Nederlands tijdschrift voor tandheelkunde最新文献

Saliva is essential for oral health. Factors such as medication, chemotherapy and radiotherapy, and systemic diseases can reduce saliva production, which can lead to chronic dry mouth. This study focused on restoring both the quantity and quality of saliva. In a clinical study, healthy participants were exposed to volatiles from mastic resin and ?-pinene, while those with chronic dry mouth were exposed only to mastic resin, significantly increasing saliva secretion in both groups. In patients with dry mouth, saliva quality increased after exposure to mastic resin volatiles as could be deduced from increased spinnbarkeit, pH, sodium and MUC5B concentrations. Additionally, synthetic peptides were developed to specifically bind MUC5B using the phage display technique. The presence of peptide MBP12 stabilized the spinnbarkeit of saliva in vitro. Experiments in epitope characterization revealed that MBP12 bound to the galactose residue of MUC5B. These findings suggest that olfactory stimuli of mastic resin and MUC5B-binding peptides are promising, non-invasive methods for treating chronic dry mouth.

A 28-year-old man was referred to an oral and maxillofacial surgeon, complaining of fatigue, a tugging sensation in his right eye and difficulty focusing. Closer investigation revealed a progressive shifting of the position of the right eyeball as a result of silent sinus syndrome, as a delayed consequence of an orbital floor fracture. Although clinical symptoms usually occur soon after an orbital fracture, there are dormant sequelae that only develop later, such as the silent sinus syndrome. Displacement of the orbital floor can cause the infundibulum of the maxillary sinus to the nose to become obstructed. This can create a vacuum in the maxillary sinus which pulls the walls inwards. Since the roof of the sinus is also the floor of the orbit, a slow yet progressive change in the position of the eyeball can occur. In addition to a traumatic cause (orbital floor fracture), chronic sinusitis, possibly of odontogenic origin, can also be the cause of silent sinus syndrome. Early referral to an oral and maxillofacial surgeon prevents worsening of this syndrome.

With ageing, chances of illness and physical problems increase; these are often accompanied by the need to use medication. With today s ageing of the population, oral healthcare providers will see increasing numbers of older people with multimorbidity and polypharmacy (using 5 or more different medicines) in their practice. Due to likely complications and possible interactions as a result of oral healthcare interventions, knowledge about health issues and medication used is of great importance. This article aims to inform the reader about issues concerning the use of medication by older people with frailty in the oral healthcare practice. Medicines most often used by older people, problems encountered by oral healthcare providers when acquiring proper insight into the medical situation of an older person with frailty (not merely physical but cognitive and social, too) and medical-dental interactions of medication used by older people are discussed.

Ectodermal dysplasia can present in various ways. A reduced number of constructed teeth, deformed teeth and an underdeveloped alveolar process are common oral features in ectodermal dysplasia. Although the dental treatment goal is always to restore function, there is no standard treatment protocol for this condition. The dental treatment plan must be individually tailored based on the oral situation, (technical) possibilities, age and wishes of the patient. This requires a multidisciplinary approach among different healthcare providers: a maxillofacial prosthodontist, an oral and maxillofacial surgeon, implantologist, orthodontist, a dental technician, speech therapist, dietician and a psychologist. In this second part of this two-part article, 2 cases of ectodermal dysplasia are presented.

An overview of all-ceramic dental restorations during the past 50 years poses a challenge. This is mainly due to the great variety of manufacturing processes, which were just as essential to the quality and functioning of the restorations as the composition of the different ceramics. Developments and innovations in the field of all-ceramic restorations have greatly contributed to much better biocompatibility and aesthetics. Without CAD/CAM software and (intraoral) scanners, developments from the first all-ceramic restorations with feldspar porcelain in 1973 to today's milled lithium silicate or zirconium dioxide restorations would not have been possible. In this first of a two-part article, developments up to the advent of zirconium dioxide are presented.

Worldwide, there are significant differences in caries prevalence among groups differing in socio-economic position. Understanding these differences is crucial to improving accessibility to oral healthcare for all population groups. Our study assessed caries prevalence and severity in a random sample of children aged 1 to 6.5 years from high and low socio-economic positions. At 4 years of age, 39% versus 57% of children of high and low socio-economic positions, respectively, had dental caries. This was 43% versus 72% at 6.5 years of age. The number of surfaces affected by caries and the percentage of carious teeth increased significantly over time among children with caries experience from low socio-economic positions. From the ages of 4 and 6.5 years, children with low socio-economic positions had significantly more carious surfaces and a higher percentage of carious teeth compared to those in the high socio-economic positions group. This emphasizes an inequality in caries experience among groups differing in socio-economic position.

Eliminating saliva or blood from contaminating adhesive treatments becomes increasingly challenging as the cavity size increases, especially when the preparation margin is located below the cementoenamel junction. A direct composite restoration can elevate this margin to a supragingival level, allowing for better isolation with a rubber dam. This process, known as deep margin elevation, enables dentists to more reliably bond partial restorations. This dissertation investigates how severely compromised teeth with deep preparation margins can best be restored, with a focus on the use of deep margin elevation in combination with partial indirect restorations. Through clinical and laboratory research, the survival, durability, and mechanical performance of these restorations are evaluated. The findings indicate that deep margin elevation is an effective technique, although there is still a lack of knowledge regarding long-term success rates, particularly concerning different restorative materials and the biological impact of deep preparation margins.

Two patients presented themselves with a recurrent swelling under their tongue. The first patient was a 10-year-old boy, whose swelling was enucleated, but recurred after some time. The second patient was an 18-year-old boy, whose swelling had previously been marsupialized. In the second case a MRI was performed, showing a cystic lesion which arose from the Blandin-Nuhn salivary glands. In both patients the lesions were removed under general anaesthesia and in both cases the histopathological findings confirmed this diagnosis; cyst of the Blandin-Nuhn salivary glands.

Ectodermal dysplasia can present in various ways. A reduced number of constructed teeth, deformed teeth and an underdeveloped alveolar process are common oral features in ectodermal dysplasia. Although the dental treatment goal is always to restore function, there is no standard treatment protocol for this condition. The dental treatment plan must be individually tailored based on the oral situation, (technical) possibilities, age and wishes of the patient. This requires a multidisciplinary approach among different healthcare providers. In this first part of a two-part article, 2 cases of ectodermal dysplasia are presented.

Dentists today have an increasing number of ways to restore chewing function lost due to missing teeth. The loss of chewing function has many more consequences than one might initially think. Oral function concerns not only chewing but also proprioception and osseoperception, and it influences brain function too. With this in mind, preserving natural teeth is important, and it is unwise to choose implants in the first instance if a compromised tooth can be saved with some effort or chewing function can be restored with bridges on natural teeth. Options differ on this question: should implants be considered the 'holy grail' or a last resort? Conventional bridgework is still a very relevant treatment option that affects the dynamics of the masticatory system less than implant-supported constructions and also requires less maintenance. A self-critical attitude on the part of a dentist remains necessary if patients are to be treated optimally.