[Patient acceptable solution to a pseudoprognathism].
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The acute intermittent porphyria is mainly a porphyrimmetabolism disorder inheritable through autosomes. This disorder is characterized by intermittent abdominal pains, neurological symptoms of central as well as peripheral genesis, and by psychotic syndromes. An acute attack is fatal in many cases. Among others, it can be induced by numerous factors, such as local anesthetics, analgetics and sedatives. Thus, it is important that the dentist is aware of this rare disease should he find himself in a position where treatment of this type of patient is imminent.
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At the Department of Oral and Maxillo-facial Surgery of Heidelberg University, apicectomies in posterior teeth have long been performed in addition to implantation. We always aimed at maintaining a vital periodontium, before alloplastic materials for implantation were considered. In follow-up examinations of 247 resected roots of posterior teeth, we recorded a success rate of 90%.
The authors report of a case of secondary retention of a lower first molar. It turned out to be a true "re-inclusion" of the tooth without involvement of the antrum. The radiograph of a central metal filling performed 10 years ago also suggests a retrograde movement of this teeth and its re-inclusion in the mandible.
Starting from the description of an innovator's suggestion (registration number: 172097), the author deals with the use of suitable anterior matrixes made of aluminium foil. Practical experience and clinical results with the filling material Frontasil recommend the technique described for wide use.
Any restorative procedure which is not effected with clinical precision and with due consideration to the principles of preventive dentistry is bound to fail. The main causes of failure, whether direct or indirect, are iatrogenic and can be avoided. Restorative procedures may be qualified as a success when a favorable, durable result is obtained. This result depends partly on the technique employed and partly on the products used, products which are too often tardively and insufficiently tested. This state of affairs underlines the urgent necessity of introducing standardized clinical controls for all new dental products.
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Proper planning of a course of treatment for the older patient will form the basis of success. Treatment planning is a stringent test of clinical acumen: requiring consideration of what the patient desires, what the patient can tolerate and what can be achieved. In this article the authors outline the principles of treatment planning for the ageing patient.
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