An Analysis of the hemophilia of the royal families of Europe, its startling implication and dentistry's role in treating the hemophiliac patient.

Hemophilia is an inherited x-linked recessive disorder. It is known popularly as "The Royal Disease," as it has affected many of the royal families of Europe by virtue of Queen Victoria being a carrier for the gene and, subsequently, passing it on to her offspring. They, in turn, married and had children with other royal families of Europe. Hemophilia is certainly not limited to royalty. There are many hemophiliacs living in our communities, and they must receive both proper dental home-care education and dental treatment in order to prevent possibly life-threatening emergency dental episodes. Individuals with hemophilia pose different management issues to the dental professional. The various precautions and modifications that must be taken in order to ensure the safe delivery of dental care to hemophiliac dental patients are discussed.

Oral and dental manifestations of celiac disease.

Celiac disease is an autoimmune disease characterized by the malabsorption of nutrients because the villi of the small intestines are unable to process these nutrients. It is brought on by gluten food products. A pattern of enamel defects and oral aphthae are common findings in celiac disease, thus making the dentist an integral part of the diagnostic team.

Value of prophylactic antibiotics for invasive dental procedures unclear.

DATA SOURCES: The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, the US National Institutes of Health Trials Register and the metaRegister of Controlled Trials. STUDY SELECTION: Randomised controlled trials (RCTs) and controlled clinical trials (CCTs) would be included where available. Due to the low incidence of bacterial endocarditis it was anticipated that few such trials would be found. Cohort and case-control studies were included where suitably matched control or comparison groups had been studied. DATA EXTRACTION AND SYNTHESIS: Two review authors independently selected studies for inclusion then assessed risk of bias and extracted data from the included study. RESULTS: Only one case controlled study met the inclusion criteria. It collected all the cases of endocarditis in the Netherlands over two years, finding a total of 24 people who developed endocarditis within 180 days of an invasive dental procedure, definitely requiring prophylaxis according to current guidelines, and who were at increased risk of endocarditis due to a pre-existing cardiac problem. This study included participants who died because of the endocarditis (using proxies). Controls attended local cardiology outpatient clinics for similar cardiac problems, had undergone an invasive dental procedure within the past 180 days, and were matched by age with the cases. No significant effect of penicillin prophylaxis on the incidence of endocarditis could be seen. No data were found on other outcomes. CONCLUSIONS: There remains no evidence that antibiotic prophylaxis is either effective or ineffective against bacterial endocarditis in people considered at risk who are about to undergo an invasive dental procedure. It is not clear whether the potential harms and costs of penicillin administration outweigh any beneficial effect. Ethically, practitioners need to discuss the potential benefits and harms of antibiotic prophylaxis with their patients before a decision is made about administration.

Use of a visible light-cured periodontal dressing material as a temporary restoration for inlay/onlay preparations.

There are numerous materials that are used as temporaries for inlay and onlay preparations while the permanent restoration is being made. This article looks at 2 types of temporary materials that were placed into inlay or onlay preparations by student dentists: a methylmethacrylate acrylic material (DuraLay Inlay Pattern Resin) and a visible light-cured (VLC) periodontal surgical dressing (Barricaid). The resilience and effectiveness of both products are compared and evaluated for use as temporary restorations in inlay or onlay preparations. The study found that use of the VLC periodontal dressing material offers a novel technique for a quick and efficient method to provide a temporary restoration for various inlay and onlay preparations.

Technological advances in caries diagnosis.

Understanding the nature of the caries lesion, disease activity, and the patient's caries risk are all used in determining the nature of dental care to be delivered. An examination should include a health and social history and clinical examination using appropriate technologies. This allows proper assessment and suggests a logical management intervention. Minimally invasive dentistry is a concept based on an assessment of a patient's caries risk and the application of the current therapies to prevent, control, and treat the disease. The history of the dental examination and the variety of current technologies are discussed.