Annals of the Royal Australasian College of Dental Surgeons最新文献

Computer-guided implant treatment is one of the popular options in the rehabilitation of dentitions in the edentulous situation. Patients should benefit not only from the advent of precise implant installation, but also the possibility of restoration of function and aesthetics immediately after the treatment. This poster presentation illustrated, from the view of the prosthodontist, the procedures and precautions involved using a clinical case as an example.

In the past decade, distraction osteogenesis (DO) has become increasingly popular and has opened new therapeutic perspectives for the treatment of numerous congenital and acquired craniofacial skeletal anomalies. However, DO mechanisms still remain unclear and different treatment protocols are applied by different groups. Here the authors use their 14 years-clinical experience to evaluate DO parameters such as maxillary and mandibular DO stability over time, especially in growing patients, DO effects on soft tissues and the correlation between the bone gain and lengthening capabilities of the device. Based on these data, clinical indications and treatment protocols for mandibular and maxillary DO are suggested. The application of DO to the membranous bones of the craniofacial skeleton has opened a new chapter in the surgical treatment of several congenital and acquired craniofacial deformities. Based on this experience, the authors recommend DO indications guidelines in selected cases of hemifacial microsomia, maxillary hypoplasia and narrow mandible with anterior dental crowding.

A technique is presented for the use of a transparent polyvinyl siloxane template constructed from a diagnostic wax-up to rapidly reproduce the anatomical structure with direct restorative materials in the mouth. This technique is beneficial for a number of geriatric patients who would be unable to undertake long and complex dental treatment sessions and provides an alternative for those unable to meet the immediate costs of multiple indirect restorations. Consideration of increases in vertical dimension to create space for the new restorations and reconstruction utilizing a combination of direct and indirect procedures provides control and predictability over the final restorative result. In the short to medium term, the use of minimally invasive adhesive techniques enables tooth surface loss to be replaced with minimal destruction of the remaining sound tooth material, yet still enables the option for a more definitive restorative option at a later date.

Periodontal disease is the most commonly occurring yet unusual infection in humans. It is initiated by pathogenic plaque biofilm and characterized by bacteria-induced inflammatory destruction of tooth-supporting structures and alveolar bone. Periodontitis remains the most common cause of tooth loss in adults. Currently, periodontal diseases are also recognized as serious infections with profound effects on general health. In recent years, new concepts and discoveries have been made in further understanding of the nature of periodontal disease and its aetiopathogenesis. These can be well reflected in recognition of dental plaque as a biofilm; identification and characterization of periodontopathogens and their virulence factors; recognition of the importance of host-microbe symbiosis in periodontal health; identification of novel innate host defence molecules in periodontal tissues; further understanding of the molecular mechanisms involved in tissue destruction and alveolar bone resorption; appreciation of the crucial role of host susceptibility in periodontal pathogenesis; and identification of risk factors and incorporation of risk assessment in clinical practice. Committed oral health care professionals should therefore keep abreast of these changing concepts in periodontology and updated strategies for appropriate evidence-based practice. These views are fundamentally important for prevention, diagnosis and treatment of periodontal diseases and peri-implant infections, as well as for long-term maintenance of periodontal health and implant stability. This paper updates the advances in aetiopathogenesis of periodontal disease and highlights the relevant clinical implications and future perspectives.

Introduction: Periodontal disease and associated bone loss can severely hinder orthodontic treatment. Actinobacillus actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) are bacteria which are strongly associated with this type of bone loss. Quercetin, a unique flavonoid, which is found in many common foods including apples, onions and tea may have a effect against these bacteria.

Aims: To study the effect of quercetin on the in vitro growth of periodontal pathogens Aa and Pg.

Material and methods: The antimicrobial effects were determined in vitro using a broth dilution assay. Aa and Pg were grown to a density of 10(7) to 10(8) cfu/mL and subsequently incubated with test solutions of quercetin at different concentrations (0.025 g/mL, 0.05 g/mL, and 0.1 g/ mL). 0.2% chlorhexidine was used as the positive control and 0.9% sodium chloride (NaCl) as the negative control. Aliquots for the growth assay were taken as soon as the solutions were mixed, and after 1, 3, 6, and 24 hours of incubation in an anaerobic chamber for Aa and Pg. Colonies appearing on the blood agar plates were visually counted after three days for Aa and 5 days for Pg.

Results: This study demonstrated that quercetin is a potent antimicrobial agent. When Aa and Pg were incubated with quercetin, their growth began to be inhibited at 1 hour. Aa, shows a transient inhibitory effect for 1 to 12 hours after which the antimicrobial effect gradually decreasds. With Pg, the effect increased with time and complete inhibition was achieved with concentrations of 0.1 g/mL, 0.05 g/mL and 0.025 g/mL by 24 hours. No significant difference was found between the chlorhexidine group and the quercetin solution after 24 hours of incubation.

Conclusion: Quercetin has an inhibitory effect on Aa and Pg.

The incidence of tooth wear or non-carious tooth surface loss (NCTSL) is increasing and oral rehabilitation of patients with tooth tissue loss requires strategies that address all the factors relevant to the aetiology and pathogenesis of the disease. The multifactorial nature of the disease and the variability in its clinical presentation provides treatment challenges for the clinician. Management of tooth wear must be more than just restoration. Risk assessment, compliance and a commitment from both professional and patient underpin overall success of the treatment. Understanding that long term success is affected by the patient's oral environment and how diet, lifestyle and medical factors modify this environment. Improvements in the quantity and quality of saliva and remineralization strategies to enhance the remaining tooth structure are essential pre-restorative requirements. Successful management requires recognition of the problem, stabilization of the oral environment, remineralization of the tooth structure and when appropriate restoration.

Objective: Relationships between demographic, health behaviour and diabetes mellitus (DM) parameters and periodontal status were assessed among a group of nonsmoking, low-income, middle-aged to elderly medically treated Hong Kong Chinese subjects with type 2 diabetes mellitus (DM).

Materials and methods: 193 Chinese, dentate, type 2 DM patients (56.5 +/- 9.0 years; recorded DM duration 7.0 +/- 5.2 years) attending a charity hospital specialist clinic were surveyed. Subject demography, periodontal status, Body Mass Index (BMI), DM control, serum TNF-alpha level and general health behaviour (GHB) were recorded.

Results: Periodontitis was prevalent (80.3% of subjects with PPD > or = 5 mm and 65.8% subjects with full-mouth mean PAL > 3.0 mm). Mean HbA1c, fasting plasma glucose and BMI were 7.6 +/- 1.6%, 8.2 +/- 2.9 mmol/L and 25.4 +/- 3.7 kg/m2 respectively. Serum TNF-alpha level was similar to the reported Chinese population norm. Full-mouth mean clinical attachment level was associated with DM duration while full-mouth mean probing pocket depth was associated with GHB (p < 0.05). The Gingival Index, was greater in men, and associated with higher HbA1c% and lower education attainment (p < 0.03).

Conclusion: In this group of non-smoking, predominantly low-education background, overweight, Chinese subjects with fairly well-controlled type 2 DM, periodontal attachment loss and periodontal disease appeared to be associated with DM duration and health behaviour. Health care providers should consider paying more attention to improving the GHB of their type 2 DM patients with long DM duration. DM subjects with a low educational background, having higher HbA1c% and males are more likely to experience gingival inflammation.