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PCIntern

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Gender: Male
Hometown: Philly
Home country: USA!USA!USA!
Current location: Philly suburbs
Member since: Sun Feb 22, 2004, 09:01 AM
Number of posts: 20,360

Journal Archives

Sunday Dental Thread: Leaking Composite Restorations and the Kennedy Assassination:

Do I have your attention? Perhaps? Good...then please read this entire post before you start spitting out your cornflakes or wheat germ or whatever...

In the early 1980's, what with all the narcissism, self-help books, ego-boosting, People Magazine buying, self-improvement kicks, one of things which people took note of was the presence of "unsightly" metal in their mouths, specifically amalgam and gold restorations otherwise known as fillings. In order to achieve a Hawthorn-ian Perfection of appearance, patients asked their dentists if they could place composite, normally specified only for front teeth, in their premolars and molars. The dental manufacturers, sensing a good thing, developed composites which were marginally appropriate for back teeth, if what you want to define as "marginally appropriate" was horrendously poor by then-community standards. This material began to fail, for the most part, before the check for the services rendered cleared the bank. Of course, the last thing a dentist wanted to do in those days was to have to revisit a tooth he or she had restored within 10-15 years and the practitioners were upset and most agitated that they were not having their usual 95-99% success rate. You must understand that 95% success over 10-15 years was considered poor back then. So the companies started working on their composite materials day and night and you cannot imagine the number of different brands proffered to the profession since then.

Now this is the interesting part of the story thus far: the economic pressures to increase production at the practitioner level brought a level of carelessness not often seen in the profession. We have a term for each material which we utilize which is how "technique sensitive" it is: that for example, you can place an amalgam restoration in the presence of some moisture, which you would call saliva, and be assured that it will have some fair success, say 10-12 years rather than 25-40 years. So amalgam is not too bad in this regard. Composite, however, has to be placed in an absolutely dry field and the etching for the placement of the unfilled resin has to be 100%...not 98...not 95...100% or it will begin leaking immediately leading to recurrent decay and virtually certain doom for the dental pulp of the tooth, necessitating a root canal, or if left undetected long enough, fracture and extraction. Now that is not the only problem: there are many others associated with composites. For example, if you place too much composite in a tooth which has a wide isthmus, or channel on the biting surface, the material will shrink, and since it is bonded to the outer and inner cusps of the tooth, it will tend to pull them together causing constant pain, as though someone placed extraction forceps on the tooth and squeezed continuously. This pain can be relieved, by the way, by channeling medio-laterally through the restoration and refilling it, thus relieving the internal tensions.

Now, what with all this going on, the manufacturers might have been screwn as they say, but no. They just kept merrily producing this stuff to this day and denying that there are any problems associated with its placement. Meanwhile, the technic (yes that is spelled correctly in dentistry) requires the use of aids to place it properly which are extremely time-consuming, intricate, and often simply fail: these include but are not limited to, fancy matrix bands and wedging techniques in order to establish a contact so food doesn't pack between the teeth, bases and liners which protect the nerve inside the tooth from the harm which might befall it due to the nature of the treatment materials, and other arcane issues which require resolution in order to have a satisfactory outcome. And of course, since there is a big big big profit motive here, and I say this without a smile on my face, there is NO CREDIBLE EVIDENCE THAT THIS MATERIAL CAUSES PROBLEMS WHEN USED CORRECTLY. As an aside, my friends who are endodontists who do root canals all day, were well-pleased that some of their referring practitioners use this composite even for upper second molars which even we have problems visualizing with a mirror and bright light. Now of course, the manufacturers are dealing with people who are actually pretty bright, so instead of publishing a comprehensive study which would demonstrate that there is a dental morbidity and mortality associated with its use, they published literally hundreds of studies with all kinds of variables which were so confusing when read that you had no idea whether you were coming or going. And now, composite is the "material of choice" for back teeth. Anytime you attempt to quote a study which might demonstrate that there are significant problems, someone else will come up with three papers showing fifty different conclusions and you spend much of your time debating the experimental issues rather than the issues at hand.

And so it is with the assassinations of the Sixties and beyond: they put out so many theories, some sounding reasonable, some, not so reasonable, and some downright insane, that many people who can't distinguish one form the other, lump them all together and say, well, since I can't make heads or tails out of all this, then the official version must be true. Those who deny that there was variance with the Reports which emanated from official sources have many techniques for doing so which include but are not limited to: pure denial, denial of the existence of any credibility of any evidence to the contrary of their stated "facts", diminishing of the individual by associating them with such "wacky" issues as ostensibly faked moon-landings, disproving of the individual by pointing out one possible flaw in the entire argument, postulating that eyewitnesses are notoriously unreliable, stating unequivocally that there is an absolute profit motive surrounding the perpetuation of the issue, and many others.

To these and others I say, hogwash. The truth is staring you in the face, but the Establishment and others have set up so many two-way mirrors and falsities that you have no idea what is truth now and what is fiction. But the manufacturers have convinced many that their product is sound, we have come to accept failure as routine as a populus so that not only will you get restorations replaced in your mouth every five years instead of twenty-five years and that is all right, and also, incidentally, that you can have your President, his brother, and the leading Civil Right figure shot down in their primes and it really does not matter who might or might not have been involved. Good luck to all of us in these, and all respects. We are going to need it.

A belated "Gobble Tov" to everyone!! nt

A short post for the conspiracy naysayers.

You don't believe a word of one, two, or any of the various theories out there. Fine. As a CT believer for the entire fifty years since the occurrence, I could not be happier that you are all so resolute in your opinions. I sincerely mean that. Certainty is a wonderful thing, I must say.

I have only one question: why are you so angry at us for suggesting that which even Lyndon Johnson did when he impugned the Warren Report as it was handed to him ceremonially. Why the vituperation? Why the ridicule? Why the demeaning?

In my humble opinion, and I am humble in this regard at least, it is neither an exercise in intellectualism nor in realpolitik to dismiss an argument out of hand. The statement that there is no credible evidence to the contrary of the Official Version 1.0 is simply a falsehood. There may be contrary evidence, there may be evidence which is shown to be false or misinterpreted, but that it was not 'credible' is not reasonable. In a debate, one may have a civil discussion, and, as the cliche goes, agree to disagree.

I for one am not angry at those who accept the Warren Report as Gospel. I shrug my shoulders and discuss, but I do not hate. I attempt to posit logical arguments and am willing to listen. Most of us are. It is just that when it is reported that Ruby shot Oswald because he did not want Jackie to have to endure the rigors of a trial, well, it just doesn't quite ring true for me. But I'll be pleased to consider that his empathy for the Kennedys overcame his desire to live out his existence outside of a jail cell or a gas chamber.

Anyway, good luck to all of you. May you be so certain and in addition, so absolutely correct about everything else in your, and everyone else's, existence.

Space.com launch! About 16 minutes to go,

A couple minutes ago you could hear someone say "uh-oh" and then someone else said that there was a hot mic! LOL!

Hilarity: Zimmerman has the presumption of innocence...

Yuh-huh...

Pure as the driven snow...one thing I'll say, at least he varies his choice of weapons.

Creative....

For the second time in a week, a beloved patient of ours has died suddenly

The nicest two men you'd ever want to meet

http://articles.philly.com/2013-11-07/news/43734135_1_street-cafe-piano-jazz

And another fellow who was just the kindest person - a big teddy bear of a guy who just went to bed and didn't awaken.

I'm just so sad. This sucks.

Just posted this to vent...sorry.

Montgomery County (PA) GOP Chairman accused of sexual assault

http://www.philly.com/philly/news/20131114_Sources__Montco_GOP_chair_under_investigation_in_alleged_sex_assault.html


THE CHAIRMAN of the Montgomery County Republican Committee is under investigation by county authorities for alleged sexual assault, sources with knowledge of the probe told the Daily News yesterday.

The GOP chairman, Robert J. Kerns, a partner in a Lansdale law firm, allegedly got drunk Oct. 25, the night after a major GOP power-broker dinner, and sexually assaulted a woman with whom he worked, according to the sources, who spoke on the condition of anonymity.

No charges had been filed by the Montgomery County District Attorney's Office as of last night. Kerns, who is married and has two grown sons, did not return calls from the Daily News seeking comment.

"Somebody alleged that he was drinking and sexually assaulted her," said one source. "It was supposedly a woman that worked with him. It took place the following evening, 24 hours later - not associated with the county dinner."
++++++++++++++++++++++++++++++++++++++++++

Wotta bunch...this dinner was in celebration of healing of rifts which have plagued the Party for years. Nice job.

Read more at http://www.philly.com/philly/news/20131114_Sources__Montco_GOP_chair_under_investigation_in_alleged_sex_assault.html#bsBRBH2sbPQOk2It.99

My feelings about Sen. Inhofe's son's untimely passing:

As Jews, we have a custom, at Passover, of diminishing our cups of wine, drop by drop, as each of the Ten Plagues is mentioned. This ritual is to demonstrate that we grieve for the losses of even our enemies, that every human life lost is a tragedy.

No matter what animus I may feel about the gentleman's father's policies and attitudes, I feel the pain at the loss of his son.

The most significant observation of Morning Joe today is:

Willie clearly needs a new razor. For the third day in a row.

Other than that, it is the usual....

So I voted last night in Lower Merion, PA (Read: Main Line Philly):

the people at the empty polling place told me that they were amazed by the relatively high 23% turnout at their polling place. Our election was judicial and school board stuff, but as we all know, the Rethugs conquered much of this country starting at these levels.

I wouldn't miss voting for anything, no matter what. Straight D of course...and no, even I, a rabid pro-Zionist, never ever voted for Arlen Specter of Blessed Memory.
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