An overview is presented on the development of the treatment with oral implants in the maxillofacial skeleton during the last five decades. This overview has been divided into three periods: subperiosteal frame implants, transmandibular implants and endosseous implants. The latter period is also marked by significant developments in reconstructive preprosthetic surgery of hard and soft tissues to enable reliable implant placement.

In this study, the hypothesis was examined that a better retention and stability of a mandibular denture improve oral function. Eighteen edentulous subjects received 2 permucosal implants, a new denture, and successively 3 types of mesostructures (magnets, ball, bar-clip). Maximum bite force and electrical activity of the masseter and temporalis muscles were measured at various moments. The maximum bite force of an implant-retained overdenture nearly doubled, when compared with the new denture without mesostructure, independent of the type of mesostructure. With an implant-retained overdenture maximum bite force was two-thirds of the value obtained for dentate subjects. No large differences in muscle activity were found among the 3 types of mesostructures. Temporalis activity was significant lower than masseter activity when subjects clenched with their old conventional denture and with the new denture without mesostructure. There was no difference in activity of muscles when subjects clenched with an implant-retained overdenture.

The ability of dentists to select caries risk patients on the basis of what they see and know, varies considerably. There is a need for objective methods. Methods using bacterial counts and salivary tests appeared to be inferior compared to methods based on the caries experience of the patient. There are two models, Nexø and Dentoprog, using the caries experience as caries predictor. The well documented Nexø method does not predict caries increment, but gives the provider a tool to target preventive intervention to those patients in need. The Dentoprog method is accurate, but has only one level of caries risk, which is considered by most providers as too low and thus unpractical.

This paper presents a method, which, on the basis of the caries experience, predicts the caries increment up to the age of 15 years. This method provides the best caries prediction so far available. By applying the principles of medical decision-making cut-off points of risk can be assessed, whereby children can be selected as at risk or not at risk. The method is applicable in child populations with different caries incidences and meets the requirements of accuracy. With the user-friendly method, more than 80% of the children at risk can be identified and selected.

This article reports the treatment of a maxillary central incisor, which appeared to be a fused tooth with two separate immature roots. After hemisection, the mesial part of the tooth was removed and the remaining part was treated by a direct pulp capping with a flowable dentin-bonded composite. The central diastema was closed orthodontically. Follow-up after six and eighteen months revealed a healthy pulp and an undisturbed root formation. Finally, a review of the literature on the aetiology and treatment of fused teeth is presented.

Normally, only the anterior teeth have to be retained after an orthodontic treatment. For that purpose, a lingually bonded wire is prefered in the mandible and a removable plate in the maxilla. The design of the Van der Linden-retainer is based on theoretical considerations and secures rigid fixation of the six anterior teeth with solid anchorage in that region. A retention plate should not be used to move anterior teeth. However, with instant corrections small improvements can be realized. The fabrication and clinical use of the Van der Linden-retainer is explained and illustrated.

Scleroderma is a rare connective tissue disease of unknown origin. It is characterized by increased collagen deposition leading to fibrosis and degeneration of the skin and sometimes of internal organs. There are two main groups of scleroderma: circumscribed scleroderma and systemic sclerosis. Circumscribed scleroderma is limited to the skin and systemic sclerosis has involvement of internal organs. The main oral manifestation of scleroderma is microstoma, which is a limiting factor in oral selfcare and professional oral health care. A case report is presented of the treatment of a 15-year-old female scleroderma patient with microstoma.

The quality of the overwhelming amount of health information on the internet is difficult to evaluate. Organisations such as the European Commission are establishing quality criteria for health related web sites. In this issue a review of methods is given to the user to evaluate the credibility of the information offered on these sites.