Quintessence International, 02/2000

Behcet's disease is a chronic, multisystem disorder. It has 3 primary components: recurrent inflammations of the eye, ulcerations of the oral mucous membranes, and ulcerations of the genitalia. Diagnosis of Behcet's disease relies mainly on history taking and clinical manifestations. This article describes the oral soft tissue and dental complications and the prosthetic problems encountered in a young patient. If dentists encounter patients with chronic ocular inflammations and recurrent oral mucous membrane ulcers, the index of suspicion should increase.

An innovative direct technique that improves the accuracy of provisional acrylic resin restorations is introduced. A custom impression tray is modified to facilitate complete occlusal closure. This open tray is used to make an accurate overimpression prior to beginning tooth preparation procedures. Following tooth preparation, the acrylic resin-filled overimpression is returned to its intraoral position, and the patient occludes into the previously indexed impression material. The pressure overimpression technique is offered as an expedient technique for improving the accuracy of provisional restorations.

Etiology and Epidemiology: The Greek term aphthai was initially used in relation to disorders of the mouth and is credited to Hippocrates (460-370 bc). Today, recurrent aphthous ulceration, or recurrent aphthous stomatitis (RAS), is recognized as the most common oral mucosal disease known to human beings. Considerable research attention has been devoted to elucidating the causes of RAS; local and systemic conditions, and genetic, immunologic, and infectious microbial factors all have been identified as potential etiopathogenic agent. However, to date, no principal etiology has been discovered. Epidemiologic studies indicate that the prevalence of RAS is between 2% and 50% in the general population; most estimates fall between 5% and 25%. In selected groups, such as medical and dental students, it has been observed with a frequency as high as 50% to 60%. The peak age of onset for RAS is between 10 and 19 years. After childhood and adolescence, it may continue throughout the entire human lifespan without geographic or age-, sex-, or race-related preference.

Objective: This study examined the effect of an alkaline, salt-containing toothpaste, a toothgel of similar contents, and a conventional toothpaste on gingival inflammation. Method and materials: One hundred fifteen patients suffering from mild to moderate chronic gingivitis were enrolled in a double-blind clinical study. All subjects had at least 20 teeth, probing depths of less than 6 mm, and a sulcular bleeding index of 50% or more. At the beginning of the study period, the subjects were randomly assigned to 3 study groups. The baseline examination recorded the number of decayed, missing, and filled teeth, an approximal plaque index, a sulcular bleeding index, and the gingival index. Results: After an 8-week study period, statistically significant reductions in the plaque and bleeding indexes were observed in all 3 groups. There were no significant differences among the 3 dentifrices examined. Conclusion: The effectiveness of salt-containing dentifrices in patients with gingivitis was comparable to that of a conventional toothpaste.

Objective: The purpose of this study was to compare the effectiveness of 2 mouthrinses (conventional Meridol and alcohol-free Meridol). Method and materials: A controlled, single-blind clinical study of 3 weeks' duration was conducted on 80 adult subjects in good general health and without severe periodontitis (probing depths no deeper than 4 mm). The mouthrinses supplemented regular measures of oral hygiene for the reduction of plaque and gingivitis. In preliminary examinations to determine general conditions of oral health, especially the level of plaque, gingivitis, and periodontal findings, the approximal plaque index, sulcular bleeding index, and gingival index were established for each subject. Afterward the subjects were provided with a professional toothcleaning, as required. Each subject was randomly provided with 1 of the 2 mouthrinses, to be used 3 times daily in addition to routine oral health measures. The 3 indexes were reevaluated after 3 weeks; in addition, an optional stain index was employed. Results: In both subject groups, a statistically significant reduction in plaque accumulation, as well as a reduction in inflammation and the tendency to bleeding, was observed. Reversible staining of the teeth and tongue was observed in fewer than one third of the subjects in both groups. Conclusion: Comparison of the 2 Meridol mouthrinses revealed no difference in effectiveness related to the alcohol content.

Replacement of a post-and-core restoration that has failed because of caries or fracture presents a restorative challenge to the general dentist. This case report describes a new technique that enables the utilization of an unremovable preexisting post in the fabrication of a new post-and-core complex. This complex served as a foundation for a restoration that restored form and function to the patient's dentition.

Objective: The introduction of the current enamel-dentin adhesives has simplified the reattachment of fractured dentinal fragments. The objective of this study was to determine the strength needed to detach coronal fragments reattached with the most recent adhesives. Method and materials: A complete coronal fracture was caused on the incisal one third of 40 noncarious maxillary and mandibular lateral and central incisors. Each fractured coronal fragment was reattached to its tooth with the enamel-dentin adhesive Scotchbond MP, All-Bond 2, Dentastic, or One-Step (10 specimens each). Results: There was no statistically significant difference between 2 similar fourth-generation adhesives that use orthophosphoric acid as etchant (Dentastic and All-Bond 2) and a fourth-generation adhesive that uses maleic acid as etchant (Scotchbond MP). The values obtained with the fifth-generation adhesive (One-Step) were significantly inferior to those obtained with the other 3 enamel-dentin adhesives. Conclusion: In the reattachment of fractured tooth fragments, fourth-generation adhesives can guarantee a bonding force stronger than fifth-generation adhesives.