The science of communicating the art of esthetic dentistry. Part III: precise shade communication.

Shade matching is inherently complex and involves understanding the science of color, determining the shade and surface characteristics of teeth, and communicating this information to the laboratory technician. The laboratory technician then has the difficult task of mimicking the selected shade and ultimately reproducing it in the final restoration.

An in vitro comparison of 5 techniques for impressing dowel space preparations.

PURPOSE: This in vitro study compared 5 different dowel space impression techniques using polyvinyl siloxane impression material to determine which method produced fewer voids in the dowel space impression. MATERIALS AND METHODS: Five techniques were used to make impressions of a prepared dowel space in a simulated endodontically treated tooth. Technique I used a 25-gauge anesthetic needle to act as a vent at the apex of the preparation to reduce voids produced during the expression of light body impression material. The anesthetic needle was removed after the impression material was injected, and an impression post was then inserted to the depth of the preparation. Twenty impressions made using this technique were compared with other techniques that used the vent without a post, no vent with a post, no vent without a post, and a lentulo spiral with a post (Techniques II through V, respectively). The percentage of impressions with voids from each group was compared to determine which technique consistently produced a void-free impression of the complete preparation length. If voids were observed in the impression, the specimen was considered inadequate. RESULTS: The percents of void-free impressions using Techniques I through V were 100%, 70%, 40%, 60%, and 20%, respectively. CONCLUSIONS: Using a 25-gauge needle as a vent while expressing impression material into the dowel space followed by placing the impression post consistently produced void-free dowel space impressions.

The science of communicating the art of esthetic dentistry. Part I: Patient-dentist-patient communication.

Many contemporary restorative procedures are primarily esthetically driven, and patients have high expectations. It is imperative for the restorative dentist to understand patients' desires and expectations prior to initiating irreversible therapy. It is equally important for patients to understand the anatomic and technical limitations inherent with restorative therapy.

The science of communicating the art of esthetic dentistry. Part II: Diagnostic provisional restorations.

Provisional restorations fulfill many functions in restorative dentistry. Quality provisional restorations can provide the clinician, the patient, and the laboratory technician much valuable information prior to fabrication of the definitive restoration. Such diagnostic provisional restorations fabricated with acrylic resin are easily adjusted and modified until both esthetic and functional results are approved by the patient. Once this approval has been obtained, the definitive restorations can be fabricated with confidence, using the esthetic form of the provisional restorations as a blueprint.

The science of communicating the art of dentistry.

Laboratory work authorization forms are mainly developed in the form of written instructions, two-dimensional drawings or photographs. These can be supplemented with other forms of communications, which will give three-dimensional information and take into account the lips, which are considered the frame of the teeth. This article will describe a systematic approach to communication with a patient and laboratory technician using three-dimensional aids such as a smile replica, lip reproductions, provisional restoration casts and soft tissue casts.

Ultrastructural features of cyclosporine A-induced gingival hyperplasia.

The present work collected data on the ultrastructural features of the attached gingiva in kidney transplant patients who showed gingival hyperplasia following cyclosporin A (Cy A) treatment. Ultrastructural examination was carried out on biopsies of attached gingiva obtained from 8 male patients (30 to 60 years old) undergoing treatment at the Dental Clinic of the University of Ferrara. The data showed that, although many fibroblasts are present in Cy A-induced hyperplasia, there is a particular abundance of amorphous substance compared to fibrous, as well as marked plasma cell infiltration. On the basis of the data collected, we hypothesize that the morphological features of the dimensional increase in gingival tissue associated with Cy A treatment in kidney transplant patients may be considered local manifestations of a systemic phenomenon.

[Primary gastric lymphoma]. / Il linfoma gastrico primitivo.

Primary gastric lymphoma (P.G.L.), though rare, is nevertheless the most frequent non-epithelial neoplasm of the stomach. The Authors report their experience based on 18 cases of lymphoma observed from 1975 throughout 1989. Diagnostic and therapeutic problems related to the disease are stressed, uncertain in the results the former, still discussed the latter. The crucial role of surgery, either diagnostic or therapeutic, even in advanced stages, is underlined.

[Comparative scintigraphic functional study of 3 different reconstruction technics following total gastrectomy]. / Studio funzionale scintigrafico comparato di tre diverse tecniche di ricostruzione dopo gastrectomia totale.

Esophago-jejunal reconstruction, after total gastrectomy, is best performed by one of the following three operations: interposed jejunal loop, Roux-en-Y loop and "omega" loop with Braun anastomosis. To assess the effects of the three mentioned techniques three groups of 15 patients each were examined after total gastrectomy for I, II or III stage cancer. Four to ten months after surgery all patients underwent the following tests: a) esophago-jejunal transit with labeled solid meal; b) cholangio-scintigraphy and c) absorption test of biliary acids. A group of 10 patients, without gastrointestinal pathology, was selected for comparison. The data obtained from the comparative study, in agreement with the opinions held by many Authors and our previous research, demonstrate that the interposition of jejunal loop (Mouchet) is the reconstructive technique closest to the unoperated stomach and, for this reason, is to be preferred after total gastrectomy.

[Use of imipenem-cilastatin in antibiotic therapy and prevention in general surgery. One year of clinical experience]. / L'uso dell'imipenem-cilastatina nell'antibioticoterapia e nella profilassi in chirurgia generale. Un anno di sperimentazione clinica.

The authors report one year of clinical experience with imipenem-cilastatin, first antibiotic of thienamycin class, in the therapy and prophylaxis of postoperative infectious diseases. One hundred thirty four patients were treated with antibiotic therapy and 10 days after in 98.5% of cases a clinical remission of the disease was obtained; only in 2 patients the effect wasn't evaluable because they died for not drug-related causes. The prophylactic use of this antibiotic was limited to 34 patients with high risk of infectious diseases; only 3 cases (8.8%) showed bacterial contamination and one of them had clinical signs of disease which indicated the absolute need for antibiotic therapy. The Authors also emphasize the excellent results, the tolerability of the drug and the absence of side-effects.

[Effects of therapy with aminaftone on chronic venous and lymphatic stasis]. / Effetti della terapia con aminaftone sulla stasi venosa e linfatica cronica.

Following a short introduction on the physiopathology of the phlebo-lymphatic system, the results of a study carried out on 114 patients suffering from chronic venous insufficiency (CVI) treated at the Department of General Clinical Surgery and Surgical Therapy of the University of Ferrara are reported. These patients were subdivided into two random groups and treated with common phlebotonic drugs and aminaftone, respectively. Both groups were also subjected to those physical and medical measures that are usually adopted for the treatment of such patients. The therapeutic effects were assessed by comparing symptomatology before and after 90 days of treatment, both subjectively (patient's assessment of the symptoms by means of a scoring system) and with objective methods (measurements and echo-Doppler examinations). The differences between the two groups were statistically very significant in favour of patients who had taken aminaftone. Excellent results were obtained in the treatment of CVI as well as in lymphatic-related pathology (lymphedema).