Use of electrosurgery and lasers in the presence of dental implants.

Use of electrosurgery or laser surgery in the presence of metallic implants has been implicated in generating heat-induced injury to peri-implant bone, with the subsequent loss of osseointegration. Studies involving lasers offer conflicting results, while in the case of the electrosurg, little research has been published supporting or refuting these claims. This study measured local heat effects created by use of a unipolar electrosurgical unit, a bipolar electrosurgical unit, and a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. Absolute temperature increase was measured during an in vitro uncovering surgical procedure performed with each unit. Analysis of variance for repeated measures was performed. Second, absolute temperature increase for each unit was compared with a theoretical clinical limit of a 10 degrees C increase. The findings suggest that use of the unipolar electrosurgical unit should be avoided, while judicious use of both the bipolar unit or the laser unit should produce temperature profiles well within clinical limits.

Placement and restoration of implants by predoctoral students: the Creighton experience.

Teaching of implant dentistry in the predoctoral dental curriculum has evolved dramatically over the past 20 years. In 1974, only one third of American dental schools addressed the topic of implants. Today, 48 of the 54 American dental schools have predoctoral curricula. The Creighton University experience offers some unique and instructive insights into a 10-year process of developing and implementing a predoctoral implant dentistry curriculum. All interested students may perform both the surgical placement and restoration of implant prostheses. Clinical instruction involves all restorative and surgical faculty members. Favorable 3-year (91%) and 5-year (87%) surgical success rates have been maintained. This article presents one university's program for examination and discussion.

A case of acromegaly identified after patient complaint of apertognathia.

Acromegaly results from the over production of growth hormone after the age at which the epiphyses of the bones have fused. The most common cause is an adenoma of the anterior pituitary gland. Early signs and symptoms are subtle and delayed diagnosis is common. The health consequences of untreated acromegaly are considerable. A brief description of the condition is given and a case report is included. The condition of the patient was first diagnosed after a dental examination at which he voiced a complaint of the inability to incise and a progressive open bite that he attributed to prosthetic treatment. On the basis of his intraoral radiograph history, it is probable that he developed the disease more than 5 years before its diagnosis.

Incidence of hepatitis B exposure among USAF dental laboratory technicians.

The purpose of this study was to survey, serologically, the exposure history of USAF dental laboratory technicians to hepatitis B virus (HBV), and to compare the incidence to that found in the general military population. Blood samples from 145 technicians, with an average age of 26.9 (S.D. = 6.9) in four locations in the USA and Europe, were tested for the presence of HBV core antibody using a standard enzyme immunoassay (EIA) procedure. These results were compared against 397 military members in non-medical fields of equivalent age and rank. The binomially distributed data was converted to a z distribution and a statistically significant difference was found in a comparison of the probability of detecting anti-HBc in each population (P = 0.034) where the incidence among the technicians was 2.7% and the military population 0.76%. Use of a "barrier system" in the laboratory, and vaccinations, could prevent any increase in this incidence from an occupational source.

The management of clotted angiographic catheters.

In our experience, clotted angiographic catheters pulled back to near the puncture site and severed near the skin will spontaneously clear, facilitating insertion of a guidewire and catheter exchange without repuncture or other manipulation.