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Special thanks to Dr B Praveen for compiling this abstract
 1. Enamel de/remineralization on teeth adjacent to fluoride releasing materials
 2. Interproximal caries; Fluoridated dentifrice; Demineralization; Remineralization
 3. Primary molars; Amalgam restorations; Dyract;rM restorations
 4. Oligodontia; Anodontia; Prostheses
 5. Orofacial myofunctional therapy; Cephalometric radiograph; Pediatric dentistry
 6. Transposition of incisor and canine; Treatment
 7. Children; Oral burns; Thermal burns
 8. Native Americans; Parenting practices; Bottle as pacifier
 9. Nursing caries; Early childhood caries; Caries distribution; Children; Texas
10. Developmental disabilities; Mental retardation; Dental education
11. Surgical Management of Intraosseous Skull Base Tumors with Aid of Operating Arm System
12. Deformable Modeling of Facial Tissue for Craniofacial Surgery Simulation
13. Navigation in Maxillofacial and Craniofacial Surgery

Bynum, Ann M. and Donly, Kevin J.: Enamel de/remineralization on teeth adjacent to fluoride releasing materials with and without dentifrice exposure. J Dent Child, 66:89-92, March-April 1999.
Interproximal caries presents a continual clinical concern. The purpose of this study was to evaluate the ability of fluoride-releasing materials to remineralize incipient caries lesions on adjacent teeth, at the interproximal site with and without exposure to a fluoridated dentifrice. Thirty extracted teeth had Class II preparations placed, then equal numbers were restored with amalgam (Tytin (3-Kerr), glass ionomer (Ketac Fil;rM-ESPE) or composite (Heliomolar ;rM-Ivoclar). Thirty additional teeth had 1 x 5 mm artificial caries lesions formed at the interproximal contact point. One hundred ;gmm thick sections were obtained at the caries sites and polarized photomicrographs were taken. The sections had varnish placed, leaving only the external section site exposed, and were situated back into the original tooth. These teeth were then mounted with the artificial lesion having an interproximal contact with the adjacent tooth restoration. Specimens were placed in closed environments of artificial saliva for two weeks; the saliva was changed every forty-eight hours. All teeth were cycled through an artificial caries system for thirty minutes, three times per day. Half the specimens in each group were brushed with Crest;rM (Procter and Gamble) for two minutes, twice per day.

The same sections were again photographed under polarized light and areas of the lesions were digitized quantitatively. Results demonstrated the mean (;pmS.D.) percent change in lesion size (water imbibition) for each material nonexposed and exposed to fluoridated dentifrice to be: Amalgam ;ms64.1 ;pm 22.0, ;ms1.0 ;pm8.5; Glass Ionomer 2.2 ;pm10.6, 14.0 ;pm7.2; Composite;ms28.1 ;pm11.7, 18.2 ;pm6.7. Negative numbers represent demineralization and positive numbers represent remineralization. Duncan's analysis indicated the nonbrushed fluoride-releasing glass ionomer and composite resin to have significantly greater demineralization inhibition compared to the nonbrushed amalgam group and remineralization enhancement effects on adjacent interproximal lesions (p ;lt 0.05) compared to the brushed amalgam group.

Interproximal caries; Fluoridated dentifrice; Demineralization; Remineralization

Mass, Eliyahu; Gordon, Moshe; Fuks, Anna B.: Assessment of compomer proximal restorations in primary molars: a retrospective study in children. J Dent Child, 66:93-97, March-April 1999.

The aim of the present retrospective study was to observe the clinical and radiographic performances of a compomer (Dyract;rM) in proximal restorations of primary molars as compared to amalgam restorations. The study was performed at the principal investigator's office. Children between three to eleven years old, who had at least two primary molars with a small to moderate approximal caries lesion were included in the study. The assessed material consisted of 107 proximal restorations (63 Dyract;rM and 44 amalgam) placed in primary molars during the years 1994 to 1997 in forty-two children who were available for follow-up examinations. All the evaluated restorations were clinically acceptable, with smooth surface appearance, satisfactory color match, neither secondary caries nor fracture. The margins of two Dyract;rM restorations presented minimal stain. Of the 63 Dyract;rM restorations evaluated radiographically, two presented with bubbles, one with an overhang, and nine had pooling at the tooth-restoration interface. Minimal overhangs were disclosed in six amalgam restorations, and neither bubbles nor defects were seen at the tooth-restoration interface. These differences were statistically significant (p;lt0.001).

Based on the clinical performance of the material and on the radiographic findings, the authors conclude that Dyract;rM can be a suitable alternative for restoring primary teeth that need to be retained up to two years. More extensive follow-up is needed to assess longer-term performance.

Primary molars; Amalgam restorations; Dyract;rM restorations

Mussa, Roxana; Esposito, Salvatore J.; Cowper, Thomas R.: The use of colored elastomeric "Os" as a motivational instrument for patients with anodontia: Report of case. J Dent Child, 66:98-102, March-April 1999.

Complete and/or removable partial dentures are the most commonly selected treatment for the prosthodontic management of young patients who present with oligodontia or anodontia such as in the case of patients with ectodermal dysplasia. Bakri, Belanger and Nowak have reported on the different ways that these prostheses can be modified to ease the child's burden of growing up with missing teeth and having to wear prostheses that make them different from their peers.<+>1-3

Some of their suggestions include the placement of diastemas, the use of artificial "baby" teeth and their subsequent replacement with permanent teeth to simulate the primary and mixed dentition stages. They have also recommended deleting primary teeth to mimic the normal exfoliation pattern. The purpose of this article is to report the attitude change and improvement in self-esteem experienced by two young girls from the simple addition of colored elastomeric molded "Os" to the orthodontic appliances placed on their prostheses.

Oligodontia; Anodontia; Prostheses Haruki, Takanobu; Kishi, Kanji; Zimmerman, Joseph: The importance of orofacial myofunctional therapy in pediatric dentistry: Reports of two cases. J Dent Child, 66:103-109, March-April 1999.
It is essential that the practitioner determine the factors that arc etiologically operative in oral myofunctional therapy in order to establish effective methods of intervention. Of these methods, cephalometrics and facial analysis are especially valuable in revealing and differentiating open-bite syndrome. We indicated two cases treated with only the theory of myofunctional therapy and evaluated with cephalometric radiographs and intraoral photos. This is the first report to evaluate for treatment change of myofunctional therapy with cephalometric radiographs.
Orofacial myofunctional therapy; Cephalometric radiograph; Pediatric dentistry Taner, T;auulin and Uzami;als, Meryem: Orthodontic management of mandibular later-incisor-canine transpositions: Reports of cases. J Dent Child, 66:110-115, March-April 1999.
This article presents different treatment aspects in three mandibular lateral incisor-canine transposition cases. The early identification of transposed teeth simplifies orthodontic correction. Incomplete transposition cases can be managed successfully by interceptive orthodontic treatment. If complete transposition occurs, two treatment alternatives may be possible: Extraction of the transposed tooth or keep the teeth in their transposed positions.
Transposition of incisor and canine; Treatment Milano, Michael: Oral electrical and thermal burns in children: Review and report of case. J Dent Child, 66:116-119, March-April 1999.

Oral burns in children, whether electrical or thermal, can result in severe local and systemic complications. Use of an oral burn splint following perioral electrical burns in children is a widely accepted treatment. It is felt that these appliances reduce oral scarring and, in some cases, may eliminate the need for future surgical procedures. These appliances, however, can also be beneficial in case of thermal burns in children.

Children; Oral burns; Thermal burns

Weinstein, Philip; Troyer, Rick; Jacobi, Deborah et al

: Dental experiences and parenting practices of native American mothers and caretakers: What we can learn for the prevention of BBTD. J Dent Child, 66:120-126, March-April 1999.

This study, attempts to gather information concerning the dental experiences, beliefs, and parenting practices of Native Americans. Five Native American women were trained to conduct interviews in their own language. After pilot testing, seventeen questions were asked. Sixty- two interviews were tape-recorded and transcribed. Content analysis was performed on the transcriptions. Results indicate maternal and caretaker upset and displeasure with the dental experiences of adults and children. Fear and pain were prominent. Parenting practices indicate children are expected to clean their own teeth at about a year of age and parental awareness of risks associated with sleeping with a bottle. About half of the mothers and caretakers who used a bottle as a pacifier report engaging in one or more protective activities such as removing the bottle when the child falls asleep. Mothers and caretakers with greater parenting experience are likelier to be aware of these protective activities. In conclusion, results of this study highlight the importance of providing positive dental experiences for mothers and caretakers and the need to be aware of actual parenting practices before making recommendations or counseling mothers or caretakers.

Native Americans; Parenting practices; Bottle as pacifier
Quartey, James B. and Williamson, Dan D.: Prevalence of early childhood caries at Harris county clinics. J Dent Child, 66:127-131, March-April 1999.

Nursing caries has been found to be positively associated with children from families of low socioeconomic status. The Harris County Health Department (HCHD) serves a population consisting predominately of low-income, low-educational-level clients who reside in the suburban areas surrounding Houston, Texas. The purpose of this study was to determine the prevalence of early childhood caries and nursing caries among patients of the HCHD dental clinics. The study method was a retrospective chart review of all patients seen at the HCHD dental clinics within the two years before the study. There were 135 children in the sample, with a mean age of fifty-seven months. About half of the children had a quarter (five or more) of their primary teeth filled or decayed. The prevalence of early childhood caries was 76 percent and 44 percent of the children were classified in the group with nursing caries. The prevalence of early childhood caries and nursing caries among patients from low socioeconomic families is still high.
Nursing caries; Early childhood caries; Caries distribution; Children; Texas
Romer, Maureen; Dougherty, Nancy; Amores-Lafleur, Evangeline: Paving the way to better access? Education in special care dentistry at the predoctoral level. J Dent Child, 66:132-135, March-April 1999.

The number of people with mental retardation and developmental disabilities (MR/DD) living in small community-based group residences is increasing throughout the United States. Dental services to this population, once provided in large institutional settings, must increasingly be sought at the community level.

The purpose of this study was to determine whether U.S. and Canadian dental schools are adequately training their students to provide quality dental care to this group with complex psychosocial and medical issues.

With a response rate of 78 percent to a mail survey, it was found that 53 percent of the schools provide less than five hours of didactic training in special care dentistry. Clinical training in this area comprised only 0-5 percent of predoctoral students' time in 73 percent of the responding schools.

Developmental disabilities; Mental retardation; Dental education
Waldman, H. Barry and Swerdloff, Mark: Health insurance for children: A new federal initiative and opportunity. J Dent Child, 66:136-139, March-April 1999.

In 1997, Congress enacted the State Children's Health Insurance Program to extend health insurance coverage to low-income children who are ineligible for other insurance, including Medicaid. The program is reviewed and considered in terms of children's access to health care and their health status.

Surgical Management of Intraosseous Skull Base Tumors with Aid of Operating Arm System
Christoph Schul, M.D., Hansdetlef Wassmann, M.D., Gero Bernd Skopp, M.D.,Marin Marinov, M.D., PH.D., Johannes Wölfer, M.D., Gerhard Schuierer, M.D.,Ulrich Joos, M.D., and Normann Willich, M.D.Neurosurgical (C.S., H.W., G.B.S., J.W.), Maxillofacial (U.J.), andRadiooncological (G.S., N.W.) University Clinics, Münster, Germany, andNeurosurgical Clinic at the Faculty Hospital, St. Ann, Sofia, Bulgaria (M.M.)


Invasion of bone and critical neurovascular structures often impedes complete resection of intraosseous skull base neoplasms, and these lesions tend to recur unless all infiltrated bone is removed. Evolving experience with image guidance over the past few years indicates the potential value of neuronavigation in skull base lesions diffusely infiltrating or fixed to bone structures. We report our early experience with the Radionics® Operating Arm System (OAS), specifically emphasizing its utility as an adjunct in the treatment of intraosseous skull base tumors, mainly meningiomas.

In April 1995 the OAS was introduced into clinical use at the neurosurgical university clinic in Münster, Germany. Since then, the system's utility has been explored in 10 patients out of the total neuronavigation series presenting with intraosseous skull base tumors (nine females and one male, mean age 47 years; nine meningiomas, one chordoma). For navigational planning, both 3-mm computed tomography scans and a set of 3-mm fat-suppression magnetic resonance images were chosen. At least four adhesive skin markers were used for system calibration.

The system was technically usable in all cases in this small series. Because of the relative immobility of the bone structures and/or the tumor, no significant deviation from the preoperative registration accuracy was noted at the end of the procedures. The main advantages were easier localization and resection of infiltrated bone, which is often not grossly identifiable, even under the microscope.

Our preliminary experience with the OAS suggests that image guidance is helpful in this type of lesion, providing better anatomical orientation during surgery and delineating tumor margins and their relation to critical neurovascular structures. The problem of a possible intracranial tumor and brain shift can be neglected in these lesions. The system facilitates resection by volumetric contour information, allowing more aggressive and complete resection. Comp Aid Surg 3:312-319 (1998). ©1999 Wiley-Liss, Inc.

Deformable Modeling of Facial Tissue for Craniofacial Surgery Simulation
Erwin Keeve, PH.D., Sabine Girod, M.D., D.D.S., PH.D., Ron Kikinis, M.D., and Bernd Girod, PH.D. Surgical Planning Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA (E.K., R.K.); Department of Oral and Maxillofacial Surgery, University Hospital of Erlangen-Nuremberg, Germany (S.G.); and Telecommunications Institute, Department of Electrical Engineering, University of Erlangen-Nuremberg, Germany (E.K., B.G.)


While deformable object modeling has been studied by computer graphics specialists for more than two decades, only a few applications in the field of surgical simulation have been developed which provide both real-time and physically realistic modeling of complex, nonlinear tissue deformations. Particularly in craniofacial surgery, the prediction of soft-tissue changes–which result from alterations in the underlying bone structure–is critical to the surgical outcome. The prediction of these tissue changes and, therefore, the prognosis of the postoperative appearance of the patient, is still based on empirical studies of the relationship between bone and tissue movements: There exists no physical model which takes into account the individual patient anatomy to simulate the resulting tissue changes during craniofacial surgery. In this article we present two different deformable tissue models which are integrated in an interactive surgical simulation testbed. Both techniques allow precise preoperative simulation of the resulting soft tissue changes during craniofacial surgery and visualization of the patient's postoperative appearance. The different deformable models are described in detail and both are applied to the same craniofacial case study. The simulation results are shown and compared with regard to the speed and accuracy of the prediction of the patient's postoperative appearance. Comp Aid Surg 3:228-238 (1998). ©1999 Wiley-Liss,Inc.

Navigation in Maxillofacial and Craniofacial Surgery

Stefan Hassfeld, M.D., D.M.D., PH.D., and Joachim Mühling, M.D., D.M.D., PH.D.Department of Maxillofacial and Craniofacial Surgery, Ruprecht-Karls-University, Heidelberg, Germany


The standardized operational techniques available today make it possible to perform extensive surgeries for the treatment of craniofacial malformations and advanced tumors in this anatomically complex region. The new techniques of computer-assisted surgery allow us to interactively use the three-dimensional image data of the patient during surgery. Simulation of complex osteotomies in individual patients is now possible with the aid of new software developments for virtual cutting and shifting of bone segments. Intraoperative realization with navigation systems has been performed at our clinic for the past 4 years, and we have gained extensive experience from more than 100 clinical applications of mechanical and optoelectronic navigation systems. These passive localization systems supply the surgeon with direct intraoperative support while performing the surgeries. It is the primary goal of computer-assisted surgery to support the surgeon during diagnosis, operational planning, and intraoperative navigation. We can thereby achieve a reduction in operational risk and duration, which in turn results in a considerable stress reduction for the patient. Comp Aid Surg 3:183-187 (1998). ©1999 Wiley-Liss, Inc.

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