[Adhesive dentistry II. Direct techniques, practical course].
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Personality profiles and the motivations for seeking orthodontic treatment were investigated in a sample of adult patients. An improvement in dental esthetics was found to be the prime motivating factor, and the decision to seek treatment was usually made by the adult patients themselves. Questionnaires to assess personality traits revealed an atypical group of patients demonstrating neurotic traits. These patients were found to have a significantly different perception of their malocclusion than did the "normal" group of adult patients. Patients with neurotic traits may pose problems for clinicians with regard to expectations both during and at the end of treatment.
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Creating a flow sheet may assist in the decision whether to use conventional orthodontics and what the limitations of treating the patient will be if treatment is performed without any orthodontics. The decision process can be viewed as a series of questions, and depending upon the answer to the questions, the practitioner and patient can decide on whether to involve orthodontics or not. Questions can create a framework to help separate the patients who would benefit from orthodontic intervention from those we all enjoy treating who can be managed with purely restorative care.
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Human immunodeficiency virus (HIV) causes an immune incompetence that weakens the body's defense against pathogens. It has been supposed that HIV-positive patients are more likely to develop both early and late postoperative complications, such as septicemia and poor wound healing. This has not been corroborated by more recent studies but seems to depend on the patient's level of CD4 cells and his or her general condition. As the life expectancy of HIV-positive individuals increases and the condition becomes increasingly controllable, esthetic dental treatment becomes more significant and implant-supported prostheses may be considered as an alternative to removable dentures. Except for a single case report on the immediate placement of a single-tooth implant, no reports are available on implant dentistry in HIV-positive patients. This case report concerns implant placement in the maxilla and mandible of an HIV-positive individual and complete dental and implant rehabilitation. Two years after implant placement, the prosthesis is functioning well.
OBJECTIVES: this 18.1 year-old girl presented with a chief complaint of progressive worsening of facial and dental esthetics, crowding, headache and facial pain. MATERIALS AND METHODS: clinically, she was at the end of her growth and exhibited a severe facial asymmetry, but with normal sagittal and vertical cranial relationships. Clicking in the right TMJ was evident. This was accompanied by a deviation upon opening, and pain in the joint. The pain she experienced during jaw movement, and upon palpation, was significant. There was a shift to the right from centric relation to intercuspal position. Intraorally, the tissues were normal, with mild tetracycline staining, still present primary canines, impacted third molars and upper permanent canines. Her first molars had fillings. Orthodontically, her occlusion was a severe Class III subdivision left, with a severe right-side crossbite, lower midline deviation to the right 6 mm, and a 1 mm lateral shift in intercuspal position. She also exhibited severe crowding and asymmetry in both arches. The sequence of her treatment was as follows: (a) extraction of primary canines and impacted third molars, surgical exposure of impacted canines, (b) lower occlusal splint for TMJ dysfunction and an upper arch fixed appliance for ideal alignment and leveling, (c) upper occlusal splint for the maintenance of TMJ function and lower arch fixed appliance for ideal alignment and leveling, (d) surgical skeletal correction, (e) post-surgical orthodontic finishing, (f) post-treatment retention.
OBJECTIVES: To investigate the surface roughness changes of newer esthetic dental restorative materials with aging and acid erosion in a simulated oral environment. METHODS: The materials included two viscous conventional glass ionomer cements originally marketed for the ART approach, one resin-modified glass ionomer cement and two resin composites. Ten specimens for each material were prepared according to the manufacturers' instructions, then each specimen was immersed in 2 ml of buffered artificial saliva at 37 degrees C for three weeks. For each material, five specimens (Group B) were then coated with 1.23% acidulated phosphate fluoride (APF) gel for four minutes, rinsed and immersed again in artificial saliva for another three weeks. Gel was not applied to the Group A specimens. For each material, the surface roughness of an additional three fresh specimens and those from Groups A and B were evaluated using a profilometer and SEM. RESULTS: The resin composites showed the least effects of acidic corrosion on their surface texture. The viscous glass ionomer cements showed the greatest changes, with significantly increased surface roughness p<0.001). CONCLUSIONS: The immersion of two newer viscous GICs in a buffered artificial saliva and the single application of APF gel resulted in significantly rougher surfaces over a relatively short six-week period.
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Although comprehensive orthodontic treatment cannot preclude the possibility of periodontal disease developing later, it can be a useful part of the overall treatment plan for a patient who already has periodontal involvement. A careful clinical examination must determine the patient's dental health status, including any existing destruction or deficiencies of the teeth and their support, as well as the patient's ability to achieve and maintain good overall oral hygiene. Two major criteria should be considered in the treatment of these patients: (1) the patient should be seen frequently for periodontal maintenance and (2) minimal orthodontic forces should be applied. Segmented archwires could be used for the treatment mechanics. After treatment, splinting of the teeth is necessary both short- and long-term. With this orthodontic approach, both dental esthetics and function improve and can be maintained. A male patient, 50 years of age, with severe periodontal involvement was referred to the authors' clinic, from the periodontal department, for treatment. The mandibular incisors were intruded by using segmental archwires. At the end of treatment, permanent retention was required due to the severe bone loss.
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