John Nalbandian

Autosomal recessive rough hypoplastic amelogenesis imperfecta. A case report with clinical, light microscopic, radiographic, and electron microscopic observations.

A case is presented of a 12-year-old Japanese girl with nearly complete lack of enamel in the deciduous and the permanent dentitions, coupled with a gross abnormality in the pattern of eruption. There was no family history of a similar condition. Deciduous molars were extracted, and hyperplastic gingival tissue was resected. On the basis of clinical, radiographic, and microscopic findings, a diagnosis of autosomal recessive rough hypoplastic amelogenesis imperfecta was made. The configuration of the abnormal enamel was examined with scanning and transmission electron microscopy as well as with light microscopy. Prismatic structure was virtually absent, and the scant enamel showed globular protrusions superficially. Two different surface structures were identified as covering parts of the enamel. At the ultrastructural level, calcified bodies located in the gingival tissue appeared to be composed, in part, of a dense enamel-like substance and, in part, of a tissue with features of afibrillar cementum.

The quality of restorative dental care.

This study investigated the quality of restorative care in a group of health center employees. With limitations in sample size, representativeness of the sample, and methods of measuring quality clearly recognized, the results of the study suggest that significant improvements in the quality of amalgams, synthetic restorations, crowns, fixed partial denture abutments, and pontics will probably require advances in the science and technology of dentistry and modifications in the present system for delivering dental care. The impact of a quality review system is unlikely to affect the care provided by the majority of dentists. Quality review should play a role in monitoring the services fo the small percentage of dentists whose care is very inadequate. Admittedly, these conclusions are speculative and are not based on a large body of experimental information. Nevertheless, the evidence that is available is suggestive, and the development of a national policy to monitor the quality of dental care must consider what can be reasonably achieved with a quality assurance system.

Response of the periodontal tissues of the beagle dog to polytetrafluorethylene implants

The healing response of the periodontal tissues to polytetrafluorethylene was examined in the beagle dog. At midroot level, by way of a mucosal incision and a surgically created fenestration in the facial alveolar bone, a cylinder of polytetrafluorethylene 2 mm. in diameter was fitted tightly into a cavity preparation and cut even with the root surface. Histologic observations were made after 57 and 91 days of healing. In sites with optimal healing (minimal or no inflammation present) a thin layer of connective tissue with capillaries had proliferated into the narrow space between the implant and the cavity walls, and new cementum had formed on the walls and floors of the preparations. Bone replacement occurred in the peripheral parts of the fenestrations and in several instances a complete or nearly complete covering of bone had developed at the outer surface of the implant as well. Osseous tissue often contacted the polymer. Inflammatory infiltrate, concentrated at the cavosurface angles, was observed in sites with the poorest healing. This was associated with microscopic pulpal exposure and/or irritants in the interface between the polymer and the cavity walls. The implant material per se did not appear to produce an inflammatory response or impede the development of cementum and bone. Observations confirm the inertness of polytetrafluorethylene and suggest its use as a covering for reimplanted teeth.