The nature and frequency of medical emergencies among patients in a dental school setting.

As health care improves and life expectancy increases, dentists and dental students are treating a growing number of elderly and medically compromised patients, increasing the likelihood of a medical emergency during treatment. Previous studies examining emergencies in a dental setting have relied upon self-reports and are therefore subject to biases in reporting. The purpose of this study was to examine data generated from documentation of CODE-5 medical emergency events at the University at Buffalo School of Dental Medicine over an eight-and-a-half-year period.

Serving the public good: challenges of dental education in the twenty-first century.

The purpose of this study was to explore perceptions of the roles and responsibilities of dental education in serving the public good, and the extent to which they are being met, from the vantage point of leaders at the university and state level. Five questions were developed to gather views on dental education's success in meeting the expectations and needs of the public. Fifty-one interviews were conducted with leaders at seven institutions and with public officials in six states.

CT-based dental imaging for implant planning and surgical guidance.

CT-based dental imaging for implant planning and surgical guidance carries both clinical and radiographic information for implant positioning as far as trajectory, depth and distribution. The significance of accurate planning and surgical guidance as it pertains to critical anatomical landmarks, such as the mandibular canal, maxillary sinus and adjacent teeth, cannot be overstated. This case report describes a systematic approach to the planning and surgical placement of a single, implant-supported crown, using CT-based dental imaging for implant planning and surgical guidance.

Jacob Hemet. Dentist to royalty and entrepreneur extraordinaire.

One of the most prominent dentists in late-18th century London was Jacob Hemet, member of a long family of dentists. He was appointed royal dentist to Queen Charlotte, wife of George the Third, and to George's favorite daughter, Amelia, and the Prince of Wales. He advertised widely, both in this country and in several European countries, including his native France.

Cavernous hemangioma of the palate. A review of etiology, pathogenesis and treatment options.

Cavernous hemangiomas of the palate are a rare but not infrequent sighting in the oral and maxillofacial region. The etiology and pathogenesis of these lesions are not definitively understood and are currently being explored. Treatment options usually include, but are not limited to, surgical excision of the lesion.

The role of automated external defibrillators in dental practice.

Dental practices are seeing an increasing number of elderly and medically compromised patients, making it likely that staff will be called upon to respond to medical emergencies in the office, including cardiac arrest. Out-of-hospital cardiac arrests account for nearly half of all cardiovascular deaths in the United States. In adult cardiac arrest victims, the most frequent cause of sudden cardiac arrest is ventricular dysrhythmia, either ventricular tachycardia or ventricular fibrillation.

Maxillary and mandibular overlay removable partial dentures for restoration of worn teeth. A three-year follow-up.

This clinical report describes the fabrication and a three-year follow-up of maxillary and mandibular cast overlay removable partial dentures for the restoration of severely worn dentition with accompanying loss of vertical dimension of occlusion. The frameworks supported porcelain veneers for esthetics, and metal occlusal surfaces for strength and durability.

Recurrence of early childhood caries after comprehensive treatment with general anesthesia and follow-up.

Purpose: Children diagnosed with early childhood caries (ECC) receive comprehensive treatment using general anesthesia at the Women and Children's Hospital of Buffalo. The purpose of this study was to determine the likelihood of new caries, and if attendance at immediate follow-up can prevent relapse.

Methods: All patients with ECC who had been scheduled for treatment using general anesthesia in the year 2000 were reviewed.

Computerized tomography-based imaging and surgical guidance in oral implantology.

Computerized tomography (CT)-based imaging and surgical guidance carry both radiographic information such as height, density, and width of bone and clinical information such as axis of orientation for a successful prosthodontic result, thus determining the trajectory, depth, and distribution of the implants. The objective of this report is to review the associated literature and recent developments in CT-image-based information and surgical guidance systems. This report attempts to provide an argument for the development of evidence-based research on the utility of such systems and their effect on outcome in oral implantology.

Bisphosphonate-associated osteonecrosis of the jaws: a review of current knowledge.

Background: Increasing numbers of dental patients are taking bisphosphonate medications for a variety of indications. These drugs may be associated with poor healing, spontaneous intraoral ulceration and bone necrosis in the oral and maxillofacial region.

Case Description: The authors describe a case of osteonecroSis of the jaws in a patient receiving long-term bisphosphonate therapy for cancer.

Use of interdisciplinary team approach in establishing esthetic restorative dentistry.

Managing crown lengthening in cases of attrition (wear or loss of tooth substance) and achieving desired esthetic outcomes, especially in the esthetic zone, is challenging. This case report presents an interdisciplinary approach to case management. Concomitant use of digital imaging, along with model wax-ups and surgical guide, were used to enhance patient acceptance during treatment planning and to facilitate communication and treatment implementation among dental professionals and laboratory technicians.

Peripheral primitive neuroectodermal tumor associated with the anterior mandible: a case report and review of the literature.

Neuroectodermal tumors may arise in many places throughout the body including the diverse tissues of the head and neck. The primitive neuroectodermal tumor is a predominately neural, nonepithelial neoplasm similar to Ewing sarcoma. This article describes an 18-year-old female patient with a highly malignant peripheral primitive neuroectodermal tumor located in the soft tissue anterior to the mandibular symphysis.

Is estrogen deficiency a risk factor for periodontal disease?

In recent years, interest in the relationship between osteopenia, osteoporosis, estrogen status, and periodontal disease has grown considerably. A substantial number of studies have attempted to address this important question. Despite the large body of evidence, controversy persists concerning a possible association between these conditions.

Hepatitis: still a concern?

Although some forms of viral hepatitis were identified more than 50 years ago, hepatitis continues to have an impact on the practice of dentistry. Possible transmission in the dental setting, management of the chronically ill, and legal issues related to treatment of infectious patients combine to emphasize that hepatitis is still an important issue for dental health care workers. Currently, 7 viral forms are recognized.

Platelet-derived growth factor enhancement of a mineral-collagen bone substitute.

Background: Anorganic bovine bone-collagen matrix is commercially available for bone regeneration procedures. Platelet-derived growth factor-BB (PDGF-BB) has been demonstrated to stimulate bone formation in vivo and in vitro. It was the aim of these studies to examine 1) the interaction of this mineral-collagen matrix with PDGF-BB and 2) determine if the adsorption of PDGF-BB to the mineral-collagen matrix stimulates osteoblastic cell proliferation above that of the untreated matrix.

A new survey instrument: a sample of a typical TMD practice.

The study evaluated 646 patients treated in a full time TMD practice with a new survey tool based on a patient self-report questionnaire. It would appear that this new approach to practice evaluation has not been previously reported in the literature. The results indicate that the average patient has a significant time delay of 24 to 120 months from onset of symptoms to the beginning therapy and that the majority of patients see three or more practitioners before reaching the TMD therapist.

Hyperaeration of the sphenoid sinus: cause for concern?

A case of exuberant pneumatization of the left sphenoid sinus into the pterygoid process and floor of the middle cranial fossa is presented. The fact that pneumatization of the sphenoid sinus is frequently atypical is of clinical import because there is an intimate relationship between the contents of a hyperaerated sinus and adjacent vital facial and cranial structures. It is imperative that clinicians determine the location and extent of the walls of the sphenoid sinus and its relationship to adjacent vital structures whenever endoscopic sinus surgery is contemplated to avoid morbid consequences during surgery.

Modification of an osteoconductive anorganic bovine bone mineral matrix with growth factors.

Background: Osteoconductive anorganic bovine bone mineral matrix material has been used clinically in bone regeneration procedures. Platelet-derived growth factor-BB (PDGF-BB) and insulin-like growth factor (IGF-I) are important anabolic growth factors for bone. It was the aim of these studies to 1) examine the interaction of this bone graft material with PDGF-BB and IGF-I and 2) determine if the combination of growth factors with the matrix could stimulate osteoblastic cell proliferation.

Anorganic bovine bone supports osteoblastic cell attachment and proliferation.

Background: It was the aim of these studies to examine the ability of an anorganic bovine bone matrix material as an alternative to autogenous bone grafts and demineralized cadaver bone to support the attachment, spreading, and proliferation of isolated osteoblastic cells.

Methods: Primary culture osteoblastic cells were isolated from neonatal rat calvaria by sequential collagenase digestion. In the attachment studies, cells which had been labeled with 3H-leucine were incubated with the matrix material in sterile microfuge tubes for 15, 90, or 180 minutes or 24 hours.

Primary leiomyosarcoma of the mandible in a 7-year-old girl: report of a case and review of the literature.

Leiomyosarcoma is a malignant neoplasm of smooth muscle origin that manifests itself uncommonly in the oral cavity because of the paucity of smooth muscle in that location. To the best of our knowledge, only 10 cases of leiomyosarcoma primary to the jawbones have been reported in the English language literature. We report the first pediatric case of leiomyosarcoma arising from the mandible.

The role of the darkroom in radiograph quality control.

Quality is key to being able to read radiographs. If it is lacking or poor, it is impossible to make a proper diagnosis. This article describes simple techniques and provides answers to problems encountered in the production of quality radiographs, such as, darkroom management, correct safelights, fresh chemistry and clean equipment.

The nature and extent of jaw involvement in Gaucher disease: observations in a series of 28 patients.

A wide variety of osteoarticular pathoses plague the clinical course of many patients with Gaucher disease. Osseous lesions involving the jaws have been described, usually as isolated case reports. The purpose of this study was to ascertain the nature and extent of mandibulo-maxillofacial pathosis in 28 patients with documented Gaucher disease by means of panoramic radiography.

Carotid calcifications on panoramic radiography identify an asymptomatic male patient at risk for stroke. A case report.

Although stroke may be preventable, a major challenge is to find effective methods of detection of stroke-prone patients. Most noncardiogenic strokes occur as a result of atherosclerosis involving the proximal internal carotid artery, calcifications of which can be detected on dental panoramic radiography. This report describes the case of an asymptomatic patient whose dental radiographic findings led to carotid endarterectomy.