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Modern concepts in the diagnosis and treatment of fissure caries
Douglas and Fundingsland:
Microleakage
Holtan J. R., Nystrom G. P., Douglas W. H. et al. (1990) Microleakage and marginal placement of a glass-ionomer liner. Quintessence ht. 21, 117-122. Pintado M. R. and Douglas W. H. (1988) The comparison of microleakage between two different dentin bonding resin systems. Quintessence ht. 19, 905-907.
of three fluoride-releasing
liner/bases
369
Tyas M. J. (198.5) Clinical evaluation of dentine bonding agents. J. Dent. Res. 64, (abstr. 71), 657. Welbury R. R. and Murray J. J. (1990) A clinical trial of the glass-ionomer cement-composite resin ‘sandwich’ technique in Class II cavities in permanent premolar and molar teeth. Quintessence Int 21, 507-512.
Book Reviews Modern Concepts in the Diagnosis and Treatment of Fissure Caries. R. C. Paterson, A. Watts, W. P. Saunders and N. B. Pit&. Pp. 80. 1991. New Malden, Quintessence. Hardback, f 24.00 Dental health and treatment have altered dramatically in recent decades and the publication of a book devoted entirely to the clinical management of fissure caries is one indication of the extent of the changes. Its stated aim is to provide an illustrated guide for the busy practitioner who wishes to keep abreast of new techniques. The book begins by considering the limitations of the currently available methods of diagnosing fissure caries. It is this problem which underlies modern management, the difficulty being to strike a balance between unnecessary treatment resulting from overdiagnosis and failure to treat active lesions until tooth destruction is well advanced because of underdiagnosis. This is clearly explained and well illustrated with photographs of sections cut through sound and carious fissures. The next 14 pages are an update on relevant restorative materials: sealants, composite, bonding agents for enamel and dentine and glass ionomer cements. Factors which affect handling and selection are emphasized and there are tables which ‘name names’ and summarize the properties of currently available products. Although this approach may be useful in the short term, its value will be limited by constantly changing brandnames and formulations. The authors then introduce and justify the concept of minimal extension in which cavity preparation is limited to caries investigation and removal, after which combinations of adhesive materials are used to restore all but the largest cavities, for which amalgam is still considered appropriate. The rest of the book is a how-to-do-it guide to examination and treatment techniques. Most of the copious illustrations are of extracted third molars rather than clinical photographs but they are of excellent quality and complement the text well. Generally this is a useful book which achieves its aims. However, two omissions could be mentioned. First, some authorities, both in the UK and USA, now recommend the deliberate placement of sealants over small lesions extending into dentine without any cavity preparation. Surprisingly, the authors who support the concept of minimal intervention, dismiss this technique without any attempt to cite or summarize the considerable literature both for and against it. Secondly, some paedodontic input would have been welcome. For example, treatment choices where isolation is difficult because of limited cooperation are not discussed, nor is the established value of fluoride varnish application for fissure caries prevention during eruption. With these reservations, this small book can be recommended to practitioners as a well-illustrated guide to a much changed area of operative dentistry. F. J. Hill
Brazen Plate and Brazen Impudence. C. Hillam. Pp. 322. 1991. Liverpool, Liverpool University Press. Hardback, f 17.50. This authoritative book, which is based upon the work Dr Hillam carried out for her PhD thesis, traces the gradual emergence of dental practice in the period 1755-l 855. The data for this study was drawn largely from a systematic search through all the existing trade directories, which started to be published in the 1760s. supplemented by a partial search in newspapers of the time. The work is supported by reference to a number of contemporary books and journals. The author shows how dental practice evolved from the barbers and itinerant toothdrawers to develop into a profession which not only extracted teeth and fitted dentures but also cleaned, aligned and restored teeth, and treated diseases of the gums. It is also a most interesting social study of society in the period, demonstrating the many factors which led to the time being right for dental practice to emerge as a identifiable profession. Such factors included the increase in the levels of dental disease associated with higher sugar consumption, improvements in transport, the establishment of newspapers and trade directories which provided a mechanism for advertising and, of course, the scientific and technical advances which enabled more satisfactory materials and operating techniques to be used. Following the main text are a series of appendices which list the names and addresses of all dentists for whom entries have been found in trade directories together with the dates that they appear and, for some, a brief biography. This excellent book is, perhaps, let down by the printing and presentation. Each chapter is followed by an extensive list of notes and references. It would have been easier to read if the notes had been printed separately at the bottom of the page to which they relate. The actual printing makes the superscript numbers so small and thick that sometimes they become little more than blobs. However, these minor problems should not detract from a most interesting book which should be read by all those, whether dentists or historians, with an interest in how dentistry as we know it today came into being. Dr Hillam is following up this work by coordinating an international venture looking at Dentistry in Europe in the 1790s. The British component will include a systematic search of all existing newspapers of that time. Anyone interested in helping should contact her at Liverpool Dental School. J. F. Beal
Microleakage
Holtan J. R., Nystrom G. P., Douglas W. H. et al. (1990) Microleakage and marginal placement of a glass-ionomer liner. Quintessence ht. 21, 117-122. Pintado M. R. and Douglas W. H. (1988) The comparison of microleakage between two different dentin bonding resin systems. Quintessence ht. 19, 905-907.
of three fluoride-releasing
liner/bases
369
Tyas M. J. (198.5) Clinical evaluation of dentine bonding agents. J. Dent. Res. 64, (abstr. 71), 657. Welbury R. R. and Murray J. J. (1990) A clinical trial of the glass-ionomer cement-composite resin ‘sandwich’ technique in Class II cavities in permanent premolar and molar teeth. Quintessence Int 21, 507-512.
Book Reviews Modern Concepts in the Diagnosis and Treatment of Fissure Caries. R. C. Paterson, A. Watts, W. P. Saunders and N. B. Pit&. Pp. 80. 1991. New Malden, Quintessence. Hardback, f 24.00 Dental health and treatment have altered dramatically in recent decades and the publication of a book devoted entirely to the clinical management of fissure caries is one indication of the extent of the changes. Its stated aim is to provide an illustrated guide for the busy practitioner who wishes to keep abreast of new techniques. The book begins by considering the limitations of the currently available methods of diagnosing fissure caries. It is this problem which underlies modern management, the difficulty being to strike a balance between unnecessary treatment resulting from overdiagnosis and failure to treat active lesions until tooth destruction is well advanced because of underdiagnosis. This is clearly explained and well illustrated with photographs of sections cut through sound and carious fissures. The next 14 pages are an update on relevant restorative materials: sealants, composite, bonding agents for enamel and dentine and glass ionomer cements. Factors which affect handling and selection are emphasized and there are tables which ‘name names’ and summarize the properties of currently available products. Although this approach may be useful in the short term, its value will be limited by constantly changing brandnames and formulations. The authors then introduce and justify the concept of minimal extension in which cavity preparation is limited to caries investigation and removal, after which combinations of adhesive materials are used to restore all but the largest cavities, for which amalgam is still considered appropriate. The rest of the book is a how-to-do-it guide to examination and treatment techniques. Most of the copious illustrations are of extracted third molars rather than clinical photographs but they are of excellent quality and complement the text well. Generally this is a useful book which achieves its aims. However, two omissions could be mentioned. First, some authorities, both in the UK and USA, now recommend the deliberate placement of sealants over small lesions extending into dentine without any cavity preparation. Surprisingly, the authors who support the concept of minimal intervention, dismiss this technique without any attempt to cite or summarize the considerable literature both for and against it. Secondly, some paedodontic input would have been welcome. For example, treatment choices where isolation is difficult because of limited cooperation are not discussed, nor is the established value of fluoride varnish application for fissure caries prevention during eruption. With these reservations, this small book can be recommended to practitioners as a well-illustrated guide to a much changed area of operative dentistry. F. J. Hill
Brazen Plate and Brazen Impudence. C. Hillam. Pp. 322. 1991. Liverpool, Liverpool University Press. Hardback, f 17.50. This authoritative book, which is based upon the work Dr Hillam carried out for her PhD thesis, traces the gradual emergence of dental practice in the period 1755-l 855. The data for this study was drawn largely from a systematic search through all the existing trade directories, which started to be published in the 1760s. supplemented by a partial search in newspapers of the time. The work is supported by reference to a number of contemporary books and journals. The author shows how dental practice evolved from the barbers and itinerant toothdrawers to develop into a profession which not only extracted teeth and fitted dentures but also cleaned, aligned and restored teeth, and treated diseases of the gums. It is also a most interesting social study of society in the period, demonstrating the many factors which led to the time being right for dental practice to emerge as a identifiable profession. Such factors included the increase in the levels of dental disease associated with higher sugar consumption, improvements in transport, the establishment of newspapers and trade directories which provided a mechanism for advertising and, of course, the scientific and technical advances which enabled more satisfactory materials and operating techniques to be used. Following the main text are a series of appendices which list the names and addresses of all dentists for whom entries have been found in trade directories together with the dates that they appear and, for some, a brief biography. This excellent book is, perhaps, let down by the printing and presentation. Each chapter is followed by an extensive list of notes and references. It would have been easier to read if the notes had been printed separately at the bottom of the page to which they relate. The actual printing makes the superscript numbers so small and thick that sometimes they become little more than blobs. However, these minor problems should not detract from a most interesting book which should be read by all those, whether dentists or historians, with an interest in how dentistry as we know it today came into being. Dr Hillam is following up this work by coordinating an international venture looking at Dentistry in Europe in the 1790s. The British component will include a systematic search of all existing newspapers of that time. Anyone interested in helping should contact her at Liverpool Dental School. J. F. Beal