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A case of localized juvenile periodontitis with bone loss affecting molars and premolars with advanced destruction around the lower first molars is described. These lesions were associated with areas of excess occlusal trauma. The ramifications of combined therapy aimed at the elimination and control of both the inflammatory and occlusal components of the disease are discussed relative to the successful treatment of this case. A description of the periodontal status of a sibling of the patient has been included. Extensive defects are associated with the anterior teeth and in this case the patient presented with excessive trauma in the anterior region. Considering the localities of the disease and the similarities between the inflammatory components in both cases, a link between occlusal trauma and Juvenile periodontitis is discussed. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Periodontology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Periodontology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Periodontology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Ectodermal dysplasia (ED) is a rare inherited disorder that affects structures derived from embryonic ectoderm. Due to associated ridge deficiency, and anodontia found in these patients, multiple surgeries are often indicated before replacement of missing teeth with implants, resulting in increased morbidity and treatment time., Materials and Methods: In this case report, a 31-year-old woman was transitioned from failing tooth-supported fixed restorations to a fully implant-supported fixed prosthesis using immediate implants and narrow diameter implants (NDI). By using some of her existing dentition to support the provisional restorations while osseointegration took place, the patient was able to retain function during treatment. Full-fixed implant-supported prostheses were delivered, providing an esthetic and functional outcome that has been maintained for 3 years., Conclusion: In ED patients, NDI together with immediate implant placement can be used successfully to support a complete fixed restoration and should be considered as an alternative to major reconstruction surgeries. Key factors associated with increased predictability are discussed together with a review of the literature.

Objectives: Most data on HIV prevalence in low-risk populations in sub-Saharan Africa are drawn from sentinel surveys of pregnant women attending antenatal clinics and are not representative of formal sector workforces. We surveyed workforces in southern Africa to determine HIV prevalence among formally employed, largely male populations., Methods: Voluntary, anonymous, unlinked seroprevalence surveys of 34 workforces with 44,000 employees were carried out in South Africa, Botswana, and Zambia in 2000-2001. Results were stratified to obtain estimates of prevalence by industrial sector, location, age, sex, and job level., Results: Average HIV prevalence for the entire sample was 16.6% (95% CI: 16.3-17.0%). Country-wide prevalence was 14.5% (14.1-14.9%) in South Africa, 17.9% (17.1-18.7%) in Zambia, and 24.6% (23.6-25.7%) in Botswana. Among industrial sectors, mining (18.0%, 17.6-18.5%) and metal processing (17.3%, 15.9-18.7%) had the highest infection rates. Males, who comprised 85% of participants of known sex, were more likely (16.3%, 15.3-17.4%) to be infected than were females (10.7%, 8.7-12.7%). Contract (23%, 21.9-24.1%), unskilled (18.3%, 17.5-19.1%), and semi-skilled workers (18.7%, 18.1-19.4%) were much more likely to be infected than were skilled workers (10.5%, 9.5-11.4%) and managers (4.5%, 3.4-5.6%). Participation in the surveys averaged 63% of eligible employees., Conclusions: HIV prevalence among formally employed workers in southern Africa shows different patterns than among antenatal clinic attendees. Anonymous workplace surveys generate prevalence estimates for demographic groups that are not represented in antenatal surveys and can strengthen support for prevention and treatment interventions.

The Evian Debridement Bur facilitates two fundamental techniques in periodontal surgery--soft-tissue debridement and root planing. The bur debrides granulation and other soft tissues attached to the root or bone and removes hard deposits from root surfaces. It can also be used as an adjunct while performing crown-lengthening procedures and endodontic surgery. The bur is made with blunted flutes and, if used with a relatively light touch, will not cut into the alveolus and will not damage the tooth surface. This article reviews the use and advantages of this bur and shows its effect on the root surface at the ultrastructural level.

Although nonsubmerged implant surgery can reduce patient trauma and costs by eliminating the uncovering procedure, one-piece implants cannot be shortened for esthetic results. However, a new implant design that comes preattached on a multipurpose collar is used for insertion, nonsubmerged healing, and as an abutment base. For submucosal margins, the collar can be replaced by an esthetic abutment that connects directly to the implant. Surface treatments include midsections roughened by hydroxyapatite or titanium plasma spray coatings, with smoother, acid-etched necks and self-tapping apical ends. Screw-retained, friction-fit abutments offer prosthodontic stability and uniformity, despite the submucosal implant type.

This article compares the survival rates of two root-form implants-hydroxyapatite-coated (HA-coated) Micro-Vent and pure titanium Swede-Vent implants-during a 6-year period. A total of 390 implants were placed in 166 patients aged 18 to 81 years. Fifteen implants were lost before prosthesis placement, and one was lost after prosthesis loading. The overall success rates were 96.8% for the HA-coated Micro-Vent implants and 95.2% for the titanium Swede-Vent implants. The survival rates were similar for both the maxilla and the mandible and for the anterior and the posterior areas. Although most of the HA-coated implants were generally placed in types III and IV bone, results indicated that the survival rate was similar to that of pure titanium implants, which were placed more often in types I and II bone.

Failure to osseointegrate traditionally mandates immediate implant removal, followed by a 1-year healing period before placing a second implant into the same area. This report presents five cases in which failed screw-type, commercially pure titanium implants were immediately replaced by ledge-type, hydroxyapatite-coated, Ti-6Al-4V implants in the same sockets. These cases suggest that the 1-year healing period may not be necessary, provided that (1) the socket can be reprepared to eliminate thread grooves and invasive soft tissue, (2) the replacement implant is larger in diameter than the original implant, and (3) sufficient available bone remains for the procedures.

The purpose of this study was to evaluate the use of autogenous gingival grafts as barriers for endosseous implants placed directly into fresh extraction sockets. This study consisted of four patients who presented with hopeless teeth due to endodontic pathology, caries, or root resorption. In all cases, the teeth in question were extracted at the Stage 1 surgery. An endosseous root form implant was immediately placed into the extraction socket in each case. As a consequence of immediate placement, there was a lack of primary closure over the fixture and a large space was present between the fixture and the remaining alveolus. An autogenous gingival graft was sutured in place to cover the fixture and act as a physical barrier to epithelium, food debris, and possibly bacteria. At the Stage 2 surgery, all implants achieved complete osseointegration clinically and radiographically. The results at 16 to 24 months reveal continued success in all four cases. This report demonstrates the potential of autogenous gingival grafts in immediate implant placement. A clinical trial to fully assess the potential of this procedure is recommended.

Excessive gingiva can result from delayed or altered tooth eruption. This condition should be considered in restorative dentistry, orthodontic and esthetic treatment.

A cavity was prepared in a submerged and impacted maxillary canine in the location of a missing lateral incisor. An 8-mm-long Screw-Vent implant was threaded into the site to function as a dental pin via mechanical retention. A Swede-Vent implant was placed in the area of the adjacent central incisor. After a 6-month submerged healing period, the Swede-Vent implant had clinically osseointegrated, and no breakdown of the dental tissue around the Screw-Vent implant was observed. The implants were restored with a two-unit splinted fixed prosthesis.

The Johannesburg City Health Department embarked on an AIDS awareness campaign using messages placed on the outside of 30 city buses. The selection of the message and the campaign are outlined briefly. An evaluation to assess the overall effectiveness and the cost-effectiveness of using buses as a "vehicle' for exposing the local community to AIDS awareness messages is described. Two cross-sectional studies using telephone interviews were done 2 1/2 and 6 months after the campaign began; 30.2% and 31.5%, respectively, of respondents had seen the message. Accurate recall of the message was generally poor. The overall cost of the campaign was R7 627. Various other aspects of the study are discussed. The study revealed that signs on buses are a cost-effective means of conveying simple and brief health-related messages.

In January 1989, the Johannesburg City Health Department developed an AIDS education poster. The poster was adapted from a cartoon in the Sowetan newspaper and was formally evaluated before its final production. As a result of this evaluation further editing and restructuring of the poster proved necessary. The methodology used in the evaluation is outlined, and some of the findings that emerged during the evaluation are discussed, since few formal evaluations of health education material seem to have been documented in South Africa. This study highlights the importance of formative evaluation of printed health educational media by a sample of the target audience before production and distribution.

The purpose of this study was to examine the variability in bacterial proportions between individual periodontal sites in patients with chronic periodontitis by means of differential dark-field microscopy. Fourteen patients with untreated, moderate to advanced disease were included. Probing depth, plaque and gingival index scores were recorded for each patient. Microbial samples were collected from the tooth surface with the greatest proving depth in each sextant and examined individually by dark-field microscopy. The results indicated that proportions of spirochetes and motile rods at any given probing depth varied considerably, ranging from those expected at healthy sites to those expected at diseased sites. In accordance with previous studies, mean percentages of spirochetes tended to vary directly with increased PD, PlI and GI scores, while mean percentages of coccoid cells tended to follow a reverse pattern. However, no significant correlations could be demonstrated when measurements from individual sites were analyzed. Most of the variance in the data was due to differences between subjects rather than differences between sites. It is postulated that the large variance between subjects and sites is due in part to the cyclical nature of the disease and to the lack of synchrony between remissions and exacerbations at different sites and in different patients.

Ninety-two subjects with a history of treatment for chronic periodontitis were monitored on a regular basis for an average period of 10.7 months. During this monitoring period, in spite of their participation in a preventive maintenance program, 19 subjects out of 92 showed evidence of significantly increased probing depth (greater than or equal to 3 mm from base line measurements) on at least one tooth surface, or approximately 1% of the dental units at risk in this population. A comparison of differential microscopic counts of subgingival bacteria from the affected tooth surfaces with a pooled sample of 6 other surfaces with the greatest probing depth, in the same mouth, taken at the same appointment, revealed no significant differences between proportions of coccoid cells, spirochetes, motile rods or other cell types. These findings suggest that disease recurrence, as measured by a comparatively rapid increase in probing depth, might be accounted for on the basis of the following hypotheses: an alteration in the host response without a detectable change in the composition of the subgingival microbiota, a qualitative change in the microbial flora not detectable by a microscopic assay, relatively brief episodes of disease activity which may be accompanied by brief, transient, qualitative changes in the local microbiota that cannot be readily detected by biannual examinations.