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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 study examines the effect of preparing teeth with six varying convergence angles (ranging between 12 and 120 degrees) and height (1 and 2 mm) on the retention of cast gold crowns. Six groups of 4 human premolar teeth were prepared to give a flat occlusal surface in dentine with very short axial wall heights (1 or 2 mm) and variation in axial wall convergence (between 12 and 120 degrees). Impressions were recorded of the prepared teeth and custom castings made using a high copper content precious metal alloy. The castings were luted with an adhesive resin and stored in water at 37 degrees C for 24 hours prior to determining the pull-off force in an Instron Universal testing Machine at a cross head speed of 1mm min(-1). Twenty two of the twenty four tested specimens failed within the dentine of the tooth, irrespective of preparation orientation. Statistical testing using ANOVA demonstrated that there were no differences between the bond strength values for any of the preparation convergence angles or between preparations with 1 and 2 mm axial wall heights. This suggests that attachment strength of adhesively bonded castings with minimal axial wall height preparations is not influenced by the convergence angle of the preparation. The attachment strength exceeded that cohesive strength of the underlying dentine in nearly all of the adhesively luted restorations.

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.

The shear bond strength of three adhesives, Panavia 21, Superbond, All Bond CB Cement, and a dual cure resin (Variolink), to Ni-Cr-Be (Rexillium III), Midigold (Type III gold) and Amalgam (Sybraloy) were determined. Fifteen samples were prepared using 800 grit abrasive papers for Ni-Cr and Midi-Gold, and 100 grit papers for amalgam. Ni-Cr-Be and Midi-Gold samples were sandblasted for 30 s and steam cleaned for 10 s. The adhesives were bonded to the samples using gelatine capsules and were matured for 24 h in water at 37 degrees C. The samples were debonded in shear using an Instron at a cross-head speed of 1 mm/min. The data was analysed using ANOVA and a Tukey test. The bond strength of Superbond to both metal alloys was significantly higher (P0.05) than any of the materials tested, with the exception Panavia 21 to gold. The bond strength of All Bond CB cement had shown to be not significant difference from those of Panavia 21 and Variolink, when bonded to Rexillium and Midi-Gold, respectively. The bond strength of All Bond CB Cement to amalgam was significantly greater (P0.05) than those of the other materials tested. The shear bond strength to gold showed lower bonding for all adhesives when compared with Rexillium (P.001). The ranking of bond strength to both alloys was as follows: SuperbondPanavia 21All Bond CBVariolink. The nature of substrate to be used for bonding and the adhesive material itself are important factors in bonding which can be achieved between cast metals and prepared teeth with amalgam filling. Superbond should be successful as an adhesive for the attachment of all substrates tested, with the possible exception of amalgam, for which All Bond CB Cement gives the best result.

The volumetric contraction of a variety of luting agents, including Panavia 21, All-Bond CB Cement, Superbond., Variolink and zinc phosphate cement, was assessed and compared using a minimal transducer The contraction among the materials tested was determined from the post-gel linear displacement of a deflecting coverslip resting on 4 silicone rubber spacers between which a mixed material was centrally located. Finally, the rate and duration of shrinkage over a period of 60 minutes from the moment of rigid contraction for all materials were investigated, and the final shrinkage values among the materials tested were compared. The analysis of variance showed that there were highly significant differences (P0.001) between the materials and the mean of each group was significantly different from that of any of the other groups (Tukey's test). Superbond produced the highest values of the final polymerisation shrinkage, followed by All bond CB, Variolink, Panavia 21 and zinc phosphate cement respectively. Also, there was a marked variation in the overall magnitude of shrinkage (from 1.34% to 4.62%) among the materials tested. The method used to measure the polymerisation shrinkage in the present study was shown to be a precise measure in that it produced consistent and reproducible results. It can also offer the ability to observe the development of polymerisation shrinkage against time, during the post-gelation phase, for a range of chemically-cured resin materials.

The Swiss Health Surveys are conducted every 5 yr, and alternate surveys contain information on oral health. Worldwide the population is ageing and oral health is improving. The aim of this study was to identify if these trends are continuing in a relatively affluent society with low levels of edentulousness. Participants in the 1992 and 2002 surveys completed a written questionnaire including items on oral health (response rates 75% and 86% respectively). Data were weighted and bivariate analyses were performed to calculate the average number of missing teeth and the prevalence of different prosthetic dental restorations for each cohort. Over the 10-yr period the proportion of subjects retaining all natural teeth increased, and the mean number of teeth increased, on average, by 1.3. Among those who required prosthetic dental restorations, fixed restorations increased and complete denture use was reduced. Strikingly, 4.4% of this sample reported having oral implants in 2002. Greater numbers of missing teeth and a higher prevalence of use of removable prostheses were still seen in women, in those who had only completed compulsory education, in subjects from families with low income, in those who smoke, and in those who were overweight, in 2002.

The film thickness and rheological properties [viscosity and tan sigma], of different resin based crown and bridge luting agents, including Panavia 21, Superbond, All Bond CB Cement, Variolink were compared with zinc phosphate cement. A modification of the method in ISO 9917 (1991) and a controlled stress rheometer were used to monitor the changes in the film thickness and rheological properties respectively. For each material, the film thickness and rheological characteristics were determined at 60s after start of mixing and then made at regular intervals until immediately before the material was set. For the initial film thickness, the difference among the values for Varionk, Superbond and zinc phosphate cement was not significant (P0.05), and less than 25microm. The values for All Bond CB Cement and Panavia 21 were at least twice that of the other materials tested. All Bond CB Cement produced the highest film thickness value at both the initial period and at 240s. Regarding viscosity, Superbond had the lowest initial value but the highest value at 240s. Variolink gave the highest initial value of viscosity, but the differences in the initial values among the other materials were small. During the whole period of testing, zinc phosphate cement gave the highest values of tan sigma, and Panavia 21 showed no significant change in any of the measured properties. The methods were able to distinguish the behaviour of different cement materials. Some resin cements produce larger than optimal values of film thickness and in some cases this is related to a rapid increase in viscosity after mixing. It is expected that differences in the ability of cements to form thin films will affect the seating of cemented restorations.

The aim of this study was to investigate the impact of both population age changes and falling edentulism rate on the denture market in three European countries.Detailed information on the rate of edentulism for only three European countries (Finland, Sweden, and the UK) was available. For the UK and Sweden, published predicted rates of edentulism for the future decades were used, whereas predictions for Finland were computed using published edentulism rates. Edentulousness in one jaw was also predicted and included in the computation. Demographic projections were taken from government agency websites.The denture market will decrease in the three countries. Sweden, where edentulism is already low, will experience the largest percentage decrease (60%) over 20 years, but, in absolute number, the change will be of smaller magnitude than that in the UK and Finland. The range of projections for Finland was large, reflecting the difficulty of predicting trends with incomplete information. Within the limitations of this study's design, the impact of population age changes will not increase the denture market in Europe, even with the most pessimistic projections for edentulism rate.The complete denture market in Europe will fall despite changing age demographics. The falling rates are large enough to markedly affect future patterns of treatment provision and training.

In this study, the penetration of three proprietary dentine-bonding agents (PrimeBond 2.1, Single Bond, Liner Bond 2) and experimental dentine-bonding systems incorporating an antibacterial monomer, 12-methacryloyloxydodecylpyridinium bromide (MDPB), into artificial root caries lesions was evaluated, and the bactericidal activity of each material against Streptococcus mutans or Lactobacillus casei impregnated into demineralized dentine blocks was assessed. All of the commercial dentine-bonding agents were capable of penetrating into the artificial carious lesions to more than 150 microm. The depth of penetration of the experimental systems, which were based on Liner Bond 2, was not significantly different from that of their parent product. Liner Bond 2 primer exhibited the greatest bactericidal effects among the three proprietary dentine-bonding agents tested. Bactericidal activities of experimental primers containing MDPB were greater than those of any other products, and the application of 4% MDPB-containing primer resulted in complete killing of bacteria in demineralized dentine. The results indicate that the penetration of dentine-bonding agents into extensively demineralized root dentine is possible in vitro, and the experimental dentine-bonding systems containing the antibacterial monomer MDPB are capable of killing bacteria within demineralized dentine. This could be of benefit when managing root caries lesions.

Objective To determine the effect on the bond strength of modern dentine bonding agents to etched enamel of surface contamination with water. Design Fifteen bond strength measurements were made for bonds prepared to both moist and dry etched enamel for each of three test and one control materials. Results For two materials (Scotchbond 1 and Prime and Bond 2.1) the bond strength was not affected by the presence of water on the etched enamel surface. A mean bond strength in excess of 25 MPa was achieved for both materials under all conditions. One material (Optibond Solo) showed a 30% increase in bond strength when bonds were formed under wet condition (21.10 MPa compared with 15.35 MPa). The bond strength of the control material, a conventional unfilled bonding resin, decreased markedly with aqueous contamination (9.14 MPa compared with 26.75 MPa). Conclusion Etched enamel should be rehydrated routinely prior to bonding composite resin to its surface using a water displacing dentine bonding system.

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.

A patient presented with recurrent facial dermatitis associated with dental work. Dermatology referral identified the cause as allergic contact dermatitis to the epoxy acrylate BIS-GMA. Occupationally-induced allergic contact dermatitis to epoxy resin was also demonstrated. A structurally distinct aliphatic acrylate was successfully substituted. Contact sensitivity to BIS-GMA is reviewed and the potential for epoxy sensitive patients to cross-react to BIS-GMA is discussed.

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