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than in 2002 (41%), P= 0.027. ABPM recordings showed significantly fewer undiagnosed hypertensive individuals in 2012 (14%) that in 2002 (28%), P< 0.001. Significantly more hypertensive individuals were optimally treated in 2012, (44%) versus (19%), P < 0.001. Minimum and mean systolic BP were significantly lower in the 2012 cohort, but maximum systolic BP and diastolic BP did not differ. Use of ACE inhibitor, angiotensin receptor blockers and diuretics had significantly increased over the 10-year interval. Patient reported rates of falls, dizziness and syncope had not risen significantly. Ischaemic heart disease was significantly less common in the 2012 cohort, P< 0.05. Conclusion: Hypertension in older people is better recognised and more effectively managed now than 10 years ago. This has not been associated with a significant change in rates of falls, dizziness or syncope.

This paper describes the dental care provided at an English hospice. Dental care is felt to be important because the ability to enjoy food is an important element in the quality of life. Over a three-year period, 67 patients were referred for dental advice of whom all but four were edentulous. The commonest complaint was of ill-fitting dentures, and the causes and possible solutions to this problem are reviewed.

A case is described where an abdominal fistula was temporarily closed using a plug made from dental addition curing silicone rubber impression material. An effective seal was maintained using a stoma flange and a gentle pressure dressing; this still allowed normal gastric function.

Objective Aim of the present study was to evaluate the clinical suitability of the condensable metal-reinforced glass ionomer cement Hi-Dense in classes I and II cavities of primary molars. Methods Seventeen children received a total of fifty four Hi-Dense fillings (nineteen class I and thirty five class II). The restorations were clinically assessed at baseline, after one and after two years of clinical service according to modified USPHS codes and criteria. The restorations were replicated in each recall and representative samples were qualitatively analysed under a SEM. Results Over the observation period of two years, five restorations failed due to total retention loss, two fillings needed replacement because of persisting hypersensitivity, one filling was lost because of an unsuccessful endodontic treatment, and four restorations remained intact until natural exfoliation (Two year survival rate: 92% for Class I and 66% for Class II). The SEM analysis of surfaces and marginal areas exhibited an inferior adhesive performance primarily in proximal areas, whereas a negative step formation due to wear was frequently observed in occlusal parts. Conclusions The results clearly indicate that the condensable, metal-reinforced GIC Hi-Dense reveals no enhanced performance and lifetime expectancy for class II restorations in primary molars when compared to other non-resin-modified GICs.

Objective To compile an inventory of data from clinical studies on anterior veneer restorations, with special reference to clinical trials to produce a mean survival result using a meta-analysis. Data sources Medline search 1983 to November 1996 using key words ‘dental’ and ‘Veneer’. Study selection A two-stage selection was employed. Initially all non-clinical studies case reports and descriptive papers were excluded. Subsequently all papers which did not meet the following criteria were excluded: English language, 2-year or more follow-up, type, number and location of restoration noted, number of patients stated together with type of restoration, study outcome shown as failure or survival. A quality scoring system was applied to the selected papers and used in combination with the sample size for combining the studies. Results Initially 1056 studies were identified after the initial selection 25 clinical studies remained; this was reduced to 15 at the subsequent selection. Two further studies were excluded, as their data did not allow calculation of survival curves. The cumulative proportion of survival for porcelain and pre-formed acrylic veneer restoration after 3 years is shown in the table below. Conclusion Porcelain veneers show acceptable longevity after 3 years, which appears better than the preformed acrylic type. The evaluative and statistical analysis of clinical veneer restoration studies may be improved. Kreulen C M, Creugers N H J, Meijering A C. Meta-analysis of anterior veneer restorations in clinical studies. J Dent 1998; 26: 345–353