D. C. Gerke

Clinical evaluation of occlusal glass ionomer, resin, and amalgam restorations

The purpose of the study was to evaluate four materials (a glass ionomer (polyalkenoate) silver cermet, two composite resin restoratives and a high copper content dental amalgam) placed in either conventional Class I cavities or in modified odontotomy-enameloplasty-sealant (OES) fissure preparations. One experienced operator inserted 438 occlusal. Class I restorations in the posterior permanent teeth of 124 patients in a private dental practice. Restorations were assessed for bulk loss of material, surface voids and cracking, restoration margin fractures and staining, and surface staining and roughness, by using colour transparencies taken at baseline and at recalls for up to 3 years. The glass ionomer cermet was the most difficult material to handle and also gave the least satisfactory clinical result. Loss of material and surface voids were common in the cermet restorations with surface cracking or crazing being seen in 11.4 per cent of the restorations, especially in the larger, conventional Class I preparations. One posterior resin was more viscous and difficult to handle than the other resin and exhibited more surface voids. The amalgam alloy was used in Class I preparations only and showed more restoration margin fractures and surface staining than did the other three materials. However, there were no unsatisfactory clinical assessments given for either restoration margin fracture and staining, or surface staining and roughness for any of the materials. Patient acceptance of the modified OES fissure preparation was extremely good.

Effect of training on the scope of oral and maxillofacial surgery

The relationships between training and qualifications and the scope of oral and maxillofacial surgical practice was investigated by a survey of all full members of the Australian and New Zealand Association of Oral and Maxillofacial surgeons. It was found that scope did correlate to length of training. Three were differences in scope for more recently trained surgeons and by practice location. The possession of medical qualification did not necessarily affect scope of practice but did affect attitudes.

Clinical evaluation of four high-copper amalgam alloys

Abstract In this study, 446 amalgam restorations placed in the posterior permanent teeth of 56 patients were evaluated over periods of up to 3 years. Four alloy types were assessed for failures, marginal fracture and staining, and surface roughness and tarnishing. Sybraloy showed more changes from baseline values than did the other three alloys, and more instances of heavy surface tarnishing.

The Relation of Age to Temporomandibular Joint Dysfunction

There are conflicting reports in the literature on the effects of age on temporomandibular joint pain. A multivariate analysis was performed to determine the effect of age on clinical presentation, findings, and management of a consecutive series of patients with this common condition. These factors were compared with a matched control group. It was found that age had little effect on the clinical signs and symptoms, radiologic findings, or outcome of treatment. There was an increased loss of teeth and occlusal support but this was similar between the control and experimental groups. There were clear differences with psychological variables between the groups with different ages and in comparison with controls. The increase in life events and abnormal illness behavior with increasing age seemed closely linked to patients seeking treatment.

Factors Affecting the Outcome of Treatment for Temporomandibular Joint Dysfunction

AbstractIn this study of 103 patients with temporomandibular joint dysfunction, a multivariant analysis of numerous clinical and psychological variables was performed and related to the outcome of treatment. Treatment was nonsurgical and mainly by short-term exercises. No statistically significant associations were found between physical and psychological features and the outcome of treatment.

Clinical behaviour of high-copper amalgams with time, site, size and class of cavity preparation

In this study 767 amalgam restorations placed in the posterior permanent teeth of 122 patients were evaluated at 6-monthly intervals up to 2 years. Six commercially available high-copper alloy amalgams were assessed for surface roughness, surface tarnish, marginal staining and marginal fracture and the results were related to product, restoration age, restoration cavity class type, restoration size (normal or large Class II preparations) and tooth type (premolar or permanent molar). Dispersalloy (Johnson and Johnson, East Windsor, USA) gave restorations which were overall superior for the clinical characteristics examined. Large restorations on the occlusal surfaces of molar teeth showed more signs of deterioration over the study than did other restoration types. However, all restorations remained clinically satisfactory throughout the study.

The indirect sympathomimetic activity of etilefrine — a comparison with tyramine and ephedrine using [3H]noradrenaline

The indirect sympathomimetic activity of etilefrine has been examined using the ventral caudal artery of the rat. This vessel has a rich sympathetic innervation and lends itself to studies on [3H]noradrenaline efflux from these sites. Etilefrine possessed significant indirect activity on the artery and this action, although less than that of tyramine, was equivalent to that caused by ephedrine. Pretreatment of the vessels with a mixture of iproniazid, doca, cocaine and U0521 (3′,4′‐dihydroxy‐2‐methyl propiophenone) significantly enhanced[3H]‐noradrenaline efflux from the artery.

The effects of etilefrine on blood vessels in the rat tail.

Etilefrine was found to constrict blood vessels in the rat tail through a mechanism which was partly dependent on the sympathetic nerves present in these vessels. The response to the drug was enhanced by pretreatment with noradrenaline and cocaine, and totally abolished by the α‐receptor antagonist phentolamine. When compared with several other sympathomimetic agents which were tested on the vessel, etilefrine appeared to have a low order of vasoconstrictor activity. These findings would seem to have considerable relevance to the clinical situation where an attempt has been made to use etilefrine in the treatment of patients with orthostatic hypotension.

The effect of local anaesthetics on the vasoconstrictor response of the isolated perfused artery to adrenaline and noradrenaline

The vascular response to intraluminally and extraluminally administered catecholamines mixed in combination with local anaesthetics has been studied using the isolated perfused rabbit ear artery as the model system. Potentiation of the vascular response to extraluminal adrenaline was observed when prilocaine, lignocaine or cocaine were combined in low concentrations with the vasoconstrictor. No potentiation of the vascular response to extraluminally administered noradrenaline could be demonstrated in the presence of prilocaine or lignocaine. Further, no potentiation to either catecholamine was found if the artery had been denervated or the drugs were applied intraluminally. Possible mechanisms for the potentiation of extraluminally applied adrenaline are discussed.