Training Australian military health care personnel in the primary care of maxillofacial wounds from improvised explosive devices.

Severe facial wounds frequently result from improvised explosive devices (IEDs) as the face is still vulnerable despite advances in personal protection of soldiers. In contrast to the poor outcomes with civilian maxillofacial trauma management methods initially employed by the US Army for maxillofacial wounds from IEDs, advances in wound management methods for such injuries by the US Army have resulted in significant improvements in appearance and function. This article describes the features of a short course in the primary management of combat related maxillofacial wounds for deployed health care personnel who may not be facial specialists, including contemporary treatment techniques for those confronting wounds from IEDs which are explained in this course.

Detection of DNA point mutations and mRNA expression levels by rolling circle amplification in individual cells.

Rolling circle amplification has been useful for detecting point mutations in isolated nucleic acids, but its application in cytological preparations has been problematic. By pretreating cells with a combination of restriction enzymes and exonucleases, we demonstrate that rolling circle amplification in situ can detect gene copy number and single base mutations in fixed cells with efficiencies up to 90%. It can also detect and quantify transcribed RNA in individual cells, making it a versatile tool for cell-based assays.

Orofacial sensitivity reactions and the role of dietary components. Case reports.

Dietary components have proven to be important aetiological factors in orofacial sensitivity reactions such as plasma cell gingivitis and orofacial granulomatosis. The use of elimination diets to identify these dietary antigens can be instrumental in both diagnosis and effective treatment for these disorders.

Long-term periodontal status after orthodontic treatment.

This study evaluated the clinical periodontal status of persons who had completed orthodontic therapy at least 10 years previously (study) and compared the findings to those of adults with untreated malocclusions (control). Subjects in the study (n = 112; 63 female subjects, 49 male subjects; mean age 29.3 +/- 4.2 [SD] years) and control (n = 111; 62 female subjects, 49 male subjects; mean age 32.9 +/- 6.5 years) populations underwent a comprehensive periodontal examination that consisted of measurements taken at six points around the circumference of each tooth: (1) plaque, (2) visual inflammation, (3) bleeding after probing, (4) pocket depth, (5) gingival recession, and (6) loss of connective tissue attachment. Data from the individual measuring points were organized into 14 different combinations of either tooth types or surface locations; each was subjected to a four-way ANOVA partitioned on group (study vs. control), sex, socioeconomic status, and malocclusion type. The results showed that differences in age distribution within the groups were affecting the comparisons between the groups. Consequently, the groups were balanced for age and analyses were done to investigate group differences by means of multiple regression techniques. The comparisons showed no significant differences between the groups for any of the periodontal variables. It was concluded that orthodontic treatment during adolescence had no discernible effect upon later periodontal health.

Long-term periodontal status of teeth moved into extraction sites.

The present study was undertaken to assess the long-term periodontal status adjacent to teeth that had been moved orthodontically into extraction sites. Twelve persons with a mean age of 29.2 +/- 5.7 (SD) years, who had completed orthodontic therapy at least 10 years previously, were examined. The orthodontic treatment had included bilateral premolar extraction in only the maxilla. Interproximal tooth surfaces in the maxilla adjacent to the extraction sites (study group) were compared to corresponding tooth surfaces in the mandible (control group) with respect to plaque, visual inflammation, bleeding after probing, pocket depth, gingival recession, loss of connective tissue attachment, radiographic bone height, and root resorption. Statistical comparisons were made via analyses of variance and t tests. There were no differences between the groups for any clinical parameter except the presence of less visual inflammation in study subjects. Radiographically, there were no differences in crestal alveolar bone levels measured from the cementoenamel junction. Bone height evaluation by the Bjorn method showed less alveolar support in the study group. However, this was due to the influence of root resorption rather than an effect on crestal height. It was concluded that orthodontic movement of teeth into extraction sites had been without detrimental effect upon the adjacent periodontal status.

Relationships between bitewing and periapical radiographs in assessing crestal alveolar bone levels.

Bitewing (BW) and periapical (PA) radiographic techniques are used in clinical and epidemiologic studies to assess crestal alveolar bone levels. Since there appeared to be no basis for choosing one technique over the other, the present study investigated relationships between these techniques by assessing alveolar crest location at the same site. BW and PA radiographs were available from posterior quadrants of 210 subjects. Individual radiographs were projected at a magnification x 5.9 using a Leitz Prado-Universal projector. The distance from the cemento-enamel junction to the alveolar crest (CEJ-CR) was measured for each proximal surface from the distal of the cuspid to the distal of the second molar. Data were arranged according to the proximal surface examined, and BW and PA measurements were compared using paired t tests. In addition, the degree of congruence of the two sets (BW/PA) of CEJ-CR measurements was evaluated through computation of the Pearson Correlation. The data showed significant differences between mean BW and PA measurements for 50% of the tooth surfaces, and this trend was consistent through maxillary and mandibular quadrants, and mesial and distal surfaces. In situations of a significant difference, the BW measurement was greater than the PA 94% of the time. The correlations between the two types of measurements showed low reliability. It was concluded that BW and PA techniques provided significantly different values in assessing crestal alveolar bone levels, and data generated by these techniques should not be used interchangeably on an individual or group basis.

Long-term effect of orthodontic treatment on crestal alveolar bone levels.

It was the purpose of the present study to evaluate crestal alveolar bone levels in individuals (Study group, n = 104) who had completed orthodontic treatment at least 10 years previously and compare the findings with adults who had untreated malocclusions (Control group, n = 76). Crestal alveolar bone levels were determined on both bitewing and periapical radiographs by direct measurement from the cemento-enamel junction to the alveolar crest. Data from the individual tooth surface measurements were subjected to analyses of variance partitioned on group (Study vs Control), radiographic method, tooth type, dental arch and surface location. There was no significant difference between crestal alveolar bone levels between the study and control group. A Group/Tooth/Surface interaction occurred for the distal surface of molars. The alveolar crest level was significantly less in the orthodontically treated group. Examination of the numerical data suggested that the measured dimension was low relative to normal values, and this effect may have been related to tooth intrusion during orthodontic treatment. It was concluded that orthodontic treatment during adolescence had no detrimental long-term effect upon crestal alveolar bone levels.