Seroepidemiology of hepatitis C antibodies among dentists and their self-reported use of infection control measures.

OBJECTIVES: To determine the prevalence of hepatitis C virus (HCV) antibodies among dentists graduated from various countries and assess the use of infection control measures in their dental practice. RESEARCH DESIGN: The study included 301 Israeli dentists who attended an annual dental conference. Participants filled out a structured questionnaire regarding demographic (age, gender, number of siblings, number of children) and occupational characteristics. Venous blood was examined for presence of HCV antibodies by enzyme immunoassay and confirmed by a third generation line immunoassay, which assesses antibodies to HCV-core antigens (INN-LIA HCV Ab III update, 100% sensitivity, 100% specificity). RESULTS: The prevalence of HCV antibodies among Israeli dentists was 1/301 (0.33%), similar to the prevalence range (0.1-0.5%) among the general Israeli population. The studied population included dentists (30.6%) who immigrated from Asia, Eastern Europe and the former USSR, where HCV prevalence ranges from 3.1% to 26.5%. Dentists routinely used gloves (99.6%), gown (93.3%), autoclaves (90.3%), dry heat (29.1%) and mask (81%). Dentists who graduated after 1985 used a mask or gown significantly more often than dentists who graduated before 1985 (p < 0.001 and p = 0.004, respectively). CONCLUSION: It seems that dentists who usually adhere to basic infection control measures are not at an increased risk for HCV.

Interpretation of bitewing radiographs. Part 1. Evaluation of the presence of approximal lesions.

OBJECTIVE: Bitewing radiographs are the main tool for approximal caries detection. However, interpretation of findings is affected by numerous factors, such as beam angulation, exposure conditions, morphologic variations, etc. The objective of the present study was to compare the ability to detect virtually identical, artificial lesions in different tooth surfaces. METHODS: The in vitro model included preparation and radiologic evaluation of approximal artificial lesions in premolars and molars in depths ranging from 0.00 mm to 1.50 mm. RESULTS: Significant differences were found in the prospect of a lesion detection between the different lesion depths (p < 0.0000) and between the different surfaces examined (p < 0.05). The interaction between lesion depth and tooth surface was significant at the 0.0001 level (ANOVA with repeated measures). CONCLUSIONS: The results indicate that initial approximal lesions of uniform size are more readily detected in premolars than in molars and that the chance of an incipient lesion to remain undetected is twice as high in molars than in premolars.

Interpretation of bitewing radiographs. Part 2. Evaluation of the size of approximal lesions and need for treatment.

OBJECTIVE: The decision to treat initial approximal carious lesions is based mainly on interpretation of bitewing radiographs. In a previous report, it was shown that artificial approximal lesions of uniform size are more readily detected on radiographs in premolars than in molars. The objective of the present study was to compare the ability to evaluate the depth of similar size artificial lesions on radiographs and reach decisions concerning treatment, in premolars and molars. METHOD: Clinicians were asked to evaluate on radiographs, the size of in vitro prepared artificial lesions, and decide at which point they would perform a restoration. RESULTS: Significant differences were found in the evaluation of lesion depth between different tooth surfaces. The interaction between lesion depth and tooth surface originated from the examiners' trend to score same size lesions as penetrating deeper into the tooth in premolars than in molars. The probability of the examiners to decide on restorative treatment in shallow lesions (0.25 mm, 0.50 mm) was higher in premolars than in molars. CONCLUSIONS: The findings suggest that clinicians evaluate initial lesions as being deeper and more prone to treatment in premolars than in molars.

Radiologic features of central giant cell granuloma of the jaws.

The radiologic features of central giant cell granuloma (CGCG) have not been clearly defined, and conflicting descriptions appear in the literature. This study analyzes the radiologic and clinical features of 80 cases of CGCG. In nearly 50% of the cases the lesion is located in the posterior area of the jaws, that is, the molar, ramus, and tuberosity, and not in the deciduous teeth-bearing area as was accepted in the past. Only 51% of CGCGs are multilocular, and the frequency of these lesions is significantly higher in the mandible than in the maxilla. The correlation between the lesion's size and its locularity is statistically significant, and larger lesions assume a multilocular appearance. Only 6% of the lesions crossed the midline of the jaws, a feature that was considered in the past as typical for CGCG.

Influence of soft tissue on density and relative contrast between gutta-percha and dentin images. An in vitro study.

The current ANSI/ADA standard for density of gutta-percha (GP) has been found to be insufficient for clinical purposes. Furthermore, it does not take into account the possible influence of soft tissue on the image of GP in the root canal. The present study evaluated the density of GP according to the standard and the influence of soft tissue on the contrast between GP and dentin in vitro. The optical density of all tested GP brands was higher than the recommended standard. Soft tissue significantly influenced the relative contrast between dentin and GP and a decrease of more than 10% was observed when soft-tissue-equivalent phantom was added (p<0.000). A test simulating a clinical condition is recommended for improving the standard for the density of GP.

Radiographic features of anterior buccal mandibular depression in modern human cadavers.

The anterior buccal mandibular depression (ABMD) becomes significant when evaluating edentulous patients prior to implant insertion. The features of the ABMD in dry mandibles from ancient populations have been reported. In the present study the prevalence and radiological appearance of the ABMD and the influence of soft tissue superposition on its radiological detectability in the jaws of modern human cadavers were evaluated. The prevalence of ABMD was 32%. The presence of soft tissue significantly influenced the radiopacity of the ABMD area and the degree of definition of the borders (p=0.0003 and 0.0001 respectively). Changes in the trabecular pattern were observed in 36% of the cases without soft tissue compared with 29% with soft tissue. The ABMD was more readily detected on CT scans than on conventional periapical or panoramic radiographs.

Detection of psychopathologic trends in glossodynia patients.

Glossodynia affects primarily middle-aged women. Although many possible etiologies have been proposed for the syndrome, most have not been substantiated. In the present study 56 glossodynia patients were evaluated for their psychopathologic profile as reflected by the SCL-90 questionnaire. The data show that glossodynia patients present a relatively high psychopathologic profile, especially on the scales of somatization and depression. Significant correlations were found between the intensity of pain experienced by the patients and some of the SCL-90 scales (somatization, depression, anxiety, GSI and PSDI). No correlations were found between SCL-90 scores and duration of symptoms, prevalence of symptoms per day and patient's condition during the past year. Patients living alone were found to differ significantly from those living with a significant other (overall group effect significant at the 0.01 level). The data suggest that psychopathologic trends may be associated with glossodynia.

The prevalence of oral cancer in relation to the ethnic origin of Israeli Jews.

Smoking, alcohol, and familial background are considered major cofactors in the cause of oral cancer. The purpose of the present study was to determine the relationship between ethnic origin and oral cancer in the Israeli Jewish Population. Data were collected during the years 1970 to 1980 from 342 dental records of patients in Israeli hospitals. Results showed a male/female ratio of 2:1. Of 264 patients with clearly determined ethnic origin, 72% were Ashkenazi, 15% Sephardi, and 13% Eastern ethnic origin. The relative prevalence showed that the risk of the Ashkenazi group to develop oral cancer was at least twice as high as the other two ethnic groups. The increase in occurrence of oral cancer with age in each ethnic group was highly significant (p < 0.001). The most common type of malignancy was squamous cell carcinoma (95%) with 99% of this malignancy occurring in patients in their sixth and seventh decade. A significant (p < 0.02) relationship between site of involvement and ethnic origin was also noted. The tongue was the leading site in the Ashkenazi and Sephardi groups, whereas the lip and alveolar ridges were the most affected sites in the Eastern ethnic group.

Anterior buccal mandibular depression (ABMD). Anatomic and histologic features.

The anterior buccal mandibular depression (ABMD) is a bilateral symmetrical depression located anterior to the mental foramen and extends under the alveoli of the first premolar to the central incisor. The prevalence, dimensions and contents of the ABMD in cadavers of fetuses and adult modern humans were evaluated. ABMD was found in all fetuses and in 31.8% of adults. The average dimensions of the ABMD in adults were depth 2.36 mm, width 5.44 mm and length 12.43 mm. The present study contributes to a better evaluation of the differential diagnosis and treatment planning in the anterior region of the mandible. A possible etiology for the development of ABMD is suggested.

Extraction site healing in rats. A radiologic densitometric study.

The present study uses a simple, objective method to radiographically evaluate the changes that occur during socket healing in rats. Mandibular left first molars were extracted in 35 Wistar rats, which were then sacrificed at 0, 7, 14, 21, 28, 45, and 60 days after surgery. Mandibles were removed, placed on an ANSI size 2 film, and exposed with an aluminum step-wedge, 0.5 to 3.0 mm. Socket density was measured with a digital densitometer and related to the equivalent density of aluminum. Increased density of the image of the apical and crestal areas of the socket was observed on day 7. Maximum density was reached by day 28 in the apical area; in the crestal area, density increased at a slower rate. The density changes found in the present study agree with the known histologic reports of socket healing in rats. Densitometric evaluation of extraction socket healing, using a step-wedge with 0.5 mm increments, is a useful and reliable tool to objectively assess bone formation and mineralization.

The anterior buccal mandibular depression: physical and radiologic features.

The anterior buccal mandibular depression (ABMD), an anatomic variation not previously mentioned in the dental literature, is considered. Its physical and radiologic configuration is evaluated, and its significance in the differential diagnosis of radiolucent lesions in the anterior portion of the mandible is discussed. The general prevalence of ABMD was found to be 19.8%, with a significantly higher prevalence in children (p less than 0.001). In the majority of cases, the depression was radiologically detected. The radiopacity of the area was significantly dependent on depth of the depression (p less than 0.001). The radiographic image of the ABMD resembles, in many cases, the image of the less common anterior lingual salivary gland depression. The relatively high frequency of the ABMD indicates the importance of recognizing its radiologic features.

Severe infraclusion ankylosis: report of three cases.

Tooth ankylosis may occur at any time during eruption and may show varying degrees of infraclusion. Cases of fully erupted teeth subsequently becoming totally embedded in bone are rare. The three reports described here show cases of severe infraclusion ankylosis; the etiology and related problems are discussed. Associated periodontal, prosthetic and orthodontic problems can be avoided with early diagnosis and treatment.

The anterior buccal mandibular depressions: ontogeny and phylogeny.

The frequency of an anterior buccal depression in the mandible (ABMD), or a mental fossa, is reported on 970 human mandibles of various groups and different ages, as well as in 38 mandibles of nonhuman primates. The ontogenetic and phylogenetic significance of the results relevant to development of a chin in Homo sapiens is discussed. The ABMD is also compared with the occurrence of a lingual mandibular depression.

The simple central odontogenic fibroma. A case report.

A rare case of central odontogenic fibroma - a simple type according to Gardner's classification - is presented. Clinical manifestations and treatment are described. The aetiology and histopathological differential diagnosis are discussed.

Migratory stomatitis.

Migratory stomatitis is a unique oral condition with several descriptive names. The diagnosis is based on the clinical appearance and the history of the lesions. The etiology of this entity is still open to debate. A review of the literature and a clinical description of a study group consisting of seven additional cases, in which long-term follow-up was done, are presented. Migratory stomatitis is suggested as the most suitable term to describe accurately the nature and the behavior of this condition.