A 10-year longitudinal report of case of an institutionalized autistic male dental patient is described. Interpretation of the data in the clinical and medical charts during this period points to possible clues to facilitating treatment for autistic individuals. One potentially important finding is the apparent inverse relationship that was found between level of sedation and patient cooperation. The impact of the specific medical diagnosis on the comprehensive care for these patients is also addressed.

Adolescent↗

PubMedDate not supplied

Restraint and sedation of the dental patient with developmental disabilities.

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Anti-Infective Agents, Local↗

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Adhesive penetration in human artificial and natural white spots.

Penetration of a liquid adhesive into human artificial and natural white spots, both acid-conditioned and nonconditioned, was studied. All artificial white spots showed penetration of the adhesive. Acid-conditioned natural lesions exhibited penetration to a lesser amount than in vitro lesions. Penetration in nonconditioned natural lesions was not apparent.

Adhesiveness↗

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Bonding to dentin: evaluation of three adhesive materials.

Dye penetration was observed in all specimens. SEM demonstrated isolated areas with no gap formation, suggesting a partial bond with dentin. A correlation is evident from the results of both techniques. Since dye-penetration was found to be similar in all the specimens, it was difficult to assess the effect of thermocycling on the amount of dye penetration. The use of posterior composites should be considered as a short-term tested procedure. It should be utilized carefully, following the manufacturer's instructions, and monitored routinely. Undoubtedly, the utilization of posterior composite materials is a very technique-sensitive procedure. Comparing the results of this in vitro study with those previously reported suggests that little improvement has been made in the bonding of the materials tested. Development of new materials and improved techniques are necessary.

Adhesives↗

PubMedDate not supplied

A study of behavior modification for developmentally disabled children.

A tape-slide series, using a desensitization and modeling approach, was developed in order to prepare three- and four-year-old developmentally disabled children for an initial dental examination. The tape-slide series pleasantly describes what to expect during the first visit to the dental office. A clown and a four-year-old girl were used as models. Twenty-eight children participated in the study, divided into two groups: control and experimental. A requirement for qualification as a patient was that the child not have had any previous dental experience. Three techniques for measuring behavior were used: heart rate, a modified Melamed's scale, and a dentist's subjective evaluation. The results demonstrated that: a) The experimental group was in a high state of arousal when starting the dental procedures; b) Children exposed to the tapeslide series showed worse behavior and a higher heart rate than children not exposed to the series; c) Heart rate was sensitive and objective in measuring anxiety and arousal in the dental setting; d) Modified Melamed's scale was not sensitive enough to measure microbehavior in this study; e) The subjective dentist's evaluation showed the impossibility of preventing a biased interpretation of behavior by the evaluator.

Analysis of Variance↗

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Marginal adaptation of composite resins and dentinal bonding agents.

The purpose of this in vitro study was to determine the bonding qualities of three commercially available dentin bonding agents, namely Dentin Adhesit/Heliomolar, Creation Bond/Visar Fil and Scotchbond/P30. Microleakage tests and a scanning electron microscopy study of the interface between dentin and resin were performed. In eighteen specimens, the penetration of 0.5 percent basic fuchsin solution was studied across the enamel and dentin interfaces with the resin. Half of the specimens in each group of products were thermocycled. Leakage was evaluated after sectioning under a light optical stereomicroscope at 20 x magnification, using a classification reported by Eriksen and Buonocore. The interface between the restorative resin and the dentin axial walls of the preparation and its floor were examined by scanning electron microscopy (SEM). The results showed that leakage was commonly found at the resin/dentin interface and SEM showed gaps between the restoration and walls and floor of the preparation. It was concluded that the dentin bonding agents failed to provide a bond between restorative resin and dental tissue.

Acrylic Resins↗

PubMedDate not supplied

Clinical and microscopic evaluation of a bridge using the acid-etch resin technique.

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Acid Etching, Dental↗

PubMedDate not supplied

Differences between normal and developmentally disabled children in a first dental visit.

Twenty-eight three- and four-year-old normal children participated in a study where they were exposed to a tape-slide series before a first dental examination. The audiovisual product gives an explanation about a first examination, the children having no previous dental experience. The purposes of the study were to evaluate the behavior modification that took place and to see whether differences could be found with the results of the same study performed four years before, with developmentally disabled children. The results obtained with normal children were the opposite of those obtained with special children. The normal population subjected to the audiovisual technique behaved better and had a lower heart rate throughout the appointment.

Audiovisual Aids↗

PubMedDate not supplied

Comparison of the sedative effectiveness of two pharmacological regimens.

This study was designed to evaluate the effectiveness of two orally administered pharmacological regimens. The subjects were twenty-six patients requiring a sedative premedication for dental treatment, due to difficult behavior. A randomized, double-blind, cross-over design was employed using chloral hydrate syrup, 30 mg/Kg; and diphenhydramine HCl, 1.5 mg/Kg orally, not to exceed 2,000mg and 75mg, respectively; and chloral hydrate syrup, 30 mg/Kg; and diazepam solution, 0.2 mg/Kg orally, not to exceed 2000mg and 10mg, respectively. The level of conscious sedation was assessed, utilizing two scales employed previously in other studies. It was demonstrated that it is possible to maintain a low-dose range of sedative medication with satisfactory results. The combination of diazepam and chloral hydrate was found to be more effective than the diphenhydramine, chloral hydrate combination.

Adult↗

PubMedDate not supplied

Oral appliance attached to a bubble helmet for prevention of self-inflicted injury.

A six-year-old girl was referred to the Dental Clinic of Monroe Developmental Center by the New York State School for the Blind. She had a history of self-abusive behavior, particularly in biting her lower lip, and had previously had all primary teeth removed to prevent further damage. The school psychologist was concerned about new injuries because her permanent first molars were erupting and cheek lacerations were already present in those areas. An oral appliance attached to a bubble helmet was designed and fabricated. The patient tolerated it well. Her behavior improved with a change in psychotropic medication, and the lacerations of oral and peri-oral areas healed. At this time, more permanent teeth are present in the oral cavity.

Cerebral Palsy↗