Functional outcomes of cleft lip surgery. Part III: Measurement of lip forces.

Objective: To investigate lip force dynamics among participants with a repaired cleft of the lip and noncleft control participants.

Design: A parallel, three-group, nonrandomized clinical trial.

Subjects: Forty-eight participants with cleft lip and 36 noncleft participants.

Functional outcomes of cleft lip surgery. Part II: Quantification of nasolabial movement.

Objective: To explore nasolabial movements in participants with repaired cleft lip and palate.

Design: A parallel, three-group, nonrandomized clinical trial.

Subjects: Group 1=31 participants with a cleft lip slated for revision surgery (revision), group 2=32 participants with a cleft lip who did not have surgery (nonrevision), and group 3=37 noncleft control participants.

Functional outcomes of cleft lip surgery. Part I: Study design and surgeon ratings of lip disability and need for lip revision.

Objective: Children with a cleft of the upper lip exhibit obvious facial disfigurement. Many require multiple lip surgeries for an optimal esthetic result. However, because the decision for lip revision is based on subjective clinical criteria, clinicians may disagree on whether these surgeries should be performed.

An ultra-morphological characterization of collagen-depleted etched dentin.

Purpose: To evaluate the ultramorphology of superficial and deep dentin after etching with 35% phosphoric acid (H3PO4) and after etching with 35% H3PO4 followed by deproteinization with 5% sodium hypochlorite (NaOCl).

Materials And Methods: Two dentin disks (superficial and deep dentin) were obtained from each of 10 extracted human third molars by slow-speed sectioning. Dentin was polished with wet 600-grit SiC abrasive paper for 1 min to provide smooth surfaces.

The effect of a re-wetting agent on dentin bonding.

Objectives: Recently, a new generation of simplified one-bottle dentin bonding systems, sensitive to variations in the degree of substrate moisture, was introduced. This in vitro project compared the dentin bond strengths and interfacial ultra-morphology formed by three one-bottle bonding systems [OptiBond SOLO (ethanol-based), Prime&Bond 2.1 (acetone-based), and Single Bond (ethanol- and water-based)].

Immunologic and viral markers of HIV-1 disease progression: implications for dentistry.

Background: Current medical care for patients infected with the human immunodeficiency virus type 1, or HIV-1, involves monitoring laboratory assays for CD4+ lymphocyte cell count and plasma viral load.

Types Of Studies Reviewed: The authors reviewed recent medical and dental studies that contribute to our current understanding of these immunologic and viral markers and their relevance to systemic and oral health.

Results: Dramatic reduction in plasma viral load resulting from more potent antiretroviral drug combinations is the goal of medical management for HIV.

Referring adult patients for orthodontic treatment.

Background: An increasing number of adults are undergoing orthodontic treatment, but they still make up only a small proportion of all adults who could benefit from such therapy. The purpose of this article is to illustrate the appropriateness and value of orthodontic treatment in adults.

Methods: The authors review and summarize previous studies regarding adult orthodontic treatment.

Effect of systemic tetracycline and amoxicillin on inflammatory root resorption of replanted dogs' teeth.

The use of systemic penicillin after an avulsion injury has been recommended as a way to decrease the occurrence of resorption complications. Our previous study has shown systemic tetracycline to possess anti-resorptive properties independent of potential anti-bacterial actions. The purpose of this study was to compare histologically the effectiveness of tetracycline and amoxicillin in limiting inflammatory root resorption (IR) secondary to pulpal infection, in replanted dogs' teeth.

Effect of projective aspects variations on estimates of changes in bone mass using digital subtraction radiography.

This study tests the hypothesis that estimates of changes in bone mass derived from subtraction data obtained in accord with published methods are independent of the spatial aspect of the lesion being evaluated when calibrations are performed independently. Nineteen sliver-shaped bone chips ranging in mass from approximately 1 to 35 mg were orientated with broad side parallel to the facial surface of a hemisectioned dry human mandible and radiographed using conventional exposure parameters on conventional E-speed dental X-ray film. Also attached to the film was a standardized aluminium calibration wedge that facilitated quantitative analysis of resulting subtraction data using established methodology.

The role of the oral environment in HIV-1 transmission.

Human immunodeficiency virus type 1, or HIV-1, is infrequently transmitted through the mouth, unlike other mucosal sites. Factors such as low salivary viral titers, low numbers of CD4-positive target cells, anti-HIV antibodies and endogenous salivary antiviral factors work in concert to protect oral tissues from infection and reduce the risk of viral transmission through salivary secretions. This review summarizes the various factors thought to influence oral transmission HIV-1, focusing on the mucosal protein secretory leukocyte protease inhibitor, or SLPI.

Strengthening immature teeth during and after apexification.

The purpose of this study was to evaluate the strengthening effect of an internal resin bonding technique. One hundred central incisors were endodontically treated and divided equally into five groups. Group 1, without any cervical preparation and with access repaired with bonded resin, served as the positive control.

Tritiated thymidine uptake in periodontal ligament cells of dogs' teeth stored in various media for extended time periods.

The purpose of this study was to evaluate a new storage solution, Conditioned Medium, vs Hank's balanced salt solution and ViaSpan with respect to the viability of periodontal ligament cells of exarticulated teeth. Teeth were stored for periods of 6, 48, and 96 hours in Hank's balanced salt solution, ViaSpan (Dupont Pharmaceuticals), or Conditioned Medium. Teeth were cultured for 24 hours in Dulbecco's medium supplemented with tritiated thymidine.

The accuracy of clinical neurosensory testing for nerve injury diagnosis.

Purpose: The accuracy of the clinical neurosensory test to diagnose trigeminal nerve injuries has never been statistically evaluated. The purpose of this study was to determine the statistical efficacy of the clinical neurosensory test using surgical findings as the "gold" standard, and to determine whether a correlation existed between the sensory impairment score obtained by preoperative testing and the degree of nerve injury found at surgery.

Materials And Methods: A multisite, randomized, prospective, blinded, clinical trial was conducted on 130 patients with inferior alveolar nerve (IAN) and lingual nerve (LN) injuries.

Meta-analysis of the effect of systemic metronidazole as an adjunct to scaling and root planing for adult periodontitis.

The purpose of this meta-analysis was to provide a quantitative overview of clinical trials assessing the use of systemic metronidazole (S-MET) as an adjunct to scaling and root planning (S&RP) in the treatment of adult periodontitis. Eight clinical trials were chosen based upon a priori selection criteria, and two outcomes, "reduction in probing pocket depth" (PD) and "gain in clinical attachment level" (CAL), were analyzed. Results for each outcome were stratified by initial PD 1-3 mm, 4-6 mm, or > or = 7 mm and length of follow-up 4-6 wk, 9-13 wk, or 14-26 wk.

Effects of a self-etching primer on enamel shear bond strengths and SEM morphology.

Purpose: To study a dental adhesive system containing a self-etching primer, by evaluating the enamel shear bond strengths and comparing the SEM interfacial morphology.

Materials And Methods: 100 flat enamel bonding sites were prepared to 600-grit on proximal surfaces of caries-free human molars. The bonding surfaces were treated with Clearfil Liner Bond 2 as recommended by the manufacturer, or combined with various acidic etchants.

Restorative considerations with vital tooth bleaching.

This paper explores the implications of bleaching procedures on restorative dentistry. The effects of tooth whitening systems on the bond strength, marginal integrity, color and other properties of restorative materials are reviewed. Also, clinical considerations in combining bleaching and aesthetic restorative techniques are discussed.

The effect of resin desensitizing agents on crown retention.

Many dentists use resin primers and adhesives to prevent post-cementation sensitivity of teeth restored with crowns. However, little information is available regarding the effect of these resins on crown retention. This laboratory study concluded that two popular resins, Gluma Desensitizer (Heraeus Kulzer) and One-Step (Bisco Dental Products), had little or no effect on the retention of crowns luted with zinc phosphate, glass ionomer or resin-modified glass ionomer cements.

Prosthodontic and periodontal considerations for implant-supported dental restorations.

In the past two years, many reports concerning the outcome of treatment using dental implants have included more detailed data which allow insight into prosthodontic and periodontal considerations that affect success. It has become evident that unique biomechanical sequelae reflect the screw-joint character of the dental implant prosthesis. The relative stability of the screw joint and the biomechanical integrity of the components and prostheses themselves are new issues to contend with for restorative dentistry.

Myasthenia gravis: dental treatment considerations.

Myasthenia gravis is an autoimmune neuromuscular disorder that presents challenges for the dental practitioner. Facial and masticatory muscles may be involved and complicate dental treatment. Exacerbations of the skeletal muscle weakness and fatigability that characterize this disorder can be precipitated by certain medications used in dentistry.

Protein characterization of fluorosed human enamel.

Despite extensive investigation, the development mechanism or mechanisms resulting in dental fluorosis are unknown. Several hypotheses suggest abnormal matrix synthesis, secretion, and delayed and/or defective matrix degradation with retention of enamel protein. The purpose of this study was to characterize the protein composition of fluorosed human enamel.

Abnormal enamel development in a cystic fibrosis transgenic mouse model.

Cystic fibrosis (CF) is a hereditary condition that affects cAMP-regulated chloride channels in epithelial tissues due to a defect in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Recently, a transgenic CF mouse model was developed at UNC that exhibits no CFTR expression. Interestingly, the CF mouse demonstrates abnormal incisor enamel.

Nasalance and nasal area values: cross-racial study.

Nasometry and nasal cross-sectional area data were obtained from 80 normal male and female speakers (40 African-Americans and 40 white Americans) all of whom were over the age of 18 and spoke the Mid-Atlantic dialect of American English. The nasalance scores for readings of the Zoo Passage did not differ significantly between the groups. However, nasalance scores for readings of the Nasal Sentences were found to be significantly higher among the white speakers.

Structural and compositional alteration of tooth enamel in hereditary epidermolysis bullosa.

Epidermolysis bullosa (EB) is a group of conditions characterized by basement membrane and cellular defects that result in skin fragility and variable extra-cutaneous involvement. The teeth can be severely affected with marked enamel malformations. The purpose of this study was to characterize the structure and composition of teeth from individuals representing the major EB groups (EB simplex, dystrophic EB and junctional EB).

Resource allocation, health policy, and rationing craniofacial care.

The United States allocates health care without an overt system of rationing. This article analyzes the forces that guide resource allocation to craniofacial care. Various possible allocation systems are reviewed for how decision makers might evaluate proposed programs for legislative funding.