agenecies of maxillary permanent first molars and lateral incisors. The management plans are highlighted, and phase I orthodontic-restorative treatment mechanics and its result are described. The benefits for early orthodontic treatment intervention for this case presented here are discussed.

Dental erosion: a complication of pervasive developmental disorder.

A young teenage male presenting for a routine check-up reported no health problems. Initial clinical examination revealed some enamel loss on the palatal surfaces of the maxillary incisors. Erosion lesions were suspected. Similar lesions, however, were not found throughout the mixed dentition and radiographic findings were inconclusive. To confirm the diagnosis of these lesions and, more importantly, to disclose the etiology, a thorough and detailed clinical examination of these lesions was conducted. Study models were made, mounted in centric occluding position, and closely screened. In addition, the health history was revisited, by interviewing the patient and his legal guardian. The information gathered led to the conclusion that the lesions in question were erosion lesions with concomitant wear facets that resulted from attrition of the softened enamel surface. An ample light on the possible etiological factors was shed, which assisted in the planning phase for the course of management. It is not uncommon that dental health care providers encounter in daily practice cases of early erosion lesions similar to those reported here. In most of these instances, minor changes in tooth morphology that represent a slight departure from the norm could be overlooked and often ignored. If such lesions go undetected, the underlying causes may escape diagnosis. However, if action is taken to pursue investigation of the causative factor, the result could assist in understanding the overall complexity of the health condition of the patient. This would enable planning the proper course of management for the total well being of the patient.