Treatment of oral granulation tissue with the flashlamp pulsed dye laser.

BACKGROUND: Surgical excision and debridement is the standard therapy for cutaneous and intraoral pyogenic granulomas (PGs). Occasionally the mass of granulation tissue proves unresponsive to the usual treatment methods. OBJECTIVE: We report a case in which the flashlamp pulsed dye laser (PDL), previously reported as useful in cutaneous PGs, was used in a patient with persistent granulation tissue around dental implant posts. METHODS: An illustrative case is presented with a brief discussion of the use of lasers in dentistry and in the treatment of PGs. RESULTS: Previously resolute tissue responded well to a series of treatments with the PDL. CONCLUSION: The PDL may have utility in this oral condition, providing a new venue for cooperation between dentists and dermatologists.

Evaluation of three different dental implants in ligature-induced peri-implantitis in the beagle dog. Part I. Clinical evaluation.

The purpose of this study was to clinically evaluate experimental peri-implant breakdown. Hydroxyapatite-coated, titanium plasma-sprayed, and machined titanium-alloy surfaces were investigated. Eighty-four implants were placed in 14 beagle dogs. Pocket probing depths and clinical attachment level and mobility measurements were made. Dogs were sacrificed at 3 and 6 months. All experimental implants showed a significant loss in clinical attachment level (P < .05). Increased pocket probing depths for experimental implants occurred during the first 2 months, after which a plateau was reached. At the 3- and 6-month evaluation, pocket probing depths at experimental implants were significantly increased (P < .05). No differences among the three implant types were noted for clinical attachment levels and pocket probing depths. In general, greater mobility was found with the titanium-alloy implants than with hydroxyapatite-coated and titanium plasma-sprayed implants (P < .025). In addition, mobility measurements were significantly greater for experimental titanium-alloy implants during the first 3 months (P < .05). Clinical attachment level measurements were most sensitive to peri-implant status. All implants were equally susceptible to ligature-induced peri-implant breakdown. Consequently, meticulous oral hygiene and regular maintenance care are prerequisites for successful implantology.

An investigation of new metal framework design for metal ceramic restorations.

STATEMENT OF PROBLEM: Metal ceramic restorations have been implicated in the discoloration of associated gingival tissues. Attempts to remedy this by altering the design of the metal frameworks for such restorations may lead to unacceptable decreases in fracture resistance. PURPOSE: This study evaluated a new metal framework design for metal-ceramic restorations. MATERIAL AND METHODS: Twenty artificial crowns were fabricated with various degrees of facial metal reduction; 0, 1, 2, and 3 mm. The study was conducted in two parts. The first part evaluated changes in light transmission into adjacent root tissue. A light box was fabricated so sample crowns could be illuminated on a mounted natural tooth. The root of the tooth remained outside the light box, and the light transmitted through the crowns into root tissue was measured with a light meter. The second part of the study evaluated changes in fracture strength. The sample crowns were subjected to a vertical load until fracture with use of an Instron machine at a crosshead speed of 1 mm per minute. The load at fracture was recorded. RESULTS: Results indicated a statistically significant increase in light transmission with 1 mm framework reduction or greater, and fracture strengths did not decrease with up to 1 mm of framework reduction. A 1 mm facial axial reduction of the metal framework may be indicated for anterior metal-ceramic restorations.

An update on fixed prosthodontics.

The practice of fixed prosthodontics has continually evolved as a result of progress in laboratory and biomaterials science, clinical technologies and adjunctive multidisciplinary treatment advancements. This brief review describes those enhancements and how they affect the state-of-the-art practice of fixed prosthodontics.

Variability of expression of the orofaciodigital syndrome type I in black females: six cases.

Orofaciodigital syndrome type I (OFD I) includes striking orodental, facial, digital, renal, and central nervous system (CNS) abnormalities. Frequently associated with mental retardation, OFD I is inherited as an X-linked dominant trait, lethal in males. Here, we report the variable expressivity of OFD I in 6 black U.S. females and review findings in 2 previously reported black patients. Only these 8 of over 160 reported cases involve blacks. Abnormalities observed in black patients are similar to those observed in whites, but with specific differences. Only 25% of the blacks had cleft palate and none was observed with midline cleft of the upper lip. Among whites, 80% have cleft palate and 45% midline cleft of the upper lip. These findings suggest that racial genetic factors may protect lip and palate development in blacks, even in the presence of the OFD I gene. CNS abnormalities, including agenesis of the corpus callosum, hydrocephaly, cystic brain lesions, seizures, and mental retardation, were present in 50% of our the cases. This figure is greater than previously reported. Polycystic kidneys were present in 3 of our patients. Including a previously reported patient, 50% of the black OFD I patients show polycystic kidneys. Hyperplastic and supernumerary frenula, with or without brachydactyly, have been shown to be strong diagnostic criteria in our patients. New findings reported here include intracranial berry aneurysm, periodontal disease, and lip pits. Clinicians treating these patients should be aware of the pleiotropic manifestations of the syndrome, which may include renal and CNS anomalies. Ultrasonic and computed tomography scan studies are indicated in patients diagnosed with OFD I.