Outpatient management protocol of skin tattoos with simple chemo/dermabrasion technique

As the incidence of tattoo placement continues to increase, so does the demand for tattoo removal. Treatment of tattoos with various different methods often yields unsatisfactory results and are costly to the patients. Ideal method should be highly effective for removal of tattoos without significant scars or permanent pigmentary change to the skin. We present our clinical experience on cosmetic tattoo removal and the important issues practitioners should consider in the management of tattoos. We have established a cost effective management protocol that could be followed and performed as an outpatient. This protocol consist of three parts, preoperative skin preparation utilizing all-trans retinoic acid, secondly an operative surgical procedure of simple dermabrasion followed by a third stage of intensive postoperative skin care protocol with local application of anti-scar formation ointments. 12 male patients were treated under local or general anesthesia with this protocol. Tattoo pigment was removed successfully in all 12 patients. One patient each developed hypertrophic scar and post-inflammatory hyperpigmentation which subsequently improved. Chemo/dermabrasion was successful with a high rate of tattoo removal [100%] and less incidence of hypertrophic scar formation of the treated skin

Creeping attachment after free connective tissue graft for treatment of gingival recession

This paper reviews in details aspects of reported creeping attachment in the literature and in addition reports a clinical case with detailed descriptions and follow-up period of one year. The case report describes a creeping attachment that developed after using free connective tissue graft to treat a gingival recession on the lower left central incisor. Most of the cases on creeping attachment were reported in literature following free gingival grafts and submerged connective tissue grafts. To the author's knowledge, this type of creeping attachment using purely free connective tissue graft has not been previously reported in the dental literature. The developed creeping attachment in this case displayed a similar way of healing events that had been reported following free gingival grafts

Clinical biological width dimension around dentition of a selected Saudi population

Biologic Width [BW] is the physiologic dimension of the junctional epithelium and connective tissue attachment located between the base of the sulcus and the alveolar bone crest. The purpose of the study is to find the average biological width around teeth of selected Saudi patients and to correlate these dimensions with the periodontal status. The data was gathered by measurements from 50 Saudi male patients with age ranging from 20-50 years old. The Ramfjord teeth [six teeth] were selected for each patient and clinical parameters such as plaque index, bleeding index, tooth status, probing depth were evaluated. The distance from gingival margin to crest of bone at three buccal sites per tooth; which were the mesiobuccal, buccal and distobuccal areas were measured. Clinical biological width was calculated by subtracting Probing depth from the distance between gingival margin to crest of bone. The results showed that the average biological width for this study was 1.24 mm with a highest value at the mesiobuccal area [1.4 mm]. The mean Plaque index was 0.64, the mean bleeding index was 0.47 and the mean probing depth was 2.44 mm. It can be concluded that the term clinical biological width is more reliable to be used clinically, and creation of 1.24 mm at maximum from proposed margin of restoration when restoring fractured or carious teeth during surgical crown lengthening is recommended to maintain the dimension of clinical biological width

Needs, demands and appropriateness of referral to orthodontic treatment in the North West Armed Forces Hospital in Tabuk, Saudi Arabia

This study aimed at assessing normative needs for orthodontic treatment, other dental problems, socioeconomic condition and attitude toward dentistry among a sample of patients who were referred for orthodontic treatment in the Northwest Armed Forces Hospital [NWAFH] in Tabuk, Saudi Arabia. A convenient sample of 320 patients who were referred for orthodontic treatment was selected to participate in the study. Patients were asked to complete a questionnaire on perception of their oral health status, demands for orthodontic treatment, other oral treatment needs, attitude toward dentistry and socioeconomic factors. Patients were examined by a consultant orthodontist to assess their normative orthodontic needs using the Index for Orthodontic Treatment Needs [IOTN]. Other dental needs were also assessed. Percentage of females referred for orthodontic treatment was slightly higher than males [60 percent]. Socioeconomic factors did not seem to influence demands for the service. Only 34 percent of the sample had IOTN score of 3 or more [moderate to very great needs], 52 percent had caries in at least one tooth, 48 percent bleeding on probing, 22.3 percent had calculus, and 5.6 percent had pocket 4 mm or more. The results of the study indicated that while demands for orthodontic treatment seemed to be exaggerated, needs for other dental treatments were underestimated. The results implied that expensive and specialized dental services were highly promoted in a community that lacks appropriate access to primary dental care. The results necessitate the development and implementation of proper guidelines for referral for orthodontic treatment. There is also a need to increase the emphasis on highly needed primary dental care