- Email: [email protected]
Steps to control airborne contamination
Fifteen specimens were submitted for each group. All the definitive casts were evaluated for positional accuracy of the implant replica heads and compared with the measurements obtained on the reference resin model. Results.—The horizontal distances between the definitive casts from groups R and NM and the definitive casts from groups R and M differed significantly. On the reference resin model, the distance between implants 1 and 4 was 28,160 µm. On the NM casts the distance was 46.21 µm greater than the reference distance, on the R casts the distance was 18.17 µm greater, and on the M casts the distance was 41.27 µm greater. The distances between anterior implants also exceeded those of the resin model, with groups NM and M having variations significantly greater than those of group R compared to the resin model. The distance between implants 2 and 3 was 12,910 µm on the resin standard. The NM, R, and M groups had distances that were 43.23, 15.23, and 38.17 µm greater than on the resin standard.
joined with autopolymerizing acrylic resin. Casts made from transfer impressions with nonmodified implant impression copings and airborne particle-abraded, adhesivecoated copings were not nearly as accurate.
Clinical Significance.—Accuracy of the master cast is essential to the success of prostheses retained by multiple abutments. Splinting of the multiple abutment impression copings before impression taking seems to produce a more reliable cast.
Vigolo P, Fonzi F, Majzoub Z, et al: An evaluation of impression techniques for multiple internal connection implant prostheses. J Prosthet Dent 92:470-476, 2004 Reprints available from P Vigolo, Via Vecchia Ferriera, 13, 36100 Vicenza, Italy; fax: 39-0444-964545; e-mail: [email protected]
Discussion.—This in vitro study found that the most accurate casts were made with square impression copings
Infection Control Steps to control airborne contamination Background.—Contaminated aerosols and splatter are produced routinely during dental treatment. Many dental procedures produce aerosols that are highly contaminated with bacteria and viruses and contain blood components. Control of these contaminated aerosols must be considered a priority in dental practice. The procedures that cause the most airborne contaminations involve powerdriven equipment, water sprays, or compressed air. The patient’s saliva, blood, subgingival fluids, and nasopharyngeal matter form the most significant reservoir for potentially harmful organisms.
Control Measures.—The routine use of a rubber dam and a high volume evacuator (HVE) constitutes a work practice that can reduce patient source contamination. The rubber dam prevents contamination from sources other than the tooth itself, which should be minimal. When a rubber dam cannot be used, the HVE offers the opportunity to reduce airborne bacterial contamination by more than 90%. However, the HVE is generally not used during dental hygiene procedures. In addition, the ultrasonic scaler, which is a routine instrument used in dental hygiene, is the largest source of aerosol contamination. Thus, an HVE
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should always be used with ultrasonic scalers. To remove the largest amount of air in a short time requires a relatively large inside diameter for the evacuator tip, preferably at least 6 to 8 mm. Three steps are recommended for the control of aerosols during dental procedures. First, preprocedural antiseptic rinses reduce the number of bacteria. Second, basic barrier protection must be used routinely. Third, the use of a large-bore HVE is the least expensive and most effective way to remove airborne contamination. Additional devices that can be used are the high-efficiency air filter or an ultraviolet (UV) “upper room” air sanitizer. The high-efficiency air filter is extremely effective in filtering particles from the air but requires considerable time to circulate the air through the filter and can only remove contaminants that are already in the air. The air sanitizer is placed in the airconditioning system and exposes circulating air to a germicidal UV light. This is an expensive option, but it should be considered when new construction or major remodeling is being done. Neither of these last options should be considered a first line of protection for dental personnel because
these devices only remove contamination that is already in the air. Discussion.—Controlling contaminated aerosols produced during dental procedures is a significant problem that has not been addressed sufficiently until lately. Following 3 simple steps can help to control infection that is spread by the airborne route.
Clinical Significance.—The recent SARS outbreaks have focused attention on airborne contaminants, for which dental offices are a rich source. Presented are ideas for controlling this potential threat.
Harrel SK: Airborne spread of disease—the implications for dentistry. Calif Dent Assoc J 32:901-906, 2004 Reprints available from SK Harrel, Baylor College of Dentistry, 10246 Midway Rd, Suite 101, Dallas, TX 75229
Oral and Maxillofacial Pathology Clinical facts about oral lichen planus Background.—Oral lichen planus (OLP) is among the most common mucosal conditions a dental professional is likely to encounter during practice. The etiology of this immunologically based, chronic inflammatory mucocutaneous disorder is unknown, but it affects about 0.5% to 2.3% of the general population. It is seen most commonly among women in the fourth through sixth decades of life. Conditions with a possible relationship with OLP are hepatitis C virus (HCV) infection and oral squamous cell carcinoma. Clinical Manifestations and Diagnosis.—Twenty clinical types have been identified for LP. OLP is found concurrently in up to 65% of patients with cutaneous LP. OLP le-
212 Dental Abstracts
sions seldom exhibit remission and are less amenable to treatment than the cutaneous form. From 15% to 35% of patients have only OLP, which can manifest in 6 clinical forms: reticular, papular, plaque, atrophic, erosive, and bullous. Generally, only the reticular, atrophic, or erosive manifestations are noted. The reticular form is the most common and manifests as mucosal keratotic lines arranged in a characteristic lacy pattern, plaques, or papules. In the atrophic form, a red or erythematous component is added to the keratotic form. A shallow ulcerative component along with the keratotic manifestations is characteristic of the erosive form. The forms can be present in any combination at any time in OLP. In most cases, the buccal mucosa is involved, but the tongue, lips, floor
joined with autopolymerizing acrylic resin. Casts made from transfer impressions with nonmodified implant impression copings and airborne particle-abraded, adhesivecoated copings were not nearly as accurate.
Clinical Significance.—Accuracy of the master cast is essential to the success of prostheses retained by multiple abutments. Splinting of the multiple abutment impression copings before impression taking seems to produce a more reliable cast.
Vigolo P, Fonzi F, Majzoub Z, et al: An evaluation of impression techniques for multiple internal connection implant prostheses. J Prosthet Dent 92:470-476, 2004 Reprints available from P Vigolo, Via Vecchia Ferriera, 13, 36100 Vicenza, Italy; fax: 39-0444-964545; e-mail: [email protected]
Discussion.—This in vitro study found that the most accurate casts were made with square impression copings
Infection Control Steps to control airborne contamination Background.—Contaminated aerosols and splatter are produced routinely during dental treatment. Many dental procedures produce aerosols that are highly contaminated with bacteria and viruses and contain blood components. Control of these contaminated aerosols must be considered a priority in dental practice. The procedures that cause the most airborne contaminations involve powerdriven equipment, water sprays, or compressed air. The patient’s saliva, blood, subgingival fluids, and nasopharyngeal matter form the most significant reservoir for potentially harmful organisms.
Control Measures.—The routine use of a rubber dam and a high volume evacuator (HVE) constitutes a work practice that can reduce patient source contamination. The rubber dam prevents contamination from sources other than the tooth itself, which should be minimal. When a rubber dam cannot be used, the HVE offers the opportunity to reduce airborne bacterial contamination by more than 90%. However, the HVE is generally not used during dental hygiene procedures. In addition, the ultrasonic scaler, which is a routine instrument used in dental hygiene, is the largest source of aerosol contamination. Thus, an HVE
Volume 50 • Issue 4 • 2005 211
should always be used with ultrasonic scalers. To remove the largest amount of air in a short time requires a relatively large inside diameter for the evacuator tip, preferably at least 6 to 8 mm. Three steps are recommended for the control of aerosols during dental procedures. First, preprocedural antiseptic rinses reduce the number of bacteria. Second, basic barrier protection must be used routinely. Third, the use of a large-bore HVE is the least expensive and most effective way to remove airborne contamination. Additional devices that can be used are the high-efficiency air filter or an ultraviolet (UV) “upper room” air sanitizer. The high-efficiency air filter is extremely effective in filtering particles from the air but requires considerable time to circulate the air through the filter and can only remove contaminants that are already in the air. The air sanitizer is placed in the airconditioning system and exposes circulating air to a germicidal UV light. This is an expensive option, but it should be considered when new construction or major remodeling is being done. Neither of these last options should be considered a first line of protection for dental personnel because
these devices only remove contamination that is already in the air. Discussion.—Controlling contaminated aerosols produced during dental procedures is a significant problem that has not been addressed sufficiently until lately. Following 3 simple steps can help to control infection that is spread by the airborne route.
Clinical Significance.—The recent SARS outbreaks have focused attention on airborne contaminants, for which dental offices are a rich source. Presented are ideas for controlling this potential threat.
Harrel SK: Airborne spread of disease—the implications for dentistry. Calif Dent Assoc J 32:901-906, 2004 Reprints available from SK Harrel, Baylor College of Dentistry, 10246 Midway Rd, Suite 101, Dallas, TX 75229
Oral and Maxillofacial Pathology Clinical facts about oral lichen planus Background.—Oral lichen planus (OLP) is among the most common mucosal conditions a dental professional is likely to encounter during practice. The etiology of this immunologically based, chronic inflammatory mucocutaneous disorder is unknown, but it affects about 0.5% to 2.3% of the general population. It is seen most commonly among women in the fourth through sixth decades of life. Conditions with a possible relationship with OLP are hepatitis C virus (HCV) infection and oral squamous cell carcinoma. Clinical Manifestations and Diagnosis.—Twenty clinical types have been identified for LP. OLP is found concurrently in up to 65% of patients with cutaneous LP. OLP le-
212 Dental Abstracts
sions seldom exhibit remission and are less amenable to treatment than the cutaneous form. From 15% to 35% of patients have only OLP, which can manifest in 6 clinical forms: reticular, papular, plaque, atrophic, erosive, and bullous. Generally, only the reticular, atrophic, or erosive manifestations are noted. The reticular form is the most common and manifests as mucosal keratotic lines arranged in a characteristic lacy pattern, plaques, or papules. In the atrophic form, a red or erythematous component is added to the keratotic form. A shallow ulcerative component along with the keratotic manifestations is characteristic of the erosive form. The forms can be present in any combination at any time in OLP. In most cases, the buccal mucosa is involved, but the tongue, lips, floor