Quarterly Dental Review 273

delay in splinting as laboratory facilities are not necessary and frightened children can be assured that ‘the drill’ will not be used.

Graham J. Roberts

CRAWFORD P. J. M., BURRIL C. and GROGAN J. The effect of modifying toothbrush handles on plaque control in handicapped chil- dren - preliminary report, Proc. Br. Paedodont. Sot. 7 (1978) 11-l 3.

The oral hygiene of many handicapped children is poor. This may be because of ignorance on the part of the patient or parents but in many cases is due to the difficulty of cleaning. This small pilot study investigated the benefits to be gained by the use of a bicycle handle-bar grip placed around a regular toothbrush. This made it easier for the child to grip and made him or her less dependent on others. Plaque indices fell after the use of this modified brush.

R. S. Brandt

LLEWELYN D. R. A pilot study of 230 restorations in children’s mouths, Proc. Br. Paedodont. Sot. 7 (1978) 19-21.

Two hundred and thirty restorations placed by dental students were examined critically. Approximately 10 per cent of these restora- tions warranted replacement. Isthmus fracture was a common cause of failure, and this may be due to a ‘high’ restoration or failure to stone the opposing cusp. Only 3 out of 95 stainless steel crowns were found to be unsatisfactory. The restoration of first primary molars might therefore be better effected by stainless steel crown construction rather than by amalgam.

R. S. Brandt

HOBSON P. Dental treatment of children with haemo- philia and related conditions, Proc. Br. Paedodont. Sot. 7 (1978) 8-l 0.

Tremendous advances have been made recently in the control of haemorrhage in patients suffering from haemophilia and related conditions. The dental condition of such patients is, however, much worse than one would wish. In part this is due to old- fashioned concepts about haemophilia by

the dental profession. Nowadays, prevention is strongly emphasized and one should attempt to maintain a disease-free mouth. The precautions to be taken when treating haemophiliacs are enumerated. Dentists should provide comprehensive care and preventive treatment for such patients so that their dental health is maintained and a major problem is removed. These measures will improve the quality of life for haemophiliacs.

R. S. Brandt

MAGNUSSON 6. and SUNDELL S. Stepwisa excavation of dwp carious lesions in primerY teeth, J. ht. Assoc. Dent. Child. 8 (1977) 36-40.

A clinical evaluation of stepwise excavation of deep carious lesions was carried out on 110 primary molars. Some teeth had all caries removed at one sitting, whilst others were excavated in two sessions. The initial session removed all the superficial caries but left a thin layer of softened dentine on the pulpal floor. This was covered with calcium hydroxide and zinc oxideleugenol cement for 4-6 weeks, after which time the cavities were reopened and all the remaining softened dentine removed. In the first group (caries removed at one session) the pulp was exposed in more than half the cases, whilst in the second group (caries excavated step- wise) the pulp was exposed in only 15 per cent of the cases. This difference is statisti- cally significant and would seem to indicate that stepwise excavation may obviate a considerable number of pulp treatments in primary molars.

R. S. Brandt

MAZDYASNA S and STONER J. E. Factors influencing gingival recession in the lower incisor region, Proc. Br. Paedodont. Sot. 7 (1978) 15-17.

A series of 1003 children aged 15 years was studied to determine the prevalence of labial gingival recession in the lower incisor region. The relationship between recession and tooth/arch relationship, poor oral hygiene, high frasnel attachment and inadequate width of keratinized gingiva was investigated. Eighteen per cent of the sample had some form of recession involving 214 teeth. It was