Feeding Infants with Cleft and the Postoperative Cleft Management.

Cleft lip and palate malformations affect the ability of infants to adequately feed. Choosing the appropriate feeding technique must allow functioning of the suck-swallow-breathing mechanism and development of oral-motor function. Feeding in the postsurgical setting should be returned to normal as soon as possible to maintain adequate nutritional intake and good wound healing, an essential component to cleft repair. This article outlines the complex mechanism of wound healing, gives options to augment the process of aesthetic scar healing, and presents feeding modifications.

Depth of penetration of methylene blue in mandibular cortical bone.

BACKGROUND: Surgeons treating keratinizing odontogenic tumors (KOT) and other intrabony lesions frequently use methylene blue as an adjunct in peripheral ostectomy in estimating the depth of bone that has been removed. Depth of methylene blue penetration in cortical bone has not been evaluated. STUDY DESIGN: Specimens of mandible harvested from 9 fresh unembalmed cadaveric mandibles were stained with methylene blue. A microcaliper was used to measure total thickness of the cortical specimen along with the amount of dye penetration within the cortical block to the nearest 0.1 mm. RESULTS: Average depth of dye penetration was 0.48 mm in the symphysis. Average dye penetration was 0.53 mm in the body. Average depth of penetration of 0.42 mm in the angle. CONCLUSIONS: The use of methylene blue as a depth gauge to ensure adequate ostectomy with a single application of the dye may be inadequate to ensure complete removal of lesion from bony wall.

Bond strengths of one- and two-step self-etch adhesive systems.

STATEMENT OF PROBLEM: One-bottle self-etching adhesives have been introduced that combine the etchant, primer, and adhesive into a single bottle in an effort to reduce the number of bonding steps. Limited research has been conducted comparing the efficacy of 1-bottle and 2-bottle self-etching adhesives. PURPOSE: This investigation evaluated the microtensile bond strength (MTBS) of 3 one-step self-etching adhesives, 2 two-step self-etching adhesives, and a total-etch adhesive. A secondary objective was to evaluate the effect of an intermediary layer of elastic resin on the MTBS of 2 of the self-etching adhesives. MATERIAL AND METHODS: The MTBS of 3 one-step self-etching adhesives (G-Bond, iBond, and Clearfil S(3)), 2 two-step self-etching adhesives (Clearfil SE and Optibond Solo Plus Self-Etch), and a total-etch adhesive (Prime & Bond NT) was evaluated. Microtensile bond strength (MPa) was determined using composite resin (Herculite XRV) cylinders bonded to the dentin surface of human third molars (n=24) using 6 bonding agents. Each bonded tooth specimen was longitudinally sectioned to produce bar-shaped specimens with a square cross-sectional nominal bond area of 1.4 mm(2) (n=20). Bonded specimens were stored in distilled water at 37 degrees C +/- 2 degrees C for 72 hours, during which time they were subjected to thermal cycling (1500 cycles, in water baths of 5 degrees C and 55 degrees C, for a dwell time of 30 seconds). Testing was performed on a universal testing machine at a crosshead speed of 1.0 mm/min. One-way ANOVA, Ryan-Einot-Gabriel-Welsh multiple range test, and Wald chi square test, each using an overall alpha=.05, were performed on all data. Low-power (x20) microscopic examination of the bond failure was observed for each specimen. RESULTS: The 1-way ANOVA (P<.001) and Ryan-Einot-Gabriel-Welsh multiple range test (P<.05) showed significant differences between the mean MTBS values for several of the bonding agents tested. The Wald chi square test of the Weibull distribution showed significant differences between adhesives (P<.001). CONCLUSION: Of the bonding agents tested, significantly higher MTBS was obtained with the total-etch 2-stage adhesive. The results of this study suggest that there are similar bond strengths between the 1- and 2-bottle self-etch adhesives.