Treatment of trauma to the primary and young permanent dentitions.

An overview of the various possibilities for trauma to the primary and young permanent dentition has been presented. Appropriate treatment procedures have been described. Advances in dental science have been great, and dental materials have become superior to what they were just a few years ago. The dentist must never forget the variabilities of human responses to any of the treatment techniques, however, and the dentist must never be dogmatic in approach. The dentist should be able to diagnose, interpret, and alter any of the treatment techniques as more scientific evidence is obtained.

Advances in the treatment of acquired and developmental defects of hard dental tissues.

With the decline in dental caries, the dental profession and the general public have become sensitized to the "new" specialty of cosmetic dentistry. As a consequence, research in the field of dental materials for the ideal, most natural restorative materials and techniques has become a primary focus and has had a profound influence on dental education and practice. This brief article will highlight some of these newer concepts.

Physical properties of proprietary light-cured lining materials.

Physical parameters of four photopolymerized lining materials were evaluated for comparative purposes and to contribute to the understanding of these novel materials. Properties investigated included compressive, diametral and flexural strength, modulus of elasticity, fluoride and calcium release for four weeks, and pH values for 24 hours. In general Cavalite and TimeLine were significantly stronger than Vitrabond and XR-lonomer and were essentially neutral in pH. All the materials exhibited a yield upon compressive strength testing. The fluoride release was intermediate for TimeLine and negligible with Cavalite. Vitrabond and XR-lonomer released significant amounts of fluoride at all time periods. XR-lonomer was the only material investigated to have significant calcium release, and this may have been related to its visible dissolution in water. This material also showed a low initial pH of 2.2. It, along with Vitrabond, demonstrated a gradual increase in pH over time. The behavior of TimeLine and Cavalite is therefore more consistent with that of a modified composite resin, whereas Vitrabond and XR-lonomer are similar in nature to glass-ionomer liners.

Pulpotomy medicaments for vital primary teeth. Surveys to determine use and attitudes in pediatric dental practice and in dental schools throughout the world.

Surveys were sent to all Canadian pediatric dental specialists and to Heads of Departments of Pediatric Dentistry of selected dental schools throughout the world, in order to determine the use of and attitudes toward pulpal techniques on vital primary teeth. The preferred pulpotomy medicament of Canadian pediatric dental specialists was the 1:5 formocresol dilution, which was used by 50 percent of the respondents. The second most prevalent medicament was full-strength formocresol, used by 42.2 percent of respondents. The most prevalent medicament utilized in pediatric dental departments of dental schools was full-strength formocresol (40.8 percent) followed in popularity by the 1:5 formocresol dilution (36 percent). Scandinavia was the only geographic region to deviate from formocresol as the preferred pulpotomy medicament. Seventy percent (70 percent) of the pediatric dental departments in Scandinavia preferred calcium hydroxide for pulpotomies. Although 50 percent of the pediatric dental specialists and 55.2 percent of pediatric dental departments expressed concern about harmful effects of the preferred pulpotomy medicament, only 21.2 percent of the dentists and 29.6 percent of the schools were contemplating a change to another material. Because of its long history and lasting popularity, formocresol has been the most widely studied of the many pulpotomy medicaments. Although other techniques have been proposed and studied, the vast majority of pediatric dental practitioners in Canada (92.4 percent) and dental schools worldwide (76.8 percent) utilize either the full-strength or the 1:5 dilution of formocresol as the preferred pulpotomy medicament for vital primary teeth.(ABSTRACT TRUNCATED AT 250 WORDS)

Custom-made veneers for permanent anterior teeth.

The reduction of the enamel on the labial surface of the affected teeth makes the procedure irreversible. However, the procedures provide a superior functional and, more importantly, physiological result while still offering a conservative type of treatment. The uniqueness of the technique is in its ability to restore the physiological relationship of the gingiva and the labial surface, rather than to compromise this relationship by making a bulbous tooth of a greater labiolingual dimension than a normal tooth. It must be explained to the patients who require this type of procedure that the next step would be the complete reduction of the affected teeth and the construction of porcelain jacket crowns.

Aesthetic dental veneering materials.

They are numerous clinical indications for the use of aesthetic tooth coverings including heavily stained teeth, hypoplasia and other developmental disorders, and traumatic injuries. The acid etch technique provides a means of attaching composite resins and preformed acrylic veneers to enamel to cope with these problems. Four basic techniques are in use: (a) freehand placement of cold-cured or light-cured acrylic resins, (b) use of a crown form with technique (a), (c) commercially performed acrylic laminated bonded to the tooth with cold- or light-cured resins and (d) individually made preformed laminates bonded as in (c). A meticulous acid etch technique is necessary, including the use of 35 per cent phosphoric acid for up to 120 seconds on difficult surfaces such as primary or highly fluorosed enamel. Special care is needed at the gingival margin, for poor bonding is obtained by dentin/cementum. Successful results can be obtained with all four techniques when experience has been gained. The quickest and most flexible technique is (a), whereas (d) is capable of the best contour, adaptation and aesthetics. However, in (d) laboratory procedures add to costs. The most convenient resins for freehand placement and bonding of veneers are the light-cured (composite) resins. Cold-cure resins have short working time and are best used with an unfilled resin primer. Clinical studies indicate that a life of at least 3-4 years for enamel veneers can be expected if incisal coverage is avoided. Research is in progress to improve durability. These restorations should be regarded at present at medium-term treatments and should be so presented to the patient. Even with current materials, a dramatic improvement in appearance can effect a major transformation in the self-esteem of the patient.