Louis W. Ripa

Talon cusp: A clinically significant anomaly

Abstract Talon cusp is an anomaly occurring in permanent incisors of either arch. Its occurrence raises problems in esthetics, caries control, and occlusal accommodation for the patient and problems in diagnosis and clinical management for the dentist. The dentist must be aware of the anomaly prior to eruption, so that it is not mistaken for a supernumerary tooth. This problem is especially significant because the maxillary incisor region is also the principal site of supernumerary teeth. When encountered on an erupted tooth, it is recommended that the groove between the cusp and the tooth be prophylactically restored to prevent caries at this susceptible area. If the anomaly interferes with occlusion, it must be removed. This inevitably results in exposure of pulp tissue, requiring subsequent endodontic therapy. Talon cusp is an unusual and relatively rare anomaly. Since its presence usually demands that definitive treatment be instituted, it represents a problem of clinical significance rather than being merely a dental oddity.

Effects of Self-Applied Topical Fluoride Preparations in Orthodontic Patients

The purpose of this study was to compare the effectiveness of toothbrushing followed by fluoride rinsing, fluoride gel brushing, or fluoride gel dentifrice brushing alone in controlling the demineralization that often follows orthodontic treatment. Seventy-eight consecutive adolescent patients undergoing orthodontic care were divided into 3 groups: group 1 (control) used a low-potency, high-frequency fluoride rinse; group 2 used a high-potency, high-frequency fluoride brush-on gel; and group 3 used a high-potency, high-frequency fluoride gel dentifrice. When pretreatment levels of demineralization were subtracted from posttreatment values, both gel groups displayed a significant difference (P < .05) in smooth surface demineralization sites when compared to controls. Reversal of white-spot lesions occurred in 15% of sites that exhibited pathology as a result of the fluoride and preventive regimen. These results indicate that a daily use of a 5000-ppm fluoride gel along with toothbrushing with a fluoride paste or brushing twice daily with a 5000-ppm fluoride dentifrice alone provides greater protection beyond that of tooth-brushing with a fluoride paste (1000 ppm) and rinsing with a 0.05% sodium fluoride rinse.

The use of fiber optics transillumination for the detection of proximal caries

Abstract Children in the mixed-dentition stage were examined for proximal caries by means of mirror and explorer, fiber optics transillumination (FOTI), and bitewing radiographs. Examinations were performed with portable dental equipment in two public grammar schools. The purpose was to evaluate FOTI as a diagnostic tool for caries diagnosis in a clinical field situation. The greatest percentage increase in proximal lesions detected by FOTI was recorded in the permanent incisors; however, radiographs were not available for diagnostic confirmation. FOTI proved to be an insensitive method for detecting proximal caries in posterior deciduous or permanent teeth above that which was found by an initial mirror-and-explorer examination.

The Histology of the Early Carious Lesion in Primary Teeth with Special Reference to a "Prismless" Outer Layer of Primary Enamel

SYNOPSIS IN INTERLINGUA HISTOLOGIA DEL PRECOCE LESION CARIOSE.—Attention special esseva prestate al contribution del adamantin prismas e strias de Retzius al morphologia del lesion. Le conformation del lesion macula blanc in molares primari, como illo se presenta in le section transverse, pare esser determinate exclusivemente per le direction del prismas adamantin. Le strias de Retzius non pare servir como portas de intrata, e illos non pare facilitar le dissemination occlusogingival del lesion, como on to ha reportate pro simile lesiones in dentes permanente.

The effect of calcium hydroxide and zinc oxide-eugenol on dentine in extracted human teeth

Abstract An in vitro investigation using clinical radiographs and microradiography was designed to test the effects of zinc oxide-eugenol and calcium hydroxide (Dycal) on sound and carious dentine in sixty-four previously extracted human teeth. No change in radiodensity was detected for the sound samples treated with calcium hydroxide or zinc oxide-eugenol or for the carious samples treated with zinc oxide-eugenol. Seven of the sixteen carious samples (42 per cent) treated with calcium hydroxide demonstrated, on microradiographs, a radiopaque area beneath the treatment site which was interpreted as a penetration of the calcium hydroxide into the carious dentinal tubuli.