Treatment of oral chronic graft-versus-host disease with PUVA therapy: case report and literature review.

Chronic graft-versus-host disease commonly appears with oral manifestations subsequent to allogeneic bone marrow transplantation. These manifestations include leukoplakia, mucosal atrophy, erythema, ulcers, and xerostomia. Some lesions are resistant to treatment with immunosuppressive medications. Ultraviolet A irradiation therapy with oral psoralen has been shown to be effective in treating these resistant lesions. This article presents a review of the literature and a case report.

The performance of bonded vs. pin-retained complex amalgam restorations: a five-year clinical evaluation.

BACKGROUND: The authors compared the clinical performance of complex amalgam restorations, replacing at least one cusp--retained either mechanically with self-threading pins or bonded--with a filled, 4-methacryloxyethyl trimellitate anhydride, or 4-META-based resin designed for amalgam bonding. METHODS: The authors placed 60 amalgam restorations (28 pin-retained and 32 bonded), each restoration replacing at least one cusp. They used self-threading stainless steel pins in the pin-retained group and a filled, 4-META-based bonding resin in the bonded group. For both groups, the authors left in place any retention form remaining after removal of an old restoration but did not enhance it. RESULTS: At four years, six restorations had failed. At five years, of the 40 restorations available for evaluation, three had failed, for a total of nine failed restorations; seven of those were pin-retained and two were bonded. Using the Fisher exact test to compare the groups at five years, the authors found no significant difference in failure rate, marginal adaptation, marginal discoloration, secondary caries, tooth sensitivity or tooth vitality. CONCLUSIONS: At five years, there was no difference in the performance of pin-retained amalgam restorations and bonded amalgam restorations. This study will be continued for at least a sixth year. CLINICAL IMPLICATIONS: Bonding with a filled, 4-META-based bonding resin appears to be a satisfactory method of retaining large amalgam restorations replacing cusps.

Dentin treatment with an oxalate solution and glass ionomer bond strength.

PURPOSE: To evaluate the effect of dentin surface treatment on shear bond strengths of two visible light-cured glass ionomer restorative materials to dentin. MATERIALS AND METHODS: Cylinders of Fuji II LC and VariGlass VLC were bonded to dentin surfaces that were (1) treated as directed by the manufacturer, (2) treated with a monohydrogen-monopotassium oxalate solution (Protect Dentin Desensitizer), or (3) treated with the monohydrogen-monopotassium oxalate solution followed by treatment per the manufacturer. Specimens were thermocycled and tested in shear at 7 days. Data for each restorative material were subjected to a one-way ANOVA and the Scheffé F-test (P < 0.05). After shear bond testing the specimens were examined using a stereomicroscope at x8 to determine the mode of failure (adhesive, cohesive or mixed). Dentin specimens were also surface treated as described above, sputter-coated, and examined using a scanning electron microscope. RESULTS: In every instance, the oxalate solution significantly reduced the shear bond strength of both materials.

Dentin surface treatment and bond strength of glass ionomers.

This study evaluated the effect of dentin surface treatment on shear bond strengths of two light- cured glass ionomer restorative materials to dentin. Cylinders of Fuji II LC and VariGlass VLC were bonded to dentin surfaces that were untreated, treated with a 10% polyacrylic acid (GC Conditioner), or treated with a dentin bonding agent primer (Prisma Universal Bond 3 Primer). Specimens were thermocycled and tested in shear at 7 days. Data for each restorative material were subjected to one way ANOVA and Tukey's procedure at the 0.05 probability level. For Fuji II LC, mean bond strength to conditioner-treated dentin was significantly higher than mean bond strength to primer-treated dentin and to untreated dentin. For VariGlass VLC, mean bond strength to primer-treated dentin was significantly higher than mean bond strength to untreated dentin. Bond strengths to primer-treated dentin and conditioner-treated dentin were not significantly different.

Evaluation of resins for provisional restorations.

An in vivo study of two resin materials (Barricaid and Caulk Temporary Crown and Bridge Resin) was done to determine the retention, post-operative sensitivity, and fabrication time of provisional restorations made from these materials. Following the placement of these resins in 67 intracoronal cavity preparations of 19 adult patients, a baseline evaluation was made which included a clinical examination and color slides. Twenty-four hours after the temporary restorations were placed, the patients completed evaluations of the post-operative sensitivity experienced. There was no difference in post-operative sensitivity between the teeth restored with Barricaid or Caulk Temporary Crown and Bridge Resin. At the insertion appointment of the final restoration, the interim restoration's success rate was determined. There was no difference between the retention of the two provisional materials. Fabrication time was significantly different with Barricaid restorations requiring less than one-half the fabrication time of the Caulk Temporary Crown and Bridge Resin material.

Multiple endocrine neoplasia syndrome, type III: review and case report.

Successful treatment of the multiple endocrine neoplasia type III (MEN III) syndrome requires early diagnosis. It is highly possible that the patient's dentist may be the first practitioner with the opportunity to diagnose this potentially fatal syndrome. Additionally, patients with this syndrome having a pheochromocytoma and needing invasive dental treatment pose a life-threatening dental management risk. This article presents a review of the MEN II syndrome and a case report on the surgical management of a MEN III patient with a pheochromocytoma.

Treating the discomfort of oral ulceration resulting from cancer chemotherapy.

Chemotherapy-induced oral mucositis can result in inadequate oral intake, local and systemic infection, a prolonged hospital stay, and increased cost of treatment. Treatment of the pain resulting from this condition can greatly lessen these problems. Hydroxypropyl cellulose gel with benzocaine (Zilactin B) has been shown to effectively reduce the pain of mucositis for up to 3 hours.

Dental management and treatment of xerostomic patients.

Saliva is extremely important for the health and comfort of the oral cavity. Diminution in salivary flow is accompanied by a plethora of problems. A salivary flow inadequate to protect the oral cavity may be an occult condition. Dentists should evaluate those patients presenting with a high incidence or increased incidence of dental caries for a decreased salivary flow. We have presented diagnostic aids, management techniques and treatment modalities for these patients.

Posterior accessory foramina of the human mandible.

A study was performed on 150 dry, adult, human mandibles from cadavers of unspecified sex and unknown ethnic background, which had been imported from India. These mandibles were placed in the "standard basal position" and topographically divided into 11 bilateral areas posterior to the second bicuspid teeth. The accessory foramina in these areas were studied to determine their mean diameter, incidence of occurrence, and the areas in which they occurred. The medical surfaces of the mandibles exhibited foramina more frequently and in greater numbers than did the lateral surfaces. The right and left halves of the mandibles showed remarkable similarity. Much of the data obtained correlated with previous investigations, indicating that neurovascular components enter and leave the body on the mandible in the posterior region. Foramina 0.4 mm. or larger in diameter were evaluated separately. These larger foramina occur most often in the superior and middle thirds on the medial surface of the ramus (areas 6 and 7). They also occur fairly frequently in the retromolar area (area 11). This information can be usefully applied to future dissection studies concerning the soft-tissue components of these foramina. The data obtained reveal that these foramina occur frequently and in approximately the same locations. This suggests that these foramina are functionally important in supplying neural and/or vascular components to the mandible.

Clinical evaluation of two desensitizing agents for use under Class 5 silver amalgam restorations.

STATEMENT OF PROBLEM: Postoperative sensitivity is sometimes reported to be a clinical problem after placement of silver amalgam restorations. PURPOSE: This study compared postoperative sensitivity of Class 5 caries restored with amalgam restorations and Copalite or DentinBloc cavity liners. MATERIAL AND METHODS: At least 1 pair of amalgam restorations were placed in each of 16 patients and tested for sensitivity at 5 time periods. RESULTS: Sensitivity was significantly less with DentinBloc cavity liner (P < .05) at 24 hours, and 2 and 4 weeks. There was a directional but nonsignificant effect (P > .05) in favor of DentinBloc cavity liner at 1 and 16 weeks. CONCLUSION: DentinBloc cavity liner was more effective than Copalite cavity liner in reducing sort term postoperative sensitivity for amalgam restorations.