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A colour atlas of endodontics
Book Reviews
Webster’s Medical Dictionary is more of a disappointment, not helped by the use of rather coarse paper. The editor claims it is something entirely novel, a language rather than a medical reference book. While this may mean there is more space for the entries, over 55000, many of these are no more than lists of sodium, potassium and calcium salts and of doubtful value. Despite access to Webster’s considerable lexical resources, the book is not without errors: acantholysis is not atrophy of the prickle cell layer. The choice of eponyms, as indeed the compilation as a whole, is based on the current literature but this does not justify including Watson and Crick when Albright is omitted, and if AlbersSchonberg was the first to describe the X-ray grid, as well as osteopetrosis, who then were Drs Bucky and Potter? Dr Peter Mark Roget was already a distinguished retired physician and inventor of the log-log scale when, in 1852, at the age of 7 1, he first published his Thesaurus, and it remains today an enduring monument to the best kind of (early) Victorian values. His plan of classification of the English language into six classes with subsequent, tree-like subdivisions has withstood the test of time and the present edition updates it for the Eighties. Dentate appears under notch, its architectural connotation, and dentist and orthodontist under doctor, a list that also includes leech and quack. P. N. Hirschmann Dentine and Dentine Reactions in the Oral Cavity. Edited by A. Thylstrup, S. A. Leach and V. Qvist. Pp. 270. 1987. Oxford, IRL Press. Softback, f35.00. Both new and established information on the biology of dentine, dentine reactions, dentine and root canes and adhesion to dentine was presented in the course of 24 papers by more than 50 contributors at a Workshop in February 1987 sponsored by the Council of Europe. It opened with a stimulating proposal of criteria for deciding whether to restore or try reversal of caries, which sets the scene for a good review of the biology of dentine. By contrast that on reaction patterns in dentine is short and disappointing. The last paper on scanning microscopy of dentine surfaces gives interesting observations on dentine structure, mineralization and its resorption by osteoclasts, but interpreting the unlabelled photographs and printed stereo pictures which lack instructions is a problem. Dentine microhardness features in the title but not in the text. ‘Dentine Reactions’ discusses first the optical properties of dentine. The authors of a study on the fall in dentine solubility after its exposure to saliva found no plaquemediated increase of fluoride uptake in dentine slabs. A histochemical study of odontoblast function during the secondary dentine reaction to caries precedes a wellbalanced review on the microbiology of dentine caries, which asks whether it is safe to leave microorganisms deep in dentine under restorations. Root caries is shown to be similar to coronal caries. The informative quantitation of the demineralization in dentine and enamel in vitro is confirmed in the next paper using a different in vitro model for dentine caries. Other papers in this section consider the histology of root caries, carious degradation of dentine matrix, odontoblast sulphate metabolism in fluorosis, and clinically ‘active’ versus ‘inactive’ root caries, and it ends with two papers from Oslo which show that calcium fluoride is present as insoluble particles on dentine (or enamel) surfaces for several days after a single exposure to metal fluoride solutions, and thus revive the earlier controversy about
207
the desirability of forming calcium fluoride in topical fluoride treatment. The final section gives an overview of dentine bonding materials, but the methods for testing bond strengths seemed out of place here. A trio of papers on adhesion of bacteria to dentine starts from theoretical predictions to progress through their laboratory and in vivo testing with some surprises in store. Camera-ready publications of this type often contain a range of typefaces, styles and errors, but the editors have kept these down to a minimum and compiled a wealth of recent information on dentine, with only the odd omission, such as dentine permeability. There is however no index limiting its usefulness for the postgraduate or research worker who would benefit most by consulting it. A. Tatevossian Appearance and Aesthetics in Denture Practice. Dental Practitioner Handbook 37. D. J. Lamb. Pp. 1 10. 1987. Guildford, Wright. Softback, f 1 1.95. This recent addition to the series of Dental Practitioner Handbooks offers a very reasonably priced introduction to a difficult and demanding area of dentistry. The greater wealth and leisure of the middle-aged and elderly in recent years has led to increased expectations of dentures in maintaining, or even improving, personal appearance and masticatory efficiency. As the author himself states, the Denture Conciliation Committees often provide witness to dentists’ ‘heroic failures’ to satisfy patients’ demands. The first four chapters deal with the problems that may be posed by tooth loss, the general effects of ageing on appearance, clinical assessment of patients and, in some detail, the management of complete denture cases. The final two chapters deal rather more briefly with the problems posed by partial and immediate dentures. Appendices on denture cleansing, clinical photography and a useful bibliography conclude the volume. The book opens somewhat surprisingly with a photograph of the author as an ‘ideal face’ but closer examination would probably show that his tongue is in his cheek! As the book develops, his clinical expertise and experience are everywhere apparent. Although there is little that is new to the experienced prosthetist, the fundamental principles are refreshingly well explained with a clear understanding of the compromises that may have to be made. Students and the recently qualified will learn a lot from reading it and should feel much more confident in choosing and positioning teeth as a result. The budget price of this handbook has precluded the use of colour illustrations and the quality of the many black and white illustrations is variable (Figures 4*8a and 4.8b are printed in the wrong order). None the less this text can be warmly recommended to all concerned with aesthetics in denture construction as a very clear distillation of the guiding principles involved in achieving that harmonious, if sometimes elusive, combination of appearance and function. A R. Ogden A Colour Atlas of Endodontics. J. J. Messing and C. R. Stock. Pp. 273. 1988. London, Wolfe Medical Publications. Hardback f 60.00. This is the latest in the series of atlases which, the publishers claim, is now probably the largest published collection of diagnostic colour photographs. The quality here is first class, with excellent colour balance and sharp
208
J. Dent. 1989; 17: No. 4
focus, printed on high-quality paper with the text and illustrations combined to give interesting page layouts. The authors state that their objective has been to provide a ‘simple description, liberally illustrated, of the modern concept of endodontics’ directed at both the undergraduate and the general practitioner. The book could be used as a systematic text or as a reference work when practical difficulties are experienced. Much of the material will be familiar to anyone who has attended either author’s excellent lectures. The assembly of this material into a single text has clearly been a major but very worthwhile undertaking. The result is a comprehensive account of modern endodontic diagnosis and treatment. Inevitably teachers have different approaches but I was surprised that, having found space for an account of pulp embryology, there was mention of neither the more recent work on dentine tubule fluid movement nor the role of microleakage at restoration margins in the aetiology of pulp disease. The section on pulp inflammation is sadly dated. The range of instruments, measuring and sterilizing methods is very clearly described and would provide an admirable introduction for the novice or refresher for anyone wishing to update their knowledge. It may be an accident of page layout, but I am unhappy about the apparent prominence given to the use of Ledermix paste as a root canal medicament. A warning should have been given about the dangers of overfilling with sealers containing paraformaldehyde. There is some useful advice on how to manage teeth with broken-down crowns, and the preparation of access cavities is particularly well illustrated, while the problem of how to show clearly instrumentation and filling of canals is overcome by the use of some good line diagrams. However, it is surprising to find when considering calcium hydroxide so much space allocated to ‘Biocalex’, with only the limited qualification that ‘it should be reserved for those difficult teeth which defeat conventional, accepted procedures’. This is an excellent book which will stimulate much discussion among students and practitioners alike. It represents remarkably good value for money and should be available to all undergraduate and postgraduate students, while practitioners with a significant endodontic caseload will find it a worthwhile purchase. R. P. Paterson
Change Your Smile, 2nd edition. R. E. Goldstein. Pp. 425. 1988. New Malden, Quintessence. Hardback, f 2 1 .OO. As a profession we are often accused of failing to communicate with our patients, particularly about what modern dentistry can offer, and this superb book is an invaluable vehicle to help to remedy this. As such, it should be in every practice waiting room, particularly as in today’s climate everyone is aware of beauty and smiles, and what we have here is a comprehensive, detailed coverage of every facet of cosmetic dentistry. It begins with a smile analysis, reinforced in every case with before and after photographs. These are quite correctly presented as full-face in which patients readily can identify their own particular problems, much more useful than close-up intraoral views to which they cannot relate.
Next comes advice for patients on how to determine whether they have the right dentist; this section is a must for every practitioner who will find a wealth of advice on correct practice management and patient communication. The nine chapters that follow describe the various methods of improving smiles, covering badly stained teeth, fractures, distemas, irregular teeth, abnormal bites, periodontal problems and the ageing smile. The latter is particularly important-how many of us fail to realize that even old people want to have nice-looking teeth and beautiful smiles? There is rather too much space devoted to bleaching and acrylic laminates, now rarely practised in England and on the other hand, too little to porcelain veneers. Dr Goldstein gives the life expectancy of these restorations as 5-l 2 years, which, considering the limited time they have been in general clinical use, could be rather a dangerous prediction. Crowns and posterior restorations are explained in the form of line drawings rather than photographs, which will not only be far from clear to the lay man but also do not do justice to either the technique or the results. Each method of restoration is summarized, giving details of the time required, patient maintenance, results, life-expectancy and costs together with the advantages and disadvantages. These are easy to understand and must be very useful for the patient In conclusion, superbly produced, with excellent photographs, ideal not only for patient education but also as a textbook of cosmetic dentistry, this is one book which every dentist should possess. J. E. Paul Dental Surgery Assistants’ Handbook Edited by R. G. Smith. Pp. 152. 1988. London, Gower Medical. Softback f 12.00. This is a well-written textbook, accurately aimed at its target audience, admirably laid out and printed, and in which the illustrations are as good as any I have seen. I do not know if credit is due to Roger Smith as compiler, or whether ‘Bristol Man’ thinks as one, but the eight authors of the 16 chapters have produced a text that reads as a whole. Overall, the selection of subjects and their coverage is hard to fault: the standard is such that dental students would benefit from the purchase of a copy. The chapter on medical emergencies would be better expanded from the point of view of the DSA stressing her essential preventive role by supporting those patients who are at risk. The paragraph on health and safety (Chapter 16) is both concise and clear but a similar paragraph should be added on medicolegal requirements. Radiology needs a chapter, not a page; DSAs dealing with radiographs need guidance on the law, processing and mounting films, their storage and retrieval, and simple quality control. While some authors have taken pains to explain difficult words, a glossary in future editions would be useful. The illustrations are in general appropriate: however, Figure 4.7 should be modified at the earliest opportunity to match the text and avoid the unnecessary distress it will cause in its present form, while Figure 14.5 presents a hydraulic novelty. Compliments are due all round to the team, and I recommend this as a textbook and also a suitable introduction, for any young person joining a practice as a DSA. M. G. H. Bishop
Webster’s Medical Dictionary is more of a disappointment, not helped by the use of rather coarse paper. The editor claims it is something entirely novel, a language rather than a medical reference book. While this may mean there is more space for the entries, over 55000, many of these are no more than lists of sodium, potassium and calcium salts and of doubtful value. Despite access to Webster’s considerable lexical resources, the book is not without errors: acantholysis is not atrophy of the prickle cell layer. The choice of eponyms, as indeed the compilation as a whole, is based on the current literature but this does not justify including Watson and Crick when Albright is omitted, and if AlbersSchonberg was the first to describe the X-ray grid, as well as osteopetrosis, who then were Drs Bucky and Potter? Dr Peter Mark Roget was already a distinguished retired physician and inventor of the log-log scale when, in 1852, at the age of 7 1, he first published his Thesaurus, and it remains today an enduring monument to the best kind of (early) Victorian values. His plan of classification of the English language into six classes with subsequent, tree-like subdivisions has withstood the test of time and the present edition updates it for the Eighties. Dentate appears under notch, its architectural connotation, and dentist and orthodontist under doctor, a list that also includes leech and quack. P. N. Hirschmann Dentine and Dentine Reactions in the Oral Cavity. Edited by A. Thylstrup, S. A. Leach and V. Qvist. Pp. 270. 1987. Oxford, IRL Press. Softback, f35.00. Both new and established information on the biology of dentine, dentine reactions, dentine and root canes and adhesion to dentine was presented in the course of 24 papers by more than 50 contributors at a Workshop in February 1987 sponsored by the Council of Europe. It opened with a stimulating proposal of criteria for deciding whether to restore or try reversal of caries, which sets the scene for a good review of the biology of dentine. By contrast that on reaction patterns in dentine is short and disappointing. The last paper on scanning microscopy of dentine surfaces gives interesting observations on dentine structure, mineralization and its resorption by osteoclasts, but interpreting the unlabelled photographs and printed stereo pictures which lack instructions is a problem. Dentine microhardness features in the title but not in the text. ‘Dentine Reactions’ discusses first the optical properties of dentine. The authors of a study on the fall in dentine solubility after its exposure to saliva found no plaquemediated increase of fluoride uptake in dentine slabs. A histochemical study of odontoblast function during the secondary dentine reaction to caries precedes a wellbalanced review on the microbiology of dentine caries, which asks whether it is safe to leave microorganisms deep in dentine under restorations. Root caries is shown to be similar to coronal caries. The informative quantitation of the demineralization in dentine and enamel in vitro is confirmed in the next paper using a different in vitro model for dentine caries. Other papers in this section consider the histology of root caries, carious degradation of dentine matrix, odontoblast sulphate metabolism in fluorosis, and clinically ‘active’ versus ‘inactive’ root caries, and it ends with two papers from Oslo which show that calcium fluoride is present as insoluble particles on dentine (or enamel) surfaces for several days after a single exposure to metal fluoride solutions, and thus revive the earlier controversy about
207
the desirability of forming calcium fluoride in topical fluoride treatment. The final section gives an overview of dentine bonding materials, but the methods for testing bond strengths seemed out of place here. A trio of papers on adhesion of bacteria to dentine starts from theoretical predictions to progress through their laboratory and in vivo testing with some surprises in store. Camera-ready publications of this type often contain a range of typefaces, styles and errors, but the editors have kept these down to a minimum and compiled a wealth of recent information on dentine, with only the odd omission, such as dentine permeability. There is however no index limiting its usefulness for the postgraduate or research worker who would benefit most by consulting it. A. Tatevossian Appearance and Aesthetics in Denture Practice. Dental Practitioner Handbook 37. D. J. Lamb. Pp. 1 10. 1987. Guildford, Wright. Softback, f 1 1.95. This recent addition to the series of Dental Practitioner Handbooks offers a very reasonably priced introduction to a difficult and demanding area of dentistry. The greater wealth and leisure of the middle-aged and elderly in recent years has led to increased expectations of dentures in maintaining, or even improving, personal appearance and masticatory efficiency. As the author himself states, the Denture Conciliation Committees often provide witness to dentists’ ‘heroic failures’ to satisfy patients’ demands. The first four chapters deal with the problems that may be posed by tooth loss, the general effects of ageing on appearance, clinical assessment of patients and, in some detail, the management of complete denture cases. The final two chapters deal rather more briefly with the problems posed by partial and immediate dentures. Appendices on denture cleansing, clinical photography and a useful bibliography conclude the volume. The book opens somewhat surprisingly with a photograph of the author as an ‘ideal face’ but closer examination would probably show that his tongue is in his cheek! As the book develops, his clinical expertise and experience are everywhere apparent. Although there is little that is new to the experienced prosthetist, the fundamental principles are refreshingly well explained with a clear understanding of the compromises that may have to be made. Students and the recently qualified will learn a lot from reading it and should feel much more confident in choosing and positioning teeth as a result. The budget price of this handbook has precluded the use of colour illustrations and the quality of the many black and white illustrations is variable (Figures 4*8a and 4.8b are printed in the wrong order). None the less this text can be warmly recommended to all concerned with aesthetics in denture construction as a very clear distillation of the guiding principles involved in achieving that harmonious, if sometimes elusive, combination of appearance and function. A R. Ogden A Colour Atlas of Endodontics. J. J. Messing and C. R. Stock. Pp. 273. 1988. London, Wolfe Medical Publications. Hardback f 60.00. This is the latest in the series of atlases which, the publishers claim, is now probably the largest published collection of diagnostic colour photographs. The quality here is first class, with excellent colour balance and sharp
208
J. Dent. 1989; 17: No. 4
focus, printed on high-quality paper with the text and illustrations combined to give interesting page layouts. The authors state that their objective has been to provide a ‘simple description, liberally illustrated, of the modern concept of endodontics’ directed at both the undergraduate and the general practitioner. The book could be used as a systematic text or as a reference work when practical difficulties are experienced. Much of the material will be familiar to anyone who has attended either author’s excellent lectures. The assembly of this material into a single text has clearly been a major but very worthwhile undertaking. The result is a comprehensive account of modern endodontic diagnosis and treatment. Inevitably teachers have different approaches but I was surprised that, having found space for an account of pulp embryology, there was mention of neither the more recent work on dentine tubule fluid movement nor the role of microleakage at restoration margins in the aetiology of pulp disease. The section on pulp inflammation is sadly dated. The range of instruments, measuring and sterilizing methods is very clearly described and would provide an admirable introduction for the novice or refresher for anyone wishing to update their knowledge. It may be an accident of page layout, but I am unhappy about the apparent prominence given to the use of Ledermix paste as a root canal medicament. A warning should have been given about the dangers of overfilling with sealers containing paraformaldehyde. There is some useful advice on how to manage teeth with broken-down crowns, and the preparation of access cavities is particularly well illustrated, while the problem of how to show clearly instrumentation and filling of canals is overcome by the use of some good line diagrams. However, it is surprising to find when considering calcium hydroxide so much space allocated to ‘Biocalex’, with only the limited qualification that ‘it should be reserved for those difficult teeth which defeat conventional, accepted procedures’. This is an excellent book which will stimulate much discussion among students and practitioners alike. It represents remarkably good value for money and should be available to all undergraduate and postgraduate students, while practitioners with a significant endodontic caseload will find it a worthwhile purchase. R. P. Paterson
Change Your Smile, 2nd edition. R. E. Goldstein. Pp. 425. 1988. New Malden, Quintessence. Hardback, f 2 1 .OO. As a profession we are often accused of failing to communicate with our patients, particularly about what modern dentistry can offer, and this superb book is an invaluable vehicle to help to remedy this. As such, it should be in every practice waiting room, particularly as in today’s climate everyone is aware of beauty and smiles, and what we have here is a comprehensive, detailed coverage of every facet of cosmetic dentistry. It begins with a smile analysis, reinforced in every case with before and after photographs. These are quite correctly presented as full-face in which patients readily can identify their own particular problems, much more useful than close-up intraoral views to which they cannot relate.
Next comes advice for patients on how to determine whether they have the right dentist; this section is a must for every practitioner who will find a wealth of advice on correct practice management and patient communication. The nine chapters that follow describe the various methods of improving smiles, covering badly stained teeth, fractures, distemas, irregular teeth, abnormal bites, periodontal problems and the ageing smile. The latter is particularly important-how many of us fail to realize that even old people want to have nice-looking teeth and beautiful smiles? There is rather too much space devoted to bleaching and acrylic laminates, now rarely practised in England and on the other hand, too little to porcelain veneers. Dr Goldstein gives the life expectancy of these restorations as 5-l 2 years, which, considering the limited time they have been in general clinical use, could be rather a dangerous prediction. Crowns and posterior restorations are explained in the form of line drawings rather than photographs, which will not only be far from clear to the lay man but also do not do justice to either the technique or the results. Each method of restoration is summarized, giving details of the time required, patient maintenance, results, life-expectancy and costs together with the advantages and disadvantages. These are easy to understand and must be very useful for the patient In conclusion, superbly produced, with excellent photographs, ideal not only for patient education but also as a textbook of cosmetic dentistry, this is one book which every dentist should possess. J. E. Paul Dental Surgery Assistants’ Handbook Edited by R. G. Smith. Pp. 152. 1988. London, Gower Medical. Softback f 12.00. This is a well-written textbook, accurately aimed at its target audience, admirably laid out and printed, and in which the illustrations are as good as any I have seen. I do not know if credit is due to Roger Smith as compiler, or whether ‘Bristol Man’ thinks as one, but the eight authors of the 16 chapters have produced a text that reads as a whole. Overall, the selection of subjects and their coverage is hard to fault: the standard is such that dental students would benefit from the purchase of a copy. The chapter on medical emergencies would be better expanded from the point of view of the DSA stressing her essential preventive role by supporting those patients who are at risk. The paragraph on health and safety (Chapter 16) is both concise and clear but a similar paragraph should be added on medicolegal requirements. Radiology needs a chapter, not a page; DSAs dealing with radiographs need guidance on the law, processing and mounting films, their storage and retrieval, and simple quality control. While some authors have taken pains to explain difficult words, a glossary in future editions would be useful. The illustrations are in general appropriate: however, Figure 4.7 should be modified at the earliest opportunity to match the text and avoid the unnecessary distress it will cause in its present form, while Figure 14.5 presents a hydraulic novelty. Compliments are due all round to the team, and I recommend this as a textbook and also a suitable introduction, for any young person joining a practice as a DSA. M. G. H. Bishop