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Enamel Micro-abrasion is a technique where an acid is used in combination with an abrasive to remove the superficial layer of enamel which has certain dental colorants within its structure. It is indicated as the treatment of choice for superficial enamel stains and is a technique which every dentist should offer to their patients. It is a simple, conservative, efficient and durable procedure.
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The efficacy of Peroxyl mouthrinse in reducing the extrinsic stain produced by Peridex, a chlorhexidine mouthrinse, was evaluated in a double-blind, three-month clinical study. Intraoral safety, extrinsic tooth stain and plaque accumulation scores were determined on 119 healthy adult subjects at baseline and at 30-, 60- and 90-day intervals following use of Peroxyl or placebo formulations in combination with the Peridex product. Subjects were randomly assigned to two groups. The test group used the chlorhexidine mouthrinse plus Peroxyl mouthrinse, while the control group used the chlorhexidine mouthrinse plus a placebo mouthrinse. All participants were given an oral prophylaxis prior to use of the mouthrinses. The assigned mouthrinse combinations were used by 58 test and 61 control subjects, who followed specific toothbrushing and mouthrinse regimens throughout the three-month period. Both the examiner and the subjects were unaware of the identities of the products tested. Use of Peroxyl mouthrinse significantly reduced extrinsic tooth stain produced by chlorhexidine rinsing. The mean stain scores for all teeth were significantly lower for the Peroxyl/chlorhexidine group, at 60 and 90 days of use, compared to the placebo/chlorhexidine group. At all three time points, the mean stain scores of the anterior teeth of the individuals using Peroxyl/chlorhexidine rinses had significantly less stain compared to the placebo/chlorhexidine rinse group means. No intraoral soft tissue side effects, attributed to product use, were observed or reported throughout the study.
The clinical use of a flexible, removable gingival prosthesis that is constructed by the dental laboratory on a stone cast to reproduce interdental spaces resulting from gingival recession is described. The thin prosthesis replaces lost gingival tissue and is retained by extension into interproximal undercuts. It is readily removable for convenient home care.
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New improved refractory die materials are now being introduced onto the UK market which make it possible to construct porcelain facings and inlays directly onto refractory dies. From previous experience with several refractory die facing systems, it was decided that the Flexo-Ceram system should be used. This is because the porcelain is matched to the full Vita shade range and the materials are relatively easy to handle.
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This study was designed to compare the clinical effectiveness of rubber cup polishing and airpolishing. Polishing time was controlled to approximate the time spent on plaque and stain removal in clinical dental hygiene practice. Effectiveness of polishing techniques was evaluated using indices to measure plaque, stain, and gingival trauma prior to and after the polishing treatment. Thirty adult subjects, with comparable numbers of teeth contralaterally, exhibiting observable plaque and stain, participated in the study. Patients with contra-indications for either polishing technique were excluded from the sample. Data were collected using a randomized split mouth design; one side of a subject's mouth was polished with a rubber cup and flour of pumice and the other side was polished with the Prophy-Jet airpolishing device. The time employed for both treatments was held constant at five minutes for each technique. Plaque, stain, and gingival trauma measurements were assessed prior to and following both polishing treatments. Analysis of variance was utilized to compute the data. Results indicate that, when comparing the effectiveness of polishing treatments, there is no statistically significant difference in plaque removal, stain removal, or gingival trauma within the established time interval. The authors conclude that other factors, in addition to effectiveness and time efficiency, should be considered when selecting rubbercup polishing with flour of pumice or an airpolishing device.
A patient whose teeth had been severely stained by improper use of tetracycline was treated through a direct system of facial veneering. The technique associates the use of a light-activating glass-ionomer cement with two kinds of light-activating composite resin. Satisfactory esthetics were obtained immediately.
This study utilized a vital bleaching agent as well as an enamel microabrasion compound with low hydrochloric acid concentration to remove intrinsic stains on the facial surfaces of anterior teeth. In addition, scanning electron microscopic analyses of enamel from extracted teeth compared the etching pattern of the commercial compound used in this study to 18% hydrochloric acid. Type 1 and Type 2 etch patterns were observed with 18% hydrochloric acid after 5 and 20 seconds, respectively. Milder and more diffuse etch patterns were observed with the enamel microabrasion compound. A conservative form of treatment to remove intrinsic stains would employ the use of a vital bleaching agent, followed by an enamel microabrasion compound.
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The purpose of this article is to present a treatment of dentinogenesis imperfecta in a 3 years old child. We reviewed some of the aspects to consider in the treatments of this alteration in primary dentition.
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A family of five was examined. Four of them presented with enamel alteration including changes in colour and loss of enamel surface. A genetic study was undertaken which revealed an autosomal dominant inheritance with complete penetration and variable expressivity. This is reflected in shape, number, extension and depth of the affected areas. Amelogénesis Imperfecta type IV was diagnosed using Shields classification.
Dietary staining studies have proved useful determinants of chlorhixidine activity in mouthrinse products, and results correlate with plaque inhibitory effects. This investigation compared the staining and antimicrobial action in vitro of two known and similarly effective, commercially available chlorhexidine mouthrinses with a reformulated 0.1% chlordexidine preparation. After adjustment for original concentration the 0.2%, 0.12% and reformulated 0.1% products had essentially similar, minimum inhibitory-dilution values against standard test organisms. The 0.1% preparation was more effective against Capnocytophaga ochracea, suggesting additional antimicrobial activity derived from an ingredient other than chlorhexidine. The staining in vitro of tooth and acrylic specimens was equivalent with the 0.2% and 0.12% products. By comparison with equivalent concentrations of the diluted 0.2% preparation, the 0.1% formulation produced less staining, particularly when diluted. The data suggest that the 0.1% formulation, when used in diluted form as recommended by the manufacturer, may have slightly reduced plaque-inhibitory effects by comparison to the 0.2% or 0.12% products. However, the results raise the question whether chlorhexidine solutions could be formulated to reduce side effects, in particular, tooth staining at the expense of some loss of antiplaque activity.
Toothpastes have improved significantly over the last 2000 years to the point where they are very proficient in their cleaning attributes. However, research continues, so further improvement may still be possible.
A young adolescent girl suffering from Amelogenesis imperfecta was examined. The treatment plan: teeth kept vital, preparation of provisional resin crowns and their replacement by definitive single crowns. Thus re-establishing aesthetics and function, and furthermore the possibility of giving this young patient the pleasure of finally being able to smile, no longer hiding her teeth.