[Treatment of an impacted upper cuspid: a different approach].
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Biomedical subjects
Publications and source records attributed to R J Swart.
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Strengthening of the Montreal Protocol is recently being negotiated in London in 1990 in order to achieve further reductions of the regulated CFCs and to include possibly more substances. In this article the implications of different policies with respect to control of ozone depleting substances for climate change are analysed, including the proposed substitution by HCFCs and HFCs, carbon tetrachloride and methylchloroform. A special halocarbon module was developed within the framework of RIVM's Integrated Model to Assess the Greenhouse Effect (IMAGE). IMAGE is a parameterized science based policy model and has been developed to give policy agencies a concise overview of the quantitative aspects of the greenhouse problem, to evaluate various policy options concerning climate change and to serve as a means of communication. It is concluded, from simulations with the halocarbon module, that it is of primary importance to achieve a further reduction of the regulated CFCs compared to the Montreal Protocol with compliance by as many countries as possible. From the perspective of the greenhouse effect the inclusion of longer lived halocarbons, such as carbon tetrachloride and HCFC-22 in the protocol comes second. The application of methylchloroform, halons and HCFCs and HFCs with lower global warming potentials (GWPs) than HCFC-22 contributes only marginally to the greenhouse effect in comparison with the much more important greenhouse gases carbon dioxide, methane, ozone and nitrous oxide. Especially if further growth of the total production of HCFCs after complete replacement of the present CFCs can be avoided by using these alternatives with a lower GWP, these substances could therefore be tolerated in a transition period, from the perspective of global warming.
Attention is paid to the normal and disturbed eruption of the upper cuspid. Genetic factors seem to play the most important role in impaction or delayed eruption. The dentist needs to be aware of the diagnostic and roentgenological features of this phenomenon.
Delayed eruption of impacted canines in more or less guaranteed by using the modified window technique. A decision for futher treatment can be made afterwards. If orthodontic treatment is required, fixed appliance is recommended for uneventful orthodontic positioning of these teeth.
Prevention of impaction depends in many cases on the knowledge of variations in eruption sequences. However, in case of impaction, spontaneous eruption can be stimulated by exposing the tooth with the modified window-technique. Frequent communications between dentist, orthodontist and oral surgeon are required to determine the right time of intervention.
A review of the treatment of the impacted upper cuspid is presented. A description of a modified exposure technique is given. Up to the present day more than 400 impacted cuspids have been treated with this technique.
Treatment goal of the maxillary impacted cuspid should include health periodontal end results. This clinical and radiographic study reveals in 75% of the cases a satisfying periodontal condition.
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