Compendium-Continuing Education for Veterinarians最新文献

Intramuscular (IM) sedation techniques remain the least used by clinicians, possibly because of their limited exposure in the undergraduate and graduate dental curricula. To assess the safety and efficacy of these techniques, the authors conducted a retrospective study of 900 dental cases. A total of 308 patients received ketamine, 356 received a meperidine/promethazine combination, and 236 received midazolam. Results revealed a high safety record, efficacy, and good evaluations from clinicians and patients, in addition to some advantages over other sedation techniques.

Two previous double-blind studies have shown that 1 week of metronidazole, plus scaling and root planing, can significantly reduce the number of teeth per patient that require periodontal surgery, when compared to a positive-control treatment that consisted of 1 week of placebo treatment plus scaling and root planing. The only difference between the two studies was that in one, metronidazole or placebo tablets were taken at the beginning of the debridement procedures, while in the other, the tablets were taken after all debridement was completed. This article describes the results obtained by combining the data from both studies and using an analysis of variance to identify the effects of medication and those of the study protocol. There was an average reduction in surgical needs of about 7.1 teeth per patient using metronidazole compared to 2.4 teeth in the positive-control group (P = 0.004). In the deep pockets, there was a significant protocol effect because there were additional improvements associated with using the medications after the debridement was completed.

Chemotherapy is frequently used as a primary or adjunctive modality in the treatment of patients with cancer. As the incidence of cancer in the population increases, the ability to properly detect, diagnose, and treat oral side effects of chemotherapy becomes ever more important. Depending on the types and dosages of chemotherapeutic agents used, a wide range of oral complications may appear. This article, in two parts, reviews the potential oral manifestations associated with cancer chemotherapy and appropriate management techniques.

Dental caries, caused by the etiologic agent Streptococcus mutans, is considered the most common human infectious disease. Development of a vaccine has been under investigation for more than 25 years. Possible approaches include immunizing patients using an oral vaccine containing components of the causative bacterium and by intramuscular injection. Although both approaches have proved promising, several considerations have delayed further development of a vaccine. This article reviews the scientific results and status of the various vaccines.

The potential for drug interactions is a concern to all dentists. The issue is made even more imposing by the amount of scientific information published each month. It is not only important for dentists to be aware of interactions that have been established, but also those that are no longer tenable. Of particular concern are continued misconceptions about the antibiotic-oral contraceptive and the vasopressor-antidepressant interactions. This article will clarify these issues as well as highlight established interactions associated with those drug classes used most frequently in dental practices.

Medical advances for treating organ diseases have resulted in thousands of organ transplants being performed each year. Every patient receiving a transplanted organ will also be placed on drugs that may induce gingival hyperplasia as a side effect. This article discusses the multiphasic approach to treating the disfiguring hyperplasia through chemical and mechanical plaque control, surgical removal of the tissue by lasers, and postsurgical rinses with folate.

Molar teeth present more problems during endodontic therapy than do bicuspid or anterior teeth. The major reasons for this are that molars can have complicated canal systems with unexpectedly large numbers of teeth with four canals, and they often have quite curved canals, which are more difficult to prepare and fill. The mandibular second molar generally is the easiest of these difficult teeth to treat, but they do have some areas of complication, too. The mesial root almost always has two--not one--canals and a rarely described condition, the C-shaped canal system, may be present.