Controversies in occlusion.

The tissues and structures of the stomatognathic system adapt in different ways but in a coordinated manner to functional forces. This adaptive capacity differs from individual to individual and tends to cloud the picture as to how these mechanisms function. This leads to many areas of disagreement as to the role of occlusal trauma in the etiology of periodontal disease; the importance of centric, bite collapse versus arch collapse; the role of incisal guidance in maintaining occlusal stability; canine protected-guided occlusion versus group function; the use of appliances in occlusal therapy; prophylactic versus interceptive occlusal adjustment; and the role of bruxism and other parafunctional habits in occlusal trauma.

Rapid loss of alveolar bone associated with nonprecious alloy crowns in two patients with nickel hypersensitivity.

In recent years there has been a dramatic increase in the use of nonprecious alloy and porcelain crowns in clinical dentistry. The alloy in these restorations frequently contains a high percentage (greater than 70%) of nickel. Most cases of metal hypersensitivity are related to nickel, and clinical manifestations of the hypersensitivity are the result of a cellular (T lymphocyte) immune response.

Role of the polymorphonuclear leukocyte in periodontal health and disease.

This review presents evidence for lysosomal enzymes being at least partly responsible for the tissue destruction seen in periodontal disease. However, many other inflammatory and immunologic mechanisms have been identified that can contribute to tissue destruction (Nisengard 1977). The relationship of PMN to the periodontal tissues is equivalent to the proverbial double-edged sword.

Chronic pemphigus vulgaris of the gingiva. A case report with a 6-year follow-up.

Since the initial lesions of pemphigus vulgaris often appear in the oral cavity, dentists have a major role in the recognition and diagnosis of this condition. The patient reported here was seen with a mild gingival form of the disease and has been managed successfully for the past 6 years without systemic steroids and with minimal topical steroid therapy. For most of that period he was managed without medication.