Implant Dentistry Implant treatment without bone grafting in severely resorbed edentulous maxillae

Mattson T Köndell P-Å et al. J Oral Maxillofac Surg 1999; 57: 281–287

This paper describes a simpler method of implant use in situations where there is little bone.

Where there is little bone, operators have used a variety of techniques to place implants, including iliac or rib grafting, guided bone regeneration and other procedures. These additional procedures all have potential complications of their own.

In 15 patients aged 44–75 years (mean 59) who had inadequate maxillary bone volume for conventional implant treatment without bone grafting, the largest possible implants were placed using a novel technique. Following CT scans and treatment planning, the maxillary antrum and nasal floor were surgically exposed so as to allow the best assessment of available bone. Implants were angled mesio-distally and bucco-lingually to varying degrees and the tissues allowed to heal fully before fixed prostheses were placed.

In each patient, 4–6 implants were placed. There were minimal prosthetic complications during the first year, and no implants were lost during the 3 to 4.5 years of follow-up

Dental public health Knowledge and reported behaviour concerning the prevention of caries in children: a questionnaire survey of Japanese parents resident in London, UK

Mikami Y Croucher R et al. Int Dent J 1999; 49: 115–121

Japanese families living in UK culture appeared dentally disadvantaged, although they come from an economically advanced nation.

In 3 London districts where large numbers of Japanese were known to live, 17 schools attended by Japanese children were identified. The Japanese School and other schools not run by UK authorities were excluded. Questionnaires were distributed to parents of 162 children, and 111 responses were received. These related to children aged 3–11 years (mean 6.7), of whom three-quarters had been born in Japan and one-fifth in UK.

Children below the average age, and those born in Japan, were less likely to attend a dentist regularly. There appeared to be occasional problems of communication with dentists, but half the respondents had received some advice on their children's teeth from a UK dental professional. Parents of UK-born children were more likely to consider that sweet foods caused caries, and that it could be prevented by avoiding them. Toothbrushing was reported as somewhat less frequent than in surveys of UK-resident children. The authors discuss the cultural differences which may relate to their findings.

Trauma; physical abuse Head, neck and facial injuries as markers of domestic violence in women

Perciaccante VJ Ochs HA et al. J Oral Maxillofac Surg 1999; 57: 760–762

The presence of these injuries suggests physical abuse, but their absence does not rule it out.

Women attending an Atlanta hospital for reasons of injury were recruited at specified times over a period of 3.5 years. Domestic violence (DV) was ascertained by patient testimony, in 34 of 100 trauma cases. DV patients differed significantly in age (33 ± 7 years) from others ( 44 ± 18), but not in the severity of injury or the nature of trauma.

In 31 of the 34 DV cases, injury involved the head, neck or face, as opposed to 27 of the 66 patients not giving a DV history. A woman presenting with injuries which involved these areas was calculated as 7.5 times more likely (relative risk) to be a victim of DV than those with injuries limited to other parts of the body. A statistical model was developed which suggested that age and location together were a better predictor of DV, with sensitivity of 88% and specificity of 65%.

Oral medicine; epidemiology Cancer of mouth, pharynx and nasopharynx in Asian and Chinese immigrants resident in Thames regions

Waarnakulasuriya KAAS Johnson NW et al. Oral Oncol 1999; 35: 471–475

These ethnic groups are more likely to have one of these tumours at an earlier age.

Data for 7,521 of these tumours were recorded over a 6 year period in the Thames Cancer Registry, which covers a population of nearly 14 million people. Asian and Chinese subjects were identified by names and place of birth. Asian subjects had 232 tumours and Chinese subjects, 67. Mean age at diagnosis was 65 years for the whole group, but 52 for the Asians and 48 for the Chinese. However, there were no differences between groups with regard to the stage of tumour at diagnosis.

There were ethnic differences in the predominant sites at which tumours were diagnosed. In the Chinese group, 67% of tumours were nasopharyngeal, compared with 6% in the Asian group and 3% in other subjects; in the Asian group, mouth and oropharynx accounted for 41% of tumours, compared with 10% in the Chinese and 29% in the others. Mean survival for all tumours in all subjects was 2.2 years, with median survival around 1.5 years. Asian and Chinese subjects had slightly better survival rates.