Educating a patient with dental implants

A functional dentition can be restored for edentulous and partially edentulous patients through the placement of dental implants. Dental assistants have a significant role in the education of implant patients so that meticulous oral self-care can be accomplished. Only through the combined team efforts of the dental office staff and patients themselves will the continued success of dental implantology be insured.     

Histological evaluation of bone reactions to aluminium oxide dental implants in man: a case report

Alumina implants have been shown to possess high biocompatibility. The authors present the case of an aluminium oxide ceramic implant removed because of fracture of the abutment after a 30-month loading period. It was possible to observe microscopically that the implant was covered by highly mineralized mature compact lamellar bone; no connective tissue or inflammatory cells were present at the interface. Osteocytes were observed very close to the bone-implant interface. These features indicate the good biocompatibility of the implant.     

Detecting approximal dental caries with transillumination: a clinical evaluation

Independent examinations of 300 patients were conducted to evaluate fiber optic transillumination's performance in caries detection. FOTI was used as an adjunct to clinical and radiographic examinations for caries, restoration or secondary caries of approximal surfaces in maxillary anterior permanent teeth. Clinical and radiographic examinations were significantly more effective.     

Computer systems for dental practice management: a new generation of independent dental software

A new generation of computer programs for dental patient management eliminates total dependence on the vendor for programming support. The software design enables information collected with the dental system to be transferred to popular off-the-shelf programs designed for business. A simplified example is used to illustrate the practitioners the advantages of this type of data structure management. Programs designed on this basis offer optimum performance and expandability for both present and future needs.     

Mandibular metastasis of endometrial carcinoma diagnosed via a dental radiograph

OBJECTIVE: To identify risk factors associated with Neospora caninum infection in dairy herds in Québec and to estimate seroprevalence in case and control herds. DESIGN: Herd-based case-control and seroprevalence study. ANIMALS: 3,059 cows from 24 case and 22 control dairy herds in Québec. PROCEDURE: Blood samples were obtained from each cow, and sera were tested, using an ELISA, for antibodies to N caninum. Owners of herds answered questionnaires requesting information on demographics and herd management practices. Seroprevalence was compared between case and control herds, using the Mann-Whitney test. Risk factors were compared between case and control herds, using logistic regression. RESULTS: All case herds and 73% of control herds had at least one seropositive cow. Median seroprevalence was significantly greater among case herds (22.5%) than among control herds (7.5%). Dogs were found most often and in greatest numbers on farms housing case herds compared with control herds during the past 3 years. CLINICAL IMPLICATIONS: Although the exact role that dogs have in transmission of N caninum in dairy herds needs to be elucidated, dogs should have limited access to barns and cattle.     

Crevicular fluid enzymes from endosseous dental implants and natural teeth

Several neutrophil-derived enzymes that are present in the gingival crevicular fluid have been evaluated for use as risk markers for periodontal disease progression. However, very little information is available about the presence of these enzymes in peri-implant tissues. The purpose of this cross-sectional study was to compare levels of enzymes in gingival crevicular fluid between natural teeth and endosseous dental implants and between well-integrated and failing implants. Scores of plaque and gingivitis were recorded for 68 integrated implants, five failing implants, and 34 natural teeth in 12 completely edentulous and 18 partially edentulous subjects. Samples of gingival crevicular fluid were obtained from these sites using filter paper strips and were assayed for levels of neutral protease, neutrophil elastase, myeloperoxidase, and beta-glucuronidase. Neutral protease levels were higher (P = .066) at moderately to severely inflamed implant sites (Gingival Index of 2, 3) compared to mildly or noninflamed sites (Gingival Index of = 0, 1). Despite the small number (n = 5) of failing implants evaluated in this study, levels of neutrophil elastase, myeloperoxidase, and beta-glucuronidase were significantly higher (P < or = .001) around failing implants compared to successful implants. Neutral protease levels were also elevated around failing implants, but the difference was not statistically significant. Results of this study indicate that neutrophil elastase, myeloperoxidase, and beta-glucuronidase levels in GCF appear to be good candidates for study as risk markers of implant failure.     

Delayed implants in the anterior maxilla with the IMZ-implant system: a radiographical evaluation

One hundred and seventy-three IMZ-implants in 81 patients, placed in the anterior region of the maxilla, were evaluated radiographically by two observers. Radiographs were evaluated at three intervals, namely at the time of implant placement, the time of prosthetic restoration and at the latest available radiograph, on average 2 1/2 years after implant placement. In this study marginal bone height and the type of radiolucency adjacent to the implant were determined. Both observers were able to classify the marginal bone height (mesial and distal) and the distinctive type of resorptive defects to an acceptable level of agreement, with Cohen's kappa ranging between 0.48 and 0.69. It was found that, at the most recent visit to the clinic, angular-shaped resorptive defects are found mesially and/or distally of the implants at approximately 25% of the implants. At this stage 20.7% of the mesial implant sites and 27.9% of the distal implant sites show marginal bone heights less than three-quarters of the implant length. These findings do not fully underscore and sometimes even contradict the clinical observations which were considered highly satisfactory.     

Crisis intervention: program evaluation

Crisis intervention is based upon crisis theory and is defined as a short-term active mode of therapy that focuses on solving the client's immediate problem and reestablishing psychological equilibrium. The crisis intervention program was the first phase in the development of a broader mental health program with advancement decisions being based upon evaluation results of this initial phase. An evaluation methodology using the Stufflebeam Goal-Stakeholder Model (1980) was designed and implemented. A satisfaction survey was conducted to develop a database relative to the program's process. The Mental Health Category Measure, and the Crisis Call Outcome Rating Scale were used to capture outcome data. Analysis of the qualitative and quantitative data indicate that stakeholders are satisfied with the program. outcome data demonstrates that the program produces the intended outcomes. Triangulation, a method of comparing the qualitative and quantitative findings revealed consistency, and thus provides confidence in the accuracy of the findings.     

Mediastinal lymph node metastasis from lung cancer: evaluation with Tl-201 SPECT--comparison with CT

PURPOSE: To assess the usefulness of thallium-201 single photon emission computed tomography (SPECT) in detection of mediastinal lymph node metastasis from lung cancer. MATERIALS AND METHODS: Computed tomography (CT) and Tl-201 SPECT were performed in 113 patients with lung cancer. Surgical staging was performed in all patients, and the results of the two modalities were compared with the pathologic findings in 364 node stations. RESULTS: Cancerous nodes were found in 32.7% of the patients. The sensitivity of CT in detecting mediastinal node metastasis was 62%; specificity was 80%. These rates were higher for Tl-201 SPECT (76% and 92%, respectively). Furthermore, these rates were excellent in patients with enlarged mediastinal nodes at CT (87% and 93%, respectively). However, Tl-201 SPECT had more limited spatial resolution than did CT. CONCLUSION: Tl-201 SPECT is useful in evaluation of mediastinal node metastasis in lung cancer, especially for patients with enlarged nodes at CT.     

Establishing a cancer risk evaluation program

Most of the clinical, histological and immunohistological features of fogo selvagem resemble those of idiopathic pemphigus foliaceus (PF). Both diseases are clinically characterized by small flaccid bullae evolving into to scaly and crusted lesions, sometimes with pustules, mainly in seborrheic areas of the skin. Mucosal surfaces are mostly spared. The main histologic feature of endemic pemphigus foliaceus is a subcorneal acantholytic blister. Standard immunofluorescence studies demonstrate intercellular IgG deposits throughout the entire epidermis. These IgG antibodies are mainly of the IgG4-subclass. Almost all patients have circulating IgG-autoantibodies in their serum directed against stratified epithelial desmosomes. The fogo selvagem autoantibodies and the PF antibodies are directed against the 160 kD desmosomal glycoprotein desmoglein 1 which together with plakoglobin (85 kD) forms a complex of adhesion proteins with desmosomes of stratified epithelia. Fogo selvagem occurs in endemic foci in some areas of Brazil and possibly in neighbouring South American countries, very often in children, adolescents and young adults. The etiology of fogo selvagem is still unknown. The frequent association with insect bites has lead to the concept of fogo selvagem being a transmissible disease with acquired immunity in adulthood. However, the infectious agent and possible vectors have not yet been identified.     

Development of a computer-assisted learning software package on dental traumatology

The development of computer-assisted learning software packages is a relatively new field of computer application. The progress made in personal computer technology toward more user-friendly operating systems has stimulated the academic community to develop computer-assisted learning for pre- and postgraduate students. The ability of computers to combine audio and visual data in an interactive form provides a powerful educational tool. The purpose of this study was to develop and evaluate a computer-assisted learning package on dental traumatology. This program contains background information on the diagnosis, classification, and management of dental injuries in both the permanent and the deciduous dentitions. It is structured into chapters according to the nature of the injury and whether injury has occurred in the primary or permanent dentition. At the end of each chapter there is a self-assessment questionnaire as well as references to relevant literature. Extensive use of pictures and video provides a comprehensive overview of the subject.     

Lives on hold: evaluation of a caregiver''s support program

BACKGROUND: With the increasing number of surgeons using phacoemulsification techniques combined with sutureless scleral tunnel and clear corneal incisions for cataract surgery, the majority of patients will undergo an uncomplicated course of visual rehabilitation requiring no more than standard topical antibiotic and steroid regimen. Occasionally--even with an uneventful surgical course--postoperative complications arise. Many of these postoperative complications can be managed medically, without surgical intervention. Topical and oral glaucoma and nonsteroidal anti-inflammatory agents play an important role in the management of postoperative cataract complications. METHODS: A review of the common postoperative complications and their medical management using topical and oral pharmaceutical agents are presented. Emphasis is placed on current trends in treatment following contemporary cataract surgery. CONCLUSION: Although the complication rate is reduced with modern cataract surgery techniques, the primary care clinician should be prepared to identify and manage the most common clinical conditions. Armed with the proper knowledge of ophthalmic medications and their possible ocular and systemic interactions, optometrists can successfully manage and co-manage many postoperative cataract complications. Common postoperative complications are reviewed, along with current treatment regiments and dosage forms.     

Temporary vehicle immobilization: evaluation of a program in Ohio

Undifferentiated glandular stomach tissue fragments from 16.5-day fetal rats were transplanted under the kidney capsule of syngeneic adult rats, and the proliferation, differentiation and morphogenesis of the transplanted tissues were investigated. Gastric epithelial cells began to invaginate 3-4 days after the transplantation and immature glands were formed after 1 week. During the period, there was a gradual increase in the expression of pepsinogen and cathepsin E, markers of cytodifferentiation of the stomach epithelia, both at protein and mRNA levels. Cathepsin E was weakly expressed in undifferentiated gastric epithelial cells at 16.5 days of gestation, and a higher level of the expression was observed in differentiated epithelia of the transplants. In contrast, the pepsinogen-producing cells first appeared around days 3-4 after transplantation and gradually increased in number to about 30% of the epithelial cells and became localized at the bottom of the gland. During the period of the experiment up to 1 month, the pepsinogen-producing cells were all positive for class III mucin and cathepsin E, indicating the immature character of these cells. In addition, no parietal cells were observed. When the tissue fragments were transplanted into adrenalectomized animals, the epithelial differentiation and morphogenesis was suppressed, but its proliferation was enhanced. The observed changes were reversed by hydrocortisone replacement. These results suggest that the development of the 16.5-day fetal stomach is regulated intrinsically to a certain extent by the genetic program of the cells involved and various gastric functions develop in the absence of luminal stimulation, stage-specific systemic hormonal change, neuronal regulation or other systemic influences, and that glucocorticoids modulate the developmental program of the fetal stomach tissues.