Vitremer restorative cement for children: three clinicians' observations in three pediatric dental practices.

BACKGROUND: The authors retrospectively evaluated the clinical performance of a resin-modified glass ionomer cement as a Class I, Class II, Class III, and Class V restorative material in primary teeth. METHODS: Three hundred and six patients that had received 864 resin-modified glass ionomer restorations, which had been in the mouth for a minimum of three years, were included in this evaluation. RESULTS: The results demonstrated an overall 93.4 percent restoration success rate, Class I restorations presenting a 92.6 percent success. Class II restorations presenting a 93.4 percent success, Class III restorations presenting a 100 percent success and Class V restorations presenting a 98 percent success, respectively. CONCLUSIONS: The resin-modified glass ionomer cement functioned well as a Class I, Class II, Class III, and Class V restorative material in the primary dentition. CLINICAL IMPLICATIONS: Resin-modified glass ionomer cement restorative material functions well for Class I, Class II, Class III, and Class V restorations in primary teeth.

Enamel microabrasion: a new approach.

Enamel microabrasion is a proven method of removing superficial intrinsic enamel discoloration defects. The method is safe, easily performed, and causes no discomfort for the patient. A new commercially available microabrasion system has been introduced by Ultradent Products Inc. In addition, a new tooth isolation material is available, along with a visible light-activated in-office hydrogen peroxide solution. This article describes these new products and documents tooth-color correction for two young patients using this new tooth-color correction approach.

Antibiotic prophylaxis in dental patients with ventriculo-peritoneal shunts: a pilot study.

Fourteen hydrocephalic children with ventriculo-peritoneal shunts received routine dental prophylaxis and topical fluoride application. No antibiotics were administered to these children for any reason during the three months before treatment or during the twelve months after treatment. None of these children presented with any signs of shunt infection during the twelve-month posttreatment period. In spite of the small sample size, this prospective pilot study suggests that patients with ventriculo-peritoneal shunts are not susceptible to shunt infection following a bacteremia induced by a dental prophylaxis and topical fluoride treatment. Dental prophylaxis without antibiotic coverage in patients with V-P shunts, therefore, does appear safe. We recommend that further study with a larger population, or a collaborative study by several medical centers, be performed to establish more conclusively that prophylactic antibiotics are not necessary for patients with ventriculo-peritoneal shunts who receive dental procedures. In addition, other investigations are needed to determine the risk of shunt infection with more invasive dental procedures, such as periodontal surgery or tooth extraction.

Dental students' attitude to gender roles.

This investigation assessed attitudes held by United States women and men dental students toward professional and sex role concepts. The concepts included: female dental student, male dental student, dentist, adult woman, adult man, wife and husband. These attitudes were evaluated and compared in the context of the students' current and future professional roles and their sex roles. Although there were several differences in attitudes between the two subject groups, the results suggest that the women and men dental students viewed their various roles as consistent with one another. It is particularly important to note that the women dental student is viewed by both gender groups as having professional and sex roles which do not conflict.

Preformed resin-veneered stainless steel crowns for restoration of primary incisors.

Stainless steel crown forms with bonded resin veneers for primary incisors are commercially available to dentists. This type of preveneered crown was developed to serve as a convenient, durable, reliable, and esthetic solution to the difficult challenge of restoring severely carious primary incisors. This article describes preveneered crowns, reviews their advantages and disadvantages, and details a technique for placement of such restorations.

Severe restriction in jaw movement after routine injection of local anesthetic in patients who have fibrodysplasia ossificans progressiva.

OBJECTIVE: To determine the relationship of dental procedures to immediate ossification and ankylosis of the jaw in patients who have fibrodysplasia ossificans progressiva. STUDY DESIGN: A mail survey was conducted of the 60 patient-members of the International Fibrodysplasia Ossificans Progressiva Association. All 41 patients (18 males, 23 females) who responded were examined. Instantaneous exact hazard rates for ossification of the jaw were calculated by the Weibull model. RESULTS: Thirty-six patients had dental procedures performed. Twenty-one (58%) patients had received an injection of local anesthetic. Five (24%) patients had an immediate flare-up of fibrodysplasia ossificans progressiva with ossification and permanent ankylosis of the jaw (expected occurrence, 0.031; p < 0.0001). None of the 12 patients who had comparable dental work without injections developed heterotopic ossification (expected occurrence, 0.019; not significant). CONCLUSION: Injections of local anesthetic during dental procedures pose serious and immediate risk for inciting heterotopic ossification and ankylosis of the jaw in patients who have fibrodysplasia ossificans progressiva and should be assiduously avoided.

Oral findings in Michelin Tire syndrome: report of case.

Michelin Tire syndrome is a genetic disease caused by smooth muscle hematoma formation, a condition which causes symmetrical, ringed creases around all extremities and the torso. Oral findings in a child with this syndrome were unusual and are presented in this case report.

Class II Vitremer restoration of primary molars.

Several resin-modified, glass-ionomer cements have proved successful when used in Class III and Class V cavities in primary teeth. One of them, Vitremer, is proving to be very durable when used in Class I and Class II cavities in primary teeth. The material is handled as quickly and easily as silver amalgam. The components of the Vitremer Tri-Cure System are: Primer, Glass powder, Liquid, and Resin gloss. In addition to a light-curing mechanism, Vitremer hardens by the acid base, glass-ionomer reaction, and a chemical "dark cure", catalyzed by a reduction/oxidation reaction. Over 600 Class II Vitremer restorations have been placed and over 250 have been in the teeth long enough (12 to 18 months) to be observed regularly.

A restorative dentistry renaissance for children: light-hardened glass ionomer/resin cement.

The light-hardened glass ionomer/resin dental restorative material was introduced in 1992. Its formula includes 80 percent glass ionomer material combined with a 20 percent visible light polymerized resin component. The authors have completed over 1300 class I, class III, and class V restorations in primary teeth, using the new material. The new material is considered by the authors to be a great improvement over the self-hardening glass ionomers. The addition of the 20 percent light-hardened resin component to the glass ionomer formula gives the material an initial setting time under sixty seconds, and improves resistance to wear and fracture.

Local anesthetic mortality: report of case.

The case of a healthy five-year-old, thirty-six pound female patient scheduled for multiple extractions is reported. The child received a total dose of 270 mg of mepivacaine, instead of the correct dose of 72 mg, which resulted in multiple seizures, hospital admission, pneumonia, and death caused by anoxic brain injury secondary to cardiopulmonary arrest following the overdose.

Clean vs sterile technique for pediatric dental patients in the operating room.

Recommendations on the need for clean or sterile technique have been made based on personal experience. This retrospective analysis of 100 children and adolescents who received dental treatment in the operating room shows no statistical difference in morbidity or postoperative complications between patients treated with the different techniques.

Bilateral fusion and gemination: a literature analysis and case report.

The dental literature concerning the bilateral presentation of fusion and gemination is reviewed and analyzed. Tables are presented to show the prevalence and distribution of these anomalies in both the primary and permanent dentitions. In addition, the first prevalence statistics for the bilateral occurrence of fusion and gemination in the primary and permanent dentitions are determined. The first case of bilateral fusion of mandibular primary incisors to be reported in 13 years is presented. The presence of all four succedaneous incisors and the diagnosis of bilateral fusion are confirmed radiographically. The developmental concerns and possible sequelae of bilateral fusion and gemination are also discussed.

Ankylosis in monozygotic twins.

In this case report, Twin A had four teeth ankylosed and Twin B had five teeth involved; there was a nearly identical pattern of distribution and severity of ankylosis.

Complications following radiation therapy to the head.

A case is presented in which a child who received therapeutic radiation as part of his treatment regimen for rhabdomyosarcoma of the infratemporal and parapharyngeal region demonstrated undesirable sequelae in the dentition and the mandible.

Troubleshooting for the laminate veneer restoration.

The laminate veneer restoration may present problems for the practitioner when stain lines occur at the incisal edge, after a period of use. This paper describes a successful conservative technique that avoids compromising the veneer by applying a heating source to a bleaching medium on the tooth.