Sir Henry Trentham Butlin: the father of British head and neck surgery.

Sir Henry Butlin was our first pioneer in head and neck surgery. Though the man himself has been all but lost to history, surgeons in the UK and the USA are returning to the technique of selective neck dissection that he first described over a century ago.

Perceived sources of occupational stress in general dental practitioners.

Aim: To evaluate levels of occupational stress in general dental practitioners (GDPs) and compare them with those reported by Cooper et al. (1987).

Design/setting: Postal questionnaire in England and Wales.

The emotional effects of tooth loss in edentulous people.

Aim: To explore the range of reactions to, and feelings about, tooth loss.

Method: In this qualitative study, 50 edentulous people undergoing routine prosthetic dental care were interviewed privately using a reflexive, in-depth technique. All the interviews were tape-recorded and transcribed.

Experience of undergraduates from three London dental schools and trainers from the south east of England on interviews for vocational training in 1996.

Objective: To assess the current perceptions, motivations and expectations of trainers and vocational dental practitioners (VDPs) of vocational training (VT) interviews.

Design: Questionnaire based study.

Setting: General practice study carried out in 1996.

An evaluation of the diagnostic yield from bitewing radiographs of small approximal and occlusal carious lesions in a low prevalence sample in vitro using different film types and speeds.

Aim: To compare diagnostic yield in caries diagnosis from D- and E-speed films.

Design: A laboratory study.

Setting: A UK dental school between 1992 and 1994.

The electronic diagnosis of caries in pits and fissures: site-specific stable conductance readings or cumulative resistance readings?

A prototype electronic caries meter (ECM II; LODE, Groningen. The Netherlands) was designed to deliver a conductance reading when the reading had remained stable for 3 consecutive seconds. The aim of this study was to determine whether this type of stable conductance reading was optimal for caries diagnosis.

The effect of airflow on site-specific electrical conductance measurements used in the diagnosis of pit and fissure caries in vitro.

There has been renewed interest in the electronic diagnosis of occlusal caries using measurement of conductance or impedance. One of two previously manufactured electronic caries detectors (the Vanguard electronic caries detector, Massachusetts Manufacturing Corporation, Cambridge, Mass., USA) had a probe tip with an integral air supply.

Antibacterial activity of peptides homologous to a loop region in human lactoferrin.

Human lactoferrin contains a 46 residue sequence named lactoferricin H thought to be responsible for its antimicrobial properties. Synthetic peptides HLT1, corresponding to the loop region of human lactoferricin (FQWQR-NMRKVRGPPVS) and HLT2, corresponding to its charged portion (FQWQRNMRKVR), exerted significant antibacterial effects against E. coli serotype O111 strains NCTC 8007 and ML35.

Mechanical defects in dental enamel vs. natural dental caries: observer differentiation using Ektaspeed Plus film.

The value of imaging modalities in enabling the observer to detect proximal dental caries has been tested previously using both natural carious cavitations and mechanical defects. This study compared the ability of dentists to detect mechanically created defects and natural dental carious cavitations on the proximal surfaces of extracted teeth, and to differentiate between the two. Detection rates according to lesion depth were also investigated.

Histological validation of electrical resistance measurements in the diagnosis of occlusal caries.

Diagnosis of occlusal caries is difficult from visual and radiographic examination. The use of electrical resistance measurement has been described previously and reported to be a potentially sensitive alternative technique. This is possibly due to the decreased resistance of carious pits and fissures.

Clinical and radiographic diagnosis of occlusal caries: a study in vitro.

Various methods of diagnosing occlusal caries have been described, but only visual, clinical examination and radiographic examination are commonly used in dental practice. This laboratory study investigated the ability of 12 examiners to detect the presence or absence of occlusal caries in 48 extracted molar teeth using these two techniques. The presence or absence of caries was subsequently verified by sectioning the teeth.

Occlusal caries diagnosis: a changing challenge for clinicians and epidemiologists.

The diagnosis of occlusal caries is an integral part of an epidemiologist's task, whether carrying out cross-sectional national caries prevalence surveys to assist with planning and the evaluation of service provision, or clinical trials of caries preventive agents. Similarly, the clinician also carries out this same overall diagnostic procedure in order to plan care for individual patients, although he/she will usually have access to improved facilities and diagnostic aids. This paper reviews the different problems now being encountered by both epidemiologists and clinicians in the face of changes in the presentation of the disease at this site and the qualifications which should now be appreciated when extrapolating from the results of surveys employing comparatively gross criteria.

Prevalence of clinically undetected and untreated molar occlusal dentine caries in adolescents on the Isle of Wight.

The prevalence of clinically undetected occlusal dentine caries was determined in a group of adolescents living on the Isle of Wight by comparing data from clinical and radiographic examinations carried out in 1987. 6.3% of maxillary molars and 12.

Management of the palatal ectopic and unerupted maxillary canine.

Some problems associated with the diagnosis of the ectopic maxillary canine are discussed. A treatment regimen is outlined for the tooth that is displaced palatally and unerupted.

Response of the oral mucosa to denture wearing.

This paper reviews both past and current knowledge concerning the controversial subject of mucosal responses associated with denture wearing. The subject has been considered in terms of both gross clinical and histopathological changes arising from daily prosthesis use. Displacement of basal seat tissues during function has been discussed, along with denture-induced alterations of the local microfloral ecosystems.

Fluoride, calcium and inorganic phosphorus concentrations in approximal plaque collected from young adults 1 and 24 h after toothbrushing with fluoride toothpastes.

A within-subject double-blind cross-over study was carried out to examine whether the chemical composition of approximal plaque was altered 1 and 24 h after brushing with fluoride toothpaste. Three fluoride toothpastes were tested, containing either sodium monofluorophosphate with calcium glycerophosphate supplement and calcium carbonate abrasive, a combination of sodium monofluorophosphate and sodium fluoride with the same supplement and abrasive or sodium fluoride with a silica abrasive. A fluoride-free toothpaste with a silica abrasive acted as the control.

Caries diagnosis within restored teeth.

Secondary caries is the most common reason given by dentists for the replacement of restorations, and yet this is a diagnosis that is difficult to make with confidence. This paper attempts to define some of the problems in the diagnosis of caries in restored teeth. The histology of the secondary carious lesion shows that it may be considered in two parts: an outer lesion adjacent to the filling, and a wall lesion which will occur only if there is leakage between the filling and the tooth.

Bond strengths of three chemical adhesive cements adhered to a nickel-chromium alloy for direct bonded retainers.

Sandblasted surfaces of a beryllium-free, nickel-chromium alloy were bonded with one of three chemical adhesives. After either immersion in water for up to 6 months or thermal cycling between 5 degrees and 60 degrees C for 500 cycles, the bonded specimens were tested for both shear and tensile strength. The highest values of tensile and shear bond strengths were found with Panavia Ex material, and these values showed no significant changes after thermal cycling.

Palatopharyngeal activity in cleft palate subjects.

A literature review of the nature of the musculature of the cleft palate and the pharynx is provided and a rationale presented for determining the anatomic level at which muscle activity occurs. Nasal endoscopy with a rigid telescope and the placement of miniaturized pressure transducers against the pharyngeal walls were the techniques used to investigate palatopharyngeal defects in cleft palate subjects. Ten basic patterns of palatopharyngeal movement are described and the likely interplay of the various muscles in producing these complex movements is discussed.

Relationships between the biochemical composition of both free smooth surface and approximal plaque and salivary composition and a 24-hour retrospective dietary history of sugar intake in adolescents.

The relationships between the composition of both free smooth surface and approximal plaque and salivary composition and sugar intake assessed from a retrospective 24-hour dietary history were investigated. The inorganic phosphorus concentrations of both types of plaque collected from the permanent dentition were directly related to concentrations in stimulated whole saliva of 45 males aged 12-13 years. The calcium, inorganic phosphorus, water-soluble carbohydrate and protein concentrations of free smooth surface plaque were related to both the time since the last reported sugar intake and the amount of sugar and number of sugar intakes consumed in the previous 24 h as assessed from the retrospective diet histories of 75 females aged 14-15 years.

Effect of brushing with fluoride toothpastes on the fluoride, calcium, and inorganic phosphorus concentrations in approximal plaque of young adults.

A within-subject cross-over study was carried out to examine whether brushing with fluoride toothpastes would alter the composition of approximal plaque. Approximal plaque was collected from 22 subjects following brushing with toothpastes containing sodium fluoride and sodium monofluorophosphate with calcium glycerophosphate and a fluoride-free control toothpaste. Concentrations of plaque calcium, inorganic phosphorus, and fluoride were estimated.

The effects of experimental variations in dietary sugar intake and oral hygiene on the biochemical composition and pH of free smooth-surface and approximal plaque.

The biochemical compositions of free smooth-surface and approximal plaque were compared after 48 hours in the presence and absence of twice-daily toothbrushing and during ingestion of either high- or low-sugar diets in ten young adults. In addition, the effect of a single sugar intake on the pH of both types of plaque was investigated. The results confirmed previously reported differences in biochemical composition between free smooth-surface and approximal plaque, the concentrations of inorganic ions and carbohydrate fractions being generally lower in the approximal sample after all experimental regimens.

Assessment of bone loss in periodontitis from panoramic radiographs.

Bone loss in chronic periodontitis was assessed from panoramic radiographs by direct measurement from the cemento-enamel junction (CEJ) and by measuring the proportion of the tooth length supported by bone. Mesial and distal bone levels of all available teeth were assessed for 50 patients aged 30-39 years referred for periodontal treatment. 85% and 74% of surfaces were measurable by the proportional and direct techniques, respectively.