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Complete dentures can be produced with different types of occlusal forms. There is some evidence to suggest that it may be advantageous to provide complete dentures with cusped posterior teeth. The aim of this research was to compare the levels of subject satisfaction with 3 types of posterior occlusal forms for complete dentures, in a randomized cross-over trial design. Forty-five participants were randomly assigned 3 sets of complete dentures with different posterior occlusal forms (zero-degree, anatomic, and lingualized occlusions). Subjective data were collected according to visual analogue scales after 8 weeks of denture-wearing. Statistical analysis consisted of repeated-measures analysis of variance, followed by paired t tests. Lingualized and anatomic occlusal forms were perceived to be significantly superior in terms of chewing ability, when compared with zero-degree posterior occlusal surfaces. [ABSTRACT FROM AUTHOR]

Orofacial pain is often persistent, but it is not clear why it lasts in some patients but not in others. We aimed to describe the natural course of orofacial pain in a general population sample over a four-year period and to identify factors that would predict the persistence of pain. A cross-sectional population-based survey was conducted in the United Kingdom, involving 2504 participants (participation rate 74%), of whom 646 (26%) reported orofacial pain. Overall, 424 (79% adjusted participation rate) of these individuals participated at the four-year follow-up, of whom 229 (54%) reported orofacial pain and 195 (46%) did not report such pain. Persistent orofacial pain was associated with females, older age, psychological distress, widespread body pain, and taking medication for orofacial pain at baseline. These findings may have implications for the identification and treatment of patients with orofacial pain. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to conduct a systematic review of ceramic inlays, assess the quality of published clinical studies, and determine the clinical effectiveness of ceramic inlays compared to other forms of posterior restorations. Prospective clinical trials of ceramic inlays published from 1990 to 2001 were retrieved by electronic and hand searching. The methodological quality of each study was assessed by two calibrated reviewers using a standardised checklist. The clinical effectiveness of ceramic inlays was evaluated in terms of failure rate, postoperative pain, and aesthetics. The results were compared to those of other forms of posterior restorations by means of an odds ratio. Among 46 articles selected for quality assessment, only five (10.6%) reported randomised controlled trials and 15 (32.6%) presented controlled clinical trials. The remaining 26 papers (56.5%) were longitudinal clinical trials lacking control groups. Only three papers fulfilled the requirement for statistical analysis to evaluate the clinical effectiveness of ceramic inlays. The results indicate no significant differences in longevity or postoperative sensitivity between ceramic and other posterior restorations over assessment periods of up to 1 year. It is concluded that no strong evidence is available to confirm the clinical effectiveness of ceramic inlays in comparison to other posterior restorations. Greater attention is required to the design and reporting of studies to improve the quality of clinical trials of ceramic inlays. [ABSTRACT FROM AUTHOR]

The objectives of this study were to determine whether oral prophylactic agents are superior to placebo or no treatment on the incidence of oral mucositis and oral candidiasis for patients with cancer. A Cochrane systematic review was conducted of randomized trials of oral (and topical) prophylactic agents for mucositis and oral candidiasis, anywhere in the world, among patients with cancer (excluding head and neck) who were receiving chemotherapy. Eleven studies were included in the meta-analysis for mucositis. Of the six prophylactic agents used for mucositis, only one--ice chips--was effective (relative risk 0.57, 95% CI 0.43 to 0.77). Fifteen studies were included in the meta-analysis for oral candidiasis. There is evidence that antifungal agents that are partially or fully absorbed from the gastrointestinal tract prevent oral candidiasis and that the partially absorbed agents may be more effective than the fully absorbed agents. The RR for partially absorbed agents was 0.13 (95% CI 0.06 to 0.27). In conclusion, there is weak and unreliable evidence that ice chips prevent mucositis. There is evidence that prophylactic use of antifungal agents, which are absorbed or partially absorbed from the gastrointestinal tract, reduce the clinical signs of oral candidiasis. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether a standard Resuscitation Council (UK) ALS course is appropriate for primary care dentists or whether a course should be specifically designed for dentists.Design: Opinions canvassed by pre-course expectation and post-course evaluation questionnaires.Subjects: 23 West Pennine primary care dentists providing a general anaesthetic or conscious sedation service who attended an ALS course.Results: Knowledge and skills were rated on a 5-point scale from 1 (not important at all) to 5 (extremely important). Basic airway management (mean = 5) and anaphylaxis (mean = 4.9) scored the highest on the 'expectation' questionnaire. Rhythm recognition (P < 0.001), defibrillation (P = 0.007) and arrest algorithms (P = 0.047) were rated as significantly more important after the course than before. Knowledge about rhythm disorder management, cardiac pacing, post-resuscitation care, blood gas interpretation and bereavement were not considered to be so important either before or after the course.Conclusions: Despite rating some aspects as unimportant, all dentists stated that this course had been appropriate. They did not want a specially designed ALS course for dentistry. Taking exactly the same recognised course and assessments as other healthcare professionals and gaining the same certification was felt to be important to this group of dentists. [ABSTRACT FROM AUTHOR]

The aims of this study were (1) to monitor the progression and patterns of progression of loss of attachment ≥ 1 mm on a site basis over a 5-year period in adolescents, and (2) to relate the presence of oral deposits and inflammation to the subsequent development and progression of loss of attachment on a site basis. 167 subjects were examined at ages 14, 16 and 19 years. Loss of attachment ≥ 1 mm, plaque, subgingival calculus, gingival bleeding and gingival colour change were assessed on the mesio-buccal sites of the 1st molars, 1st premolars and central incisors. Each site was treated separately in the analysis to avoid the problem of within-subject site dependence. Sites were classed as progressing, non-progressing or fluctuating according to the probing attachment level measurements at each of the 3 examinations. During the 5 years of this study, a total of 542 sites in 128 subjects progressed; 1136 sites in 162 subjects did not progress: 43 sites in 30 subjects had fluctuating attachment level measurements. Sites which subsequently progressed had significantly more plaque, subgingival calculus and gingival inflammation than non-progressing sites at the baseline examination and throughout the study (p < 0.001). Between 55-57% of the maxillary 1st molars and 46-49% of the mandibular incisors progressed. In contrast, there was no progression of loss of attachment on over 80% of the maxillary central incisors and mandibular 1st premolars. [ABSTRACT FROM AUTHOR]

The article presents a study investigating some features of communicating health messages to young people who are below average in reading and learning abilities. The effective communication with such persons can be influenced by three major factors: their psychosocial needs, the quality of the message channel, and the suitability of the educational material. It was found essential in the study that the health educators consider the psychosocial needs but the factors such as peer group norms and socio-cultural background need special attention.

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An empirical investigation was carried out on data from four caries clinical trials of subjects who were initially 11 to 12 years old. The three baseline variables suggested by Adkins (1977), as possibly being related to caries increment, were each calculated on specific groupings of teeth, and these were then considered as predictor variables for the dependent variable, caries increment. A gain in efficiency of approximately 20% was obtained when an analysis of covariance was used with these predictor variables, over a straightforward analysis of variance. However, this was only slightly more efficient than using baseline DMFS as a covariable. This investigation did not support the results of initial work done by Adkins (1977). [ABSTRACT FROM AUTHOR]

This article presents a speech by P. J. Holloway and H. V. Worthington, delivered at a meeting of the U.S. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research held at the University of Iowa, in which they discussed the role of Institution Review Boards (IRB's) in promoting medical ethics, ethical considerations of the randomized clinical trial (RCT), and ethical considerations of dental caries research.

'Immediate' implants are placed in dental sockets just after tooth extraction. 'Immediate-delayed' implants are those implants inserted after weeks up to about a couple of months to allow for soft tissue healing. 'Delayed' implants are those placed thereafter in partially or completely healed bone. The potential advantages of immediate implants are that treatment time can be shortened and that bone volumes might be partially maintained thus possibly providing good aesthetic results. The potential disadvantages are an increased risk of infection and failures. After implant placement in postextractive sites, gaps can be present between the implant and the bony walls. It is possible to fill these gaps and to augment bone simultaneously to implant placement. There are many techniques to achieve this but it is unclear when augmentation is needed and which could be the best augmentation technique. To evaluate success, complications, aesthetics and patient satisfaction between 'immediate', 'immediate-delayed' and 'delayed' implants. To evaluate whether and when augmentation procedures are necessary and which is the most effective technique. The Cochrane Oral Health Group's Trials Register (to 2 June 2010), CENTRAL ( The Cochrane Library 2010, Issue 2), MEDLINE via OVID (1950 - 2 June 2010) and EMBASE via OVID (1980 - 2 June 2010) were searched. Several dental journals were handsearched. Randomized controlled trials (RCTs) comparing immediate, immediate-delayed and delayed implants, or comparing various bone augmentation procedures around the inserted implants, reporting the outcome of the interventions to at least 1 year after functional loading. Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted independently and in duplicate. Trial authors were contacted for any missing information. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CIs). The statistical unit of the analysis was the patient. Fourteen eligible RCTs were identified but only 7 trials could be included. Four RCTs evaluated implant placement timing. Two RCTs compared immediate versus delayed implants in 126 patients and found no statistically significant differences. One RCT compared immediate-delayed versus delayed implants in 46 patients. After 2 years patients in the immediate-delayed group perceived the time to functional loading significantly shorter, were more satisfied and an independent blinded assessor judged the level of the peri-implant marginal mucosa in relation to that of the adjacent teeth as more appropriate (RR = 1.68; 95% CI 1.04 to 2.72). These differences disappeared 5 years after loading but significantly more complications occurred in the immediate-delayed group (RR = 4.20; 95% CI 1.01 to 17.43). One RCT compared immediate with immediately delayed implants in 16 patients for 2 years and found no differences. Three RCTs evaluated different techniques of bone grafting for implants immediately placed in extraction sockets. No statistically significant difference was observed when evaluating whether autogenous bone is needed in postextractive sites (1 trial with 26 patients) or which was the most effective augmentation technique (2 trials with 56 patients). There is insufficient evidence to determine possible advantages or disadvantages of immediate, immediate-delayed or delayed implants, therefore these preliminary conclusions are based on a few underpowered trials often judged to be at high risk of bias. There is a suggestion that immediate and immediate-delayed implants may be at higher risks of implant failures and complications than delayed implants. On the other hand the aesthetic outcome might be better when placing implants just after teeth extraction. There is not enough reliable evidence supporting or refuting the need for augmentation procedures at immediate implants placed in fresh extraction sockets or whether any of the augmentation techniques are superior to the others. [ABSTRACT FROM AUTHOR]

Background: Treatment of cancer is increasingly effective but associated with short and long-term side effects. Oral side effects, including oral mucositis (mouth ulceration), remain a major source of illness despite the use of a variety of agents to treat them. Objectives: To assess the effectiveness of interventions for treating oral mucositis or its associated pain in patients with cancer receiving chemotherapy or radiotherapy or both. Search strategy: Computerized searches of Cochrane Oral Health Group’s Trials Register; Cochrane Pain, Palliative and Supportive Care Group’s Trials Register; CENTRAL; MEDLINE and EMBASE were undertaken. Reference lists from relevant articles were searched and the authors of eligible trials were contacted to identify trials and obtain additional information. Date of the most recent searches June 2006: CENTRAL (The Cochrane Library 2006, Issue 2). Selection criteria: All randomized controlled trials comparing agents prescribed to treat oral mucositis in people receiving chemotherapy or radiotherapy or both. Outcomes were oral mucositis, time to heal mucositis, oral pain, duration of pain control, dysphagia, systemic infection, amount of analgesia, length of hospitalization, cost and quality of life. Data collection and analysis: Data were independently extracted, in duplicate, by two review authors. Authors were contacted for details of randomization, blindness and withdrawals. Quality assessment was carried out on these three criteria. The Cochrane Oral Health Group statistical guidelines were followed and risk ratio (RR) values calculated using fixed effect models. Main results: Twenty-six trials involving 1353 patients satisfied the inclusion criteria. Four agents, each in single trials, were found to be effective for improving (allopurinol RR 3.33, 95% confidence interval (CI) 1.06 to 10.49; granulocyte macrophage-colony stimulating factor RR 4.23, 95% CI 1.35 to 13.24; immunoglobulin RR 1.81, 95% CI 1.24 to 2.65; human placentral extract RR 4.50, 95% CI 2.29 to 8.86) or eradicating mucositis (allopurinol RR 19.00, 95% CI 1.17 to 307.63). Three of these trials were rated as at moderate risk of bias and one as at high risk of bias. The following agents were not found to be effective: benzydamine HCl, sucralfate, tetrachlorodecaoxide, chlorhexidine and ‘magic’ (lidocaine solution, diphenhydramine hydrochloride and aluminum hydroxide suspension). Six trials compared the time to heal and mucositis was found to heal more quickly with two interventions: granulocyte macrophage-colony stimulating factor when compared to povidone iodine, with mean difference −3.5 days (95% CI −4.1 to −2.9) and allopurinol compared to placebo, with mean difference −4.5 days (95% CI −5.8 to −3.2). Three trials compared patient controlled analgesia (PCA) to the continuous infusion method for controlling pain. There was no evidence of a difference, however, less opiate was used per hour for PCA, and the duration of pain was shorter. One trial demonstrated that pharmacokinetically based analgesia (PKPCA) reduced pain compared with PCA: however, more opiate was used with PKPCA. Authors’ conclusions: There is weak and unreliable evidence that allopurinol mouthwash, granulocyte macrophage-colony stimulating factor, immunoglobulin or human placental extract improve or eradicate mucositis. There is no evidence that patient controlled analgesia (PCA) is better than continuous infusion method for controlling pain, however, less opiate was used per hour, and duration of pain was shorter, for PCA. Further, well designed, placebo-controlled trials assessing the effectiveness of allopurinol mouthwash, granulocyte macrophage-colony stimulating factor, immunoglobulin, human placental extract, other interventions investigated in this review and new interventions for treating mucositis are needed. [ABSTRACT FROM AUTHOR]

The article reports on the study that evaluates to ability Electronic Carries Monitor (ECM) to predict the development of dentine caries in the occlusal surfaces of second permanent molar teeth. It shows that ECM has the capacity to detect early, non-cavitated lesions which can potentially remineralise. It suggests that ECM was a good predictor of the surfaces that would develop caries or be restored during an 18 month period.

An abstract is presented for a systematic review of research about the therapeutic use of hyperbaric oxygen for irradiated dental implant patients.

A proprietary calcium hydroxide paste, Reogan Rapid, that previously has been demonstrated to induce apical closure in non-vital immature incisor teeth, was becoming unavailable. A prospective clinical trial was conducted to compare Reogan Rapid with another proprietary paste, Hypo-cal. For teeth treated with Reogan Rapid apical closure was obtained in an average of 6.8 months involving 3.1 visits and the respective figures for teeth treated with Hypo-cal were 5. 1 months and 2.4 visits. These results demonstrated that Hypo-cal was as effective as Reogan Rapid when used in a standardised technique for inducing apical closure. [ABSTRACT FROM AUTHOR]