Peri-implantitis.

The anatomy of the periodontal tissues of a tooth differs from that of a dental implant. The largest differences are in the lack of a periodontal membrane between the bone and a dental implant and its lack of an organized connective tissue attachment at the collar. These anatomical differences may influence the inflammatory response of each to bacterial plaque. Similarity has been demonstrated between the bacterial plaque on implants and teeth, but the significance of the difference between plaques at healthy and diseased sites on implants has not been determined. The consequence of periodontitis is loss of fibrous tissue attachment to the tooth and loss of supporting bone. A similar loss of supporting bone adjacent to dental implants has also been observed. Regenerative surgical techniques have been developed to reform the fibrous tissue attachment to the tooth and replace the lost supporting bone and these techniques have not been applied to dental implants. Healing and regeneration after periodontitis is now better understood, but regeneration around implants remains controversial. The evidence for the existence of a distinct entity, 'peri-implantitis', and its treatment are discussed.

Rehabilitation of the edentulous mandible with osseointegrated dental implants: 10 year follow-up.

Long-term retrospective studies on the efficacy of implant retained bridgework are relatively few. In this study, 10 year follow-up results are reported on the rehabilitation of the edentulous mandible with osseointegrated implant anchored bridges. Fifteen patients were closely maintained and monitored using the conventional indices used in longitudinal periodontal research, together with serial intraoral periapical and extraoral panoramic radiographs. The need for prosthetic maintenance and the effects of the treatment on soft tissues, supporting bone, opposing dentition and the behavioural aspects of such rehabilitation are discussed. Based on the reviewed results of the study and numerous other investigations, the treatment of mandibular edentulism with fixed bridges supported by osseointegrated implants ad modum Brånemark is a highly effective method, giving predictable long-term results.

Current concepts of periodontal maintenance.

Changing concepts and a more complete understanding of the aetiology of chronic marginal periodontitis allow a more rational approach to the treatment of patients with periodontal diseases. A sequence of treatment steps of increasing complexity is presented for the prevention of recurrence of chronic marginal periodontitis during the maintenance phase of treatment.

Clinical and microscopic findings in edentulous patients 3 years after incorporation of osseointegrated implant-supported bridgework.

15 mandibular fixed prostheses supported by osseointegrated titanium implants were examined 3 years after insertion. No implants had been lost after 3 years and all prostheses were present and continuously functional. The morphotypic analysis of the microbial plaque taken from titanium implants adjacent to clinically inflamed tissues was different from that described of the dental plaque associated with sites of gingival inflammation. Radiographs demonstrated early horizontal bone loss adjacent to osseointegrated fixtures and occasional continuing horizontal bone loss at some sites during the 1st and 2nd years after prosthesis installation. All fixtures remained integrated after 3 years of function supporting fixed prostheses. Minor differences between the results of this study and earlier studies may reflect differences in surgical technique.

The teaching of dento-maxillo-facial radiology in Australian dental schools.

The skills necessary to successfully perform radiological procedures in general dental practice are described and should be used as criteria when developing an effective undergraduate curriculum and as determinants of the contents of continuing education programmes. The present status of undergraduate curricula. continuing education, and postgraduate programmes as well as the recognition of the specialized nature of dento-maxillo-facial radiology, are discussed and recommendations for future developments are made.

Furcation morphology relative to periodontal treatment. Furcation entrance architecture.

The furcation entrance diameter of first permanent molar teeth has been investigated in a sample of 114 maxillary and 103 mandibular teeth, and found to be smaller than the blade face width of commonly used periodontal curettes in 58% of the furcations examined. It is suggested that because of this size disparity curettes when used alone may not be suitable for root preparation in this area as part of periodontal therapy. Alternative methods of instrumentation require clinical appraisal before recommendation. The buccal furcation entrance diameters of the maxillary first molar teeth examined tended to be smaller than either the mesiopalatal or distopalatal. Similarly the buccal entrance diameter in the mandibular first molar teeth examined tended to be smaller than the linqual. The mesiodistal widths at the cementoenamel junction of both maxillary and mandibular first molar teeth were found to have very low correlation with their furcation entrance diameters. Large teeth therefore do not necessarily have large furcation entrance diameters.

Furcation involvement--a suggested rationale for treatment.

Furcation involvement is classified and methods of treatment discussed. Evidence is presented to indicate that altered plaque elimination techniques are essential in the furcation region.

Secondary intention post and core.

Methods for restoring existing crown and bridge restorations to normal function following pulp death are reviewed. Endodontic therapy must be supplemental by a reinforcing post-core system if the crown or bridge is to withstand normal functional loads indefinitely.

Post core systems in crown and bridgework.

Pulpless teeth require reinforcement if they are to act as supports for crown and bridgework restorations. Post core reinforcements can be accomplished by utilization of post core systems which offer the clinician a broad range of techniques. The mechanical procedures involved should be biologically oriented and related to stress distribution to the tooth root.

Periodontal considerations in the restoration of non-vital teeth.

Periodontal status is considered in relation to the construction of post core retained restorations. The surgical management of those problems apical to the gingival tissues is discussed in detail.

Effects of alpha-tocopherol acetate on the swimming endurance of trained swimmers.

Well-trained, competitive swimmers were divided into two groups. Group A was given 900 IU alpha-tocopherol acetate daily for 6 months while group B was given placebos. A swimming endurance test was given before the start of supplementation and after 1, 2, 5 and 6 months. No difference in swimmers' endurance was observed between the two groups during the 6-month period. There was also no difference in postexercise serum lactic acid levels. Younger, less well-trained, competitive swimmers were also divided into two groups. Group A received 900 IU alpha-tocopherol acetate daily while group B received placebos. Swimming times for these swimmers were erratic, reflecting a lack of training. alpha-Tocopherol did not appear to have any effect on their swimming endurance.