James T. Martinoff

Intracoronal reinforcement and coronal coverage: A study of endodontically treated teeth

T echniques to reinforce endodontically treated teeth have been available for more than 100 years. However, few dentists have questioned the rationale that dictates automatic dowel reinforcement and coronal coverage of pulpless teeth. The difficulties of in vivo studies have motivated investigators to increase the number of in vitro studies of endodontically treated teeth. Although findings from in vitro studies provide guidelines, direct application of tensile, torque, and shear tests on experimental models or extracted teeth are questionable. This is particularly true if the elasticity of tooth structure, alveolar bone, and periodontal ligament is considered. The purpose of this study was to correlate clinical and laboratory studies of 1273 endodontically treated teeth in retrospect and determine the clinical significance of post reinforcement and coronal coverage. The location of the tooth in the arch and how it modifies the restorative requirements of an endodontically treated tooth are evaluated.

The prevalence of mandibular dysfunction. Part I : Sex and age distribution of related signs and symptoms

This study concludes the following: 1. Mandibular dysfunction is extensive. 2. Age and sex differences are apparent with various signs and symptoms. 3. Women and younger patients tend to respond positively more often than men and older patients to questions relating to subjective TMJ and muscle symptoms. 4. Objective TMJ and occlusal signs show little age or sex differentiation. 5. Positive responses to questions regarding bruxism were more common in men. 6. Age and sex differences in the prevalence of mandibular dysfunction may be influenced by the method of investigation (anamnestic versus clinical examination) and by the signs and symptoms selected to be representative of this disorder. When compared with the findings of earlier investigations, the conclusions suggest that social, cultural, psychologic, sex, and age differences contribute to the responses to questions pertaining to mandibular dysfunction. However, this may not be an accurate reflection of the prevalence of mandibular dysfunction since the objective signs do not show the age and sex differences that the subjective symptoms indicate. Therefore, additional studies are needed to correlate all data to establish a more reliable profile of both signs and symptoms of mandibular dysfunction.

Endodontically treated teeth as abutments

occlusal rest (Fig. 5, B), and guiding planes (Fig. 5, C). If there are voids or irregularities, they are filled with monomer and powder with a paint brush. 9. Try-in the removable partial denture (Fig. 6) to ensure a proper adaptation of the resin coping (Fig. 7). The die spacer can be removed from the tooth with a cotton pellet soaked in die spacer thinner. Rinse the tooth several times before cementing the temporary restoration. 10. Transfer the resin coping to the working stone die and finish the margins with wax (Fig. 8). If the surface of the resin coping is not smooth, paint it with a thin layer of liquid wax (Hi-Glass liquid wax glaze, George Taub Products and Fusion Co., Inc., Jersey City, N.J.) before investing and casting. There is little need for an opposing cast because the coping has all the details of the previous cast crown or tooth before preparation; but an opposing model can be used to verify occlusal relationships. 11. Cast, polish, and finish the casting. At the try-in stage, the margins and the occlusion are secured. Finally, adaptation of the RPD to the new crown is appraised (Fig. 9). Cement the crown when all necessary adjustments have been made.

Long-term follow up of transoral rib grafts for mandibular atrophy

Nineteen patients who had autologous rib grafts for mandibular augmentation were monitored for six to 13 years to evaluate the rate of resorption as a function of time. Data were collected from panoramic radiographs that were corrected for distortion. The findings indicated that rapid resorption occurs during the first two years after grafting and decreases markedly thereafter. Although some prolonged benefits resulted from the procedure, it was concluded that it is not an ideal solution to the problem of ridge augmentation.

A comparison of gingival inflammation related to retraction cords

Potassium aluminum sulfate, aluminum chloride, and 8% racemic epinephrine did not demonstrate practical differences, although potassium aluminum sulfate produced fewer inflammatory changes than the other agents. 2. It appears that factors other than the chemical agent (e.g., physiologic differences in patients) may play a role in the amount of gingival inflammation induced. 3. Additional studies using a larger sample size and an untreated control site should be undertaken.

The prevalence of mandibular dysfunction. Part II: A multiphasic dysfunction profile

The frequency of occurrence of 20 signs and symptoms commonly associated with mandibular dysfunction was used to numerically rate the clinical severity of mandibular dysfunction. Some signs and symptoms had a clearly direct relationship whereas other signs demonstrated a diminished direct relationship, no relationship, or an inverse relationship in advanced dysfunction stages. Further study is needed to determine if there exists an exact relationship of some clinical signs to mandibular dysfunction.

Effect of die spacer on the seating of complete cast gold crowns with grooves

Fifty crowns were constructed with an indirect technique for a standardized Ivorine tooth preparation to determine whether casting relief would improve the seating of complete cast crowns with zinc phosphate cement. The variables were two grooves in the preparations and die spacer casting relief of approximately 20 to 40 micron. The tooth preparations of two groups had no grooves, but castings were made with internal relief for only one group. Three groups had buccal and lingual grooves in the preparation. One group had no relief, a second group had complete relief, and a third group had relief but not in the grooves. The discrepancies noted before and after cementation of the castings were measured. The average discrepancy for each group and the significance between groups was determined. Results of this study demonstrated the following. Die relief significantly improved the seating of complete cast-gold crowns with or without grooves. Omitting die spacer from grooves did not reduce the benefits of relieving the remainder of the die. Partial internal relief was better than no relief. The grooves did not disrupt seating when die spacer application was complete or specifically omitted from the grooves alone.

Growth of microorganisms in total nutrient admixtures.

It has been reported that intravenous fat emulsions, because of their isotonicity and neutral pH, support microbial growth, but traditional parenteral nutrition solutions, being hypertonic and more acidic, are not as supportive. To date, few studies have documented microbial growth in total nutrient admixtures (TNA) containing dextrose, amino acids, fat, electrolytes, vitamins, and trace elements. This study was undertaken to analyze the growth of Staphylococcus aureus, Candida albicans and four gram-negative enteric bacilli in three different nutrient admixtures, with and without the inclusion of 5% fat emulsion. The composition of the admixtures was either 5, 10, or 25% dextrose; either 0 or 5% fat; and 3% amino acids, electrolytes, vitamins, and trace elements. All admixtures were innoculated with 100 colony-forming units per milliliter, incubated at room (25°C) or refrigerated (4°C) temperature, with samples withdrawn at 0, 3, 6, 12, 24, and 48 hours and plated in triplicate. Only C. albicans demonstrated any significant growth regardless of fat content. The pH of the admixtures was similar (acidic), and all solutions were hypertonic and found to inhibit bacterial growth. Conclusions suggest that TNA, when formulated with normal concentrations of additives, is no more likely to support growth of contaminant organisms than the traditional solutions. This contradicts the notion that the addition of fat to total parenteral nutrition will enhance the ability of these admixtures to support microbial growth.

Comparison of the multiphasic dysfunction profile with lateral transcranial radiographs

Lateral transcranial radiographs of 926 patients were analyzed for condylar position, TMJ space, and obvious condylar morphologic changes. Differences in condylar position and joint space variations were noted between men and women. An increase in nonconcentric condylar position, joint space variations, and condylar morphologic changes were found with advancing age. There was a significant correlation of condylar position, joint space variations, and condylar morphology with mandibular dysfunction profile scores. Mandibular dysfunction is manifested by a wide range of signs and symptoms, none of which is always present with the disorder. Although TRs are limited in their total diagnostic value, their use in discerning major TMJ changes serves as an important adjunct in the examination and diagnosis of mandibular dysfunction.

An 18-month clinical evaluation of semiprecious and nonprecious alloy restorations

SEM studies indicate that the control alloy, Minigold, WLW, and Litecast metals presented similar results in relation to marginal fit when proper techniques are followed. Clinical evaluation based on the criteria of gingival irritation, patient sensitivity, and abrasion demonstrated no statistically significant differences between the casting alloys tested and the control. The control alloy had significantly fewer restorations with tarnish and corrosion than either WLW or Litecast. There was no significant difference between the control alloy and Minigold in terms of tarnish and corrosion.