It was concluded, therefore, that laser Doppler flowmetry can be of use in assessing the vitality of anterior teeth and that this is the preferred combination of recording variables for further investigations.

The management of adult dental patients with congenital bleeding disorders has caused a considerable number of problems to the dental profession. There is a need to simplify the process and identify what can be safely carried out on a 'shared care' basis in General Dental Practice or the Community Dental Service. Particular problems are discussed with special reference to those requiring hospital care. The Scottish Oral Health Group for Medically Compromised Patients has developed this clinical guidance in conjunction with the Scottish Haemophilia Directors. It is important that dental care is easily available for this group of patients, especially those living at some distance from the regional centres. The aim is to simplify planning dental care for this group of patients and remove a number of myths concerning their management. The hospital departments, both medical and dental, must be available for advice and to arrange for treatment that is inappropriate outside a specialist hospital.

Cavity preparation with this Erbium:YAG laser did not influence the microleakage of Compoglass restorations adversely. Different pulse energies were required for optimum cavity sealing at the enamel and dentine margins and for different materials.

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Dual-peak LED LCUs may not be best suited for curing non-Lucirin(®) TPO-containing materials. A clear sealant showed a better cure throughout the material and may be more appropriate than opaque versions in deep fissures.

This study found no difference in the degree of microleakage of fissure sealants polymerized by either light source.

Background Curing of resin-based composites depends on the delivery of adequate total energy, which may be operator dependent. Aim To determine the effect of interincisal opening, cavity location and operator experience on the total energy delivered to simulated cavity preparation sites. Design Three cohorts were included: junior dental nurses, senior dental nurses and qualified dentists (N=5, each cohort). Each operator (participant) followed the same procedure and light-cured two simulated restorations in a MARC® patient simulator using a Demi™ light-curing unit for 20 seconds in each of the following situations: left upper second molar (UL7), interincisal opening at both 25mm and 45mm; upper central incisor (UR1), interincisal opening at 45mm. The light energy delivered by each operator in each situation was recorded. Five readings for each operator were taken at each interincisal distance. Statistical comparisons of delivered energy (J/cm2) between interincisal openings, location and groups in the total energy delivered were performed using the Kruskal-Wallis nonparametric test: α=0.05. Results Less total energy was delivered to the posterior cavity at 25mm (12.0 ± 5.3J/cm2) than at 45mm (16.9 ± 5.6J/cm2) by all operators ( P<0.05). At 45mm, less total energy was delivered to the posterior cavity compared to the anterior cavity (25.1 ± 7.4J/cm2; P<0.05). There was no statistically significant difference between junior nurses and qualified dentists ( P>0.05) but there was a significant difference in the total energy delivered between senior nurses (20.1 ± 7.8J/cm2) and junior nurses (17.5 ± 7.6J/cm2) and between senior nurses and qualified dentists (16.6 ± 8.7J/cm2) ( P<0.05). Conclusions Interincisal mouth opening, location of the cavity and operator experience affected the total energy delivered to cavities in a simulated clinical environment.

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