Remineralization of enamel by a saliva substitute designed for use by irradiated patients.

A saliva substitute, VA-OraLube, was evaluated for ability to reharden dental enamel and to relieve intraoral soft tissue symptoms in patients receiving radiotherapy for malignancies of the head and neck. Treatments of 15, 30 and 60 minutes rehardened enamel by 3.1%, 4.0%, and 5.5%, respectively. In the second experiment, treatment for 60 minutes with the complete solution rehardened enamel by 5.2%. Omitting calcium, phosphorus and/or fluoride from the formulation greatly decreased this rehardening potential. Treatment of enamel with fresh whole saliva induced rehardening at a 7.3% level in comparison to the 5.5% and 5.2% derived by using the saliva substitute. Since the xerostomic patient usually uses the product very frequently, there is a remineralization potential of significant consequence. A total of 125 xerostomic patients used the saliva substitute on an ad lib basis over a period of 4 months. Patient responses indicated a very high level of acceptance and the virtual elimination of troublesome problems previously associated with the dry mouth state.

Effect of waterborne fluoride on fluoride concentration and solubility of dental enamel.

Enamel F level and depth of acid etch were measured in 166 teeth from 8 communities with water F ranging from .07-5.0 ppm. Enamel F decreased progressively from the surface inward and was positively correlated with water F. Depth of acid etch was inversely related to enamel F and water F. Relationships between water F, enamel F and enamel solubility were most consistent at water F levels up to 1.0-2.0 ppm.

Cryotherapy in the treatment of ameloblastoma of the mandible: report of cases.

Two cases of ameloblastoma treated in part by cryotherapy have been presented. The first case was of particular interest because of the extensive intraoral involvement and history of recurrences. The second case evolved as an example of the rare peripheral ameloblastoma. In both cases, cryotherapy was used as an adjunctive modality to conserve mandibular bone without compromising the primary objective of adequately treating the tumor. We contend that the judicious use of cryotherapy offers the advantage of treating a broad area of bone without destruction of the basic structural matrix of this tissue.

Cancellous-marrow bone grafts in irradiated tissue.

Discontinuity defects of the mandible have been successfully treated by means of cancellous-marrow grafting techniques. This method of reconstruction has not been widely reported in the repair of defects in mandibles that have been exposed to radiation therapy. In the two cases presented in this article, the patients were previously treated for oral squamous-cell carcinoma by irradiation and partial mandibulectomy. Later, cancellous-marrow grafts were implanted. One patient received 3,000 rads of Cobalt-60 and had the body of the right mandible resected. The subsequent grafting procedure was successful in this patient. The second patient received 6,000 rads of Cobalt-60 and underwent resection of the mandible anterior to the molar region. The subsequent graft failed in this case.