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CURRENT LITERATURE

Effect on Caries Incidence of a Single ingly high incidence of dental defects in


Topical Application of a Fluoride selectees for military service, industrial work
Solution to the Teeth of Young Adult ers, National Youth Administration appli
Males of a Military Population cants and the public at large appears even to
F
r a n c i sA. A , J ., H. T
r n o l d r
the casual observer more than coincidental.
r e n d l e y

De a n and D E. S
e n n i s , J .
Dentistrys service to the public must be
in g l e t o n r

augmented for better protection and conser


In a study in which a single application of
vation of dental health. Restorative dentistry
a fluoride solution (5,000 parts per million)
cannot compete with destructive forces and
was made to the teeth of 258 cadets at
must be supplemented by preventive meas
the U. S. Coast Guard Academy, com
ures along nutritional lines. There is avail
plete dental examinations were made one
able for ready and practical application
year apart, including roentgenograms and L.
much acceptable and valuable information
acidophilus counts of the saliva. Cadets were
pertaining to the rle of nutrition in the pro
divided into control and experimental groups
tection of dental health. Also, rapidly ac
at the start of the study on the basis of com
cumulating data from creditable investiga
parable oral condition in regard to L. aci
tions indicate a probable explanation of the
dophilus count, fluoride exposure, caries ex
mechanism of the effect of improved general
perience and age. Results in 188 cadets who
nutrition on dental health. Recognition of
remained in the study throughout the year
these obligations involves the very integrity of
indicate: (a) no change in dental caries in- ?
the dental profession. Remuneration will
cidence in fluoride treated group, (b) de
come with education of the public. J. ad
velopment in control and experimental
Dist. D. Soc., 2 9 :215, M ay 1943.
groups of about the same number of new cari
ous surfaces or areas and (c) according to Dental Jurisprudence
L. acidophilus counts during study period, no J F a c o b e i n m a n

beneficial effect in the treated group. There


The field of dental jurisprudence is rapidly
is no evidence in this study that a single
expanding. Some interesting legal trends cen
topical application of a fluoride solution of
ter about the indemnification of dentists, em
this concentration to the teeth of young
ployed by municipalities, from all harm or
adults would result in reduction of the dental
damage that may result from a malpractice
caries incidence. J. D. Res., 23:155, June
suit. Dentists are individually liable for their
1944.
acts whether committed in private or in pub
lic employ. However, when in public em
Dentists Responsibilities in Health Con ploy, the dentist may interplead his employer,
servation either municipal or state. The latter may be
E. C . M B c e a t h
sued only after prescribed conditions are
Dentistry, now a well-established branch of complied with. One condition, namely, the
health service, must be more aware of its statute of limitations, is often at variance in
responsibilities in health conservation, par malpractice actions as against a dentist or a
ticularly with the increasing limitation of . municipality. Thus, where an action against
medical and dental service to the general a city must be instituted within six months,
public. The whole nation is aroused over the while the same action could be instituted
reports of nutritional surveys of the entire against the dentist within two years, an
country showing a universal prevalence of action in malpractice will be barred against
malnutrition especially among the employed both city and dentist after six months;
population. The parallelism of this wide whereas, if the action were brought within
spread nutritional deficiency and the alarm the six-month period, the dentist would be
Jour. A.D.A., Vol. 31, December 1, 1944 168 5
1686 T h e J o u r n a l o f t h e A m e r ic a n D e n t a l A s s o c ia t io n

protected against any judgment that may was established within each dental arch.
be rendered against him. Previously prepared models indicated the de
Another trend is away from actions in sired goal of treatment. Necessary movement
malpractice with its short period of statute was achieved by variously arranged intermax
of limitations, and toward actions in breach illary elastics with an elastic bandage to a
of contract. The danger of guaranteeing serv headcap as an adjunct. The stability of the
ices or assuring a specific result lies in the appliance was adequate. It was not cum
fact that it facilitates an action in breach of bersome and was readily tolerated by the
contract. Such actions are simpler to prose patient. It permitted the application of
cute and are often as disastrous as malprac force in the desired direction. Some freedom
tice suits with their concomitant judg in opening the mouth was possible and a
ments. J. ad Dist. D. Soc., 22:133, March maximum of mouth hygiene could be main
1943 - tained. A firm and uneventful union of the
parts and occlusal relationships existing prior
Observations on- Radiolucency as a Sig to the accident were realized. Angle Ortho
nificant Physical Property of Acrylic dontist, 13:30, January-April 1943.
Dental Materials
G. L. R o b e r t s '
Action of Vitamin D on the Incisor
A is directed to the fact that
t t e n t io n
Teeth of Rats Consuming Diets with
acrylic plastics now employed in artificial a High or Low Calcium : Phosphorus
dental restorations and construction of splints Ratio
for the control of fractured jaws are radio- J. T . I r v in g
lucent and may show no shadow in the
Y o u n grats weighing from 50 to 60 gm.
roentgenograms. Danger lies in the possi
were given modified Steenbock and Black
bility that the roentgenologist, not realizing
rachitogenic diets with calcium :phosphorus
his inability to assist in the location of acrylic
ratios of 1.8, 4.4 and 0.29. After twenty-
fragments traumatically dispersed in the tis
eight days on the ration, they received 18.4
sues, may issue a negative finding where
international units of vitamin D. Some were
findings should be positive. T h e roentgen
injected with a sodium fluoride solution to
ologist is advised to familiarize himself with
provide a mark on the tooth. A ll were
plastic dental materials and consult the
killed at successive intervals. The response
patients or other dentist when in doubt.
of incisor dentin permitted computation of
Brit. J. Radiol., 17:218, 1944.
the time of action of the vitamin. Rats that
H. B. M C . c a u l e y
received the diet with a calcium phosphorus
ratio of 1.8 were stunted, but the bone ash
Treatment of Complete Transverse Max was normal. Incisors were slightly under
illary Fracture with Edgewise Arch calcified. T he action of vitamin D, detect
Mechanism able in twenty-four hours, caused completely
R B. M
o b e r t u r r a y
normal tooth formation. Rats on the diet
A man, a shipyard worker, was struck by with a calcium phosphorus ratio of 4.4 were
a cran handling pipe, complete transverse rachitic, but vitamin D caused resumption of
fracture of the ijiaxill^e resulting. When the dentin calcification. A logarithmic response
mechanics, . offered by a Kingsley splint to varying dose levels was observed. Ani
proved inadequate, the opinion of an ortho mals that received the diet with a calcium:
dontist .was sought and, owing- to the sim phosphorus ratio of 0.29 showed a lowered
ilarity between this case and one: in the bone ash and poorly calcified incisors. The
literature, it was decided to institute treat vitamin therapy caused resumption of calci
ment with .an, orthodontic appliance. Edge fication on the lingual surfaces and irregular
wise arch wing-bracket bands were placed on deposition of interglobular dentin labially.
the mandibular bicuspids and cuspids and on These responses were detectable in thirty
the njaxijlary, bicuspids. T he four first,mol hours. Vitamin action was apparently not
ars carried bands with suitable sheaths. ,Edge restricted to intestinal absorption. J. Phys
wise archwires were adapted passively to iol., I 0 3 :g, J944 -
both arches, and thereby a unit of anchorage H. B. M C c .
a u l e y
C u r r e n t L it e r a t u r e

Comminuted Fractures of the Mandible laterally. Fractures were confined to bone


J. B. C u T H B E R T and incisors anteriorly from the molar teeth
S healing of comminuted mandibular
i n c e
and were not immobilized. Animals were
fractures is frequently delayed for many killed from six and one-half hours to 1 5 8
weeks by suppuration and sequestration, it days after operation. Effects were studied in
was decided to treat such cases by removing living and dead animals, visually, roent-
all portions of bone that might sequestrate genographically and histologically. Roent-
and providing drainage through submandibu genographic findings could not be correlated
lar incision. Speedier repair of grossly com with the stage of histologic repair. The
minuted and contaminated fractures was mandible was occasionally grossly distorted
achieved by bone grafting. In a series of because of posterior shifting of the buccal
twenty-five cases, eleven were treated con protuberance of the incisor base and perfora
servatively, fourteen radically. Conserva tion of the incisor through the .inferior
tively treated cases required an average of border. Fractured incisors, .showed, resorp
twenty-eight weeks to recover. T h e average tion and arrested calcification of enamel
time required for bony union in the radically matrix. In some instances, the epithelial
treated cases was ten weeks. Conservative covering was replaced by connective tissue
treatment consisted of interdental fixation and cementum. Dentin fragments became
and the usual procedure. Radical treatment imfiltrated by pulpal elernents or periodontal
included removal of all bone fragments of membrane. T h e function of odontoblasts
uncertain viability and bone grafting (five was affected as indicated hy atypical second
cases). Lancet, 1:748, 1944. . ary cementum formation. Pulp reaction
P H. K . a u l e y e s
varied from necrosis to complete recovery.
Healing of the fractured mandible resembled
the process as observed in other flat bones.
Effect of Vitamin C on Gingival and Arch. Surg., 49:23, I944 - - ,
Periodontal Disease in Indian Children P H. K .
a u l e y e s

C. D . M and K . L. S h o u r i e
a r s h a l l D a y

One hundred Indian children in a Lahore Wounds of the Neck and Larynx
orphanage were divided into two equal R. S. L e w i s

groups with regard for age, sex, weight and C wounds appear to have received
e r v i c a l

incidence of gingival disease. Each child in little separate consideration in the . surgical
one group received 100 mg. of ascorbic acid writings of this war. T he twelve cases de
orally for 100 days. Children in the other scribed illustrate the kind of lesions and
group received no supplement. Since there complications that may be met and the
was no apparent improvement in the gingi methods by which they may be treated. Dur
val condition of children in the test group ing ..early treatment, relief. or prevention of
after fifty days, it was decided to give local respiratory obstruction, arrest of hemorrhage
treatment to one-half of those in each group. and prevention of infection of the wound
Treatment included extractions, fillings, are the main considerations. In some, cases,
scaling and soft-tissue dressing. On appli there then follows the problem of feeding
cation, the gingival conditions improved the patient if he is unable to swallow, while,
somewhat, but not strikingly. A t the termina in the late stages,. stenosis of the air-and-
tion of the experimental period, no change food passages may have to be relieved.
in gingival condition could be attributed Lancet, 1 : 7 8 1 , June. 1 7 , 1 9 4 4 .
to the administration of ascorbic acid. J. E. G . i l d a

Indian J. M . Res., 31:253, 1943.


P H. K . a u l e y e s
Fractures of the Jaw
W. A. C o a k l e y and J. M. B a l s e r

Effect of Experimental Fracture on Bone, D on 2 1 2 cases of fractured jaws are


a t a

Dentin and Enamel analyzed with respect to etiology, associated


B. G. and I
S a r n a tS s a a c c h o u r
injuries, surgical service admitting,I time of
M of thirty-eight rats were frac
a n d i b l e s admission, time elapsing from injury to fixa
tured, twenty-nine unilaterally and nine bi tion and number and location of fractures.
T h e J o u r n a l o f t h e A m e r ic a n D e n t a l A s s o c ia t io n

No attempt is made to evaluate the findings lower endentulous gum, extending forward
presented. Am. J. Surg., 65:244, August about an inch from the angle of the jaw. A
1944 - diagnosis of papillomatous carcinoma in
J. E. G i l d a . vading the mandible was made. The growth
was found to be infested by a mite of the
Maxillary Forceps genus Tyroglyphus, possibly T . longior.
S . G o r d o n
Large quantities of feces were found in the
material from the deeper layers of the
T replacement of impacted maxillary
h e
growth. Some of the mites were living and
fractures is often difficult because a satis
eggs were present. These findings suggest
factory instrument for reduction is not avail
that it had had a long stay in the tumor.
able. A pair of forceps, designed to meet
Mites of this fam ily customarily live on
this need, is illustrated. Each of them (right
cheese, flour and dried fruits. Lancet, 1:
and left) consists of a pyramidal block with
740, June 3, 1944.
curved upper and outer (palatal) surfaces.
The block is fixed on a shaft which in turn J. E. G . i l d a

is curved to clear the teeth. Opposing it is


a narrow curved rectangular blade that fits Non-Secreting Cysts of the Maxillary
into the buccal sulcus and is hinged in the Sinuses
horizontal plane. Gripping surfaces are cov J. W . G r o s s m a n and H. D. W a l t z

ered with latex. The right or left forceps A series of eighty roentgeno-
c o n s e c u t iv e

can be used separately, or, if desired, they graphic sinus examinations for suspected
may be applied at the same time. Lancet, disease disclosed thirteen indications of
2:8o, July 15, 1944. antral cyst formation. Six of these resulted
J. E. G i l d a . in complete antral opacity and were found
to represent the non-secreting (mesothelial)
Stomatitis Due to Riboflavin Deficiency type of cyst, probably the most common
H. E. J , T . G. A
o n e s , H. F. r m s t r o n g type occurring in the sinuses. Even large
and V. C
G r e e n h a d w i c k non-secreting cysts may have meager or no
S t o m was observed in 1,746 of 10,-
a t it is
local manifestations. T h ey transilluminate
313 men of many racial elements living in a satisfactorily, irrigate with negative results
camp in North Africa. T he symptoms com and may be entirely overlooked in antral
prised sore tongue, sore lips (to a lesser puncture. However, in cases of a large cyst
extent), some degree of trismus from the under pressure, severe toothache with lack
cheilosis and excessive salivation. T he pain of tenderness over the involved antrum may
was variable and did not always correspond be a predominating symptom. These cysts
with the degree of change observed in the are readily manifested in the roentgenogram,
mouth. T he lesions on the tongue were the only dependable medium for determin
studied with a slit-lamp. ing their presence. Roentgenographic opac
T he stomatitis developed about two ity is constant in horizontal and upright
months after a dietary change reduced the positions, and there are no changes to be
riboflavin intake per person per day from found in the sinus wall that would indicate
1.61 mg. to about 1 mg. and was not abol invasion, infection or pressure atrophy.
ished by an intake of 1.28 mg. in the fol Am. J. Roentgenol. & Rad. Therap., 52 :
lowing month. The condition yielded rap 136, 1944.
idly to treatment either with riboflavin (100 H. B. M C . c a u l e y

mg. in five days) or with fresh yeast (one-


half ounce daily). Lancet, 1:720, June 3, Tomography of the Temporomandibular
J944 - Joint and Ramus of the Mandible
J. E. G . i l d a
C. W. C . G o u g h

D in the interpretation of
i f f i c u l t i e s
Mites Infesting Carcinoma of the Jaw standard views of the temporomandibular
R. E. H o p e S im p s o n
joint due to distortion of the neck and
A w o m a n , aged 54, was found to have a ramus of the mandible m ay be met by a
growth approximately an inch long on the simple technic of tomography. T he time, re
C u r r e n t L it e r a t u r e

quired to make the exposure is no greater micro-organisms that fail to grow aerobically
than that for routine views and has the are probably present in any of these lesions.
added advantage of improved reproduc There is available evidence that Streptococ
ibility. Tomographs of both sides or of' one cus viridans is probably only a secondary
side with the jaws opened or closed may be invader in mixed infections of the oral cavity
made on a single plate. A home-made tom if it contributes to them at all. Any patho
ograph attachment (Twining 1937), using genicity it might have appears to be depen
a target-film distance of 40 inches with the dent on the physical state of the host. How
patients head in true lateral position, was ever, the rle of non-hemolytic streptococci
found satisfactory. The section selected was in subacute bacterial endocarditis appears
1 inch below the surface. Brit. J. Radiol., adequately established. An increasing num
17:213, 1944. ber of reports indicate a close relationship
H. B. M C . c a u l e y between antecedent tooth extraction or
other dental instrumentation and subsequent
endocarditis, probably through the produc
Comparison of Various Types of Local
tion of transient bacteremia. Medicine, 2 3 :
Treatment in a Controlled Series of 249, 1944.
Experimental Burns in Human Vol
H. B. M C . c a u l e y
unteers.
J. A . D i n g w a l l and W. DeW. A n d r u s

T efficacy of twelve different local


h e
Tannic Acid and the Treatment of
treatments is evaluated in a controlled series Burns: An Obsequy.
of eighty-two second-degree burns in human R . D. M c C l u r e , C . R . L am and H. R om-
volunteers. Best results were found in a E N C E

group treated with a sulfonamide-impreg In 1924, the use of tannic acid in the treat
nated plastic film (sulfafilm). Almost ment of burns was introduced in the Henry
equally good were results obtained by local Ford Hospital, Detroit. In the past twenty
treatment with a bland ointment and sul years, hundreds of thousands of cases have
fonamides administered orally. Frequent been treated with this substance. Physicians
change of dressings is contraindicated. .Non- working in the same institution today recom
debrided lesions healed as well, and as ra mend the abandonment of this and related
pidly as debrided ones. This series provides methods. Clinical experience and animal ex
additional evidence for the abandonment of periments reveal that tannic acid moder
any type of treatment with escharotic ately inhibits the healing of wounds and
agents. Ann. Surg., 120:377, September may produce a severe narcosis of the liver.
1944. Ann. Surg., 120:387, September 1944.
P H. K .
a u l e y e s P H. K .a u l e y e s

Aerobic Non-Hemolytic Streptococci. Some Observations on Dental Conditions


T h e o d o r R o s e b u r y in Possible Riboflavin Deficiency.
A streptococci the presence of which
e r o b ic
J o h n A. Ross
fails to change or discolor blood are prob An interesting dental condition in which
ably the most characteristic members of the incisor teeth become palpably loosened
the normal flora of the oral cavity. Most was observed in a large number of young
commonly found in the mouth and throat native men in .a Middle East military camp.
are Streptococcus salivarious and mitior. A dietary deficiency of riboflavin appeared
Greening streptococci appear to have been to be the cause. The condition was asso
implicated in common oral disorders such ciated with slightly lowered blood calcium.
as dental caries, pulpitis, periapical disease, T he gingival tissues were not affected,
gingivitis and periodontal infections, but but roentgenographic examination disclosed
whether they play a role in production of marked alveolar absorption and marginal
the lesions is obscure. Findings of pure cul osteoporosis. No abnormal changes could be
tures from such sources may reflect the found in other bones. Brit. J. Radiol., 17 :
employment of aerobic cultural methods 247, 1944.
such as the streaked blood-agar plate. Other H. B. M C . c a u l e y

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