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Hygiene Tribune Middle East & Africa Edition

hygiene tribune Dental Tribune Middle East & Africa Edition | May-June 20154B < Page 2B Kerr) (fig. 13). A colour charac- terisation of the occlusal surface was intentionally avoided, as the application of dyes in the fissure in the worst case could even put at risk to the overall integration of the restoration [12]. In gen- eral, most patients like to avoid such colour-stains; for them, it is important that the restora- tion cannot be identified as such at a normal speaking distance. This is the case in the present restoration. With complex find- ings such as MIH, the stability of the restoration primarily takes priority. This request was taken into account in that all sectional aspects – adhesive sealing with a proven adhesive, the use of a stable and shrinkage stress- reduced resincomposite, the anatomical shaping (sufficient sectional matrix system) and the correct light polymerization – were satisfied. References 1. Geinzer E, Muschweck A, Petschelt A, Lohbauer U. Me- chanical fatigue degradation of ceramics versus resin compos- ites for dental restorations. Dent Mater 2014; 30: 424-432. 2. Ernst CP: Die 20 beliebtesten Fehler beim Kleben. DFZ 2010; 11: 66–83. 3. Ernst CP: Komposit im Seiten- zahnbereich: Möglichkeiten und Grenzen. Quintessenz 2010; 61: 545-557. 4. Ernst CP, Rullmann I, Janssen B, Willershausen B. Polymeri- zation shrinkage stress of bulk fill resin composites. Lecture at the IADR Annual Meeting 2014. https://iadr.confex.com/ iadr/13iags/webprogram/Pa- per170911.html. 5. Ferracane J, Watts DC, Bar- ghi N, Ernst CP, Rueggeberg FA, Shortall A, Price R, Strassler H. Der effiziente Einsatz von Li- chtpolymerisationsgeräten – ein Leitfaden für Zahnärzte. ZMK 2014; 30: 166-180. 6. Hahnel S, Henrich A, Bürg- ers R, Handel G, Rosentritt M. Investigation of mechanical properties of modern dental composites after artificial aging for one year. Oper Dent 2010; 35: 412-419. 7. Loomans BA, Opdam NJ, Ro- eters FJ, Bronkhorst EM, Burg- ersdijk RC Comparison of proxi- mal contacts of Class II resin composite restorations in vitro. Oper Dent 2006; 3: 688-693. 8. Loomans BA, Roeters FJ, Op- dam NJ, Kuijs RH The effect of proximal contour on marginal ridge fracture of Class II com- posite resin restorations. J Dent 2008; 36: 828-832 9. Loomans BA, Opdam NJ, Ro- eters JF, Bronkhorst EM, Plass- chaert AJ Influence of composite resin consistency and placement technique on proximal contact tightness of Class II restorations. J Adhes Dent 2006; 8: 305-310 10. Rosentritt M, Behr M, Kol- beck C, Handel G. Flexural strength of restorative compos- ites after different aging condi- tions. Lecture at the IADR An- nual Meeting 2014. https://iadr. confex.com/iadr/13iags/web- program/Paper171330.html 11. Rullmann I, Schattenberg A, Marx M, Willershausen B, Ernst CP: Spannungsoptische Mes- sungen der Polymerisationss- chrumpfungskraft schrumpfre- duzierter Komposite. Schweiz Monatsschr Zahnmed 2012; 122: 8-12. 12. Pucci CR, Barcellos DC, Pala- zon MT, Borges AB, da Silva MA, de Paiva Gonçalves SE. Evalua- tion of the cohesive strength be- tween resin composite and light- curing characterizing materials. J Adhes Dent 2012; 14: 69-73 Prof. Dr. Claus-Peter Ernst University Medical Centre of the Johannes Gutenberg University Mainz Department for Operative Dentistry Augustusplatz 2, 55131 Mainz ernst@uni-mainz.de Contact Information By Patricia Walsh, RDH, USA While anxiously waiting for the “Downton Abbey” television se- ries to start up again, I got my English history fix by reading the history of Wentworth Castle. The book covered the trials and tribulations of an aristocratic family in a home three times the size of Buckingham Palace. I was taken by surprise when the author mentioned the cause of death of a high-ranking noble- man as “quinsy throat.” In modern times, with the ar- rival of antibiotics, you wouldn’t hear of this — at least not in a developed nation. The more I thought about it, I don’t think I had heard the term “quinsy sore throat”for a very long time. Around here, if your throat is starting to close off, you’ve prob- ably gotten yourself to an emer- gency room “pronto.” It is an abscess in the peritonsillar area that often needs drainage. While tonsillitis is more com- mon in children, both kids and adults are susceptible to quinsy. One can only assume that if the breathing restrictions don’t kill you, the resulting septicemia might later. A quinsy sore throat can infect both the blood supply and individual organs. I can recall having my ton- sils painted with iodine by the school nurse when I was start- ing to “come down with some- thing.” A tall canister of extra long cotton swabs were one of the staples of her office. I can’t say whether there’s any scientific proof that tonsil paint- ing reduced cases of severe ton- sillitis. But I do know that some homeopathic remedies call for gargling with a watered down Betadine solution even today. I’ve also heard that eating three or four marshmallows helps to soothe a sore throat. Apparently it has something to do with the gelatin. I suppose if you’re not eating at all, any caloric intake will do, so it might as well be fun! Washington’s epiglottitis George Washington’s physi- cian mentions his quinsy sore throat prior to his death at age 63. He was thought to have suf- fered from a quinsy sore throat that quickly turned into epiglot- titis — most likely his cause of death. The swelling of his epi- glottis cut off his air supply. He also suffered from malaria, TB and smallpox during his life- time. How sad that it may have been a very bad sore throat that got him in the end. The blood- letting technique that was used at the time probably hindered his recovery as well. When I was a dental hygiene student, we were occasionally brought to a local city clinic to do checkups on grammar school children. These children were the poorest of the poor and were seen on old WWII wooden field chairs. There was no money in the budget for fancy things like “disclosing tablets.” Instead, we used iodine on long cotton swabs to paint the teeth and dis- close the plaque. Our instructor kept the large bottle of iodine. The iodine that a physician uses is water-based as opposed to the alcohol-based type available for home use. We used eye droppers to fill up our little green-glass dappen dishes for each patient. I would think the taste alone would put children off dentist- ry for some time to come. We rinsed their mouths with a rub- ber ball syringe, and they expec- torated into a kidney basin. Con- sidering the number of patients I currently see with known iodine allergies, it’s amazing we never heard of any children having a reaction. Then again, people are now more “allergy aware” then they once were. There is prob- ably an equal number of chil- dren with red-dye allergies who would have done no better with the modern disclosing tablets. In spite of iodine’s unpleasant taste, I have been known to rec- ommend subgingival irrigation with a Betadine solution (brand name for povidone-iodine). The key to this is the dosage. I tell the patient that if the water turns brown, they’ve added too much. There is a huge tempta- tion to use too much because most drug stores sell only very large bottles. But between the bad taste and the potential for staining, it’s easy to see why less is more. Iodine kills the gram negative bacteria that live in the darker recesses of a deep perio pocket. There is another clinical appli- cation for iodine in dentistry. An iodine staining test used to assist in discerning attached gingiva as mentioned in “Periodontics Revisited” by Shalu Bathla, MD. The clinician can: “paint the gin- giva and oral mucosa with Lu- gols solution (iodine,water and potassium iodide). The aveolar mucosa takes on a brown color owing to its glycogen content Patricia Walsh, RDH, (Photo: Hygiene Tribune U.S. Edition) while the glycogen- free attached gingiva remains unstained. Measure the total width at the unstained gingiva and subtract the sulcus/pocket depth from it to deter- mine the width of the attached gingiva.” In the Chernobyl dis- aster, some Lugols solution was used as an emergency source of iodide to block ra- diation iodine uptake, simply because it was widely available as a drinking water decon- taminant, and pure po- tassium iodide without iodine (the preferred agent) was not avail- able. Mama don’t take my Mecuro- chrome away Mecurochrome and merthiolate were also very popular in my childhood. We proudly wore our hot pink tinctures over scraped knees like playground battle scars. When it was determined that mercury was detrimental to one’s overall health, Mecuro- chrome was banned from gen- eral use. The U.S. Food and Drug Administration put very strict limitations on the sale of Mercu- rochrome in 1998 and stated that it was no longer considered to be a GRAS (generally recognized as safe) over-the-counter product. Merthiolate was another com- monly found antiseptic and an- tifungal agent that was banned because of its mercury content. Iodine was determined by the U.S. Justice Department to have a roll in the production of methamphetamine and is now a restricted purchase. I wouldn’t recommend bringing back any- thing more than 4 fl. oz. of tinc- ture of iodine from your next Mexican vacation. Scrape your feet on a coral reef, and you might find yourself detained at customs for questioning about your toiletry kit. While iodine crystals are the form of choice for illegal drug labs, some smaller manufac- turers are known to combine tincture of iodine with hydro- gen peroxide. Some businesses have removed iodine from the shelves, while others are simply restricting large quantity sales — i.e., more than $100 worth. When I asked my local pharma- cist about Walgreen’s policy, he pointed to the surveillance cam- eras above the tincture of iodine shelf. Legitimate medical labo- ratories that do gram staining now have additional paperwork due to the restrictions on iodine strengths and quantities. Iodine getting harder to find The old-time iodine bottle with the skull and crossbones sit- ting in the medicine cabinet has come and gone. In this new age of communication and en- tertainment, I wonder if a child would even be put off by the sight of a poison label. Children are exposed to cartoon pirates at such an early age. In the mid 19th century, cobalt blue bottles or raised glass lettering were used to help in the identification of poison. While there is no federal man- date for small quantities, iodine has disappeared from a few pharmacies and department store shelves the way Sudafed did most recently. Home brew- ers take heart, these pharma- cists just require that you sign a poison-control statement and list the reason for your pur- chase. For those of you who still buy your beer in the traditional manner, iodine is often used as a test for starch conversion in the mash. This article was published in Hy- giene Tribune U.S. Edition, Vol. 8 No. 2, February 2015 issue. Reflecting on oral-health’s good old iodine days

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