Within the same patient, teeth with abfractions presented more attachment loss than those without abfractions. However, associations were not demonstrated between PCCR and the presence of abfractions or increased attachment loss. Future studies are needed to improve the knowledge regarding interactions among occlusal factors, attachment loss, and abfractions.

The technique is practical and simple to perform. This approach, involving partial palatal deepithelialization and the applied tunnel surgical procedure, resulted in a successful clinical outcome with increased gingival tissue thickness, keratinized tissue, and root coverage.

Background Reports from studies of twins, disease aggregation in families, animal models for periodontal disease, and various genetic-analysis studies have determined that genetics plays a role in the susceptibility to periodontal disease. The purpose of this pilot study was to evaluate the effect of genetics on periodontal disease by evaluating the heritability of alveolar bone loss in a captive baboon population. Methods A collection of baboon skulls from a pedigreed colony (for which scientists and veterinarians maintain complete genealogical and veterinary records) were obtained from the Southwest National Primate Research Center and used in this pilot study. Measurements of alveolar bone loss were performed on 390 dry baboon skulls. A periodontal probe was used to measure alveolar bone loss. Maximum likelihood methods (designed to handle complex genealogies) were used to determine the heritability of alveolar bone loss. This software utilized known pedigrees in the captive baboon sample and tested the relationship between pairwise kinship and alveolar bone loss data to determine the heritability of alveolar bone loss from periodontal disease. Results Genetic data were available for 347 of the 390 specimens. Using age and sex as covariates, genetic analysis indicated a heritability of 35% (standard error=20%, p=0.01). While sex was not a significant factor in periodontal disease (p=0.96), age was highly significantly associated with periodontal disease (p<0.0001). Conclusion In this pilot study, analysis of alveolar bone loss measurements from captive baboons indicates that bone loss increases with age and that a portion of periodontal disease risk may be due to genetic variance. These findings provide evidence that periodontal disease is heritable in captive baboons and indicate that a larger, more-detailed study is warranted.

The etiology in this case remains unclear and could not be strongly supported by any reports in the literature. Future studies on gingival enlargement may explain such an unusual clinical occurrence.

of Medicine and are experienced teachers of undergraduate immunology. The book is primarily aimed at undergraduate students in medicine and biomedical sciences and their teachers. The book was first published in 2001 and the third edition has been revised to incorporate recent changes in the understanding of the functioning of the immune system and host defence against infection. Immunology is a rapidly developing and dynamic field. Finding a path through this intricate maze of information can be very difficult and puzzling for the student, as often both clinically and experimentally there are numerous caveats, which the authors have wisely chosen not to cover in the main text. The emphasis is therefore on the key concepts in immunology rather than dwelling on the minutiae of the molecular mechanisms. For those readers desiring a detailed description of the human cell differentiation molecules and their function, a comprehensive summary table can be found in part II of the appendix and online by accessing the free 'Student Consult' web pages. Therefore, the authors focus on guiding the reader through the defining principles of how the human immune system works, with evidence-based data coming from experiments derived in the main from human rather than animal research. So there are no drawings of mice in this textbook! The real strength of the book lies in the masterly and clever construction of the colourful, bold annotated diagrams which constitute about half of the book. Chapters are designed to be stand-alone but do benefit educationally from being read in sequence. Each chapter ends with summaries and reflective questions. The constant mental shift between the diagrams and the text makes for an active reading experience. In the later chapters of the book the authors explore the clinical application of the fundamentals of immunology. It is these clinical aspects of the book that I suspect are most likely to be of interest to the dental reader. There are useful and informative chapters on the elimination of extracellular microbes and toxins, hypersensitivity, immune responses against tumours and implants, and congenital and acquired immuno deficiency diseases. The authors have chosen to discuss immunological disease from the perspective of understanding the underlying principles, but with just the right level of examples of specific clinical syndromes and fundamentals of treatment for the non-specialist. A range of clinical case scenarios (and answers) can be found in part III of the appendix. A superb glossary of immunological terminology and processes is also located in the appendix. In my opinion, the authors of this textbook have achieved their aim of making immunology both accessible and fascinating to current and future generations of clinicians. London: Saunders (Elsevier); 2008 (3rd ed) £36.99; Softcover; 320 pp ISBN: 978 1 4160 4688 2 B o o k r e v i e w BackgroundIt has been suggested that eccentric occlusal forces may be an etiologic factor for abfraction lesions. It has also been suggested that trau...

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Introduction: Bisphosphonates (BPs) are commonly used in the United States primarily in postmenopausal females with a history of osteoporosis. BP therapy may result in bisphosphonate‐related osteonecrosis of the jaw (BRONJ). BRONJ is described as exposed bone in the maxillofacial region persisting for >8 weeks in a patient who is taking or has taken a BP and has not had radiation therapy to the head and neck. The prevalence of BRONJ seems to vary depending on the mode and frequency of administration, drug potency, duration of treatment, and other factors. Case Presentation: This case report describes an incidence of BP‐induced osteonecrosis of a mid‐palatal torus in a 77‐year‐old patient of African‐European heritage who was previously treated for osteoporosis. The lesion appeared as a pustulated erythematous soft‐tissue mass with partially exposed bone covered in plaque. The lesion was surgically debrided using a modified flap procedure and sent for histopathologic analysis. Systemic antibiotics, pain medication, and antimicrobial mouthrinse were prescribed. The mid‐palatal area healed without complications, and the histopathology was consistent with BP‐induced osteonecrosis with evidence of Actinomyces species. Conclusions: With the widespread use of BPs and the prevalence of tori and/or exostoses, it is likely that clinicians may encounter a greater frequency of BP‐induced osteonecrosis of these poorly vascularized bony growths that may initiate from daily traumatic oral activities. Clinicians should communicate to their patients the potential dangers that necrosis may cause. Treatment should be decisive, urgent, and incorporate aggressive management.