L. Abraham-Inpijn

Radiographic interpretation of the mandibular angular cortex: A diagnostic tool in metabolic bone loss

Panoramic radiographs of patients with chronic renal failure showed a loss of cortical bone at the mandibular angle; the loss of cortical bone correlated very well with the degree of renal osteodystrophy, established by biopsy of the undecalcified iliac crest. The value of using the cortical thickness at the mandibular angle as a parameter in diagnosing metabolic bone loss is discussed.

Radiographic interpretation of the mandibular angular cortex: A diagnostic tool in metabolic bone loss: Part I. Normal state

Abstract The thickness of the mandibular angular cortex at gonion was measured on panoramic radiographs of 180 normal persons. Before the fifteenth year a distinct cortical layer is missing. After the fifteenth year, the thickness of the mandibular angular cortex is relatively constant except in postmenopausal women of 60 years and older, where the cortical thickness is distinctly thinner.

Blood pressure response to routine restorative dental treatment with and without local anesthesia: Continuous noninvasive blood pressure registration with a finger manometer

A continuous noninvasive blood pressure registration with the Finapres finger manometer was carried out during routine dental treatment, with and without local anesthesia. Forty patients (21 male), 21 to 64 years of age, were studied. Blood pressure was recorded continuously from 10 minutes before dental treatment to 10 minutes after treatment was completed. No local anesthetic was used in 25 patients. In 15 patients (seven men) local anesthetic was used. All patients showed a considerable blood pressure variation. During treatment a significant mean blood pressure increase was registered in the patients treated without local anesthesia. In the patients treated with local anesthesia no significant mean blood pressure changes during dental treatment could be established. However, during the actual administration of the local anesthetic solution a transient blood pressure increase was found, followed by a decrease shortly after removal of the needle from the mouth. After treatment of both groups of patients, a mean blood pressure decrease was established.

Blood pressure measurements during dental checkups representative of 26-hour registration☆

The effect of dental checkups on blood pressure was investigated. In 27 normotensive patients (13 men and 14 women) aged 22 to 64 years (mean 39.75 +/- 10.5 years), a 26-hour continuous, noninvasive blood pressure registration was carried out. Of each patient at least 175 blood pressure measurements were registered during these 26 hours, giving a total amount of 4725 blood pressure measurements. A dental checkup appointment with the family dentist was included. Blood pressure values displayed the well-known diurnal variation, but the visit to the dental surgeon was not accompanied by a rise in blood pressure. There was no significant difference between the blood pressure values during the 26-hour period and those during the checkup period. During a rest period after the dental checkup, neither the systolic nor the diastolic pressure fell to any degree in relation to the 26-hour values or the visit to the surgeon.

Lack of evidence for link between intradental lesions and chronic renal failure

In at least three publications, radiographic intradental changes have been mentioned in connection with end-stage renal failure with and without renal osteodystrophy. The influence of immunosuppressive therapy has been suggested. In 63 patients with one or a combination of the above-mentioned criteria, no evidence was found on intradental radiolucencies or of extreme narrowing (obliteration) of the dental pulp cavity.