Chlamydia psittaci infection as a cause of respiratory disease in neonatal foals.

BACKGROUND: During 2016-2018, 15 critically ill neonatal foals with acute respiratory distress associated with Chlamydia psittaci infection were presented to three referral hospitals in New South Wales. Chlamydia psittaci has not previously been associated with the development of neonatal respiratory disease. OBJECTIVES: To investigate and describe the clinical features and outcome of C. psittaci infection in neonatal foals. STUDY DESIGN: Multicentre retrospective case series. METHODS: The clinical, clinicopathological, necropsy and histological features of 15 foals with confirmed C. psittaci infection were reviewed and reported. RESULTS: Thirteen foals with C. psittaci infection died or were subjected to euthanasia within 36 h of hospitalisation and two foals survived to discharge. Findings during post-mortem examination of nonsurviving foals included bronchopneumonia, pulmonary congestion, hepatic congestion and hepatic inflammation. Detection of C. psittaci was achieved using polymerase chain reaction (PCR) testing of swabs of nasal secretions (4/6) and rectal mucosa (5/7) from live foals, lung tissues of foals at necropsy (11/14) and foetal membranes (4/5). MAIN LIMITATIONS: Small numbers of confirmed cases of neonatal C. psittaci infection and inconsistent sampling methods. CONCLUSIONS: Chlamydia psittaci should be considered a differential diagnosis for neonatal foals with signs of severe systemic disease, including equine neonatal acute respiratory distress syndrome (EqNARDS). Chlamydia psittaci is a zoonotic pathogen and a personal protective equipment (PPE) should be worn for the management of foals with suspected or confirmed infection.

Hypernatraemia in 39 hospitalised foals: clinical findings, primary diagnosis and outcome.

OBJECTIVE: To evaluate hypernatraemia in foals presenting as medical emergencies to an intensive care unit (ICU) to determine the prevalence, clinical findings, primary diagnosis and outcome. METHODS: Retrospective case study of records from Thoroughbred foals aged less than 3 months that presented to an ICU as medical emergencies in 2002-12. Data retrieved included signalment, clinical findings, laboratory results, primary diagnosis and outcome. Foals with hypernatraemia (serum sodium > 145 mmol/L) on admission laboratory data were identified and further evaluated. RESULTS: A total of 39 of 1718 foals (2.3%) were diagnosed with hypernatraemia; all foals were less than 7 days of age. The most common primary diagnoses in the foals with hypernatraemia were neonatal syndrome (19/39, 48.7%) and sepsis (15/39, 38.5%). Foals with hypernatraemia at presentation were more likely to die or be euthanased during their hospitalisation than foals with a normal serum sodium concentration on ICU admission (33.3% vs 16.1%; odds ratio, 2.3; 95% confidence interval, 1.2-4.6; P = 0.02). CONCLUSION: Admission hypernatraemia was an uncommon but important electrolyte abnormality in this population of hospitalised foals. Although the short-term outcome in survivors was most likely dependent on the underlying disease process, hypernatraemia was negatively associated with outcome in hospitalised foals.

Severe hyponatraemia in foals: clinical findings, primary diagnosis and outcome.

OBJECTIVE: To evaluate severe hyponatraemia in foals presenting as medical emergencies to an intensive care unit (ICU) in order to determine the prevalence, clinical findings, primary diagnosis and outcome. DESIGN: Retrospective case study of records from Thoroughbred foals aged less than 3 months presenting to an ICU as medical emergencies in 2002-12; foals with severe hyponatraemia (serum sodium <122 mmol/L) on admission laboratory data were identified. Data retrieved included signalment, clinical findings, laboratory results, primary diagnosis, treatment and outcome. RESULTS: Severe hyponatraemia was identified in 69/1718 Thoroughbred foals (4%) presenting to the ICU during the study period. Of the 69 foals, 11 (15.9%) presented with neurological signs attributable to hyponatraemic encephalopathy and 7 of these foals had seizures; other neurological signs included obtundation, ataxia and apparent blindness. The three most common primary diagnoses of the 69 foals with severe hyponatraemia were renal disease (18/69, 26.1%), enterocolitis (16/69, 23.2%) and uroperitoneum (15/69, 21.7%). Treatment was directed at the primary disease and correction of the hyponatraemia. A total of 50 of the 69 foals (72.5%) with severe hyponatraemia survived to hospital discharge and 38 of them (76%) survived at least 12 months following discharge. CONCLUSION: The prevalence of severe hyponatraemia in this study population was 4%. The majority of foals with severe hyponatraemia did not demonstrate direct clinical manifestations as a result of the low serum sodium concentration. The outcome of foals with severe hyponatraemia was mostly favourable.

Age-related changes in dynamic compressive properties of trochanteric soft tissues over the hip.

Hip fracture risk increases dramatically with age, and 90% of fractures are due to falls. During a fall on the hip, the soft tissues overlying the hip region (skin, fat, and muscle) act as shock absorbers to absorb energy and reduce the peak force applied to the underlying bone. We conducted dynamic indentation experiments with young women (aged 19-30; n=17) and older women (aged 65-81; n=17) to test the hypothesis that changes occur with age in the stiffness and damping properties of these tissues. Tissue stiffness and damping were derived from experiments where subjects lay sideways on a bed with the greater trochanter contacting a 3.8cm diameter indenter, which applied sinusoidal compression between 5 to 30Hz with a peak-to-peak amplitude of 1mm. Soft tissue thickness was measured using ultrasound. On average, stiffness was 2.9-fold smaller in older than young women (5.7 versus 16.8kN/m, p=0.0005) and damping was 3.5-fold smaller in older than young women (81 versus 282Ns/m, p=0.001). Neither parameter associated with soft tissue thickness. Our results indicate substantial age-related reductions in the stiffness and damping of soft tissues over the hip region, which likely reduce their capacity to absorb and dissipate energy (before "bottoming out") during a fall. Strategies such as wearable hip protectors or compliant flooringmay compensate for age-related reductions in the shock-absorbing properties of soft tissues and decrease the injury potential of falls.

Equine multinodular pulmonary fibrosis in three horses in Australia.

BACKGROUND: Equine multinodular pulmonary fibrosis (EMPF) is a recently described form of interstitial pneumonia associated with the presence of equine herpesvirus type 5 (EHV-5). Since 2007, several case reports from America, Europe and the United Kingdom have further characterised the clinical presentation and laboratory findings of this disease. CASE REPORTS: Three Thoroughbred broodmares were diagnosed with EMPF. Diagnosis was based on lung histopathology and positive identification of EHV-5 using PCR DNA amplification. There was multiple organ involvement in all three cases, including identification of EHV-5 in hepatic tissue in one case. Two of the three horses died. Treatment with acyclovir was unsuccessful in one horse and one horse survived without antiviral or corticosteroid treatment. CONCLUSION: This case series is, to the authors' knowledge, the first report of EMPF in Australia and adds to the clinical description of the disease.

Methicillin-resistant Staphylococcus aureus in a population of horses in Australia.

OBJECTIVE: To evaluate if methicillin-resistant Staphylococcus aureus (MRSA) is present in the horse population in Australia. DESIGN: A two-part retrospective study of laboratory submissions of microbial culture results from horses. METHODS: Part A: medical records of 216 horses that had MRSA screening performed on nasal swabs collected over a 30-day period at admission to the Scone Equine Hospital Clovelly Intensive Care Unit were retrieved. Part B: laboratory records from 2004 to 2009 of culture submissions to the Scone Veterinary Laboratory were reviewed and cultures that grew MRSA were identified. The MRSA isolates from Parts A and B were genotyped over an 18-month period. RESULTS: MRSA screening of 216 horses identified eight (3.7%) positive samples. MRSA was isolated from cultures of 80 (0.002%) clinical bacteriology samples over a 6-year period. Genotypic analysis was performed on 36 isolates. All MRSA characterised had the same pulse field gel electrophoresis pattern (type 1), with eight closely related subtypes identified (subtypes A-F and H) and 66% of isolates classified as subtype D, which multilocus sequence and staphylococcal cassette chromosome mec typing analysis identified as ST612-MRSA-IVa, a clonal complex (CC) 8 S. aureus strain. Antimicrobial resistance to more than two classes of antimicrobials was common. CONCLUSIONS: MRSA was present in a population of horses in Australia. Genotypic analysis of the isolates identified the MRSA strain as CC8 S. aureus. Further research needs to be undertaken to evaluate MRSA infection and colonisation of horses and personnel in Australia.

Erythrocytosis and pleural effusion associated with a hepatoblastoma in a Thoroughbred yearling.

A 10-month-old Thoroughbred filly was presented with a 2-month history of recurrent fever and pleural effusion. Major clinical findings were pyrexia and congested mucous membranes. Clinical pathology tests revealed an erythrocytosis, hyperfibrinogenaemia and hyperglobulinaemia. Pleural fluid was seen on ultrasonographic examination of the thorax and analysis of a thoracocentesis sample indicated a lymphocytic, modified transudate. A transtracheal aspirate was normal. The erythrocytosis persisted despite IV fluid therapy. Arterial blood gas analysis and bone marrow aspirate were normal. These findings were indicative of secondary inappropriate erythrocytosis. Ultrasonographic examination of the abdomen showed a large encapsulated heterogeneous mass in the left lobe of the liver. Histopathological evaluation of a biopsy of the mass was indicative of a hepatic carcinoma. The filly was euthanased and necropsy confirmed the presence of a hepatic tumour with no evidence of systemic metastasis. Further histopathological evaluation confirmed the tumour to be an embryonal macrotrabecular epithelial-type hepatoblastoma, a type of hepatoblastoma that has not previously been reported in a horse.

Blood culture isolates and antimicrobial sensitivities from 427 critically ill neonatal foals.

OBJECTIVE: To assist correct decision-making about antimicrobial treatment of equine neonates with septicaemia. DESIGN: Retrospective study of microbial blood culture results obtained from foals less than 7 days of age. METHODS: Microbial blood culture results from foals less than 7 days of age admitted to an intensive care unit between July 1999 and December 2004 were reviewed. Antimicrobial sensitivity was assessed by the Kirby Bauer disc diffusion method. Antimicrobials were defined as an effective first-line choice antimicrobial if greater than 70% of isolates were susceptible. Multiple drug resistance (MDR) was defined as resistance to at least three antimicrobials in different chemical classes or with different mechanisms of resistance. RESULTS: Of the 427 Thoroughbred foals included in the study, a positive blood culture was obtained in 110 foals and 124 microorganisms were isolated. Gram-positive isolates, predominantly Streptococcus/Enterococcus spp, were obtained in 41% of foals. Gram-negative isolates were predominantly of the Enterobacteriaceae family, in particular Escherichia coli. The overall antimicrobial sensitivity of the isolates was low. The Gram-positive organisms had unpredictable sensitivity patterns. MDR was recorded in 32% of isolates. In total, 81% of foals were discharged from hospital and 74.5% of foals with a positive blood culture were discharged. CONCLUSION: With the increasing prevalence of Gram-positive microorganisms and their unpredictable sensitivity patterns, blood cultures remain important in the diagnosis and treatment of equine neonatal septicaemia.

Evidence of a critical leucite particle size for microcracking in dental porcelains.

The leucite particles in dental porcelains are often partially encircled by microcracks that are the result of the thermal expansion mismatch between leucite and the surrounding glass matrix. Although the magnitude of the stress at the particle-matrix interface is independent of the particle size (Selsing, 1961), Davidge and Green (1968) showed experimentally that there is a critical particle size below which microcracking is absent. The critical particle size is explained by a Griffith-type energy balance criterion: Below the critical size, the stress magnitude may be sufficient to cause cracking, but there is insufficient strain energy for the creation of the new surfaces of the microcrack. The purpose of the present study was to determine whether the mean leucite particle size of a dental porcelain influences the degree of microcracking in the porcelain. Microcrack density, leucite particle surface area per unit volume, and leucite mean volume-surface diameter, D3,2, were determined by quantitative stereology on 10 specimens each of 6 dental porcelains and Component No. 1 of the Weinstein et al. patent (US Patent 3,052,982, 1962). The fraction of leucite particles with microcracks around them, f(mc), was estimated for each porcelain from the microcrack density and the leucite surface area. Using the equations of Selsing (1961) and Davidge and Green (1968), we calculated the critical particle diameter, Dc, for leucite to be 4 microm. The porcelains were partitioned according to whether their mean leucite particle diameters, D3,2, fell above or below Dc, and their values of f(mc) were analyzed by a permutation test with random re-sampling. The porcelains with mean leucite particle diameters below Dc had a significantly lower fraction of cracked particles compared with the porcelains with mean leucite particle diameters above Dc (p < 0.05). This study provides evidence that microcracking in dental porcelain can be minimized by a reduction of the mean leucite particle diameter to less than 4 microm.

H+-induced tension development in demineralized dentin matrix.

Recent atomic force microscopy studies have shown that acid-etching dentin causes the surface to recede. The purpose of this work was to test the hypothesis that acidic solutions can cause contraction of demineralized dentin matrix. Small beams of dentin were cut from extracted human third molars. The central region of each specimen was completely demineralized in EDTA. Specimens held in a tester were immersed in acidic solutions, and the amount of tension was recorded. Test variables included gauge length, cross-sectional area, pre-strain, and pH. The results showed that immersion of demineralized dentin in acidic solutions caused tension that was directly related both to H+ concentration at pH < 2 and to pre-strain. The contractile stress development (ca. 0.2-0.4 MPa) was sufficient to cause a collapse of demineralized dentin matrix. The mechanism for this effect probably involves H+-induced conformation changes in the collagen matrix.

Water-enhanced crystallization of leucite in dental porcelain.

OBJECTIVE: The purpose of this study was to determine whether long-term exposure of dental porcelain to saliva during temporary cementation of a porcelain-fused-to-metal (PFM) restoration could enhance leucite crystallization if the restoration is refired. Such water-enhanced leucite crystallization in dental porcelains could lead to porcelain-metal thermal incompatibility problems. METHODS: Six commercial dental body porcelains and the Component No. 1 (leucite-containing) frit of the Weinstein et al. [13] patent were studied. For each porcelain, 30 coupon specimens were randomly assigned to a treatment group. Ten specimens were placed in artificial saliva, 10 in distilled water, and 10 in a desiccator and were stored for six months. At the end of the six months, an additional 10 coupons of each porcelain were prepared to serve as a control. All 40 specimens of each porcelain were randomized and subjected to one additional firing. Leucite weight fraction was determined by quantitative X-ray powder diffraction analysis via an internal standard technique. RESULTS: Comparisons among the treatments via the least-squares-means test-adjusting for porcelain showed that the saliva group mean leucite weight fraction was significantly higher than that of the other groups. The change in porcelain thermal expansion that would be associated with a leucite change in this range would be between 0.2 x 10(-6) K-1 and 0.3 x 10(-6) K-1. SIGNIFICANCE: The results of this work constitute the first demonstration that moisture absorbed by a porcelain can act as a glass modifier and enhance the crystallization of the glass during subsequent firing. The effect was sufficiently large to generate thermal expansion changes that would exceed the maximum safe mismatch between porcelain and metal.

Relapse in Angle Class II Division 1 Malocclusion treated by tandem mechanics without extraction of permanent teeth: A retrospective analysis.

Ideal orthodontic treatment should achieve long-term stability of the occlusion. The mandibular incisor segment has been described as the segment that is most likely to exhibit relapse after treatment and retention. Therefore, relapse of this is a challenge that clinicians need to address. The purpose of this study is to evaluate the amount of relapse that may occur in Angle Class II Division 1 patients, treated orthodontically with tandem mechanics. All cases in this study were treated without extraction of permanent teeth, and the patients were followed for at least 2 years after the end of the retention phase of treatment. Six predictors were investigated at pretreatment, posttreatment, and postretention periods. A synopsis of this study shows the correction of lower incisor crowding as measured by the irregularity index was stable over 5.2 years of postretention follow-up; but longer follow-up time revealed increased relapse of incisor irregularity. Intermolar width increased during treatment and remained stable in the follow-up period. Overjet and overbite corrections and changes in the lower incisor to mandibular plane angle were also stable in the follow-up period. In addition, the amounts of overjet correction and loss of expansion of intercanine distance after treatment were associated with increased irregularity index in the follow-up period. It appears the discrepancies between this and previously published works are sufficiently dramatic that the whole question of treatment philosophy and long-term stability may need to be reevaluated.

Comparison of direct digital and conventional radiography for the detection of proximal surface caries in the mixed dentition.

PURPOSE: The aim of this study was to compare the performance of direct digital radiography and traditional dental radiography for the detection of proximal surface dental caries in the mixed dentition. METHODS: 15 quadrants of extracted teeth, arranged from the primary canine to permanent first molar, were imaged using direct digital (Schick Technologies, Long Island City, NY, USA) and conventional films (D-speed and E-speed Plus; Eastman Kodak Co., Rochester, NY, USA). Five pediatric dentists viewed the images and scored the 270 proximal surfaces for presence of caries on a 5 point scale and extent of caries on a 4 point scale. The teeth were sectioned and viewed microscopically to determine the gold standard. Receiver operating characteristic (ROC) analysis and analysis of variance (ANOVA) were used to evaluate the viewer's performance for detecting proximal caries using the 3 different image receptor types. RESULTS: Experienced examiners were significantly more accurate in diagnosis of proximal surface caries using either D-speed or E-speed Plus films than they were using the direct digital receptor. The mean areas under the ROC curve (Az) for the viewers were 0.7595 for D-speed film, 0.7557 for E-speed Plus film, and 0.5928 for the direct digital receptor. The results also indicated that selected viewers' accuracy increased when viewing the direct digital images a second time. CONCLUSION: CCD based direct digital radiography was not as accurate as conventional film images for the purpose of diagnosing proximal surface caries in the mixed dentition. However, the results imply that with increased experience, direct digital images may be as accurate as conventional film based images for diagnosis.

Permeability of demineralized dentin to HEMA.

OBJECTIVES: The objectives of this study were to develop a macromodel of the demineralized layer of dentin that is formed after acid-etching, and to determine if the amount of HEMA uptake was responsive to air drying. The hypothesis that was tested was that HEMA uptake by demineralized dentin depends upon the degree of expansion of the collagen fibril network. METHODS: Dentin cubes (2 x 2 x 2 mm) were prepared in coronal dentin from extracted unerupted human third molars. They were incubated in 100% HEMA for up to 1000 min and then removed and blotted free of excess adherent HEMA. The HEMA taken up by each cube was extracted in 2 ml of water for 1 hr with shaking. This was repeated and the extracts combined. HEMA was quantitated spectrophometrically. The dentin cubes were then demineralized in 0.5 M EDTA for 10 days and the HEMA uptake remeasured at 1, 10, 100 and 1000 min. Then the cubes were air-dried and the HEMA uptake remeasured. After re-expanding the specimens in water, the cubes were stiffened in ascending concentrations of acetone of 100%, then allowed to air dry again in a more expanded state, and HEMA uptake was remeasured. Finally, after rehydration, the dentin cubes were "acid-etched" for 1 or 10 min with 37 wt% phosphoric acid and HEMA uptake remeasured. RESULTS: Before demineralization, the dentin took up little HEMA (ca. 4.8 x 10(-7) moles min-3) compared to after demineralization when the uptake for 10, 100 and 1000 min was 27.4, 43.8 and 51.4 x 10(-3) moles mm-3, respectively. Acid etching for 1 or 10 min had no effect on HEMA uptake. Air drying produced a 72% volumetric shrinkage but a 97% reduction in uptake. When the demineralized matrix was stiffened in acetone prior to air-drying, the volumetric shrinkage was only 27% and the HEMA uptake only fell 16% compared to the wet, fully expanded condition. SIGNIFICANCE: The results support the hypothesis that the uptake of HEMA by demineralized dentin depends on the degree of expansion of the dentin matrix.

Assessing dentin color changes from nightguard vital bleaching.

BACKGROUND: At-home bleaching with 10 percent carbamide peroxide in a custom-fitted tray has been reported to change the color of dentin. The purpose of this study was to validate the color change of dentin and to determine whether the color change was uniform or occurred from the outside (the dentinoenamel junction) to the inside (the pulpal wall). METHODS: The authors sectioned 10 extracted human teeth incisogingivally through the midfacial long axis, and sealed their cut surface against glass microscope slides. Identifying marks were placed on the glass over the tooth sections to serve as a color control and in the dentinal areas closest to the dentinoenamel junction and the pulpal wall. Teeth were bleached for 10 days with 10 percent carbamide peroxide. Photographs were taken from the glass-covered side of the teeth, digitized and converted to gray-scale levels (consisting of 256 shades of gray ranging from black to white). Marked areas were measured with a National Institutes of Health Image software program and analyzed statistically for changes in lightness between the control marks and the inner and outer dentinal marks over time. RESULTS: Paired t-tests and analysis of variance indicated a significant increase in lightness (P = .01) for the inner and outer dentinal areas during bleaching compared with the control areas. No significant differences were found in the rate of change for the inner and outer dentinal areas (P = .89). CONCLUSIONS: The increase in lightness confirms that a significant color change occurred in the dentin during bleaching with 10 percent carbamide peroxide. This change occurred throughout the dentin at a uniform rate, rather than from the outside inward. CLINICAL IMPLICATIONS: The results of this study show that at-home bleaching with 10 percent carbamide peroxide can change the color of dentin, which is important to treat intrinsic stains from tetracycline treatment, trauma and aging or inherited discolorations. The bleaching material easily penetrates the tooth to change the dentin color at the same rate throughout, indicating that the type of stain may be the important factor in determining bleaching success.

A comparison of the efficacy of 2 powered toothbrushes in affecting plaque accumulation, gingivitis, and gingival bleeding.

BACKGROUND: The purpose of this 30-day blinded, parallel-design study was to compare the effect of 2 powered toothbrushes, the Rowenta MH700 and the Braun Plak Control Ultra, on reducing plaque accumulation, gingivitis, and gingival bleeding in a cohort of 60 healthy adults. METHODS: After baseline evaluation of plaque, gingivitis, and gingival bleeding, subjects were randomly assigned to one of the experimental groups, provided written and verbal toothbrushing instructions, and had their teeth polished. At 2 weeks (follow-up 1) and 4 weeks (follow-up 2), all clinical parameters were again evaluated. RESULTS: The Braun group demonstrated a nearly significant reduction in gingival index (GI) and a significant reduction in GI at follow-up 2. The Rowenta group demonstrated significant reductions in GI, plaque index (PI), and bleeding index (GBI) at both follow-up 1 and 2 examinations. At follow-up 1, the Braun group demonstrated a nearly significant reduction in GI, a significant reduction in PI, and a non-significant reduction in GBI. At follow-up 2, the Braun group demonstrated a significant reduction in GBI, but not a significant reduction in PI. The reduction in GI for the Rowenta group was significantly greater (P values of 0.0001 and 0.0001, respectively) than that demonstrated in the Braun group. However, the Rowenta group did not demonstrate a significantly greater reduction in PI (P values of 0.7135 and 0.3184 for follow-up 1 and follow-up 2, respectively) or GBI than the Braun group at either examination (P values of 0.0663 and 0.3397 for follow-up 1 and 2, respectively). CONCLUSIONS: The results of this study support the findings of numerous other studies that powered toothbrushes have great potential to remove plaque and improve gingival health and that the improvement can be demonstrated in a relatively short period of time.

A retrospective study of Angle Class I malocclusions treated orthodontically without extractions using two palatal expansion methods.

The correction and relapse of mandibular anterior crowding was evaluated in a population of 58 patients with Angle Class I malocclusion who were treated orthodontically without extraction of permanent teeth. The subjects were retrospectively evaluated from records taken before treatment, posttreatment, and postretention. The postretention period averaged 8 years (minimum of 4 and maximum of 20 years). All cases in Groups A and B were given orthopedic treatment to develop the maxillary apical base in the transverse and anteroposterior planes. Group A was treated with expansion of the inner bow of the face bow appliance (Kloehn), and Group B was treated with the Haas palatal expansion appliance. Both groups were then treated orthodontically with tandem mechanics. The response variables measured were: overbite, overjet, intercanine distance, intermolar distance, and irregularity index. Study groups A and B were not significantly different for subject age, retention, or postretention time. Moreover, the groups did not show significant difference for any of the response variables before treatment. However, there was a statistically significant difference in the treatment times (P =.0133). A statistically significant treatment effect was observed for most response variables in the groups. Overbite, overjet, and irregularity index were significantly reduced, intermolar distance was significantly increased, and intercanine distance showed no significant change in Groups A and B. In the postretention period, there was a tendency for variables to change slightly toward their before treatment values but no compromise of orthodontic correction was noted. The irregularity index in Group A was corrected from 4.8 to 1.1 mm and remained at 1.1 mm in the postretention period. The irregularity index in Group B was corrected from 5.1 to 1.2 mm (P =.0001) and changed slightly from 1. 2 to 1.7 mm (P =.0540) in the postretention period. We concluded that mandibular incisors tended to become more crowded postretention. However, in contrast to previous reports, we calculate this relapse to be small. Neither before treatment nor posttreatment variables were predictive of relapse.

Dental caries and fluorosis among children in a rural Georgia area.

PURPOSE: This IRB-approved study compared the caries experience, fluorosis prevalence, and plaque and salivary fluoride concentrations ([F]) in middle school (MS; N = 51) and elementary school (ES; N = 144) children residing in nonfluoridated and fluoridated communities in rural Georgia. All participants were exposed to fluoridated water at school (0.5-1.2 ppm), some received that level at home, and others received home water with < 0.1 ppm F. METHODS: Subjects' parents completed a questionnaire regarding fluoride exposure. Children were examined at school by two calibrated dentists. RESULTS: No significant differences were seen in DMFS+dfs between children with or without fluoridated home water, nor for those with or without fluorosis. MS children with non-fluoridated home water had lower mean salivary [F] values than MS children with fluoridated home water. No differences were found among MS and ES children in mean plaque [F] for those with or without fluorosis. CONCLUSIONS: Home water fluoridation had little effect on the variables measured. These findings appear to be due to fluoride exposure from fluoridated dentifrices, fluoridated drinking water at school, and the fluoride "halo" effect.

Width/length ratios of normal clinical crowns of the maxillary anterior dentition in man.

The purpose of this investigation was to analyze the clinical crown of the 3 tooth groups of the maxillary anterior sextant of the permanent dentition of normal subjects with respect to (i) width, length and the width/length ratios and (ii) determine if there is a correlation between tooth dimensions or tooth group ratios and subject height. Subjects (> or = 20 y.o.) were recruited for this study if (i) the free gingival margin on the facial surface of teeth in the maxillary sextant was positioned apical to the cervical bulge, (ii) there was no evidence of attachment loss; as determined by lack of a detectable CEJ and (iii) the marginal tissue was knife edged in form, firm in consistency and coral pink in color. Teeth were excluded if (i) there was evidence of gingival alteration, i.e., gingival overgrowth/hyperplasia, inflammation, altered passive eruption, attachment loss, gingival recession or history of periodontal surgery, or (ii) there was evidence or history of incisal edge/proximal tooth alteration as in, i.e., restorative intervention, traumatic injury or occlusal wear into dentin. At least 1 suitable tooth from each tooth group of the maxillary anterior dentition had to be present. A maxillary impression was taken and poured in yellow die stone. The widest mesial-distal portion and the longest apical-coronal portion of the test teeth were measured. Gender, ethnicity and subject height (SH) were recorded for each participant. Due to a limited ethnic diversity only data from the Caucasian group were analyzed. The mean coronal tooth width (mm) of males versus females was CI: 8.59 versus 8.06, LI: 6.59 versus 6.13 and CA: 7.64 versus 07.15. The mean coronal tooth length (mm) of males versus females was CI: 10.19 versus 9.39, LI: 8.70 versus 7.79 and CA: 10.06 versus 8.89. All width and length measures were significantly greater for males than for females. The mean coronal tooth width/length ratios for males versus females was CI: 0.85 versus 0.86, LI: 0.76 versus 0.79 and CA: 0.77 versus 0.81. A comparison between genders of the width/length ratios of the CI and LI were found not to differ, however the CA ratio for females was significantly greater than for males. A statistically significant difference was found to exist between the mean (cm) SH for males versus females: 181.2 versus 164.0. A positive correlation (p < or = 0.0001 to 0.0691) was found to exist between tooth group width/height ratios within genders. No significant correlation was found between any of the tooth dimensions or tooth group ratios and SH. The results of this study indicate that within male and female Caucasians, the mean width/length ratio of the maxillary 3 anterior tooth groups is 0.81. As well, within both genders there is a positive correlation between tooth group width/length ratios. The significance of these findings with respect to periodontal mucogingival plastic surgical procedures is discussed.

Durability of resin-dentin bonds.

PURPOSE: The purpose of this study was to determine if the durability of resin-dentin bonds could be evaluated more quickly if the bond specimen was divided into 1 x 1 x 8 mm beams incubated at 37 degrees C for a 90-day period. MATERIALS AND METHODS: Extracted human third molars were prepared for bonding by removing the occlusal surface near the dento-enamel junction (superficial dentin group) or near the pulp (deep dentin group). The teeth were bonded either with MacBond, One Step or Clearfil Liner Bond 2, and then builtup to form a flat resin composite crown. After 24 hours in water, each buildup was vertically divided into slabs 1 mm thick, the top half of which was resin, with the bottom half as dentin. Each slab was then vertically sectioned at 1-mm increments to create 1 x 1 x 8-mm beams of resin-bonded dentin. They were incubated for 1 day or 90 days at 37 degrees C, followed by measurement of the tensile bond strengths. The results were analyzed by the Least-Squares Means method at the 95% confidence level. RESULTS: MacBond gave the highest (p < 0.05) 1-day bond strengths to superficial dentin, but significantly lower bond strengths were measured in deep dentin. There were no significant differences in the bond strengths of either One Step or Clearfil Liner Bond 2 to superficial vs deep dentin at 1 day, but at 90 days their bond strengths to deep dentin had fallen significantly (p < 0.05). Prepolymerized cylinders of resin composite bonded together with One Step showed little variation in bond strength over the 90-day experiment. SEM examination of the failed bonds showed increased porosity in intertubular dentin over time. CONCLUSION: The results indicate that division of large specimens into many small beams accelerated the deterioration of bond strength in deep dentin in all three bonding systems and in both superficial and deep dentin in the MacBond treated specimens. This method seems promising for studying the durability of resin-dentin bonds.