Dentinal sensitivity: a periodontist's perspective.
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Biomedical subjects
Publications and source records attributed to H M Goldman.
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Female guinea pigs were fed a scorbutigenic diet supplemented with either L-ascorbic acid or D-isoascorbic acid or combinations of these. Their responses were judged by changes in body weight, serum alkaline phosphatase levels, wound healing, and tooth structure. Large additions (100 mg daily) of D-isoascorbic acid to the scorbutigenic diet resulted in normal growth over a 7-wk period and normal serum alkaline phosphatase levels, tooth structure development, and collagen formation after wounding. The addition of 0.5 or 5.0 mg of L-ascorbic acid to this high D-isoascorbic diet improved neither growth rate nor collagen deposition during wound healing. On the basis of changes in tooth structure, D-isoascorbic acid has 1/20 the potency of L-ascorbic acid. Its effect is additive to subminimal maintenance levels of L-ascorbic acid implying that there is no competitive inhibition in the utilization of the two compounds. The relatively weak activity of D-isoascorbic acid is probably due to poor transport to the tissues and ineffective binding to functional sites. This explains why the onset of scurvy is much more rapid after withdrawal of D-isoascorbic acid from the diet when it had been the sole antiscorbutic dietary constituent. It is concluded that D-isoascorbic acid is a "weakly" antiscorbutic agent on the basis that it is both poorly absorbed and retained by the tissue; that in fact it may, to the degree that it is taken up by the tissues and retained, be equal in antiscorbutic potency to L-ascorbic acid.
Protein concentrations in gingival fluid exudate were obtained in both the clinically minimal and severe inflammatory states. A comparison of the results indicated no significant differences in the two groups studied. Since total protein concentrations do not appear to reflect accurately the clinical inflammatory status of the gingival tissues, specific components of the protein molecule should be studied.
In order for successful coverage of denuded roots to be accomplished, correctly applied fundamental biological principles must be considered in the choice and utilization of the surgical modality. In this report some representative clinical cases are presented to indicate favorable results that may be achieved with stimulated osteoperiosteal pedicle flaps. These cases are part of an ongoing clinical and statistical evaluation.
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A rationale and technique for the utilization of the combined procedures of the gingival autograft and the gingivectomy technics for the purpose of pocket elimination and creation of an adequate zone of attached gingiva has been presented. It allows for the predictable and relatively atraumatic treatment of gingival problems in which there has been no deformity of the underlying osseous structures.
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1. A long term (54 months) supervised, double-blind human clinical study has been conducted to ascertain whether the routine use of a commercially available cosmetic dentifrice, with purported stain removal and flavor impact characteristics, would cause adverse manifestations in the oral tissues, as compared to the similar use of a more conventional type of commercially available dentifrice. 2. One hundred and twenty male and female subjects (aged 12 to 70) were randomly assigned to the use of one of the two dentifrices under investigation, after which they used the assigned dentifrices twice daily (1 min each brushing) under supervised conditions for a period of 54 months. 3. Clinical examinations were conducted on all subjects initially (base line), and at 3-month intervals throughout the 54-month course of the study. This examination included a complete and thorough inspection of the oral soft and hard tissues. 4. The results after 54 months of continuous use of the dentifrices (representing a total dentifrice/oral tissues exposure time of approximately 45 hours per subject) indicated that neither of the two dentifrices caused any adverse reactions of the oral soft tissues and that both dentifrice groups had similar patterns and levels of cervical abrasion and/or erosion. 5. The results also indicate a lack of direct correlation between laboratory abrasivity values (as determined by a radioactive dentin abrasion procedure) and the clinical situation, thus suggesting that factors other than dentifrice abrasivity may play an important role with regard to tooth wear.
As can be seen from this incomplete list of dental specialties and functions they perform in the hospital, there is an increasing participation of dental specialists in the delivery of total health care to the hospitalized patient. In order to disseminate knowledge further of the special protocols of hospital practice and of special hospital dentistry problems, the American Association of Hospital Dentists was formed and publishes a journal containing this special information.
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