Maxillofacial prosthetics.

Investigations are continuing in methods to preserve the dentition and to improve the quality of tissues for the patient receiving radiation to the head and neck. Increased knowledge related to obstructive sleep apnea presents the prosthodontist with an opportunity to provide support during the treatment of these patients. Advances in implant prosthodontics have increased our capability to rehabilitate the patient with intraoral or facial defects. Advances have been made in the use of light-cured materials as well as in the utilization of microwave energy to fabricate prostheses. Unfortunately, the ideal material to be used as a soft liner or for maxillofacial restoration continues to elude the profession.

An in vitro study of the tensile strength of the resin bond between chemically etched non-noble alloy and enamel.

A model was made to represent the in vivo situation for resin-bonded restorations using metal bonded to enamel. The tensile bond strength of chemically etched metal bonded to enamel was compared with that obtained with electrolytically etched metal. Four resin luting agents were used with the following results: the tensile bond strength of chemically etched non-noble alloy bonded to enamel was lower than strengths obtained for electrolytically etched alloy. The differences, however, were not statistically significant. Of the four luting resins, Comspan Regular gave the highest mean bond strength.

The effect of three different surface treatments on the tensile strength of the resin bond to nickel-chromium-beryllium alloy.

The effect of three different metal surface treatments on the tensile strength of the resin bond to non-noble nickel-chromium-beryllium alloy was studied by bonding metal to metal. Chemical etching of the metal for 1 hour obtained the highest strength, followed by air-abraded bond specimens. Lowest strength was obtained with the gel-etch method. All resulted in clinically acceptable values.

Dimensional accuracy of two denture base processing methods.

The mucosal surfaces of maxillary complete dentures processed using the SR-Ivocap injection technique and the Lucitone heat-polymerized compression molding technique were compared to a metal master impression to determine if one method of denture processing produced a more accurate denture base. Comparisons were made before and after polishing the prepared bases to determine if changes occur as a result of this procedure. The dental comparator, described by Rupp and others in 1957, was used to compare selected points on the palatal surface of the denture bases. No statistical differences were found in the accuracy of the denture bases processed using either of the two techniques.

Prosthodontics. Diagnostic, treatment planning, and prognostic considerations.

The prosthodontic rehabilitation of a patient is usually the culmination of a patient's dental treatment. In order to maximize the prognosis, it is necessary to understand the patient, to make a thorough diagnosis, to coordinate the restoration with the other disciplines of dentistry, and to be knowledgeable of the spectrum of treatment modalities available.

Computed tomography in the diagnosis of an odontogenic keratocyst.

Computed tomography (CT) was found to be useful in the diagnosis of an odontogenic keratocyst. A CT scanner is described and its advantages, radiation dose levels, and limitations are discussed.

Reaction of the anterior abutment of a Kennedy Class II removable partial denture to various clasp arm designs: an in vitro study.

Five clasp arm designs were selected for in vitro testing of the anterior abutment of a Kennedy Class II removable partial denture. The clasps were a circumferential clasp with the cast retentive arm placed at the survey line, a circumferential clasp with a cast retentive arm placed into a mesiofacial undercut of 0.01 inch, a circumferential clasp with a wrought wire retentive arm placed into a mesiofacial undercut of 0.01 inch, a buccal I-bar placed at the greatest facial curvature into a 0.01 inch undercut, and a half T-bar buccal arm placed into a 0.01 inch distofacial undercut. The relative movement of the abutments was recorded by a polygraph on a line from a point of force in the extension and through the rest seat of the anterior abutment, 90 degrees from the first direction, and vertically in the long axis of the abutment. The amount of movement of the abutment tested varied relative to the clasp design and the directions recorded. The cast circumferential arm placed at the survey line consistently showed less movement, and a cast circumferential arm placed into an undercut showed the greatest total movement. The decision to use any of these clasp arm designs should be correlated with other clinical conditions that are present for a specific patient.

Arteriovenous malformation of the mandible.

Large intraosseous arteriovenous malformations (AVM) of the mandible are rare lesions. A review of the American literature has revealed sixty cases involving the mandible. This article presents a case of left mandibular AVM in which the initial treatment was embolization. Eventually, however, an emergency hemimandibulectomy became necessary. Postoperative physiotherapy is considered an important part of the treatment in patients who have undergone hemimandibulectomy. An unusual feature in this case has been the amount of spontaneous regeneration of bone in the surgical site.

Perimolysis: unveiling the surreptitious vomiter.

Perimolysis is a dental condition linked to chronic regurgitation. When perimolysis is found in the patient who denies vomiting, one must suspect anorexia nervosa, a disorder with a high rate of morbidity and mortality. The dental literature has not provided guidelines for confirming the suspicion of surreptitious vomiting. The purpose of this case report is to describe our approach, using simple blood and urine studies, which establishes whether a patient who has perimolysis but denies vomiting is a surreptitious vomiter.

Evaluation of three variables affecting the casting of base metal alloys.

All the vented samples with sprue widths of 2 mm or more were defect free, whereas the corresponding unvented samples had extensive voids and porosity in all but one casting. All castings with a sprue width of 1 mm were defective regardless of whether or not vents were used. The thickness of the investment above the pattern had no effect on casting results.

Retention of obturator-removable partial dentures: a comparison of buccal and lingual retention.

An in vitro study was performed to measure the influence of a simulated obturator on the amount of force required to dislodge a simulated unilateral removable partial denture with various clasp designs. The presence of an obturator reduces the retentive capability of a removable partial denture. Lingual retention appeared to provide more resistance to displacement than buccal retention. Infrabulge clasp designs appeared to be more retentive than suprabulge clasp designs.

Hereditary angioedema controlled with danazol. Report of a case.

Hereditary angioedema is a condition which should be approached with caution and concern for the patient. The fact that the disease can be fatal cannot be overemphasized. The routine medical history should include questions aimed at identifying these patients. If the angioedema patient is to be treated, provisions must be made for maintenance of an adequate airway. This should include intubation if deemed necessary, and the practitioner should be prepared for a tracheostomy. Close observation following extubation is indicated. A case report in which the patient was controlled with danazol, a synthetic androgen, has been presented. The primary advantage of this drug is a decrease in the various side effects which have been associated with other therapeutic agents used previously in the treatment of hereditary angioedema.