Case series of medication-related osteonecrosis of the jaw (MRONJ) patients prescribed a drug holiday.

The role of a drug holiday in the management of medication-related osteonecrosis of the jaw (MRONJ) remains controversial. Current UK guidance does not recommend this practice given the lack of conclusive evidence, and potential risk of skeletal-related events or cancer metastasis. This paper aims to describe a series of fifty patients with confirmed MRONJ who were prescribed a drug holiday as part of their management.

Defective dental restorations: to repair or not to repair? Part 2: All-ceramics and porcelain fused to metal systems.

Unlabelled: With the increasing use of ceramics in restorative dentistry, and trends to extend restoration longevity through the use of minimal interventive techniques, dental practitioners should be familiar with the factors that may influence the decision either to repair or replace fractured metal-ceramic and all-ceramic restorations and, also, the materials and techniques available to repair these restorations. This second of two papers addresses the possible modes of failure of ceramic restorations and outlines indications and techniques in this developing aspect of restoration repair in clinical practice.

Clinical Relevance: The repair of metal-ceramic and all-ceramic restorations is a reliable low-cost, low-risk technique that may be of value for the management of loss or fracture of porcelain from a crown or bridge in clinical practice.

Defective dental restorations: to repair or not to repair? Part 2: all-ceramics and porcelain fused to metal systems.

With the increasing use of ceramics in restorative dentistry, and trends to extend restoration longevity through the use of minimal interventive techniques, dental practitioners should be familiar with the factors that may influence the decision either to repair or replace fractured metal-ceramic and all-ceramic restorations and, also, the materials and techniques available to repair these restorations. This second of two papers addresses the possible modes of failure of ceramic restorations and outlines indications and techniques in this developing aspect of restoration repair in clinical practice.

The microbiology of periodontal disease.

Periodontal disease result from mixed bacterial infections, in which both host resistance barriers and bacterial interactions are important. Approximately ten bacterial species are strongly implicated with various forms of periodontal disease, although species that cannot yet be cultivated are likely also to be relevant. New technologies have shown that pathogenic bacterial species are present in defined complexes within subgingival plaque, thus identifying specific targets for therapeutic intervention.

A survey of the opinions of orthodontic specialist trainees in the U.K.

A questionnaire survey was carried out to ascertain a profile of orthodontic postgraduates in training in the United Kingdom during 1993. Information about the postgraduates, their programmes and their career plans was collected. Eighty-nine questionnaires were distributed to those enrolled in 13 of the training programmes in the U.

Effects of transforming growth factor beta-1 on growth-regulatory genes in tumour-derived human oral keratinocytes.

This study examined the effect of transforming growth factor beta-1 (TGF-beta 1) on c-myc, RB1, junB and p53 expression together with pRb phosphorylation, in carcinoma-derived and normal human oral keratinocytes with a range of inhibitory responses to this ligand. Amplification of c-myc was observed in eight of eight tumour-derived cell lines and resulted in corresponding mRNA expression. The down-regulation of c-myc expression by TGF-beta 1 predominantly reflected growth inhibition by TGF-beta 1, but in two of eight tumour-derived cell lines which were partially responsive to TGF-beta 1 c-myc expression was unaltered by this ligand.

The effect of changes in caries prevalence on dental education.

While rising levels of dental caries were primarily responsible for the growth in dental schools in developed countries, the recent decline in caries prevalence has not resulted in a major decline in dental education. Indeed, the reduction in caries prevalence has had very little influence upon a group of major changes that arguably should have had a marked effect upon dental education in recent years, but which have failed so to do. These include a quantum leap in applying the scientific basis of caries management, focused down to the teaching of minimally invasive restorative care within a context of risk assessment and maximum non-invasive care where appropriate.

Measurement of residual monomer in denture base material: studies on variations in methodology using gas-liquid chromatography.

It is known that high levels of residual monomer have a deleterious effect on the properties of denture base polymers and may cause irritation or hypersensitivity of the oral tissues. In the present study variations in determination methodology and their influence on residual monomer levels are evaluated. The results demonstrate that filtration of the sample, sealed storage and incorporation of an appropriate volume of internal standard enhanced the accuracy of the technique.

Tongue piercing (oral body art).

Oral body art is a relatively recent fashion in the West where jewelry is inserted in the oral soft tissues. A patient who had tongue-piercing is presented, and the subject of oral piercing reviewed.

Are viruses associated with aphthae and oral vesiculo-erosive disorders?

Oral and maxillofacial surgeons in District General Hospitals in UK often carry the major workload of patients with chronic oral ulcerative conditions. Although the immunopathogenic basis of many of these is being unravelled, the aetiology is often unclear, though a role for viruses is increasingly suspected. This paper reviews the current evidence.

Oral cancer: new insights into pathogenesis.

Understanding the pathogenesis of cancer may well lead to improved diagnostic tests, preventive treatment and management. This paper reviews the gene changes, the evidence implicating viruses in the aetiology of oral cancer, and the mechanisms whereby viruses may affect gene function and thereby contribute to carcinogenesis.

Complications of dental surgery in persons with HIV disease.

Post tooth extraction infective complications have occasionally been described in HIV-infected persons. However, there is little objective data as to the frequency of this and the need for antibiotic prophylaxis. Similarly the frequency of postextraction bleeding in patients infected with HIV, who may have thrombocytopenia, is unknown.

Pigmented purpuric stomatitis.

The pigmented purpuric dermatoses are a group of disorders in which there is chronic capillaritis, with pigmented purpuric lesions predominantly on the lower limbs. We report a case with chronic oral lesions that had histologic features most in keeping with the purpuric lichenoid dermatitis of Gougerot and Blum syndrome.

The ranking of facial attractiveness.

A method of assessing facial attractiveness is described in which facial photographs were ranked by adults in order from the most to the least attractive. The rankings of a group of normal 10-year-old children were compared to those given to a group of similarly aged patients with repaired clefts. Most previous methods have grouped patients into categories, but this tends to obscure individual differences in facial attractiveness: patients with small differences in appearance are generally placed in the same group.

Laser etching of teeth for orthodontic bracket placement: a preliminary clinical study.

Current interest in the use of layers in clinical dentistry has suggested that this technique may be applicable to enamel etching in orthodontics. A pulsed Nd:YAG laser was used to etch the enamel surfaces of teeth in vivo prior to the bonding of orthodontic brackets with composite resin. Overall laser bonding took considerably longer, was less reliable in terms of bond strength, and produced more discomfort than conventional acid etching.

Cross-infection control: attitudes of patients toward the wearing of gloves and masks by dentists in the United Kingdom in 1987.

Dental patients in the United Kingdom were surveyed in February 1987 with respect to their views on whether dentists should wear gloves and/or masks. Most patients believed that gloves should be worn and few saw no need for either. Patients receiving care in a dental hospital were more enthusiastic than those seen in general practice in the belief that dentists should wear gloves and/or a mask.

Female victims of assault. A study of hospital attenders.

During the first six months of 1986, 294 consecutive victims of assault were examined to determine the patterns of injury. Forty-three victims were women aged 15-46 years (mean: 25 years). In comparison with the hospital catchment population, the unemployed were over-represented and the greater than 40 age range under-represented.