Differential Identification of Three Young Housefire Victims: Methods when Age Assessment Fails.

Multiple fatality incidents involving more than one child of statistically same age (including twins) can be challenging from an identification standpoint. This case details an urban fire, in which four children perished. Age assessment on three of the victims utilizing maturity staging described by Moorrees, Fanning, and Hunt yielded insignificant results. However, a plot of the MFH data shows the difference between two identical twins and a third child. The twins share a similar growth pattern, whereas the other was different. Based on this graphical interpretation, the nontwin victim was positively identified through exclusion. These results were verified through statistical testing. This case demonstrates a method to repurpose age assessment data to graphically distinguish between child victims. Further, it is shown that radiographic and clinical presentation in childhood identical twins can elicit genetic versus acquired similarities and differences, which can be used for identification of individuals and exclusion of others.

Magnification in dental practice and education: experience and attitudes of a dental school faculty.

The routine use of magnification and enhanced lighting by oral health care providers, educators, and students is growing, but there is little consensus regarding its implementation and use. Many students and faculty at the Temple University Kornberg School of Dentistry elect to use some form of magnification in their real and simulated patient care activities, even though the school does not mandate or suggest standards for its utilization. A questionnaire was administered to the clinical faculty to assess two parameters: experience with magnification, and attitudes concerning the value of enhanced vision. Eighty-two out of 124 eligible participants completed the questionnaire successfully for a 66 percent return rate. Sixty-one percent of respondents reported their primary practice or teaching activities as "general dentistry or restorative/prosthodontics." The remainder of the respondents represented a cross-section of other departments and specialists. All endodontists and periodontists who completed the survey and 56 percent of the general/restorative dentists indicated they use magnification. This group accounted for 91 percent of all magnification users. Thirty-nine percent in the magnification users group indicated that they avoid using magnification for some procedures. Faculty magnification users are not in full agreement about the value of enhanced vision in a dental education program. Nearly one-quarter of all magnification users indicated it is unlikely they would use magnification in the teaching environment, even though they may use it in private practice. Various explanations were given for this inconsistency. Only 61 percent of magnification users indicated they make a point to talk to students about the uses and benefits of magnification. While 91 percent of users said that magnification offers significant benefits, only 73 percent believe it should be a program requirement, and 61 percent think it should be required beginning in the first year of the curriculum. The findings of this survey suggest that educational institutions would be wise to address faculty concerns and reasons for resistance before moving to the mandated use of magnification.

Osteonecrosis of the jaw and oral bisphosphonate treatment.

BACKGROUND: Bisphosphonates are becoming recognized increasingly as having a significant impact on dental therapies. This case report describes adverse clinical sequelae and successful treatment following periodontal surgery in a dental patient receiving bisphosphonate treatment. CASE DESCRIPTION: A 78-year-old woman experienced a nonhealing interproximal wound subsequent to a minor periodontal procedure performed to facilitate restoration of an adjacent tooth. Her medical history revealed that she had been taking an oral bisphosphonate every day for the previous five years for treatment of osteoporosis. After three months of periodic débridement and meticulous oral home care, one of the authors recovered a large piece of necrotic bone. The wound healed after the author performed surgery at the site. CLINICAL IMPLICATIONS: Dentists should exercise caution when considering surgical procedures for patients with a history of oral bisphosphonate use. Thorough treatment of nonhealing wounds in these patients can lead to favorable outcomes.

A proposal for universal nomenclature in implant prosthodontics.

Attempts have been made at formulating standardized nomenclature for implantology. Although these classification systems have advanced the concept of universal nomenclature in implantology, they can be improved upon. Most of them present terms in glossary form, which can limit their applicability. Others deviate significantly from accepted basic terminology and can be foreign or ambiguous to the average clinician. This article outlines the semiotic approach to language formulation, discusses slight changes to accepted conventional prosthodontic terminology to better encompass implant dentistry, and introduces the shortform and support-retention-connection-prosthesis classification systems.

The clinical operating microscope advantage in fixed prosthodontics.

Over the last 20 years, magnification and operating light have become more available to dentists in the form of head-mounted loupes and headlights. More recently, restorative dentists have utilized the multiple steps of magnification and reciprocal illumination provided by the clinical operating microscope. The advantages of this technology now are being applied to fixed prosthodontics. This article discusses the specific uses and advantages of the clinical operating microscope, specifically as they relate to optics, ergonomics, and documentation.